Cerebral Regional Homogeneity Alternation of Pregnant Women With Antenatal Depression During the Pandemic.

Purpose: The COVID-19 epidemic has been a threat to the health of people all over the world. Various precautions during COVID-19 in China have kept a large number of people in isolation, and this has inconvenienced and placed enormous stress on pregnant women. Pregnant women are more likely to suffer from antenatal depression (ANDP) with social isolation or low social support. This research aims to investigate the neurobiological mechanisms underlying ANDP, which impedes early detection and intervention in this disorder. Methods: A total of 43 singleton pregnant women who experienced isolation were recruited, including 21 treatment-naïve ANDP patients and 22 healthy pregnant women (HPW). To explore the intrinsic cerebral activity alternations in ANDP using resting-state functional MRI (rsfMRI), we assessed the local regional homogeneity (ReHo) differences in two groups using the voxel-based whole-brain analysis. The correlation between the regional functional abnormalities and clinical variables in ANDP patients was also examined. Results: Compared with HPW, ANDP patients showed decreased ReHo in the left dorsolateral prefrontal cortex, right insular and the cluster coving the right ventral temporal cortex (VTC), amygdala (AMG), and hippocampus (HIP). The Edinburgh Postnatal Depression Scale (EPDS) scores of ANDP patients negatively correlated with the ReHo in the right VTC, AMG, and HIP. Conclusion: Elucidating the neurobiological features of ANDP patients during COVID-19 is crucial for evolving adequate methods for early diagnosis, precaution, and intervention in a future epidemic.

Initial Experience with Pediatrics Online Learning for Nonclinical Medical Students During the COVID-19 Pandemic (preprint)

Background: To minimize the risk of infection during the COVID-19 pandemic, the learning mode of universities in China has been adjusted, and the online learning of clinical medicine is facing great challenges. This study preliminarily discusses the experience of express team-based learning (eTBL) combined with a flipped classroom (FC) and case-based learning (CBL) online for nonclinical medical students and addresses the distribution of online learning resources used in pediatrics. This study helps to document additional experience in online learning during the global trend of digital learning. Methods: When online learning was fully launched at Sichuan University in the spring of 2020, 236 penultimate-year students of nonclinical medicine majors were selected as the research objects. The penultimate-year students of the same majors in the spring of 2019 were taken as the reference objects. The research objects successively used the methods of eTBL combined with FC and CBL methods to conduct online learning in pediatrics, and students were encouraged to search and share online learning resources. The reference objects used the method of eTBL combined with CBL for offline face-to-face learning, and the test results of the two learning environments were compared. At the end of the pediatrics course in the spring of 2020, the research objects were invited to participate anonymously in an online questionnaire survey involving 12 items on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree) to evaluate the participation, satisfaction, and distribution of online learning resources used in pediatrics. Results: 1. Student participation and test scores: i. A total of 75.8% (179/236) of the respondents completed the questionnaire effectively, and 7 items on the Likert scale indicated that online learning with eTBL + FC had higher student participation than eTBL + CBL (4.64 vs 4.27, P < 0.001). ii. In the spring of 2019 and 2020, the average scores of the last four subjects were higher than those of the first four subjects (P < 0.001). The average scores of online learning courses in the spring of 2020 were higher than those of offline learning in the spring of 2019 (P < 0.001). 2. Online learning resources: i. The main motivations for students to use online learning resources were pre-class preparation (4.83), class discussion (4.28) and pre-class testing (3.79). ii. A total of 72.9% (129/179) of the students “most or all of the time” searched online learning resources in the pre-class preparation stage. iii. Students' online learning resources mainly included Chinese academic databases, search engines, teaching platforms and foreign databases. iv. The information retrieval ability of students was improved after the above online learning methods (after versus before, Mdn 5 VS 4, U = 591.0, P = 0.007). 3. More students thought that the online learning method of eTBL + CBL was more beneficial for understanding than that of eTBL + FC (P = 0.044), while the online learning method of eTBL + FC was more conducive for online learning resource retrieval than that of eTBL + CBL (P = 0.034), and the workload was greater (P = 0.001). Both of the online learning methods were conducive to online learning resource sharing (P = 0.298). 4. The results of five items on the Likert scale in the questionnaire showed that students' satisfaction with the online learning mode was high (4.16). Conclusion: i. During the COVID-19 pandemic, online eTBL shortened the learning time of typical TBL. After online learning with eTBL, in combination with FC, CBL and the use of online learning resources, students had high rates of participation and satisfaction. ii. Online learning test results were as good as offline test results. iii. The main motivation for students to use online learning resources came from learning tasks. Chinese academic databases and search engines were the main learning resources for nonclinical medical students. iv. Both online combined learning methods were helpful for students to share online learning resources. eTBL + FC was more helpful in retrieving online learning resources, and the workload was also larger, while eTBL + CBL was more helpful for students to understand course content.

Community evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission through air.

BACKGROUND: Nine COVID-19 (Corona Virus Disease, 2019) cases were observed in one community in Guangzhou. All the cases lived in three vertically aligned units of one building sharing the same piping system, which provided one unique opportunity to examine the transmission mode of SARS-CoV-2. METHODS: We interviewed the cases on the history of travelling and close contact with the index patients. Respiratory samples from all the cases were collected for viral phylogenetic analyses. A simulation experiment in the building and a parallel control experiment in a similar building were then conducted to investigate the possibility of transmission through air. RESULTS: Index patients living in Apartment 15-b had a travelling history in Wuhan, and four cases who lived in Apartment 25-b and 27-b were subsequently diagnosed. Phylogenetic analyses showed that virus of all the patients were from the same strain of the virus. No close contacts between the index cases and other families indicated that the transmission might not occur through droplet and close contacts. Airflow detection and simulation experiment revealed that flushing the toilets could increase the speed of airflow in the pipes and transmitted the airflow from Apartment 15-b to 25-b and 27-b. Reduced exhaust flow rates in the infected building might have contributed to the outbreak. CONCLUSIONS: The outbreak of COVID-19 in this community could be largely explained by the transmission through air, and future efforts to prevent the infection should take the possibility of transmission through air into consideration. A disconnected drain pipe and exhaust pipe for toilet should be considered in the architectural design to help prevent possible virus spreading through the air.