Risk of preterm birth in maternal influenza or SARS-CoV-2 infection: a systematic review and meta-analysis.

Background: Influenza is a major threat to global health and is an important cause of respiratory diseases. However, there was a controversy on the impacts of influenza infection on adverse pregnancy outcomes and the infant's health. This meta-analysis aimed to investigate the impact of maternal influenza infection on preterm birth. Methods: Five databases, including PubMed, Embase, Cochrane Library, Web of Science, and China National Knowledge Infrastructure (CNKI) were searched for eligible studies on December 29, 2022. The Newcastle-Ottawa Scale (NOS) was used to assess the included quality of the included studies. As for the incidence of preterm birth, odds ratios (OR) and 95% confidence intervals (CIs) were pooled, and the results of the current meta-analysis were displayed in forest plots. Subgroup analyses based on similarity in different aspects were conducted for further analysis. A funnel plot was used to assess the publication bias. All of the above data analyses were performed using STATA SE 16.0 software. Results: A total of 24 studies involving 24,760,890 patients were included in this meta-analysis. Through the analysis, we found that maternal influenza infection significantly increased the risk of preterm birth (OR =1.52, 95% CI: 1.18 to 1.97, I2=97.35%, P=0.00). After subgroup analysis based on different types of influenzas, we found that women infected with influenza A and B (OR =2.05, 95% CI: 1.26 to 3.32, I2=96.14%, P<0.1), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (OR =2.16, 95% CI: 1.75 to 2.66, I2=0.00%, P<0.1) in pregnancy were at an increased risk of preterm birth, while those infected with influenza A alone or seasonal influenza were not (P>0.1). Conclusions: Women should take active steps to avoid influenza infection during pregnancy, especially influenza A and B and SARS-CoV-2, to reduce the possibility of preterm birth.

Ethnic Differences in Response to COVID-19: A Study of American-Asian and Non-Asian College Students.

Asian American students have experienced additional physical and emotional hardships associated with the COVID-19 pandemic due to increased xenophobic and anti-Asian discrimination. This study investigates different coping patterns and risk factors affecting Asian and non-Asian college students in response to COVID-19 challenges by studying the differences in their responses within four domains after the onset of the pandemic: academic adjustment, emotional adjustment, social support, and discriminatory impacts related to COVID-19. We first employed a machine learning approach to identify well-adjusted and poorly adjusted students in each of the four domains for the Asian and non-Asian groups, respectively. Next, we applied the SHAP method to study the principal risk factors associated with each classification task and analyzed the differences between the two groups. We based our study on a proprietary survey dataset collected from U.S. college students during the initial peak of the pandemic. Our findings provide insights into the risk factors and their directional impact affecting Asian and non-Asian students' well-being during the pandemic. The results could help universities establish customized strategies to support these two groups of students in this era of uncertainty. Applications for international communities are discussed.

Asian American University Students' Adjustment, Coping, and Stress during the COVID-19 Pandemic

The COVID-19 outbreak caused global disruptions in all aspects of life. Social distancing regulations were enforced in an attempt to halt virus spread. Universities across the country closed for in-person instruction and activities, transitioning to remote learning. University students faced unprecedented challenges and stressors, especially Asian American students due to COVID-19-associated xenophobic attitudes, harassment, and assault against people of Asian complexions. The purpose of this study was to examine the experiences, coping, stress, and adjustment of Asian American students during the COVID-19 pandemic. Secondary analyses were conducted on the survey responses of 207 participants (n = 103 Asian American university students, n = 104 non-Asian American students) from a larger-scale study, which focused on adaptation to the university, perceived stress, ways of coping, and COVID-19-specific factors. A series of independent samples t tests and regression analyses showed significant relationships between some university adjustment factors, ways of coping methods, and race with perceived stress and COVID-19 factors. Implications, limitations, and ideas for future directions in research are discussed.

Asian American University Students' Adjustment, Coping, and Stress during the COVID-19 Pandemic.

