Mental Health Impacts of Working from Home after COVID-19: Does Gender Matter?

Background: The COVID-19 pandemic has led to various social distancing practices such as mandatory working from home, which aim to reduce the spread of SARS-CoV-2. The purpose of this study was to compare the mental health impacts between men and women being forced to work from home following a COVID-19 outbreak. Methods: This study analyzed data collected from two rounds of surveys conducted in four cities in China: Beijing, Chengdu, Changsha, and Wuhan. A total of 940 individual responses were analyzed in this study. Multiple linear regression and ordinal logistic models were used to analyze the relationship between being forced to work from home, demographic variables, work-related variables, COVID-19 variables, family ties variables, and mental health variables. Results: The analysis showed that being forced to work from home was associated with worse mental health in men, but not among women. Married men reported better mental health compared with unmarried men, while the association between marital status and mental health was the opposite in women. Mental health was worse among those in higher job positions for both men and women. In addition, being forced to work from home was also associated with worse mental health among young, high-income men, and highly educated women. Conclusions: The impacts of the COVID-19 pandemic are far-reaching and amy persist for years. Furthermore, the number of workers who choose to work from home is expected to increase. The findings of this study can inform policy-making that will improve the mental health of employees working from home, with particular attention to men forced to work from home.

Removal of 26 corticosteroids, potential COVID-19 remedies, at environmentally relevant concentrations in water using UV/free chlorine, UV/monochloramine, and UV/hydrogen peroxide

As a class of endocrine disrupting compounds (EDCs), corticosteroids (CSs) have attracted increasing attention due to their large excretion masses and toxic effects. However, compared to the very well-studied estrogens and androgens, few studies have been made dealing with the removal of CSs at environmentally relevant concentrations using advanced water and wastewater treatment processes. In this study, degradation performances of 26 natural and synthetic CSs in secondary effluent at environmentally relevant concentrations were comparatively investigated during UV/free chlorine (UV/Cl-2), UV/monochloramine (UV/NH2Cl) and UV/hydrogen peroxide (UV/H2O2) treatments. The 26 CSs could be divided into two groups: UV sensitive CSs, which have two double bonds in ring A (Delta(1,4)), and UV insensitive CSs, which have only one double bond in ring A (Delta(4)). The UV sensitive CSs could be effectively removed (removal efficiency >60%) by a UV dose of 100 mJ cm(-2) while the UV insensitive CSs could be removed (removal efficiency >40%) by a UV dose of 800 mJ cm(-2). The removal efficiencies of UV insensitive CSs increased with the increase of UV dose. Most of the CSs were poorly removed by sole Cl-2, NH2Cl, or H2O2 treatment (removal efficiency <40%). However, the addition of Cl-2, NH2Cl, and H2O2 promoted the UV degradation of CSs, especially for UV-insensitive CSs. UV photolysis would be the predominant mechanism in the UV/Cl-2, UV/NH2Cl, and UV/H2O2 processes for removing CSs in water. Besides the UV photolysis, HO radicals also functioned for CS removal. Compared with the insignificant effects of reactive chlorine species (RCS), the reactive nitrogen species (RNS) showed obvious selectivity in CS degradation. This study expanded the UV induced oxidation performances of CSs, which lays a foundation for exploring degradation mechanisms and eliminating the pollution from CSs.

Using AI to Create O2O Labor Law Consultation and Training Integration Scheme

In recent years, with the rapid development of economy, China's labor relations are constantly changing, and the demands of workers for interests are increasing. In addition, with the outbreak of COVID-19, enterprises are facing severe challenges under both external and internal pressure. In view of this, relying on AI technology and professional personnel, Wish Magic provides consultation and service of labor laws and regulations for people or enterprises in need of relevant help, mediates labor disputes and strives for legitimate interests through online AI keyword search and offline VIP face-to-face expert consultation. © The Authors, published by EDP Sciences, 2021.

