Essential elements of weight loss apps for a multi-ethnic population with high BMI: a qualitative study with practical recommendations.

Smartphone weight loss apps are constantly being developed but the essential elements needed by a multi-ethnic population with overweight and obesity remains unclear. Purpose: To explore the perceptions of an Asian multi-ethnic population with overweight and obesity on the essential elements of weight loss apps. Twenty two participants were purposively sampled from a specialist weight management clinic in Singapore from 13 April to 30 April 2021. Recorded interviews were conducted using face-to-face and videoconferencing modalities. Data saturation was reached at the 18th participant. Data analysis was performed using inductive content analysis with constant comparison between and within transcripts. Findings: Three themes and eight subthemes on the essential app components emerged-(a) comprehensive and flexible calorie counters; (b) holistic, gradual and individualized behavior change recommendations tailored for people with overweight and obesity, and (c) just-in-time reminders of future consequences. There was a need to incorporate flexible options for food logging; break down general recommendations into small steps towards sustainable changes; tailor app contents for people with overweight and obesity; and evoke one's considerations of future consequences. Future weight loss apps should be designed to meet the needs of those with overweight and obesity, the very population that needs assistance with weight loss. Future apps could consider leveraging the capacity of artificial intelligence to provide personalized weight management in terms of sustaining self-regulation behaviors, optimizing goal-setting and providing personalized and timely recommendations for weight loss.

Weight loss smartphone apps are ubiquitous but the essential elements needed and preferred by people with overweight and obesity remains unclear. Therefore, we conducted a qualitative study to explore the perceptions and needs of this population in a weight loss app to prolong app engagement and enhance weight loss success. 22 participants were interviewed through face-to-face or videoconferencing sessions during the peak of the COVID-19 pandemic. Interview transcripts were analyzed within and between participants to develop codes, subthemes and themes that represent the participants' perceptions and needs in weight loss apps. Participants expressed the need for (a) comprehensive and flexible calorie counters; (b) holistic, gradual, and individualized behavior change recommendations tailored for people with overweight and obesity; and (c) just-in-time reminders of future consequences. Our findings showed a need to incorporate flexible options for food logging; break down general recommendations into small steps towards sustainable changes; tailor app contents for people with overweight and obesity; and evoke one's considerations of future consequences. Future apps could consider leveraging the capacity of artificial intelligence to provide personalized weight management in terms of sustaining self-regulation behaviors, optimizing goal-setting and providing personalized and timely recommendations for weight loss.

Barriers and Facilitators of Robot-Assisted Education in Higher Education: A Systematic Mixed-Studies Review

Lack of motivation and enjoyment is a challenge that many students face. Due to the current coronavirus pandemic, many lessons are not being conducted face-to-face. However, the use of robots has been proven able to alleviate this challenge. This review explores the barriers and facilitators of robot-assisted education among higher education students. Ten databases were comprehensively searched for studies in English. Both published and unpublished studies were considered without a time limit. A systematic mixed-studies review was adopted and the mixed method appraisal tool was used to assess the methodological quality of the selected articles. The qualitative and quantitative findings were then synthesized via thematic and narrative syntheses, respectively. To integrate these two sets of findings, a result-based convergent synthesis was performed. A total of 28 studies covering 1689 higher education students across 14 countries were eventually used for the analysis. Most of these studies had average to high methodological quality. Two barrier themes were identified from these studies, namely, poor audio verbatim from the robots, and disruption and restrictions from software and hardware of the robot. Meanwhile, three themes related to facilitators were identified, namely, greater engagement in learning, facilitation in remote learning, and knowledge enhancement. The use of robot-assisted education has been proven to improve student learning in higher education. Robot-assisted education is an alternate educational technique that can be utilized to supplement and augment ongoing teaching arrangements. Future studies should examine a specific type of robot in a comparable learning environment. Supplementary Information The online version contains supplementary material available at 10.1007/s10758-022-09637-3.

Generation Z undergraduate students' resilience during the COVID-19 pandemic: a qualitative study.

