Service-learning under COVID-19: A scoping review of the challenges and opportunities for practicing service-learning in the 'New Normal'.

Service-learning collaborations have the potential to effectively respond to community needs, students' needs, and institutional priorities. However, natural and man-made crises oftentimes throw these arrangements into disarray. The coronavirus (COVID-19) is one such significant crisis that continues to challenge service-learning collaborations worldwide. Based on a systematic scoping review of scholarship on service-learning programs conducted during COVID-19, this study aimed to explore thematic similarities and differences between them, elucidating key observations and insights for future action. Overall, findings from 13 peer-reviewed articles indicated that, although not immune to the wide-ranging adverse effects of COVID-19, service-learning has proven itself to be an effective responsive pedagogy in times of crisis.

Aberrant Brain Entropy in Posttraumatic Stress disorder Comorbid with Major Depressive Disorder during the Coronavirus Disease 2019 Pandemic (preprint)

Aim Previously, neuroimaging studies on comorbid Posttraumatic-Major depression disorder (PTSD-MDD) comorbidity found abnormalities in multiple brain regions among patients. Recent neuroimaging studies have revealed dynamic nature on human brain activity during resting state, and entropy as an indicator of dynamic regularity may provide a new perspective for studying abnormalities of brain function among PTSD-MDD patients. During the COVID-19 pandemic, there has been a significant increase in the number of patients with PTSD-MDD. We have decided to conduct research on resting-state brain functional activity of patients who developed PTSD-MDD during this period using entropy.Methods 33 patients with PTSD-MDD and 36 matched TCs were recruited. PTSD and depression symptoms were assessed using multiple clinical scales. All subjects underwent functional magnetic resonance imaging (fMRI) scans. And the brain entropy (BEN) maps were calculated using the BEN mapping toolbox. A two-sample t-test was used to compare the differences in the brain entropy between the PTSD-MDD comorbidity group and TC group. Furthermore, correlation analysis was conducted between the BEN changes in patients with PTSD-MDD and clinical scales.Results Compared to the TCs, PTSD-MDD patients had a reduced BEN in the right middle frontal orbital gyrus (R_MFOG), left putamen, and right inferior frontal gyrus, opercular part (R_IFOG). Furthermore, a higher BEN in the R_MFOG was related to higher CAPS and HAMD-24 scores in the patients with PTSD-MDD.Conclusion The results showed that the R_MFOG is a potential marker for showing the symptom severity of PTSD-MDD comorbidity. Consequently, PTSD-MDD may have reduced BEN in frontal and basal ganglia regions which are related to emotional dysregulation and cognitive deficits.

Impact of COVID-19 on Pregnancy.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is an emerging disease. There has been a rapid increase in cases and deaths since it was identified in Wuhan, China, in early December 2019, with over 4,000,000 cases of COVID-19 including at least 250,000 deaths worldwide as of May 2020. However, limited data about the clinical characteristics of pregnant women with COVID-19 have been reported. Given the maternal physiologic and immune function changes during pregnancy, pregnant women may be at a higher risk of being infected with SARS-CoV-2 and developing more complicated clinical events. Information on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) may provide insights into the effects of COVID-19's during pregnancy. Even though SARS and MERS have been associated with miscarriage, intrauterine death, fetal growth restriction and high case fatality rates, the clinical course of COVID-19 pneumonia in pregnant women has been reported to be similar to that in non-pregnant women. In addition, pregnant women do not appear to be at a higher risk of catching COVID-19 or suffering from more severe disease than other adults of similar age. Moreover, there is currently no evidence that the virus can be transmitted to the fetus during pregnancy or during childbirth. Babies and young children are also known to only experience mild forms of COVID-19. The aims of this systematic review were to summarize the possible symptoms, treatments, and pregnancy outcomes of women infected with COVID-19 during pregnancy.

