Application of Multidisciplinary Diagnosis and Treatment (MDT) Clinical Teaching Model in the Clinical Teaching of Some Undergraduates of Breast Diseases in Surgery (preprint)

Background Breast surgery, emerging as an independent discipline with a wealth of specialist cases and an extensive case resource library in medical history. Contemporary clinical teaching faces challenges with traditional methods unable to address students' theoretical strength and practical limitations. The COVID-19 pandemic further strained learning environments, limiting students' exposure to patient diagnosis and treatment. Conventional clinical teaching, organized by disciplines, often results in technical isolation and a narrow clinical perspective, impeding the development of well-rounded medical professionals. Multidisciplinary Comprehensive Diagnosis and Treatment (MDT) emerges as a patient-centric, collaborative approach involving various medical departments in clinical decision-making. Despite its success in clinical settings, the effectiveness of MDT in undergraduate medical education remains largely unexplored.Methods This study conducted at the Breast Department of the First Affiliated Hospital of Zhengzhou University, aimed to compare the learning outcomes of clinical interns under traditional and MDT teaching modes. In a randomized controlled trial with 140 participants, the MDT group received comprehensive training from diverse healthcare professionals, while the traditional group had standard teaching. Evaluation included pre-test and post-test assessments on knowledge acquisition, skill acquisition, and clinical decision-making. Longitudinal analysis and statistical tests, including t-tests and multiple regression, were employed.Results A total of 140 clinical medicine students participated, randomly assigned to MDT (n = 70) and Traditional Teaching Mode (n = 70) groups. Key baseline characteristics, such as age, gender, and completion rates, were comparable between groups. For each group’s pre- and post-test scores, MDT group means consistently surpassed Traditional Teaching Mode, with significant differences (p < 0.05).Correlation analysis showed that there were no significant variable correlations between individual performance characteristics and test scores. Post-training, significant score improvements were observed in both groups across all tests (p < 2.2e-16). Utilizing the Wilcoxon rank sum test, pre-test differences were not significant. However, post-test scores favored the MDT group significantly (p = 0.0016, 2.8e-09, 3.6e-07). For students pursuing a master's, no statistically significant differences in specialty choice were observed between groups, though a trend towards more MDT students choosing surgical specialties was noted.Conclusion This study pioneers the application of the MDT teaching method in breast cancer clinical education, comparing its efficacy against traditional teaching modes. Findings demonstrate that MDT-based breast cancer diagnosis and treatment education is more efficient and optimized, offering a transformative basis for clinical undergraduate education reform in China. The results advocate for the reconfiguration of multidisciplinary consultation clinical teaching and traditional methods, promising enhanced educational outcomes and heightened medical student knowledge.

Rare Fundus Lesions in Patients after SARS-Cov-2 Infection: A Multicenter and Multimodal Imaging Study (preprint)

Purpose To define the characteristics of fundus manifestations in patients after SARS-Cov-2 infection with multimodal imaging techniques.Methods This is a retrospective multicenter and multimodal imaging study including 90 patients. All patients with a visual complaint occurring immediately after SARS-Cov-2 infection were referred to six clinics between December 2022 and February 2023. Demographic information and the temporal relationship between SARS-Cov-2 infection and visual symptoms were documented. The characteristics of the fundus lesions were evaluated using multimodal imaging.Results Ninety patients from six hospitals were enrolled in this study, including 24 males (26.67%) and 66 (73.33%) females. Seventy-eight patients (86.66%) (146 eyes) were diagnosed with AMN. The AMN patients were primarily young women (67.95%). Sixty-eight patients (87.18%) had AMN in both eyes. Thirty-eight eyes (24.36%) included Purtscher or Purtscher-like lesions. optical coherence tomography and infrared retinal photographs can show AMN lesions well. Eleven cases were diagnosed with simple Purtscher or Purtscher-like retinopathy (2 cases, 2.22%), VKH or VKH-like uveitis (3 cases, 3.33%), MEWDS (2 cases, 2.22%), and ROCM (5 cases, 5.56%).Conclusions After SARS-Cov-2 infection, diversified fundus lesions were evident in patients with visual complaints. In this report, AMN was the dominant manifestation, followed by Purtscher or Purtscher-like retinopathy, MEWDS, VKH-like uveitis, and ROCM.