Resilience has been documented as an essential component in managing stress. However, understanding how undergraduate students with different sociodemographic characteristics perceive resilience remains understudied. This study aimed to explore how undergraduate students in one university define and build resilience during the COVID-19 pandemic. Students' perception and preferences for receiving resilience training were additionally solicited. A descriptive qualitative cross-sectional study was conducted. Twenty-seven students were interviewed using a semi-structured interview guide via Skype instant messaging. The thematic analysis generated five themes: resilience as enduring and withstanding; the building blocks of resilience; resilience: learning or earning; pedagogical considerations for resilience training; and a blended platform for resilience training. Participants described resilience as an enduring and withstanding trait essential for university students. Resilience can be built from intrinsic and extrinsic factors. Intrinsic factors that enhanced resilience included desire to succeed and motivation. Extrinsic factors were relational in nature, and friends, family, teachers, and religion were found to boost resilience. Students had several recommendations in designing resilience training, and they recommended the use of a blended platform. Further, students suggested the use of videos, narratives from resilient individuals, and using reflective practice as a pedagogy in resilience training. Future resilience training should consist of personal and interpersonal factors and should be introduced early during the academic term of students' university life. As the COVID-19 pandemic compounds an already challenging academic climate, this study lends it findings to expand the resilience literature and develop future resilience training.

Becoming More Resilient during COVID-19: Insights from a Process Evaluation of Digital Resilience Training.

Resilience training is gaining attention as a strategy to build students' resistance to adversity and promote their mental well-being. However, owing to inconsistencies and variations in the content and delivery of resilience training, more work is needed to examine students' experiences and preferences to address issues relating to intervention fidelity. This study adopted a qualitative approach in exploring students' experience of synchronous and asynchronous versions of a digital resilience training program. Seventeen students were interviewed using a semi-structured virtual face-to-face interview via Zoom. The thematic analyses unveiled four themes: embarking on a journey toward resilience, discovering strategies to develop resilience, finding a balance to benefit from resilience skill enhancement, and instilling resilience in the everyday. Future resilience training should consider students' workload and interactivity to enhance their engagement. As being resilient is associated with better mental well-being, the findings of this study may support the development of future wellness programs.

Resilience for Undergraduate Students: Development and Evaluation of a Theory-Driven, Evidence-Based and Learner Centered Digital Resilience Skills Enhancement (RISE) Program.

Protective factors that build students' resilience are known. A six-week digital resilience training program was developed on the basis of theory, evidence, and contextual information. The feasibility study sought to evaluate the acceptability, appropriateness, demand, implementation, and limited efficacy of a digital resilience skills enhancement program for undergraduate students. A single group, pre-test, post-test, concurrent mixed methods design among 10 undergraduate students was conducted in one university in Singapore. The content analysis concluded that students accepted and perceived the digital resilience skills enhancement program as appropriate. Students also proposed several improvements, such as the initiation of the program and revisions to the content. The Wilcoxon signed-rank test found significant improvements in resilience (p = 0.02) and meta-cognitive self-regulation (p = 0.01) scores with medium (d = 0.79, 95% CI: -0.15 to 1.74) and very large effect sizes (d = 1.31, 95% CI: 0.30-2.33), respectively. Students found the digital resilience program appropriate and were able to apply their newly acquired skills to promote their resilience and learning. Although, several improvements are proposed to enhance the rigor of the digital resilience program, the findings of this study suggests that digital resilience programs are important for students' well-being.

Efficacy of umbilical cord mesenchymal stromal cells for COVID-19: A systematic review and meta-analysis.

Objectives: A major challenge for COVID-19 therapy is dysregulated immune response associated with the disease. Umbilical cord mesenchymal stromal cells (UC-MSCs) may be a promising candidate for COVID-19 treatment owing to their immunomodulatory and anti-inflammatory functions. Therefore, this study aimed to evaluate the effectiveness of UC-MSCs inpatients with COVID-19. Method: Medline, Embase, PubMed, Cochrane Library, and Web of Science databases were searched to collect clinical trials concerning UC-MSCs for the treatment of COVID-19. After literature screening, quality assessment, and data extraction, a systematic review and meta-analysis of the included study were performed. Results: This systematic review and meta-analysis were prospectively registered on PROSPERO, and the registration number is CRD42022304061. After screening, 10 studies involving 293 patients with COVID-19 were eventually included. Our meta-analysis results showed that UC-MSCs can reduce mortality (relative risk [RR] =0.60, 95% confidence interval [CI]: [0.38, 0.95], P=0.03) in COVID-19 patients. No significant correlation was observed between adverse events and UC-MSC treatment (RR=0.85, 95% CI: [0.65, 1.10], P=0.22; RR=1.00, 95%CI: [0.64, 1.58], P=1.00). In addition, treatment with UC-MSCs was found to suppress inflammation and improve pulmonary symptoms. Conclusions: UC-MSCs hold promise as a safe and effective treatment for COVID-19. Systematic Review Registartion: PROSPERO, identifier CRD42022304061.

