Depression and quality of life among Macau residents in the 2022 COVID-19 pandemic wave from the perspective of network analysis.

Background: In the summer of 2022, Macau experienced a surge of COVID-19 infections (the 618 COVID-19 wave), which had serious effects on mental health and quality of life (QoL). However, there is scant research on mental health problems and QoL among Macau residents during the 618 COVID-19 wave. This study examined the network structure of depressive symptoms (hereafter depression), and the interconnection between different depressive symptoms and QoL among Macau residents during this period. Method: A cross-sectional study was conducted between 26th July and 9th September 2022. Depressive symptoms were measured with the 9-item Patient Health Questionnaire (PHQ-9), while the global QoL was measured with the two items of the World Health Organization Quality of Life-brief version (WHOQOL-BREF). Correlates of depression were explored using univariate and multivariate analyses. The association between depression and QoL was investigated using analysis of covariance (ANCOVA). Network analysis was used to evaluate the structure of depression. The centrality index "Expected Influence" (EI) was used to identify the most central symptoms and the flow function was used to identify depressive symptoms that had a direct bearing on QoL. Results: A total 1,008 participants were included in this study. The overall prevalence of depression was 62.5% (n = 630; 95% CI = 60.00-65.00%). Having depression was significantly associated with younger age (OR = 0.970; p < 0.001), anxiety (OR = 1.515; p < 0.001), fatigue (OR = 1.338; p < 0.001), and economic loss (OR = 1.933; p = 0.026). Participants with depression had lower QoL F (1, 1,008) =5.538, p = 0.019). The most central symptoms included PHQ2 ("Sad Mood") (EI: 1.044), PHQ4 ("Fatigue") (EI: 1.016), and PHQ6 ("Guilt") (EI: 0.975) in the depression network model, while PHQ4 ("Fatigue"), PHQ9 ("Suicide"), and PHQ6 ("Guilt") had strong negative associations with QoL. Conclusion: Depression was common among Macao residents during the 618 COVID-19 wave. Given the negative impact of depression on QoL, interventions targeting central symptoms identified in the network model (e.g., cognitive behavioral therapy) should be developed and implemented for Macau residents with depression.

Effects of mild/asymptomatic COVID-19 on semen parameters and sex-related hormone levels in men: a systematic review and meta-analysis.

Coronavirus disease 2019 (COVID-19) has yet to be proven to alter male reproductive function, particularly in the majority of mild/asymptomatic patients. The purpose of this study was to explore whether mild/asymptomatic COVID-19 affects semen quality and sex-related hormone levels. To find suitable comparative studies, a systematic review and meta-analysis was done up to January 22, 2022, by using multiple databases (Web of Science, PubMed, and Embase). Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to identify and choose the studies. Meta-analysis was used to examine the semen parameters and sex-related hormones of mild/asymptomatic COVID-19 patients before and after infection. The effects of semen collection time, fever, and intensity of verification on semen following infection were also investigated. A total of 13 studies (n = 770) were included in the analysis, including three case-control studies, six pre-post studies, and four single-arm studies. A meta-analysis of five pre-post studies showed that after infection with COVID-19, sperm concentration (I2 = 0; P = 0.003), total sperm count (I2 = 46.3%; P = 0.043), progressive motility (I2 = 50.0%; P < 0.001), total sperm motility (I2 = 76.1%; P = 0.047), and normal sperm morphology (I2 = 0; P = 0.001) decreased. Simultaneously, a systematic review of 13 studies found a significant relationship between semen collection time after infection, inflammation severity, and semen parameter values, with fever having only bearing on semen concentration. Furthermore, there was no significant difference in sex-related hormone levels before and after infection in mild/asymptomatic patients. Mild/asymptomatic COVID-19 infection had a significant effect on semen quality in the short term. It is recommended to avoid initiating a pregnancy during this period of time.

