The relationships of preventive behaviors and psychological resilience with depression, anxiety, and stress among university students during the COVID-19 pandemic: A two-wave longitudinal study in Shandong Province, China.

Introduction: Studies have shown that the psychological impact of the COVID-19 pandemic may lead to long-term health problems; therefore, more attention should be paid to the mental health of university students. This study aimed to explore the longitudinal effects of preventive behaviors and psychological resilience on the mental health of Chinese college students during COVID-19. Methods: We recruited 2,948 university students from five universities in Shandong Province. We used a generalized estimating equation (GEE) model to estimate the impact of preventive behaviors and psychological resilience on mental health. Results: In the follow-up survey, the prevalence of anxiety (44.8% at T1 vs 41.2% at T2) and stress (23.0% at T1 vs 19.6% at T2) decreased over time, whereas the prevalence of depression (35.2% at T1 vs 36.9% at T2) increased significantly (P < 0.001). Senior students were more likely to report depression (OR = 1.710, P < 0.001), anxiety (OR = 0.815, P = 0.019), and stress (OR = 1.385, P = 0.011). Among all majors, medical students were most likely to report depression (OR = 1.373, P = 0.021), anxiety (OR = 1.310, P = 0.040), and stress (OR = 1.775, P < 0.001). Students who wore a mask outside were less likely to report depression (OR = 0.761, P = 0.027) and anxiety (OR = 0.686, P = 0.002) compared to those who did not wear masks. Students who complied with the standard hand-washing technique were less likely to report depression (OR = 0.628, P < 0.001), anxiety (OR = 0.701, P < 0.001), and stress (OR = 0.638, P < 0.001). Students who maintained a distance of one meter in queues were less likely to report depression (OR = 0.668, P < 0.001), anxiety (OR = 0.634, P < 0.001), and stress (OR = 0.638, P < 0.001). Psychological resilience was a protective factor against depression (OR = 0.973, P < 0.001), anxiety (OR = 0.980, P < 0.001), and stress (OR = 0.976, P < 0.001). Discussion: The prevalence of depression among university students increased at follow-up, while the prevalence of anxiety and stress decreased. Senior students and medical students are vulnerable groups. University students should continue to follow relevant preventive behaviors to protect their mental health. Improving psychological resilience may help maintain and promote university students' mental health.

Chinese young people's perceptions and preferences with regard to various edible urban plants. / 中国年轻人对各种可食用城市植物的看法和偏好.

The World Health Organization (WHO) defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO, 2017), and mental health is defined as not only the absence of mental illness, but also the presence of psychological well-being. An expanding body of evidence highlights the relationship between nature (such as urban greenspace) and health (Li et al., 2019; Flaxman et al., 2020). However, human development and subsequent effects such as climate change and epidemic disease (COVID-19) lead to altered living environments and lifestyles. Expanding cities and urban residents have inequitable access to nature, particularly in areas of greater depriv­ation, where both public and private greenspaces are less available (Feng et al., 2021). In addition, young people spend more than 80% of their time indoors due to constant use of electronic devices for work, study, and entertainment (Klepeis et al., 2001). Mobile phones, personal computers, and video-game devices have become the main means for them to release stress. Excessive use of these electronic devices may affect normal brain activity, increasing the risk of Internet addiction and producing a range of physical and mental problems (Tran et al., 2017). These signal the pressing need for scientific investigation of efficient and convenient ways to increase contact with nature, or alternatively, to better regulate emotions indoors.

Clinical study of lurasidone combined with nutritional intervention strategy in the treatment of chronic schizophrenia

