Anxiety and depression among epilepsy patients in low-risk areas for COVID-19 in the northern part of Guizhou Province, China, during the COVID-19 pandemic

BackgroundThis study was aimed to investigate whether patients with epilepsy (PWE) have higher depression and anxiety levels than the normal population in low-risk areas for coronavirus disease 2019 (COVID-19) in the northern part of Guizhou Province, China, during the COVID-19 epidemic, to evaluate their knowledge on COVID-19, and to analyze related factors for the psychological distress of PWE at this special time.MethodsThe survey was conducted online from February 28, 2020 to March 7, 2020 via a questionnaire. PWE from the outpatient clinic of epilepsy of the Affiliated Hospital of Zunyi Medical University, and healthy people matched for age and sex, participated in this study. Mental health was assessed via a generalized anxiety self-rating scale (GAD-7) and the self-rating depression scale (PHQ-9). The knowledge of COVID-19 in both groups was investigated.ResultsThere were no significant differences in the general demographics between the PWE and healthy control groups. The scores of PHQ-9 (P < 0.01) and GAD-7 (P < 0.001) were higher in the PWE group than in the healthy group. There was a significant difference in the proportions of respondents with different severities of depression and anxiety, between the two groups, which revealed significantly higher degree of depression and anxiety in PWE than in healthy people (P = 0, P = 0). Overwhelming awareness and stressful concerns for the pandemic and female patients with epilepsy were key factors that affect the level of anxiety and depression in PWE. Further, the PWE had less accurate knowledge of COVID-19 than healthy people (P < 0.001). There was no statistically significant difference between the two groups in the knowledge of virus transmission route, incubation period, susceptible population, transmission speed, clinical characteristics, and isolation measures on COVID-19 (P > 0.05). PWE knew less about some of the prevention and control measures of COVID-19 than healthy people.ConclusionsDuring the COVID-19 epidemic, excessive attention to the epidemic and the female sex are factors associated with anxiety and depression in PWE, even in low-risk areas.

Clinical study of qingke pingchuan granules in treatment of light and common type of novel Coronavirus infection

Objective To observe the clinical efficacy and safety of Qingke Pingchuan Granules in treatment of light and common type of novel coronavirus infection(phlegm heat stagnating lung syndrome). Methods Sixty patients with novel coronavirus infection(phlegm heat stagnating lung syndrome) hospitalized in the Novel Coronavirus Unit of Shanghai Public Health Clinical Center from March 2022to June 2022 were selected and divided into control group and treatment group according to different therapeutic drugs, with 30 cases in each group. Patients in the control group were given conventional treatment. Patients in the treatment group were po administered with Qingke Pingchuan Granules on the basis of conventional treatment, 10 g/time, 3 times daily. The efficacy of TCM syndromes, inflammatory indexes and adverse reactions were observed before and after treatment. Results After treatment, the total effective rate in the treatment group(86.7%) was significantly higher than that in the control group(66.7%)(P < 0.05). After treatment, daytime and nighttime cough scores in 2 groups were lower than before treatment(P < 0.05), and daytime and nighttime cough scores in the treatment group were lower than those in the control group(P < 0.05). There was no significant difference in the levels of peripheral blood leukocytes and procalcitonin between the two groups before and after treatment. After treatment, the level of C-reactive protein(CRP) in the two groups was significantly lower than that before treatment(P < 0.05), and the CRP level in the treatment group was lower than that in the control group(P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion Qingke Pingchuan Granules has good clinical efficacy in treatment of light and common type of novel coronavirus infection(phlegm heat stagnating lung syndrome), and can relieve the clinical symptoms of patients, which has good safety.

Prevalence and influencing factors of anxiety and depression symptoms among the first-line medical staff in Wuhan mobile cabin hospital during the COVID-19 epidemic: A cross-sectional survey.

