Continuous evolution and emerging lineage of seasonal human coronaviruses: A multicenter surveillance study.

The seasonal human coronaviruses (HCoVs) have zoonotic origins, repeated infections, and global transmission. The objectives of this study are to elaborate the epidemiological and evolutionary characteristics of HCoVs from patients with acute respiratory illness. We conducted a multicenter surveillance at 36 sentinel hospitals of Beijing Metropolis, China, during 2016-2019. Patients with influenza-like illness (ILI) and severe acute respiratory infection (SARI) were included, and submitted respiratory samples for screening HCoVs by multiplex real-time reverse transcription-polymerase chain reaction assays. All the positive samples were used for metatranscriptomic sequencing to get whole genomes of HCoVs for genetical and evolutionary analyses. Totally, 321 of 15 677 patients with ILI or SARI were found to be positive for HCoVs, with an infection rate of 2.0% (95% confidence interval, 1.8%-2.3%). HCoV-229E, HCoV-NL63, HCoV-OC43, and HCoV-HKU1 infections accounted for 18.7%, 38.3%, 40.5%, and 2.5%, respectively. In comparison to ILI cases, SARI cases were significantly older, more likely caused by HCoV-229E and HCoV-OC43, and more often co-infected with other respiratory pathogens. A total of 179 full genome sequences of HCoVs were obtained from 321 positive patients. The phylogenetical analyses revealed that HCoV-229E, HCoV-NL63 and HCoV-OC43 continuously yielded novel lineages, respectively. The nonsynonymous to synonymous ratio of all key genes in each HCoV was less than one, indicating that all four HCoVs were under negative selection pressure. Multiple substitution modes were observed in spike glycoprotein among the four HCoVs. Our findings highlight the importance of enhancing surveillance on HCoVs, and imply that more variants might occur in the future.

Perceived Crisis Management and Post-Traumatic Growth among Chinese Preschool Teachers during COVID-19: Risk Perception as a Moderator.

This study explored post-traumatic growth among preschool teachers during COVID-19 and investigated associations among post-traumatic growth, perceived crisis management, and risk perception. The participants were 2921 Chinese preschool teachers (96.5% women). Teachers' reports of post-traumatic growth, perceived crisis management, and risk perception were analyzed by multivariate techniques. The results revealed that preschool teachers' post-traumatic growth was at an intermediate level, and there was no significant difference in post-traumatic growth by risk level area. Post-traumatic growth was significantly related to risk perception and perceived crisis management, and risk perception appeared to moderate the relationship between perceived crisis management and post-traumatic growth. Our findings highlight the importance of considering the roles of perceived crisis management and risk perception in preschool teachers' post-traumatic growth. Related suggestions for preschool teachers' mental health are discussed.

Comparative Efficacy of Chinese Herbal Injections for Treating Severe Pneumonia: A Systematic Review and Bayesian Network Meta-Analysis of Randomized Controlled Trials.

Background: Severe pneumonia (SP) has a high mortality rate and is responsible for significant healthcare costs. Chinese herbal injections (CHIs) have been widely used in China as a novel and promising treatment option for SP. Therefore, this study assessed and ranked the effectiveness of CHIs to provide more sights for the selection of SP treatment. Method: Seven databases were searched from their inception up to April 1, 2021. The methodological quality of included study was evaluated by the Cochrane risk-of-bias tool. Then, a Bayesian network meta-analysis (NMA) was performed by OpenBUGS 3.2.3 and STATA 14.0 software. The surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the examined treatments. A clustering analysis was utilized to compare the effect of CHIs between two different outcomes. Results: A total of 64 eligible randomized controlled trials (RCTs) involving 5,904 participants were identified for this analysis. Six CHIs including Xuebijing injection (XBJ), Tanreqing injection (TRQ), Reduning injection (RDN), Xiyanping injection (XYP), Shenfu injection (SF), and Shenmai injection (SM) were included. The results of the NMA showed that XBJ [odds ratio (OR) = 0.24, 95% credible interval (CI): 0.19, 0.30], TRQ (OR = 0.22, 95% CI: 0.12, 0.37), RDN (OR = 0.29, 95% CI: 0.04, 0.94), and SM (OR = 0.27, 95% CI: 0.08, 0.63) combined with conventional Western medicine (WM) improved the clinical effective rate more significantly than WM alone. Based on SUCRA values, TRQ + WM (SUCRA: 66.4%) ranked the highest in improving the clinical effective rate, second in four different outcomes, and third in only one. According to the cluster analysis, TRQ + WM exerted a positive effect on improving the efficacy of SP. As for safety, less than 30% (18 RCTs) of the included studies reported adverse drug reactions/adverse drug events (ADRs/ADEs), including 14 RCTs of XBJ, 3 RCTs of TRQ, and 1 RCT of RDN. Conclusion: In conclusion, the study found that the CHIs as co-adjuvant therapy could be beneficial for patients with SP. TRQ + WM showed an outstanding improvement in patients with SP considering both the clinical effective rate and other outcomes. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42021244587].

Dual Stressors and Female Pre-school Teachers' Job Satisfaction During the COVID-19: The Mediation of Work-Family Conflict.

