Tracing the Century-Long Evolution of Microplastics Deposition in a Cold Seep.

Microplastic (MP) pollution is one of the greatest threats to marine ecosystems. Cold seeps are characterized by methane-rich fluid seepage fueling one of the richest ecosystems on the seafloor, and there are approximately more than 900 cold seeps globally. While the long-term evolution of MPs in cold seeps remains unclear. Here, how MPs have been deposited in the Haima cold seep since the invention of plastics is demonstrated. It is found that the burial rates of MPs in the non-seepage areas significantly increased since the massive global use of plastics in the 1930s, nevertheless, the burial rates and abundance of MPs in the methane seepage areas are much lower than the non-seepage area of the cold seep, suggesting the degradation potential of MPs in cold seeps. More MP-degrading microorganism populations and functional genes are discovered in methane seepage areas to support this discovery. It is further investigated that the upwelling fluid seepage facilitated the fragmentation and degradation behaviors of MPs. Risk assessment indicated that long-term transport and transformation of MPs in the deeper sediments can reduce the potential environmental and ecological risks. The findings illuminated the need to determine fundamental strategies for sustainable marine plastic pollution mitigation in the natural deep-sea environments.

Impact of a postpartum care rehabilitation program to prevent postpartum depression at a Secondary Municipal Hospital in Qingdao China: a cross-sectional study (preprint)

Background The emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and other possible influencing factors for PPD among Chinese women during the first postnatal six weeks.Methods The cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 December 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc.Results PPR program has shown a clearly positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with longer relationship duration years (2–5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50).Conclusion Our results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women’s mental and physical health in the early postpartum in China.

Prediction of Symptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection by Quantitative Digital Polymerase Chain Reaction Normalized to International Units.

Although numerous studies have evaluated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection using cycle threshold (Ct) values as a surrogate of viral ribonucleic acid (RNA) load, few studies have used standardized, quantitative methods. We validated a quantitative SARS-CoV-2 digital polymerase chain reaction assay normalized to World Health Organization International Units and correlated viral RNA load with symptoms and disease severity.

An Explorative Study of Affiliate Stigma, Resilience, and Quality of Life Among Parents of Children with Autism Spectrum Disorder (ASD).

Purpose: Children diagnosed with ASD usually have impaired social functions, exhibit repetitive, stereotyped and self-stimulatory behaviors, which make them prone to be stigmatized by the public. However, stigma not only affects those with stigmatization characteristics such as children with ASD but also tends to include other people related to them including parents. This is called affiliate stigma. However, affiliate stigma is unlikely to occur if public awareness is high. Considering that awareness of ASD is still comparatively low in this region and that, as a review of the literature showed, there have been limited studies on stigma and ASD conducted in South-East Asia, particularly in Malaysia, this study is of great significance, especially in the context of the East and other developing countries. The aim of this study was to explore parents' experiences of caring and perceptions of affiliate stigma, resilience and quality of life (QoL) when caring for a child with ASD. Methods: This paper is part of the sequential explanatory mixed-methods study in which, after a cross-sectional study of 144 parents, a qualitative approach was used to explore parents' experiences of caring and their perceptions of affiliate stigma, resilience, and QoL. Participants were recruited when they were accompanying their children to therapy at two tertiary public hospitals in one of the north-eastern states of Malaysia. Eleven parents of children with ASD aged 2-12 years participated. Qualitative data analysis followed Braun and Clarke's methodology of thematic analysis. Results: Four themes were identified: the meaning of QoL, ASD and life adjustment, perceived stigma, and resilience. Conclusion: This is the first Southeast Asian study on parent-perceived affiliate stigma, resilience, and QoL in the context of ASD. These findings can inform healthcare personnel and policymakers into day-to-day parenting realities and therefore an effort to coordinate support services across all disciplines could be made to improve outcomes for both parents and children.

Correlation of gut microbiota and metabolic functions with the antibody response to the BBIBP-CorV vaccine.