The COVID-19 outbreak caused global disruptions in all aspects of life. Social distancing regulations were enforced in an attempt to halt virus spread. Universities across the country closed for in-person instruction and activities, transitioning to remote learning. University students faced unprecedented challenges and stressors, especially Asian American students due to COVID-19-associated xenophobic attitudes, harassment, and assault against people of Asian complexions. The purpose of this study was to examine the experiences, coping, stress, and adjustment of Asian American students during the COVID-19 pandemic. Secondary analyses were conducted on the survey responses of 207 participants (n = 103 Asian American university students, n = 104 non-Asian American students) from a larger-scale study, which focused on adaptation to the university, perceived stress, ways of coping, and COVID-19-specific factors. A series of independent samples t tests and regression analyses showed significant relationships between some university adjustment factors, ways of coping methods, and race with perceived stress and COVID-19 factors. Implications, limitations, and ideas for future directions in research are discussed.

A Video is Worth a Thousand Words: The Use of Home Videos in Pediatric Neurology.

The use of home video recordings (HVRs) may aid in the diagnosis of neurological disorders. However, this practice remains underutilized. Through an anonymous survey, we sought to understand the perspectives of healthcare providers regarding the sharing of HVRs alongside referrals for responsive and economical pediatric neurology care. This was timely given COVID-19 has worsened wait times for diagnosis and consequently treatment. Most providers agree that sharing of HVRs improves patient care (93.1%: 67/73) and prevents both additional investigations (67%: 49/73) and hospital admissions (68.5%: 50/73). However, a minority of providers (21.9 %: 16/73) currently share HVRs alongside their referrals.

The first imported case of monkeypox in Taiwan.

he first imported case of monkeypox in Taiwan was diagnosed in an Asian man with HIV-1 infection and asymptomatic COVID-19, returning from Germany. Atypical presentations included asynchronous skin lesions, anogenital lesions and prominent inguinal lymphadenopathy. Whole genomic sequence alignment indicate that the Taiwan strain clustered together with human monkeypox virus West African clade B.1, currently circulating in Europe. Prompt diagnosis and infection control measures are crucial to mitigate the spread of monkeypox.

Curcumae Rhizoma: A botanical drug against infectious diseases.

Curcumae Rhizoma is the dry rhizome coming from Curcuma longa L. which grow widely in tropical south and southwest Asia. It has been used to treat conditions such as dermatoses, infections, stress, and depression. Moreover, in China, Curcumae Rhizoma and its active constituents have been made into different pharmaceutical preparations. Growing evidence suggests that these preparations can exert antioxidant, anti-inflammatory, and anti-cancer effects, which may play crucial roles in the treatment of various diseases, including cancer, infectious-, autoimmune-, neurological-, and cardiovascular diseases, as well as diabetes. The anti-infective effect of Curcumae Rhizoma has become a popular field of research around the world, including for the treatment of COVID-19, influenza virus, hepatitis B virus, human immunodeficiency virus, and human papilloma virus, among others. In this paper, the basic characteristics of Curcumae Rhizoma and its active constituents are briefly introduced, and we also give an overview on their applications and mechanisms in infectious diseases.

A multicentre study on the incidence of respiratory viruses in children with community-acquired pneumonia requiring hospitalization in the setting of the zero-COVID policy in China.