ACE2 negatively regulates the Warburg effect and suppresses hepatocellular carcinoma progression via reducing ROS-HIF1α activity.

Aerobic glycolysis has pleiotropic roles in the pathogenesis of hepatocellular carcinoma (HCC). Emerging studies revealed key promoters of aerobic glycolysis, however, little is known about its negative regulators in HCC. In this study, an integrative analysis identifies a repertoire of differentially expressed genes (DNASE1L3, SLC22A1, ACE2, CES3, CCL14, GYS2, ADH4, and CFHR3) that are inversely associated with the glycolytic phenotype in HCC. ACE2, a member of the rennin-angiotensin system, is revealed to be downregulated in HCC and predicts a poor prognosis. ACE2 overexpression significantly inhibits the glycolytic flux as evidenced by reduced glucose uptake, lactate release, extracellular acidification rate, and the expression of glycolytic genes. Opposite results are noticed in loss-of-function studies. Mechanistically, ACE2 metabolizes Ang II to Ang-(1-7), which activates Mas receptor and leads to the phosphorylation of Src homology 2-containing inositol phosphatase 2 (SHP-2). SHP2 activation further blocks reactive oxygen species (ROS)-HIF1α signaling. Addition of Ang-(1-7) or the antioxidant N-acetylcysteine compromises in vivo additive tumor growth and aerobic glycolysis induced by ACE2 knockdown. Moreover, growth advantages afforded by ACE2 knockdown are largely glycolysis-dependent. In clinical settings, a close link between ACE2 expression and HIF1α or the phosphorated level of SHP2 is found. Overexpression of ACE2 significantly retards tumor growth in patient-derived xenograft model. Collectively, our findings suggest that ACE2 is a negative glycolytic regulator, and targeting the ACE2/Ang-(1-7)/Mas receptor/ROS/HIF1α axis may be a promising therapeutic strategy for HCC treatment.

Who benefits and appreciates more? An evaluation of Online Service-Learning Projects in Mainland China during the COVID-19 pandemic.

Previous studies have reported the feasibility and benefits of online service learning, but little is known about who benefits more from online SL and who is more satisfied. This study addressed these questions based on an evaluation of online service learning projects implemented in Xi'an and Chengdu, China, during the COVID-19 pandemic. Pretest-posttest comparison showed significant positive changes in two intended learning outcomes (i.e., positive youth development qualities and service leadership qualities) and life satisfaction before and after the service among participating students in the Xi'an project. Cross-lagged modeling based on Xi'an and Chengdu data revealed that students with better initial positive youth development qualities tended to show increased service leadership qualities and life satisfaction after the service, while initial service leadership qualities did not predict positive youth development qualities and life satisfaction after the service. However, the two-line test indicated that some of these relationships might be curvilinear. Finally, Pearson correlation analyses demonstrated that students who experienced greater changes in positive youth development qualities and service leadership qualities reported better appraisal of course qualities, teacher performance, and course effectiveness, while multiple regression analyses showed the unique effects of change in service leadership qualities (but not change in positive youth development qualities) on the perception of teacher performance and course effectiveness. Altogether, this study not only showcases the potential benefits of online SL, but also provides initial evidence suggesting the variation in (perceived) benefits by students' psychosocial competencies and learning experiences.

Determinants of quality of life in frontline healthcare providers caring for COVID-19 patients.

