A Portable Self‐Powered Turbine Spirometer for Rehabilitation Monitoring on COVID‐19

Coronavirus disease 2019 (COVID‐19) patients may experience persistent impairment of the lungs after recovery and discharge, which can cause a decline in pulmonary function. Therefore, regular pulmonary function tests are essential for COVID‐19 recovered patients, and portable, home‐based pulmonary function test devices are of great significance during the pandemic. Herein, a portable self‐powered turbine spirometer (PSTS) is designed for respiratory flow measurement and assessment of pulmonary function with high accuracy, humidity resistance, good durability, and low cost. The respiratory airflow can directly drive PSTS to produce a sinusoidal signal with a signal‐to‐noise of 40.64 dB. By utilizing the long short‐term memory (LSTM) model, the flow is successfully predicted, and the "lag‐before‐start” and "spin‐after‐stop” defects of the turbine spirometer are eliminated effectively. For pulmonary function tests, the flow‐volume loop curve can be obtained from PSTS, and pulmonary function parameters such as inspiratory capacity (IC), forced vital capacity (FVC) and forced expiratory volume in the first 1 s (FEV1) can be calculated. The accuracy of IC is over 95%, and others can reach over 97%. A portable smart pulmonary function assessment system is further developed and used to test the pulmonary function of COVID‐19 patients one month after symptom onset, demonstrating potential for assessing rehabilitation trends and long‐term follow‐up of COVID‐19 recovered patients. [ FROM AUTHOR] Copyright of Advanced Materials Technologies is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

The relationship between perceived organizational support and insomnia in Chinese nurses: The Serial multiple mediation analysis.

Background: Nurses are in high-pressure, high-load, and high-risk environment for a long time, and their insomnia cannot be ignored. Insomnia not only has a negative impact on the physical and mental health of nurses, but also on the efficiency and quality of nursing work. Objective: The purpose of this study was to investigate the multiple mediating effect of psychological capital, effort-reward ratio, and overcommitment in the relationship between perceived organizational support and insomnia among Chinese nurses. Methods: A cross-sectional study has been carried out in a tertiary grade A hospital in Shandong Province, China from March 2021 to May 2021. The demographic questionnaire, Perceived Organization Support Questionnaire, Psychological Capital Questionnaire, Chinese version Effort-Reward Imbalance, Questionnaire and Athens Insomnia Scale were used for data collection. SPSS PROCESS 3.4 macro program developed by Hayes was used to test the serial multiple mediation. Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson's correlation analyses, ordinary least-squares regression, and the bootstrap method were used for data analysis. Results: 658 valid questionnaires were collected (81.2%). Nurses' perceived organizational support was positively correlated with psychological capital (r = 0.455, p < 0.001), and was significantly negatively correlated with effort-reward ratio (r = -0.318, p < 0.001), overcommitment (r = -0.328, p < 0.001), and insomnia (r = -0.358, p < 0.001); Psychological capital was negatively correlated with effort-reward ratio (r = -0.275, p < 0.001), overcommitment (r = -0.339, p < 0.001), and insomnia (r = -0.402, p < 0.001), respectively; effort-reward ratio and overcommitment were significantly positively correlated with insomnia (r = 0.379, p < 0.001; r = 0.466, p < 0.001), respectively. In the model of perceived organizational support-psychological capital-effort-reward ratio-insomnia, the overall mediating effect was -0.080 (95%CI: -0.109 ~ -0.058), and the mediating effect of psychological capital was -0.050, accounting for 34.30% of the total effect; the mediating effect of effort-reward ratio was -0.024, accounting for 16.49% of the total effect; the chain mediating effect of psychological capital and effort-reward ratio was -0.007, accounting for 4.49% of the total effect. In the model of perceived organizational support-psychological capital-overcommitment-insomnia, the overall mediating effect was -0.085 (95%CI: -0.109 ~ -0.064), and the mediating effect of psychological capital was -0.042, accounting for 28.64% of the total effect; the mediating effect of overcommitment was -0.029, accounting for 19.81% of the total effect; the chain mediating effect of psychological capital and overcommitment was -0.015, accounting for 10.14% of the total effect. Conclusion: Perceived organizational support had direct negative influence on insomnia. Psychological capital and effort-reward ratio/overcommitment acted as chained mediating factor could partially relieve insomnia symptoms related to perceived organizational support. It is suggested to improve the level of organizational support and psychological capital of nurses, and reduce the effort-reward imbalance and overcommitment of nurses, so as to effectively decline and deal with nurses' insomnia.