ABSTRACT: To investigate the prevalence of anxiety and depressive symptoms and the associated risk factors among first-line medical staff in Wuhan during the coronavirus disease 2019 (COVID-19) epidemic.From March 5 to 15, 2020, the Hamilton Anxiety Scale and Hamilton Depression scale were used to investigate the anxiety and depression status of medical staff in Wuhan Cabin Hospital (a Hospital). Two hundred seventy-six questionnaires were received from 96 doctors and 180 nurses, including 79 males and 197 females.During the COVID-19 epidemic, the prevalence rate of anxiety and depression was 27.9% and 18.1%, respectively, among 276 front-line medical staff in Wuhan. The prevalence rate of anxiety and depression among doctors was 19.8% and 11.5%, respectively, and the prevalence rate of anxiety and depression among nurses was 32.2% and 21.7%, respectively. Females recorded higher total scores for anxiety and depression than males, and nurses recorded higher scores for anxiety and depression than doctors.During the COVID-19 epidemic, some first-line medical staff experienced mental health problems such as depression and anxiety. Nurses were more prone to anxiety and depression than doctors. Effective strategies toward to improving the mental health should be provided to first-line medical staff, especially female medical staff and nurses.

Anxiety and depression among medical staff facing SARS-CoV-2 vaccination in China.

BACKGROUND: SARS-COV-2 vaccination is being carried out worldwide. However, little is known about the effect of SARS-COV-2 vaccination on psychological problems faced by the medical staff. This study aimed to examine the prevalence and factors contributing to anxiety and depression among medical staff facing SARS-COV-2 vaccination. METHODS: The GAD-7 and the PHQ-9 scales were used to investigate the anxiety and depression among participants involved in SARS-CoV-2 vaccination. Multivariate logistics regression analysis method was used to assess the risk factors related to anxiety or depression. RESULTS: A total of 6984 people responded to all the surveyed questions in our study, including 2707 medical staff and 4277 nonmedical staff. Of the participants, 680 reported anxiety, while 1354 reported depression. Higher anxiety levels were observed among medical staff (13.1 % vs. 7.6 % among the non-medical staff). Participants suffered from depression with higher numbers among medical staff (24.7 % vs. 16.0 % among the non-medical staff). Multivariate logistic regression analysis showed that female medical staff was at higher risk of anxiety and depression compared to their male counterparts (OR = 1.497; OR = 1.417). Pregnancy intention increased the risk of anxiety and depression among medical staff (OR = 1.601; OR = 1.724). LIMITATIONS: Our findings may not be extrapolated to other countries. CONCLUSION: Medical staff facing SARS-CoV-2 vaccination were more likely to suffer from anxiety or depression, especially the females planning for pregnancy. These results should assist in updating intervention guidelines for the mental health of medical staff facing vaccination.

University freshmen's excessive smartphone use and psychological safety during the COVID-19 pandemic.

Although excessive smartphone use has been confirmed as being associated with specific representations of mental health (e. g., anxiety, depression, wellbeing, etc.) throughout the COVID-19 pandemic, the relationship between excessive smartphone use and cognitive representations of mental health (i.e., psychological safety) is not yet fully understood. This study aimed to identify the association between excessive smartphone use and psychological safety among university freshmen during the COVID-19 pandemic; in addition, we examined the mediation effects of hardiness and interpersonal distress in this relationship. In this study, 1,224 university freshmen were selected at random from several universities in Guizhou Province of China. The Psychological Safety Scale was used to evaluate the mental health of university freshmen; the Mobile Phone Dependence Scale was used to evaluate excessive smartphone use; the Hardiness Questionnaire was used to evaluate hardiness; and the Interpersonal Relation Synthetic Diagnose Test was used to evaluate interpersonal distress. The findings showed that: (1) the greater the degree of excessive smartphone use, the more serious respondents' interpersonal distress and the lower their hardiness; (2) excessive smartphone use was not only directly related to the psychological safety of university freshmen but also indirectly related to their psychological safety through the independent mediation of hardiness and interpersonal distress, as well as through the chain mediation of hardiness and interpersonal distress. In general, excessive smartphone use in university freshmen could lead to a decline in their psychological safety. Also, hardiness and interpersonal distress play a complex role in this relationship. During the COVID-19 pandemic, interventions on the mental health of college freshmen should not only provide guidance on how to use their smartphone responsibly but also to provide them with support and guidance for the enhancement of their hardiness and improvement of their interpersonal relationships.

