Job Stress during the COVID-19 Pandemic amongst Social Workers: A Comparison between Chinese Mainland and Macao

The COVID-19 pandemic may have resulted in front line social workers experiencing job stress, burnout and other psychological distress. Little is known about the work-related stress experienced by Chinese social workers during the pandemic. This study focused on the job stress of social workers from Mainland and Macao. The research aims of this study included: (1) testing whether there is a difference in job stress between social workers from Mainland and Macao during the pandemic and (2) identifying mediating factors that helped explain such regional differences. An online survey collected data from 292 social workers in Mainland China and 108 from Macao in 2020. Mainland participants reported significantly higher job stress than Macao participants. Regional differences in job stress amongst Mainland and Macao social workers were partially attributed to their age and professional role identity. More attention needs to be paid to social workers in Mainland China as they experience higher job stress than their counterparts from Macao. Future research is needed to examine other factors (e.g. job demand and financial compensation) that may contribute to such regional differences.

SpyStapler-mediated assembly of nanoparticle vaccines.

The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has wreaked havoc around the globe, with no end in sight. The rapid emergence of viral mutants, marked by rapid transmission and effective immune evasion, has also posed unprecedented challenges for vaccine development, not least in its speed, mass production, and distribution. Here we report a versatile "plug-and-display" strategy for creating protein vaccines, including those against malaria parasites and SARS-CoV-2, through the combined use of the intrinsically disordered protein ligase SpyStapler and computationally designed viral-like particles. The resulting protein nanoparticles harboring multiple antigens induce potent neutralizing antibody responses in mice, substantially stronger than those induced by the corresponding free antigens. This modular vaccine design enabled by SpyStapler furnishes us with a new weapon for combatting infectious diseases. Electronic Supplementary Material: Supplementary material (further details of the protein sequences, cloning procedures, TEM imaging, ELISA details, and reaction controls) is available in the online version of this article at 10.1007/s12274-022-4951-9.

Therapeutic Polypeptides and Peptidomimetics: Powerful Tools for COVID-19 Treatment.

The coronavirus disease 2019 (COVID-19) pandemic has swept the whole world and brought about a public health crisis of unprecedented proportions. To combat the rapid transmission and possible deaths due to the disease, researchers and companies around the world are developing all possible strategies. Due to the advantages of safety, specificity, and fewer adverse effects, polypeptide and peptidomimetic drugs are considered promising strategies. This review comprehensively summarizes and discusses the progress in development of peptide drugs for use in the treatment of COVID-19. Based on the latest results in this field, we divided them into clinically approved drugs, clinical trial drugs, and clinically ineffective drugs, and outlined the molecular targets and mechanisms of action one by one to reveal their feasibility as promising therapeutic agents for COVID-19. Notably, monoclonal antibodies have shown beneficial effects in the early stages of infection, while Paxlovid can significantly reduce hospitalization and mortality among non-vaccinated patients. Among clinical experimental drugs, both the interleukin-1 receptor antagonist anakinra and the bradykinin B2 receptor antagonist icatibant are well tolerated and effective in patients with COVID-19, but long-term trials are needed to confirm the durability of efficacy.

SpyStapler-mediated assembly of nanoparticle vaccines

The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has wreaked havoc around the globe, with no end in sight. The rapid emergence of viral mutants, marked by rapid transmission and effective immune evasion, has also posed unprecedented challenges for vaccine development, not least in its speed, mass production, and distribution. Here we report a versatile “plug-and-display” strategy for creating protein vaccines, including those against malaria parasites and SARS-CoV-2, through the combined use of the intrinsically disordered protein ligase SpyStapler and computationally designed viral-like particles. The resulting protein nanoparticles harboring multiple antigens induce potent neutralizing antibody responses in mice, substantially stronger than those induced by the corresponding free antigens. This modular vaccine design enabled by SpyStapler furnishes us with a new weapon for combatting infectious diseases. Electronic Supplementary Material Supplementary material (further details of the protein sequences, cloning procedures, TEM imaging, ELISA details, and reaction controls) is available in the online version of this article at 10.1007/s12274-022-4951-9.

The impact of crop specialization on nutritional intake: Evidence from farm households in China.