Changes in interferon-γ release assay readout after COVID-19 vaccination: A prospective cohort study.

OBJECTIVES: Interferon-γ release assays (IGRAs) are widely used in public health practice to diagnose latent tuberculosis. During the COVID-19 pandemic and rollout of COVID-19 vaccination, it has remained unclear whether COVID-19 vaccines interfere with IGRA readouts. METHODS: We prospectively recruited healthcare workers during their annual occupational health examinations in 2021. Baseline IGRA readouts were compared with follow-up data after the participants had received two doses of COVID-19 vaccination. RESULTS: A total of 134 baseline IGRA-negative cases (92 with ChAdOx1 vaccine, 27 with mRNA-1273 vaccine, and 15 with heterologous vaccination) and seven baseline IGRA-positive cases were analyzed. Among the baseline IGRA-negative cases, there were decreased interferon-γ concentrations over the Nil (P = 0.005) and increased Mitogen-Nil (P < 0.001) values after vaccination. For TB2-Nil value, a similar trend (P = 0.057) of increase was observed. Compared with the 0.35 IU/ml threshold, the baseline and follow-up readout differences were less than |± 0.10| IU/ml over the TB1-Nil and TB2-Nil values in >90% baseline IGRA-negative cases. No significant readout difference was observed among baseline IGRA-positive cases. CONCLUSION: COVID-19 vaccination did not change IGRA interpretation in most cases. Cases showing conversion/borderline IGRA readouts should be given special consideration.

Occupational Stress and Insomnia Symptoms Among Nurses During the Outbreak of COVID-19 in China: The Chain Mediating Effect of Perceived Organizational Support and Psychological Capital.

Background: Nurses play an important role in medical and health services and insomnia symptoms were relatively high among nurses, especially during the epidemic of 2019 coronavirus disease. Insomnia not only damages the physical and mental health of the individual, but also reduces the efficiency of their work and the quality of care, ultimately impacting on patient care. Objective: The purpose of this study was to explore the role of perceived organizational support and psychological capital in the relationship between occupational stress and insomnia among Chinese nurses. Methods: A cross-sectional study has been carried out in a tertiary grade A hospital in Shandong Province, China from March 2021 to May 2021. The self-administered questionnaires were distributed to 810 nurses, which including Chinese Effort-Reward Imbalance Scale, Athens Insomnia Scale, Perceived Organizational Support Questionnaire, Chinese Psychological Capital Questionnaire, gender, age, education level and other demographic characteristics. Effective respondents were 658 (81.2%). Descriptive analysis, independent-samples t-test, one-way analysis of variance, Pearson correlation analyses, ordinary least-squares regression and the bootstrap method were used for data analysis. Results: The prevalence of insomnia symptoms in this study was found to be 57.3%. There were significant differences in insomnia symptoms in weekly working hours (t = -2.027, P = 0.043), with chronic disease (t = -2.825, P = 0.005), negative life events (t = -5.340, P < 0.001), departments (F = 3.077, P = 0.006) and position (t = 2.322, P = 0.021) among nurses. Overall, the serial-multiple mediations of perceived organizational support and psychological capital in the relationship between occupational stress and insomnia were found to be statistically significant. Conclusions: The prevalence of insomnia symptoms was comparatively high among Chinese nurses, and occupational stress had direct negative influence on it. Perceived organizational support and psychological capital acted as chained mediating factor could partially relieve insomnia symptoms related to occupational stress. Supportive working environment should be provided, and improving psychological capital levels to help nurses coping with insomnia symptoms.

Hypochlorous acid initiated lipid chlorination at air-water interface.

