Single-Cell RNA Sequencing Reveals Heterogeneity of ALI Model and Epithelial Cell Alterations after Exposure to Electronic Cigarette Vapor (preprint)

Background Electronic cigarettes (e-cigarettes) have been advertised as a healthier alternative to traditional cigarettes; however, their exact effects on the bronchial epithelium are poorly understood. Air-liquid interface (ALI) culture allows human primary bronchial epithelial cells to differentiate into bronchial epithelium (ALI-HBE), providing an in vitro model that simulates the biological characteristics of normal bronchial epithelium.Methods Single-cell RNA sequencing of ALI-HBE was used to reveal previously unrecognized transcriptional heterogeneity within the human bronchial epithelium and cell type–specific responses to acute exposure to e-cigarette vapor (e-vapor) containing distinct components (nicotine and/or flavoring).Results Acute exposure to e-vapor containing nicotine affected gene expression related to secretory function and basal-to-secretory transformation. In addition, acute exposure to e-vapor containing flavoring might promote susceptibility to virus infection and activate epithelial-to-mesenchymal transition.Conclusion The ALI-HBE model recapitulates the heterogeneity and transcriptional characteristics of human bronchial epithelium. Single-cell sequencing data provided high-resolution insights into e-vapor–induced remodeling of bronchial epithelium. The data also indicate factors on bronchial epithelial cells that may promote SARS-CoV-2 infection and suggest therapeutic targets for restoring normal bronchial epithelium function after e-cigarette use.

Post-COVID chronic neuropsychiatric symptoms persisting beyond one year from infection- a case-control study and network analysis (preprint)

Background Limited data about chronic post-COVID neuropsychiatric complaints exist in the literature. Aim: Our study aims to delineate the phenotypes of chronic neuropsychiatric symptoms among adult subjects recovering from their first COVID that occurred more than one year ago. We also aim to explore the clinical and socioeconomic risk factors of having a high loading of chronic neuropsychiatric symptoms. Methods We recruited a post-COVID group who suffered from their first pre-Omicron COVID more than a year ago, and a control group who had never had COVID. The subjects completed app-based questionnaires on demographic, socioeconomic and health status, a COVID symptoms checklist, mental and sleep health measures, and neurocognitive tests. Results The post-COVID group has a statistically significantly higher level of fatigue compared to the control group (p<0.001). Among the post-COVID group, the lack of any COVID vaccination before the first COVID and a higher level of material deprivation before the COVID pandemic predicts a higher load of chronic post-COVID neuropsychiatric symptoms. Partial correlation network analysis suggests that the chronic post-COVID neuropsychiatric symptoms can be clustered into two major (cognitive complaints -fatigue and anxiety-depression) and one minor (headache-dizziness) cluster. A higher level of material deprivation predicts a higher number of symptoms in both major clusters, but the lack of any COVID vaccination before the first COVID only predicts a higher number of symptoms in the cognitive complaints-fatigue cluster. Conclusions Our result suggests heterogeneity among chronic post-COVID neuropsychiatric symptoms, which are associated with the complex interplay of biological and socioeconomic factors.

Use of Information and Communications Technology in Family Services and Its Perceived Benefits amid the COVID-19 Pandemic in Hong Kong-Jockey Club SMART Family-Link Project.

INTRODUCTION: We examined information and communications technology (ICT) use in family services and its perceived benefits and barriers amid the COVID-19 pandemic in Hong Kong. METHODS: We invited all family service social workers of 12 NGOs to complete an anonymous online questionnaire in May 2020 (Part A) and a management representative from each NGO to provide written feedback on ICT use in January 2021 (Part B). RESULTS: In Part A, of 255 respondents (response rate: 67.3%), perceived ICT use in conducting programmes, groups, casework and preventive family programmes showed net increases of 33.9-54.5%; perceived ICT use in different work processes showed net increases of 18.8-48.6%. The three most common perceived benefits were "providing another option to service users" (74.2%), "more convenient service" (60.2%) and "maintaining normal service" (59.7%). In Part B, 12 management representatives consistently reported positive impacts of ICT use on family services. They shared actionable strategies (e.g., ICT skill-related training) and concerns about data privacy and management. CONCLUSIONS: ICT use in family services markedly increased amid the COVID-19 pandemic in Hong Kong. It helped make the services more accessible especially when the pandemic restricted face-to-face services.

