Mortality burden due to ambient nitrogen dioxide pollution in China: Application of high-resolution models.

BACKGROUND: A large gap exists between the latest Global Air Quality Guidelines (AQG 2021) and Chinese air quality standards for NO2. Assessing whether and to what extent air quality standards for NO2 should be tightened in China requires a comprehensive understanding of the spatiotemporal characteristics of population exposure to ambient NO2 and related health risks, which have not been studied to date. OBJECTIVE: We predicted ground NO2 concentrations with high resolution in mainland China, explored exposure characteristics to NO2 pollution, and assessed the mortality burden attributable to NO2 exposure. METHODS: Daily NO2 concentrations in 2019 were predicted at 1-km spatial resolution in mainland China using random forest models incorporating multiple predictors. From these high-resolution predictions, we explored the spatiotemporal distribution of NO2, population and area percentages with NO2 exposure exceeding criterion levels, and premature deaths attributable to long- and short-term NO2 exposure in China. RESULTS: The cross-validation R2and root mean squared error of the NO2 predicting model were 0.80 and 7.78 µg/m3, respectively,at the daily level in 2019.The percentage of people (population number) with annual NO2 exposure over 40 µg/m3 in mainland China in 2019 was 10.40 % (145,605,200), and it reached 99.68 % (1,395,569,840) with the AQG guideline value of 10 µg/m3. NO2 levels and population exposure risk were elevated in urban areas than in rural. Long- and short-term exposures to NO2 were associated with 285,036 and 121,263 non-accidental deaths, respectively, in China in 2019. Tightening standards in steps gradually would increase the potential health benefit. CONCLUSION: In China, NO2 pollution is associated with significant mortality burden. Spatial disparities exist in NO2 pollution and exposure risks. China's current air quality standards may no longer objectively reflect the severity of NO2 pollution and exposure risk. Tightening the national standards for NO2 is needed and will lead to significant health benefits.

Potential herb‒drug interactions between anti-COVID-19 drugs and traditional Chinese medicine.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. Effective treatments against COVID-19 remain urgently in need although vaccination significantly reduces the incidence, hospitalization, and mortality. At present, antiviral drugs including Nirmatrelvir/Ritonavir (PaxlovidTM), Remdesivir, and Molnupiravir have been authorized to treat COVID-19 and become more globally available. On the other hand, traditional Chinese medicine (TCM) has been used for the treatment of epidemic diseases for a long history. Currently, various TCM formulae against COVID-19 such as Qingfei Paidu decoction, Xuanfei Baidu granule, Huashi Baidu granule, Jinhua Qinggan granule, Lianhua Qingwen capsule, and Xuebijing injection have been widely used in clinical practice in China, which may cause potential herb-drug interactions (HDIs) in patients under treatment with antiviral drugs and affect the efficacy and safety of medicines. However, information on potential HDIs between the above anti-COVID-19 drugs and TCM formulae is lacking, and thus this work seeks to summarize and highlight potential HDIs between antiviral drugs and TCM formulae against COVID-19, and especially pharmacokinetic HDIs mediated by metabolizing enzymes and/or transporters. These well-characterized HDIs could provide useful information on clinical concomitant medicine use to maximize clinical outcomes and minimize adverse and toxic effects.

Lymphocytes, Mean Platelet Volume, and Albumin in Critically Ill COVID-19 Patients with Venous Thromboembolism.

As one of the frequent complications leading to poor prognosis in hospitalized COVID-19 patients, a better understanding of venous thromboembolism (VTE) in COVID-19 patients is needed. We conducted a single-center, retrospective study on 96 COVID-19 patients admitted to the intensive care unit (ICU) from April to June 2022, in Shanghai Renji Hospital. Records of these COVID-19 patients upon admission were reviewed for demographic information, co-morbidities, vaccinations, treatment, and laboratory tests. VTE occurred in 11 (11.5%) cases among 96 COVID-19 patients despite the standard thromboprophylaxis since ICU admission. In COVID-VTE patients, a significant increase in B cells and a decrease in Ts cells were observed and a strong negative correlation (r = -0.9524, P = .0003) was found between these two populations. In COVID-19 patients with VTE, increased MPV and decreased albumin levels were seen in addition to the common VTE indicators of D-dimer abnormalities. The altered lymphocyte composition in COVID-VTE patients is noteworthy. In addition to D-dimer, MPV and albumin levels might be novel indicators for the risk of VTE in COVID-19 patients.