Spotlight on noncognitive skills: Views from nursing students and educators.

BACKGROUND: Noncognitive skills have a considerable role in influencing nursing students' performance in clinical and educational settings. Understanding how nursing students and educators perceive noncognitive skills is important given the broad classifications of noncognitive competencies. OBJECTIVE: This study sought to examine nursing students' and educators' perception of noncognitive skills. DESIGN: This study adopted a descriptive qualitative approach. SETTING: This study was conducted virtually via Zoom in one university in Singapore. PARTICIPANTS: Purposive sampling through a maximum variation technique was used to select 35 nursing students and 12 educators. METHODS: Semistructured interviews were conducted through eight virtual face-to-face focus group discussions. Interviews were audio- and videorecorded and transcribed verbatim. Data were analysed through thematic analysis. RESULTS: The participants stated that individual and interpersonal skills contribute to one's noncognitive skills. Two themes emerged from the participants' narratives: (1) the ability to manage oneself and (2) social interactions with others. The first theme describes the various individual characteristics such as growth mindset, adaptability, resilience, and emotional regulation. The second theme describes the importance of empathy and meaningful relationships as types of non-cognitive skills. CONCLUSIONS: The findings of this study provide the basis for the development of noncognitive assessment tools by educators. In addition, they pave the foundation for the curation of future programs that promote the noncognitive skills of nursing students. Hospital-based educators may use these findings to curate suitable programs for improving the noncognitive abilities of nurses.

Digital training for building resilience: Systematic review, meta-analysis, and meta-regression.

Resilience is learnable and broadly described as an individual's adaptive coping ability, its potential value for stress reduction must be explored. With a global coronavirus pandemic, innovative ways to deliver resilience training amidst heightened mental health concerns must be urgently examined. This systematic review aimed to (1) evaluate the effectiveness of digital training for building resilience and reducing anxiety, depressive and stress symptoms and (2) to identify essential features for designing future digital training. A three-step search was conducted in eight electronic databases, trial registries and grey literature to locate eligible studies. Randomised controlled trials examining the effects of digital training aimed at enhancing resilience were included. Data analysis was conducted using the Stata version 17. Twenty-two randomised controlled trials involving 2876 participants were included. Meta-analysis revealed that digital training significantly enhanced the participants' resilience with moderate to large effect (g = 0.54-1.09) at post-intervention and follow-up. Subgroup analyses suggested that training delivered via the Internet with a flexible programme schedule was more effective than its counterparts. This review supports the use of digital training in improving resilience. Further high-quality randomised controlled trials with large sample size are needed.

The association between insecurity and subjective well-being among youth during the COVID-19 outbreak: A moderated mediation model.

BACKGROUND: Sudden and unpredictable changes caused by the COVID-19 pandemic have profoundly threatened the psychological well-being and increased insecurity among adolescents worldwide. At a critical developmental stage, the well-being of the youth is more vulnerable to adverse environments. This study constructed a moderated mediation model to explore the buffering factors between insecurity and subjective well-being of the youth during the pandemic. METHODS: During the COVID-19 outbreak in June 2020, data of 5,503 Chinese youth (15-29 years old) were collected via an online questionnaire. Subjective well-being, insecurity, self-control, and hope were measured, and the moderated mediation model was analyzed. RESULTS: Findings from this study showed that with the mediating effect of self-control, insecurity negatively predicted subjective well-being, and hope moderated the association between insecurity and self-control. Specifically, the link between insecurity and self-control was stronger when hope was low but weaker when hope was high. LIMITATIONS: Since this study was mainly conducted in China, and considering the continuous change of the pandemic on a global scale, it is of great significance to conduct cross-cultural and cross-time studies in the future. CONCLUSIONS: The results demonstrate that self-control and hope play important roles in buffering the negative effects of insecurity on the subjective well-being of adolescents and young adults. The findings provide implications for reducing the negative impact of insecurity from a positive psychology perspective and for youth mental health interventions during public health crises.

Exploration of severe Covid-19 associated risk factor in China: Meta-analysis of current evidence.