Prevalence of insomnia and its association with quality of life among Macau residents shortly after the summer 2022 COVID-19 outbreak: A network analysis perspective

Background The latest wave of the coronavirus disease 2019 (COVID-19) pandemic in Macau began on 18 June 2022 and was more serious than previous waves. Ensuing disruption from the wave is likely to have had a variety of negative mental health consequences for Macau residents including increased risk for insomnia. This study investigated the prevalence and correlates of insomnia among Macau residents during this wave as well as its association with quality of life (QoL) from a network analysis perspective. Methods A cross-sectional study was conducted between 26 July and 9 September 2022. Univariate and multivariate analyses explored correlates of insomnia. Analysis of covariance (ANCOVA) examined the relationship between insomnia and QoL. Network analysis assessed the structure of insomnia including "Expected influence” to identify central symptoms in the network, and the flow function to identify specific symptoms that were directly associated with QoL. Network stability was examined using a case-dropping bootstrap procedure. Results A total of 1,008 Macau residents were included in this study. The overall prevalence of insomnia was 49.0% (n = 494;95% CI = 45.9–52.1%). A binary logistic regression analysis indicated people with insomnia were more likely to report depression (OR = 1.237;P < 0.001) and anxiety symptoms (OR = 1.119;P < 0.001), as well as being quarantined during the COVID-19 pandemic (OR = 1.172;P = 0.034). An ANCOVA found people with insomnia had lower QoL (F(1,1,008) = 17.45, P < 0.001). "Sleep maintenance” (ISI2), "Distress caused by the sleep difficulties” (ISI7) and "Interference with daytime functioning” (ISI5) were the most central symptoms in the insomnia network model, while "Sleep dissatisfaction” (ISI4), "Interference with daytime functioning” (ISI5), and "Distress caused by the sleep difficulties” (ISI7) had the strongest negative associations with QoL. Conclusion The high prevalence of insomnia among Macau residents during the COVID-19 pandemic warrants attention. Being quarantined during the pandemic and having psychiatric problems were correlates of insomnia. Future research should target central symptoms and symptoms linked to QoL observed in our network models to improve insomnia and QoL.

Prevalence of insomnia and its association with quality of life among Macau residents shortly after the summer 2022 COVID-19 outbreak: A network analysis perspective.

Background: The latest wave of the coronavirus disease 2019 (COVID-19) pandemic in Macau began on 18 June 2022 and was more serious than previous waves. Ensuing disruption from the wave is likely to have had a variety of negative mental health consequences for Macau residents including increased risk for insomnia. This study investigated the prevalence and correlates of insomnia among Macau residents during this wave as well as its association with quality of life (QoL) from a network analysis perspective. Methods: A cross-sectional study was conducted between 26 July and 9 September 2022. Univariate and multivariate analyses explored correlates of insomnia. Analysis of covariance (ANCOVA) examined the relationship between insomnia and QoL. Network analysis assessed the structure of insomnia including "Expected influence" to identify central symptoms in the network, and the flow function to identify specific symptoms that were directly associated with QoL. Network stability was examined using a case-dropping bootstrap procedure. Results: A total of 1,008 Macau residents were included in this study. The overall prevalence of insomnia was 49.0% (n = 494; 95% CI = 45.9-52.1%). A binary logistic regression analysis indicated people with insomnia were more likely to report depression (OR = 1.237; P < 0.001) and anxiety symptoms (OR = 1.119; P < 0.001), as well as being quarantined during the COVID-19 pandemic (OR = 1.172; P = 0.034). An ANCOVA found people with insomnia had lower QoL (F(1,1,008) = 17.45, P < 0.001). "Sleep maintenance" (ISI2), "Distress caused by the sleep difficulties" (ISI7) and "Interference with daytime functioning" (ISI5) were the most central symptoms in the insomnia network model, while "Sleep dissatisfaction" (ISI4), "Interference with daytime functioning" (ISI5), and "Distress caused by the sleep difficulties" (ISI7) had the strongest negative associations with QoL. Conclusion: The high prevalence of insomnia among Macau residents during the COVID-19 pandemic warrants attention. Being quarantined during the pandemic and having psychiatric problems were correlates of insomnia. Future research should target central symptoms and symptoms linked to QoL observed in our network models to improve insomnia and QoL.