There has been a surge of interest in interfacial hypochlorous acid (HOCl) chemistry for indoor air quality and public health. Here we combined nanoelectrospray mass spectrometry (nESI-MS) and acoustic levitation (AL) techniques to study the chlorination chemistry of three model lipids (DPPE, POPG, DOPG) mediated by HOCl at the air-water interface of levitated water droplet. For DPPE with no CC double bonds, HOCl was insensitive to the alkane chains, and showed considerable delay directing to head amino groups compared to that in aqueous environment. Chlorination chemistry, for POPG and DOPG with CC double bonds, preferentially reacted with double bonds of one chain. The mechanism was discussed in light of these observations, and it is concluded that the increased hydrophilicity of the chlorinated chain disturbed the lipid packing and attracted it toward the water phase. In addition, the reaction rate constant and reactive uptake coefficient suggested that the chlorination of lipids exposed to HOCl at the air-water interface is likely to occur rapidly. These results gain the knowledge of HOCl mediated lipid interface reaction at the molecule level, and would better understand the adverse health effects associated with elevated indoor pollutants.

Burden of Sleep Disturbance During COVID-19 Pandemic: A Systematic Review.

Coronavirus disease 2019 (COVID-19) pandemic may exert adverse impacts on sleep among populations, which may raise awareness of the burden of sleep disturbance, and the demand of intervention strategies for different populations. We aimed to summarize the current evidence for the impacts of COVID-19 on sleep in patients with COVID-19, healthcare workers (HWs), and the general population. We searched PubMed and Embase for studies on the prevalence of sleep disturbance. Totally, 86 studies were included in the review, including 16 studies for COVID-19 patients, 34 studies for HWs, and 36 studies for the general population. The prevalence of sleep disturbance was 33.3%-84.7%, and 29.5-40% in hospitalized COVID-19 patients and discharged COVID-19 survivors, respectively. Physiologic and psychological traumatic effects of the infection may interact with environmental factors to increase the risk of sleep disturbance in COVID-19 patients. The prevalence of sleep disturbance was 18.4-84.7% in HWs, and the contributors mainly included high workloads and shift work, occupation-related factors, and psychological factors. The prevalence of sleep disturbance was 17.65-81% in the general population. Physiologic and social-psychological factors contributed to sleep disturbance of the general population during COVID-19 pandemic. In summary, the sleep disturbance was highly prevalent during COVID-19 pandemic. Specific health strategies should be implemented to tackle sleep disturbance.

Optimizing Management to Reduce the Mortality of COVID-19: Experience From a Designated Hospital for Severely and Critically Ill Patients in China.

Background: The coronavirus disease 2019 (COVID-19) has swept through the world at a tremendous speed, and there is still limited data available on the treatment for COVID-19. The mortality of severely and critically ill COVID-19 patients in the Optical Valley Branch of Tongji Hospital was low. We aimed to analyze the available treatment strategies to reduce mortality. Methods: In this retrospective, single-center study, we included 1,106 COVID-19 patients admitted to the Optical Valley Branch of Tongji Hospital from February 9 to March 9, 2020. Cases were analyzed for demographic and clinical features, laboratory data, and treatment methods. Outcomes were followed up until March 29, 2020. Results: Inflammation-related indices (hs-CRP, ESR, serum ferritin, and procalcitonin) were significantly higher in severe and critically ill patients than those in moderate patients. The levels of cytokines, including IL-6, IL2R, IL-8, and TNF-α, were also higher in the critical patients. Incidence of acute respiratory distress syndrome (ARDS) in the severely and critically ill group was 23.0% (99/431). Sixty-one patients underwent invasive mechanical ventilation. The correlation between SpO2/FiO2 and PaO2/FiO2 was confirmed, and the cut-off value of SpO2/FiO2 related to survival was 134.43. The mortality of patients with low SpO2/FiO2 (<134.43) at intubation was higher than that of patients with high SpO2/FiO2 (>134.43) (72.7 vs. 33.3%). Among critical patients, the application rates of glucocorticoid therapy, continuous renal replacement therapy (CRRT), and anticoagulation treatment reached 55.2% (238/431), 7.2% (31/431), and 37.1% (160/431), respectively. Among the intubated patients, the application rates of glucocorticoid therapy, CRRT, and anticoagulation treatment were respectively 77.0% (47/61), 54.1% (33/61), and 98.4% (60/61). Conclusion: No vaccines or specific antiviral drugs for COVID-19 have been shown to be sufficiently safe and effective to date. Comprehensive treatment including ventilatory support, multiple organ function preservation, glucocorticoid use, renal replacement therapy, anticoagulation, and restrictive fluid management was the main treatment strategy. Early recognition and intervention, multidisciplinary collaboration, multi-organ function support, and personalized treatment might be the key for reducing mortality.

