Newly Characterized Porcine Epidemic Diarrhea Virus GII Subtype Strain

Diarrhea outbreaks in piglets on pig farms are commonly attributed to porcine epidemic diarrhea virus (PEDV) infection. This research analyzed the S gene prevalence variation and recombination patterns in PEDV GII strains. Throughout the previous two years, 172 clinical samples of piglet diarrhea have been collected, from which 24 PEDV isolates have been isolated. Analysis of the evolutionary relationships among all 24 S genes revealed that 21 were most closely related to strains within the GII-a subgroup. The 2 isolates grouped into one clade with the GII-b subgroup. According to the mutation analysis of the amino acids (aa) that encode the S protein, 43 of the common aa in strains of the GII subtype were found to have undergone a change in polarity or charge, and 36 of these aa had a mutation frequency of more than 90%. Three different aa mutation sites were identified as exclusive to GII-a subtype strains. The genomes of three PEDV isolates were sequenced, and the resulting range in genome length was 28,035−28,041 nt. The results of recombination analysis showed that the SD1 isolate is a novel strain recombinant from the foreign S-INDEL strain and a domestic GII subtype strain. Based on the findings, the PEDV GII-a strain has been the most circulating strain in several parts of China during the previous two years. Our study reveals for the first time the unique change of aa mutations in the S protein of the GII-a subtype strain and the new characteristics of the recombination of foreign strains and domestic GII subtype strains, indicating that it is crucial to monitor the epidemic dynamics of PEDV promptly to prevent and control the occurrence of PED effectively.

COVID-19 Experiences of Relatives of Nursing Home Residents.

Nursing home residents comprise a disproportionate share of coronavirus-related deaths in the United States. Additionally, lockdown restrictions disrupted residents' relationships with their family members to an unknown extent. This study explored family members' perceived family role and interactions with nursing home residents and staff during the COVID-19 pandemic. Using a qualitative descriptive approach, 10 family members were interviewed using a semi-structured guide. Interviews were audio-recorded and transcribed verbatim, and data were analyzed using Braun and Clarke's Reflexive Thematic analysis. Themes and subthemes indicated that family members accounted for residents' care in new ways, found existing relationships becoming amplified under stress, maintained connections through creative alternatives, and also felt powerless to provide care, despite their knowledge and experience. Family members increasingly relied on staff to meet residents' care needs and provide updates, and often desired to provide assistance and companionship beyond what policy permitted, representing a major opportunity for improving experiences.

Porcine epidemic diarrhea virus strain FJzz1 infection induces type I/III IFNs production through RLRs and TLRs-mediated signaling.

Interferons (IFNs) including type I/III IFNs are the major components of the host innate immune response against porcine epidemic diarrhea virus (PEDV) infection, and several viral proteins have been identified to antagonize type I/III IFNs productions through diverse strategies. However, the modulation of PEDV infection upon the activation of the host's innate immune response has not been fully characterized. In this study, we observed that various IFN-stimulated genes (ISGs) were upregulated significantly in a time- and dose-dependent manner in LLC-PK1 cells infected with the PEDV G2 strain FJzz1. The transcriptions of IRF9 and STAT1 were increased markedly in the late stage of FJzz1 infection and the promotion of the phosphorylation and nuclear translocation of STAT1, implicating the activation of the JAK-STAT signaling pathway during FJzz1 infection. In addition, abundant type I/III IFNs were produced after FJzz1 infection. However, type I/III IFNs and ISGs decreased greatly in FJzz1-infected LLC-PK1 cells following the silencing of the RIG-I-like receptors (RLRs), including RIG-I and MDA5, and the Toll-like receptors (TLRs) adaptors, MyD88 and TRIF. Altogether, FJzz1 infection induces the production of type-I/III IFNs in LLC-PK1 cells, in which RLRs and TLRs signaling pathways are involved, followed by the activation of the JAK-STAT signaling cascade, triggering the production of numerous ISGs to exert antiviral effects of innate immunity.

Cell-derived membrane biomimetic nanocarriers for targeted therapy of pulmonary disease.

Pulmonary diseases are currently one of the major threats of human health, especially considering the recent COVID-19 pandemic. However, the current treatments are facing the challenges like insufficient local drug concentrations, the fast lung clearance and risks to induce unexpected inflammation. Cell-derived membrane biomimetic nanocarriers are recently emerged delivery strategy, showing advantages of long circulation time, excellent biocompatibility and immune escape ability. In this review, applications of using cell-derived membrane biomimetic nanocarriers from diverse cell sources for the targeted therapy of pulmonary disease were summarized. In addition, improvements of the cell-derived membrane biomimetic nanocarriers for augmented therapeutic ability against different kinds of pulmonary diseases were introduced. This review is expected to provide a general guideline for the potential applications of cell-derived membrane biomimetic nanocarriers to treat pulmonary diseases.