BackgroundSchizophrenia is a complex mental disorder with a chronic course. The atypical antipsychotics represented by lurasidone are commonly used in chronic schizophrenia, and its mechanism of action determines the superiority of efficacy and safety. However so far, there are still some adverse reactions, of which the more significant are lethargy, nausea, and sedentary inability. In view of these situations, we will combine nutrition intervention with the use of lurasidone to eliminate adverse reactions and provide help for the formulation of treatment plans.Subjects and MethodsThe study will be based on whether to add nutrition intervention as a difference set up control experiment, the experimental group using lurasidone combined nutrition intervention, the control group using lurasidone single factor intervention. The patients who received treatment in the psychiatric department of our hospital from March 2021 to March 2022 were selected as the research objects, and the efficacy and adverse reactions of the patients were monitored during the treatment. The efficacy will be judged by the medical scale of symptom severity of patients with schizophrenia (Positive and Negative Syndrome Scale, PANSS) and the monitoring data will be statistically analyzed by SPSS.ResultsWith the treatment, the results of the Experimental group and the control group are shown in Table 1. The PANSS scores of the two groups finally reached a range of 30-40, with a difference of 4. The incidence of nausea, lethargy and sedentary disorder in adverse symptoms was higher in the control group, and the difference was statistically significant (P < 0.05). It shows that nutritional intervention cannot affect the efficacy of psychosis itself, yet can alleviate the adverse symptoms after medication.Table 1.Efficacy and adverse reactions of the two groupsGroupPANSSNauseaSomnolenceSedentary disorderExperimental group (n=46)32.3±4.13(6.5%)4(8.7%)2(4.3%)Control group (n=41)36.3±5.28(19.5%)6(14.6%)5(12.2%)P>0.05<0.05<0.05<0.05ConclusionsThe group of schizophrenics is not limited to a certain age. Therefore, adverse symptoms caused by psychotropic drugs need to be considered in the practice. Symptoms in the course of the patient's disease can be used as a treatment optimization path. Although the nutrition intervention strategy has no direct impact on the indicators of mental illness, the prevention of adverse symptoms during treatment can improve the actual experience of patients. In the future, the nutrition strategy will be adaptively optimized to improve the rehabilitation effect of chronic schizophrenia.AcknowledgementsThe research is supported by: Key Discipline of Nutrition and Food Hygiene of Changsha Medical university Quality Engineering Construction Project+2016;Study on Intervention Effect of Mindfulness Acceptance Stress Project on Nurses Aid to COVID-19+Outstanding Youth Project of Scientific Research of Hunan Education Department +2020(264)20B070.

Focus on the Mental Health of Pediatric Medical Workers in China After the COVID-19 Epidemic.

As was previously known, pediatric medical staff in China faced several hurdles including high occupational risk, multiple contradictions, heavy workload, and long working hours. After the outbreak of 2019 novel coronavirus, facing the overload of work and the potential risk of infection, pediatric medical workers may be under great psychological pressure. The purpose of this article was to call attention to the impact of the epidemic on the mental health of Chinese pediatric workers, and developing psychological intervention program that are tailored to them. The experiences from this public health emergency should inform the efficiency and quality of future crisis intervention of the Chinese government and authorities around the world.

Analysis of Pathogenic Bacteria and Drug Resistance Among Girls with Bacterial Vaginitis.

Objective: The aim of this study was to analyze the prevalence of vaginal flora and drug resistance in bacterial vaginitis among girls. Methods: A total of 3099 girls (0-10 years old) with vaginitis who visited the Beijing Children's Hospital from January 2020 to December 2021 were included in the present study. The clinical data, results of bacterial culture of vaginal secretions, and drug sensitivity reports of the subjects were collected and analyzed. Results: Of the 3099 girls with vaginitis, 399 girls had a positive bacterial culture of vaginal secretions. Nineteen types of bacteria were cultured from the vaginal secretions of these 399 girls, with a total of 419 strains. The top three infective bacteria were Haemophilus influenzae (127 strains, 30.31%), Staphylococcus aureus (66 strains, 15.75%), and Streptococcus agalactiae (32 strains, 7.64%). Additionally, 20 girls were simultaneously infected with two types of bacteria. Staphylococcus aureus, Group G Streptococcus, Haemophilus parainfluenzae, and Pseudomonas aeruginosa more frequently occurred in mixed infections. The number and bacterial detection rate among school-age girls were higher than those of preschool-age girls. We found seasonal variation in infection rates, and vaginitis among girls was higher in summer. Recurrence of vaginitis in girls was not related to the type of pathogenic bacteria in the infection. Drug sensitivity analyses showed that the resistance rates of clindamycin and erythromycin were generally high, 70-100%. After the coronavirus disease 2019 outbreak, the resistance rates of some antibiotics had decreased to varying degrees. Conclusion: Improving the understanding of vaginal flora and drug resistance in girls with vaginitis will facilitate the selection of highly effective and sensitive antibacterial drugs and reduce the production of drug-resistant strains.