Effects of Probiotics and Gut Microbiota on Bone Metabolism in Chickens: A Review.

Broiler leg diseases are a common abnormal bone metabolism issue that leads to poor leg health in growing poultry. Bone metabolism is a complicated regulatory process controlled by genetic, nutritional, feeding management, environmental, or other influencing factors. The gut microbiota constitutes the largest micro-ecosystem in animals and is closely related to many metabolic disorders, including bone disease, by affecting the absorption of nutrients and the barrier function of the gastrointestinal tract and regulating the immune system and even the brain-gut-bone axis. Recently, probiotic-based dietary supplementation has emerged as an emerging strategy to improve bone health in chickens by regulating bone metabolism based on the gut-bone axis. This review aims to summarize the regulatory mechanisms of probiotics in the gut microbiota on bone metabolism and to provide new insights for the prevention and treatment of bone diseases in broiler chickens.

Uncovery of the action mechanisms and major bioactive compounds responsible for the protective effects of Toujie Quwen Granules on COVID-19 based on network pharmacology and molecular docking

Objective: To explore the mechanism of action and active constituents of Toujie Quwen Granules (TJQWG) for treatment of COVID-19, and provide a scientific reference for its clinical application.

Trafficked Malayan pangolins contain viral pathogens of humans.

Pangolins are the most trafficked wild animal in the world according to the World Wildlife Fund. The discovery of SARS-CoV-2-related coronaviruses in Malayan pangolins has piqued interest in the viromes of these wild, scaly-skinned mammals. We sequenced the viromes of 161 pangolins that were smuggled into China and assembled 28 vertebrate-associated viruses, 21 of which have not been previously reported in vertebrates. We named 16 members of Hunnivirus, Pestivirus and Copiparvovirus pangolin-associated viruses. We report that the L-protein has been lost from all hunniviruses identified in pangolins. Sequences of four human-associated viruses were detected in pangolin viromes, including respiratory syncytial virus, Orthopneumovirus, Rotavirus A and Mammalian orthoreovirus. The genomic sequences of five mammal-associated and three tick-associated viruses were also present. Notably, a coronavirus related to HKU4-CoV, which was originally found in bats, was identified. The presence of these viruses in smuggled pangolins identifies these mammals as a potential source of emergent pathogenic viruses.

When health care workers became patients with COVID-19: A qualitative study.

AIMS: This study aimed to describe the experiences of nurses and other health care workers who were infected with coronavirus disease 2019. METHODS: An empirical phenomenological approach was used. Sixteen participants were recruited in Wuhan using purposive and snowball sampling. Semistructured, in-depth interviews were conducted by telephone in February 2020. Interviews were transcribed verbatim and analysed following Colaizzi's method. RESULTS: Two themes emerged: (1) Intense emotional distress since becoming infected. Participants were fearful of spreading the virus to family and overwhelmed by a lack of information, experienced uncertainty and worried about treatment, felt lonely during isolation and reported moral distress about inadequate health care staffing. (2) Coping strategies were needed. They tried their best to address negative psychological reactions using their professional knowledge and gaining support from others and community resources. CONCLUSIONS: Preparedness for catastrophic events and providing timely and accurate information are major considerations in government policy development, related to pandemics and adequacy of health care personnel. Mental health resources and support, both short- and long-term should be anticipated for health care providers to alleviate their fear and anxiety.

Changes in Nursing Students' Career Choices Following the COVID-19 Pandemic in China.