AIM: This meta-analysis aimed to explore potential risk factors for severe Covid-19. METHODS: We systemically and comprehensively retrieved the eligible study evaluating clinical differences between severe vs non-severe Covid-19. Main effect sizes were demographic characteristics, comorbidities, signs and symptoms, laboratory findings as well as radiological features of chest CT. RESULTS: A total of 2566 Covid-19 people (771 in the severe group and 1795 in the non-severe group) from 14 studies were eligible for this meta-analysis. It was demonstrated that older age and males were more likely to have severe Covid-19. Patients with underlying comorbidities, such as hypertension, diabetes, heart disease and COPD were significantly more susceptible to severe Covid-19. Patients with dyspnoea were more likely to be severely ill. Depressed total lymphocytes were observed in this article. Meanwhile, although reticulation (30.8%), intrathoracic lymph node enlargement (20.5%) and pleural effusions (30.8%) were relatively infrequent, meta-analysis revealed that patients with these presentations in chest CT were associated with increased risk of severe Covid-19. CONCLUSIONS: There are significant differences in clinical characteristics between the severe and non-severe Covid-19 patients. Many factors are related to the severity of the disease, which can help clinicians to differentiate severe patients from non-severe patients.

Trans-ethnic genome-wide association study of severe COVID-19.

COVID-19 has caused numerous infections with diverse clinical symptoms. To identify human genetic variants contributing to the clinical development of COVID-19, we genotyped 1457 (598/859 with severe/mild symptoms) and sequenced 1141 (severe/mild: 474/667) patients of Chinese ancestry. We further incorporated 1401 genotyped and 948 sequenced ancestry-matched population controls, and tested genome-wide association on 1072 severe cases versus 3875 mild or population controls, followed by trans-ethnic meta-analysis with summary statistics of 3199 hospitalized cases and 897,488 population controls from the COVID-19 Host Genetics Initiative. We identified three significant signals outside the well-established 3p21.31 locus: an intronic variant in FOXP4-AS1 (rs1853837, odds ratio OR = 1.28, P = 2.51 × 10-10, allele frequencies in Chinese/European AF = 0.345/0.105), a frameshift insertion in ABO (rs8176719, OR = 1.19, P = 8.98 × 10-9, AF = 0.422/0.395) and a Chinese-specific intronic variant in MEF2B (rs74490654, OR = 8.73, P = 1.22 × 10-8, AF = 0.004/0). These findings highlight an important role of the adaptive immunity and the ABO blood-group system in protection from developing severe COVID-19.

The relationship of perceived social support to feelings of hopelessness under COVID-19 pandemic: The effects of epidemic risk and meaning in life.

Lockdown orders were issued on January 23, 2020 in Wuhan, China, for the purpose of preventing and controlling COVID-19, which led to severe psychological problems for residents. The present study aimed to investigate the recovery model of hopelessness through interpersonal pathways during the COVID-19 epidemic. An online survey was conducted in 34 provinces (those in autonomous regions and municipalities) of China. This survey investigated residents' hopelessness and the impact of three factors on it, including their perceived social support, meaning in life, and epidemic risk levels. Results showed that both perceived social support and meaning in life negatively predicted hopelessness, while meaning in life played a partial mediating role between perceived social support and hopelessness. Further, epidemic risk level played a moderating role between perceived social support and meaning in life, indicating a "marginal zone effect." Specifically, when comparing other province, perceived social support showed a stronger positive relationship with meaning in life among residents living in other regions of Hubei province. In sum, this study extends the recovery model of hopelessness through interpersonal pathways, and has important implications for public health emergency management.

COVID-19 pandemic response behaviors: a Singapore experience of the "circuit breaker".

Preventive health behaviors such as hand hygiene are crucial amidst pandemics like COVID-19 but reports on nonadherence persist. This could be due to the lack of Consideration of Future Consequences (CFC), a cognitive-motivational construct known to improve health-related behaviors. Therefore, we examined the relationship between CFC and five behaviors-mask-wearing, social distancing, hand hygiene, excessive necessities buying, and COVID-19 information searching using an internet-based Singapore-wide survey conducted from April 20 to May 4, 2020. Behavioral differences 2 weeks before and after the state-wide confinement were examined using paired t-tests. Relationships between CFC and COVID-19 behaviors were examined using regression analyses adjusted for depression and anxiety. Participants were regrouped into three categories-increased behavior performance, maintained high performance, and maintained low performance where mean differences were analysed using MANOVA. Three hundred and thirty-six participants completed the survey (mean age, SD = 32.9 years [SD = 12.6]; 38.7% males). CFCfuture predicted mask wearing (B = 0.16; p < .05), social distancing (B = 0.0.19; p < .01), hand hygiene (B = 0.17; p < .01), and information searching (B = 0.21; p < .001). CFCimmediate predicted hand hygiene (B = 0.09; p < .05), excessive necessities buying (B = 0.07; p < .05) and information searching (B = 0.08; p < .05). Anxiety predicted excessive buying (B = 0.08; p < .05) and hand hygiene (B = 0.13; p < .01). Post-hoc test showed significantly higher CFCfuture (p < .01) in participants who increased and maintained high behavioral performance.