A comparison of sleep-wake patterns among school-age children and adolescents in Hong Kong before and during the COVID-19 pandemic (preprint)

Background The lifestyles of children and adolescents have changed extensively during the COVID-19 pandemic due to school suspension and social distancing measures, which can affect their sleep health. Existing studies have used convenient samples and focused on the initial months of the pandemic. Method As part of a territory-wide epidemiological study in Hong Kong, this cross-sectional study recruited primary and secondary school students by stratified random sampling. We investigated the pandemic's effects on sleep parameters using multivariate regression, adjusting for age, sex, household income, seasonality and presence of mental disorders, and the moderators and mediators of the effects. Findings Between 1 September 2019 and 2 June 2021, 791 primary and 442 secondary school students were recruited and analysed. Assessment during COVID predicted a longer sleep latency in both groups on school days (95% CI= 1.0-5.2 minutes, adjusted p-value= 0.010; and 95% CI= 3.9-13.0 minutes, adjusted p-value= 0.004, respectively) and non-school days (95% CI= 1.7-7.2 minutes, adjusted p-value= 0.005; 95% CI= 3.4-13.7 minutes, adjusted p-value= 0.014, respectively). Low household income was a moderator for later bedtime (adjusted p-value= 0.032) and later sleep onset (adjusted p-value= 0.043) during non-school days among secondary school students. Sex and digital leisure time were respectively not a moderator and mediator of the pandemic's effect on sleep parameters. Interpretation Changes associated with COVID have a widespread and enduring effect on the sleep health of school-aged students in Hong Kong. Household income plays a role in adolescent sleep health resilience, and effects of anti-epidemic measures on the health gaps of the youth should be considered. Funding Government of the Hong Kong Special Administrative Region, Food and Health Bureau, Health and Medical Research Fund (Ref. No.: MHS-P1(Part 1)-CUHK).

Principal of environmental life cycle assessment for medical waste during COVID-19 outbreak to support sustainable development goals.

Disposal of medical waste (MW) must be considered as a vital need to prevent the spread of pandemics during Coronavirus disease of the pandemic in 2019 (COVID-19) outbreak in the globe. In addition, many concerns have been raised due to the significant increase in the generation of MW in recent years. A structured evaluation is required as a framework for the quantifying of potential environmental impacts of the disposal of MW which ultimately leads to the realization of sustainable development goals (SDG). Life cycle assessment (LCA) is considered as a practical approach to examine environmental impacts of any potential processes during all stages of a product's life, including material mining, manufacturing, and delivery. As a result, LCA is known as a suitable method for evaluating environmental impacts for the disposal of MW. In this research, existing scenarios for MW with a unique approach to emergency scenarios for the management of COVID-19 medical waste (CMW) are investigated. In the next step, LCA and its stages are defined comprehensively with the CMW management approach. Moreover, ReCiPe2016 is the most up-to-date method for computing environmental damages in LCA. Then the application of this method for defined scenarios of CMW is examined, and interpretation of results is explained regarding some examples. In the last step, the process of selecting the best environmental-friendly scenario is illustrated by applying weighting analysis. Finally, it can be concluded that LCA can be considered as an effective method to evaluate the environmental burden of CMW management scenarios in present critical conditions of the world to support SDG.

COVID-19 vaccination in patients with rheumatic diseases: Vaccination rates, patient perspectives, and side effects.

INTRODUCTION: To investigate the vaccination rate, reported side effects, and patient concerns for COVID-19 vaccination in patients with rheumatic diseases. METHODS: A multicentre cross-sectional study from rheumatology clinics in two major hospitals in Hong Kong was conducted between June 3, 2021 and October 8, 2021. Patient interviews for demographics, clinical characteristics, vaccination status, reported side effects, and factors influencing decisions about vaccination were supplemented with structured questionnaires. RESULTS: Out of 1367 patients, 413 (30.2%) had received COVID-19 vaccination. Side effects were reported in 335 (81.1%) of patients, of which the most common were injection site pain or swelling (66.3%), fatigue (57.1%), fever (19.9%), and headache (19.6%). Multivariate logistic regression models showed that males (odds ratio [OR] = 1.80; p < .001), higher education level (OR = 1.64; p < .001) and healthcare professionals (OR = 4.5; p < .001) were significantly more likely to have received the vaccine. In contrast, patients with hypertension (OR = 0.73; p = .04), systemic lupus erythematous (OR = 0.53; p < .001), stroke (OR = 0.29; p = .01), steroid therapy (OR = 0.59; p = .01), and leflunomide therapy (OR = 0.45; p = .05) were significantly less likely to be vaccinated. Younger age (age, OR = 0.96; p = .003) and messenger RNA (mRNA) vaccines (OR = 4.79; p < .001) were associated with more side effects. There was no difference in risk of side effects between specific rheumatic diseases or drug therapies. CONCLUSION: COVID-19 vaccination is associated with no increased risk of side effects in any particular disease or drug therapy, therefore vaccination should be encouraged in patients with rheumatic disease. In addition, younger age is associated minimally, while mRNA vaccine is associated with increased side effects.