Increasing evidence indicates that gut microbiota may play a key role in vaccination immunity. Here, we investigate whether the human gut microbiota and metabolic function correlate with the BBIBP-CorV vaccine response. A total of 207 participants who received the BBIBP-CorV vaccine are enrolled. The gut microbiome and metabolic functions are investigated using metagenomic sequencing and metabolomic assays. We find that BBIBP-CorV vaccination is accompanied by altered microbiome composition and functional pathways, and the gut microbiome and its functional profiles correlate with the vaccine response. The levels of short-chain fatty acids (SCFAs) are much higher in the high antibody response group compared to the low response group, and several SCFAs display a positive correlation with the antibody response. Our study highlights that the gut microbiome and its function is associated with the BBIBP-CorV vaccine response, providing evidence for further exploration of microbiome modulation to improve COVID-19 vaccine efficacy.

Effect of Health Education via Mobile Application in Promoting Quality of Life Among Asthmatic Schoolchildren in Urban Malaysia During the COVID-19 Era: A Quasi-experimental Study.

Bronchial asthma among children is a common chronic disease that may impact quality of life. Health education is one of the strategies to improve knowledge and quality of life. This study aims to assess the effect of health education via a mobile application in promoting the quality of life among schoolchildren with asthma in urban Malaysia during the COVID-19 era. A quasi-experimental, pre- and post-intervention design was used in this study involving a total of 214 students, randomly assigned into two groups (an intervention group and a control group). The control group received face-to-face health education, whereas the experimental group received health education via a mobile application. The findings showed that the total score of quality of life improved from a mean total score at pre-intervention of 5.31 ± 1.27 to post-intervention of 5.66 ± 1.28 for the control group, compared with the experimental group with a mean total score of quality of life at pre-intervention of 5.01 ± 1.36 and post-intervention of 5.85 ± 1.29. A comparison between the experimental and control groups using an independent t test showed statistically significant differences in their mean quality of life scores. The effect of health education via a mobile application showed a statistically significant improvement in the mean quality of life score from pre- to post-intervention ( F1,288 = 57.46, P < .01). As recommended, the use of mobile technology in health education improved the quality of life of schoolchildren with asthma as compared with the traditional methods of a face-to-face lecture and/or a handbook. Thus, educational modules using mobile applications do improve quality of life.

Changes in blood pressure and related risk factors among nurses working in a negative pressure isolation ward

Objective To observe changes in blood pressure (ΔBP) and explore potential risk factors for high ΔBP among nurses working in a negative pressure isolation ward (NPIW). Methods Data from the single-center prospective observational study were used. Based on a routine practice plan, female nurses working in NPIW were scheduled to work for 4 days/week in different shifts, with each day working continuously for either 5 or 6 h. BP was measured when they entered and left NPIW. Multivariable logistic regression was used to assess potential risk factors in relation to ΔBP ≥ 5 mm Hg. Results A total of 84 nurses were included in the analysis. The ΔBP was found to fluctuate on different working days;no significant difference in ΔBP was observed between the schedules of 5 and 6 h/day. The standardized score from the self-rating anxiety scale (SAS) was significantly associated with an increased risk of ΔBP ≥ 5 mm Hg (odds ratio [OR] = 1.12, 95% CI: 1.00–1.24). Working 6 h/day (vs. 5 h/day) in NPIW was non-significantly related to decreased risk of ΔBP (OR = 0.70), while ≥ 2 consecutive working days (vs. 1 working day) was non-significantly associated with increased risk of ΔBP (OR = 1.50). Conclusion This study revealed no significant trend for ΔBP by working days or working time. Anxiety was found to be significantly associated with increased ΔBP, while no <2 consecutive working days were non-significantly related to ΔBP. These findings may provide some preliminary evidence for BP control in nurses who are working in NPIW for Coronavirus Disease 2019 (COVID-19).

covidscreen: a web app and R Package for assessing asymptomatic COVID-19 testing strategies.