Global Impact of COVID-19 on Weight and Weight-Related Behaviors in the Adult Population: A Scoping Review.

Objective: To provide an overview of what is known about the impact of COVID-19 on weight and weight-related behaviors. Methods: Systematic scoping review using the Arksey and O'Malley methodology. Results: A total of 19 out of 396 articles were included. All studies were conducted using online self-report surveys. The average age of respondents ranged from 19 to 47 years old, comprised of more females. Almost one-half and one-fifth of the respondents gained and lost weight during the COVID-19 pandemic, respectively. Among articles that examined weight, diet and physical activity changes concurrently, weight gain was reported alongside a 36.3% to 59.6% increase in total food consumption and a 67.4% to 61.4% decrease in physical activities. Weight gain predictors included female sex, middle-age, increased appetite, snacking after dinner, less physical exercise, sedentary behaviors of ≥6 h/day, low water consumption and less sleep at night. Included articles did not illustrate significant associations between alcohol consumption, screen time, education, place of living and employment status, although sedentary behaviors, including screen time, did increase significantly. Conclusions: Examining behavioral differences alone is insufficient in predicting weight status. Future research could examine differences in personality and coping mechanisms to design more personalized and effective weight management interventions.

The immunodominant and neutralization linear epitopes for SARS-CoV-2 (preprint)

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) becomes a tremendous threat to global health. Although vaccines against the virus are under development, the antigen epitopes on the virus and their immunogenicity are poorly understood. Here, we simulated the three-dimensional structures of SARS-CoV-2 proteins with high performance computer, predicted the B cell epitopes on spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins of SARS-CoV-2 using structure-based approaches, and then validated the epitope immunogenicity by immunizing mice. Almost all 33 predicted epitopes effectively induced antibody production, six of which were immunodominant epitopes in patients identified via the binding of epitopes with the sera from domestic and imported COVID-19 patients, and 23 were conserved within SARS-CoV-2, SARS-CoV and bat coronavirus RaTG13. We also found that the immunodominant epitopes of domestic SARS-CoV-2 were different from that of the imported, which may be caused by the mutations on S (G614D) and N proteins. Importantly, we validated that eight epitopes on S protein elicited neutralizing antibodies that blocked the cell entry of both D614 and G614 pseudo-virus of SARS-CoV-2, three and nine epitopes induced D614 or G614 neutralizing antibodies, respectively. Our present study shed light on the immunodominance, neutralization, and conserved epitopes on SARS-CoV-2 which are potently used for the diagnosis, virus classification and the vaccine design tackling inefficiency, virus mutation and different species of coronaviruses.

SARS-CoV-2 Nucleocapsid protein is decorated with multiple N- and O-glycans. (preprint)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19) started at the end of 2019 in Wuhan, China has spread rapidly and became a pandemic. Since there is no therapy available that is proven as fully protective against COVID-19, a vaccine to protect against deadly COVID-19 is urgently needed. Nucleocapsid protein (N protein), is one of the most abundant proteins in coronaviruses and is a potential target for both vaccine development and point of care diagnostics. The variable mass of N protein (45 to 60 kDa), suggests the presence of post-translational modifications (PTMs), and it is critical to clearly define these PTMs to gain the structural understanding necessary for further vaccine research. There have been several reports suggesting that the N protein is phosphorylated but lacks glycosylation. Our comprehensive glycomics and glycoproteomics experiments confirm that the N protein is highly O-glycosylated and also contains significant levels of N-glycosylation. We were able to confirm the presence of O-glycans on seven sites with substantial glycan occupancy, in addition to less abundant O-glycans on four sites. We also detected N-glycans on two out of five potential N-glycosylation sites. Moreover, we were able to confirm one phosphorylation site. Recent studies have indicated that the N protein can serve as an important diagnostic marker for coronavirus disease and a major immunogen by priming protective immune responses. Thus, detailed structural characterization of the N protein may provide useful insights for understanding the roles of glycosylation on viral pathogenesis and also in vaccine design and development.

