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1.
Int J Public Health ; 67:1604979, 2022.
Article in English | PubMed | ID: covidwho-2023043

##### ABSTRACT

Objectives: The study aimed at analyzing the prevalence of five psychological outcomes (depression, anxiety, stress, post-traumatic stress disorder (PTSD), and suicidal ideation) among Chinese healthcare workers (HCWs), and measured the total possible negative psychological impact 1 year after the COVID-19 initial outbreak. Methods: A cross-sectional nationwide multi-center study was performed between November 2020 and March 2021 in China. A self-report questionnaire was applied, and three psychological scales were used. Binary logistic regression was performed to analyze the risk factors associated with each psychological outcome. Results: The findings demonstrated that the COVID-19 pandemic had a negative psychological impact on HCWs, which was still evident 1 year after the initial outbreak. Nurses showed higher depression and anxiety than other HCWs. Female gender, passive coping, long working hours, having a chronic disease, and experiencing violence, among other factors, were all risk factors for psychological impairment. Conclusion: Developing and promoting programs to improve mental health among HCWs, and identifying those who might need psychological support is still relevant 1 year after the initial outbreak.

2.
PLoS One ; 17(9):e0273694, 2022.
Article in English | PubMed | ID: covidwho-2021937

##### ABSTRACT

Accurate estimates of natural and/or vaccine-induced antibodies to SARS-CoV-2 are difficult to obtain. Although model-based estimates of seroprevalence have been proposed, they require inputting unknown parameters including viral reproduction number, longevity of immune response, and other dynamic factors. In contrast to a model-based approach, the current study presents a data-driven detailed statistical procedure for estimating total seroprevalence (defined as antibodies from natural infection or from full vaccination) in a region using prospectively collected serological data and state-level vaccination data. Specifically, we conducted a longitudinal statewide serological survey with 88,605 participants 5 years or older with 3 prospective blood draws beginning September 30, 2020. Along with state vaccination data, as of October 31, 2021, the estimated percentage of those 5 years or older with naturally occurring antibodies to SARS-CoV-2 in Texas is 35.0% (95% CI = (33.1%, 36.9%)). This is 3× higher than, state-confirmed COVID-19 cases (11.83%) for all ages. The percentage with naturally occurring or vaccine-induced antibodies (total seroprevalence) is 77.42%. This methodology is integral to pandemic preparedness as accurate estimates of seroprevalence can inform policy-making decisions relevant to SARS-CoV-2.

3.
7th International Conference on Distance Education and Learning, ICDEL 2022 ; : 197-203, 2022.
Article in English | Scopus | ID: covidwho-2020442

##### ABSTRACT

The COVID-19 pandemic requires EFL teachers to take charge of emergency remote teaching shortly. Understanding students' perception of the online teaching and learning could help instructors optimize the virtual EFL lecture planning. This study aimed to probe how learners would reflect towards the EFL online teaching and learning in terms of teachers' behavior, teaching content, learning process, and learning outcomes. An online questionnaire was framed and issued to 1108 year 1 and year 2 non-English majors in a university located in the southern part of China. Data were collected and coded via thematic analysis. Conclusions indicated that a) a sense of belonging to the online learning community played a key role for the students to perform positively;b) virtual EFL learning and teaching could be even more successful when the differences between face-to-face interaction and e-classroom interaction were taken into consideration;c) curiosity-arousing learning activities were conducive to learners' further autonomous online learning;d) motivational teaching design could enhance study when students enjoy the online learning achievements. © 2022 ACM.

4.
IEEE Access ; 10:85571-85581, 2022.
Article in English | Scopus | ID: covidwho-2018604

##### ABSTRACT

Chest X-ray is one of the most common radiological examinations for screening thoracic diseases. Despite the existing methods based on convolution neural network that have achieved remarkable progress in thoracic disease classification from chest X-ray images, the scale variation of the pathological abnormalities in different thoracic diseases is still challenging in chest X-ray image classification. Based on the above problems, this paper proposes a residual network model based on a pyramidal convolution module and shuffle attention module (PCSANet). Specifically, the pyramid convolution is used to extract more discriminative features of pathological abnormality compared with the standard $3\times 3$ convolution;the shuffle attention enables the PCSANet model to focus on more pathological abnormality features. The extensive experiment on the ChestX-ray14 and COVIDx datasets demonstrate that the PCSANet model achieves superior performance compared with the other state-of-the-art methods. The ablation study further proves that pyramidal convolution and shuffle attention can effectively improve thoracic disease classification performance. © 2022 IEEE.

