Mediating effect of perceived social support between mindfulness level and mental health of nursing undergraduates during the epidemic of novel coronavirus pneumonia

Objective: To study students' mental health status during epidemic of novel coronavirus pneumonia, and to explore the influence of mindfulness level and perceived social support on mental health. Methods: A total of 240 undergraduate nursing students were investigated with Depression Anxiety and Stress Scale, Five Facets Mindfulness Questionnaire, Perceived Social Support Scale and Pittsburgh Sleep Quality Index. SAS and Mplus were applied to describe the data and conduct mediation analysis. Results: About 18.8% of the participants were depressed and 27.9% were anxious, 13.3% were stressed, and 31.7% had problems of sleeping. The mindfulness level could directly affect sleep disorder (beta = - 0.242, P < 0.001), stress (beta = - 0.397, P < 0.001), anxiety (beta = - 0.350, P < 0.001)and depression(beta = - 0.484, P < 0.001), and could also indirectly affect sleep disorder (beta = - 0.171, P < 0.001), stress (beta = - 0.105, P = 0.029), anxiety (beta = - 0.102, P = 0.034) and depression (beta = - 0.180, P < 0.001) via the mediation role of perceived social support with the mediating effects accounted for 41.40%, 20.92%, 22.52% and 37.19%, respectively. Conclusions: Mindfulness level can improve the mental health of nursing undergraduates through direct action and understanding the intermediary role of social support. Nursing educators can consider integrating mindfulness decompression training into daily teaching, and give nursing undergraduates enough psychological and emotional support and encouragement to improve their mental health level.

Real-World COPD Management Over 3 Years at the Community Health Service Center of Shanghai During the COVID-19 Pandemic in China.

Objective: To evaluate the real-world situation for the management of chronic obstructive pulmonary disease (COPD) and poorly controlled disease risk factors in the Chinese community. Methods: This retrospective multicentre study analysed data from COPDMICand MICHC in Shanghai Songjiang District, Shanghai, China. The differences in COPD Assessment Test (CAT), the modified Medical Research Council (mMRC) dyspnea scale, and the number of emergency cases, emergency visits, inpatient cases, and hospitalisations from January 2018 to December 2020 were analysed. The impact of coronavirus disease 2019 (COVID-19) on COPD management was also assessed. Results: For 2020 versus 2018, analysis of 468 COPD cases from COPDMIC matched with MICHC data showed significantly more patients with improved mMRC grades, significantly fewer emergency cases and emergency visits, and significantly fewer hospitalisation cases and hospitalisations. Differences in the number of emergency visits and hospitalisations per capita were statistically significant. Compared to GOLD 3-4, GOLD 1-2 patients showed significant improvements in CAT score, mMRC grade, the number of emergency visits and hospitalisations per capita. Treatment adherence from 2018 to 2020 was 25%, 29.1%, and 6.8%, and the proportion of medication regimens consistent with guidelines was 43.44%, 50.98%, and 71.87%, respectively. Higher treatment adherence resulted in significantly improved CAT scores and mMRC grades and fewer emergency department visits and hospitalisations per capita. Conclusion: Combined with remote management tools, patients with COPD achieved continuous improvement in symptoms and exacerbations over 3 years. In the context of COVID-19 prevention/control measures, improvements were significant for patients with GOLD 1-2 COPD but limited with GOLD 3-4. Pharmacologic treatment significantly improved clinical symptoms and reduced emergency visits and hospitalisations. Severe airflow limitation and poor adherence to pharmacologic treatment were important risk factors for lack of disease remission.

Supercoiling Structure-Based Design of a Trimeric Coiled-Coil Peptide with High Potency against HIV-1 and Human ß-Coronavirus Infection.