Short-course radiotherapy and subsequent CAPOX pluscamrelizumab followed by delayedsurgery for locally advanced rectalcancer: Short-term results of aphase II trial

Background: Chemoradiotherapy followed byradical surgery is standard treatment for patients with locally advanced rectal cancer(LARC). Short-course radiotherapy (SCRT), either with immediate or delayed surgery, providessimilar oncological results compared with long-course radiotherapy with delayed surgery.Delayed surgery with the addition of neoadjuvant immunotherapy may bring betterdownstaging effect and minimize the risk of distant relapse. We conducted this single-armphase 2 trial to investigate the efficacy and safety of SCRT combined with subsequentcapecitabine and oxaliplatin (CAPOX) plusCamrelizumab (anti-PD-1 antibody) followed bydelayed surgery in patients with LARC. Methods: Patients with histologically confirmed T3-4 N0 M0 or T1-4 N+ M0 rectal cancer, previouslyuntreated disease, and ECOG performancestatus of 0-1, received SCRT (5×5 Gy) withsubsequent two 21-day cycles of CAPOX(oxaliplatin 130 mg/m2 ivgtt, d1;capecitabine1000 mg/m2 po bid, d1-14) plus Camrelizumab(200 mg iv drip, d1) after 1 week, followed byradical surgery after 1 week. Adjuvant therapy was decided by the investigator. The primaryendpoint was pathological complete response(pCR) rate, defined as the absence of viabletumor cells in the primary tumor and lymphnodes. The study is ongoing to follow up thesurvival outcomes and obtain the results of nextgeneration sequencing and PD-L1 expression.The data cutoff date was September 8, 2020. Results: From November 2019 to September2020, a targeted number of patients (n = 29)were enrolled and are expected to complete thesurgery by November 2020. The median age was 57 (range 31-73) years, 55% (16/29) of patients had ECOG performance status of 1, and the median distance from tumor to the anal verge was 5 (range, 1.9-9) cm. At data cutoff, 10 patients had undergone the surgery, with R0 resection rate of 100%. The pCR rate was 60% (6/10), including 56% (5/9) for those with mismatch repair-proficient, and 100% (1/1) for those with mismatch repair-deficient. Of 4 patients without pCR, 2 only received one cycle of CAPOX plus Camrelizumab due to the outbreak of COVID-19 in Wuhan, and 1 had signet-ring cell rectal carcinoma. At data cutoff, 20 patients had received at least one dose of Camrelizumab. Immune-related adverse events (irAEs) were all grade 1-2, and the most common irAE was reactive cutaneous capillary endothelial proliferation in 10 (50%) of 20 patients. Postoperative bleeding and infection occurred in 1 (10%) and 2 (20%) of 10 patients, respectively. No treatment-related death was observed. Conclusions: SCRT combined with subsequent CAPOX plus Camrelizumab followed by delayed surgery showed promising pCR rate with good tolerance in patients with LARC, regardless of the mismatch repair status, suggesting a candidate strategy for the neoadjuvant therapy.

Ultrasound-guided pathological sampling of cadaver lung tissue in cases of COVID-19

Objective: To investigate the method and application of ultrasound-guided post-mortem lung tissue sampling in cases of COVID-19. Methods: Ultrasound-guided post-mortem lung tissue sampling was performed with 14G biopsy needles in 17 confirmed COVID-19 cases in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from Feb to Mar 2020. ①Ten conventional puncture points were designed according to the anatomy of human lung lobes and the projections on the body surface. The 3rd and 6th intercostal spaces in the left midclavicular line were the puncture points for the tissues of the medial areas of the upper and lower lobes of the left lung, and the 3rd, 4th, and 6th intercostal spaces in the right midclavicular line were the puncture points of the lung tissues taken from the medial areas of the upper, middle, and lower lobes of the right lung. The 4th and 7th intercostal spaces in the left midaxillary line were the puncture points of the lung tissues from the upper and lower lateral lobes, and the 4th, 5th, and 7th intercostal spaces in the right midaxillary line were the puncture points of the lung tissues from the lateral areas of the upper, middle and lower lobes of the right lung. ②According to the sonographic findings of the lung tissues at each puncture point, it was divided into three types: air-containing lung, consolidated lung and compressed lung. And the corresponding sampling methods were designed to complete multiple points of the medial and lateral areas of the left and right lung lobes. ③The time required for each lung sampling was recorded, and the sizes of the specimens were measured. The success rates of all puncture points were compared and the success rates of various type lung tissues were compared. Results: ①In 17 COVID-19 death cases, 174 puncture points were selected for bilateral lung tissues, and 288 lung tissue specimens were obtained by puncture. ②There were differences in the success rates of the puncture points, and the success rate of the 6th intercostal puncture points on the left and right midclavicular lines were lower than those of the other puncture points(P<0.05). ③There were differences in the success rate of corpse lung sampling with different types of ultrasonographic performance. The success rates of gas-containing lung sampling was 74.4%, which was lower than that of consolidation lung (86.8%)and compressed lung(84.1%)(P<0.05). ④The length of the compressed lung specimen was 11.4(10.6, 12.3)mm, which was lower than that of gas-containing lung and consolidation lung[14.6(12.5, 15.2)mm, 13.5(12.5, 15.0)mm] (P<0.05). Conclusions: This study introduces an ultrasound-guided minimally invasive puncture method for cadaver lung tissue sampling, and itmay be a reliable method for collecting lung tissues in COVID-19 cases. © 2020 Chinese Medical Association