5.
Physical Chemistry Chemical Physics ; 09:09, 2022.
Article in English | MEDLINE | ID: covidwho-2016863

##### ABSTRACT

The pneumonia outbreak caused by the SARS-CoV-2 virus poses a serious threat to human health and the world economy. The development of safe and highly effective antiviral drugs is of great significance for the treatment of COVID-19. The main protease (Mpro) of SARS-CoV-2 is a key enzyme for viral replication and transcription and has no homolog in humans. Therefore, the Mpro is an ideal target for the design of drugs against COVID-19. Insights into the inhibitor-Mpro binding mechanism and conformational changes of the Mpro are essential for the design of potent drugs that target the Mpro. In this study, we analyzed the conformational changes of the Mpro that are induced by the binding of three inhibitors, YTV, YSP and YU4, using multiple replica accelerated molecular dynamics (MR-aMD) simulations, dynamic cross-correlation map (DCCM) calculations, principal component analysis (PCA), and free energy landscape (FEL) analysis. The results from DCCM calculations and PCA show that the binding of inhibitors significantly affects the kinetic behavior of the Mpro and induces a conformational rearrangement of the Mpro. The binding ability and binding mechanism of YTV, YSP and YU4 to the Mpro were investigated using the molecular mechanics Poisson-Boltzmann surface area (MM-PBSA) method. The results indicate that substitution of the tert-butanol group by methylbenzene and trifluoromethyl groups enhances the binding ability of YSP and YU4 to the Mpro compared with YTV;moreover, massive hydrophobic interactions are detected between the inhibitors and the Mpro. Meanwhile, T25, L27, H41, M49, N142, G143, C145, M165, E166 and Q189 are identified as the key residues for inhibitor-Mpro interactions using residue-based free energy decomposition calculations, which can be employed as efficient targets in the design of drugs that inhibit the activity of the Mpro.

6.
Journal of Medical Virology ; 02:02, 2022.
Article in English | MEDLINE | ID: covidwho-2013639

##### ABSTRACT

We aim to evaluate the evolution differences in the incidence and case fatality rate (CFR) of SARS-CoV-2 Delta and Omicron variants. The average incidence and CFRs were described between different countries. Generalized linear mixed model (GLMM) was used to compare the CFRs of Delta and Omicron variants based on the vaccination coverage. Totally, 50 countries were included for analyses. The incidence of COVID-19 ranged from 0.16/100,000 to 82.95/100,000 during the Delta period and 0.03/100,000 to 440.88/100,000 during the Omicron period. The median CFRs were 8.56 (interquartile range [IQR] 4.76~18.39) during the Delta period and 3.04 (IQR 1.87~7.48) during the Omicron period, respectively. 47 out of 50 countries showed decreased CFRs of Omicron variant with the rate ratio ranging from 0.02 (95%CI 0.01~0.03) (in Cambodia) to 0.97 (95%CI 0.87~1.08) (in Ireland). Gamma GLMM analysis showed that the decreased CFR was largely a result of the decreased pathogenicity of Omicron besides the increased vaccination coverage. The Omicron variant shows a higher incidence but a lower CFR around the world as a whole, which is mainly a result of the decreased pathogenicity by SARS-CoV-2's mutation, while the vaccination against SARS-CoV-2 still acts as a valuable measure in preventing people from death. This article is protected by copyright. All rights reserved.

