Decisional procrastination and problematic mobile phone use: the mediation of anxiety and the moderation of 2019-nCoV traumatic experience (preprint)

Background Decisional procrastination (DP) has an important effect on problematic mobile phone use (PMPU); however, the potential mechanisism and boundary conditions between DP and PMPU remianed to be further explored. This essay studied the mediation of anxiety between DP and PMPU and whether 2019-nCoV traumatic experience moderated the mediation process.Methods A questionnaire was used in this study. A valid sample of 798 college students reported levels of decisional procrastination, problematic mobile phone use, anxiety, and 2019-nCoV traumatic experience.Results The results indicated that decisional procrastination is positively associated with problematic mobile phone use among college students. Anxiety served as a partial mediator in the association between decisional procrastination and problematic mobile phone use. 2019-nCoV traumatic experience would positively moderated the mediating effects of anxiety between DP and PMPU. A higher degree of 2019-nCoV traumatic experience would strengthen the mediation effects of DP to PMPU through anxiety.Conclusions This study deepens our understanding of how DP affects college students' PMPU. It was found in the study that 2019-nCoV traumatic experience positively moderated the mediation effects of anxiety between DP and PMPU. These findings provide universities with a theoretical foundation for preventing PMPU among college students.

Parallel use of human stem cell lung and heart models provide insights for SARS-CoV-2 treatment.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily infects the respiratory tract, but pulmonary and cardiac complications occur in severe coronavirus disease 2019 (COVID-19). To elucidate molecular mechanisms in the lung and heart, we conducted paired experiments in human stem cell-derived lung alveolar type II (AT2) epithelial cell and cardiac cultures infected with SARS-CoV-2. With CRISPR-Cas9-mediated knockout of ACE2, we demonstrated that angiotensin-converting enzyme 2 (ACE2) was essential for SARS-CoV-2 infection of both cell types but that further processing in lung cells required TMPRSS2, while cardiac cells required the endosomal pathway. Host responses were significantly different; transcriptome profiling and phosphoproteomics responses depended strongly on the cell type. We identified several antiviral compounds with distinct antiviral and toxicity profiles in lung AT2 and cardiac cells, highlighting the importance of using several relevant cell types for evaluation of antiviral drugs. Our data provide new insights into rational drug combinations for effective treatment of a virus that affects multiple organ systems.

Occupational low back pain prevention capacity of nurses in China: A multicenter cross-sectional study.

Introduction: Nurses have a high prevalence of occupational low back pain, especially since the outbreak of the COVID-19 pandemic, which has increased the nurses' workloads. It has brought a huge burden on nurses and their professional development. Nurses' occupational low back pain prevention capacity is the logical starting point and core of interventions to prevent its occurrence. To date, there is no study investigating it with a scientific scale. Therefore, a multicenter cross-sectional study was conducted to explore the current status of nurses' capacity in occupational low back pain prevention and its influencing factors in China. Methods: Using a two-stage, purposive and convenience mixed sampling method, 1331 nurses from 8 hospitals across 5 provinces (Hubei, Zhejiang, Shandong, Henan, and Sichuan) in the southern, western, northern, and central areas of mainland China were involved in this study. The demographic questionnaire and occupational low back pain prevention behavior questionnaire were used for data collection. The descriptive analysis, univariate analysis, and multiple stepwise linear regression were used for data analysis. Results: The results showed that the occupational low back pain prevention behavior questionnaire score was 89.00 (80.00, 103.00) [M (Q1, Q3)], which indicated that nurses' ability was at a moderate level. Participation in prevention training before, perceived stress at work, and working hours per week were predictors for nurses' occupational low back pain prevention capacity. Discussion: To improve nurses' prevention ability, nursing managers should organize various training programs, strengthen regulations to reduce nurses' workload and stress, provide a healthy workplace, and offer incentives to motivate nurses.

Research on the relationship between architectural features in northeast China and vertical aerosol transmission of COVID-19.