AIMS AND OBJECTIVES: To investigate the factors affecting quality of life in healthcare providers who care for patients with COVID-19. BACKGROUND: Healthcare providers caring for COVID-19 patients during the pandemic suffered a deterioration in their quality of life. Several studies have explored their psychological impact of working with COVID patients, but none have examined the causes of this deterioration. DESIGN: A cross-sectional study. METHODS: In the current study, the authors investigated the factors affecting quality of life in 293 healthcare providers recruited from a medical centre in northern Taiwan who had recently cared for patients with suspected or confirmed COVID-19 by analysing their responses to an online self-report questionnaire, using bivariate correlations and structural equation modelling. Reporting of this research adheres to the STROBE guideline. RESULTS: The study identified an important sequence of factors that mediated the effects of perceived success of epidemic prevention policies, family relations problems and education level on quality of life in a sample of healthcare workers caring for COVID-19 patients. The mediators were use of approach-oriented coping strategies and current mental health status. Specifically, use of approach-oriented coping strategies was found to directly cause improved quality of life and indirectly cause improved mental health, whereas use of avoidant coping strategies was found to directly cause worsening of mental health. Poor mental health predicted poor quality of life. CONCLUSIONS: Results suggest that implementation of sound epidemic prevention policies that promote adoption of approach-oriented coping behaviour should lead to a better quality of life in the future for healthcare providers working in challenging circumstances. RELEVANCE TO CLINICAL PRACTICE: Assessment of these policies as well as the providers' family relations are necessary first steps to improving the success of approach-oriented coping behaviour in this population, which in turn can improve their mental health and quality of life. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor members of the public were involved in the design or execution of the study.

Response and duration of serum anti-SARS-CoV-2 antibodies induced by the third dose of an inactivated vaccine: A prospective longitudinal cohort study at 21 serial time points over 641 days.

Given the prevalence of low-pathogenic but highly infectious Omicron variants, a cohort study was conducted to assess the response and duration of novel coronavirus-inactivated vaccine-induced antibodies 1 year after the third dose (Day 641). Blood samples were collected and anti-spike neutralizing antibodies (neutralizing antibody), total antibodies against the receptor-binding domain of the spike protein (total antibody), and immunoglobulin G antibodies against the spike protein (IgG antibody) were determined. Antibody kinetics and attenuation were evaluated. The results showed that the levels of neutralizing, total, and IgG antibodies on Day 641 were 98.05 IU/mL, 152.8 AU/mL, and 7.68 S/CO, respectively. Levels of anti-SARS-CoV-2 antibodies were higher in the younger subgroup than in the older subgroup at several time points after the second and third doses. The seropositive rate of neutralizing antibodies providing protection from infection or severe infection was 46.87% and 87.5%, and the seropositive rates of total antibody and IgG antibody were maintained at 100% and 90.63%, respectively. The half-lives of neutralizing, total, and IgG antibodies were 186.89, 363.04, and 417.50 days, respectively. Collectively, anti-SARS-CoV-2 antibodies may provide a certain degree of protection from infection 1 year after the third dose and high protection from severe infection.

The expression of respiratory tract virus in pediatric glomerular disease: a retrospective study of 45 renal biopsy in China.

BACKGROUND: More attention has been put on the relationship between pediatric glomerular disease and respiratory tract virus infection. Children with glomerular illness, however, are uncommonly found to have biopsy-proven pathological evidence of viral infection. The purpose of this study is to determine whether and what kind of respiratory viruses are found in renal biopsy from glomerular disorders. METHODS: We used a multiplex PCR to identify a wide range of respiratory tract viruses in the renal biopsy samples (n = 45) from children with glomerular disorders and a specific PCR to verify their expression. RESULTS: These case series included 45 of 47 renal biopsy specimens, with 37.8% of male and 62.2% of female patients. Indications for a kidney biopsy were present in all of the individuals. In 80% of the samples, respiratory syncytial virus was discovered. Following that, the RSV subtypes in several pediatric renal disorders were found. There were 16 RSVA positives, 5 RSVB positives, and 15 RSVA/B positives, accounting for 44.4%, 13.9%, and 41.7%, respectively. Nephrotic syndrome samples made up 62.5% of RSVA positive specimens. The RSVA/B-positive was detected in all pathological histological types. CONCLUSIONS: Patients with glomerular disease exhibit respiratory tract viral expression in the renal tissues, especially respiratory syncytial virus. This research offers new information on the detection of respiratory tract viruses in renal tissue, which may facilitate the identification and treatment of pediatric glomerular diseases.

