Anxiety and depression among pregnant women undergoing IVF-ET and WeChat group peer support during the COVID-19 pandemic: Study protocol for a randomized controlled trial

Introduction: The psychological well-being of pregnant women following assisted reproductive has increasingly gained attention in recent years. Anxiety and depression may be associated to pregnancy outcomes. This study aims to determine whether peer support and the WeChat group platform will reduce anxiety and depression among in vitro fertilization and embryo transfer (IVF-ET) women. Methods and Analysis: In the present randomized controlled study, 296 patients with confirmed clinical pregnancy following IVF-ET will be randomly assigned to receive standard intervention support or WeChat peer support on a 1:1 basis. The levels of anxiety and depression are the primary endpoints. Assessments will be performed at baseline measurements, first trimester, second trimester, and third trimester, and data will be collected. Ethics and Dissemination: This study has been approved as ethical by the affiliated hospital of Shandong University of Traditional Chinese Medicine's Reproductive Ethics Committee. Each patient will sign a written statement of informed permission. All information and biological samples will be legally protected. A peer-reviewed academic journal will publish the findings of this investigation. Discussion: Given the inconvenience of visits due to the current pandemic of COVID-19, this study addresses the patient's visit needs by combining WeChat, the most widely used social software in China, with peer support, while helping improve maternal anxiety, depression, and pregnancy outcomes following IVF-ET.

Generation and functional analysis of defective viral genomes during SARS-CoV-2 infection (preprint)

Defective viral genomes (DVGs) have been identified in many RNA viruses as a major factor influencing antiviral immune response and viral pathogenesis. However, the generation and function of DVGs in SARS-CoV-2 infection are less known. In this study, we elucidated DVG generation in SARS-CoV-2 and its relationship with host antiviral immune response. We observed DVGs ubiquitously from RNA-seq datasets of in vitro infections and autopsy lung tissues of COVID-19 patients. Four genomic hotspots were identified for DVG recombination and RNA secondary structures were suggested to mediate DVG formation. Functionally, bulk and single cell RNA-seq analysis indicated the IFN stimulation of SARS-CoV-2 DVGs. We further applied our criteria to the NGS dataset from a published cohort study and observed significantly higher DVG amount and frequency in symptomatic patients than that in asymptomatic patients. Finally, we observed unusually high DVG frequency in one immunosuppressive patient up to 140 days after admitted to hospital due to COVID-19, first-time suggesting an association between DVGs and persistent viral infections in SARS-CoV-2. Together, our findings strongly suggest a critical role of DVGs in modulating host IFN responses and symptom development, calling for further inquiry into the mechanisms of DVG generation and how DVGs modulate host responses and infection outcome during SARS-CoV-2 infection.

A Study on the Correlation Between Undergraduate Students’ Exercise Motivation, Exercise Self-Efficacy, and Exercise Behaviour Under the COVID-19 Epidemic Environment

The outbreak of COVID-19 epidemic has influenced human beings from various aspects including physical exercise behaviours. This study aims to explore the influence of the COVID-19 epidemic on exercise self-efficacy and exercise behaviour, as well as the intermediary effects of exercise motivation. A sample of 1,115 undergraduate students was investigated using the physical exercise behaviour scale, exercise self-efficacy scale, and exercise motivation scale, combined with the COVID-19 epidemic environment as an influencing factor. SPSS was used for statistical analysis and AMOS for the prediction model building. Logical analysis was undertaken to sort out and analyse the data. The structural equation model reveals that exercise self-efficacy has a positive effect on exercise motivation and exercise behaviour. Meanwhile, the COVID-19 epidemic environment negatively influences exercise behaviour through the intermediary role of exercise self-efficacy and exercise motivation. Moreover, the intermediary effect of exercise self-efficacy is greater than that of exercise self-efficacy and exercise motivation. This study provides both theoretical implications and practical guidelines for society and undergraduate students to improve their exercise behaviour during epidemic.

The Coevolutionary Process of Maritime Management of Shipping Industry in the Context of the COVID-19 Pandemic

This study investigates how international organizations, International Maritime Organization (IMO) member states, and associate members have embarked on maritime management (MM) measures to address dire situations in the context of the COVID-19 pandemic. It explores the evolution of MM practices from international organizations, IMO member states, and associate members to ensure the resilience and sustainability of the shipping industry. Corpus linguistics was employed as a computer-assisted method to assess a large number of naturally occurring texts. Circular letters from international organizations and member states listed on the IMO website from January 2020 to July 2021 were curated and built into three corpora. Through corpus linguistic analysis of circulars from three different crisis phases (Pre-/early-crisis, Crisis in progress, Post-COVID-19 crisis phase), we discovered an MM progression mechanism developed between stakeholders in conjunction with the post-crisis period. The study presented the “MM-as-process” vision to emphasize the time-varying dynamic nature of MM development during the disruption.