Family Advocacy for Residents in Nursing Homes During the COVID-19 Pandemic

To protect one of the most vulnerable populations from COVID-19, nursing homes enacted and enforced visiting restrictions and other measures to limit the spread of this communicable disease. Family members, many of whom are former caregivers, were suddenly cut off from nursing home residents, and struggled to maintain connection with their loved ones residing in nursing homes. The purpose of this study was to describe the experiences of family members of residents in nursing homes in advocating for residents and themselves during a time of uncertainty and many challenges. This study used a qualitative descriptive approach to conduct individual interviews. Ten family members of residents of two nursing homes in a Northeastern state were interviewed by phone or videoconference using a semi-structured guide. Interviews were transcribed verbatim and analyzed using Braun and Clarke’s Reflexive Thematic Analysis. Family members expressed concerns for the lockdown’s impact on residents’ psychosocial wellbeing in addition to the potential physical dangers of COVID-19. They explored creative means of meeting needs for information and interaction, but often felt that these efforts fell short of replicating the connectedness of in-person visits. Family members identified multiple missed opportunities for involvement in care, and voiced willingness to comply with infection prevention guidelines, such as maintaining distance, to be present with residents. Our findings indicate that family members advocated for residents’ interests to ensure quality care. Future research and policy should consider family members as a potential resource for providing care and companionship during times of crisis.

Failure to Thrive: Nursing Home Staff Experiences in Caring for Residents during the COVID-19 Pandemic

Nursing home residents and staff have accounted for roughly 40% of Coronavirus-related deaths in the U.S. The burden of caring for vulnerable residents coupled with isolation policies has taken a significant emotional toll among direct health care staff in long term care facilities. This study explores nursing home staff’s experiences in caring for residents during the COVID-19 pandemic. A qualitative descriptive approach with a semi-structured guide was used to conduct individual interviews. We recruited nursing home staff employed during the COVID-19 pandemic in long term care facilities located in New York State. Interviews were recorded, transcribed verbatim, and then analyzed using Braun and Clarke’s Reflexive Thematic analysis. Twelve nursing home staff were interviewed. Participants consistently refer to failure-to-thrive as an extremely concerning problem because many residents demonstrate decreased appetite and poor nutrition, inactivity, and depressive symptoms due to social isolation. They also often feel frustrated and overwhelmed due to uncertainty and shortages of staff. Five main themes were identified, including doing their best to manage residents’ failure-to-thrive, working as a team, keeping family members informed and connected, struggling to balance competing personal and professional demands, and needing support to reduce stress and build strength. Our study findings indicate that nursing home staff experienced a high level of stress and identified failure-to-thrive caused by isolation and loneliness as a common phenomenon among nursing home residents during the COVID-19 pandemic. Interventions are urgently needed to reduce isolation and loneness in nursing home residents and to provide support for staff.

Optimization of medical waste recycling network considering disposal capacity bottlenecks under a novel coronavirus pneumonia outbreak.

The sudden outbreak and prolonged impact of the global novel coronavirus disease (COVID-19) epidemic has caused an increase in demand for medical products, such as masks and protective clothing, leading to an exponential increase in the generation of medical waste. As medical waste under the epidemic is highly infectious, it poses a great danger to human health. Therefore, with the proliferation of medical waste, it has become crucial to construct a reverse logistics recycling network that can handle medical waste quickly and efficiently. In this study, we construct a multi-period medical waste emergency reverse logistics network siting model with the objectives of minimum cost, minimum safety risk, and minimum time for the safe and quick disposal of medical waste. The model considers disposal capacity bottlenecks of existing facilities. Based on an empirical analysis using the COVID-19 epidemic in New York City, USA, as a case study, we find that the use of a suitable number of synergistic facilities and the establishment of temporary medical waste disposal centers are viable options for handling the dramatic increase in medical waste during the peak of the COVID-19 epidemic.

Incidence of workplace violence against nurses among Chinese hospitals: A meta-analysis.

AIMS: To explore the incidence of workplace violence against nurses in Chinese hospitals. BACKGROUND: Previous systematic reviews on the incidence of workplace violence against Chinese health care workers did not include many articles published in Chinese. Although several studies have investigated cases of violence against health care providers in China, no meta-analysis has been conducted to assess the incidence of violence against Chinese nurses. EVALUATION: In this study, relevant data were retrieved from studies published up to July 2020. A meta-analysis was conducted using R software (Version 4.0). KEY FINDINGS: The 12-month incidence of workplace violence among Chinese nurses was 71% (95% CI 67%-75%), and verbal violence was the most common sub-type of violence (63%, 95% CI 58%-67%). CONCLUSION: Chinese nurses are at a high risk of violence at workplace. Hospital managers should explore ways to reduce violence against their employees, especially the younger nurses who work in secondary hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study highlight the need to enhance the legal system in terms of laws meant to effectively mitigate violence against nurses in Chinese hospitals. Measures should be particularly taken to protect younger nurses who work in secondary hospitals.