Online education has become a vital weapon to fight against the COVID-19 epidemic in the world. In the home-based online education environment, female pre-school teachers are expected to balance the dual roles of teacher and mother at the same time, which may trigger the work-family conflict. Although previous studies analyzed individual stressors, work-family conflict and its outcomes, there is little research on pre-school teachers' work and parenting experience during major public health emergencies. The current study examined the associations among work overload, parenting stress, work-family conflict, and job satisfaction during the COVID-19. Seven hundred eighteen female pre-school teachers with children who worked online at home participated in the study. Female pre-school teachers reported that the COVID-19 has increased work overload and parenting stress. Moreover, work overload was negatively associated with job satisfaction via its positive association with work-to-family conflict. Parenting stress was negatively associated with job satisfaction via both family-to-work conflict and work-to-family conflict. The study contributes to a better understanding of the association among female pre-school teachers' work overload, parenting stress, work-family conflict, and job satisfaction. Our findings highlighted potential avenues for interventions aimed at balancing female pre-school teachers' work and family and improving their job satisfaction during the COVID-19.

Preschool Teachers' Technology Acceptance During the COVID-19: An Adapted Technology Acceptance Model.

Online education has become a major reaction to the COVID-19 epidemic, which requires preschool teachers to quickly adapt to online education and accept educational technology. In this emergency background, research on the preschool teachers' technology acceptance provides clues to improve preschool teachers' intention to use educational technology. The Technology Acceptance Model (TAM) is widely used to examine the process of individuals' technology acceptance in the previous literature. Therefore, this study seeks to examine preschool teachers' technology acceptance with the adapted TAM and their determinant factors. The proposed model was empirically validated by using survey data from 1,568 preschool teachers during the COVID-19. Results indicate that preschool teachers' behavioral intention was moderate to high level. Perceived usefulness and perceived ease of use are direct significant predictors of preschool teachers' behavioral intention. Perceived usefulness is affected by perceived ease of use and job relevance. Computer self-efficacy and perceptions of external control are the positive factors toward perceived ease of use. Our findings present powerful evidence for the applicability of the adapted TAM in a sample of Chinese preschool teachers under emergency circumstances. These results highlighted some potential avenues for interventions aimed at improving preschool teachers' acceptance toward educational technology.

Protecting healthcare workers from COVID-19: learning from variation in practice and policy identified through a global cross-sectional survey.

AIMS: The COVID-19 pandemic presents an unprecedented burden on global healthcare systems, and existing infrastructures must adapt and evolve to meet the challenge. With health systems reliant on the health of their workforce, the importance of protection against disease transmission in healthcare workers (HCWs) is clear. This study collated responses from several countries, provided by clinicians familiar with practice in each location, to identify areas of best practice and policy so as to build consensus of those measures that might reduce the risk of transmission of COVID-19 to HCWs at work. METHODS: A cross-sectional descriptive survey was designed with ten open and closed questions and sent to a representative sample. The sample was selected on a convenience basis of 27 senior surgeons, members of an international surgical society, who were all frontline workers in the COVID-19 pandemic. This study was reported according to the Standards for Reporting Qualitative Research (SRQR) checklist. RESULTS: Responses were received by all 27 surgeons from 22 countries across six continents. A number of the study respondents reported COVID-19-related infection and mortality in HCWs in their countries. Differing areas of practice and policy were identified and organized into themes including the specification of units receiving COVID-19 patients, availability and usage of personal protective equipment (PPE), other measures to reduce staff exposure, and communicating with and supporting HCWs. Areas more specific to surgery also identified some variation in practice and policy in relation to visitors to the hospital, the outpatient department, and in the operating room for both non-urgent and emergency care. CONCLUSION: COVID-19 presents a disproportionate risk to HCWs, potentially resulting in a diminished health system capacity, and consequently an impairment to population health. Implementation of these recommendations at an international level could provide a framework to reduce this burden.

Masks or N95 Respirators During COVID-19 Pandemic-Which One Should I Wear?

PURPOSE: Coronavirus Disease 2019 (COVID-19) has caused suffering and death around the world. Careful selection of facial protection is paramount for preventing virus spread among healthcare workers and preserving mask and N95 respirator supplies. METHODS: This paper is a comprehensive review of literature written in English and available on Pubmed comparing the risk of viral respiratory infections when wearing masks and N95 respirators. Current international oral and maxillofacial surgery guidelines for mask and N95 respirator use, patient COVID-19 disease status, aerosol producing procedures were also collected and incorporated into a workflow for selecting appropriate facial protection for oral and maxillofacial surgery procedures during the current pandemic. RESULTS: Most studies suggest N95 respirators and masks are equally protective against respiratory viruses. Some evidence favors N95 respirators, which are preferred for high-risk procedures when aerosol production is likely or when the COVID-19 status of a patient is positive or unknown. N95 respirators may also be used for multiple patients or reused depending on the type of procedure and condition of the respirator after each patient encounter. CONCLUSION: N95 respirators are preferred over masks against viral respiratory pathogens, especially during aerosol-generating procedures or when a patient's COVID-19 status is positive or unknown.