7.
Chemistry, An Asian Journal ; 27:27, 2022.
Article in English | MEDLINE | ID: covidwho-2013362

##### ABSTRACT

The main protease (M pro ), which is highly conserved and plays a critical role in the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a natural biomarker for SARS-CoV-2. Accurate assessment of the M pro activity is crucial for the detection of SARS-CoV-2. Herein, we report a nanopore-based sensing strategy that uses an enzyme-catalyzed cleavage reaction of a peptide substrate to measure the M pro activity. The peptide was specifically cleaved by the M pro , thereby releasing the output products that, when translocated through aerolysin, quantitatively produced the signature current events. The proposed method exhibited high sensitivity, allowing the detection of M pro concentrations as low as 1 nM without the use of any signal amplification techniques. This simple, convenient, and label-free nanopore assay may expand the diagnostic tools for viruses.

8.
Journal of Xi'an Jiaotong University (Medical Sciences) ; 43(5):797-801, 2022.
Article in Chinese | EMBASE | ID: covidwho-2010485

##### ABSTRACT

Objective: To compare the clinical features of Omicron and Delta cases, so as to provide scientific basis for the prevention and treatment of COVID-19. Methods: The case-control study method was used to retrospectively analyze the clinical data of the Omicron cases admitted to the designated hospital for the treatment of COVID-19 in Xi'an from December 2021 to January 2022. and the Delta cases admitted during the same period were used as the control group. The demographic data, epidemiological history, vaccination status, clinical characteristics, laboratory tests, nucleic acid and antibody levels, and outcomes of patients in the two groups were collected and compared. Results: A total of 21 patients were included in the study, 5 were Omicron patients and 16 were Delta cases. The mean age of the patients in the two groups were (38.20±15.07) and (37.69±10.39) years, respectively.The time interval between the last vaccination and the diagnosis was (145.40±77.92) days and (159.00±99.74) days, respectively. For the initial symptoms, the patients with Omicron were mainly characterized by throat discomfort (3, 60%), cough and sputum (2, 40%), and the patients with Delta were mainly characterized by throat discomfort (5, 31.25%), fatigue (5, 31.25%), cough and sputum (4, 25%). On admission, laboratory tests showed that 60% of Omicron patients had low lymphocytes and elevated erythrocyte sedimentation rate, and 50% of patients in the delta group had elevated hemoglobin. The Ct values of ORFlab gene, N gene and E gene with Omicron were lower than those with Delta. And the difference of E gene between the two groups was statistically significant (t=-2.711, P=0.024). IgG antibody levels increased in both groups.The time for nucleic acid to turn negative with Omicron was (28.20±5.89) days, and it was (18.50±7.73) days with Delta, and the difference between the groups was statistically significant (t=2.565, P=0.019). The length of hospitalization with Omicron was (30.60±4.88) days, and that with Delta was (22.13±7.81) days, and the difference was statistically significant (t=2.270, P =0.035). Conclusions: The initial symptoms of Omicron patients are mainly throat discomfort, cough and sputum. The clinical manifestations are generally mild. The nucleic acid test Ct value is lower. The time for nucleic acid to turn negative and the time for hospitalization are longer, and the potential infectiousness is stronger. Those eligible for vaccination should complete the full course of vaccination and booster vaccination as soon as possible. At the same time, the management of "early detection, early reporting, early isolation, and early treatment" should be implemented.

9.
Frontiers in Microbiology ; 13, 2022.
Article in English | EMBASE | ID: covidwho-2009887

##### ABSTRACT

The coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). According to the World Health Organization statistics, more than 500 million individuals have been infected and more than 6 million deaths have resulted worldwide. Although COVID-19 mainly affects the respiratory system, considerable evidence shows that the digestive, cardiovascular, nervous, and reproductive systems can all be involved. Angiotensin-converting enzyme 2 (AEC2), the target of SARS-CoV-2 invasion of the host is mainly distributed in the respiratory and gastrointestinal tract. Studies found that microbiota contributes to the onset and progression of many diseases, including COVID-19. Here, we firstly conclude the characterization of respiratory, gut, and oral microbial dysbiosis, including bacteria, fungi, and viruses. Then we explore the potential mechanisms of microbial involvement in COVID-19. Microbial dysbiosis could influence COVID-19 by complex interactions with SARS-CoV-2 and host immunity. Moreover, microbiota may have an impact on COVID-19 through their metabolites or modulation of ACE2 expression. Subsequently, we generalize the potential of microbiota as diagnostic markers for COVID-19 patients and its possible association with post-acute COVID-19 syndrome (PACS) and relapse after recovery. Finally, we proposed directed microbiota-targeted treatments from the perspective of gut microecology such as probiotics and prebiotics, fecal transplantation and antibiotics, and other interventions such as traditional Chinese medicine, COVID-19 vaccines, and ACE2-based treatments.