Background: Health professionals including nurses have experienced heavy workload and great physical and mental health challenges during the coronavirus disease 19 (COVID-19) pandemic, which may affect nursing students' career choices. This study examined the changes in nursing students' career choices after the onset of the COVID-19 pandemic in China. Methods: This study was conducted in five University nursing schools in China between September 14, 2020 and October 7, 2020. Career choices before and after the COVID-19 pandemic were collected and analyzed. Results: In total, 1,070 nursing students participated in the study. The reported choice of nursing as future career increased from 50.9% [95% confidence interval (CI): 47.9-53.9%] before the COVID-19 pandemic to 62.7% (95%CI: 59.8-65.6%) after the onset of COVID-19 pandemic. Students who chose nursing as their future career following the COVID-19 outbreak had less severe depression and anxiety compared to those who did not choose nursing, but the associations of depression and anxiety with career choice disappeared in multivariable analyses. Binary logistic regression analysis revealed that male gender [odds ratio (OR) = 0.68, 95% CI: 0.50-0.91], rural residence (OR = 1.53, 95%CI: 1.17-2.00), fourth year students (OR = 0.50, 95%CI: 0.35-0.72), negative experiences during the COVID-19 pandemic (OR = 0.66, 95%CI: 0.47-0.92), and good health (OR = 4.6, 95%CI: 1.78-11.87) were significantly associated with the choice of nursing as future career after the onset of the COVID-19 pandemic. Conclusions: The COVID-19 pandemic appeared to have a positive influence on the career choice of nursing among Chinese nursing students.

Prevalence of problematic Internet use and its association with quality of life among undergraduate nursing students in the later stage of COVID-19 pandemic era in China.

BACKGROUND AND OBJECTIVES: The prevalence of problematic Internet use (PIU) in the post-COVID-19 pandemic era is not known. This cross-sectional study aimed to determine the prevalence of PIU among baccalaureate nursing students (hereafter: nursing students) in the post-COVID-19 era. METHODS: A total of 1070 nursing students were consecutively invited to participate in this study from the nursing schools of five universities. PIU and quality of life (QOL) were assessed using the Internet Addiction Test (IAT) and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF), respectively. t Tests, χ2 , tests, and Kruskal-Wallis tests were used to compare basic demographic and clinical characteristics between participants with and without PIU. Binary logistic regression analysis was used to examine independent correlates. RESULTS: The prevalence of PIU was 23.3% (95% confidence interval [CI]: 20.7%-25.8%). Multiple logistic regression analysis revealed that second- (p = .024) and third-year (p = .012) students were more likely to suffer from PIU compared with first year students. Students with more severe depressive (p = .014) and anxiety symptoms (p = .011) were independently and significantly associated with more severe PIU. After controlling for covariates, nursing students with PIU had a lower overall QOL score (p = .002). CONCLUSION AND SCIENTIFIC SIGNIFICANCE: Problematic Internet use (PIU) was common among nursing students in the post-COVID-19 era. Considering the negative impact of PIU on QOL and academic performance, regular screening should be conducted and effective interventions implemented for nursing students with PIU. This was the first study on the prevalence of PIU among nursing students in the post-COVID-19 era. The findings of this study could help health professionals and education authorities to understand the patterns of PIU and its influence on QOL among nursing students and to allocate health resources and develop effective measures to reduce the risk of PIU in this population.

Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic.

BACKGROUND: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and well-being of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic. METHOD: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. RESULTS: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights. LIMITATIONS: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic. CONCLUSIONS: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population.

Effectiveness of a Brief Mindfulness-Based Intervention of “STOP" (Stop, Take a Breath, Observe, Proceed) Touching Your Face” During the COVID-19 Pandemic: Randomised Controlled Trial (preprint)