Spike protein multiorgan tropism suppressed by antibodies targeting SARS-CoV-2.

While there is SARS-CoV-2 multiorgan tropism in severely infected COVID-19 patients, it's unclear if this occurs in healthy young individuals. In addition, for antibodies that target the spike protein (SP), it's unclear if these reduce SARS-CoV-2/SP multiorgan tropism equally. We used fluorescently labeled SP-NIRF to study viral behavior, using an in vivo dynamic imaging system and ex in vivo tissue analysis, in young mice. We found a SP body-wide biodistribution followed by a slow regional elimination, except for the liver, which showed an accumulation. SP uptake was highest for the lungs, and this was followed by kidney, heart and liver, but, unlike the choroid plexus, it was not detected in the brain parenchyma or CSF. Thus, the brain vascular barriers were effective in restricting the entry of SP into brain parenchyma in young healthy mice. While both anti-ACE2 and anti-SP antibodies suppressed SP biodistribution and organ uptake, anti-SP antibody was more effective. By extension, our data support the efficacy of these antibodies on SARS-CoV-2 multiorgan tropism, which could determine COVID-19 organ-specific outcomes.

A scoping review of physical activity interventions for older adults.

BACKGROUND: To inform implementation and future research, this scoping review investigates the volume of evidence for physical activity interventions among adults aged 60+. Our research questions are: (1) what is the evidence regarding interventions designed to increase total physical activity in adults aged 60+ years, in accordance with three of the four strategic objectives of GAPPA (active societies, active environments, active people); (2) what is the current evidence regarding the effectiveness of physical activity programmes and services designed for older adults?; and (3) What are the evidence gaps requiring further research? METHODS: We searched PEDro, MEDLINE, CINAHL and Cochrane from 1 January 2010 to 1 November 2020 for systematic reviews and meta-analyses of physical activity interventions in adults aged 60+. We identified interventions designed to: (1) increase physical activity; and (2) deliver physical activity programmes and services in home, community or outpatient settings. We extracted and coded data from eligible reviews according to our proposed framework informed by TIDieR, Prevention of Falls Network Europe (PROFANE), and WHO's International Classification of Functioning, Disability and Health (ICF). We classified the overall findings as positive, negative or inconclusive. RESULTS: We identified 39 reviews of interventions to increase physical activity and 342 reviews of programmes/services for older adults. Interventions were predominantly structured exercise programmes, including balance strength/resistance training, and physical recreation, such as yoga and tai chi. There were few reviews of health promotion/coaching and health professional education/referral, and none of sport, workplace, sociocultural or environmental interventions. Fewer reported outcomes of total physical activity, social participation and quality of life/well-being. We noted insufficient coverage in diverse and disadvantaged samples and low-middle income countries. CONCLUSIONS: There is a modest but growing volume of evidence regarding interventions designed to increase total physical activity in older adults, although more interventional studies with long term follow-up are needed, particularly for GAPPA 1. Active Societies and GAPPA 2. Active Environments. By comparison, there is abundant evidence for GAPPA 3. specific programmes and services, but coverage of sport and workplace interventions, and diverse samples and settings is lacking. Comprehensive reviews of individual studies are now needed as well as research targeting neglected outcomes, populations and settings.

Development of a Novel, Genome Subtraction-Derived, SARS-CoV-2-Specific COVID-19-nsp2 Real-Time RT-PCR Assay and Its Evaluation Using Clinical Specimens.

The pandemic novel coronavirus infection, Coronavirus Disease 2019 (COVID-19), has affected at least 190 countries or territories, with 465,915 confirmed cases and 21,031 deaths. In a containment-based strategy, rapid, sensitive and specific testing is important in epidemiological control and clinical management. Using 96 SARS-CoV-2 and 104 non-SARS-CoV-2 coronavirus genomes and our in-house program, GolayMetaMiner, four specific regions longer than 50 nucleotides in the SARS-CoV-2 genome were identified. Primers were designed to target the longest and previously untargeted nsp2 region and optimized as a probe-free real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. The new COVID-19-nsp2 assay had a limit of detection (LOD) of 1.8 TCID50/mL and did not amplify other human-pathogenic coronaviruses and respiratory viruses. Assay reproducibility in terms of cycle threshold (Cp) values was satisfactory, with the total imprecision (% CV) values well below 5%. Evaluation of the new assay using 59 clinical specimens from 14 confirmed cases showed 100% concordance with our previously developed COVID-19-RdRp/Hel reference assay. A rapid, sensitive, SARS-CoV-2-specific real-time RT-PCR assay, COVID-19-nsp2, was developed.