Research on the development status and high quality development mode of recreational fishery in China

First, this paper defines the definition and classification of recreational fishery. Second, the paper analyzes the present situation of recreational fishery from production scale, growth rate, proportion of annual output value of fishery and industrial structure, then discusses the development opportunities of recreational fishery in terms of policy, economy, culture and technology. Third, the paper analyzes the problem of recreational fishery in terms of the talent, the ability to bear risk, the influence of COVID-19. Finally, the paper discusses the high quality development mode of recreational fishery in China against the background of industrial integration. The research showed:the production scale of recreational fishery increased, the growth rate of recreational fishery declined but higher than the annual output growth rate of the total annual output of the fishery, proportion of annual output value of fishery increased steadily, and the structure of recreational fishery developed steadily, guided by recreational fishing and collecting industry and tourism-oriented recreational fishery, supplemented by fishing tackle, bait ornamental fish, fishery medicine, aquatic equipment, other related industries, ornamental fish industry developed rapidly. At present, recreational fisheries has a series of opportunities such as self-advantages, government policy support, good external economic environment and cultural environment, good facilities and technology. At the same time, recreational fishery facing a series of challenges such as shortage of talents, the ability to bear risk is limited and the shock of COVID-19. Finally, The paper proposes the three-dimensional mode of recreational fishery developing in high quality based on industrial convergence to promote the long-term, steady and high-quality development of recreational fishery.

Multi-organ microphysiological system: A new paradigm for COVID-19 research.

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, is a systemic disease with a broad spectrum of manifestations in multiple organs. Till now, it remains unclear whether these multi-organ dysfunctions arise from direct viral infection, or indirect injuries. There is an urgent need to evaluate the impacts of SARS-CoV-2 infection on human bodies and explore the pathogenesis of extrapulmonary organ injuries at a systemic level. Multi-organ microphysiological systems, which can model whole-body physiology with engineered tissues and physiological communications between different organs, serve as powerful platforms to model COVID-19 in a multi-organ manner. In this perspective, we summarize the recent advancement in multi-organ microphysiological system-based researches, discuss the remaining challenges, and proposed some prospects in the application of multi-organ model system for COVID-19 research.

Designing multi-epitope mRNA construct as a universal influenza vaccine candidate for future epidemic/pandemic preparedness.

Despite the availability of prevention and treatment strategies and advancing immunization approaches, the influenza virus remains a global threat that continues to plague humanity with unpredictable pandemics. Due to the unusual genetic variability and segmented genome, the reassortment between different strains of influenza is facilitated and the viruses continuously evolve and adapt to the host cell's immunity. This underlies the seasonal vaccine mismatches that decrease the vaccine efficacy and increase the risk of outbreaks. Thus, the development of a universal vaccine covering all the influenza A and B strains would reduce the pervasiveness of the influenza virus. In the current study, a potentially universal influenza multi-epitope vaccine was designed based on the experimentally tested conserved T cell and B cell epitopes of hemagglutinin (HA), neuraminidase (NA), nucleoprotein (NP), and matrix-2 proton channel (M2) of the virus. The immune simulation and molecular docking of the vaccine construct with TLR2, TLR3, and TLR4 elicited the favorable immunogenicity of the vaccine and the formation of stable complexes, respectively. Ultimately, based on the immunoinformatics analysis, the universal mRNA multi-epitope vaccine designed in this study might have a protection potential against the various subtypes of influenza A and B.