Background: Avoid touching our eyes, nose, and mouth (T-zone) is one of recommended strategies to reduce the spread of the coronavirus disease 2019 (COVID-19) and other infectious diseases. However, face-touching is a frequent behaviour, and it is often done automatically without self-awareness. Raising self-awareness of habituated face-touching behaviour may help individuals to avoid face-touching by contaminated hands. Our aim was to evaluate whether mindfulness-based brief behaviour-change intervention (MBI) named “STOP (Stop, Take a Breath, Observe, Proceed) touching your face” can reduce face-touching behavior. Methods: In this online-based, two group, wait-list, randomized controlled trial, participants aged 18 years or more from general population in China were recruited via Chinese social media platforms. Eligible participants were randomly assigned in a 1:1 ratio to receive “STOP touching your face” intervention or control intervention. Those researchers who assessing outcomes were masked to group allocation. A 60-minute self-monitoring of face-touching behaviour was required to report in the pre- and post-intervention. Reduction of percentage of T-Zone touching was set as primary outcome, with reduction of face-touching frequency being a key secondary outcome. These outcomes were analysed in the intention-to-treat (ITT) basis with a complete case analysis (CCA). Safety was monitored in all randomly assigned participants. This trial is registered at ClinicalTrials.gov (Trial registration number: NCT04330352), and is completed. Findings: Between April 2, 2020 to July 2, 2020, 10194 participants were invited to the trial. Of these, we recruited and randomly assigned 1090 (10.7%) participants to the “STOP touching your face” intervention group (n=545) or to the wait-list control intervention (comparator) group (n=545) after reporting the first 60-minute self-monitoring of face-touching behaviour (pre-intervention). Among them, 71.6% (n=390) participants from the intervention group and 63.9% (n=348) from the control group reported the second 60-minute self-monitoring of face-touching behaviour (post-intervention). ITT analysis revealed that percentage of T-Zone touching was significantly reduced by 8.1% in the intervention group (from 81.1% to 73.0%, RR=0.901, OR=0.631, RD=-0.081, p=0.002), and insignificantly reduced by 0.6% in the control intervention (from 80.0% to 79.4%, p=0.821). Group comparison showed that fewer participants had T-Zone touching in the intervention group than that in the control group (73.0% vs 79.4%, RR=0.919, OR=0.700, RD=-0.064, p=0.015) after intervention, and that there was more reduction of T-Zone touching frequency in the intervention group than that in the control group (mean ± SD: 1.7 ± 5.13 vs 0.7 ± 3.98, Mean difference (95% CI): 1.03 (0.48 to 1.58), p<0.001, Cohen's d=-0.218). The above results were further confirmed by CCA. Compared with older individuals (≥30 years old), young adults (18–29 years old) have twice risk of having T-Zone touching behaviour (OR=2.029, 95% CI=1.145 to 3.597, p=0.015), and younger participants reduced face-touching frequency more than their older counterparts (mean ± SD: 9.9 ± 14.24 vs 3.6 ± 11.25, Mean difference (95% CI)=6.270 (3.615 to 8.924), p<0.001, Cohen's d=-0.47). Interpretation This trial is the first to evaluate the efficacy of “STOP touching your face” intervention to reduce face-touching behaviour during the outbreak of COVID-19. The findings of significantly reduced T-Zone touching behaviour in the intervention group supports the widely dissemination of this brief and simple mindfulness-based behaviour-change intervention to low the risk for the COVID-19 and other hand-to face-touching infectious diseases.Trial registration number: NCT04330352Trial Registration. Funding: Zhejiang University, number (2020XGZX046). Declaration of Interest: We declare no competing interests.Ethical Approval: The trial was approved by The Ethics Committee of Sir Run Run Shaw hospital, an affiliate of Zhejiang University, Medical College (NO. 20200401-32).

The prevalence of fatigue among Chinese nursing students in post-COVID-19 era.