[Pregnancy with new coronavirus infection: clinical characteristics and placental pathological analysis of three cases].

Objective: To investigate the clinical characteristics and placental pathology of 2019-nCoV infection in pregnancy,and to evaluate intrauterine vertical transmission potential of 2019-nCoV infection. Methods: The placentas delivered from pregnant women with confirmed 2019-nCoV infection which were received in the Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology by February 4, 2020 were retrospectively studied. Their clinical material including placental tissue and lung CT, and laboratory results were collected, meanwhile, nucleic acid detection of 2019-nCoV of the placentas were performed by RT-PCR. Results: Three placentas delivered from pregnant women with confirmed 2019-nCoV infection, who were all in their third trimester with emergency caesarean section. All of the three patients presented with fever (one before caesarean and two in postpartum), and had no significant leukopenia and lymphopenia. Neonatal throat swabs from three newborns were tested for 2019-nCoV, and all samples were negative for the nucleic acid of 2019-nCoV. One premature infant was transferred to Department of Neonatology due to low birth weight. By the end of February 25, 2020, none of the three patients developed severe 2019-nCoV pneumonia or died(two patients had been cured and discharged, while another one had been transferred to a square cabin hospital for isolation treatment). There were various degrees of fibrin deposition inside and around the villi with local syncytial nodule increases in all three placentas. One case of placenta showed the concomitant morphology of chorionic hemangioma and another one with massive placental infarction. No pathological change of villitis and chorioamnionitis was observed in our observation of three cases. All samples from three placentas were negative for the nucleic acid of 2019-nCoV. Conclusions: The clinical characteristics of pregnant women with 2019-nCoV infection in late pregnancy are similar to those of non-pregnant patients, and no severe adverse pregnancy outcome is found in the 3 cases of our observation. Pathological study suggests that there are no morphological changes related to infection in the three placentas. Currently no evidence for intrauterine vertical transmission of 2019-nCoV is found in the three women infected by 2019-nCoV in their late pregnancy.

[Pathological changes of the spleen in ten patients with coronavirus disease 2019(COVID-19) by postmortem needle autopsy].