BACKGROUND: In the wake of the severe impact of COVID-19 on the food security of the vulnerable groups in rural areas, the issue of how to achieve the Sustainable Development Goals 2 aims to "Zero Hunger" (SDG 2) and ensure the food safety of farmers has drawn unprecedented attention. Nutritional intake is generally used as an important indicator to reflect family food security. Under the background that Chinese farmers have gradually changed from the traditional diversified production mode to the specialized production of crops, the main purpose of this article is to explore what are the impact of crop specialization on farmers' nutritional intake? Could the specialization of crop production be taken as an important measure to ensure the food safety of farmers and achieve the SDG 2? METHODS: Based on the micro-survey data from 866 farmer households in China, this paper using Seemingly Unrelated Regressions model, Group Regression model and Mediating Effect model to analyze the average and heterogeneous effects of crop specialization on the nutritional intake of farmers, as well as the mediating effect of income. In addition, robustness test and endogenous treatment were performed by using alternative explanatory variables and IV-2SLS method was used to estimate the results. RESULTS: After correcting for endogenous bias, crop specialization had a significant negative impact on energy intake and fat intake of farmers at the statistical level of 5% and 1% respectively, especially for farmers in mountainous areas. Household income played a mediating effect on the effect of crop specialization on farmers' energy and fat intake, and the proportion of the masking effect was 8.43% and 8.96% respectively. In addition, household financial capital and social capital have a significant positive impact on farmers' nutritional intake. CONCLUSIONS: Crop specialization cannot guarantee the food safety of farmers in terms of nutritional intake. However, when the development trend of crop specialization is irreversible, more attention should be paid to improving the level of various livelihood capital of farmers, especially those in mountainous areas, and to continuously increasing their income to ease and ultimately eliminate the negative impact of crop specialization on farmers' nutritional intake, which finally make everyone realize the SDG 2.

Multiomics analysis of male infertility†.

Infertility affects 8-12% of couples globally, and the male factor is a primary cause in ~50% of couples. Male infertility is a multifactorial reproductive disorder, which can be caused by paracrine and autocrine factors, hormones, genes, and epigenetic changes. Recent studies in rodents and most notably in humans using multiomics approach have yielded important insights into understanding the biology of spermatogenesis. Nonetheless, the etiology and pathogenesis of male infertility are still largely unknown. In this review, we summarized and critically evaluated findings based on the use of advanced technologies to compare normal and obstructive azoospermic versus nonobstructive azoospermic men, including whole-genome bisulfite sequencing, single-cell RNA-seq, whole-exome sequencing, and transposase-accessible chromatin using sequencing. It is obvious that the multiomics approach is the method of choice for basic research and clinical studies including clinical diagnosis of male infertility.

Job Stress during the COVID-19 Pandemic amongst Social Workers: A Comparison between Chinese Mainland and Macao

The COVID-19 pandemic may have resulted in front line social workers experiencing job stress, burnout and other psychological distress. Little is known about the work-related stress experienced by Chinese social workers during the pandemic. This study focused on the job stress of social workers from Mainland and Macao. The research aims of this study included: (1) testing whether there is a difference in job stress between social workers from Mainland and Macao during the pandemic and (2) identifying mediating factors that helped explain such regional differences. An online survey collected data from 292 social workers in Mainland China and 108 from Macao in 2020. Mainland participants reported significantly higher job stress than Macao participants. Regional differences in job stress amongst Mainland and Macao social workers were partially attributed to their age and professional role identity. More attention needs to be paid to social workers in Mainland China as they experience higher job stress than their counterparts from Macao. Future research is needed to examine other factors (e.g. job demand and financial compensation) that may contribute to such regional differences. This article studied the job stress of social workers, during COVID-19, in two different Chinese regions. A survey collected data from 292 social workers in Mainland China and 108 social workers in Macao in 2020. The findings showed that the Mainland social workers reported higher job stress than their Macao counterparts. Regional differences in job stress were partially attributed to their age and professional role identity. Future research is needed to examine other factors (e.g. job demand and financial compensation) that may contribute to such regional differences.

Management of an emergency sample collection team under the setting of whole-community severe acute respiratory syndrome coronavirus 2 nucleic acid testing.

BACKGROUND: During the coronavirus disease 2019 pandemic, a nucleic acid test is frequently conducted to identify positive cases. Compared with a hospital-based strategy, whole-community nucleic acid testing displays a unique advantage in rapid screening of a massive population. Yet a management plan to ensure ample and contamination-free sample collection is lacking.The objective of the current study was to establish an efficient operational mode of whole-community nucleic acid testing by management of a sample collection team and to provide a reference for joint prevention work to contain the spread of severe acute respiratory syndrome coronavirus 2. METHODS: The efficient operation of nucleic acid testing within the community was implemented by urgent setting up of sample collection teams, efficient allocation of medical supplies, optimization of management procedures and coordination among multiple working departments. RESULTS: A total of 21 585 nucleic acid samples were collected within 3 d, while no one was missed or experienced a cross infection. No falls, heatstroke, disputes or other adverse events occurred. CONCLUSIONS: Under the emergency setting of nucleic acid testing of a large population, a management system with orderly organization, clear division of responsibilities and standardized operational procedures should be formulated.

