Vaccine-induced protection against SARS-CoV-2 requires IFN-γ-driven cellular immune response.

The overall success of worldwide mass vaccination in limiting the negative effect of the COVID-19 pandemics is inevitable, however, recent SARS-CoV-2 variants of concern, especially Omicron and its sub-lineages, efficiently evade humoral immunity mounted upon vaccination or previous infection. Thus, it is an important question whether these variants, or vaccines against them, induce anti-viral cellular immunity. Here we show that the mRNA vaccine BNT162b2 induces robust protective immunity in K18-hACE2 transgenic B-cell deficient (µMT) mice. We further demonstrate that the protection is attributed to cellular immunity depending on robust IFN-γ production. Viral challenge with SARS-CoV-2 Omicron BA.1 and BA.5.2 sub-variants induce boosted cellular responses in vaccinated µMT mice, which highlights the significance of cellular immunity against the ever-emerging SARS-CoV-2 variants evading antibody-mediated immunity. Our work, by providing evidence that BNT162b2 can induce significant protective immunity in mice that are unable to produce antibodies, thus highlights the importance of cellular immunity in the protection against SARS-CoV-2.

CT findings and dynamic changes of COVID-19 in the patients younger than 18 years old infected with SARS-CoV-2 omicron variant

Objective: To investigate the chest computed tomography (CT) manifestations and dynamic changes of coronavirus disease 2019 (COVID-19) in the patients younger than 18 years old infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant, and to provide a basis for determining the chest CT changes and efficacy of COVID-19 caused by Omicron virus variant in patients younger than 18 years old. Methods The clinical and imaging data of 30 cases of patients younger than 18 years old infected with COVID-19 Omicron variant, who admitted to the Third People's Hospital of Shenzhen from February 11 to March 26, 2022 were collected and retrospectively analyzed. The clinical manifestations, imaging features and dynamic changes of lesions were summarized. Results A total of 41 intrapulmonary lesions in 30 patients with COVID-19 caused by SARS-CoV-2 Omicron variant. The main manifestations were patchy or nodular ground-glass opacities and/or consolidation, with focal subpleural distribution, lesions mainly occur in the right lung (70.73%, 29/41). There were 42 lesion morphologies, with 22 (52.38%) striped shadows and 16 (38.10%) nodular shadows, with small lamellar and patchy shadows predominating. There were 36 lesion density variations, with ground glass shadows being the most common, with a total of 24 ground glass shadows (66.66%) in each lobe of the lung, and also 6 consolidation lesions (16.67%) and 6 mixed ground glass opacity and consolidation lesions (16.67%). With the progression of the disease, lesions gradually enlarged, appeared on the 2nd day (312.93 mm3), peaked on the 9th day (1 837.18 mm3). The average absorption time of the lesions was (16+or-3) days, and there was no significant difference between the absorption time of patchy and nodular lesions (ground glass and/or consolidation) (t=0.853, P > 0.05). The lesions showed focal ground-glass opacity in the early stage, 77.78% lesions were absorbed after treatment in the late stage. Inflammatory nodules were absorbed slowly (9-19 days), without residual fibrotic changes. Conclusions The imaging manifestations of COVID-19 in patients younger than 18 years old infected with SARS-CoV-2 Omicron variant have certain characteristics, showed patchy or nodular ground glass opacities and/or consolidation, mainly distributed in the subpleural area, with small and few lesions and slow change, didn't remain fibrosis. Being familiar with its clinical and imaging manifestations can assist in early diagnosis, but confirming the diagnosis requires a combination of epidemiological history, clinical symptoms, SARS-CoV-2 nucleic acid and radiological manifestations.

Parental marital conflict, negative emotions, phubbing, and academic burnout among college students in the postpandemic era: A multiple mediating models

Given the serious effects of coronavirus disease 2019 on academic burnout, this study aims to examine the multiple mediating roles of negative emotions and phubbing in the relationship between parental marital conflict and academic burnout. A total of 1353 college students participated in this study. The results showed that parental marital conflict not only had a direct effect on academic burnout but also affected academic burnout through three indirect paths: parental marital conflict‐negative emotions‐academic burnout, parental marital conflict‐phubbing‐academic burnout, and parental marital conflict‐negative emotions‐phubbing‐academic burnout. The parental marital conflict increased the risk of negative emotions and phubbing in college students and had a subsequent impact on academic burnout. Implications for prevention and intervention are discussed. Highlights: Parental marital conflict significantly predicted academic burnout in college students.Parental marital conflict affected academic burnout through the indirect effect of negative emotions and phubbing.Negative emotions and phubbing played chain‐mediating roles in the relations between parental marital conflict and academic burnout. [ FROM AUTHOR] Copyright of Psychology in the Schools is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Bacillus Calmette-Guérin-induced trained immunity protects against SARS-CoV-2 challenge in K18-hACE2 mice.