Environment-friendly surface cleaning using micro-nano bubbles

Cleaning a surface using a solution containing a large number of micro to nano scale bubbles has significant advantage regarding environmental protection. This review first briefly introduces the cleaning mechanism of micro-nano bubbles (MNBs), including physical and chemical effects. Then the applications of MNBs in cleaning of metal parts, precision parts, cultural relics or food are introduced. After that, coupled cleaning method of ultrasound and bubbles is introduced. Finally, the characterization methods for the cleaning effect are introduced, which mainly focuses on the changes of physico-chemical properties (mass or cleaning area, infiltration, colony number and light scattering intensity) of the cleaned parts or that (like conductivity) of the solvent. It is believed that MNBs technology will be applied in a broader range of surface cleaning applications.

Field-effect at electrical contacts to two-dimensional materials (preprint)

The inferior electrical contact to two-dimensional (2D) materials is a critical challenge for their application in post-silicon very large-scale integrated circuits. Electrical contacts were generally related to their resistive effect, quantified as contact resistance. With a systematic investigation, this work demonstrates a capacitive metal-insulator-semiconductor (MIS) field-effect at the electrical contacts to 2D materials: the field-effect depletes or accumulates charge carriers, redistributes the voltage potential, and give rise to abnormal current saturation and nonlinearity. On the one hand, the current saturation hinders the devices' driving ability, which can be eliminated with carefully engineered contact configurations. On the other hand, by introducing the nonlinearity to monolithic analog artificial neural network circuits, the circuits' perception ability can be significantly enhanced, as evidenced using a COVID-19 critical illness prediction model. This work provides a comprehension of the field-effect at the electrical contacts to 2D materials, which is fundamental to the design, simulation, and fabrication of electronics based on 2D material.

Higher perceived risk of COVID-19 pandemic, higher concern for climate change: evidence from a longitudinal study in China (preprint)

COVID-19 is raging globally taking a huge toll on public health. Although there seems to be a silver lining regarding mitigation of climate change given decreased emission of greenhouse gases during the pandemic, climate disruption actually constantly keeps apace. Therefore, it is important for the public to maintain alert to climate change amid the devastating pandemic. The current longitudinal study made a preliminary exploration of the relationship between public risk perception of the pandemic and climate change and we examined two possibly competing mediators which might lead to opposite effects—negative emotions and limited cognitive resources. The results show that pandemic risk perception has positive predictive effect on climate change concern mediated by negative emotions, but public attention to climate change is not impaired by increased concern for the pandemic. We discuss the value of our results and offer inspiring advice to better address climate change during COVID-19 outbreak.

Epidemiological characteristics of COVID-19 in Hainan Province, China

The epidemiology characteristics of 2019 novel coronavirus diseases (COVID-19) cases in Hainan were collected and analyzed for providing next stage control and prevention strategy in next stage. Spatial and temporal distribution, population characteristic, cluster, the interval between onset, visiting clinic, admitted were analyzed. Local cases and severe cases were also included in the analysis. Result showed that a total of 168 confirmed cases, including 36 severe cases and 5 fatal cases were reported. Cases were mainly distributed in Haikou, Sanya etc tourism cities and counties. The first case occurred in Jan 13th and the epidemic peak occurred in Jan 24th. Since Feb 6th, onset of illness has declined. The male-to-female ratio was 0.9:1. The median age was 51 years. Cases older than 50 years accounted for 54.8%. Retirees accounted for 36.9%, which was highest in all cases. Since Feb, the proportion of local cases rose dramatically. The period from onset to visiting clinic (OTV), from first visiting clinic to diagnosis (VTF), from onset to diagnosis (OTD) and from onset to be admitted (OTA) was longer in local cases than imported cases. Median age and the percentage of underlying diseases of severe/extreme cases were higher than mild/ordinary cases. OTV of severe/extreme cases was longer than mild/ordinary cases, while for VTF, the former was shorter than latter. The epidemic was divided into three stages. Most of cases in the first stage were imported cases, while in the second stage most of cases were local cases. There were few cases in the third stages. We should strengthen personal protection and health monitoring for people in service industry, isolate the close contacts, and carry out publicity and education to raise the awareness of medical treatment for people, especially for old people. Clinical doctors should monitor the state of the patients older than 60 years and with underlying diseases. We should step up epidemic monitoring prevention and control measure for people return from holiday and immigrant to consolidate the effects of prevention and control work.

Efficacy and Safety of Leflunomide for Refractory COVID-19: An Open-label Controlled Study (preprint)