Effectiveness and Safety of Lianhua Qingwen Capsules for COVID-19: A Propensity-Score Matched Cohort Study.

As a traditional Chinese medicine, Lianhua Qingwen capsules have been widely used to treat Coronavirus Disease 2019 (COVID-19). This study was aimed to demonstrate the association between treatment with Lianhua Qingwen capsules and the clinical outcomes of hospitalized patients with COVID-19. This retrospective study was conducted at four hospitals in Central China. Data of hospitalized COVID-19 patients were collected between December 19, 2019 and April 26, 2020. Based on whether Lianhua Qingwen capsules were used, patients were classified into Lianhua Qingwen and non-Lianhua Qingwen (control) groups. To control for confounding factors, we used conditional logistic regression in a propensity-score matched (PSM) cohort (1 : 1 balanced), as well as logistic regression without matching as sensitivity analysis. A total of 4918 patients were included, 2760 of whom received Lianhua Qingwen capsules and 2158 of whom did not. In the PSM model, after adjusting for confounders, the in-hospital mortality was similar between the Lianhua Qingwen group and the control group (6.8% vs. 3.3%, adjusted OR, 0.66 [95% CI, 0.38-1.15], p = 0.138). The negative conversion rate of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection was higher in the Lianhua Qingwen group (88.3% vs. 96.1%, adjusted OR, 4.02 [95% CI, 2.58-6.25], p < 0.001). The incidence of acute liver injury was comparable between the two groups (14.0% vs. 11.5%, adjusted OR: 0.85 [95% CI, 0.71-1.02], p = 0.083), and the incidence of acute kidney injury was lower in the Lianhua Qingwen group (5.3% vs. 3.0%, adjusted OR: 0.71 [95% CI, 0.50-1.00], p = 0.048). Treatment with Lianhua Qingwen capsules was not significantly associated with in-hospital mortality in COVID-19 patients. In the Lianhua Qingwen group, the negative conversion rate of SARS-CoV-2 infection was higher and the incidence of acute kidney injury was lower than in the control group.

A Simple and Rapid LC-MS/MS Method for the Quantification of Nirmatrelvir/Ritonavir in Plasma of Patients with COVID-19 (preprint)

The combined prescriptions of nirmatrelvir/ritonavir (Paxlovid) and other drugs are limited due to potential interaction, so therapeutic drug monitoring (TDM) becomes particularly important. In this study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was established for determination of the nirmatrelvir/ritonavir in plasma of patients with COVID-19, providing technical and theoretical support for the TDM. Plasma samples were processed by protein precipitation using acetonitrile and analytes were separated on an Agilent Poroshell 120 SB-C18 (2.1×75 mm,2.7 μm) column at 35°C. Acetonitrile and 0.1% formic acid in water (52:48, V:V) was utilized as the mobile phases at a flow rate of 0.3 mL/min. In multiple reaction monitoring (MRM) mode, nirmatrelvir and ritonavir were monitored using precursor/product ions: m/z 500.2/110.1 and 721.3/296.1, respectively, with selinexor as internal standard. The linear range of both analytes was 2.0-5000.0 ng/mL with good intra-and intra-day precision and accuracy, and the recovery was 91.95%-106.67% for nirmatrelvir, and 85.72%-105.84% for ritonavir. Finally, this method was successfully applied to monitor the exposure levels of nirmatrelvir/ritonavir in plasma samples from hemodialysis patients.