Associations of Problematic Internet Use, Weight-Related Self-Stigma, and Nomophobia with Physical Activity: Findings from Mainland China, Taiwan, and Malaysia.

Insufficient physical activity is a common problem for university students because they may engage in sedentary lifestyle owing to excessive time spent on their smartphones and social media use. This may result in problematic internet use (PIU) and nomophobia (fear of not having a mobile phone). Moreover, prior evidence shows that weight-related self-stigma is an important factor contributing to low physical activity. Therefore, the present study examined the associations between PIU, nomophobia, and physical activity among university students across mainland China, Taiwan, and Malaysia. Participants (3135 mainland Chinese, 600 Taiwanese, and 622 Malaysian) completed the Bergen Social Media Addiction Scale (BSMAS), Smartphone Application-Based Addiction Scale (SABAS), Nomophobia Questionnaire (NMPQ), Weight Self-Stigma Questionnaire (WSSQ), and International Physical Activity Questionnaire Short Form (IPAQ-SF). The measurement invariance of the assessed questionnaires was supported across the three regions. The present findings analyzed using partial least squares structural equation modeling showed that (i) greater nomophobia was associated with higher levels of physical activity, (ii) greater weight-related self-stigma was associated with higher levels of physical activity, and (iii) greater nomophobia was associated with greater weight-related self-stigma. Although the present findings suggest the possibility that experiencing some level of nomophobia or weight-related self-stigma appears to help improve physical activity, it is not recommended that these be encouraged, but reducing PIU should be targeted as a means to improve physical activity.

Relationship Between Negative Emotions and Job Burnout in Medical Staff During the Prevention and Control of the COVID-19 Epidemic: The Mediating Role of Psychological Resilience.

We herein investigated the relationship between psychological status and the various emotions of medical staff during the prevention and control of coronavirus disease 2019 (COVID-19) epidemic. In this study, the convenience sampling method was used to select medical staff members as participants, and a cross-sectional study design was implemented. The instruments included the Burnout Clinical Subtype Questionnaire (BCSQ-36), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the self-rated 16-item Quick Inventory of Depressive Symptomatology (QIDS-SR16), and the Self-rating Anxiety Scale (SAS). In total, 876 medical staff members were selected in this study. The CD-RISC-10 was negatively correlated with all other scales (P < 0.01). The hierarchical regression coefficients of the SAS and QIDS-SR16 against the BCSQ-36 mediated by the CD-RISC-10 were P < 0.01, and the significance of the F values in all hierarchical regression equations was P < 0.01 (Sobel test, P < 0.01). Medical staff burnout during the COVID-19 epidemic was affected by anxiety and depression, and psychological resilience had a mediating role. Attending to changes in the negative emotions of medical staff and improving their psychological resilience are beneficial to alleviate job burnout.

Anxiety and depression among epilepsy patients in low-risk areas for COVID-19 in the northern part of Guizhou Province, China, during the COVID-19 pandemic

