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Background: Following the pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and considering its capacity for rapid mutation, there have been many studies and articles on this novel coronavirus over the past three years. Therefore, providing knowledge and directions for management of SARS-CoV-2, for hospital staff is crucial. Hence, we collected the research information from different perspectives and summarized the guidelines for perinatal care on the topic of SARS-CoV-2, and for possible future viral pandemics. Method(s): A systematic review aimed at assessing the publications written in English and Chinese, offering different perspectives on the topic of perinatal care concerning SARS-CoV-2, was conducted using PubMed and Google Scholar from 2020 to 2022. In addition, we summarized the guidelines from the Taiwan Association of Obstetrics and Gynecology, American College of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine, Maternal Immunization Task Force and Partners, and Academy of Breastfeeding Medicine. Result(s): Due to physiological changes, pregnant patients may be prone to have complications, especially pre-eclampsia, affecting morbidity and mortality. Most neonates of coronavirus disease (COVID-19) infected mothers did not show any clinical abnormalities due to the infection. However, compared to the general population, infected neonates needed more invasive ventilation care, while the proportion of asymptomatic neonates was less than that in the general population. Further, long term complications are still under investigation. Evidence of vertical transmission via the placenta and umbilical cord is rare but not absent. Paxlovid (nirmatrelvir/ritonavir) can be administered to patients with comorbidities, and indications for cesarean delivery does not include COVID-19 infection. Vaccination against COVID-19 should not be delayed during pregnancy and lactation. Conclusion(s): Obstetricians and gynecologists should pay more attention to pregnant women with SARS-CoV-2 because of the physiological changes and higher risks of complications, morbidity, and mortality. Early prevention with vaccination in pregnant women is the key to controlling the COVID-19 pandemic, from which we can learn how to manage the next pandemic.Copyright © 2023 The Author(s).
ABSTRACT
Aims Hospital Miri is a district hospital with NICU that caters neonatal care service in Northern Sarawak. Preterm birth rate in our centre makes up of 10% (n=487) in 2019 and 11% (n=491) in 2020 of the live births, with mortality rate of 3% for preterm infants less than 33 weeks. According to WHO and Cochrane review (2016), Kangaroo mother care helps to reduce mortality, nosocomial infection, hypothermia, and improved growth and exclusive breastfeeding. Methods This is a retrospective observational study. Kangaroo Mother Care (KMC) Project was introduced in 2020 in Hospital Miri NICU as part of quality improvement project. Stable preterm infants with postmenstrual age 30 weeks to 34 weeks 6 days were enrolled with mother's consent into the project. It was carried out in 3 phases, with phase 1 of stable infants under room air or HFNC, phase 2 of stable infants on NIV and phase 3 with intubated infants. As COVID-19 endemic encroached, the project was put on hold at phase 2. Infants' demographic data was analysed using frequency and percentage. Outcomes were measured in mean, frequency and percentage. Maternal mental health score, knowledge score were taken prior to implementation of KMC and upon discharge. The mental health score is described as median and knowledge score is compared by wincoxon signed-rank test. Overall experience score was taken as median and mean. Results A total of 41 infants with the gestation of 32 to 34 weeks 6 days participated, 22 (53.7%) with majority of 41.5% aged 34 to 34 weeks 6 days post menstrual age at the time of enrolment. Mean length of stay was 38.34 days (SD:24.4), time taken to achieve birth weight was 11.4 days (SD: 4.05). Time taken to initiate breastfeeding range from 8 to 14 days to >22 days of life, mean: 24.78. Eighteen infants (43.9%) achieved exclusive breastfeeding on discharge. Mother's mental health, knowledge and experience were measures using Likert scale with the total score of 15 for mental health and 18 for knowledge and experience. For mental health score, pre-KMC median score:14, post-KMC median score was 15. There was improvement in the mother's experience upon discharge (p-value: <0.001). For overall experience, median was 18 with the mean score of 16.88 (SD:1.56). Conclusion Our study was suspended prematurely as per local pandemic control guideline. Knowing about the benefit of KMC to both mother and infants, we suggest that it should be encouraged and continued with adaptation and modification of the procedure during COVID-19 pandemic.