Analysis of Compounding and Broadband Extinction Properties of Novel Bioaerosols

Artificially prepared microbial spores have excellent electromagnetic attenuation properties due to their special composition and structure. At present, studies on the optical properties of microbial spores have mainly focused on those with a single band or a single germplasm, which has limitations and cannot reveal the optical properties comprehensively. In this paper, 3 kinds of laboratory-prepared microbial spores were selected for compounding, and the spectral reflectivities of single-germplasm biospores and compound biospores were measured in the wavebands of 0.25–2.4 and 3–15 μm. The complex refractive indices (CRIs) were calculated in combination with the Kramers–Kronig (K-K) algorithm. Relying on the smoke box broadband test system, the transmittance of single-germplasm bioaerosols and compound bioaerosols from the ultraviolet (UV) band to the far-infrared (FIR) band was measured, and the mass extinction coefficients were calculated. The results indicate that the trend of the complex refractive indices of the compound spores is consistent with that of the single-germplasm spores with a larger particle size. For the single-germplasm bioaerosols, the lowest transmittance values were 2.21, 5.70 and 6.27% in the visible (VIS), near-infrared (NIR) and middle-infrared (FIR) bands, and the mass extinction coefficients reached 1.15, 0.87 and 0.84 m2/g, respectively. When AO and BB spores were compounded at 4:1, the extinction performance of the bioaerosols somewhat improved in all wavebands. These results can help to comprehensively analyze the optical properties of bioaerosols and provide ideas for the development of new extinction materials.

Epidemiological and etiological analysis of a case cluster caused by norovirus in a nursing home in Lanzhou

Objective: To understand the epidemiology and etiology of a cluster of cases with gastroenteritis in a nursing home in Anning district of Lanzhou, and to provide a scientific evidence for the prevention and control of norovirus diarrhea in community nursing centers. Methods: From January 28 to February 4 2021, an epidemiological investigation was conducted on all diarrhea cases, nursing staff and chefs in a nursing home in Anning district, Lanzhou city. Samples of patients' anal swabs, feces, vomitus were collected for norovirus detection by real-time fluorescent PCR. ORF1/ORF2 junction region of norovirus in some selected positive samples(Ct value 25) was sequenced. MEGA-X software was used to construct a phylogenetic tree for genetic evolution analysis using the neighboring method. Results: The first case was confirmed on January20,2021, and the number of cases peaked during January 25and 29.A total of 58 clinically diagnosed cases were reported,57were older people, with an incidence of(57/360,15.83%). Diarrhea(50/58,86.21%),vomiting(35/58,60.34%),nausea(13/58,22.41%)and abdominal pain(6/58,10.34%)were common symptoms, all cases were mild. Fifty-three asymptomatic cases were detected among chefs, housekeepers and nurses.A total of 163specimens were tested, the positive rate of norovirus GII was 49.08%(80/163). The positive rate of fecal samples collected from nurses, chefs and housekeepers was 48.62%(53/109), and was11.11%(2/18)in environmental surface swabs. The possibility of other pathogenic infections such as SARS-CoV-2was ruled out by further tests. Thirteen positive samples were selected for sequencing, and 9were successfully sequenced, they were all recombinant GII.4Sydney_2012 [P16]genotypes, forming an independent cluster, while in a large evolutionary branch with the 2020GII.10 [P16]and 2019GII.2 [P16]virus strains in Lanzhou city, showing a relative close genetic connection. Conclusions: GII .4Sydney_2012[P16]genotype of norovirus is found to be causative pathogen of this outbreak, and close contact is the main reason of the outbreak and persistence of the infection,so asymptomatic infections of norovirus play an important role in the disease spreading. Therefore, public health management in nursing homes and other centralized nursing facilities should be strengthened especially for asymptomatic workers in order to prevent virus transmission.

Factors associated with negative conversion of viral RNA in hospitalized children infected with SARS-CoV-2 Omicron variant in Shanghai, China: a retrospective analysis.

OBJECTIVES: This study aimed to identify the related risk factors and potential predictors of SARS-CoV-2 RNA negative conversion by describing the dynamics of viral shedding in infected children admitted to two hospitals from Shanghai during the Omicron variant outbreak. METHODS: This retrospective cohort included laboratory-confirmed cases of SARS-CoV-2 infection from Shanghai between March 28 and May 31, 2022. Clinical characteristics, personal vaccination, and household vaccination rates were collected through electronic health records and telephone interviews. RESULTS: A total of 603 paediatric patients confirmed to have COVID-19 were included in this study. Both univariate and multivariate analyses were performed to filter independent factors for the duration to viral RNA negative conversion. Data on the redetection of SARS-CoV-2 in the patients after they showed negative results on the RT‒PCR test (intermittent negative status) were also analysed. The median duration of virus shedding was 12 (interquartile range, IQR: 10-14) days. The severity of clinical outcome, personal vaccination-2doses, household vaccination rates, and abnormal defecation were factors indecently affecting negative conversion of SARS-CoV-2 RNA, suggesting that patients who had abnormal defecation or with more severe conditions would have delayed virological clearance, while patients who previously had 2 doses of vaccination or had higher household vaccination rates would have accelerated virological clearance. Loss of appetite (odds ratio (OR): 5.343; 95% CI: 3.307-8.632) and abnormal defecation (OR: 2.840; 95% CI: 1.736-4.645) were significantly associated with intermittent negative status. CONCLUSION: These findings could provide clues for the early identification of paediatric patients with prolonged viral shedding and could enrich the evidence for the development of prevention and control strategies, especially vaccination policies for children and adolescents.