Background This study was aimed to investigate whether patients with epilepsy (PWE) have higher depression and anxiety levels than the normal population in low-risk areas for coronavirus disease 2019 (COVID-19) in the northern part of Guizhou Province, China, during the COVID-19 epidemic, to evaluate their knowledge on COVID-19, and to analyze related factors for the psychological distress of PWE at this special time. Methods The survey was conducted online from February 28, 2020 to March 7, 2020 via a questionnaire. PWE from the outpatient clinic of epilepsy of the Affiliated Hospital of Zunyi Medical University, and healthy people matched for age and sex, participated in this study. Mental health was assessed via a generalized anxiety self-rating scale (GAD-7) and the self-rating depression scale (PHQ-9). The knowledge of COVID-19 in both groups was investigated. Results There were no significant differences in the general demographics between the PWE and healthy control groups. The scores of PHQ-9 (P < 0.01) and GAD-7 (P < 0.001) were higher in the PWE group than in the healthy group. There was a significant difference in the proportions of respondents with different severities of depression and anxiety, between the two groups, which revealed significantly higher degree of depression and anxiety in PWE than in healthy people (P = 0, P = 0). Overwhelming awareness and stressful concerns for the pandemic and female patients with epilepsy were key factors that affect the level of anxiety and depression in PWE. Further, the PWE had less accurate knowledge of COVID-19 than healthy people (P < 0.001). There was no statistically significant difference between the two groups in the knowledge of virus transmission route, incubation period, susceptible population, transmission speed, clinical characteristics, and isolation measures on COVID-19 (P > 0.05). PWE knew less about some of the prevention and control measures of COVID-19 than healthy people. Conclusions During the COVID-19 epidemic, excessive attention to the epidemic and the female sex are factors associated with anxiety and depression in PWE, even in low-risk areas.

Gender Differences in the Associations Between Physical Activity, Smartphone Use, and Weight Stigma

Background Physical activity (PA) is important for health. However, there is little evidence on how weight stigma, time spent on sedentary activities (including smartphone, social media, online learning), time spent on outdoor activity, and nomophobia associate with PA among Chinese individuals with consideration of gender. The present study examined the aforementioned associations in the COVID-19 pandemic era. Methods University students (N = 3,135;1,798 females, 1,337 males) with a mean age of 19.65 years (SD = 2.38) years completed an online survey from November to December, 2021. The online survey assessed weight stigma (using the Perceived Weight Stigma Scale and Weight Bias Internalization Scale), PA (using the International Physical Activity Questionnaire Short Form), time spent on different activities (using self-designed items for time on smartphone, outdoor activity, social media, and online learning), and nomophobia (using the Nomophobia Questionnaire). Parallel mediation models were constructed (dependent variable: PA;mediators: perceived weight stigma, weight-related self-stigma, time spent on smartphone, time spent on outdoor activity, time spent on social media, and time spent online learning;independent variable: nomophobia) and evaluated using Hayes' Process Macro Model 4 (IBM SPSS 20.0). Results Weight-related self-stigma (β = −0.06;p = 0.03), time spent on outdoor activity (β = 0.21;p < 0.001), time spent on social media (β = 0.07;p = 0.02), time spent on online learning (β = 0.06;p = 0.03), and nomophobia (β = −0.07;p = 0.01) were all significant factors explaining the PA among female participants. Perceived weight stigma (β = −0.07;p = 0.01), time spent on outdoor activity (β = 0.27;p < 0.001), and time spent on online learning (β = 0.10;p = 0.002) were all significant factors explaining PA among male participants. Conclusion Chinese healthcare providers should design programs on weight stigma reduction and outdoor activity improvement to enhance PA among university students.

Critical Care Database Comprising Patients With Infection.

Patients treated in the intensive care unit (ICU) are closely monitored and receive intensive treatment. Such aggressive monitoring and treatment will generate high-granularity data from both electronic healthcare records and nursing charts. These data not only provide infrastructure for daily clinical practice but also can help to inform clinical studies. It is technically challenging to integrate and cleanse medical data from a variety of sources. Although there are several open-access critical care databases from western countries, there is a lack of this kind of database for Chinese adult patients. We established a critical care database involving patients with infection. A large proportion of these patients have sepsis and/or septic shock. High-granularity data comprising laboratory findings, baseline characteristics, medications, international statistical classification of diseases (ICD) code, nursing charts, and follow-up results were integrated to generate a comprehensive database. The database can be utilized for a variety of clinical studies. The dataset is fully accessible at PhysioNet(https://physionet.org/content/icu-infection-zigong-fourth/1.0/).

Linking genomic and epidemiologic information to advance the study of COVID-19.