Unprecedented Outbreak of Respiratory Syncytial Virus in Taiwan Associated with ON1 Variant Emergence between 2010 and 2020 (preprint)

Background: A national outbreak of respiratory syncytial virus (RSV) has been observed in the community since August 2020 in Taiwan even under strict COVID-19 related public health measures.Methods: We reviewed a national laboratory-based surveillance network established by Taiwan Centers for Disease Control for respiratory viral pathogens between 2010 and 2020. A retrospective study of 257 children < 5 years old hospitalized with RSV infection at Chang Gung Memorial Hospital Lin Kou and Kaohsiung branches between 2018 and 2020 was conducted, and 193 samples positive for RSV-A were sequenced. Clinical data were obtained and stratified by genotype and year.Findings: National data from 2020 showed an enormous increase in RSV case numbers. The RSV positivity rate in 2020 had an approximately 4-fold surge compared to 2010 in Taiwan (OR 3.79; 95% CI, 3.06–4.69; p < 0.001), surpassing previous years during which ON1 was prevalent. Phylogenetic analysis of G protein showed that novel ON1 variants in 2020 with 6 amino acid changes that emerged gradually in 2019 and a novel substitution, E257K were clustered separately from those of 2018 and 2019 seasons and ON1 reference strains. The F protein of the variant carried T12I and H514N substitutions, which weren’t at antigenic sites. Age (OR: 0.97; 95% CI: 0.94–0.99; p =0.02) and 2020 ON1 variant (OR: 2.52; 95% CI: 1.13–5.63; p = 0.025) were independently associated with oxygen saturation <94% during hospitalization.Interpretation: The unprecedented 2020 RSV epidemic caused by novel ON1 variants suggests that the mutations may confer a fitness advantage over other genotypes. Further studies on viral replication, antigenic changes, and virulence are required.Funding: This work was supported by the Chang Gung Memorial Hospital in Taiwan [Grant CMRPG3K1011 and CMRPG3K1141 ]; Ministry of Science Technology in Taiwan [MOST 108-2314-B-182A-156-MY3]; China Medical University, Taiwan [Grant CMU 108-S-23, CMU109-MF-111]Declaration of Interests: No potential conflict of interest was reported by the authors.Ethics Approval Statement: This study was approved by the Research and Ethics Committee of Chang Gung Memorial Hospital (IRB:202100450B0, 202100569A3).

[Nursing Experience of Caring for a Patient With COVID-19 During Isolation].

The ongoing coronavirus disease-2019 (COVID-19) epidemic continues to have a global impact. This article describes the author's experience providing nursing care to a female patient who was diagnosed with COVID-19 after returning to Taiwan from overseas. During the patient's period of isolation (February 5th to February 29th, 2020), the author used Roy's adaptation model to perform first-level holistic physical, psychological, and social nursing assessments and collected health-problem information using face-to-face interviews, telephone interviews, and observations via a remote monitoring system. A second level of assessment confirmed that the problems faced by the patient included (1) existing infections related to COVID-19 and (2) anxiety related to uncertainties about disease prognosis, forgiveness from the family, and potential violations of personal privacy by the media. Due to the special nature of the isolation ward, the author used a remote physiological monitoring system to monitor the vital signs, fever, and shortness of breath status of the patient to quickly decrease her physical discomfort and to improve her self-care ability during hospitalization. Environmental cleanliness was strictly maintained to reduce the risk of cross-infection and ensure patient safety. To alleviate patient anxiety, the author established a good therapeutic interpersonal relationship with the patient by making 10-60 minutes of caring calls to her each day, by providing individual care measures, and by using the Internet to play audio and video to teach mindfulness meditation. Caring for COVID-19 cases is a completely new experience. The author hopes that this experience may be used as a reference for caregivers.

Genomic Epidemiology of the Los Angeles COVID-19 Outbreak (preprint)

Background The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global disruption to human health and activity. Being able to trace the early outbreak of SARS-CoV-2 within a locality will inform public health measures and provide insights to contain or prevent the viral transmission to save lives. Investigation of the transmission history requires efficient sequencing methods and analytic strategy, which can be generally useful in the study of viral outbreaks.  Methods Los Angeles (LA) County has sustained a large outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To learn about the transmission history, we carried out surveillance viral genome sequencing to determine 142 viral genomes from unique patients seeking care at UCLA Health System. 86 of these genomes are from samples collected before April 19, 2020. Results We found that the early outbreak in LA, as in other international air travel hubs, was seeded by multiple introductions of strains from Asia and Europe. We identified a US-specific strain, B.1.43, which has been found predominantly in California and Washington State. While samples from LA County carry the ancestral B.1.43 genome, viral genomes from neighboring counties in California and from counties in Washington State carry additional mutations, suggesting a potential origin of B.1.43 in Southern California. We quantified the transmission rate of SARS-CoV-2 over time, and found evidence that the public health measures put in place in LA County to control the virus were effective at preventing transmission, but may have been undermined by the many introductions of SARS-CoV-2 into the region. Conclusion Our work demonstrates that genome sequencing can be a powerful tool for investigating outbreaks and informing the public health response. Our results reinforce the critical need for the U.S. to have coordinated inter-state responses to the pandemic.