Deep learning-based network pharmacology for exploring the mechanism of licorice for the treatment of COVID-19.

Licorice, a traditional Chinese medicine, has been widely used for the treatment of COVID-19, but all active compounds and corresponding targets are still not clear. Therefore, this study proposed a deep learning-based network pharmacology approach to identify more potential active compounds and targets of licorice. 4 compounds (quercetin, naringenin, liquiritigenin, and licoisoflavanone), 2 targets (SYK and JAK2) and the relevant pathways (P53, cAMP, and NF-kB) were predicted, which were confirmed by previous studies to be associated with SARS-CoV-2-infection. In addition, 2 new active compounds (glabrone and vestitol) and 2 new targets (PTEN and MAP3K8) were further validated by molecular docking and molecular dynamics simulations (simultaneous molecular dynamics), as well as the results showed that these active compounds bound well to COVID-19 related targets, including the main protease (Mpro), the spike protein (S-protein) and the angiotensin-converting enzyme 2 (ACE2). Overall, in this study, glabrone and vestitol from licorice were found to inhibit viral replication by inhibiting the activation of Mpro, S-protein and ACE2; related compounds in licorice may reduce the inflammatory response and inhibit apoptosis by acting on PTEN and MAP3K8. Therefore, licorice has been proposed as an effective candidate for the treatment of COVID-19 through PTEN, MAP3K8, Mpro, S-protein and ACE2.

Data augmentation based semi-supervised method to improve COVID-19 CT classification.

The Coronavirus (COVID-19) outbreak of December 2019 has become a serious threat to people around the world, creating a health crisis that infected millions of lives, as well as destroying the global economy. Early detection and diagnosis are essential to prevent further transmission. The detection of COVID-19 computed tomography images is one of the important approaches to rapid diagnosis. Many different branches of deep learning methods have played an important role in this area, including transfer learning, contrastive learning, ensemble strategy, etc. However, these works require a large number of samples of expensive manual labels, so in order to save costs, scholars adopted semi-supervised learning that applies only a few labels to classify COVID-19 CT images. Nevertheless, the existing semi-supervised methods focus primarily on class imbalance and pseudo-label filtering rather than on pseudo-label generation. Accordingly, in this paper, we organized a semi-supervised classification framework based on data augmentation to classify the CT images of COVID-19. We revised the classic teacher-student framework and introduced the popular data augmentation method Mixup, which widened the distribution of high confidence to improve the accuracy of selected pseudo-labels and ultimately obtain a model with better performance. For the COVID-CT dataset, our method makes precision, F1 score, accuracy and specificity 21.04%, 12.95%, 17.13% and 38.29% higher than average values for other methods respectively, For the SARS-COV-2 dataset, these increases were 8.40%, 7.59%, 9.35% and 12.80% respectively. For the Harvard Dataverse dataset, growth was 17.64%, 18.89%, 19.81% and 20.20% respectively. The codes are available at https://github.com/YutingBai99/COVID-19-SSL.

Development of a Library of Disulfide Bond-Containing Cationic Lipids for mRNA Delivery.

Lipid nanoparticles (LNPs) are the commonly used delivery tools for messenger RNA (mRNA) therapy and play an indispensable role in the success of COVID-19 mRNA vaccines. Ionizable cationic lipids are the most important component in LNPs. Herein, we developed a series of new ionizable lipids featuring bioreducible disulfide bonds, and constructed a library of lipids derived from dimercaprol. LNPs prepared from these ionizable lipids could be stored at 4 °C for a long term and are non-toxic toward HepG2 and 293T cells. In vivo experiments demonstrated that the best C4S18A formulations, which embody linoleoyl tails, show strong firefly luciferase (Fluc) mRNA expression in the liver and spleen via intravenous (IV) injection, or at the local injection site via intramuscular injection (IM). The newly designed ionizable lipids can be potentially safe and high-efficiency nanomaterials for mRNA therapy.