Objective: To study the pathological changes of the spleen in patients with COVID-19 and to analyze the relationship between the weakened immune system and splenic lesions. Methods: Postmortem needle autopsies from the spleen were carried out on 10 patients who died from COVID-19 in Wuhan. Routine hematoxylin and eosin (HE) staining was used to observe the pathological changes. The changes of lymphocytes were studied further with immunohistochemistry.RT-PCR was used to detect 2019-nCoV RNA in the spleen. In addition,the Epstein-Barr virus (EBV) was detected by in situ hybridization, and coronavirus particles were detected by transmission electron microscopy in 2 cases. Results: There were 7 males and 3 females, with an average age of 68.3 years.Of the 10 cases, 4 had cancer history and another 4 had other underlying diseases respectively.Cough, fever, malaise and dyspnea were the main clinical symptoms.The time from onset to death was 15-45 days.Ten cases patients had normal or slight increase in peripheral blood leukocyte count in the early stage of the disease, 6 cases had significant increase before death. Five patients' peripheral blood lymphocyte count decreased in the early stage of the disease, and 10 patients' peripheral blood lymphocyte count decreased significantly before the disease progressed or died. Seven cases were treated with corticosteroid (methylprednisolone ≤40 mg/d, not more than 5 days). Histopathological examination showed that the cell composition of the spleen decreased, white pulp atrophied at different levels, meanwhile lymphoid follicles decreased or absent;in addition, the ratio of red pulp to white pulp increased with varying degrees. In 7 cases, more neutrophil infiltration was found, and in 5 cases, scattered plasma cell infiltration was found. Macrophage proliferation and hemophagocytic phenomena in a few cells were found in a case. Meanwhile, necrosis and lymphocyte apoptosis were detected in 2 cases, small artery thrombosis and spleen infarction in 1 case, and fungal infection in 1 case. The results of immunohistochemistry showed that the T and B lymphocyte components of the spleen in all cases decreased in varying degrees. CD20(+) B cells were found to accumulate in the lymphoid sheath around the splenic artery in 8 cases. However, CD20 and CD21 immunostaining in 2 cases showed that the number of white pulp was almost normal, and splenic nodules were atrophic. CD3(+), CD4(+) and CD8(+)T cells were decreased. In 9 cases,CD68(+) macrophages were no significant changes in the distribution and quantity. While more CD68(+) cells were found in the medullary sinuses of 1 case (related to fungal infection). Few CD56(+) cells were found. EBV was negative by in situ hybridization. RT-PCR was used to detect the nucleic acid of 2019-nCoV. One of 10 cases was positive, 39 years old,who was the youngest patient in this group, and the other 9 cases were negative. Coronavirus particles were found in the cytoplasm of macrophage under electron microscope in 2 cases. Conclusions: The death of COVID-19 occurs mainly in the elderly, and some cases have no underlying diseases. Spleen may be one of the organs directly attacked by the virus in some patients who died from COVID-19. T and B lymphocyte in the spleen decrease in varying degrees, lymphoid follicles are atrophied, decreased or absent, and the number of NK cells do not change significantly. And the pathological changes of the spleen are not related to the use of low dose corticosteroid, which may be related to the direct attack of virus and the attack of immune system on its own tissues.

[Pathological changes of fatal coronavirus disease 2019 (COVID-19) in the lungs: report of 10 cases by postmortem needle autopsy].

Objectives: To observe the pulmonary changes with coronavirus disease 2019 (COVID-19) in postmortem needle specimens, to detect the presence of 2019 novel coronavirus(2019-nCoV) in the lung tissues, and to analyze the clinicopathological characteristics. Methods: For 10 decedents with 2019-nCoV infection in Wuhan, bilateral lungs underwent ultrasound-guided percutaneous multi-point puncture autopsy, and pulmonary pathological changes were described in routine hematoxylin-eosin staining (HE) slides. Electron microscopy was also performed. The reverse transcription polymerase chain reaction (RT-PCR) was employed to detect 2019-nCoV nucleic acid in lung tissue, and the pathological characteristics were demonstrated in combination with clinical data analysis. Results: Of the 10 deaths associated with COVID-19, 7 were male and 3 were female. The average age was 70 (39-87) years. Medical record showed that 7 patients had underlying diseases. The average course of disease was 30 (16-36) days. Nine cases showed fibrinous and suppurative exudation in the alveolar cavity accompanied by the formation of hyaline membrane, and fibroblastic proliferation of alveolar septum. Type Ⅱ alveolar epithelial cells showed reactive hyperplasia and desquamation. Many macrophages accumulated in the alveolar cavity. Capillary hyaline thrombus and intravascular mixed thrombus were noted. In some cases, acute bronchiolitis with mucous membrane exfoliation, accumulation of bronchiolar secretions, and bronchiolar epithelial metaplasia occurred. In the cohort, a large number of bacteria (cocci) were detected in 1 case and a large number of fungi (yeast type) were detected in 1 case. Nine cases were positive for the nucleic acids of 2019-nCoV while one case remained negative by RT-PCR. Coronavirus particles were detected in the cytoplasm of type Ⅱ alveolar epithelium. Conclusions: The pulmonary pathological changes of fatal COVID-19 are diffuse alveolar damage (DAD), mainly in the acute exudative stage and the organic proliferative stage. There are fibrinous exudate aggregation in alveolar cavity with hyaline membrane formation, fibroblastic proliferation in alveolar septum, and alveolar epithelial cell injuries with reactive hyperplasia and desquamation of type Ⅱ alveolar epithelial cells. A large amount of neutrophils and monocytes infiltration is present in most cases and bacteria and fungi are detected in some cases, suggesting a serious bacterial or fungal infection secondary to the DAD.