BACKGROUND: Due to the COVID-19 outbreak, all teaching activities in nursing schools were suspended in China, and many nursing students were summoned to work in hospitals to compensate for the shortage of manpower. This study examined the prevalence of fatigue and its association with quality of life (QOL) among nursing students during the post-COVID-19 era in China. METHODS: This was a multicenter, cross-sectional study. Nursing students in five Chinese universities were invited to participate. Fatigue, depressive and anxiety symptoms, pain and QOL were measured using standardized instruments. RESULTS: A total of 1,070 nursing students participated. The prevalence of fatigue was 67.3% (95% CI [64.4-70.0]). Multiple logistic regression analysis revealed that male gender (P = 0.003, OR = 1.73, 95% CI [1.20-2.49]), and being a senior nursing student (second year: OR = 2.20, 95% CI [1.46-3.33], P < 0.001; third year: OR = 3.53, 95% CI [2.31-5.41], P < 0.001; and fourth year OR = 3.59, 95% CI [2.39-5.40], P < 0.001) were significantly associated with more severe fatigue. In addition, moderate economic loss during the COVID-19 pandemic (OR = 1.48, 95% CI [1.08-3.33], P < 0.015; compared to low loss), participants with more severe depressive (OR = 1.48, 95% CI [1.22-1.78], P < 0.001) and anxiety symptoms (OR = 1.12, 95% CI [1.05-1.20], P = 0.001), and more severe pain (OR = 1.67, 95%CI [1.46-1.91], P < 0.001) were significantly associated with reported more severe fatigue. After controlling for covariates, nursing students with fatigue had a lower overall QOL score compared to those without (F (1, 1070) = 31.4, P < 0.001). CONCLUSION: Fatigue was common among nursing students in the post-COVID-19 era. Considering the negative impact of fatigue on QOL and daily functioning, routine physical and mental health screening should be conducted for nursing students. Effective stress-reduction measures should be enforced to assist this subpopulation to combat fatigue and restore optimal health.

Mental Health Status of the General Public, Frontline, and Non-frontline Healthcare Providers in the Early Stage of COVID-19.

Background: The outbreak of COVID-19 occurred in 2020 which resulted in high levels of psychological stress in both the general public and healthcare providers. Purpose: The study aimed to address the mental health status of people in China in the early stage of the COVID-19 outbreak, and to identify differences among the general public, frontline, and non-frontline healthcare providers. Method: A cross-sectional study was used to identify the mental health status of the general public and healthcare providers between Jan 29 and Feb 11, 2020. Data were collected using an online survey from a convenience sample. The instruments used included: Patient Health Questionnaire, Generalized Anxiety Disorder scale, Insomnia Severity Index, and Impact of Event Scale-Revised. Descriptive statistics were used to describe the data. Kruskal-Wallis H tests were performed to assess differences in measurements among the three groups; P < 0.05 (two-sided) was considered to be statistically significant. Results: Results showed that a majority of participants experienced post-traumatic stress (68.8%), depression (46.1%), anxiety (39.8%), and insomnia (31.4%). Significant changes in the mental health status of frontline providers was found as compared to those of the other groups (P < 0.001). Interestingly, the scores of the general public were significantly higher than those of the non-frontline healthcare providers (P < 0.001). Conclusion: These findings provide information to evaluate outbreak associated psychological stress for the general public and healthcare providers, and assist in providing professional support and actionable guidance to ease psychological stress and improve mental health.

Relationship between eHealth literacy and psychological status during COVID-19 pandemic: A survey of Chinese residents.

AIMS: To investigate the eHealth literacy and the psychological status of Chinese residents during the COVID-19 pandemic and explore their interrelationship. BACKGROUND: The COVID-19 outbreak has placed intense psychological pressure on community residents. Their psychological status may be affected by eHealth literacy due to home isolation during this rampant pandemic. METHODS: This is a Web-based cross-sectional survey conducted on the JD Health platform, which resulted in 15,000 respondents having participated in this survey. The eHealth Literacy Questionnaire (EHLQ), Patient Health Questionnaire-9 (PHQ-9), Insomnia Severity Index (ISI) and Impact of Event Scale-Revised (IES-R) were used. The Pearson correlation was used to analyse the relationship between eHealth literacy and depression, insomnia and post-traumatic stress disorder. RESULTS: The score of eHealth literacy was 48.88 ± 8.46, and 11.4%, 6.8% and 20.1% of respondents experienced moderate to severe depression, insomnia and post-traumatic stress disorder. eHealth literacy negatively correlated with depression (r = -0.331), insomnia (r = -0.366) and post-traumatic stress disorder (r = -0.320). CONCLUSION: eHealth literacy is closely related to psychological status. Improving eHealth literacy may contribute to maintaining good psychological well-being. IMPLICATIONS FOR NURSING MANAGEMENT: It is necessary to strengthen the education of primary health care providers to enhance their ability to help community residents effectively use eHealth information.