Comprehensive analysis of the novel omicron receptor AXL in cancers.

The SARS-CoV-2 is constantly mutating, and the new coronavirus such as Omicron has spread to many countries around the world. Anexelekto (AXL) is a transmembrane protein with biological functions such as promoting cell growth, migration, aggregation, metastasis and adhesion, and plays an important role in cancers and coronavirus disease 2019 (COVID-19). Unlike angiotensin-converting enzyme 2 (ACE2), AXL was highly expressed in respiratory system cells. In this study, we verified the AXL expression in cancer and normal tissues and found AXL expression was strongly correlated with cancer prognosis, tumor mutation burden (TMB), the microsatellite instability (MSI) in most tumor types. Immune infiltration analysis also demonstrated that there was an inextricable link between AXL expression and immune scores in cancer patients, especially in BLCA, BRCA and CESC. The NK-cells, plasmacytoid dendritic cells, myeloid dendritic cells, as one of the important components of the tumor microenvironment, were highly expressed AXL. In addition, AXL-related tumor neoantigens were identified and might provide the novel potential targets for tumor vaccines or SARS-Cov-2 vaccines research in cancer patients.

Self-Amplifying RNA Approach for Protein Replacement Therapy.

Messenger RNA (mRNA) technology has already been successfully tested preclinically and there are ongoing clinical trials for protein replacement purposes; however, more effort has been put into the development of prevention strategies against infectious diseases. Apparently, mRNA vaccine approval against coronavirus disease 2019 (COVID-19) is a landmark for opening new opportunities for managing diverse health disorders based on this approach. Indeed, apart from infectious diseases, it has also been widely tested in numerous directions including cancer prevention and the treatment of inherited disorders. Interestingly, self-amplifying RNA (saRNA)-based technology is believed to display more developed RNA therapy compared with conventional mRNA technique in terms of its lower dosage requirements, relatively fewer side effects, and possessing long-lasting effects. Nevertheless, some challenges still exist that need to be overcome in order to achieve saRNA-based drug approval in clinics. Hence, the current review discusses the feasibility of saRNA utility for protein replacement therapy on various health disorders including rare hereditary diseases and also provides a detailed overview of saRNA advantages, its molecular structure, mechanism of action, and relevant delivery platforms.

Imprinted SARS-CoV-2 humoral immunity induces convergent Omicron RBD evolution.

Continuous evolution of Omicron has led to a rapid and simultaneous emergence of numerous variants that display growth advantages over BA.5 (ref. 1). Despite their divergent evolutionary courses, mutations on their receptor-binding domain (RBD) converge on several hotspots. The driving force and destination of such sudden convergent evolution and its effect on humoral immunity remain unclear. Here we demonstrate that these convergent mutations can cause evasion of neutralizing antibody drugs and convalescent plasma, including those from BA.5 breakthrough infection, while maintaining sufficient ACE2-binding capability. BQ.1.1.10 (BQ.1.1 + Y144del), BA.4.6.3, XBB and CH.1.1 are the most antibody-evasive strains tested. To delineate the origin of the convergent evolution, we determined the escape mutation profiles and neutralization activity of monoclonal antibodies isolated from individuals who had BA.2 and BA.5 breakthrough infections2,3. Owing to humoral immune imprinting, BA.2 and especially BA.5 breakthrough infection reduced the diversity of the neutralizing antibody binding sites and increased proportions of non-neutralizing antibody clones, which, in turn, focused humoral immune pressure and promoted convergent evolution in the RBD. Moreover, we show that the convergent RBD mutations could be accurately inferred by deep mutational scanning profiles4,5, and the evolution trends of BA.2.75 and BA.5 subvariants could be well foreseen through constructed convergent pseudovirus mutants. These results suggest that current herd immunity and BA.5 vaccine boosters may not efficiently prevent the infection of Omicron convergent variants.

Antiviral effects of Atractyloside A on the influenza B virus (Victoria strain) infection.