Repurposing Astragalus Polysaccharide PG2 for Inhibiting ACE2 and SARS-CoV-2 Spike Syncytial Formation and Anti-Inflammatory Effects.

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses a serious threat to global public health. In an effort to develop novel anti-coronavirus therapeutics and achieve prophylactics, we used gene set enrichment analysis (GSEA) for drug screening and identified that Astragalus polysaccharide (PG2), a mixture of polysaccharides purified from Astragalus membranaceus, could effectively reverse COVID-19 signature genes. Further biological assays revealed that PG2 could prevent the fusion of BHK21-expressing wild-type (WT) viral spike (S) protein and Calu-3-expressing ACE2. Additionally, it specifically prevents the binding of recombinant viral S of WT, alpha, and beta strains to ACE2 receptor in our non-cell-based system. In addition, PG2 enhances let-7a, miR-146a, and miR-148b expression levels in the lung epithelial cells. These findings speculate that PG2 has the potential to reduce viral replication in lung and cytokine storm via these PG2-induced miRNAs. Furthermore, macrophage activation is one of the primary issues leading to the complicated condition of COVID-19 patients, and our results revealed that PG2 could regulate the activation of macrophages by promoting the polarization of THP-1-derived macrophages into an anti-inflammatory phenotype. In this study, PG2 stimulated M2 macrophage activation and increased the expression levels of anti-inflammatory cytokines IL-10 and IL-1RN. Additionally, PG2 was recently used to treat patients with severe COVID-19 symptoms by reducing the neutrophil-to-lymphocyte ratio (NLR). Therefore, our data suggest that PG2, a repurposed drug, possesses the potential to prevent WT SARS-CoV-2 S-mediated syncytia formation with the host cells; it also inhibits the binding of S proteins of WT, alpha, and beta strains to the recombinant ACE2 and halts severe COVID-19 development by regulating the polarization of macrophages to M2 cells.

Relationship Quality Change Among Partnered Older Adults During the COVID-19 Pandemic.

OBJECTIVE: The COVID-19 pandemic dramatically changed social life, but we know less about whether partnered relationships changed during this time. Because high-quality intimate relationships are key to many older Americans' wellbeing, we explore whether, how, and for whom the pandemic changed relationship quality among partnered older Americans. METHOD: Nationally representative data from 1,642 partnered adults aged 50 and up come from the 2020 National Social Life, Health, and Aging Project COVID-19 Study. Multinomial logistic regression analyses estimate the likelihood of reporting improved, unchanged, or worsened relationship quality since the pandemic began across sociodemographic groups. RESULTS: Two-thirds of respondents reported that relationship quality stayed the same during the pandemic, 22.8% reported their relationship quality got better, and 10.5% reported their relationship quality got worse. Although women and the oldest old were less likely to report improved relationship quality, Black respondents were more likely to do so, even after controlling for explanatory variables. DISCUSSION: Resilience describes many partnered older adults' experiences during the first year of the pandemic, suggesting that they were able to protect their partnerships during this public health crisis.

Who Gets Help? A National Longitudinal Study of Personal Networks and Pandemic Support among Older Adults.