Novel cleavage sites identified in SARS-CoV-2 spike protein reveal mechanism for cathepsin L-facilitated viral infection and treatment strategies.

The spike (S) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an important target for vaccine and drug development. However, the rapid emergence of variant strains with mutated S proteins has rendered many treatments ineffective. Cleavage of the S protein by host proteases is essential for viral infection. Here, we discovered that the S protein contains two previously unidentified Cathepsin L (CTSL) cleavage sites (CS-1 and CS-2). Both sites are highly conserved among all known SARS-CoV-2 variants. Our structural studies revealed that CTSL cleavage promoted S to adopt receptor-binding domain (RBD) "up" activated conformations, facilitating receptor-binding and membrane fusion. We confirmed that CTSL cleavage is essential during infection of all emerged SARS-CoV-2 variants (including the recently emerged Omicron variant) by pseudovirus (PsV) infection experiment. Furthermore, we found CTSL-specific inhibitors not only blocked infection of PsV/live virus in cells but also reduced live virus infection of ex vivo lung tissues of both human donors and human ACE2-transgenic mice. Finally, we showed that two CTSL-specific inhibitors exhibited excellent In vivo effects to prevent live virus infection in human ACE2-transgenic mice. Our work demonstrated that inhibition of CTSL cleavage of SARS-CoV-2 S protein is a promising approach for the development of future mutation-resistant therapy.

Dementia-friendly initiatives within the context of COVID-19 pandemic: Challenges and strategies perceived by service professional stakeholders from the USA and China.

PURPOSES: Dementia-friendly initiatives (DFI) are community-based movements aimed to address stigma, exclusion, and discrimination associated with dementia. This study examined the challenges faced and strategies used by DFI prior to and during the COVID-19 pandemic from the perspectives of stakeholders in the USA and China. METHODS: Qualitative interviews with 17 stakeholders involved in DFI from the United States and mainland China were conducted via the Zoom platform. Semi-structured interview questions focused on DFI challenges and strategies prior to and during the pandemic. Thematic analysis was used to analyze the data. RESULTS: Three major challenges prior to the COVID-19 pandemic included low participation of persons with dementia, difficulties in building community collaborations, and limited funding and resources needed to sustain DFI. During the COVID-19 pandemic, challenges included exacerbated difficulties of involving persons with dementia and reduced policy support for DFI. Strategies implemented prior to COVID-19 included partnerships with community organizations to outreach and engage persons with dementia, and coordination of resources and diversification of funding sources to sustain DFI. Strategies during the COVID-19 pandemic centered on the implementation of person-centered technology to support persons with dementia and family caregivers, and the development of new programs that integrated efforts to address the impact of COVID-19. IMPLICATIONS: DFI in the USA and mainland China shared similar challenges for DFI prior to and during COVID-19. During the COVID-19 pandemic, DFI in both countries showed resourcefulness through reliance on technology, community collaboration, and COVID-19-related resources to provide support and services. While it remains critical to advocate to the central government to fund DFI, DFI in both societies need to be open to other funding sources, hire persons with dementia as key staff members of DFI, and demonstrate its effectiveness through rigorous evaluation.

East Meets West: Community-Based Programs for Dementia Prevention and Support

This East Meets West Symposium presents cross-cultural evidence of community-based programs developed to address cognitive health needs of older adults or to support dementia family caregivers. It includes five studies from mainland China, Taiwan, and the U.S.A. The first study explored the adherence to computerized cognitive training to promote cognitive health among Chinese older adults using a qualitative approach. External encouragement, and self-awareness of performance improvement were found influential to older adults’ adherence. The second study spearheaded by American Association of Retired Persons (AARP) in the U.S.A shed further light on technology use in promoting brain health by comparing in-person versus online cognitive training to older Americans during the COVID-19 pandemic. The third study tested the effectiveness of a cognitive health management model for community-dwelling older adults including healthy and mild cognitively impaired (MCI) ones in Shanghai, China. Older adults with MCI who received the management service showed better cognition outcomes compared to their counterparts in the control group. The fourth study focused on a community program named “Carer Café”, developed to support dementia family caregiver in Taiwan. Participants (n=375) reported reduced stress and increased access to service referrals. The last study examined the stakeholders’ perceptions of dementia friendly initiatives (DFI) being implemented in U.S.A, mainland China, and Taiwan to support persons with dementia and family caregivers. The impacts of DFI made, challenges DFI faced, and strategies DFI used during COVID-19 pandemic were discussed. The discussant will comment on each article’s contributions and limitations in the context of literature.