Hexameric structure formation through packing of three C-terminal helices and an N-terminal trimeric coiled-coil core has been proposed as a general mechanism of class I enveloped virus entry. In this process, the C-terminal helical repeat (HR2) region of viral membrane fusion proteins becomes transiently exposed and accessible to N-terminal helical repeat (HR1) trimer-based fusion inhibitors. Herein, we describe a mimetic of the HIV-1 gp41 HR1 trimer, N3G, as a promising therapeutic against HIV-1 infection. Surprisingly, we found that in addition to protection against HIV-1 infection, N3G was also highly effective in inhibiting infection of human ß-coronaviruses, including MERS-CoV, HCoV-OC43, and SARS-CoV-2, possibly by binding the HR2 region in the spike protein of ß-coronaviruses to block their hexameric structure formation. These studies demonstrate the potential utility of anti-HIV-1 HR1 peptides in inhibiting human ß-coronavirus infection. Moreover, this strategy could be extended to the design of broad-spectrum antivirals based on the supercoiling structure of peptides.

Community Services and Social Involvement in COVID-19 Governance: Evidence from China.

This study explores how the services provided by different types of Chinese communities varied in their impact on the social involvement of residents during the COVID-19 pandemic. The literature revealed problems caused by travel restrictions, including using oversimplified measures for grassroots governance, which might result in decreased residents' social involvement during COVID-19. We argue that the services provided by "smart communities" in China not only adhered to the COVID-19 pandemic governance, but also promoted the social involvement of residents. Using a case study approach of the smart community Fang Xing and the traditional community Qili Tang, both of which are located in China, this article compared the traditional and smart community services based on 122 interviews with residents and frontline community staff members. The findings suggest that while the traditional community decreased the residents' social involvement by restricting certain services during the pandemic, the smart community was able to apply COVID-19 governance measures, considerably increasing the residents' social involvement. It offered an attractive option for residents to act as community service managers, and it prepared them for local-level pandemic governance. This study provides an understanding of the relationship between the community services and the residents' social involvement in terms of the community services. The smart community model can act as a reference for international community development during pandemic governance.

Cytokine storm-calming property of the isoquinoline alkaloids in Coptis chinensis Franch.

Coronavirus disease (COVID-19) has spread worldwide and its effects have been more devastating than any other infectious disease. Importantly, patients with severe COVID-19 show conspicuous increases in cytokines, including interleukin (IL)-6, monocyte chemoattractant protein (MCP)-1, IL-8, tumor necrosis factor (TNF)-α, IL-1, IL-18, and IL-17, with characteristics of the cytokine storm (CS). Although recently studied cytokine inhibitors are considered as potent and targeted approaches, once an immunological complication like CS happens, anti-viral or anti-inflammation based monotherapy alone is not enough. Interestingly, certain isoquinoline alkaloids in Coptis chinensis Franch. (CCFIAs) exerted a multitude of biological activities such as anti-inflammatory, antioxidant, antibacterial, and immunomodulatory etc, revealing a great potential for calming CS. Therefore, in this timeline review, we report and compare the effects of CCFIAs to attenuate the exacerbation of inflammatory responses by modulating signaling pathways like NF-ĸB, mitogen-activated protein kinase, JAK/STAT, and NLRP3. In addition, we also discuss the role of berberine (BBR) in two different triggers of CS, namely sepsis and viral infections, as well as its clinical applications. These evidence provide a rationale for considering CCFIAs as therapeutic agents against inflammatory CS and this suggestion requires further validation with clinical studies.

Covering the Broad Spectrum of Intelligent Systems: From Neuromorphic Engineering to Robotics