Genomic epidemiology of the Los Angeles COVID-19 outbreak (preprint)

Los Angeles (LA) County has sustained a large outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To learn about the transmission history of SARS-CoV-2 in LA County, we sequenced 142 viral genomes from unique patients seeking care at UCLA Health System. 86 of these genomes are from samples collected before April 19, 2020. We found that the early outbreak in LA, as in other international air travel hubs, was seeded by multiple introductions of strains from Asia and Europe. We identified a US-specific strain, B.1.43, which has been found predominantly in California and Washington State. While samples from LA County carry the ancestral B.1.43 genome, viral genomes from neighbouring counties in California and from counties in Washington State carry additional mutations, suggesting a potential origin of B.1.43 in Southern California. We quantified the transmission rate of SARS-CoV-2 over time, and found evidence that the public health measures put in place in LA County to control the virus were effective at preventing transmission, but may have been undermined by the many introductions of SARS-CoV-2 into the region. Our work demonstrates that genome sequencing can be a powerful tool for investigating outbreaks and informing the public health response. Our results reinforce the critical need for the U.S. to have coordinated inter-state responses to the pandemic.

Rapid cost-effective viral genome sequencing by V-seq (preprint)

ABSTRACT Conventional methods for viral genome sequencing largely use metatranscriptomic approaches or, alternatively, enrich for viral genomes by amplicon sequencing with virus-specific PCR or hybridization-based capture. These existing methods are costly, require extensive sample handling time, and have limited throughput. Here, we describe V-seq, an inexpensive, fast, and scalable method that performs targeted viral genome sequencing by multiplexing virus-specific primers at the cDNA synthesis step. We designed densely tiled reverse transcription (RT) primers across the SARS-CoV-2 genome, with a subset of hexamers at the 3’ end to minimize mis-priming from the abundant human rRNA repeats and human RNA PolII transcriptome. We found that overlapping RT primers do not interfere, but rather act in concert to improve viral genome coverage in samples with low viral load. We provide a path to optimize V-seq with SARS-CoV-2 as an example. We anticipate that V-seq can be applied to investigate genome evolution and track outbreaks of RNA viruses in a cost-effective manner. More broadly, the multiplexed RT approach by V-seq can be generalized to other applications of targeted RNA sequencing.

Swab-Seq: A high-throughput platform for massively scaled up SARS-CoV-2 testing (preprint)

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is due to the high rates of transmission by individuals who are asymptomatic at the time of transmission. Frequent, widespread testing of the asymptomatic population for SARS-CoV-2 is essential to suppress viral transmission and is a key element in safely reopening society. Despite increases in testing capacity, multiple challenges remain in deploying traditional reverse transcription and quantitative PCR (RT-qPCR) tests at the scale required for population screening of asymptomatic individuals. We have developed SwabSeq, a high-throughput testing platform for SARS-CoV-2 that uses next-generation sequencing as a readout. SwabSeq employs sample-specific molecular barcodes to enable thousands of samples to be combined and simultaneously analyzed for the presence or absence of SARS-CoV-2 in a single run. Importantly, SwabSeq incorporates an in vitro RNA standard that mimics the viral amplicon, but can be distinguished by sequencing. This standard allows for end-point rather than quantitative PCR, improves quantitation, reduces requirements for automation and sample-to-sample normalization, enables purification-free detection, and gives better ability to call true negatives. We show that SwabSeq can test nasal and oral specimens for SARS-CoV-2 with or without RNA extraction while maintaining analytical sensitivity better than or comparable to that of fluorescence-based RT-qPCR tests. SwabSeq is simple, sensitive, flexible, rapidly scalable, inexpensive enough to test widely and frequently, and can provide a turn around time of 12 to 24 hours.