The outbreak of Coronavirus Disease 2019 (COVID-19) at the end of 2019 turned into a global pandemic. To help analyze the spread and evolution of the virus, we collated and analyzed data related to the viral genome, sequence variations, and locations in temporal and spatial distribution from GISAID. Information from the Wikipedia web page and published research papers were categorized and mined to extract epidemiological data, which was then integrated with the public dataset. Genomic and epidemiological data were matched with public information, and the data quality was verified by manual curation. Finally, an online database centered on virus genomic information and epidemiological data can be freely accessible at https://www.biosino.org/kgcov/ , which is helpful to identify relevant knowledge and devising epidemic prevention and control policies in collaboration with disease control personnel.

Establishing and evaluating physician-pharmacist collaborative clinics to manage patients with type 2 diabetes in primary hospitals in Hunan province: study protocol of a multi-site randomized controlled trial in the era of COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has exerted an unprecedented and universal impact on global health system, resulting in noticeable challenges in traditional chronic disease care, of which diabetes was reported to be most influenced by the reduction in healthcare resources in the pandemic. China has the world's largest diabetes population, and current diabetes management in China is unsatisfactory, particularly in rural areas. Studies in developed countries have demonstrated that physician-pharmacist collaborative clinics are efficient and cost-effective for diabetes management, but little is known if this mode could be adapted in primary hospitals in China. The aim of this proposed study is to develop and evaluate physician-pharmacist collaborative clinics to manage type 2 diabetes mellitus (T2DM) in primary hospitals in Hunan province. METHODS: A multi-site randomized controlled trial will be conducted to evaluate the effectiveness and cost-effectiveness of the physician-pharmacist collaborative clinics compared with usual care for Chinese patients with T2DM. Six primary hospitals will participate in the study, which will recruit 600 eligible patients. Patients in the intervention group will receive services from both physicians and pharmacists in the collaborative clinics, while the control group will receive usual care from physicians. Patients will be followed up at the 3rd, 6th, 9th and 12th month. Comparison between the two groups will be conducted by assessing the clinical parameters, process indicators and costs on diabetes. A satisfaction survey will also be carried out at the end of the study. DISCUSSION: If effective, the physician-pharmacist collaborative clinics can be adapted and used in primary hospitals of China to improve glycemic control, enhance medication adherence, decrease incidence of complications and reduce patients' dependence on physicians. Findings from the present study are meaningful for developing evidence-based diabetes care policy in rural China, especially in the COVID-19 pandemic era. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000031839 , Registered 12 April 2020.

STUDY ON INFLUENCING FACTORS OF CHILDREN'S CONTINUOUS USE INTENTION OF EDUCATIONAL APP UNDER THE BACKGROUND OF POST EPIDEMIC ERA

With the outbreak of COVID-19 global outbreak, the traditional form of education has to be rapidly transformed into the form of online learning. The variation of strains leads to a recurrent outbreak of the epidemic. Education in the long run of the epidemic will surely become the focus of attention of the whole society. Due to the rapid change of learning forms, a large number of educational online products come out in an instant. Due to the great demand for mobile internet education services, there will be great competition among industries. The core of product development is users. Therefore, it is necessary to study the generation of users' willingness to continue to use. This study mainly focuses on the characteristics of many children's online education apps to enable parents to have a clear choice direction and firm choice will. On this point, combined with relevant literature, this paper combines the technology acceptance model with the information system technology acceptance model, and introduces two external potential variables: content quality and perceived autonomy. The purpose is to explore the influencing factors of parents on children's continuous use of online education app, build a comprehensive theoretical model in line with this study, set assumptions, and then use SPSS 23.0 and Amos24 tool tests the model and hypothesis. Explore what factors will affect the willingness of preschool and early school-age parents to let their children continue to use online education apps. The results show that continuous learning intention is directly or indirectly affected by perceived autonomy, content quality, expectation confirmation, perceived usefulness, perceived ease of use and satisfaction. Finally, the paper puts forward some suggestions for the design and management of children's online education app platform for reference.

Proteomic and metabolomic profiling of urine uncovers immune responses in patients with COVID-19.