Effects of an Online Mindful Living With Challenge (MLWC) Intervention on Mental Health and Quality of Life Among COVID-19 Patients in China: A Protocol of a Randomized Controlled Trial (preprint)

Background COVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder (PTSD), depression, and anxiety, especially for patients with COVID-19. Studies suggest that mindfulness-based intervention is an effective, easily delivered and non-aggressive online therapy for patients with mental disorders. This study aims to explore the efficacy and possible mechanism of a Mindful Living With Challenge (MLWC) intervention designed for Chinese COVID-19 survivors in alleviating their psychological problems caused by both the disease and the pandemic.Methods This study is a protocol for a randomized controlled trial. More than 1600 eligible participants will be assigned 1:1 to an online MLWC intervention group or a waitlist control group. All participants will be asked to complete online questionnaires at baseline , post-program, and 3-month follow-up. The primary outcome is mental health status which includes PTSD and other psychological symptoms (i.e. depression, anxiety). The secondary outcomes are related physical symptoms including fatigue and sleeplessness assessed by verified scales such as the Fatigue Scale-14, Pittsburgh Sleep Quality Index. In addition, Five Facets Mindfulness Questionnaire, the Nonattachment Scale, the Stillness Scale, the Resilience Style Questionnaire and the Social Support Scale will be used to assess the mindfulness, stillness, nonattachment level, resilience and perceived social support before and after the intervention, which may be the possible mediators and moderators of the link between the MLWC intervention and target outcomes. Data will be analyzed based on an intention-to-treat approach, and SPSS software will be used to perform statistical analysis.Discussion This study will provide scientific evidence on the efficacy and possible mechanism of the MLWC intervention in improving the quality of life and psychological status among COVID-19 survivors in China. Findings from this study will contribute to a growing research field that assesses the effectiveness of mobile-based and theoretically guided interventions for improving the psychological status of the COVID-19 survivors. Moreover, findings from this study will also contribute to the prevention and management of the psychological complications patients face during such public health emergencies.Trial registration Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000037524; Registered on August 29, 2020, http://www.chictr.org.cn/showproj.aspx?proj=60034. 

Management strategies for dermatomyositis during the coronavirus disease 2019 outbreak.

In late 2019, the coronavirus disease 2019 (COVID-19) broke out in Wuhan and then spread over China, which greatly affected the medical practices and health care systems. With most of the hospital's outpatient services closed, the routine clinical diagnosis and treatment for patients with dermatomyositis has been disturbed. We conducted telephone follow-up for 52 patients to know the changes in the condition and the continuation of drug therapy and to ensure the continuity, safety, and effectiveness of the treatment of patients with dermatomyositis during COVID-19.

Management Strategies of Autoimmune bullous diseases during the Outbreak of 2019 Novel Coronavirus Disease (COVID-19)

Since late December 2019, an outbreak of the novel coronavirus disease, which is mainly characterized by pulmonary lesions, has spread quickly worldwide. With the spread of the novel coronavirus, the outpatient lines of hospitals have mostly shut down, which means that routine clinical diagnosis and treatment for autoimmune bullous diseases patients have been disturbed. Due to the serious condition of autoimmune bullous diseases patients, they are prone to immune suppression and circulatory failure, and are more susceptible to infection than healthy individuals. These patients should thus be a priority group for novel coronavirus disease prevention. In this context, the protection and control measures for autoimmune bullous diseases patients against the novel coronavirus are of serious concern. Clinicians should strengthen their communication with patients, pay attention to changes in patients' conditions, and carefully adjust the treatment strategy, while protecting against the novel coronavirus infection, to ensure the continuity, safety, and effectiveness of autoimmune bullous diseases treatment.