SARS-CoV-2 has been confirmed in over 450 million confirmed cases since 2019. Although several vaccines have been certified by the WHO and people are being vaccinated on a global scale, it has been reported that multiple SARS-CoV-2 variants can escape neutralization by antibodies, resulting in vaccine breakthrough infections. Bacillus Calmette-Guérin (BCG) is known to induce heterologous protection based on trained immune responses. Here, we investigated whether BCG-induced trained immunity protected against SARS-CoV-2 in the K18-hACE2 mouse model. Our data demonstrate that i.v. BCG (BCG-i.v.) vaccination induces robust trained innate immune responses and provides protection against WT SARS-CoV-2, as well as the B.1.617.1 and B.1.617.2 variants. Further studies suggest that myeloid cell differentiation and activation of the glycolysis pathway are associated with BCG-induced training immunity in K18-hACE2 mice. Overall, our study provides the experimental evidence that establishes a causal relationship between BCG-i.v. vaccination and protection against SARS-CoV-2 challenge.

Intradermal delivery of mRNA using cryomicroneedles.

Microneedles can realize the intradermal and transdermal delivery of drugs. However, most conventional microneedles made of metal, polymer and ceramics are unsuitable for the delivery of mRNA drugs that are fragile and temperature-sensitive. This study explores the usage of cryomicroneedles (CryoMNs) for the intradermal delivery of mRNA molecules. Taking luciferase mRNA as an example, we first optimize the formulation of CryoMNs to maximize mRNA stability. Later, in the mouse model, we compare the delivery efficiency with the conventional subcutaneous injection for both the luciferase mRNA and COVID-19 Comirnaty mRNA vaccines, where CryoMNs delivered mRNA vaccines successfully induce specific B-cell antibody, neutralizing activity and T-cell responses. STATEMENT OF SIGNIFICANCE: mRNA vaccines are fragile and temperature-sensitive, so they are mainly delivered by intramuscular injection that often causes pain and requires clinical expertise to immunize patients. Microneedles permit convenient, fast and safe vaccination. However, existing microneedle platforms are ineffective to protect the integrity of mRNA vaccines in fabrication, storage, and administration. This work utilizes cryomicroneedles (CryoMNs) technology to intradermally deliver mRNA. In the mouse model, CryoMNs are compared with the subcutaneous injection for the delivery efficiency of both the luciferase mRNA and COVID-19 Comirnaty mRNA vaccines, where CryoMNs delivered mRNA vaccines successfully produce specific B-cell antibodies, T-cell responses, and neutralizing activity. This work is expected to provide a new delivery strategy for the emerging mRNA therapeutics.

Medical and non-medical students' knowledge, attitude and willingness towards the COVID-19 vaccine in China: a cross-sectional online survey.

In the context of the novel Coronavirus outbreak and China's official policy of free vaccination against COVID-19 for all, medical students' attitudes and knowledge toward vaccines can influence public acceptance to some extent, however, the large base of non-medical students cannot be ignored. We aimed to investigate the knowledge, attitude, and willingness toward the COVID-19 vaccine among medical and non-medical students. Online surveys were completed by 652 medical students and 590 non-medical students to compare differences in knowledge and attitude of COVID-19 vaccine and vaccination willingness from three universities in the Zhejiang Province. The awareness rate of the vaccine among medical students (65.3%) was higher than that of non-medical students (53.6%). The approval rate of medical students for the safety and efficacy of the COVID-19 vaccine was higher than that of non-medical students. 81.8% of university students were willing to be vaccinated against COVID-19; Multiple stepwise regression analyses showed that lower class grades, rural students' origin, COVID-19 vaccine attitude and higher cognition level of health self-management influenced the acceptance of COVID-19 vaccination among medical students. However, urban origin, COVID-19 vaccine attitude were the factors hindering non-medical students' vaccination against COVID-19. The knowledge, attitude and willingness toward the COVID-19 vaccine on medical and non-medical students had different characteristics. Moreover, health self-management was associated with COVID-19 vaccination willingness. Staff involved in the university should pay more attention to the self-managementability of students, send out accurate and transparent information to enhance their cognitive level, further improving the students' willingness to receive the COVID-19 vaccine.