Infrared Vein Imaging for Insertion of Peripheral Intravenous Catheter for Patients Requiring Isolation for Severe Acute Respiratory Syndrome Coronavirus 2 Infection: A Nonrandomized Clinical Trial.

INTRODUCTION: Establishing intravenous access is essential but may be difficult to achieve for patients requiring isolation for severe acute respiratory syndrome coronavirus 2 infection. This study aimed to investigate the effectiveness of an infrared vein visualizer on peripheral intravenous catheter therapy in patients with coronavirus disease 2019. METHODS: A nonrandomized clinical trial was performed. In total, 122 patients with coronavirus disease 2019 who required peripheral intravenous cannulation were divided into 2 groups with 60 in the control group and 62 in the intervention group. A conventional venipuncture method was applied to the control group, whereas an infrared vein imaging device was applied in the intervention group. The first attempt success rate, total procedure time, and patients' satisfaction score were compared between the 2 groups using chi-square, t test, and z test (also known as Mann-Whitney U test) statistics. RESULTS: The first attempt success rate in the intervention group was significantly higher than that of control group (91.94% vs 76.67%, ꭓ2 = 5.41, P = .02). The procedure time was shorter in the intervention group (mean [SD], 211.44 [68.58] seconds vs 388.27 [88.97] seconds, t = 12.27, P < .001). Patients from the intervention group experienced a higher degree of satisfaction (7.5 vs 6, z = -3.31, P < .001). DISCUSSION: Peripheral intravenous catheter insertion assisted by an infrared vein visualizer could improve the first attempt success rate of venipuncture, shorten the procedure time, and increase patients' satisfaction.

Mental Health Among Informal Caregivers of Older Adults in Asia

The purpose of this symposium is to highlight the mental health needs and factors associated with mental health among informal caregivers of older adults in Asia. The symposium consists of five papers. The first paper explores the perceived role, needs, and rewards of informal caregiving among caregivers of residents in independent long-term care facilities in South India. The second paper presents a systematic review and meta-analysis on the association between long-term care service use and informal caregiver burden, depression, and health status. The third paper examines the association between caregivers’ characteristics and quality of life among informal caregivers of older adults with cognitive impairment in China. The fourth paper examines the association between coping strategies and caregiver burden and depression among Chinese caregivers of older adults with cognitive impairment. The last paper examines the association between cohort, meaning making, and depression among adult caregivers during the COVID-19 pandemic in Hong Kong. Taken together, these five papers underscore of the mental health needs and protective and risk factors of mental well-being among caregivers in Asia. Findings of those papers inform the development and adaptation of culturally sensitive interventions to improve mental health outcomes among informal caregivers in Asia. The disccuant will comment on the strengths and limitations of these papers in terms of their contributions to the theory, research, and practice on mental health among informal caregivers in Asia.

Implementing Dementia Friendly Initiatives in the Community: Perceptions of Stakeholders in the USA and China

To address the exclusion of persons living with dementia (PWD), Dementia Friendly Initiatives (DFI) are being launched to build a friendly and supportive environment for PWD in the U.S.A, mainland China, and Taiwan. This study aims to identify the impact of DFI, the challenges DFI encountered, and strategies used to address such challenges within the COVID-19 context in American and Chinese societies. Individual interviews via Zoom with 9 stakeholders from the U.S.A, 8 from mainland China and one from Taiwan were transcribed for analyses. DFI have shown effectiveness in raising the public’s dementia awareness and engaging PWD in the community. COVID-19 pandemic posed the challenges of serving isolated PWD due to resources and attention shifted to COVID-19 prevention. Person-centered and technology-based means were used to deliver services for PWD during the pandemic. DFI in American and Chinese societies experienced similar sustainability challenges but showed resilience during the COVID-19 pandemic.

Nanometer-resolution in situ structure of the SARS-CoV-2 postfusion spike protein.

The spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mediates membrane fusion to allow entry of the viral genome into host cells. To understand its detailed entry mechanism and develop a specific entry inhibitor, in situ structural information on the SARS-CoV-2 spike protein in different states is urgent. Here, by using cryo-electron tomography, we observed both prefusion and postfusion spikes in ß-propiolactone-inactivated SARS-CoV-2 virions and solved the in situ structure of the postfusion spike at nanometer resolution. Compared to previous reports, the six-helix bundle fusion core, the glycosylation sites, and the location of the transmembrane domain were clearly resolved. We observed oligomerization patterns of the spikes on the viral membrane, likely suggesting a mechanism of fusion pore formation.