10.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2009582

##### ABSTRACT

Background: Patients with cancer, especially minority and low-income individuals, are at increased risk of financial toxicity and food insecurity. The COVID-19 pandemic has added dire economic challenges to vulnerable populations leading to a global increase in food insecurity. We sought to evaluate the severity and predictors of food insecurity among low-income patients with cancer. Methods: We conducted a cross-sectional multi-lingual survey (i.e., English, Spanish, and Chinese) on a convenience sample of patients with cancer who receive oncologic care at a safety-net hospital. Food insecurity and financial toxicity were measured using validated scales [i.e., US Department of Agriculture Household Food Security Survey and the Comprehensive Score for Financial Toxicity (COST)]. The primary outcome was food insecurity during COVID-19 and predictors of interest included sex, financial toxicity, insurance change, and degree of acculturation. Data was summarized using descriptive statistics and we explored associations between food insecurity and predictors of interest using bivariate regression. Results: A total of 140 patients participated in the study, of whom 56% were male and 47% were 50-64 years old. The most common cancer diagnoses were breast cancer (33%), followed by prostate (13%) and lung cancer (12%). The diverse study participants self-reported being 42% Hispanic/Latinx, 33% Asian, 18% Black or African American, and 14% White. Over half (52%) reported an annual household income ≤\$24,999 and 50% experienced a decrease in income during the COVID-19 pandemic. The median COST score was 24 (IQR: 19-31) with 41% experiencing financial toxicity (COST < 26). Most participants experienced food insecurity, including 42% with low food security and an additional 19% with very low food security. In bivariate analysis, increasing financial toxicity (i.e., lower COST score) was associated with a 21% increased risk of very low or low food security (95% CI: 1.11-1.32) and 13% increased risk of low food security (95% CI: 1.05-1.21). Male sex was associated with 312% increased risk of very low food insecurity when compared to female sex (95% CI: 1.02-9.55). Acculturation and changes in insurance coverage were not associated with increased risk of food insecurity. Conclusions: Food insecurity was highly prevalent in this multi-ethnic cohort of low-income patients with cancer. Interestingly, male sex was significantly associated with increased risk of very low food insecurity. Further analyses should explore this potentially at-risk population, their access to nutrition-related support, and the impact of food insecurity in cancer outcomes.

11.
Annals of the Rheumatic Diseases ; 81:1685, 2022.
Article in English | EMBASE | ID: covidwho-2009040

##### ABSTRACT

Background: Novel Coronavirus pneumonia 2019 (COVID-19) is a systemic infectious disease with prominent involvement of the respiratory tract, due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)[1]. Systemic lupus erythematosus is charcterized by an aberrant immune response with the presence of circulating autoantibodies, lymphopenia, and proinfammatory[2]. They are immune-compromised and vulnerable to infections with immune-suppressants treatment. However, data regarding the impact of COVID-19 pandemic in patients with SLE and drug use were relatively scarce. Objectives: The prevalence of COVID-19 in SLE patients was estimated by means of meta-analysis, and the effect of the use of anti-rheumatic drugs on the clinical outcome of SLE patients with COVID-19 was investigated. Methods: Cross-sectional investigations and case series on SLE and COVID-19 published by CBM, CNKI, China Science and Technology Journal Database, Wan Fang Data, PubMed, Embase, Web of Science, Cochrane Library and Medline from its establishment to November 10, 2021 were searched. Random effects model was used to pool data. Heterogeneity and risk of bias was examined with I-squared index (I2) statistic. Inconsistency was evaluated by using the I2. Egger tests were used for the evaluation of potential publication bias (STATA v.12.0). Results: A total of 14 studies comprising 5365 patients were identifed (Table 1). Overall prevalence of COVID-19 in SLE patients was 1.5% (95%CI: 1.2%-1.8%). Eight of the studies included patients who used hydroxychloroquine as part of their treatment regimen, with 29.8% (95%CI: 25.8%-33.8%) hospitalization rates and 14.6% (95%CI: 11.5%-17.8%) adverse outcome rates. Among patients treated with hydroxychloroquine throughout the course of disease, the prevalence was 0.7% (95%CI: 0.4%-1.0%, Figure 1). Conclusion: Patients with SLE had a higher risk of COVID-19. Hydroxychloro-quine might beneft to reduce the overall hospitalization rate and prevalence rate of COVID-19, and alleviate infammatory damage in the chronic stage of viral infection by inhibiting over activation of the immune system.