During the COVID-19 pandemic, many buildings in northeast China have had clusters of infected cases in the vertical layout. There is speculation that vertical aerosol transmission occurs. The houses in northeast China are airtight, and range hoods may be used for a long period of time when cooking. The pathway and factors influencing vertical aerosol transmission are worth studying. To elucidate a viral aerosol transmission pathway, we selected a multistory apartment and a high-rise building in Changchun city, Jilin province, China, to conduct an in-depth investigation and on-site simulation experiments. According to epidemiological investigation information on infected cases, building structures, drainage, ventilation, etc., we used fluorescent microspheres to simulate the behaviors of infected people, such as breathing and flushing the toilet after defecation, to discharge simulated viruses and track and monitor them. The field simulation experiment confirmed the transmission of fluorescent microsphere aerosols to other rooms in two types of buildings using a vertical aerosol transmission pathway of toilet flush-sewage pipe-floor drain without a water seal. Our study showed that, in the absence of a U-shaped trap or floor drain water seal whether in a multistory apartment or high-rise residential building, there is a transmission pathway of "excretion of virus through feces-toilet flushing-sewage pipe-floor drain without water seal," which will cause the vertical transmission of viral aerosol across floors during the COVID-19 pandemic. Moreover, the negative pressure generated by turning on the range hood when closing doors and windows increase aerosol transmission. Based on this negative pressure, prevention and control measures for residential buildings in northeast China during the COVID-19 pandemic were proposed.

Impact of online learning on sense of belonging among first year clinical health students during COVID-19: student and academic perspectives.

BACKGROUND: The need to belong is a fundamental human desire that provides the basis for relationships and community; it provides a sense of security that enables growth and development. This sense of belonging is pivotal to new University students, indeed, without it, students are at greater risk of failing or withdrawing from their studies. Yet developing a sense of belonging within a new cohort is complex and multi-faceted and further complicated by a sudden shift away from in-person to online learning. Using the situated-learning framework, our study explores first year clinical health students' sense of belonging in the context of the rapid transition to online learning because of the COVID-19 pandemic. METHODS: We utilised a current mixed-method approach including a survey incorporating previously validated tools, demographic and open-ended qualitative questions. Data was also gathered from three focus groups: two dedicated student groups and one academic focus group. Qualitative data was subjected to thematic analysis whilst descriptive statistics were used to describe the quantitative data. RESULTS: 179 first year students complete the survey and four students, and five academics were involved in the focus groups. All participants were from clinical health science courses at an Australian university. Our qualitative results indicated a global theme of: Navigating belonging during the COVID-19 crisis: a shared responsibility; with four organising themes describing (1) dimensions of belonging, (2) individual experiences and challenges, (3) reconceptualising teaching and learning, and (4) relationships are central to belonging. CONCLUSION: While the rapid transition to online learning did not greatly impact knowledge acquisition of first-year students in this cohort, the lack of sense of belonging highlights the need for further research into development of this essential aspect of learning in the online domain. Although contextualised in the COVID-19 pandemic, it became clear that the findings will remain relevant beyond the current situation, as a student's need to belong will always be present in the face of challenges or change.

The Relationship between Short Video Flow, Addiction, Serendipity, and Achievement Motivation among Chinese Vocational School Students: The Post-Epidemic Era Context.

Since the COVID-19 outbreak, people have been spending more time in the online world because of restrictions on face-to-face communication due to epidemic prevention controls. This has also brought the issue of Internet addiction, including the overuse and negative effects of short videos, to the forefront of attention. Past research has found that Internet addiction has a negative impact on well-being. However, there is a special concept of positive emotion called "serendipity" (). Serendipity provides a small, fleeting but positive experience, yet it is often associated with negative perceptions from an outside perspective. However, the relationship between short video addiction and serendipity is not yet known. Based on this, a theoretical model was developed in the context of the I-PACE model. To understand the relationship between short video addiction and serendipity among college students, in this study, we conducted snowball sampling and distributed online questionnaires using the Wenjuanxing platform. The target population of the questionnaire distribution was vocational college students in China, of whom 985 valid study participants responded, yielding a valid return rate of 82.1%. Of the respondents, 410 (41.6%) were male and 575 (58.4%) were female. The results were as follows: a. short video flow had a positive relationship with serendipity, a negative relationship with achievement motivation, and a positive effect on short video addiction; b. short video addiction had a positive effect on serendipity and a negative effect on achievement motivation; and c. serendipity had a negative impact on achievement motivation. This shows that short video addiction, like other Internet addictions, can have a negative impact on students' learning.