Table 1 Highly cited articles published in Advanced Intelligent Systems in 2019/2020 with more than 25 citations in 2021 (Web of Science, 13 December 2022) Article Title (Article Type) Authors (Corresponding*) DOI 2021 Citations Wearable and Stretchable Strain Sensors: Materials, Sensing Mechanisms, and Applications (Review) Hamid Souri*, Hritwick Banerjee, Ardian Jusufi, Norbert Radacsi, Adam A. Stokes, Inkyu Park, Metin Sitti, Morteza Amjadi* https://doi.org/10.1002/aisy.202000039 61 Robotics, Smart Wearable Technologies, and Autonomous Intelligent Systems for Healthcare During the COVID-19 Pandemic: An Analysis of the State of the Art and Future Vision (Essay) Mahdi Tavakoli*, Jay Carriere, Ali Torabi https://doi.org/10.1002/aisy.202000071 52 Soft Actuators for Soft Robotic Applications: A Review (Review) Nazek El-Atab, Rishabh B. Mishra, Fhad Al-Modaf, Lana Joharji, Aljohara A. Alsharif, Haneen Alamoudi, Marlon Diaz,Nadeem Qaiser, Muhammad Mustafa Hussain* https://doi.org/10.1002/aisy.202000128 35 Magnetic Actuation Systems for Miniature Robots: A Review (Review) Zhengxin Yang, Li Zhang* https://doi.org/10.1002/aisy.202000082 29 Artificial Intelligence and Machine Learning Empower Advanced Biomedical Material Design to Toxicity Prediction (Review) Ajay Vikram Singh*, Daniel Rosenkranz, Mohammad Hasan Dad Ansari, Rishabh Singh, Anurag Kanase, Shubham Pratap Singh, Blair Johnston, Jutta Tentschert, Peter Laux, Andreas Luch https://doi.org/10.1002/aisy.202000084 29 Complementary Metal-Oxide Semiconductor and Memristive Hardware for Neuromorphic Computing (Progress Report) Mostafa Rahimi Azghadi*, Ying-Chen Chen, Jason K. Eshraghian, Jia Chen,Chih-Yang Lin, Amirali Amirsoleimani, Adnan Mehonic, Anthony J. Kenyon, Burt Fowler, Jack C. Lee, Yao-Feng Chang* https://doi.org/10.1002/aisy.201900189 25 However, impact factor won't be the only metric reported by Wiley journals anymore. The scope of Advanced Intelligent Systems covers timely topics that are not only of interest to scientists and engineers but are also closely followed by the general public. Since the launch of the journal, several papers published in the journal have been highlighted by social media platforms and news outlets. Table 2 Papers published in 2022 with an Altmetric score above 40 (Altmetric, 13 Dec 2022) Article Title Authors (Corresponding*) DOI Altmetric Score An Autonomous Chemically Fueled Artificial Protein Muscle Matthias C. Huber, Uwe Jonas, Stefan M. Schiller* https://doi.org/10.1002/aisy.202100189 189 Neuromorphic Metamaterials for Mechanosensing and Perceptual Associative Learning Katherine S. Riley, Subhadeep Koner, Juan C. Osorio, Yongchao Yu, Harith Morgan, Janav P. Udani, Stephen A. Sarles*, Andres F. Arrieta* https://doi.org/10.1002/aisy.202200158 178 All-Electric Nonassociative Learning in Nickel Oxide Sandip Mondal*, Zhen Zhang, A. N. M. Nafiul Islam, Robert Andrawis, Sampath Gamage, Neda Alsadat Aghamiri, Qi Wang, Hua Zhou, Fanny Rodolakis, Richard Tran, Jasleen Kaur, Chi Chen, Shyue Ping Ong, Abhronil Sengupta, Yohannes Abate, Kaushik Roy, Shriram Ramanathan https://doi.org/10.1002/aisy.202200069 110 Autonomous Nanocrystal Doping by Self-Driving Fluidic Micro-Processors Fazel Bateni, Robert W. Epps, Kameel Antami, Rokas Dargis, Jeffery A. Bennett, Kristofer G. Reyes, Milad Abolhasani* https://doi.org/10.1002/aisy.202200017 61 Overcoming the Force Limitations of Magnetic Robotic Surgery: Magnetic Pulse Actuated Collisions for Tissue-Penetrating-Needle for Tetherless Interventions Onder Erin*, Xiaolong Liu, Jiawei Ge, Justin Opfermann, Yotam Barnoy, Lamar O. Mair, Jin U. Kang, William Gensheimer, Irving N. Weinberg, Yancy Diaz-Mercado, Axel Krieger* https://doi.org/10.1002/aisy.202200072 43 Our promotional activities to enhance the visibility of the journal and its papers continued in 2022.

Improved nasal recovery and intact olfactory function after a transseptal approach for endoscopic endonasal transsphenoidal adenomectomy: A retrospective analysis.