12.
Annals of the Rheumatic Diseases ; 81:1124-1125, 2022.
Article in English | EMBASE | ID: covidwho-2008954

##### ABSTRACT

Background: Nurse is a high-risk groups work fatigue feeling, which seriously affects the quality of conventional work efficiency and bureden pressures for contradiction between nurses and patients especially during the COVID-19 pandemic.Normalized epidemic prevention and control during the preview triage nurse need to all patients to the hospital and the accompanying personnel carries on the preliminary screening.COVID-19 fxed point hospital preview triage nurse with an infected person contact, more prone to anxiety,depression, results in the decrease of efficiency, to treat the service object formulation work sense of fatigue performance, etc. Objectives: To explore the influencing factors of work burnout of pre-test and triage nurses under normal epidemic prevention and control. Methods: A total of 110 pre-test and triage nurses from 4 Grade-A hospitals in Shanxi Province were enrolled in this study. The general data questionnaire, Nurse Job Burnout Scale, Pittsburgh Sleep Quality Index Scale, Self-Rating Anxiety Scale and Self-Rating Depression Scale were investigated towork burnout of pre-examination and triage nurses. Comparison between groups using two Independent sample t-test and single factor variance analysis. Multiple regression were applied to analysis factors affecting nurse fatigue feeling dimensions by SPSS22.0. P values<0.05 were considered signifcant. Results: As shown in Table 1, different professional title, department, and the sleep quality of preview triage nurses emotional exhaustion dimension com-parison(P<0.001), different department nurses to personalized level dimension comparison(P<0.05), nurse personal accomplishment dimension comparison of different cultural levels(P<0.05). Professional title, working department, sleep quality and educational level were the influencing factors of job burnout of pretest and triage nurses. Conclusion: In the COVID-19 epidemic, managers should pay more attention to the main factors that affect the sense of exhaustion of pre-test and triage nurses, and take targeted intervention measures to alleviate the sense of exhaustion of nurses, so as to ensure the safety of nursing.

13.
Signal Transduct Target Ther ; 7, 2022.
Article in English | PMC | ID: covidwho-2008259

##### ABSTRACT

The Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a global pandemic that seriously threatens health and socioeconomic development, but the existed antiviral drugs and vaccines still cannot yet halt the spread of the epidemic. Therefore, a comprehensive and profound understanding of the pathogenesis of SARS-CoV-2 is urgently needed to explore effective therapeutic targets. Here, we conducted a multiomics study of SARS-CoV-2-infected lung epithelial cells, including transcriptomic, proteomic, and ubiquitinomic. Multiomics analysis showed that SARS-CoV-2-infected lung epithelial cells activated strong innate immune response, including interferon and inflammatory responses. Ubiquitinomic further reveals the underlying mechanism of SARS-CoV-2 disrupting the host innate immune response. In addition, SARS-CoV-2 proteins were found to be ubiquitinated during infection despite the fact that SARS-CoV-2 itself didn’t code any E3 ligase, and that ubiquitination at three sites on the Spike protein could significantly enhance viral infection. Further screening of the E3 ubiquitin ligases and deubiquitinating enzymes (DUBs) library revealed four E3 ligases influencing SARS-CoV-2 infection, thus providing several new antiviral targets. This multiomics combined with high-throughput screening study reveals that SARS-CoV-2 not only modulates innate immunity, but also promotes viral infection, by hijacking ubiquitination-specific processes, highlighting potential antiviral and anti-inflammation targets.