The utility of the urinary proteome in infectious diseases remains unclear. Here, we analyzed the proteome and metabolome of urine and serum samples from patients with COVID-19 and healthy controls. Our data show that urinary proteins effectively classify COVID-19 by severity. We detect 197 cytokines and their receptors in urine, but only 124 in serum using TMT-based proteomics. The decrease in urinary ESCRT complex proteins correlates with active SARS-CoV-2 replication. The downregulation of urinary CXCL14 in severe COVID-19 cases positively correlates with blood lymphocyte counts. Integrative multiomics analysis suggests that innate immune activation and inflammation triggered renal injuries in patients with COVID-19. COVID-19-associated modulation of the urinary proteome offers unique insights into the pathogenesis of this disease. This study demonstrates the added value of including the urinary proteome in a suite of multiomics analytes in evaluating the immune pathobiology and clinical course of COVID-19 and, potentially, other infectious diseases.

Understanding the Antecedents of Knowledge Sharing Behavior From the Theory of Planned Behavior Model: Cross-Cultural Comparisons Between Mainland China and Malaysia.

Affected by coronavirus disease (COVID-19), in addition to keeping away the impact of the pandemic on their business practices, many enterprises have proposed relevant measures to protect their employees' job safety and security. Especially for enterprises with high dependence on knowledge resources, employees' innovation and knowledge sharing play a vital role. In the context of global economic austerity, how to put forward the corresponding plan of knowledge sharing intention to improve the knowledge sharing behavior of employees for enterprises is worth discussing. Mainland China and Malaysia have different quarantine policies and similar industrial structures. This study examines the awareness of Mainland China vs. Malaysian employees, and evaluates the relationship among self-efficacy, job security, market orientation, knowledge sharing intention, and knowledge sharing behavior from the theory of planned behavior. In this study, a total of 627 Mainland China and 434 Malaysian participants were collected to compare both groups in the development of employees' knowledge sharing behavior. In this study, a variance-based partial least squares structural equation modeling (PLS-SEM) was performed to test the proposed hypothesis and conduct comparative analysis. The results in both the samples show that self-efficacy, job security, and market orientation have positive and significant effects on knowledge sharing intention; self-efficacy has positive and significant effects on job security; knowledge sharing intention has positive and significant effects on knowledge sharing behavior. Moreover, there are several significant differences between Mainland China and Malaysia in the examinations of path comparisons.

Household Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Suzhou, China.

OBJECTIVES: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging virus causing substantial morbidity and mortality worldwide. We performed a cross-sectional investigation of SARS-CoV-2 clusters in Suzhou to determine the transmissibility of the virus among close contacts and to assess the demographic and clinical characteristics between index and secondary cases. METHODS: We review the clustered patients with SARS-CoV-2 infections in Suzhou between 22 January and 29 February 2020. The demographic and clinical characteristics were compared between index and secondary cases. We calculated the basic reproduction number (R 0) among close contacts with SLI model. RESULTS: By 22 February, 87 patients with SARS-CoV-2 infection were reported, including 50 sporadic and 37 clustered cases, who were generated from 13 clusters. On admission, 5 (20.8%) out of 24 secondary cases were asymptomatic. The male ratio of index cases was significantly higher than that of secondary cases. Additionally, the index cases were more likely to have fever and increased CRP levels than the secondary cases. The R 0 values of clusters displayed a significantly declining trend over time for all clusters. The relative risk of infection in blood-related contacts of cases versus unrelated contacts was 1.60 for SARS-CoV-2 (95% CI: 0.42-2.95). CONCLUSIONS: In conclusion, SARS-CoV-2 has great person-to-person transmission capability among close contacts. The secondary cases are more prone to have mild symptoms than index cases. There is no increased RR of secondary infection in blood relatives versus unrelated contacts. The high rate of asymptomatic SARS-CoV-2 infections highlights the urgent need to enhance active case finding strategy for early detection of infectious patients.

Evaluation of the "safe multidisciplinary app-assisted remote patient-self-testing (SMART) model" for warfarin home management during the COVID-19 pandemic: study protocol of a multi-center randomized controlled trial.