Influenza viruses pose a serious threat to human health, infecting hundreds of millions of people worldwide each year, resulting in a significant increase in global morbidity and mortality. Influenza activity has declined at the onset of the COVID-19 pandemic, but the genetic diversity of B/Victoria lineage viruses has increased significantly during this period. Therefore, the prevention and treatment of the influenza B Victoria strain virus should continue to attract research attention. In this study, we found that Atractyloside A (AA), one of the effective components in Atractylodes lancea (Thunb.) DC shows potential antiviral properties. This study shows that AA not only possesses anti-influenza B virus infection effects in vivo and in vitro but also can regulate macrophage polarization to the M2 type, which can effectively attenuate the damage caused by influenza B virus infection. Therefore, Atractyloside A may be an effective natural drug against B/Victoria influenza infection.

Bioaerosol dispersion and environmental risk simulation: Method and a case study for a biopharmaceutical plant of Gansu province, China.

Pathogenic bacteria pose a great threat to global public health from environmental and public health perspectives, especially regarding the impact of the COVID-19 pandemic worldwide. As a result, the increased risk of pathogenic bioaerosol exposure imposes a considerable health burden and raises specific concerns about the layout and location of vaccine manufacturers. This study proposed a grid computing method based on the CALPUFF modelling system and population-based environmental risks to reduce bioaerosol-related potential risks. We previously used the CALPUFF model to quantify the diffusion level, the spatial distribution of emissions, and potential environmental risks of bioaerosol leakage in Gansu province's Zhongmu Lanzhou biopharmaceutical plant from July 24, 2019, to August 20, 2019. By combining it with publicly available test data, the credibility was confirmed. Based on our previous research, the CALPUFF model application combined with the environmental population-based environmental risks in two scenarios: the layout and site selection, was explored by using the leakage accident of Zhongmu Lanzhou biopharmaceutical plant of Gansu province as a case study. Our results showed that the site selection method of scenario 2 coupled with the buffer area was more reasonable than scenario 1, and the final layout site selection point of scenario 2 was grid 157 as the optimal layout point. The simulation results demonstrated agreement with the actual survey. Our findings could assist global bioaerosol manufacturers in developing appropriate layout and site selection strategies to reduce bioaerosol-related potential environmental risks.

Cascading impacts of global metal mining on climate change and human health caused by COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has significantly disrupted global metal mining and associated supply chains. Here we analyse the cascading effects of the metal mining disruption associated with the COVID-19 pandemic on the economy, climate change, and human health. We find that the pandemic reduced global metal mining by 10-20% in 2020. This reduction subsequently led to losses in global economic output of approximately 117 billion US dollars, reduced CO2 emissions by approximately 33 million tonnes (exceeding Hungary's emissions in 2015), and reduced human health damage by 78,192 disability-adjusted life years. In particular, copper and iron mining made the most significant contribution to these effects. China and rest-of-the-world America were the most affected. The cascading effects of the metal mining disruption associated with the pandemic on the economy, climate change, and human health should be simultaneously considered in designing green economic stimulus policies.

Child-parent relationship during the Wuhan COVID-19 lockdown: Role of changes in preschool children's daily routines.

Objective: We examined the impact of the strict lockdown on 130 preschool-age children's daily routines and how their routine changes from pre-lockdown were related to child-parent relationship quality during the lockdown. Background: To contain the spread of the COVID-19, the city of Wuhan underwent a strict 76-day lockdown, during which children's routines were drastically altered, yet families did not have a frame of reference to use to determine how changes in children's routines would be related to their family dynamics. Method: Parents provided survey data on the amount of time their children spent daily on learning, screen devices, play and exercise, and nighttime sleep before, during, and after the lockdown. The also described general family functioning, child-parent closeness, and child-parent conflict during the lockdown. Results: The lockdown led to changes in all four routines, but all returned to pre-lockdown level after the lockdown was lifted. Regression analyses showed that decrease in play and exercise time was related to less child-parent closeness, and decrease in learning time and increase in nighttime sleep time were related to more child-parent conflict. Conclusion: Findings suggested changes in the children's play and exercise time, learning time, and nighttime sleep time were related to negative child-parent relationship (i.e., less closeness or more conflict), but favorable general functioning was a protective factor. Implications: Our study highlighted family resilience in restoring the children's routines after the lockdown, as well as family vulnerability during the lockdown, as changes in three of the four routines examined were linked to negative child-parent relationship.