14.
Appl Therm Eng ; 217:119256, 2022.
Article in English | PMC | ID: covidwho-2007439

##### ABSTRACT

A large outdoor air supply is required to control the airborne infection risk of respiratory diseases (e.g., COVID 19) but causes a high energy penalty. This study proposes a novel integrated system of the exhaust air heat pump and advanced air distribution to energy-efficiently provide outdoor air. The system energy performances are evaluated by the experimentally validated thermodynamic model of heat pump and heat removal efficiency model of advanced air distribution. Results show the exhaust air heat pump with advanced air distribution can save energy because of three mechanisms. First, the exhaust air heat pump reuses the exhaust air to reduce the condensation temperature, thereby improving the coefficient of performance. Second, advanced air distribution reduces ventilation load. Third, advanced air distribution reduces the condensation temperature and enhances the evaporation temperature, thereby improving the coefficient of performance. The exhaust air heat pump saves energy by 18%, advanced air distribution saves energy by 36%, and the integrated system of the exhaust air heat pump and advanced air distribution can save energy by 45%. As a specific application, compared with the conventional system (i.e., the outdoor air heat pump with mixing ventilation), the exhaust air heat pump with stratum ventilation saves energy by 21% − 35% under various outdoor air ratios and outdoor air temperatures. The proposed integrated system of the exhaust air heat pump and advanced air distribution contributes to the development of low-carbon and healthy buildings.

15.
Measurement Science and Technology ; 33(11), 2022.
Article in English | Web of Science | ID: covidwho-2004966

##### ABSTRACT

This paper proposes a novel time-frequency feature fusion method to recognise patients' behaviours based on the Frequency Modulated Continuous Wave (FMCW) radar system, which can locate patients as well as recognise their current actions and thus is expected to solve the shortage of medical staff caused by the novel coronavirus pneumonia (COVID-19). To recognise the patient's behaviour, the FMCW radar is utilised to acquire point clouds reflected by the human body, and the micro-Doppler spectrogram is generated by human motion. Then features are extracted and fused from the time-domain information of point clouds and the frequency-domain information of the micro-Doppler spectrogram respectively. According to the fused features, the patient's behaviour is recognised by a Bayesian optimisation random forest algorithm, where the role of Bayesian optimisation is to select the best hyper-parameters for the random forest, i.e. the number of random forest decision trees, the depth of leaves, and the number of features. The experimental results show that an average accuracy of 99.3% can be achieved by using the time-frequency fusion with the Bayesian optimisation random forest model to recognise six actions.

16.
Acs Photonics ; 2022.
Article in English | Web of Science | ID: covidwho-2004745

##### ABSTRACT

Recent advances in the Medical Internet of Things (MIoT) and big data enable a prospering platform for pervasive healthcare and facilitate the transformation from hospital-centered to human-centered healthcare. Wearable devices as human interfaces provide first-hand data and real-time monitoring, which are key technologies in the MIoT. Several remarkable surveys have been conducted to summarize the recent progress in wearable sensors and systems for the MIoT and pervasive medicine. However, few have focused on wearable optical sensing (WOS) technologies, which is an emerging sensing modality in wearable devices. WOS can achieve high precision, high compatibility, high anti-interference, and low motion artifacts for human vital signal acquisition, which are particularly useful in special scenarios such as intensive care units (ICUs). These technologies can also be integrated with smart fabrics or mobile computing for out-of-hospital healthcare. This work provides the first literature review of WOS for pervasive medicine. We aim to systematically summarize the emerging WOS technologies in the MIoT for disease diagnosis and health monitoring. Specifically, this review covers the technical bases and design principles of major WOS technologies and their application domains for monitoring and treatment. We also discuss the opportunities and challenges, especially in the COVID-19 outbreak.