Bibliometric analysis of articles published by scholars working in hospital management field among 12 top universities in China. (preprint)

Background Research on hospital management is essential for enhancing healthcare systems and optimizing the utilization of scarce medical resources. There are, however, few publications that give a comprehensive overview of the status of research in this field in China. By using bibliometric analysis, this study aims to pinpoint research hotspots and trends among Chinese scholars working in the hospital management administration.Methods Chinese academics served in 12 prestigious universities in the field of hospital management were included. The original articles written in English and published by them between January 1st, 2018 and December 31st, 2022 on the Web of Science Core Collection (WOSCC) database were retrieved. After removing duplicates and wrongly included studies, the bibliometric analysis methods in Biblioshiny were performed to further analyze and visualize the publications. A variety of sources including paper quantities, journals, institutions, authors, keywords, collaboration, research subjects and thematic maps were represented to pinpoint the hotspots and trends of research in the field of hospital management in China.Results A total of 1022 original articles published by 67 scholars in the field of hospital management in China’s top 12 universities were included, with average annual growth of 21.64%. International collaboration was on the rise, with close ties to the United States, Germany, and Australia. Research has primarily concentrated on disease diagnosis, treatment methodologies, and health policy during the past 5 years. Additionally, due to the ongoing Corona Virus Disease of 2019 (COVID-19) pandemic, pertinent studies like telemedicine have surged dramatically.Conclusions This study revealed that the quantities of publications increased rapidly, and the majority of these studies focused on epidemiology and healthcare system. To facilitate China's healthcare system evolution and to improve its effectiveness, more resources and efforts should be put into studies in the domain of hospital management, which are still insufficient and lack high-quality publications.

Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID-19 pandemic in Central China.

Background: Globally, the epidemiology of non-SARS-CoV-2 respiratory viruses like respiratory syncytial virus (RSV) and influenza virus was remarkably influenced by the implementation of non-pharmacological interventions (NPIs) during the COVID-19 pandemic. Our study explored the epidemiological and clinical characteristics of pediatric patients hospitalized with RSV or influenza infection before and during the pandemic after relaxation of NPIs in central China. Methods: This hospital-based prospective case-series study screened pediatric inpatients (age ≤ 14 years) enrolled with acute respiratory infections (ARI) for RSV or influenza infection from 2018 to 2021. The changes in positivity rates of viral detection, epidemiological, and clinical characteristics were analyzed and compared. Results: Median ages of all eligible ARI patients from 2018-2019 were younger than those from 2020-2021, so were ages of cases infected with RSV or influenza (RSV: 4.2 months vs. 7.2 months; influenza: 27.3 months vs. 37.0 months). Where the positivity rate for influenza was considerably decreased in 2020-2021 (1.4%, 27/1964) as compared with 2018-2019 (2.9%, 94/3275, P < 0.05), it was increased for RSV (11.4% [372/3275] vs. 13.3% [262/1964], P < 0.05) in the same period. The number of severe cases for both RSV and influenza infection were also decreased in 2020-2021 compared with 2018-2019. Conclusions: The implemented NPIs have had varied impacts on common respiratory viruses. A more effective prevention strategy for RSV infections in childhood is needed.

An Exploratory Study of Nurses' Feelings about COVID-19 after Experiencing SARS.

The outbreak of severe acute respiratory syndrome (SARS) in 2003 in Taiwan impacted Taiwanese society. However, the first case of coronavirus disease 2019 (COVID-19) was reported in Wuhan and spread around the world. During these outbreaks, nursing staff experienced different levels of pressure. Studies have explored the stress and adjustment of nurses during these periods, but studies describing the feelings of nurses during both SARS and COVID-19 outbreaks are lacking. The aim of this study was to explore the experiences of nurses who had cared for both SARS and COVID-19 patients. A qualitative study combined with snowball sampling was applied. Semi-structured questions were used to interview 10 nurses who had experienced both SARS and COVID-19. Two themes and four sub-themes were analyzed, which were: facing the epidemic from the unknown to known; and the experiences from ignorance to proficiency. The sub-themes were: the feeling of frustration and concern; bottlenecks and pressures in my work; my mission and support; and positive energy and camaraderie. The results showed that the media acts as an important resource during disease outbreaks; therefore, government departments have to use their wisdom to make good use of the media. Secondly, understanding the general public's response to the disease is also important for first-line nurses. Finally, on-the-job education and guidelines for first-line nurses are necessary, and support from the administration is also important.