Parental marital conflict, negative emotions, phubbing, and academic burnout among college students in the postpandemic era: A multiple mediating models

Given the serious effects of coronavirus disease 2019 on academic burnout, this study aims to examine the multiple mediating roles of negative emotions and phubbing in the relationship between parental marital conflict and academic burnout. A total of 1353 college students participated in this study. The results showed that parental marital conflict not only had a direct effect on academic burnout but also affected academic burnout through three indirect paths: parental marital conflict‐negative emotions‐academic burnout, parental marital conflict‐phubbing‐academic burnout, and parental marital conflict‐negative emotions‐phubbing‐academic burnout. The parental marital conflict increased the risk of negative emotions and phubbing in college students and had a subsequent impact on academic burnout. Implications for prevention and intervention are discussed. [ FROM AUTHOR] Copyright of Psychology in the Schools is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Using the theory of planned behaviour to explain junior nurses' and final-year student nurses' intention to care for COVID-19 patients in China: A multisite cross-sectional study.

AIM: To explore junior nurses' and final-year student nurses' intention to care for COVID-19 patients amidst the Delta COVID-19 variant outbreak in China using the theory of planned behaviour (TPB) as a framework. BACKGROUND: The COVID-19 pandemic has intensified global nursing shortage. Junior nurses and final-year student nurses represent the backbone of the future frontline nursing workforce. The TPB is a valid theoretical model for predicting nurses' caring behaviours. METHODS: A 47-item self-administered questionnaire was disseminated online to a convenience sample of 547 junior nurses and final-year student nurses located in 13 regions across mainland China. RESULTS: Approximately 63.4% of the participants intended to care for COVID-19 patients voluntarily and 65.6% by non-voluntary assignment. The TPB model significantly predicted 45% of the variance in behavioural intention, subjective norms being the strongest predictor. Gender, vaccination status and ethical perceptions regarding frontline work significantly correlated with the intention to provide care. CONCLUSIONS: Our findings highlight the importance of social, organisational and family support underpinning future junior nurses' professional commitment in times of public health crisis. IMPLICATIONS FOR NURSING MANAGEMENT: Pandemic-tailored workplace training programmes for nurses/student nurses that emphasize on self-care and ethical issue discussions are warranted. Hospital managers should collaborate with community partners to offer additional family support for nurses in need.

Emotional states and coping methods in nursing and non-nursing students responding to COVID-19: a cross-sectional study in China.

OBJECTIVES: To evaluate the emotion, coping strategy, dealing methods and their correlation in the COVID-19 outbreak among nursing and non-nursing students. DESIGN AND SETTING: A cross-sectional online survey. PARTICIPANTS: Full-time nursing and non-nursing undergraduate students. MAIN OUTCOME MEASURE: The Generalized Anxiety Disorder 7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to determine the emotional status in the COVID-19 pandemic among nursing and non-nursing students. Emotion Regulation Questionnaire (ERQ) was used to measure the emotion regulation strategies and the Simplified Coping Style Questionnaire (SCSQ) was used to evaluate the coping methods among nursing and non-nursing students. RESULTS: In total, 746 students including 366 nursing students and 380 non-nursing students participated in the survey. Compared with the non-nursing students, a significant decrease was noticed in GAD-7 score (p<0.01) and PHQ-9 (p<0.01) in the nursing students. The cognition re-evaluation score in the nursing students was significantly lower than that of the non-nursing students (p<0.05). In the nursing students, the score of anxiety was positively correlated with ERQ expression inhibition (p<0.01) and SCSQ negative coping (p<0.01), while the score of depression was also positively correlated with ERQ expression inhibition (p<0.01) and SCSQ negative coping (p<0.01). There was a negative correlation between SCSQ and the scores of anxiety (p<0.05) and depression (p<0.05). In the non-nursing students, the anxiety score was positively correlated with the SCSQ negative coping (p<0.01), while the depression score was positively correlated with the ERQ expression inhibition (p<0.01) and SCSQ negative coping (p<0.01). CONCLUSIONS: COVID-19 affected the emotional status of nursing and non-nursing students. The emotional status was correlated with the emotional regulation and coping methods. Staff involved in the nursing professionals should pay attention to the psychological status of the nursing and non-nursing students, and give moderate psychological interference in the presence of COVID-19.