BACKGROUND: Warfarin treatment requires frequent monitoring of INR (international normalized ratio) to adjust dosage in a therapeutic range. In China, patients living in small towns usually go to tertiary hospitals to get warfarin monitoring and dosing, resulting in low frequencies of follow-ups and high incidence of complications. Influenced by the COVID-19 pandemic, patients on warfarin have further reduced their visits to healthcare institutions. While patient self-testing (PST) via using a point-of-care testing device for INR measuring at home has been widely used in developed countries and demonstrated improved clinical outcomes compared to usual care in clinics, it is rarely applied in developing countries, including China. This proposed study will develop and assess the "Safe Multidisciplinary App-assisted Remote patient-self-Testing (SMART) model" for warfarin home management in China during the COVID-19 pandemic. METHODS: This is a multi-center randomized controlled trial. We will carry out the study in three county hospitals, three small tertiary hospitals and three large tertiary hospitals with anticoagulation clinics in Hunan province of China. Eligible patients will be randomly assigned to the SMART model group (n = 360) or the control group (usual care clinic group, n = 360; anticoagulation clinic group, n = 120). Patients in the SMART model group do PST at home once every two to 4 weeks. Controls receive usual care in the clinics. All the patients will be followed up through outpatient clinics, phone call or online interviews at the 3rd, 6th, 9th and 12th month. The percentage of time in therapeutic range (TTR), incidence of warfarin associated major bleeding and thromboembolic events and costs will be compared between the SMART model group and control groups. DISCUSSION: Patients in the SMART model group would show improved TTR, lower incidence of complications and better quality of life compared to the control groups. Our design, implementation and usage of the SMART model will provide experience and evidence in developing a novel model for chronic disease management to solve the problem of healthcare service maldistribution, an issue particularly obvious in developing countries during the COVID-19 pandemic. TRIAL REGISTRATION: ChiCTR, ChiCTR 2000038984 . Registered 11 October, 2020.

Recommendations for control and prevention of infections for pediatric orthopedics during the epidemic period of COVID-19

The outbreak of Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged and spread rapidly throughout the world. As of February 29, 2020, 79 389 cases of COVID-19 have been reported, and the outbreak is linked to 2838 deaths. The population is generally susceptible to the disease, and differences in incubation periods after infection exist among individuals. These two aspects of COVID-19 pose significant challenges to pediatric orthopedic diagnosis and treatment. As a dedicated center for managing pediatric cases of SARS-CoV-2 in Shanghai, our hospital has mobilized all branches and departments to undertake joint actions for scientific prevention and control, precise countermeasure and comprehensive anti-epidemic efforts. Combined with our experience, we have consulted the relevant national regulations and the latest research advances and have formulated the prevention and control measures of SARS-CoV-2 infection, including outpatient, emergency, inpatient and surgical cares, for clinical practices of pediatric orthopedics according to the physicochemical properties of SARS-CoV-2. It may serve as practical references and recommendations for managing SARS-CoV-2 infection in other pediatric specialties and in other hospitals.

Effective Learning Support Towards Sustainable Student Learning and Well-Being Influenced by Global Pandemic of COVID-19: A Comparison Between Mainland China and Taiwanese Students.

The novel coronavirus disease that emerged at the end of 2019 began threatening the health and lives of millions of people after a few weeks. However, social and educational problems derived from COVID-19 have changed the development of individuals and the whole country. This study examined the learning method of Taiwanese versus mainland China college students, and evaluated the relationship between learning support mechanism and subjective well-being from a social cognition theory perspective. In this study, a total of 646 Taiwanese questionnaires and 537 mainland China questionnaires were collected to compare the two sample groups in development of students' subjective well-being. The results showed that social capital and learning support had significant positive correlations with self-efficacy, student employability and well-being and self-efficacy and student employability had significant positive correlations with well-being in Taiwanese sample. In mainland China sample, except paths among social capital, learning support, student employability and well-being, all paths were significant and positive related. Finally, based on the conclusions this study proposed some suggestions specific to theoretical mode for future study.