The first imported case of monkeypox in Taiwan.

he first imported case of monkeypox in Taiwan was diagnosed in an Asian man with HIV-1 infection and asymptomatic COVID-19, returning from Germany. Atypical presentations included asynchronous skin lesions, anogenital lesions and prominent inguinal lymphadenopathy. Whole genomic sequence alignment indicate that the Taiwan strain clustered together with human monkeypox virus West African clade B.1, currently circulating in Europe. Prompt diagnosis and infection control measures are crucial to mitigate the spread of monkeypox.

Epidemiological and clinical characteristics of respiratory syncytial virus and influenza infections in hospitalized children before and during the COVID‐19 pandemic in Central China

Background Globally, the epidemiology of non‐SARS‐CoV‐2 respiratory viruses like respiratory syncytial virus (RSV) and influenza virus was remarkably influenced by the implementation of non‐pharmacological interventions (NPIs) during the COVID‐19 pandemic. Our study explored the epidemiological and clinical characteristics of pediatric patients hospitalized with RSV or influenza infection before and during the pandemic after relaxation of NPIs in central China. Methods This hospital‐based prospective case‐series study screened pediatric inpatients (age ≤ 14 years) enrolled with acute respiratory infections (ARI) for RSV or influenza infection from 2018 to 2021. The changes in positivity rates of viral detection, epidemiological, and clinical characteristics were analyzed and compared. Results Median ages of all eligible ARI patients from 2018–2019 were younger than those from 2020–2021, so were ages of cases infected with RSV or influenza (RSV: 4.2 months vs. 7.2 months;influenza: 27.3 months vs. 37.0 months). Where the positivity rate for influenza was considerably decreased in 2020–2021 (1.4%, 27/1964) as compared with 2018–2019 (2.9%, 94/3275, P < 0.05), it was increased for RSV (11.4% [372/3275] vs. 13.3% [262/1964], P < 0.05) in the same period. The number of severe cases for both RSV and influenza infection were also decreased in 2020–2021 compared with 2018–2019. Conclusions The implemented NPIs have had varied impacts on common respiratory viruses. A more effective prevention strategy for RSV infections in childhood is needed.

Analysis of home gymnastics during covid-19 / Análise da ginástica doméstica durante a covid-19 / Análisis de la gimnasia doméstica durante el covid-19