Designing of Epitope-Based Vaccine from the Conserved Region of the Spike Glycoprotein of SARS-CoV-2 (preprint)

The emergence of COVID-19 as a pandemic with a high morbidity rate is posing serious global concern. There is an urgent need to design a suitable therapy or vaccine that could fight against SARS-CoV-2 infection. As spike glycoprotein of SARS-CoV-2 plays a crucial role in receptor binding and membrane fusion inside the host, it could be a suitable target for designing of an epitope-based vaccine. SARS-CoV-2 is an RNA virus and thus has a property to mutate. So, a conserved peptide region of spike glycoprotein was used for predicting suitable B cell and T cell epitopes. 4 T cell epitopes were selected based on stability, antigenicity, allergenicity and toxicity. Further, MHC-I were found from the immune database that could best interact with the selected epitopes. Population coverage analysis was also done to check the presence of identified MHC-I, in the human population of the affected countries. The T cell epitope that binds with the respective MHC-I with highest affinity was chosen. Molecular dynamic simulation results show that the epitope is well selected. This is an in-silico based study that predicts a novel T cell epitope from the conserved spike glycoprotein that could act as a target for designing of the epitope-based vaccine. Further, B cell epitopes have also been found but the main work focuses on T cell epitope as the immunity generated by it is long lasting as compared to B cell epitope.

Rethinking Remdesivir: Synthesis of Lipid Prodrugs that Substantially Enhance Anti-Coronavirus Activity (preprint)

The FDA has granted Remdesivir (RDV, GS-5734) an emergency use authorization on the basis of an acceleration of clinical recovery in hospitalized patients with COVID-19. Unfortunately, the drug must be administered intravenously, restricting its use to those with relatively advanced disease. RDV is also unstable in plasma and has a complex activation pathway which may contribute to its highly variable antiviral efficacy in SARS-CoV-2 infected cells. A potent orally bioavailable antiviral for early treatment of SARS-CoV-2 infection is needed. We focused on making simple orally bioavailable lipid analogs of Remdesivir nucleoside (RVn, GS-441524) that are processed to RVn-monophosphate, the precursor of the active RVn-triphosphate, by a single step intracellular cleavage. In addition to likely improved oral bioavailability and simpler metabolic activation, two of the three new lipid prodrugs of RVn had anti-SARS-CoV-2 activity 9 to 24 times greater than that of RDV in Vero E6 cells

Compositional Variability and Mutation Spectra of Monophyletic SARS-CoV-2 Clades (preprint)

COVID-19 and its causative pathogen SARS-CoV-2 have rushed the world into a staggering pandemic in a few months and a global fight against both is still going on. Here, we describe an analysis procedure where genome composition and its variables are related, through the genetic code, to molecular mechanisms based on understanding of RNA replication and its feedback loop from mutation to viral proteome sequence fraternity including effective sites on replicase-transcriptase complex. Our analysis starts with primary sequence information and identity-based phylogeny based on 22,051 SARS-CoV-2 genome sequences and evaluation of sequence variation patterns as mutation spectrum and its 12 permutations among organized clades tailored to two key mechanisms: strand-biased and function-associated mutations. Our findings include: (1) The most dominant mutation is C-to-U permutation whose abundant second-codon-position counts alter amino acid composition toward higher molecular weight and lower hydrophobicity albeit assumed most slightly deleterious. (2) The second abundance group includes: three negative-strand mutations U-to-C, A-to-G, G-to-A and a positive-strand mutation G-to-U generated through an identical mechanism as C-to-U. (3) A clade-associated and biased mutation trend is found attributable to elevated level of the negative-sense strand synthesis. (4) Within-clade permutation variation is very informative for associating non-synonymous mutations and viral proteome changes. These findings demand a bioinformatics platform where emerging mutations are mapped on to mostly subtle but fast-adjusting viral proteomes and transcriptomes to provide biological and clinical information after logical convergence for effective pharmaceutical and diagnostic applications. Such thoughts and actions are in desperate need, especially in the middle of the War against COVID-19.