BACKGROUND: COVID-19 has caused over 305 million infections and nearly 5.5 million deaths globally. With complete eradication unlikely, organizations will need to evaluate their risk and the benefits of mitigation strategies, including the effects of regular asymptomatic testing. We developed a web application and R package that provides estimates and visualizations to aid the assessment of organizational infection risk and testing benefits to facilitate decision-making, which combines internal and community information with malleable assumptions. RESULTS: Our web application, covidscreen, presents estimated values of risk metrics in an intuitive graphical format. It shows the current expected number of active, primarily community-acquired infections among employees in an organization. It calculates and explains the absolute and relative risk reduction of an intervention, relative to the baseline scenario, and shows the value of testing vaccinated and unvaccinated employees. In addition, the web interface allows users to profile risk over a chosen range of input values. The performance and output are illustrated using simulations and a real-world example from the employee testing program of a pediatric oncology specialty hospital. CONCLUSIONS: As the COVID-19 pandemic continues to evolve, covidscreen can assist organizations in making informed decisions about whether to incorporate covid test based screening as part of their on-campus risk-mitigation strategy. The web application, R package, and source code are freely available online (see "Availability of data and materials").

An adaptive, asymptomatic SARS-CoV-2 workforce screening program providing real-time, actionable monitoring of the COVID-19 pandemic.

COVID-19 remains a challenge worldwide, and testing of asymptomatic individuals remains critical to pandemic control measures. Starting March 2020, a total of 7497 hospital employees were tested at least weekly for SARS CoV-2; the cumulative incidence of asymptomatic infections was 5.64%. Consistently over a 14-month period half of COVID-19 infections (414 of 820, total) were detected through the asymptomatic screening program, a third of whom never developed any symptoms during follow-up. Prompt detection and isolation of these cases substantially reduced the risk of potential workplace and outside of workplace transmission. COVID-19 vaccinations of the workforce were initiated in December 2020. Twenty-one individuals tested positive after being fully vaccinated (3.9 per 1000 vaccinated). Most (61.9%) remained asymptomatic and in majority (75%) the virus could not be sequenced due to low template RNA levels in swab samples. Further routine testing of vaccinated asymptomatic employees was stopped and will be redeployed if needed; routine testing for those not vaccinated continues. Asymptomatic SARS-CoV-2 testing, as a part of enhanced screening, monitors local dynamics of the COVID-19 pandemic and can provide valuable data to assess the ongoing impact of COVID-19 vaccination and SARS-CoV-2 variants, inform risk mitigation, and guide adaptive, operational planning including titration of screening strategies over time, based on infection risk modifiers such as vaccination.

A nucleic acid amplification test-based strategy does not help inform return to work for healthcare workers with COVID-19.

OBJECTIVE: The objective of this study is to assess the utility of a nucleic acid amplification test-based approach to shorten isolation of healthcare workers (HCWs) with COVID-19 in the setting of the highly transmissible omicron variant. METHODS: Between December 24, 2021, and January 5, 2022, HCWs who tested positive for SARS-CoV-2 were retested with PCR at least 5 days since onset of symptoms. RESULTS: Forty-six sequential fully COVID-19 vaccinated HCWs who had tested positive for SARS-CoV-2 underwent follow-up testing. All the samples were confirmed as omicron variants and only four (8.7%) were negative in the follow-up test performed at a median of 6 (range 5-12) since onset of symptoms. CONCLUSIONS: Implementation of a test-based strategy is logistically challenging, increases costs, and did not lead to shorter isolation in our institution.

Host Predictors of Broadly Cross-Reactive Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants of Concern Differ Between Infection and Vaccination.