Report on the Condition of Education 2021. NCES 2021-144

The "Condition of Education" is an annual report mandated by the U.S. Congress that summarizes the latest data on education in the United States. This report uses data from across the National Center for Education Statistics (NCES) and from other sources and is designed to help policymakers and the public monitor educational progress. This year's report includes 86 indicators on topics ranging from prekindergarten through postsecondary education, as well as labor force outcomes and international comparisons. Fifty-five indicators were updated this year, including 17 indicators on school crime and safety. For the 2021 edition of the report, most data were collected prior to 2020, either during the 2018-19 academic year or in fall 2019. Therefore, with some exceptions, this year's report presents findings from prior to COVID-19. [For "The Condition of Education 2020. NCES 2020-144," see ED605216.]

A novel CT-based radiomics in the distinction of severity of coronavirus disease 2019 (COVID-19) pneumonia.

BACKGROUND: Convenient and precise assessment of the severity in coronavirus disease 2019 (COVID-19) contributes to the timely patient treatment and prognosis improvement. We aimed to evaluate the ability of CT-based radiomics nomogram in discriminating the severity of patients with COVID-19 Pneumonia. METHODS: A total of 150 patients (training cohort n = 105; test cohort n = 45) with COVID-19 confirmed by reverse transcription polymerase chain reaction (RT-PCR) test were enrolled. Two feature selection methods, Max-Relevance and Min-Redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO), were used to extract features from CT images and construct model. A total of 30 radiomic features were finally retained. Rad-score was calculated by summing the selected features weighted by their coefficients. The radiomics nomogram incorporating clinical-radiological features was eventually constructed by multivariate regression analysis. Nomogram, calibration, and decision-curve analysis were all assessed. RESULTS: In both cohorts, 40 patients with COVID-19 pneumonia were severe and 110 patients were non-severe. By combining the 30 radiomic features extracted from CT images, the radiomics signature showed high discrimination between severe and non-severe patients in the training set [Area Under the Curve (AUC), 0.857; 95% confidence interval (CI), 0.775-0.918] and the test set (AUC, 0.867; 95% CI, 0.732-949). The final combined model that integrated age, comorbidity, CT scores, number of lesions, ground glass opacity (GGO) with consolidation, and radiomics signature, improved the AUC to 0.952 in the training cohort and 0.98 in the test cohort. The nomogram based on the combined model similarly exhibited excellent discrimination performance in both training and test cohorts. CONCLUSIONS: The developed model based on a radiomics signature derived from CT images can be a reliable marker for discriminating the severity of COVID-19 pneumonia.

A novel linker-immunodominant site (LIS) vaccine targeting the SARS-CoV-2 spike protein protects against severe COVID-19 in Syrian hamsters.

The Coronavirus Disease 2019 (COVID-19) pandemic is unlikely to abate until sufficient herd immunity is built up by either natural infection or vaccination. We previously identified ten linear immunodominant sites on the SARS-CoV-2 spike protein of which four are located within the RBD. Therefore, we designed two linkerimmunodominant site (LIS) vaccine candidates which are composed of four immunodominant sites within the RBD (RBD-ID) or all the 10 immunodominant sites within the whole spike (S-ID). They were administered by subcutaneous injection and were tested for immunogenicity and in vivo protective efficacy in a hamster model for COVID-19. We showed that the S-ID vaccine induced significantly better neutralizing antibody response than RBD-ID and alum control. As expected, hamsters vaccinated by S-ID had significantly less body weight loss, lung viral load, and histopathological changes of pneumonia. The S-ID has the potential to be an effective vaccine for protection against COVID-19.

Enlightenment from the COVID-19 Pandemic: The Roles of Environmental Factors in Future Public Health Emergency Response.

