Delivery and neonatal outcomes of pregnant women during the Shanghai lockdown: A retrospective analysis.

Objectives: Shanghai witnessed an unprecedented outbreak of COVID-19 and experienced a strict lockdown from March 28, 2022 to May 31, 2022. Most studies to date are on the first lockdown after the outbreak in December 2019. This study aimed to examine the impact of lockdown on delivery and neonatal outcomes among uninfected pregnant women in the new phase of the COVID-19 outbreak. Methods: A retrospective analysis was conducted in the Obstetrics and Gynecology Hospital of Fudan University. Pregnant women without COVID-19 who delivered from March 28, 2022 to May 31, 2022 (lockdown group) and the same period in 2021 (non-lockdown group) were recruited for this study. Logistic regression models and 1 : 1 propensity score matching (PSM) were used to assess the effect of lockdown on delivery outcomes. Results: A total of 2,962 patients were included in this study, 1,339 of whom were from the lockdown group. Compared with the non-lockdown group, pregnant women giving birth during lockdown had an increased risk of term prelabor rupture of membranes (TPROM) (aOR = 1.253, 95% CI: 1.026-1.530), and decreased risks of postpartum hemorrhage (PPH) (aOR = 0.362, 95% CI: 0.216-0.606) and fetal malformation (aOR = 0.309, 95% CI: 0.164-0.582). The risk of large for gestational age (LGA) (aOR = 0.802, 95% CI: 0.648-0.992) and rate of admission to the neonatal intensive care unit (NICU) (aOR = 0.722, 95% CI: 0.589-0.885) also significantly declined. After 1 : 1 PSM, the impact of lockdown on the risk of TPROM (aOR = 1.501, 95% CI: 1.083-2.080), PPH (aOR = 0.371, 95% CI: 0.211-0.654), fetal malformation (aOR = 0.332, 95% CI: 0.161-0.684), LGA (aOR = 0.749, 95% CI: 0.594-0.945) and rate of admission to the NICU (aOR = 0.700, 95% CI: 0.564-0.869) all remained. There were no other delivery or neonatal outcomes affected by the lockdown after the COVID-19 outbreak. Conclusion: This study indicated a significant increase in the risk of term PROM, significant decreases in the risk of PPH, fetal malformation and LGA, and a marked decline in the rate of admission to the NICU during Shanghai Lockdown.

Effects of animated pedagogical agent-guided loving-kindness meditation on flight attendants' spirituality, mindfulness, subjective wellbeing, and social presence.

Loving-kindness meditation (LKM) was first practiced by Buddhists and then developed by clinical psychologist. Previous studies on LKM have mainly focused on the impact of real person-guided meditation on depression, anxiety, and other negative psychology. During the COVID-19 pandemic, this study explored the effect and mechanism of media-guided LKM on the improvement of social presence, mindfulness, spirituality, and subjective wellbeing (SWB). From the viewpoint of positive psychology, this study compared the different media effects of animated pedagogical agent (APA)-guided LKM and audio-guided LKM. A total of 82 flight attendants were recruited from airlines; then, they were randomly assigned to two groups: APA group (41 participants) and audio group (41 participants), which both underwent an 8-week LKM training intervention. The aforementioned four main variables were measured pre and post the meditation experiment. The results indicated that both APA-guided meditation and audio-guided meditation significantly improved subjects' spirituality and SWB. Compared with audio-guided meditation, APA-guided meditation significantly improved the subjects' spirituality, SWB, and social presence. Audio-guided meditation has no significant effect on social presence. This study highlights APA-guided meditation has a positive effect on spirituality, SWB, and social presence, which may provide individuals with a simple and easy method to improve their mental health.