BACKGROUND: Following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination there is significant variability between individuals in protective antibody levels against SARS-CoV-2, and within individuals against different virus variants. However, host demographic or clinical characteristics that predict variability in cross-reactive antibody levels are not well-described. These data could inform clinicians, researchers, and policymakers on the populations most likely to require vaccine booster shots. METHODS: In an institutional review board-approved prospective observational cohort study of staff at St. Jude Children's Research Hospital, we identified participants with plasma samples collected after SARS-CoV-2 infection, after mRNA vaccination, and after vaccination following infection, and quantitated immunoglobulin G (IgG) levels by enzyme-linked immunosorbent assay to the spike receptor binding domain (RBD) from 5 important SARS-CoV-2 variants (Wuhan Hu-1, B.1.1.7, B.1.351, P.1, and B.1.617.2). We used regression models to identify factors that contributed to cross-reactive IgG against 1 or multiple viral variants. RESULTS: Following infection, a minority of the cohort generated cross-reactive antibodies, IgG antibodies that bound all tested variants. Those who did had increased disease severity, poor metabolic health, and were of a particular ancestry. Vaccination increased the levels of cross-reactive IgG levels in all populations, including immunocompromised, elderly, and persons with poor metabolic health. Younger people with a healthy weight mounted the highest responses. CONCLUSIONS: Our findings provide important new information on individual antibody responses to infection/vaccination that could inform clinicians on populations that may require follow-on immunization.

Safety of inactivated COVID-19 vaccine in tuberous sclerosis complex patients with epilepsy treated with rapamycin.

PURPOSE: To assess the safety of inactivated coronavirus 2019 disease (COVID-19) vaccine in tuberous sclerosis complex (TSC) patients with epilepsy. METHODS: All patients with epilepsy were selected from Efficacy and Safety of Sirolimus in Pediatric Patients with Tuberous Sclerosis (ESOSPIT) project and younger than 17 years old. The patients were treated with mTOR inhibitors (rapamycin). A total of 44 patients who completed the two-dose inactivated COVID-19 vaccine between July 7, 2021, and January 1, 2022, were enrolled. RESULTS: The median age of seizure onset was 23 months. About two-thirds of patients have focal seizures. Thirty-three patients use antiseizure medications. The mean duration of rapamycin treatment was 55.59 ± 18.42 months. Adverse reactions within 28 days after injection occurred in 11 patients (25%), all were under 12 years old. Injection site pain was the most reported event (20.45%), which was mild in severity and improved within one day. All patients had no seizure-related changes after vaccination. CONCLUSION: This study shows that the inactivated COVID-19 vaccine was well tolerated and safe in TSC patients with epilepsy, as well as for those treated with mTOR inhibitors.

Healthy Community-Life Circle Planning Combining Objective Measurement and Subjective Evaluation: Theoretical and Empirical Research

Background: The world faces vast health challenges, and urban residents living in high-density areas have even greater demand for healthy lifestyles. Methods: Based on the data of points of interest, a field survey, and an interview, we explored the healthy community-life circle in the downtown area of Chengdu, China from two perspectives: objective measurement and subjective perception of residents. We evaluated the coverage rate and convenience in accessing eight types of health service facilities within a 15-min walk using linear and logistics regression models to explore the degree of resident satisfaction with facilities and influencing factors. Results: Results showed significant differences in coverage rates between different districts. The overall convenience in accessing health service facilities decreased gradually from the city center to the outskirts. The social environment, the layout of health service facilities, and residents’ travel habits were related to health service facility satisfaction. Results also showed significant differences in various facilities’ accessibility satisfaction between objective measurement and residents’ perception measurement. Compared with subjective measurement, the objective measurements of accessibility for sports venues (objectively measured average minus perceived average: −1.310), sports zones (−0.740), and specialized hospitals (−1.081) were lower;those for community hospitals (0.095), clinics (1.025), and pharmacies (0.765) were higher;and facility accessibility measured by subjective perception had a more significant impact on health facility satisfaction. Pharmacies (OR: 1.932) and community hospitals (OR: 1.751) had the largest impact among the eight types of facilities. Conclusion: This study proposed to construct a healthy community-life circle with a category and hierarchy system.

Rapid Response in an Uncertain Environment: Study of COVID-19 Scientific Research Under the Parallel Model.