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Background: A promising approach to tackle the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) could be small interfering (si)RNAs. However, it is unclear so far, which viral replication steps can be efficiently inhibited with siRNAs. Here we report the first-ever in-depth analysis of RNAi-accessible SARS-CoV-2 replication steps. Methods: siRNAs were designed against four genomic regions of SARS-CoV-2. Initial screening of siRNA activity was performed with a dual luciferase reporter assay. Efficacy of siRNAs to terminate various viral replication steps was analyzed by infecting VeroE6 cells with wildtype SARS-CoV-2 or a GFP expressing recombinant SARS-CoV-2 and monitoring viral spread in real-time by time-lapse fluorescence microscopy. Positive and negative sense viral RNA transcripts were distinctly quantified via sense specific cDNA synthesis and reverse-transcriptase quantitative PCR. Finally, the antiviral activity of the siRNAs was primarily evaluated in a highly relevant model, SARS-CoV-2 infected human lung explants. Results: When applied in a prophylactic fashion, siRNAs were able to target genomic RNA (gRNA) of SARS-CoV-2 after cell entry, terminating replication before start of transcription, thereby preventing cytopathic effects. Surprisingly, siRNAs were not active against intermediate negative sense transcripts formed during replication. Targeting sequences that are commonly shared by all viral transcripts indeed allowed a simultaneous suppression of gRNA and subgenomic (sg)RNAs by a single siRNA. However, siRNAs that targeted ORF1 which is solely part of gRNA, presented an enhanced antiviral activity. We show that the reason for this was that siRNAs that targeted the common regions of transcripts were outcompeted by the highly abundant sgRNAs. Based on these findings, we developed a chemically stabilized siRNA, which targets a highly conserved region of ORF1, and which inhibited SARS-CoV-2 replication by >90% ex vivo in explants of the human lung. Conclusion: Our work strongly encourages the development of siRNA-based therapies for COVID-19 and suggests that early therapy start, or prophylactic application, together with targeting ORF1, might be key for high antiviral efficacy.
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Purpose: Consumers prefer to choose restaurants that value hygiene and safety;therefore, appropriate epidemic prevention measures could restore 30% of lost customers and enhance a restaurant’s reputation during infectious disease outbreaks. Providing customers with safe epidemic prevention service quality is an important mission of the restaurant industry during an epidemic. This study aims to construct an epidemic prevention service quality scale for restaurants (REP-SERV scale). Design/methodology/approach: The REP-SERV scale was constructed through internet big data analytics and qualitative and quantitative research procedures. Findings: A total of 16 key service factors for restaurant epidemic prevention were extracted through internet big data analytics. The REP-SERV scale contained 28 items in six dimensions, including hygiene, empathy, flexible service, support service, personnel management and body temperature and seating arrangement. Practical implications: The REP-SERV scale can help many restaurant operators clearly determine the deficiencies and risks of restaurant epidemic prevention services. Originality/value: The findings can provide references to effectively measure and improve the epidemic prevention service quality in restaurants, thereby providing customers with a comfortable and safe dining environment. © 2022, Emerald Publishing Limited.
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Purpose: This research aims to collect human body variables via 2D images captured by digital cameras. Based on those human variables, the forecast and recommendation of the Digital Camouflage Uniforms (DCU) for Taiwan's military personnel are made. Design/methodology/approach: A total of 375 subjects are recruited (male: 253;female: 122). In this study, OpenPose converts the photographed 2D images into four body variables, which are compared with those of a tape measure and 3D scanning simultaneously. Then, the recommendation model of the DCU is built by the decision tree. Meanwhile, the Euclidean distance of each size of the DCU in the manufacturing specification is calculated as the best three recommendations. Findings: The recommended size established by the decision tree is only 0.62 and 0.63. However, for the recommendation result of the best three options, the DCU Fitting Score can be as high as 0.8 or more. The results of OpenPose and 3D scanning have the highest correlation coefficient even though the method of measuring body size is different. This result confirms that OpenPose has significant measurement validity. That is, inexpensive equipment can be used to obtain reasonable results. Originality/value: In general, the method proposed in this study is suitable for applications in e-commerce and the apparel industry in a long-distance, non-contact and non-pre-labeled manner when the world is facing Covid-19. In particular, it can reduce the measurement troubles of ordinary users when purchasing clothing online. © 2021, Emerald Publishing Limited.