BACKGROUND: Stringent nonpharmaceutical interventions (NPIs) have been implemented worldwide to combat the COVID-19 pandemic, and the circulation and seasonality of common respiratory viruses have subsequently changed. There have been few multicentre studies or comparisons of the prevalence of respiratory viruses accounting for community-acquired pneumonia (CAP) in hospitalized children between the pre-COVID period and the period after community and school reopening in the setting of the zero-COVID policy. METHODS: We included 1543 children with CAP who required hospitalization from November 1, 2020 to April 30, 2021 (period 1), and 629 children with the same conditions from November 1, 2018, to April 30, 2019 (period 2), in our study. All respiratory samples from these patients were screened for six respiratory viruses (respiratory syncytial virus [RSV], adenovirus [ADV], influenza A virus [Flu A], influenza B virus [Flu B], parainfluenza virus type 1 [PIV1], and parainfluenza virus type 3 [PIV3]) using a multiplex real-time PCR assay. RESULTS AND CONCLUSIONS: The median ages of the enrolled patients at the time of diagnosis were 1.5 years and 1.0 years for period 1 and period 2, respectively. In period 1, viral pathogens were detected in 50.3% (776/1543) of the enrolled patients. The most frequently identified viral pathogen was RSV (35.9%, 554/1543), followed by PIV3 (9.6%, 148/1543), PIV1 (3.6%, 56/1543), ADV (3.4%, 52/1543), Flu A (1.0%, 16/1543), and Flu B (0.8%, 13/1543). The total detection rates of these six viruses in the peak season of CAP were at the pre-COVID level. The prevalence of Flu A decreased dramatically, and circulation activity was low compared to pre-COVID levels, while the incidence of PIV3 increased significantly. There were no significant differences in the detection rates of RSV, ADV, Flu B, and PIV1 between the two periods. Our results showed that respiratory viruses accounted for CAP in hospitalized children at pre-COVID levels as communities and schools reopened within the zero-COVID policy, although the prevalence aetiology spectrum varied.

Student adaptation to college and coping in relation to adjustment during COVID-19: A machine learning approach.

The COVID-19 pandemic has presented unprecedented challenges for university students, creating uncertainties for their academic careers, social lives, and mental health. Our study utilized a machine learning approach to examine the degree to which students' college adjustment and coping styles impacted their adjustment to COVID-19 disruptions. More specifically, we developed predictive models to distinguish between well-adjusted and not well-adjusted students in each of five psychological domains: academic adjustment, emotionality adjustment, social support adjustment, general COVID-19 regulations response, and discriminatory impact. The predictive features used for these models are students' individual characteristics in three psychological domains, i.e., Ways of Coping (WAYS), Adaptation to College (SACQ), and Perceived Stress Scale (PSS), assessed using established commercial and open-access questionnaires. We based our study on a proprietary survey dataset collected from 517 U.S. students during the initial peak of the pandemic. Our models achieved an average of 0.91 AUC score over the five domains. Using the SHAP method, we further identified the most relevant risk factors associated with each classification task. The findings reveal the relationship of students' general adaptation to college and coping in relation to their adjustment during COVID-19. Our results could help universities identify systemic and individualized strategies to support their students in coping with stress and to facilitate students' college adjustment in this era of challenges and uncertainties.

Immunogenicity, durability, and safety of an mRNA and three platform-based COVID-19 vaccines as a third dose following two doses of CoronaVac in China: A randomised, double-blinded, placebo-controlled, phase 2 trial.