Objectives: Endoscopic endonasal transsphenoidal adenomectomy (TSA) is the most frequently performed skull base surgery, and researchers have recently focused on preserving nasal function. The endoscopic transseptal approach is a promising procedure due to its reduced injury to the nasal mucosa; however, there are no studies comparing rhinological and neurosurgical outcomes concurrently with the standard endoscopic transnasal approach. Therefore, we conducted this study to investigate whether the transseptal approach could reduce nasal morbidities with comparable neurosurgical outcomes. Methods: We retrospectively reviewed 25 patients who underwent endoscopic endonasal transseptal TSA for pituitary adenoma without encasement of internal carotid artery from January 2019 to December 2020. Another 25 patients who received transnasal approach from January 2017 to December 2018 were selected as controls. Patients with diseases affecting the nasal cavity/olfaction or usage of a nasoseptal flap were excluded for a better comparison of the two procedures. We collected data from radiological studies, endocrine studies, endoscopic evaluations, 22-item sinonasal outcome tests (SNOT-22) and Top International Biotech Smell Identification Test (TIBSIT) for comparison. Results: Lower postoperative SNOT-22 and Lund-Kennedy endoscopic scores were observed in the transseptal group. The effect size of differences were classified as large effect (The absolute value of Cohen's d > 0.8). Nevertheless, the TIBSIT scores were not significantly different. The rates of gross total resection, recovery of hormonal abnormalities, and complications were not significantly different. After controlling possible confounding factors using multivariate analysis, the endoscopic transseptal approach remained an independent factor for lower SNOT-22 scores and Lund-Kennedy endoscopic scores. Conclusions: The endoscopic transseptal approach provides improved recovery of nasal mucosa and intact olfaction without compromising neurosurgical outcomes. Level of Evidence: 2b.

Future COVID19 surges prediction based on SARS-CoV-2 mutations surveillance.

COVID19 has aptly revealed that airborne viruses such as SARS-CoV-2 with the ability to rapidly mutate combined with high rates of transmission and fatality can cause a deadly worldwide pandemic in a matter of weeks (Plato et al., 2021). Apart from vaccines and post-infection treatment options, strategies for preparedness will be vital in responding to the current and future pandemics. Therefore, there is wide interest in approaches that allow predictions of increase in infections ('surges') before they occur. We describe here real-time genomic surveillance particularly based on mutation analysis, of viral proteins as a methodology for a priori determination of surge in number of infection cases. The full results are available for SARS-CoV-2 at http://pandemics.okstate.edu/covid19/, and are updated daily as new virus sequences become available. This approach is generic and will also be applicable to other pathogens.

Bibliometric and visual analysis of cardiovascular diseases and COVID-19 research.

Background: The global community has been affected by the coronavirus disease 2019 (COVID-19), which emerged in December 2019. Since then, many studies have been conducted on cardiovascular diseases (CVDs) and COVID-19. The aim of this study was to perform a bibliometric and visual analysis of the published relationship between CVDs and COVID-19. Methods: 1,890 publications were retrieved from the Web of Science Core Collection database on January 5, 2022. Microsoft Office Excel and CiteSpace were then used to carry out scientometric analysis on the relevant literature according to seven aspects: document type, countries/regions, institutions, authors, journals, references, and keywords. Results: The research on CVDs and COVID-19 is currently in a period of rapid development, with China, USA, England, and Italy leading the field. There is active cooperation between most countries and institutions. Harvard Medical School stands out among the many institutions not only for the largest number of publications, but also for their high quality. Banerjee A, Solomon SD and Narula J are three representative authors in this field. Frontiers in Cardiovascular Medicine was the journal with the highest number of published studies, and The Lancet was the most cited journal. Two documents with a high degree of significance in this field were identified. Popular research topics in this field are specific diseases, such as acute coronary syndrome and heart failure; pathogenesis related to ACE2, insulin resistance and pericyte; the specific therapeutic drug chloroquine; and clinical characteristics, physical activity, and mental health. ACE2 and NF-κB will be the focus of future research. Conclusions: This study provides useful information for the research of CVDs and COVID-19, including potential collaborators, popular research topics, and a reference for more extensive and in-depth research in the future.

A coalitional game-based joint monitoring mechanism for combating COVID-19.