ABSTRACT Introduction Gymnastics has become a viral sport thanks to home isolation and low requirements for sports venues and equipment. However, evidence is still lacking that home gymnastics can maintain physical and psychological function stability, even if performed correctly. Objective Analyze the effects of home gymnastics during covid-19 restrictions. Methods This experiment adopts the intragroup control method, five times a week for four weeks. Before and after the experiment, relevant data such as baseline physical quality, body shape, body composition, and exercise indexes are collected. The data are compared and analyzed statistically. Results Home gymnastics can effectively improve the body composition of its practitioners, improve basal metabolism, improve their body shape, improve cardiopulmonary function, and make athletes maintain good exercise ability, good lifestyle habits, and a healthy mentality. Conclusion It is recommended that teachers and interested departments actively organize students at home to perform corresponding gymnastics and use sports to ward off bad lifestyle habits and anxiety, promoting good physical and psychological function during home isolation. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução A ginástica tornou-se um esporte viral graças ao isolamento doméstico e devido a suas baixas exigências para locais e equipamentos esportivos. Porém ainda faltam evidências de que a ginástica em casa possa manter a estabilidade da função física e psicológica, ainda que executada corretamente. Objetivo Analisar os efeitos da ginástica doméstica durante as restrições da covid-19. Métodos Este experimento adota o método de controle intragrupo, cinco vezes por semana durante quatro semanas. Antes e depois do experimento, os dados relevantes como qualidade física basal, forma corporal, composição corporal e índices de exercício são coletados. Os dados são comparados e analisados estatisticamente. Resultados A ginástica em casa pode efetivamente melhorar a composição corporal dos seus praticantes, melhorar o metabolismo basal, melhorar sua forma corporal, melhorar a função cardiopulmonar, e fazer com que os esportistas mantenham boa capacidade de exercício, bons hábitos de vida e mentalidade saudável. Conclusão Recomenda-se aos professores e departamentos interessados a organizarem ativamente os estudantes em casa para realizar a ginástica correspondente e usar o esporte para afastar os maus hábitos de vida e a ansiedade, promovendo uma boa função física e psicológica durante o isolamento doméstico. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La gimnasia se ha convertido en un deporte viral gracias al aislamiento doméstico y a sus escasas necesidades de instalaciones y equipamiento deportivo. Sin embargo, todavía no hay pruebas de que la gimnasia doméstica pueda mantener la estabilidad de la función física y psicológica, incluso si se realiza correctamente. Objetivo Analizar los efectos de la gimnasia domiciliaria durante las restricciones de covid-19. Métodos Este experimento adopta el método de control intragrupo, cinco veces por semana durante cuatro semanas. Antes y después del experimento, se recogen datos relevantes como la calidad física de referencia, la forma corporal, la composición corporal y los índices de ejercicio. Los datos se comparan y se analizan estadísticamente. Resultados La gimnasia en casa puede mejorar eficazmente la composición corporal de sus practicantes, mejorar el metabolismo basal, mejorar su forma corporal, mejorar la función cardiopulmonar y hacer que los deportistas mantengan una buena capacidad de ejercicio, buenos hábitos de vida y una mentalidad saludable. Conclusión Se recomienda a los profesores y a los departamentos interesados que organicen activamente a los alumnos en casa para que realicen la gimnasia correspondiente y utilicen el deporte para alejar los malos hábitos de vida y la ansiedad, promoviendo un buen funcionamiento físico y psicológico durante el aislamiento en casa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Nasal swab is a good alternative sample for detecting SARS-CoV-2 with rapid antigen test: A meta-analysis.

BACKGROUND: We aim to determine if nasal samples have equivalent detection sensitivity to nasopharyngeal swabs for RAT and evaluate the diagnostic accuracy of nasal swabs with RAT. METHODS: PubMed and Web of Science were searched for eligible studies published before August 23, 2022. A bivariate random effects model was used to perform the quantitative synthesis. RESULTS: The pooled sensitivity, pooled specificity, positive likelihood ratio, negative likelihood ratio, and summary AUC on nasal swabs with RAT were 0.81 (95% CI, 0.77-0.85), 1.00 (95% CI: 0.99-1.00), 0.97 (95% CI, 0.95-0.98), 298.91 (95% CI, 144.71-617.42) and 0.19 (95% CI, 0.15-0.23), respectively. WHO required RAT kits to perform with a sensitivity of 0.80 and a specificity of 0.97, nasal swabs (0.81) achieved the required sensitivity while nasopharyngeal swabs (0.75) did not. The symptomatic population yielded higher pooled sensitivity than the asymptomatic population (0.86 versus 0.71), with a pooled sensitivity of 0.90 for five days of symptom onset. CONCLUSION: Nasal sampling had a great performance and yielded a high sensitivity in detecting SARS-CoV-2 using RAT, we believe that RAT performed with nasal swabs is a good alternative for detecting SARS-CoV-2, especially early in the onset of symptoms.

Analysis of home gymnastics during covid-19 / Análise da ginástica doméstica durante a covid-19 / Análisis de la gimnasia doméstica durante el covid-19

ABSTRACT Introduction Gymnastics has become a viral sport thanks to home isolation and low requirements for sports venues and equipment. However, evidence is still lacking that home gymnastics can maintain physical and psychological function stability, even if performed correctly. Objective Analyze the effects of home gymnastics during covid-19 restrictions. Methods This experiment adopts the intragroup control method, five times a week for four weeks. Before and after the experiment, relevant data such as baseline physical quality, body shape, body composition, and exercise indexes are collected. The data are compared and analyzed statistically. Results Home gymnastics can effectively improve the body composition of its practitioners, improve basal metabolism, improve their body shape, improve cardiopulmonary function, and make athletes maintain good exercise ability, good lifestyle habits, and a healthy mentality. Conclusion It is recommended that teachers and interested departments actively organize students at home to perform corresponding gymnastics and use sports to ward off bad lifestyle habits and anxiety, promoting good physical and psychological function during home isolation. Level of evidence II; Therapeutic studies - investigating treatment outcomes.