OBJECTIVES: Personal networks provide social support for older adults, perhaps especially during the COVID-19 pandemic when traditional avenues may be disrupted. We provide one of the first population-based studies on how pre-pandemic personal networks predict support during the pandemic among older adults, with attention to gender and race variation. METHOD: We analyzed longitudinal data from the National Social Life, Health, and Aging Project Round 3 (2015/16) and COVID-19 Round (2020) (N=2622, 55.68% female, 78.75% white, aged 50-99), a nationally representative survey of community-dwelling older Americans. We considered structure (i.e., size, density) and composition (i.e., proportion female and kin) of pre-pandemic personal networks, estimating multinomial logistic models to predict self-reported need and receipt of instrumental help and emotional support during the pandemic. RESULTS: Larger pre-pandemic confidant networks predicted higher risk of receiving needed pandemic help and support, higher risk of receiving help and support more often than pre-pandemic, and lower risk of being unable to get help. Denser pre-pandemic networks also predicted higher risk of receiving pandemic help and support. Furthermore, how network size and density related to support differed with respondent race, and a greater proportion of kin in pre-pandemic networks predicted higher risk of receiving help for non-white older adults only. DISCUSSION: Older adults' pre-pandemic confidant network structure and composition can provide underlying conditions for receiving pandemic social support. Findings speak to policies and programs that aim to foster social support or identify vulnerable groups that suffer the greatest unmet need for support during a global crisis.

Masked face recognition with convolutional visual self-attention network.

With the global outbreak of COVID-19, wearing face masks has been actively introduced as an effective public measure to reduce the risk of virus infection. This measure leads to the failure of face recognition in many cases. Therefore, it is very necessary to improve the recognition performance of masked face recognition (MFR). Inspired by the successful application of self-attention in computer vision, we propose a Convolutional Visual Self-Attention Network (CVSAN), which uses self-attention to augment the convolution operator. Specifically, this is achieved by connecting a convolutional feature map, which enforces local features, to a self-attention feature map that is capable of modeling long-range dependencies. Since there is currently no publicly available large-scale masked face data, we generate a Masked VGGFace2 dataset based on the face detection algorithm to train the CVSAN model. Experiments show that the CVSAN algorithm significantly improves the performance of MFR compared to other algorithms.

Analysis of Factors Influencing the Corporate Performance of Listed Companies in China's Agriculture and Forestry Sector Based on a Panel Threshold Model

The global food crisis caused by COVID-19 and the Russia-Ukraine conflict have made many countries around the world realize the significance of agroforestry to a country's food security. However, China's agroforestry R&D innovation is currently lagging behind in development, and some agricultural seeds are heavily dependent on foreign countries, which seriously affects China's national food security. It is especially important to explore the reasons why China's agroforestry R&D and innovation is lagging behind. As listed agroforestry companies face the market demand directly, there is an urgent need to study the R&D innovations of listed agroforestry companies at present. This paper analyzes the impacts of R&D innovation, corporate management and supply chain management on the corporate performance of listed agroforestry companies using the entropy weighting method, GMM estimation and panel threshold model, mainly by selecting annual panel data from CSMAR for the period 2010 to 2021. The following conclusions were drawn: (1) There is a nonlinear relationship between R&D innovation and firm performance, and a 'U';-shaped relationship. This indicates that there is an entrance threshold for R&D innovation in the agroforestry industry, below which corporate performance does not improve. (2) There is a nonlinear relationship between corporate management and corporate performance, and a U-shaped relationship. (3) There is a nonlinear relationship between supply chain management and firm performance, with an inverted-U-shaped relationship. This paper explains the reasons for the slow development of R&D innovation in China's agriculture and forestry industry and fills the gap in the theoretical study of the nonlinear relationship between R&D innovation and corporate performance of listed companies in China's agriculture and forestry industry. Finally, this paper provides a theoretical basis for the decision making of government departments related to agriculture and forestry, and offers some suggestions for listed companies in agriculture and forestry to improve their corporate performance.

Virofree, an Herbal Medicine-Based Formula, Interrupts the Viral Infection of Delta and Omicron Variants of SARS-CoV-2.