Structural and functional basis for pan-CoV fusion inhibitors against SARS-CoV-2 and its variants with preclinical evaluation.

The COVID-19 pandemic poses a global threat to public health and economy. The continuously emerging SARS-CoV-2 variants present a major challenge to the development of antiviral agents and vaccines. In this study, we identified that EK1 and cholesterol-coupled derivative of EK1, EK1C4, as pan-CoV fusion inhibitors, exhibit potent antiviral activity against SARS-CoV-2 infection in both lung- and intestine-derived cell lines (Calu-3 and Caco2, respectively). They are also effective against infection of pseudotyped SARS-CoV-2 variants B.1.1.7 (Alpha) and B.1.1.248 (Gamma) as well as those with mutations in S protein, including N417T, E484K, N501Y, and D614G, which are common in South African and Brazilian variants. Crystal structure revealed that EK1 targets the HR1 domain in the SARS-CoV-2 S protein to block virus-cell fusion and provide mechanistic insights into its broad and effective antiviral activity. Nasal administration of EK1 peptides to hACE2 transgenic mice significantly reduced viral titers in lung and intestinal tissues. EK1 showed good safety profiles in various animal models, supporting further clinical development of EK1-based pan-CoV fusion inhibitors against SARS-CoV-2 and its variants.

MBD2 serves as a viable target against pulmonary fibrosis by inhibiting macrophage M2 program.

Despite past extensive studies, the mechanisms underlying pulmonary fibrosis (PF) still remain poorly understood. Here, we demonstrated that lungs originating from different types of patients with PF, including coronavirus disease 2019, systemic sclerosis-associated interstitial lung disease, and idiopathic PF, and from mice following bleomycin (BLM)-induced PF are characterized by the altered methyl-CpG-binding domain 2 (MBD2) expression in macrophages. Depletion of Mbd2 in macrophages protected mice against BLM-induced PF. Mbd2 deficiency significantly attenuated transforming growth factor-ß1 (TGF-ß1) production and reduced M2 macrophage accumulation in the lung following BLM induction. Mechanistically, Mbd2 selectively bound to the Ship promoter in macrophages, by which it repressed Ship expression and enhanced PI3K/Akt signaling to promote the macrophage M2 program. Therefore, intratracheal administration of liposomes loaded with Mbd2 siRNA protected mice from BLM-induced lung injuries and fibrosis. Together, our data support the possibility that MBD2 could be a viable target against PF in clinical settings.

Worries, strategies, and confidence of older Chinese adults during the 2019 novel coronavirus outbreak.

OBJECTIVES: Since the novel coronavirus disease (COVID-19) outbreak started in late 2019, the older population has accounted for a large proportion of severe and fatal cases. This study investigated the mental state and attitudes of older Chinese adults during this epidemic. DESIGN: Cross-sectional online surveys on a convenience sample of China's general population at two different time points. Online surveys were disseminated through popular Chinese social media applications. Adults 18 or older living in China during the initial (N = 1148) and second stages (N = 470) were included in the survey. The Worries, Strategies, and Confidence Questionnaire was created to assess worries and awareness of the disease. RESULTS: Combined responses (N = 1618), 76.1% were female and about 7.0% were 60 years or above. In the first wave, older adults were found less likely to worry about being infected by COVID-19 (p < 0.05) and reported less attention paid to protective measures (p = 0.004) than young adults. However, as the disease evolved, older participants in the second wave were more worried than young adults (p = 0.027) and older adults in the first wave (p = 0.001). CONCLUSIONS: During the epidemic of COVID-19, watchfulness of the epidemic among older Chinese adults fluctuated over time. Initially, they were slow to respond proactively, but their worries gradually increased. Health care and social service professionals need to address the vulnerabilities of older adults to this public health crisis.

Minireview of progress in the structural study of SARS-CoV-2 proteins.

A severe form of pneumonia, named coronavirus disease 2019 (COVID-19) by the World Health Organization, broke out in China and rapidly developed into a global pandemic, with millions of cases and hundreds of thousands of deaths reported globally. The novel coronavirus, which was designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified as the etiological agent of COVID-19. On the basis of experience accumulated following previous SARS-CoV and MERS-CoV outbreaks and research, a series of studies have been conducted rapidly, and major progress has been achieved with regard to the understanding of the phylogeny and genomic organization of SARS-CoV-2 in addition its molecular mechanisms of infection and replication. In the present review, we summarized crucial developments in the elucidation of the structure and function of key SARS-CoV-2 proteins, especially the main protease, RNA-dependent RNA polymerase, spike glycoprotein, and nucleocapsid protein. Results of studies on their associated inhibitors and drugs have also been highlighted.