In the absence of effective treatment for COVID-19, disease prevention and control have become a top priority across the world. However, the general lack of effective cooperation between communities makes it difficult to suppress the community spread of the global pandemic; hence repeated outbreaks of COVID-19 have become the norm. To address this problem, this paper considers community cooperation in disease monitoring and designs a joint epidemic monitoring mechanism, in which adjacent communities cooperate to enhance their monitoring capability. In this work, we formulate the epidemiological monitoring process as a coalitional game. Then, we propose a Shapley value-based payoffs distribution scheme for the coalitional game. A comprehensive analytical framework is developed to evaluate the advantages and sustainability of the cooperation between communities. Experimental results show that the proposed mechanism performs much better than the conventional non-cooperative monitoring design and can greatly increase each community's payoffs.

Mindfulness-based online intervention on mental health among undergraduate nursing students during coronavirus disease 2019 pandemic in Beijing, China: A randomized controlled trial

Objective To evaluate the effect of mindfulness intervention on improving mental health among undergraduate nursing students during the coronavirus disease 2019 (COVID-19) pandemic in China. Methods An online mindfulness intervention course named Mindfulness Living With Challenge (MLWC) was developed by the research team, and a randomized controlled trial using MLWC among Chinese undergraduate nursing students was carried out. A total of 120 undergraduate nursing students were randomized into control (60 students) and intervention groups (60 students) via a WeChat mini program. Self-administered questionnaire surveys were conducted at pre- and post-intervention, measuring depression, anxiety, stress, mindfulness, and perceived social support. After intervention, the acceptance of the online mindfulness course among participants was assessed by employing the theory of technology acceptance model (TAM). Results Among the enrolled 120 participants, 86.67% (52/60) and 93.33% (56/60) of the intervention and control groups remained completed the trial and the questionnaire surveys. Compared with the control group, the reduction of anxiety and stress symptoms, as well as the improvement of mindfulness level and perceived social support in the MLWC intervention group were statistically significant (P < 0.05), while the change in depression was not statistically significant. The scores of the four dimensions in TAM ranged from (5.88 ± 0.94) to (5.91 ± 0.97). Conclusion Online mindfulness intervention implemented in this study is effective in improving mental health among undergraduate nursing students, and they were interested in this intervention. Clinical trial registration [www.ClinicalTrials.gov], identifier [ChiCTR2 200058103].

Construction of infectious bronchitis virsus endoribonucleasensp15 defective recombinant virus by reverse genetic system

Infectious Bronchitis Virus (1BV) belongs to the y coronavirus, however, the function of IBV encoded endoribonuclease (non - structural protein 15, nsp15) has not been determined yet. To explore the function of nsp15 in the process of IBV replication, we mutated the IBV nsp15 endonuclease core residue His238 to Ala, constructed the nsp15-defective recombinant virus rIBV-nsp15-H238A, via in vitro ligation and recombination technology. Plaque assay and TCID50 were performed to measure virus titer, virus plaque size and growth curve. The IBV Beaudette-R genome was cloned as 5 fragments in vectors, BsaI or BsmBI restriction sites were added to the end of each fragment. After plasmid amplification, the cDNA fragments were obtained by enzymatic digestion, followed with in vitro ligation and transcription. Full - length genomic RNA was electroporated into Vero cells, together with N transcript, to rescue the recombinant viruses rIBV and rIBV - nsp15- H238A. Plaque assay was performed to detect and compare the viral titer and plaque size of these two recombinant viruses. Results showed that the virus titer of rIBV -nsp15 -H238A was 2.71x106PFU/mL, 3 times lower than that of rIBV (9.4x106PFU/mL). The plaque size of rIBV-nsp15-H238A was much smaller than that of rIBV, indicating that rIBV-nsp15-11238A replicates and spreads slower than rIBV. The growth curve of rIBV-nsp15-H238A was slower than that of rIBV. Our study demonstrates that nsp15 I-1238 is the key amino acid and plays an important role in the replication and spread of IBV. The construction of nsp15 defective recombinant virus provides a powerful tool for the study of the function of nsp15.