Background: More effective vaccine candidates against variants of concern as a booster dose are needed in people primed with two-dose inactivated COVID-19 vaccines. Methods: This randomised, double-blinded, investigator-initiated phase 2 trial aims to evaluate immunogenicity, durability, and safety of an mRNA vaccine candidate (RQ3013) and three other platform vaccines (an adenovirus-vectored vaccine candidate [ChAdTS-S], a recombinant protein vaccine candidate [ZR202-CoV], and an inactivated vaccine [CoronaVac]) as a booster. 250 eligible volunteers, who had received a prime two-dose CoronaVac (3 to 5 weeks apart) vaccination 100-270 days before, were randomly assigned in a 1:1:1:1:1 ratio to receive a third dose of RQ3013 (30 µg mRNA per 0.15 mL), ChAdTS-S (5×1010 viral particles per 0.5 mL), ZR202-CoV (25 µg prefusion-stabilized Spike ectodomain trimer per 0.5 mL), CoronaVac (3 µg inactivated CN02 strain of SARS-CoV-2 per 0.5 mL) or placebo (0.5 mL of 0.9% sodium chloride solution) via intramuscular injection into the upper arm at a single clinical site in Kunming, China. Participants, investigators, and immunogenicity laboratory were masked to group assignment. The primary immunogenicity outcomes were geometric mean titres (GMTs) of neutralising antibodies against live SARS-CoV-2 (wild-type, delta and omicron) virus at day 0 (before vaccination), day 7, day 14 and day 28 after vaccination, as analysed in a modified intention-to-treat (mITT) population (all participants who completed their booster doses and had at least one post-dose immunogenicity data). Secondary outcomes include T cell responses against the wild-type and omicron SARS-CoV-2 Spike protein. The primary safety outcome was incidence of adverse events within 14 days after the booster vaccination. This trial is registered with ChiCTR.org.cn, ChiCTR2200057758. Findings: Between January 1, 2022, and February 28, 2022, 235 eligible participants were enrolled and vaccinated, and the primary analysis included 234 participants. At baseline, neutralising antibodies against wild-type virus, the delta, or omicron variants were low or undetectable in all groups. After the booster vaccination, GMTs of neutralising antibodies ranged from 75.4 (95% confidence interval [CI] 61.4-92.5) in CoronaVac to 950.1 (95% CI 785.4-1149.3) in RQ3013 against live wild-type SARS-CoV-2, and from 8.1 (95% CI: 6.1-10.7) in CoronaVac to 247.0 (95% CI 194.1-314.3) in RQ3013 against the omicron variant at day 14. Immunogenicities of all heterologous regimens were superior to that of homologous regimen in neutralisation against all tested SARS-CoV-2 strains, with RQ3013 showing the highest geometric mean ratios (GMRs) of 12.6, 14.7, and 31.3 against the wild-type, the delta variant and the omicron variant compared to CoronaVac at day 14 post-vaccination, respectively. Durability analysis at day 90 showed that >90% of participants in RQ3013 and ZR202-CoV were seropositive for the omicron variant while ZR202-CoV with adjuvants containing CpG showed a slightly better durability than RQ3013. T cell responses specific to the omicron variant were similar to that of the wild-type, with RQ3013 showing the highest boosting effect. Any solicited injection site or systemic adverse events reported within 14 days after vaccination were most commonly observed in RQ3013 (47/47, 100%), followed by ZR202-CoV (46/47, 97.9%) and ChAdTS-S (43/48, 89.6%), and then CoronaVac (37/46, 80.4%) and placebo (21/47, 44.7%). More than 90% of the adverse events were grade 1 (mild) or 2 (moderate) with a typical resolution time of 3 days. No grade 4 adverse events or serious adverse events were reported by study vaccines. Interpretation: Although all study vaccines boosted neutralising antibodies with no safety concerns, RQ3013 showed much stronger cross-neutralisation and cellular responses, adding more effective vaccine candidates against the omicron variant. Funding: Yunnan Provincial Science and Technology Department China (202102AA100051 and 202003AC100010), the Double First-class University funding to Yunnan University, National Natural Science Foundation of China (81960116, 82060368 and 82170711), Yunnan Natural Science Foundation (202001AT070085), High-level Health Technical Personnel Project of Yunnan Province (H-2018102) and Spring City Plan: The High-level Talent Promotion and Training Project of Kunming.

JC virus-induced progressive multifocal leukoencephalopathy in a presumably healthy patient.

BACKGROUND: JC virus (JCV) is common among healthy individuals and remains latent but may be reactivated under immunosuppressive conditions, resulting in progressive multifocal leukoencephalopathy (PML). Here, we present a rare case of PML caused by JC virus infection in a previously healthy and immunocompetent patient. CASE PRESENTATION: A 67-year-old female without any disease history was admitted after presenting with rapidly progressive dementia. The preoperative diagnosis was progressive multifocal leukoencephalopathy, and corticosteroid treatment did not improve the symptoms. Brain lesions were surgically sampled, and JCV infection was confirmed by high-throughput DNA gene detection. This patient received a combined treatment of mirtazapine, mefloquine, and traditional Chinese herbs, and had stabilization of the disease on followed-up. CONCLUSIONS: Although it is a rare, this case demonstrates that JC virus infection within the brain occurs in apparently healthy people. This case may increase our understanding of virus infection when facing the coronavirus epidemic in recent years, considering that similar medications were used.

Corneal Complications after COVID-19 Vaccination: A Systemic Review.

Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine administration. The literature search was conducted in March 2022 using MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews. A total of 27 articles, including 37 cases, have documented corneal adverse events that occurred following COVID-19 vaccination. The mean age was 60 ± 14.9 years (range, 27-83 years). The most common events were acute corneal graft rejection (n = 21, 56.8%), followed by herpes zoster ophthalmicus (n = 11, 29.7%) and herpes simplex keratitis (n = 2, 5.4%). The mean time from vaccination to the event was 10 ± 8.5 days (range, 1-42 days) after the first or second dose of vaccine. All patients with corneal graft rejection, immune-mediated keratolysis, and peripheral ulcerative keratitis (PUK) (n = 24, 64.9%) were managed topically with or without oral corticosteroids. Patients with herpes zoster ophthalmicus and herpes simplex keratitis were managed with oral antiviral agents. Two patients received penetrating keratoplasty due to keratolysis after invalid topical treatment. Disease resolution was noted in 29 patients (78.3%), whereas 3 (8.1%) had persistent corneal edema after graft rejection, 1 (2.7%) had corneal infiltration after HZO, and 4 (10.8%) were not mentioned in the articles. Corneal adverse events could occur after COVID-19 vaccination. After timely treatment with steroids or antiviral agents, most of the events were mild and had a good visual outcome. Administrating or increasing steroids before vaccination may be useful for the prevention of corneal graft rejection. However, the prophylactic use of antiviral treatments in patients with a herpes viral infection history is not recommend.

Pre-infection antiviral innate immunity contributes to sex differences in SARS-CoV-2 infection.

Male sex is a major risk factor for SARS-CoV-2 infection severity. To understand the basis for this sex difference, we studied SARS-CoV-2 infection in a young adult cohort of United States Marine recruits. Among 2,641 male and 244 female unvaccinated and seronegative recruits studied longitudinally, SARS-CoV-2 infections occurred in 1,033 males and 137 females. We identified sex differences in symptoms, viral load, blood transcriptome, RNA splicing, and proteomic signatures. Females had higher pre-infection expression of antiviral interferon-stimulated gene (ISG) programs. Causal mediation analysis implicated ISG differences in number of symptoms, levels of ISGs, and differential splicing of CD45 lymphocyte phosphatase during infection. Our results indicate that the antiviral innate immunity set point causally contributes to sex differences in response to SARS-CoV-2 infection. A record of this paper's transparent peer review process is included in the supplemental information.

Multiple functions of heterogeneous nuclear ribonucleoproteins in the positive single-stranded RNA virus life cycle.

The heterogeneous nuclear ribonucleoproteins (hnRNPs) are a diverse family of RNA binding proteins that are implicated in RNA metabolism, such as alternative splicing, mRNA stabilization and translational regulation. According to their different cellular localization, hnRNPs display multiple functions. Most hnRNPs were predominantly located in the nucleus, but some of them could redistribute to the cytoplasm during virus infection. HnRNPs consist of different domains and motifs that enable these proteins to recognize predetermined nucleotide sequences. In the virus-host interactions, hnRNPs specifically bind to viral RNA or proteins. And some of the viral protein-hnRNP interactions require the viral RNA or other host factors as the intermediate. Through various mechanisms, hnRNPs could regulate viral translation, viral genome replication, the switch of translation to replication and virion release. This review highlights the common features and the distinguish roles of hnRNPs in the life cycle of positive single-stranded RNA viruses.

How Is Professional Identity Associated with Teacher Career Satisfaction? A Cross-Sectional Design to Test the Multiple Mediating Roles of Psychological Empowerment and Work Engagement.