Coronavirus disease 2019 (COVID-19) remains a threat with the emergence of new variants, especially Delta and Omicron, without specific effective therapeutic drugs. The infection causes dysregulation of the immune system with a cytokine storm that eventually leads to fatal acute respiratory distress syndrome (ARDS) and further irreversible pulmonary fibrosis. Therefore, the promising way to inhibit infection is to disrupt the binding and fusion between the viral spike and the host ACE2 receptor. A transcriptome-based drug screening platform has been developed for COVID-19 to explore the possibility and potential of the long-established drugs or herbal medicines to reverse the unique genetic signature of COVID-19. In silico analysis showed that Virofree, an herbal medicine, reversed the genetic signature of COVID-19 and ARDS. Biochemical validations showed that Virofree could disrupt the binding of wild-type and Delta-variant spike proteins to ACE2 and its syncytial formation via cell-based pseudo-typed viral assays, as well as suppress binding between several variant recombinant spikes to ACE2, especially Delta and Omicron. Additionally, Virofree elevated miR-148b-5p levels, inhibited the main protease of SARS-CoV-2 (Mpro), and reduced LPS-induced TNF-α release. Virofree also prevented cellular iron accumulation leading to ferroptosis which occurs in SARS-CoV-2 patients. Furthermore, Virofree was able to reduce pulmonary fibrosis-related protein expression levels in vitro. In conclusion, Virofree was repurposed as a potential herbal medicine to combat COVID-19. This study highlights the inhibitory effect of Virofree on the entry of Delta and Omicron variants of SARS-CoV-2, which have not had any effective treatments during the emergence of the new variants spreading.

Barriers to hospital-based phase 2 cardiac rehabilitation among patients with coronary heart disease in China: a mixed-methods study.

BACKGROUND: Coronary heart disease (CHD) has become a leading cause of morbidity and premature death worldwide. Cardiac rehabilitation (CR) was proved to have substantial benefits for patients with CHD. The CR was divided into three phases. Phase 2 is the important part of CR which involves hospital-based structured and closely monitored exercises and activities. However, CR utilization is low worldwide. The barriers to hospital-based phase 2 CR in China have not been well identified. AIMS: To investigate barriers to hospital-based phase 2 cardiac rehabilitation among coronary heart disease patients in China and to explore the reasons. METHODS: This study employed an explanatory sequential mixed-methods design. The study was conducted in a university hospital in China from July 2021 to December 2021. Quantitative data was collected through the Cardiac Rehabilitation Barrier Scale. Qualitative data was collected through unstructured face-to-face interviews. Data analysis included descriptive statistics and inductive qualitative content analysis. RESULTS: One hundred and sixty patients completed the Cardiac Rehabilitation Barrier Scale and 17 patients participated in unstructured face-to-face interviews. The main barriers identified were distance (3.29 ± 1.565), transportation (2.99 ± 1.503), cost (2.76 ± 1.425), doing exercise at home (2.69 ± 1.509) and time constraints (2.48 ± 1.496). Six themes were identified; logistical factors, social support, misunderstanding of cardiac rehabilitation, program and health system-level factors, impression of CR team and psychological distress. The first four themes confirmed the quantitative results and provide a deeper explanation for the quantitative results. The last two themes were new information that emerged in the qualitative phase. CONCLUSION: This study provides a better understanding of the barriers to hospital-based phase 2 cardiac rehabilitation among coronary heart disease patients in the Chinese context during the Covid-19 pandemic. Innovative programs such as home-based CR, mobile health, and hybrid programs might be considered to overcome some of these barriers. In addition, psychosocial intervention should be included in these programs to mitigate some of the barriers associated with the impression of CR team and psychological distress.