PURPOSE: The rapid response of COVID-19 scientific research played a significant role in pandemic prevention and control but failed to block the spread of the pandemic rapidly. Besides the complexity of the virus, the effectiveness of control and prevention measures, and other factors, the adaptation of the mode of conducting scientific research is also crucial for the prevention and control of COVID-19. In this study, a parallel model was used to explore the effects of the rapid scientific response on COVID-19 to assess why pandemics continue to spread under rapid response. ANALYSIS: This study presents the response of scientific research based on country/region and publication dimensions after analyzing COVID-19 studies in the Web of Science and PubMed databases. Co-occurrence analysis of items was used to determine the generation rate of COVID-19 research under different topics to identify the reflected innovation model. RESULTS: More manifestations on rapid response of COVID-19 research, especially compared with the linear model of SARS research, showed that the COVID-19 research followed a parallel or concurrent innovation model. CONCLUSION: Early multi-stakeholder partnership, convenient information sharing, and improved research competence promote the parallel model in COVID-19. Meanwhile, the uncertainty of the COVID-19 virus and the adverse effect of rapid response may limit the time efficiency of the parallel model. In conclusion, the rapid prevention and control of the pandemic cannot fully rely on scientific research but requires more combined effort under an uncertain global setting.

Berberine regulates mesangial cell proliferation and cell cycle to attenuate diabetic nephropathy through the PI3K/Akt/AS160/GLUT1 signalling pathway.

High glucose (HG) is one of the basic factors of diabetic nephropathy (DN), which leads to high morbidity and disability. During DN, the expression of glomerular glucose transporter 1 (GLUT1) increases, but the relationship between HG and GLUT1 is unclear. Glomerular mesangial cells (GMCs) have multiple roles in HG-induced DN. Here, we report prominent glomerular dysfunction, especially GMC abnormalities, in DN mice, which is closely related to GLUT1 alteration. In vivo studies have shown that BBR can alleviate pathological changes and abnormal renal function indicators of DN mice. In vitro, BBR (30, 60 and 90 µmol/L) not only increased the proportion of G1 phase cells but also reduced the proportion of S phase cells under HG conditions at different times. BBR (60 µmol/L) significantly reduced the expression of PI3K-p85, p-Akt, p-AS160, membrane-bound GLUT1 and cyclin D1, but had almost no effect on total protein. Furthermore, BBR significantly declined the glucose uptake and retarded cyclin D1-mediated GMC cell cycle arrest in the G1 phase. This study demonstrated that BBR can inhibit the development of DN, which may be due to BBR inhibiting the PI3K/Akt/AS160/GLUT1 signalling pathway to regulate HG-induced abnormal GMC proliferation and the cell cycle, supporting BBR as a potential therapeutic drug for DN.

Pre-existing humoral immunity to human common cold coronaviruses negatively impacts the protective SARS-CoV-2 antibody response.

SARS-CoV-2 infection causes diverse outcomes ranging from asymptomatic infection to respiratory distress and death. A major unresolved question is whether prior immunity to endemic, human common cold coronaviruses (hCCCoVs) impacts susceptibility to SARS-CoV-2 infection or immunity following infection and vaccination. Therefore, we analyzed samples from the same individuals before and after SARS-CoV-2 infection or vaccination. We found hCCCoV antibody levels increase after SARS-CoV-2 exposure, demonstrating cross-reactivity. However, a case-control study indicates that baseline hCCCoV antibody levels are not associated with protection against SARS-CoV-2 infection. Rather, higher magnitudes of pre-existing betacoronavirus antibodies correlate with more SARS-CoV-2 antibodies following infection, an indicator of greater disease severity. Additionally, immunization with hCCCoV spike proteins before SARS-CoV-2 immunization impedes the generation of SARS-CoV-2-neutralizing antibodies in mice. Together, these data suggest that pre-existing hCCCoV antibodies hinder SARS-CoV-2 antibody-based immunity following infection and provide insight on how pre-existing coronavirus immunity impacts SARS-CoV-2 infection, which is critical considering emerging variants.

Roles of pulmonary telocytes in airway epithelia to benefit experimental acute lung injury through production of telocyte-driven mediators and exosomes.