OBJECTIVE To evaluate the safety and efficacy of leflunomide for the treatment of refractory COVID-19 in adult patients. DESIGN Open-label controlled study SETTING A designated hospital for patients with refractory COVID-19 in Wuhan, China. PARTICIPANTS 27 hospitalized adult patients ([≥]18 years of age) with radiologically confirmed pneumonia and SARS-CoV-2 positive for more than 28 days despite standard care were assigned to receive standard of care (SOC, grp I) or leflunomide + SOC (grp 2). After 2 weeks, grp 1 and grp 2 patients who continued to be SARS-CoV-2-positive received leflunomide for 14 days while continuing SOC. MAIN OUTCOME MEASURES The primary outcomes were the rate of and time to SARS-CoV-2 clearance and the 14-day and 30-day hospital discharge rate. RESULTS Twelve patients enrolled in grp 1 and 15 patients were in grp 2. The 14 days SARS-CoV-2 viral clearance rate was 80.0% (12/15) for grp 2 patients receiving leflunomide versus 16.7% for grp 1 patients (2/12) (P=0.002). By day 14, the median time to SARS-CoV-2 clearance was 6.0 days (range 1-12; IQR 1-12) for grp 2 patients. In grp 1, two patients converted to viral negative on days 1 and 6 (P=0.002). The 14-day discharge rate was 73.3% (11/15) for the grp 2 versus 8.3% (1/12) for grp 1 (P=0.001). The 30-day discharge rate was 100% (15/15) for the grp 2 versus 66.7% (8/12) for grp 1. No severe adverse events or deaths were reported. CONCLUSION Leflunomide is effective in enhancing SARS-CoV-2 clearance and hospital discharge in refractory COVID-19 patients. The addition of leflunomide to SOC did not increase adverse events versus SOC. These preliminary observations underscore a need for a randomized clinical study of leflunomide in SARS-CoV-2 infection.

Structural and biochemical characterization of nsp12-nsp7-nsp8 core polymerase complex from COVID-19 virus (preprint)

The ongoing global pandemic of coronavirus disease 2019 (COVID-19) has caused huge number of human deaths. Currently, there are no specific drugs or vaccines available for this virus. The viral polymerase is a promising antiviral target. However, the structure of COVID-19 virus polymerase is yet unknown. Here, we describe the near-atomic resolution structure of its core polymerase complex, consisting of nsp12 catalytic subunit and nsp7-nsp8 cofactors. This structure highly resembles the counterpart of SARS-CoV with conserved motifs for all viral RNA-dependent RNA polymerases, and suggests the mechanism for activation by cofactors. Biochemical studies revealed reduced activity of the core polymerase complex and lower thermostability of individual subunits of COVID-19 virus as compared to that of SARS-CoV. These findings provide important insights into RNA synthesis by coronavirus polymerase and indicate a well adaptation of COVID-19 virus towards humans with relatively lower body temperatures than the natural bat hosts.

Caspofungin and LTX-315 inhibit SARS-CoV-2 replication by targeting the nsp12 polymerase (preprint)

The ongoing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, previously designated as 2019-nCoV) outbreak has caused global concern1. Currently, there are no clinically approved specific drugs or vaccines available for this virus. The viral polymerase is a promising target for developing broad- spectrum antiviral drugs. Here, based on the highly similar structure of SARS- CoV non-structural protein 12 (nsp12) polymerase subunit2, we applied virtual screen for the available compounds, including both the FDA-approved and under- clinic drugs, to identify potential antiviral molecules against SARS-CoV-2. We found two drugs, the clinically approved anti-fungi drug Caspofungin Acetate (Cancidas) and the oncolytic peptide LTX-315, can bind SARS-CoV-2 nsp12 protein to block the polymerase activity in vitro. Further live virus assay revealed that both Caspofungin Acetate and LTX-315 can effectively inhibit SARS-CoV-2 replication in vero cells. These findings present promising drug candidates for treatment of related diseases and would also stimulate the development of pan- coronavirus antiviral agents.Authors Min Wang, Fei Ye, Jiaqi Su, Jingru Zhao, and Bin Yuan contributed equally to this work.

Clinical Pathology of Critical Patient with Novel Coronavirus Pneumonia (COVID-19) (preprint)

Background Critical patients with novel coronavirus pneumonia ( COVID-19) have worse outcome and high mortality. However, the histopathology of critical patient with COVID-19 remains undisclosed. Methods We performed the whole lung biopsy, and described the pathological changes of critical COVID-19 patient done with transplant by HE staining, immunohistochemistry and special staining observed under the microscopy. Findings The whole lungs displayed diffuse congestive appearance and partly haemorrhagic necrosis on gross examination. The haemorrhagic necrosis was prominently present in outer edge of the right lower lung. The cut surfaces of the lung displayed severe congestive and haemorrhagic changes. The main pathological changes showed massive pulmonary interstitial fibrosis, and partly hyaline degeneration, variable degrees of hemorrhagic pulmonary infarction. Small vessels hyperplasia, vessel wall thickening, lumen stenosis, occlusion and microthrombosis formation. Focal monocytes, lymphocytes and plasma cells infiltrating into pulmonary interstitium. Bronchiolitis and alveolitis with proliferation, atrophy, desquamation and squamous metaplasia of epithelial cells. Atrophy, vacuolar degeneration, proliferation, desquamation and squamous metaplasia in alveolar epithelial cells. Alveolar cavity congestion was prominent, and contained mucus, edema fluid, desquamated epithelial cells, and inflammatory cells. We also found several multinucleate giant cells and intracytoplasmic viral inclusion bodies. Special stains including Masson stain, sirius red staining, reticular fibers staining indicated massive pulmonary interstitial fibrosis. Immunohistochemistry showed positive for immunity cells including CD3, CD4, CD8, CD20, CD79a, CD5, CD38 and CD68. Interpretation We demonstrate the pathological findings of critical patient with COVID-19, which might provide a deep insight of the pathogenesis and severity of this disease.