RESUMO Introdução A ginástica tornou-se um esporte viral graças ao isolamento doméstico e devido a suas baixas exigências para locais e equipamentos esportivos. Porém ainda faltam evidências de que a ginástica em casa possa manter a estabilidade da função física e psicológica, ainda que executada corretamente. Objetivo Analisar os efeitos da ginástica doméstica durante as restrições da covid-19. Métodos Este experimento adota o método de controle intragrupo, cinco vezes por semana durante quatro semanas. Antes e depois do experimento, os dados relevantes como qualidade física basal, forma corporal, composição corporal e índices de exercício são coletados. Os dados são comparados e analisados estatisticamente. Resultados A ginástica em casa pode efetivamente melhorar a composição corporal dos seus praticantes, melhorar o metabolismo basal, melhorar sua forma corporal, melhorar a função cardiopulmonar, e fazer com que os esportistas mantenham boa capacidade de exercício, bons hábitos de vida e mentalidade saudável. Conclusão Recomenda-se aos professores e departamentos interessados a organizarem ativamente os estudantes em casa para realizar a ginástica correspondente e usar o esporte para afastar os maus hábitos de vida e a ansiedade, promovendo uma boa função física e psicológica durante o isolamento doméstico. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La gimnasia se ha convertido en un deporte viral gracias al aislamiento doméstico y a sus escasas necesidades de instalaciones y equipamiento deportivo. Sin embargo, todavía no hay pruebas de que la gimnasia doméstica pueda mantener la estabilidad de la función física y psicológica, incluso si se realiza correctamente. Objetivo Analizar los efectos de la gimnasia domiciliaria durante las restricciones de covid-19. Métodos Este experimento adopta el método de control intragrupo, cinco veces por semana durante cuatro semanas. Antes y después del experimento, se recogen datos relevantes como la calidad física de referencia, la forma corporal, la composición corporal y los índices de ejercicio. Los datos se comparan y se analizan estadísticamente. Resultados La gimnasia en casa puede mejorar eficazmente la composición corporal de sus practicantes, mejorar el metabolismo basal, mejorar su forma corporal, mejorar la función cardiopulmonar y hacer que los deportistas mantengan una buena capacidad de ejercicio, buenos hábitos de vida y una mentalidad saludable. Conclusión Se recomienda a los profesores y a los departamentos interesados que organicen activamente a los alumnos en casa para que realicen la gimnasia correspondiente y utilicen el deporte para alejar los malos hábitos de vida y la ansiedad, promoviendo un buen funcionamiento físico y psicológico durante el aislamiento en casa. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Minimal mRNA uptake and inflammatory response to COVID-19 mRNA vaccine exposure in human placental explants (preprint)

Despite universal recommendations for COVID-19 mRNA vaccination in pregnancy, uptake has been lower than desired. There have been limited studies of the direct impact of COVID-19 mRNA vaccine exposure in human placental tissue. Using a primary human villous explant model, we investigated the uptake of two common mRNA vaccines (BNT162b2 Pfizer-BioNTech or mRNA-1273 Moderna), and whether exposure altered villous cytokine responses. Explants derived from second or third trimester chorionic villi were incubated with vaccines at supraphysiologic concentrations and analyzed at two time points. We observed minimal uptake of mRNA vaccines in placental explants by in situ hybridization and quantitative RT-PCR. No specific or global cytokine response was elicited by either of the mRNA vaccines in multiplexed immunoassays. Our results suggest that the human placenta does not readily absorb the COVID-19 mRNA vaccines nor generate a significant inflammatory response after exposure.