Cytokine storm-calming property of the isoquinoline alkaloids in Coptis chinensis Franch

Coronavirus disease (COVID-19) has spread worldwide and its effects have been more devastating than any other infectious disease. Importantly, patients with severe COVID-19 show conspicuous increases in cytokines, including interleukin (IL)-6, monocyte chemoattractant protein (MCP)-1, IL-8, tumor necrosis factor (TNF)-α, IL-1, IL-18, and IL-17, with characteristics of the cytokine storm (CS). Although recently studied cytokine inhibitors are considered as potent and targeted approaches, once an immunological complication like CS happens, anti-viral or anti-inflammation based monotherapy alone is not enough. Interestingly, certain isoquinoline alkaloids in Coptis chinensis Franch. (CCFIAs) exerted a multitude of biological activities such as anti-inflammatory, antioxidant, antibacterial, and immunomodulatory etc, revealing a great potential for calming CS. Therefore, in this timeline review, we report and compare the effects of CCFIAs to attenuate the exacerbation of inflammatory responses by modulating signaling pathways like NF-ĸB, mitogen-activated protein kinase, JAK/STAT, and NLRP3. In addition, we also discuss the role of berberine (BBR) in two different triggers of CS, namely sepsis and viral infections, as well as its clinical applications. These evidence provide a rationale for considering CCFIAs as therapeutic agents against inflammatory CS and this suggestion requires further validation with clinical studies.

Emotional exhaustion and unhealthy eating among COVID-19 front-line healthcare workers during recuperation: A cross-sectional study.

Objective: Thousands of healthcare workers on the frontlines who have been battling the COVID-19 pandemic could face emotional and mental health risks even after their critical pandemic work. This study examined the impact of affective rumination on emotional exhaustion and the spillover effect of affective rumination on unhealthy food consumption among healthcare workers during recuperation. Methods: A total of 418 frontline healthcare workers from 10 Chinese medical institutions were recruited through random cluster sampling. A linear mixed model in SPSS25.0 was performed for hierarchical regression to analyze the effect of affective rumination on unhealthy food consumption via emotional exhaustion. A conditional process analysis was employed to investigate the moderating role of family support in the mediating effect of emotional exhaustion. Results: Front-line healthcare workers scored at a medium level on an emotional exhaustion scale (2.45 ± 0.88). Affective rumination mediated by emotional exhaustion had a significant positive predictive effect on unhealthy food consumption. The indirect effect accounted for ~43.9% of the total effect. Family support amplified the effect of emotional exhaustion on unhealthy food consumption (ß = 0.092, p < 0.05). Conclusion: Affective rumination could be a cause of emotional exhaustion and unhealthy food consumption. First-line healthcare workers could be screened for possible emotional exhaustion through the evaluation of affective rumination in order to provide them with targeted interventions. Family support did not prove to be beneficial in all cases as it enhanced the positive effect of emotional exhaustion on unhealthy eating in the current study. Therefore, family support should be carefully integrated in future interventions.

Early prediction of noninvasive ventilation failure after extubation: development and validation of a machine-learning model.

BACKGROUND: Noninvasive ventilation (NIV) has been widely used in critically ill patients after extubation. However, NIV failure is associated with poor outcomes. This study aimed to determine early predictors of NIV failure and to construct an accurate machine-learning model to identify patients at risks of NIV failure after extubation in intensive care units (ICUs). METHODS: Patients who underwent NIV after extubation in the eICU Collaborative Research Database (eICU-CRD) were included. NIV failure was defined as need for invasive ventilatory support (reintubation or tracheotomy) or death after NIV initiation. A total of 93 clinical and laboratory variables were assessed, and the recursive feature elimination algorithm was used to select key features. Hyperparameter optimization was conducted with an automated machine-learning toolkit called Neural Network Intelligence. A machine-learning model called Categorical Boosting (CatBoost) was developed and compared with nine other models. The model was then prospectively validated among patients enrolled in the Cardiac Surgical ICU of Zhongshan Hospital, Fudan University. RESULTS: Of 929 patients included in the eICU-CRD cohort, 248 (26.7%) had NIV failure. The time from extubation to NIV, age, Glasgow Coma Scale (GCS) score, heart rate, respiratory rate, mean blood pressure (MBP), saturation of pulse oxygen (SpO2), temperature, glucose, pH, pressure of oxygen in blood (PaO2), urine output, input volume, ventilation duration, and mean airway pressure were selected. After hyperparameter optimization, our model showed the greatest accuracy in predicting NIV failure (AUROC: 0.872 [95% CI 0.82-0.92]) among all predictive methods in an internal validation. In the prospective validation cohort, our model was also superior (AUROC: 0.846 [95% CI 0.80-0.89]). The sensitivity and specificity in the prediction group is 89% and 75%, while in the validation group they are 90% and 70%. MV duration and respiratory rate were the most important features. Additionally, we developed a web-based tool to help clinicians use our model. CONCLUSIONS: This study developed and prospectively validated the CatBoost model, which can be used to identify patients who are at risk of NIV failure. Thus, those patients might benefit from early triage and more intensive monitoring. TRIAL REGISTRATION: NCT03704324. Registered 1 September 2018, https://register. CLINICALTRIALS: gov .