The relationship between online courses and mental health among Chinese children

Background Previous studies on the association of online courses and mental health were mainly conducted in universities, and no study investigated the relationship between characteristics of online courses and children’s mental health in primary and secondary school. This study aimed to explore the association of online courses and children’s mental health in primary and secondary school. Methods A cross-sectional study was conducted through an online survey among 540 primary and secondary school students and their parents in the eastern, central and western region of China from April to May in 2020. Children’s mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Borderline mental health problems (SDQ total difficulties score ≥ 16) and mental health problems (SDQ total difficulties score ≥ 20) were defined according to Goodman’s standard. Multivariable linear and logistic regression models were used to examine the association between online courses and children’s mental health. Results Compared with those who did not have problems of online courses, children having the difficulty in understanding the content of online courses had a higher SDQ total difficulties score [β = 1.80, 95% confidence interval (CI): 0.89, 2.71] and a higher risk of borderline mental health problems [odds ratio (OR) = 1.93, 95%CI: 1.07, 3.49], while device or internet connection problems were not significantly associated with children’s mental health. Compared with children who had live courses, those having video-recorded courses had a higher SDQ total difficulties score (β = 0.90, 95%CI: 0.01, 1.80). Children who spent more than 4 h on online courses had a higher SDQ total difficulties score than those of less than or equal to 4 h (β = 0.95, 95%CI: 0.09, 1.81). Conclusion We found that online courses with inappropriate characteristics were associated with children’s mental health. The findings called for the efforts to optimize the online courses and improve children’s mental health. Supplementary Information The online version contains supplementary material available at 10.1186/s12888-022-03976-2.

Analysis of COVID-19 Guideline Quality and Change of Recommendations: A Systematic Review

Background Hundreds of coronavirus disease 2019 (COVID-19) clinical practice guidelines (CPGs) and expert consensus statements have been developed and published since the outbreak of the epidemic. However, these CPGs are of widely variable quality. So, this review is aimed at systematically evaluating the methodological and reporting qualities of COVID-19 CPGs, exploring factors that may influence their quality, and analyzing the change of recommendations in CPGs with evidence published. Methods We searched five electronic databases and five websites from 1 January to 31 December 2020 to retrieve all COVID-19 CPGs. The assessment of the methodological and reporting qualities of CPGs was performed using the AGREE II instrument and RIGHT checklist. Recommendations and evidence used to make recommendations in the CPGs regarding some treatments for COVID-19 (remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir) were also systematically assessed. And the statistical inference was performed to identify factors associated with the quality of CPGs. Results We included a total of 92 COVID-19 CPGs developed by 19 countries. Overall, the RIGHT checklist reporting rate of COVID-19 CPGs was 33.0%, and the AGREE II domain score was 30.4%. The overall methodological and reporting qualities of COVID-19 CPGs gradually improved during the year 2020. Factors associated with high methodological and reporting qualities included the evidence-based development process, management of conflicts of interest, and use of established rating systems to assess the quality of evidence and strength of recommendations. The recommendations of only seven (7.6%) CPGs were informed by a systematic review of evidence, and these seven CPGs have relatively high methodological and reporting qualities, in which six of them fully meet the Institute of Medicine (IOM) criteria of guidelines. Besides, a rapid advice CPG developed by the World Health Organization (WHO) of the seven CPGs got the highest overall scores in methodological (72.8%) and reporting qualities (83.8%). Many CPGs covered the same clinical questions (it refers to the clinical questions on the effectiveness of treatments of remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir in COVID-19 patients) and were published by different countries or organizations. Although randomized controlled trials and systematic reviews on the effectiveness of treatments of remdesivir, glucocorticoids, hydroxychloroquine/chloroquine, interferon, and lopinavir-ritonavir for patients with COVID-19 have been published, the recommendations on those treatments still varied greatly across COVID-19 CPGs published in different countries or regions, which may suggest that the CPGs do not make sufficient use of the latest evidence. Conclusions Both the methodological and reporting qualities of COVID-19 CPGs increased over time, but there is still room for further improvement. The lack of effective use of available evidence and management of conflicts of interest were the main reasons for the low quality of the CPGs. The use of formal rating systems for the quality of evidence and strength of recommendations may help to improve the quality of CPGs in the context of the COVID-19 pandemic. During the pandemic, we suggest developing a living guideline of which recommendations are supported by a systematic review for it can facilitate the timely translation of the latest research findings to clinical practice. We also suggest that CPG developers should register the guidelines in a registration platform at the beginning for it can reduce duplication development of guidelines on the same clinical question, increase the transparency of the development process, and promote cooperation among guideline developers all over the world. Since the International Practice Guideline Registry Platform has been created, developers could register guidelines prospectively and internationally on this platform.

Chemotherapy induces ACE2 expression in breast cancer via the ROS-AKT-HIF-1α signaling pathway: a potential prognostic marker for breast cancer patients receiving chemotherapy.