BACKGROUND: Telocytes (TCs) are experimentally evidenced as an alternative of cell therapies for organ tissue injury and repair. The aims of the present studies are to explore direct roles of TCs and the roles of TC-derived exosomes in support of experimental acute lung injury (ALI) in vivo or in vitro. MATERIALS AND METHODS: The roles of TCs in experimental ALI were firstly estimated. Phosphoinositide 3-kinase (PI3K) p110δ and α/δ/ß isoform inhibitors were used in study dynamic alterations of bio-behaviors, and in expression of functional factors of TCs per se and TC-co-cultured airway epithelial cells during the activation with lipopolysaccharide (LPS). TC-driven exosomes were furthermore characterized for intercellular communication by which activated or non-activated TCs interacted with epithelia. RESULTS: Our results showed that TCs mainly prevented from lung tissue edema and hemorrhage and decreased the levels of VEGF-A and MMP9 induced by LPS. Treatment with CAL101 (PI3K p110δ inhibitor) and LY294002 (PI3Kα/δ/ß inhibitor) could inhibit TC movement and differentiation and increase the number of dead TCs. The expression of Mtor, Hif1α, Vegf-a, or Mmp9 mRNA increased in TCs challenged with LPS, while Mtor, Hif1α, and Vegf-a even more increased after adding CAL101 or Mtor after adding LY. The rate of epithelial cell proliferation was higher in co-culture of human bronchial epithelial (HBE) and TCs than that in HBE alone under conditions with or without LPS challenge or when cells were treated with LPS and CAL101 or LY294002. The levels of mTOR, HIF1α, or VEGF-A significantly increased in mono-cultured or co-cultured cells, challenged with LPS as compared with those with vehicle. LPS-pretreated TC-derived exosomes upregulated the expression of AKT, p-AKT, HIF1α, and VEGF-A protein of HBE. CONCLUSION: The present study demonstrated that intraperitoneal administration of TCs ameliorated the severity of lung tissue edema accompanied by elevated expression of VEGF-A. TCs could nourish airway epithelial cells through nutrients produced from TCs, increasing epithelial cell proliferation, and differentiation as well as cell sensitivity to LPS challenge and PI3K p110δ and α/δ/ß inhibitors, partially through exosomes released from TCs.

Pre-existing humoral immunity to human common cold coronaviruses negatively impacts the protective SARS-CoV-2 antibody response

A major unresolved question is whether prior immunity to endemic, human common cold coronaviruses (hCCCoV) impacts susceptibility to SARS-CoV-2 infection. Lin et al. analyze hCCCoV antibodies in the same individuals before and after SARS-CoV-2 infection, finding pre-existing betacoronavirus antibodies may hinder SARS-CoV-2 effective immunity following infection.

Patients' Technology Readiness and eHealth Literacy: Implications for Adoption and Deployment of eHealth in the COVID-19 Era and Beyond.

The COVID-19 pandemic has rerouted the healthcare ecosystem by accelerating digital health, and rapid adoption of eHealth is partly influenced by eHealth literacy (eHL). This study aims to examine patients' eHL in relation to their "technology readiness"-an innate attitude that is underexplored in clinical research. A total of 276 adult inpatients with hypertension, diabetes mellitus, and coronary heart disease were surveyed cross-sectionally in 2019 using self-reported questionnaires: eHealth Literacy Scale and Technology Readiness Index (2.0). The study found moderate eHL (mean, 27.38) and moderate technology readiness (mean, 3.03) among patients. The hierarchical regression model shows that lower eHL scores were associated with patients of minor ethnicity (Malaysian Chinese), with an unemployed status, and having >1 cardiovascular risk (ß = -0.136 to -0.215, R2 = 0.283, Ps < .005). Technology readiness is a strong determinant of eHL (ΔR2 = 0.295, P < .001) with its subdomains (optimism, innovativeness, and discomfort) significantly influencing eHL (|ß| = 0.28-0.40, Ps < .001), except for the insecurity subdomain. Deployment of eHealth interventions that incorporate assessment of patients' eHL and technology readiness will enable targeted strategies, especially in resource-limited settings hit hard by the pandemic crisis.