Non-Targeted Metabolomic Analysis of Chicken Kidneys in Response to Coronavirus IBV Infection Under Stress Induced by Dexamethasone.

Stress in poultry can lead to changes in body metabolism and immunity, which can increase susceptibility to infectious diseases. However, knowledge regarding chicken responses to viral infection under stress is limited. Dexamethasone (Dex) is a synthetic glucocorticoid similar to that secreted by animals under stress conditions, and has been widely used to induce stress in chickens. Herein, we established a stress model in 7-day-old chickens injected with Dex to elucidate the effects of stress on IBV replication in the kidneys. The metabolic changes, immune status and growth of the chickens under stress conditions were comprehensively evaluated. Furthermore, the metabolic profile, weight gain, viral load, serum cholesterol levels, cytokines and peripheral blood lymphocyte ratio were compared in chickens treated with Dex and infected with IBV. An LC-MS/MS-based metabolomics method was used to examine differentially enriched metabolites in the kidneys. A total of 113 metabolites whose abundance was altered after Dex treatment were identified, most of which were lipids and lipid-like molecules. The principal metabolic alterations in chicken kidneys caused by IBV infection included fatty acid, valine, leucine and isoleucine metabolism. Dex treatment before and after IBV infection mainly affected the host's tryptophan, phenylalanine, amino sugar and nucleotide sugar metabolism. In addition, Dex led to up-regulation of serum cholesterol levels and renal viral load in chickens, and to the inhibition of weight gain, peripheral blood lymphocytes and IL-6 production. We also confirmed that the exogenous cholesterol in DF-1 cells promoted the replication of IBV. However, whether the increase in viral load in kidney tissue is associated with the up-regulation of cholesterol levels induced by Dex must be demonstrated in future experiments. In conclusion, chick growth and immune function were significantly inhibited by Dex. Host cholesterol metabolism and the response to IBV infection are regulated by Dex. This study provides valuable insights into the molecular regulatory mechanisms in poultry stress, and should support further research on the intrinsic link between cholesterol metabolism and IBV replication under stress conditions.

MID-UNet: Multi-input directional UNet for COVID-19 lung infection segmentation from CT images.

Coronavirus Disease 2019 (COVID-19) has spread globally since the first case was reported in December 2019, becoming a world-wide existential health crisis with over 90 million total confirmed cases. Segmentation of lung infection from computed tomography (CT) scans via deep learning method has a great potential in assisting the diagnosis and healthcare for COVID-19. However, current deep learning methods for segmenting infection regions from lung CT images suffer from three problems: (1) Low differentiation of semantic features between the COVID-19 infection regions, other pneumonia regions and normal lung tissues; (2) High variation of visual characteristics between different COVID-19 cases or stages; (3) High difficulty in constraining the irregular boundaries of the COVID-19 infection regions. To solve these problems, a multi-input directional UNet (MID-UNet) is proposed to segment COVID-19 infections in lung CT images. For the input part of the network, we firstly propose an image blurry descriptor to reflect the texture characteristic of the infections. Then the original CT image, the image enhanced by the adaptive histogram equalization, the image filtered by the non-local means filter and the blurry feature map are adopted together as the input of the proposed network. For the structure of the network, we propose the directional convolution block (DCB) which consist of 4 directional convolution kernels. DCBs are applied on the short-cut connections to refine the extracted features before they are transferred to the de-convolution parts. Furthermore, we propose a contour loss based on local curvature histogram then combine it with the binary cross entropy (BCE) loss and the intersection over union (IOU) loss for better segmentation boundary constraint. Experimental results on the COVID-19-CT-Seg dataset demonstrate that our proposed MID-UNet provides superior performance over the state-of-the-art methods on segmenting COVID-19 infections from CT images.