Effects of animated pedagogical agent-guided loving-kindness meditation on flight attendants’ spirituality, mindfulness, subjective wellbeing, and social presence

Loving-kindness meditation (LKM) was first practiced by Buddhists and then developed by clinical psychologist. Previous studies on LKM have mainly focused on the impact of real person-guided meditation on depression, anxiety, and other negative psychology. During the COVID-19 pandemic, this study explored the effect and mechanism of media-guided LKM on the improvement of social presence, mindfulness, spirituality, and subjective wellbeing (SWB). From the viewpoint of positive psychology, this study compared the different media effects of animated pedagogical agent (APA)-guided LKM and audio-guided LKM. A total of 82 flight attendants were recruited from airlines;then, they were randomly assigned to two groups: APA group (41 participants) and audio group (41 participants), which both underwent an 8-week LKM training intervention. The aforementioned four main variables were measured pre and post the meditation experiment. The results indicated that both APA-guided meditation and audio-guided meditation significantly improved subjects’ spirituality and SWB. Compared with audio-guided meditation, APA-guided meditation significantly improved the subjects’ spirituality, SWB, and social presence. Audio-guided meditation has no significant effect on social presence. This study highlights APA-guided meditation has a positive effect on spirituality, SWB, and social presence, which may provide individuals with a simple and easy method to improve their mental health.

SARS-CoV-2 RNA levels in Scotland's wastewater (preprint)

Nationwide, wastewater-based monitoring was newly established in Scotland to track the levels of SARS-CoV-2 viral RNA shed into the sewage network, during the COVID-19 pandemic. We present a curated, reference data set produced by this national programme, from May 2020 to February 2022. Viral levels were analysed by RT-qPCR assays of the N1 gene, on RNA extracted from wastewater sampled at 122 locations. Locations were sampled up to four times per week, typically once or twice per week, and in response to local needs. We report sampling site locations with geographical coordinates, the total population in the catchment for each site, and the information necessary for data normalisation, such as the incoming wastewater flow values and ammonia concentration, when these were available. The methodology for viral quantification and data analysis is briefly described, with links to detailed protocols online. These wastewater data are contributing to estimates of disease prevalence and the viral reproduction number (R) in Scotland and in the UK.

Associated factors of professional identity among nursing undergraduates during COVID-19: A cross-sectional study.

OBJECTIVES: Professional identity plays an important role in the long-term development of nurses, and it will change when public health emergency occurs. The objective of this study is to investigate the factors associated with the professional identity of nursing undergraduates in the epidemic of COVID-19. METHODS: A cross-sectional survey design with convenience sampling was used. A total of 3,875 nursing undergraduates were recruited from seven universities across China from March to April 2020. A general information questionnaire was used to collect students' information, and the Professional Identity Questionnaire for Nurse Students was used to survey their professional identity during the early and later stages of the first wave of the COVID-19 epidemic. RESULTS: The score of professional identity in the later stage (59.49 ± 12.41) was higher than that in the early stage (56.96 ± 12.61). The stepwise regression indicated that several factors were associated with professional identity, including gender, residential area, major, impact of the epidemic on intention to work after graduation, reasons for choosing nursing major and students' scores of professional identity in early stage. CONCLUSIONS: Nursing educators can utilize the positive impact of responding to public health emergencies to increase the professional identity of students. Meanwhile, educators should give those students with lower professional identity more targeted education to cultivate their professional identity after the occurrence of public health emergencies.

Recent advance of ACE2 and microbiota dysfunction in COVID-19 pathogenesis.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused the coronavirus disease 2019 (COVID-19) and has become the world's most pressing public health threat. Although not as common as respiratory symptoms, a substantial proportion of patients with COVID-19 presented the gastrointestinal symptoms. ACE2, as the receptor of SARS-CoV and SARS-CoV-2, is highly expressed in the epithelia of the epithelium cells in lung and intestine. In addition, ACE2 is essential for the innate immunity, amino acid transportation and the homeostasis of intestinal microecology. The composition of gut microbiota in COVID-19 patients was altered and concordant with inflammatory, which may explain the gastrointestinal symptoms in patients. Here we reviewed and discussed the evolving role for ACE2 and gut microbiota in SARS-CoV-2 infection which might provide innovative approaches to targeting ACE2 and gut microbiota for the COVID-19 therapy.

Two cases of acute endocarditis misdiagnosed as COVID-19 infection.