Optimize the management of urological tube-related emergencies during the coronavirus disease 2019 (COVID-19) pandemic.

BACKGROUND: To introduce and determine the value of optimized strategies for the management of urological tube-related emergencies with increased incidence, complexity and operational risk during the global spread of coronavirus disease 2019 (COVID-19). METHODS: All emergent urological patients at Tongji Hospital, Wuhan, during the period of January 23 (the beginning of lockdown in Wuhan) to March 23, 2020, and the corresponding period in 2019 were recruited to form this study's COVID-19 group and control group, respectively. Tongji Hospital has the most concentrated and strongest Chinese medical teams to treat the largest number of severe COVID-19 patients. Patients in the control group were routinely treated, while patients in the COVID-19 group were managed following the optimized principles and strategies. The case incidence for each type of tube-related emergency was recorded. Baseline characteristics and management outcomes (surgery time, secondary complex operation rate, readmission rate, COVID-19 infection rate) were analyzed and compared across the control and COVID-19 periods. RESULTS: The total emergent urological patients during the COVID-19 period was 42, whereas during the control period, it was 124. The incidence of tube-related emergencies increased from 53% to 88% (P<0.001) during the COVID-19 period. In particular, the incidence of nephrostomy tube-related (31% vs. 15%, P=0.027) and single-J stent-related problems (19% vs. 6%, P=0.009) increased significantly. The mean surgery times across the two periods were comparable. The number of secondary complex operations increased from 12 (18%) to 14 (38%) (P=0.028) during the COVID 19-period. The number of 2-week postoperative readmission decreased from 10 (15%) to 1 (3%) (P=0.049). No participants contracted during the COVID-19 period. CONCLUSIONS: Urological tube-related emergencies have been found to have a higher incidence and require more complicated and dangerous operations during the COVID-19 pandemic. However, the optimized management strategies introduced in this study are efficient, and safe for both urologists and patients.

Containing Epidemic Spreading on Networks with Neighbor Resource Supporting

Previous studies revealed that the susceptibility, contacting preference, and recovery probability markedly alter the epidemic outbreak size and threshold. The recovery probability of an infected node is closely related to its obtained resources. How to allocate limited resources to infected neighbors is extremely important for containing the epidemic spreading on complex networks. In this paper, we proposed an epidemic spreading model on complex networks, in which we assume that the node has heterogeneous susceptibility and contacting preference, and susceptible nodes are willing to share their resources to neighbors. Through a developed heterogeneous mean-field theory and a large number of numerical simulations, we find that the recovered nodes provide resources uniformly to their infected neighbor nodes, and the epidemic spreading can be suppressed optimally on homogeneous and heterogeneous networks. Besides, altering the susceptibility and contacting preference does not qualitatively change the results. The susceptibility of the node decreases, which makes the outbreak threshold of epidemic spreading increase, and the outbreak size decreases. Our theory agrees well with the numerical simulations.

Therapeutic experience of an 89-year-old high-risk patient with incarcerated cholecystolithiasis: A case report and literature review.

BACKGROUND: The global pandemic of coronavirus disease 2019 pneumonia poses a particular challenge to the emergency surgical treatment of elderly patients with high-risk acute abdominal diseases. Elderly patients are a high-risk group for surgical treatment. If the incarceration of gallstones cannot be relieved, emergency surgery is unavoidable. CASE SUMMARY: We report an 89-year-old male patient with acute gangrenous cholecystitis and septic shock induced by incarcerated cholecystolithiasis. He had several coexisting, high-risk underlying diseases, had a history of radical gastrectomy for gastric cancer, and was taking aspirin before the operation. Nevertheless, he underwent emergency laparoscopic cholecystectomy, with maintenance of postoperative heart and lung function, successfully recovered, and was discharged on day 8 after the operation. CONCLUSION: Emergency surgery for elderly patients with acute abdominal disease is safe and feasible during the coronavirus disease 2019 pandemic, the key is to abide strictly by the hospital's epidemic prevention regulations, fully implement the epidemic prevention procedure for emergency surgery, fully prepare before the operation, accurately perform the operation, and carefully manage the patient postoperatively.

No detection of SARS-CoV-2 from urine, expressed prostatic secretions, and semen in 74 recovered COVID-19 male patients: A perspective and urogenital evaluation.