The Relationship Between Hepcidin-Mediated Iron Dysmetabolism and COVID-19 Severity: A Meta-Analysis.

Backgrounds: Hepcidin has been identified as a systemic iron-regulatory hormone. Recent studies have suggested that iron metabolism disorders may be involved in the pathogenesis of acute respiratory distress syndrome and multiple organ dysfunction in coronavirus disease 2019 (COVID-19). Objectives: To re-evaluate the hepcidin-related iron metabolism parameters and explore the relationship between hepcidin-mediated iron dysmetabolism and COVID-19 severity. Methods: COVID-19 is classified as mild and moderate as non-severe, severe and critical as severe. A meta-analysis was conducted. Four bibliographic databases were comprehensively searched up to December 31st 2021. Results: Six unique studies with data from 477 COVID-19 patients were included. Compared to non-severe cases, severe cases had higher hepcidin (standardized mean difference (SMD), -0.39; 95% Confidence Interval (CI) [-0.76, -0.03]; P = 0.03) and ferritin (SMD, -0.84; 95% CI [-1.30, -0.38]; P = 0.0004). In five out of six studies, a total of 427 patients were tested for serum iron, and there were significant differences in their levels between severe and non-severe cases (SMD, 0.22; 95% CI [0.02, 0.41]; P = 0.03). A total of 320 patients from four out of six studies were tested for transferrin saturation, and the statistical difference was not significant (SMD, 0.06; 95% CI [-0.17, 0.28]; P = 0.64). Conclusion: Severe COVID-19 cases had higher serum levels of hepcidin and ferritin, and lower serum iron, without significant differences in transferrin saturation. Further studies are needed to verify whether targeting the hepcidin-mediated iron metabolism axis may influence the outcome and treatment of COVID-19.

Impact of COVID-19 Pandemic on Elevated Anxiety Symptoms of Maintenance Hemodialysis Patients in China: A One-Year Follow-Up Study.

Recent studies have shown that coronavirus disease 2019 (COVID-19) aggravates anxiety in patients with maintenance hemodialysis (MHD), but it is still unclear how long this adverse effect will last. This study aims to investigate the impact of COVID-19 on the elevated anxiety symptoms of MHD patients 1 year after the outbreak. Assessment of elevated anxiety symptoms was performed on patients with MHD during early COVID-19 (February 17-February 29, 2020) and 1-year follow-up (March 1-March 13, 2021), and a total of 100 patients had completed face-to-face questionnaires at the first and 1-year follow-up. At the beginning of the outbreak, 40% of the patients with MHD had anxiety symptoms [self-rating anxiety scale (SAS) score ≥ 50], and 11% (SAS score: 60-69) and 2% (SAS score ≥ 70) of the patients had moderate and severe anxiety symptoms, respectively. Multivariate analysis shows that possibility of unaccompanied transfer, possibility of family members or themselves being infected in a hospital, added body temperature monitoring during dialysis, and increased medical procedures are the risk factors in elevated anxiety symptoms during early COVID-19. At the 1-year follow-up, the incidence of anxiety symptoms in the same group of patients declined to 28%, and all the patients had mild anxiety symptoms (SAS score: 50-59), which is significantly lower than that of the early COVID-19 pandemic with statistically significant difference (p = 0.003). Increased protective measures taken by the medical staves were the only risk factor in elevated anxiety symptoms during the 1-year follow-up. This study shows that COVID-19 has a direct impact on the deterioration of anxiety symptoms in patients with MHD. With the changes of the requirements for COVID-19 prevention and control, as well as the enhancement of propaganda and education of the pandemic and psychological care, the severity and risk factors of anxiety symptoms in the patients with MHD are changing. Thus, targeted interventions are suggested to improve the psychological endurance of the patients with MHD.