(1) Purpose: Previous studies investigated the positive relationship between professional identity and career satisfaction in teachers, but the underlying reasons were not explored. Therefore, the present study explores the mediating effects of two variables, namely, psychological empowerment and work engagement on the relationship between professional identity and career satisfaction. (2) Method: The present study used the professional identity scale, psychological empowerment scale, Utrecht Work Engagement scale and career satisfaction scale to investigate 2104 teachers (Mage = 39.50 years, SD = 8.74) in a province in China. The demographic variables (e.g., gender, age, teaching age) were controlled as covariates to conduct conservative predictions. (3) Result: (a) professional identity is positively related to career satisfaction; (b) psychological empowerment and career satisfaction play parallel mediator roles between professional identity and career satisfaction; (c) psychological empowerment and career satisfaction play serial mediator roles between professional identity and career satisfaction. (4) Limitations: Data were collected by participant self-report. This method may lead to recall bias. Further, we adopted a cross-sectional rather than experimental or longitudinal design, thus precluding causal conclusions. Lastly, it would be useful to validate our findings with a national sample. (5) Conclusions: The present study indicates that the relationship between professional identity is positively associated with teacher career satisfaction. More importantly, professional identity can indirectly make an impact on teacher career satisfaction through the single mediating effects of psychological empowerment and work engagement, and the chain mediating effect, by improving the level of psychological empowerment, and thereby increasing work engagement.

Cardio- and Neurotoxicity of Selected Anti-COVID-19 Drugs.

Since December 2019, the novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected ~435 million people and caused ~6 million related deaths as of March 2022. To combat COVID-19, there have been many attempts to repurpose FDA-approved drugs or revive old drugs. However, many of the current treatment options have been known to cause adverse drug reactions. We employed a population-based drug screening platform using 13 human leukocyte antigen (HLA) homozygous human induced pluripotent cell (iPSC) lines to assess the cardiotoxicity and neurotoxicity of the first line of anti-COVID-19 drugs. We also infected iPSC-derived cells to understand the viral infection of cardiomyocytes and neurons. We found that iPSC-derived cardiomyocytes express the ACE2 receptor which correlated with a higher infection of the SARS-CoV-2 virus (r = 0.86). However, we were unable to detect ACE2 expression in neurons which correlated with a low infection rate. We then assessed the toxicity of anti-COVID-19 drugs and identified two cardiotoxic compounds (remdesivir and arbidol) and four neurotoxic compounds (arbidol, remdesivir, hydroxychloroquine, and chloroquine). These data show that this platform can quickly and easily be employed to further our understanding of cell-specific infection and identify drug toxicity of potential treatment options helping clinicians better decide on treatment options.

Near-Surface NO2 Concentration Estimation by Random Forest Modeling and Sentinel-5P and Ancillary Data

In the present study, a daily model is proposed for estimating the near-surface NO2 concentration in China, combining for the first time the Random Forest (RF) machine learning algorithm with the tropospheric NO2 columns from the TROPOspheric Monitoring Instrument (TropOMI) satellite and meteorological and NO2 data of surface sites in China for the year 2019. Furthermore, near-surface NO2 concentration data of ground sites during the COVID-19 outbreak from 1–5 February 2020 were used to verify the developed model. The daily model was verified by the ten-fold cross-validation method, revealing a coefficient of determination (R2) of 0.78 and root-mean-square error (RMSE) of 7.04 μg/m3, which are reasonable and also comparable to other published studies. In addition, our model showed that near-surface NO2 in China during the COVID-19 pandemic was significantly reduced compared with 2019, and these predictions were in good agreement with reference ground data. Our proposed model can also provide NO2 estimates for areas in western China where there are few ground monitoring sites. Therefore, all in all, our study findings suggest that the model established herein is suitable for estimating the daily NO2 concentration near the surface in China and, as such, can be used if there is a lack of surface sites and/or missing observations in some areas.

Functions of Viroporins in the Viral Life Cycle and Their Regulation of Host Cell Responses.

Viroporins are virally encoded transmembrane proteins that are essential for viral pathogenicity and can participate in various stages of the viral life cycle, thereby promoting viral proliferation. Viroporins have multifaceted effects on host cell biological functions, including altering cell membrane permeability, triggering inflammasome formation, inducing apoptosis and autophagy, and evading immune responses, thereby ensuring that the virus completes its life cycle. Viroporins are also virulence factors, and their complete or partial deletion often reduces virion release and reduces viral pathogenicity, highlighting the important role of these proteins in the viral life cycle. Thus, viroporins represent a common drug-protein target for inhibiting drugs and the development of antiviral therapies. This article reviews current studies on the functions of viroporins in the viral life cycle and their regulation of host cell responses, with the aim of improving the understanding of this growing family of viral proteins.