BACKGROUND: Angiotensin-converting enzyme 2 (ACE2) is a key enzyme of the renin-angiotensin system and a well-known functional receptor for the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into host cells. The COVID-19 pandemic has brought ACE2 into the spotlight, and ACE2 expression in tumors and its relationship with SARS-COV-2 infection and prognosis of cancer patients have received extensive attention. However, the association between ACE2 expression and tumor therapy and prognosis, especially in breast cancer, remains ambiguous and requires further investigation. We have previously reported that ACE2 is elevated in drug-resistant breast cancer cells, but the exact function of ACE2 in drug resistance and progression of this malignant disease has not been explored. METHODS: The expression of ACE2 and HIF-1α in parental and drug-resistant breast cancer cells under normoxic and hypoxic conditions was analyzed by Western blot and qRT-PCR methods. The protein levels of ACE2 in plasma samples from breast cancer patients were examined by ELISA. The relationship between ACE2 expression and breast cancer treatment and prognosis was analyzed using clinical specimens and public databases. The reactive oxygen species (ROS) levels in breast cancer cells were measured by using a fluorescent probe. Small interfering RNAs (siRNAs) or lentivirus-mediated shRNA was used to silence ACE2 and HIF-1α expression in cellular models. The effect of ACE2 knockdown on drug resistance in breast cancer was determined by Cell Counting Kit 8 (CCK-8)-based assay, colony formation assay, apoptosis and EdU assay. RESULTS: ACE2 expression is relatively low in breast cancer cells, but increases rapidly and specifically after exposure to anticancer drugs, and remains high after resistance is acquired. Mechanistically, chemotherapeutic agents increase ACE2 expression in breast cancer cells by inducing intracellular ROS production, and increased ROS levels enhance AKT phosphorylation and subsequently increase HIF-1α expression, which in turn upregulates ACE2 expression. Although ACE2 levels in plasma and cancer tissues are lower in breast cancer patients compared with healthy controls, elevated ACE2 in patients after chemotherapy is a predictor of poor treatment response and an unfavorable prognostic factor for survival in breast cancer patients. CONCLUSION: ACE2 is a gene in breast cancer cells that responds rapidly to chemotherapeutic agents through the ROS-AKT-HIF-1α axis. Elevated ACE2 modulates the sensitivity of breast cancer cells to anticancer drugs by optimizing the balance of intracellular ROS. Moreover, increased ACE2 is not only a predictor of poor response to chemotherapy, but is also associated with a worse prognosis in breast cancer patients. Thus, our findings provide novel insights into the spatiotemporal differences in the function of ACE2 in the initiation and progression of breast cancer.

The relationship between online courses and mental health among Chinese children.

BACKGROUND: Previous studies on the association of online courses and mental health were mainly conducted in universities, and no study investigated the relationship between characteristics of online courses and children's mental health in primary and secondary school. This study aimed to explore the association of online courses and children's mental health in primary and secondary school. METHODS: A cross-sectional study was conducted through an online survey among 540 primary and secondary school students and their parents in the eastern, central and western region of China from April to May in 2020. Children's mental health was assessed by the Strengths and Difficulties Questionnaire (SDQ). Borderline mental health problems (SDQ total difficulties score ≥ 16) and mental health problems (SDQ total difficulties score ≥ 20) were defined according to Goodman's standard. Multivariable linear and logistic regression models were used to examine the association between online courses and children's mental health. RESULTS: Compared with those who did not have problems of online courses, children having the difficulty in understanding the content of online courses had a higher SDQ total difficulties score [ß = 1.80, 95% confidence interval (CI): 0.89, 2.71] and a higher risk of borderline mental health problems [odds ratio (OR) = 1.93, 95%CI: 1.07, 3.49], while device or internet connection problems were not significantly associated with children's mental health. Compared with children who had live courses, those having video-recorded courses had a higher SDQ total difficulties score (ß = 0.90, 95%CI: 0.01, 1.80). Children who spent more than 4 h on online courses had a higher SDQ total difficulties score than those of less than or equal to 4 h (ß = 0.95, 95%CI: 0.09, 1.81). CONCLUSION: We found that online courses with inappropriate characteristics were associated with children's mental health. The findings called for the efforts to optimize the online courses and improve children's mental health.