The COVID-19 pandemic has presented countless new challenges for healthcare providers including the challenge of differentiating COVID-19 infection from other diseases. COVID-19 infection and acute endocarditis may present similarly, both with shortness of breath and vital sign abnormalities, yet they require very different treatments. Here, we present two cases in which life-threatening acute endocarditis was initially misdiagnosed as COVID-19 infection during the height of the pandemic in New York City. The first was a case of Klebsiella pneumoniae mitral valve endocarditis leading to papillary muscle rupture and severe mitral regurgitation, and the second a case of Streptococcus mitis aortic valve endocarditis with heart failure due to severe aortic regurgitation. These cases highlight the importance of careful clinical reasoning and demonstrate how cognitive errors may impact clinical reasoning. They also underscore the limitations of real-time reverse transcription-polymerase chain reaction (RT-PCR) for SARS-CoV-2 testing and illustrate the ways in which difficulty interpreting results may also influence clinical reasoning. Accurate diagnosis of acute endocarditis is critical given that surgical intervention can be lifesaving in unstable patients.

Study on SARS-CoV-2 transmission and the effects of control measures in China.

OBJECTIVE: To reconstruct the transmission trajectory of SARS-CoV-2 and analyze the effects of control measures in China. METHODS: Python 3.7.1 was used to write a SEIR class to model the epidemic procedure and proportional estimation method to estimate the initial true infected number. The epidemic area in China was divided into three parts, Wuhan city, Hubei province (except Wuhan) and China (except Hubei) based on the different transmission pattern. A testing capacity limitation factor for medical resources was imposed to model the number of infected but not quarantined individuals. Baidu migration data were used to assess the number of infected individuals who migrated from Wuhan to other areas. RESULTS: Basic reproduction number, R0, was 3.6 before the city was lockdown on Jan 23, 2020. The actual infected number the model predicted was 4508 in Wuhan before Jan 23, 2020. By January 22 2020, it was estimated that 1764 infected cases migrated from Wuhan to other cities in Hubei province. Effective reproductive number, R, gradually decreased from 3.6 (Wuhan), 3.4 (Hubei except Wuhan,) and 3.3 (China except Hubei) in stage 1 (from Dec 08, 2019 to Jan 22, 2020) to 0.67 (Wuhan), 0.59 (Hubei except Wuhan) and 0.63 (China except Hubei) respectively. Especially after January 23, 2020 when Wuhan City was closed, the infected number showed a turning point in Wuhan. By early April, there would be 42073 (95% confidence interval, 41673 to 42475), 21342 (95% confidence interval, 21057 to 21629) and 13384 (95% confidence interval, 13158 to 13612) infected cases in Wuhan, Hubei (except Wuhan) and China (except Hubei), respectively. CONCLUSION: A series of control measures in China have effectively prevented the spread of COVID-19, and the epidemic should be under control in early April with very few new cases occasionally reported.

Psychological symptoms of cancer survivors during the COVID-19 outbreak: A longitudinal study.

OBJECTIVE: Due to the coronavirus disease 2019 (COVID-19) pandemic, self-isolation at home was adopted to control the spread of COVID-19 in China for 3 months from 29 January 2020. The psychological status of cancer survivors is affected by their social environment. In this study, we investigated the psychological status and psychological symptoms of Chinese cancer survivors. METHODS: A longitudinal study design was adopted, and an online sample of cancer survivors was successfully recruited via the Internet communities of cancer support groups. From 14 February to 25 May, 111 cancer survivor families completed the symptom checklist 90 (SCL-90) online three times (T1:14 to 24 February; T2: 1 to 10 April; T3: 15 to 25 May). RESULTS: For survivors and their family members, the mean total score of the SCL-90 was 172.05 (13.30) and 142.76 (26.80) at T1, 155.91 (12.18) and 133.42 (15.93) at T2, and 142.75 (11.56) and 130.14 (14.16) at T3, respectively. The SCL-90 scores of cancer survivors were significantly higher than those of family members and Chinese norms at T1, T2, and T3. Nine psychological symptoms of the SCL-90 in cancer survivors significantly declined from T1 to T2 and T3. CONCLUSIONS: The COVID-19 pandemic has had a significant adverse impact on cancer survivors and their families. Psychological assistance should be provided to cancer survivors.