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been spreading all over the world since December 2019. However, medical information regarding the urogenital involvement in recovered COVID-19 patients is limited or unknown. OBJECTIVES: To comprehensively evaluate urogenital involvement in recovered COVID-19 patients. MATERIALS AND METHODS: Men aged between 20 years and 50 years who were diagnosed with SARS-CoV-2 infection and recovered when the study was conducted were enrolled in our study. Demographic and clinical characteristics, and history of hospitalization were collected and analyzed. Urine, expressed prostatic secretions (EPSs), and semen samples were collected for SARS-CoV-2 RNA detection. Semen quality and hormonal profiles were analyzed. RESULTS: Among 74 male recovered COVID-19 patients, 11 (14.9%) were asymptomatic, classified into mild type, and 31 (41.9%) were classified into moderate type. The remaining patients (32/74, 43.2%) had severe pneumonia. No critically ill recovered COVID-19 patient was recruited in our cohort. The median interval between last positive pharyngeal swab RT-PCR test and semen samples collection was 80 days (IQR, 64-93). The median age was 31 years (IQR, 27-36; range, 21-49), and the median body mass index (BMI) was 24.40 (IQR, 22.55-27.30). Forty-five (61.6%) men were married, and 28 (38.4%) were unmarried. Fifty-three (72.6%) patients denied cigarette smoking, 18 (24.7%) were active smokers, and 2 of them were past smokers. The majority of our participants (53/74, 72.6%) did not consume alcohol. Fever occurred in most of the patients (75.3%), and 63 of them had abnormal chest CT images. Only one patient complained of scrotal discomfort during the course of COVID-19, which was ruled out orchitis by MRI (data not shown). A total of 205 samples were collected for SARS-CoV-2 detection (74 urine samples, 70 semen samples, and 61 EPS samples). However, viral nucleic acid was not detected in body fluids from the urogenital system. In terms of hormonal profiles, the levels of FSH, LH, testosterone, and estradiol were 5.20 [4.23] mIU/mL, 3.95 [1.63] mIU/mL, 3.65 [1.19] ng/mL, and 39.48 [12.51] pg/mL, respectively. And these values were within the normal limits. The overall semen quality of recovered COVID-19 patients was above the lower reference limit released by the WHO. While compared with healthy control, sperm concentration, total sperm count, and total motility were significantly declined. In addition, different clinical types of COVID-19 have no significant difference in semen parameters, but total sperm count showed a descending trend. Interestingly, subjects with a longer recovery time showed worse data for sperm quality. Small sample size and lacking semen parameters before the infection are the major limitations of our study. DISCUSSION AND CONCLUSIONS: To the best of our knowledge, it is the largest cohort study with longest follow-up for urogenital evaluation comprehensively so far. Direct urogenital involvement was not found in the recovered COVID-19 male patients. SARS-CoV-2 RNA was undetectable in the urogenital secretions, and semen quality declined slightly, while hormonal profiles remained normal. Moreover, patients with a long time (≥90 days) since recovery had lower total sperm count. Great attention and further study should be conducted and follow-up on the reproductive function in the following months.

Prognostic and Immunological Value of Angiotensin-Converting Enzyme 2 in Pan-Cancer.

Angiotensin-converting enzyme 2 (ACE2) plays a pivotal role in the renin-angiotensin system and is closely related to coronavirus disease of 2019. However, the role of ACE2 in cancers remains unclear. We explored the pan-cancer expression patterns and prognostic value of ACE2 across multiple databases, including Oncomine, PrognoScan, Gene Expression Profiling Interactive Analysis, and Kaplan-Meier Plotter. Then, we investigated the correlations between ACE2 expression and immune infiltration in cancers. We found that tumor tissues had higher expression levels of ACE2 compared with normal tissue in the kidney and the liver and lower expression levels in the lung. High expression levels of ACE2 were beneficial to survival in ovarian serous cystadenocarcinoma, liver hepatocellular carcinoma, kidney renal papillary cell carcinoma, and kidney renal clear cell carcinoma, although this was not the case in lung squamous cell carcinoma. For those with a better prognosis, there were significant positive correlations between ACE2 expression and immune infiltrates, including B cells, CD8 + T cells, CD4 + T cells, neutrophils, macrophages, and dendritic cells. In conclusion, ACE2 could serve as a pan-cancer prognostic biomarker and is correlated with immune infiltrates.