Trophic state assessment of optically diverse lakes using Sentinel-3-derived trophic level index

An accurate estimation of trophic state of lakes with satellite remote sensing is a challenge due to the optical complexity and variability associated with inland waters. Match-up data from 393 sampling stations that has concurrent Sentinel-3 OLCI images were acquired across Wuhan lakes. Trophic Level Index (TLI) algorithms were developed within a global Optical Water Type (OWT) classification system. The performance of algorithms with limited training data gathered by using spectral similarity of highest Sowt was not improved compared with that on basis of no classification. In contrast, using spectral similarity of Sowt > 0.9 rather than the highest Sowt to group more training data with similar traits for each OWT can help build more robust algorithms, which performance is better than that on basis of no classification. Algorithm performance statistics of the test dataset for the stepwise multiple linear regression (SMLR) method were the following: Mean Absolute Error (MAE) = 5.56;Mean Absolute Percentage Error (MAPE) = 11.02 %;Root Mean Square Error (RMSE) = 7.24 and for the back propagation neural network on the basis of the Levenberg-Marquardt-Bayesian regularization algorithm (LMBR-BPNN) method MAE = 4.56;MAPE = 8.33 %;RMSE = 5.98. We detected 8 different OWTs (2,3,4,5,9,10,11,12) in Wuhan lakes and clear spatio-temporal patterns of the trophic state between 2018 and 2020.Our results revealed that the trophic state of Wuhan lakes did not decrease as expected during the COVID-19 lockdown period.

Serological responses to human virome define clinical outcomes of Italian patients infected with SARS-CoV-2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the pandemic respiratory infectious disease COVID-19. However, clinical manifestations and outcomes differ significantly among COVID-19 patients, ranging from asymptomatic to extremely severe, and it remains unclear what drives these disparities. Here, we studied 159 sequentially enrolled hospitalized patients with COVID-19-associated pneumonia from Brescia, Italy using the VirScan phage-display method to characterize circulating antibodies binding to 96,179 viral peptides encoded by 1,276 strains of human viruses. SARS-CoV-2 infection was associated with a marked increase in immune antibody repertoires against many known pathogenic and non-pathogenic human viruses. This antiviral antibody response was linked to longitudinal trajectories of disease severity and was further confirmed in additional 125 COVID-19 patients from the same geographical region in Northern Italy. By applying a machine-learning-based strategy, a viral exposure signature predictive of COVID-19-related disease severity linked to patient survival was developed and validated. These results provide a basis for understanding the role of memory B-cell repertoire to viral epitopes in COVID-19-related symptoms and suggest that a unique anti-viral antibody repertoire signature may be useful to define COVID-19 clinical severity.

Social participation and self-reported depression during the COVID-19 pandemic among older adults.

OBJECTIVES: The COVID-19 pandemic has increased depressive symptoms and disrupted activities that might typically mitigate depressive symptoms. Pandemic restrictions to social participation that supports well-being in older adults may contribute to worse mental health outcomes, but how participation relates to pandemic depressive symptoms is unclear. METHODS: Using longitudinal data from the nationally representative National Health and Aging Trends Study (N = 3181), we assessed whether older adults' pandemic depressive symptoms were associated with participation in paid work, volunteering, religious services, and other organized activities during the pandemic, as well as changes in participation in these activities compared to pre-pandemic engagement. RESULTS: Of participation during the pandemic, only attending religious services predicted pandemic depression, with religious attendance associated with higher risk of mild pandemic depressive symptoms. However, for changes in participation, stopping paid work during the pandemic predicted higher risk of moderate/severe pandemic depressive levels, while stopping attending religious services predicted lower risk of mild pandemic depression. CONCLUSION: This work demonstrates the importance of social participation for mental health and indicates what types of disruptions may reduce integration to increase older adults' vulnerability to depressive symptoms during a global pandemic.