The coronavirus disease 2019 (COVID-19) pandemic is challenging the current public health emergency response systems (PHERSs) of many countries. Although environmental factors, such as those influencing the survival of viruses and their transmission between species including humans, play important roles in PHERSs, little attention has been given to these factors. This study describes and elucidates the roles of environmental factors in future PHERSs. To improve countries' capability to respond to public health emergencies associated with viral infections such as the COVID-19 pandemic, a number of environmental factors should be considered before, during, and after the responses to such emergencies. More specifically, to prevent pandemic outbreaks, we should strengthen environmental and wildlife protection, conduct detailed viral surveillance in animals and hotspots, and improve early-warning systems. During the pandemic, we must study the impacts of environmental factors on viral behaviors, develop control measures to minimize secondary environmental risks, and conduct timely assessments of viral risks and secondary environmental effects with a view to reducing the impacts of the pandemic on human health and on ecosystems. After the pandemic, we should further strengthen surveillance for viruses and the prevention of viral spread, maintain control measures for minimizing secondary environmental risks, develop our capability to scientifically predict pandemics and resurgences, and prepare for the next unexpected resurgence. Meanwhile, we should restore the normal life and production of the public based on the "One Health" concept, that views global human and environmental health as inextricably linked. Our recommendations are essential for improving nations' capability to respond to global public health emergencies.

Perceived uncertainty stress and its predictors among residents in China during the COVID-19 pandemic.

The prevalence of and risk factors for uncertainty stress among residents during the COVID-19 pandemic remain unclear. An online cross-sectional survey was conducted to explore and identify the risk factors for high perceived uncertainty stress among the general public in China during the COVID-19 outbreak. Information about the respondents' socioeconomic characteristics, knowledge of and attitudes towards COVID-19, perceived uncertainty stress, social capital, anxiety, and depressive symptoms was collected and analysed. Among the 1205 respondents, 45.3% (546) reported a high level of uncertainty stress. Multiple linear regression analysis indicated that anxiety (ß=3.871,P<0.001) and depression symptoms (ß=2.458, P<0.001), family residence (in towns or rural areas) (ß=0.947, P<0.001), lack of support for local epidemic control strategies (ß=1.253, P<0.001), worry about the pandemic (ß=1.191, P<0.001), and symptoms of weakness among family members (ß=1.525, P=0.002) were positively associated with perceived uncertainty stress. Cognitive social capital (ß=-0.883, P<0.001) and social networks (ß=-0.726, P<0.001) were negatively, but social participation (ß=0.714, P<0.001) was positively associated with perceived uncertainty stress. Our findings identify factors associated with a higher level of uncertainty stress and should be helpful in the consideration of effective policies and interventions for uncertainty stress during the initial phases of public health emergencies.

Low high-density lipoprotein level is correlated with the severity of COVID-19 patients: an observational study.

BACKGROUND: The purpose of the study is to describe the blood lipid levels of patients diagnosed with coronavirus disease 2019 (COVID-19) and to analyze the correlation between blood lipid levels and the prognosis of COVID-19 patients. METHODS: In the clinical retrospective analysis, a total of 228 adults infected with COVID-19 were enrolled between January 17, 2020 and March 14, 2020, in Changsha, China. One thousand one hundred and forty healthy participants with matched age and gender were used as control. Median with interquartile range and Mann-Whitney test were adopted to describe and analyze clinical data. The Kaplan-Meier (KM) curve and Cox regression analysis were used to analyze the correlation between high-density lipoprotein cholesterol (HDL-C) and the severity of COVID-19. RESULTS: Compared with control, COVID-19 patients showed significantly lower levels of total cholesterol (TC) [median, 3.76 vs 4.65 mmol/L, P = 0.031], triglyceride [median, 1.08 vs 1.21 mmol/L, P <  0.001], low-density lipoprotein cholesterol (LDL-C) [median, 2.63 vs 2.83 mmol/L, P <  0.001], and HDL-C [median, 0.78 vs 1.37 mmol/L, P <  0.001], while compared with non-severe patients, severe COVID-19 patients only presented lower levels of HDL-C [median, 0.69 vs 0.79 mmol/L, P = 0.032]. In comparison with patients with high HDL-C, patients with low HDL-C showed a higher proportion of male (69.57% vs 45.60%, P = 0.004), higher levels of C-reactive protein (CRP) (median, 27.83 vs 12.56 mg/L, P <  0.001) and higher proportion of severe events (36.96% vs 14.84%, P = 0.001). Moreover, patients with low HDL-C at admission showed a higher risk of developing severe events compared with those with high HDL-C (Log Rank P = 0.009). After adjusting for age, gender and underlying diseases, they still had elevated possibility of developing severe cases than those with high HDL-C (HR 2.827, 95% CI 1.190-6.714, P = 0.019). CONCLUSIONS: HDL-C level was lower in COVID-19 adult patients, and low HDL-C in COVID-19 patients was correlated with a higher risk of developing severe events.