17.
Frontiers in Psychiatry ; 13, 2022.
Article in English | Web of Science | ID: covidwho-1997482

##### ABSTRACT

18.
Journal of General Internal Medicine ; 37:S314, 2022.
Article in English | EMBASE | ID: covidwho-1995739

##### ABSTRACT

BACKGROUND: Professional identity formation (PIF) is a critical part of medical education. PIF among medical students has been shown to vary as measured by the Professional Identity Essay (PIE), an assessment based on Kegan's theory of adult development and Bebeau's developmental model of professional identity. The PIE consists of written responses to nine prompts designed to elicit what students understand to be expectations from themselves, the profession, and society, as well as potential challenges in meeting these expectations. We sought to identify what themes arise for incoming medical students considering how to develop a strong professional identity. METHODS: Students at NYU complete the PIE as part of an ongoing professionalism curriculum. We examined the PIEs of 93 students entering NYU Grossman SOM in 2019, all who consented to using educational data as part of a medical education registry. Two independent readers conducted a thematic analysis of these PIEs. RESULTS: Six overarching domains were identified: “Challenges/Conflicts,” “Current and Future Personal Skills and Resources,” “Professional Norms/ Values/Ideals,” “Sources of Information About Ideal Physician,” “Emotions Expressed,” and “Emotional Tone.” Mental health is commonly expressed as an anticipated challenge. Students aspire to build resilience, yet they enter medical school with little experience of failure: “In high school/college (and especially as a premed), failure was essentially not an option.” Students rarely identify their colleagues as a source of advice and support. While students recognize the importance of self-care, there is less certainty around incorporating it into a busy schedule: “It has often been an issue for me to forego my physical and emotional health in the pursuit of my goals and responsibilities.” In addition, this fear of failure is most often associated with the challenge of a global “loss of trust” in medicine. Students fear that making a mistake will lead to an overall loss of trust in physicians, causing further mental health challenges and consequences for their career such as derailment, termination, or criminal or civil litigation. CONCLUSIONS: Given that mental health issues have been exacerbated since 2019 by the COVID-19 pandemic, educators must be aware of and address the conflict between demanding medical school expectations and the individual expectation that students maintain their mental health through selfcare. Further, students often enter medical school with a strong reliance on their individual competency. Thus, the pandemic may also represent an opportunity for medical schools to emphasize the importance of teamwork, the need for system improvements, and leadership capacity among physicians. Medical educators should actively build peer support and community to cultivate resilient physicians.

19.
Psychological Medicine ; 2022.
Article in English | Scopus | ID: covidwho-1991457

##### ABSTRACT

Background: Persistent psychological distress associated with the COVID-19 pandemic has been well documented. This study aimed to identify pre-COVID brain functional connectome that predicts pandemic-related distress symptoms among young adults. Methods: Baseline neuroimaging studies and assessment of general distress using the Depression, Anxiety and Stress Scale were performed with 100 healthy individuals prior to wide recognition of the health risks associated with the emergence of COVID-19. They were recontacted for the Impact of Event Scale-Revised and the Posttraumatic Stress Disorder Checklist at the period of community-level outbreaks, and for follow-up distress evaluation again one year later. We employed the network-based statistic approach to identify connectome that predicted the increase of distress based on 136-region-parcellation with assigned network membership. Predictive performance of connectome features and causal relations were examined by cross-validation and mediation analyses. Results: The connectome features that predicted emergence of distress after COVID contained 70 neural connections. Most within-network connections were located in the default mode network (DMN), and affective network-DMN and dorsal attention network-DMN links largely constituted between-network pairs. The hippocampus emerged as the most critical hub region. Predictive models of the connectome remained robust in cross-validation. Mediation analyses demonstrated that COVID-related posttraumatic stress partially explained the correlation of connectome to the development of general distress. Conclusions: Brain functional connectome may fingerprint individuals with vulnerability to psychological distress associated with the COVID pandemic. Individuals with brain neuromarkers may benefit from corresponding interventions to reduce the risk or severity of distress related to fear of COVID-related challenges. © 2022 Cambridge University Press. All rights reserved.

20.
Journal of Hepatology ; 77:S215-S215, 2022.
Article in English | Web of Science | ID: covidwho-1981130