The Continuous Use Intention for the Online Learning of Chinese Vocational Students in the Post-Epidemic Era: The Extended Technology Acceptance Model and Expectation Confirmation Theory

In an attempt to prevent and control the outbreak of COVID-19, education systems worldwide have comprehensively implemented online courses to fulfill the educational goal of the suspension of classes without suspending school. Numerous online courses have been developed under these circumstances. From the perspective of sustainable development goals, these online courses should be continued. However, as the epidemic gradually eases, it is questionable whether or not students will still willingly participate in these courses. The method of teaching is a critical issue for schools to decide. Compared with other related educational research, the research on the vocational education system is still limited. To expand the understanding of this topic, this study adopted snowball sampling and invited students from Chinese vocational colleges to fill in a questionnaire to help understand the perceptions that affect students' expectations, attitudes, perceived effects, and satisfaction and the persistence of online learning. A total of 819 valid questionnaires were retrieved, with an effective questionnaire response rate of 81.9%. Meanwhile, under the framework of Expectation Confirmation Theory (ECT) and the Technology Acceptance Model (TAM), this study extended the theoretical model and proposed a sustainable model. The results of this study showed the following: 1. Expectancy belief and online learning attitudes had a positive impact on perceived ease of use and usefulness;2. Perceived ease of use had a negative impact on practical class satisfaction but a positive impact on theoretical class satisfaction and perceived usefulness;3. Perceived usefulness had a negative impact on practical course satisfaction but a positive impact on theoretical course satisfaction;and 4. Both types of course satisfaction had a positive impact on continuous use intentions for learning.

Changes in endemic patterns of respiratory syncytial virus infection in pediatric patients under the pressure of nonpharmaceutical interventions for COVID-19 in Beijing, China.

A series of nonpharmaceutical interventions (NPIs) was launched in Beijing, China, on January 24, 2020, to control coronavirus disease 2019. To reveal the roles of NPIs on the respiratory syncytial virus (RSV), respiratory specimens collected from children with acute respiratory tract infection between July 2017 and Dec 2021 in Beijing were screened by capillary electrophoresis-based multiplex PCR (CEMP) assay. Specimens positive for RSV were subjected to a polymerase chain reaction (PCR) and genotyped by G gene sequencing and phylogenetic analysis using iqtree v1.6.12. The parallel and fixed (paraFix) mutations were analyzed with the R package sitePath. Clinical data were compared using SPSS 22.0 software. Before NPIs launched, each RSV endemic season started from October/November to February/March of the next year in Beijing. After that, the RSV positive rate abruptly dropped from 31.93% in January to 4.39% in February 2020; then, a dormant state with RSV positive rates ≤1% from March to September, a nearly dormant state in October (2.85%) and November (2.98%) and a delayed endemic season in 2020, and abnormal RSV positive rates remaining at approximately 10% in summer until September 2021 were detected. Finally, an endemic RSV season returned in October 2021. There was a game between Subtypes A and B, and RSV-A replaced RSV-B in July 2021 to become the dominant subtype. Six RSV-A and eight RSV-B paraFix mutations were identified on G. The percentage of severe pneumonia patients decreased to 40.51% after NPIs launched. NPIs launched in Beijing seriously interfered with the endemic season of RSV.

The changed endemic pattern of human adenovirus from species B to C among pediatric patients under the pressure of non-pharmaceutical interventions against COVID-19 in Beijing, China.

BACKGROUND: Under the pressure of non-pharmaceutical interventions (NPIs) targeting severe acute respiratory syndrome coronavirus 2, the prevalence of human adenovirus (HAdV) was monitored before and after NPIs launched on Jan 24, 2020 in pediatric patients in Beijing, China. METHODS: Respiratory samples collected from children hospitalized with acute respiratory infections from Jan 2015 to Dec 2021 were screened by direct immunofluorescence test or capillary electrophoresis-based multiplex PCR assay. The hexon, penton base, and fiber genes were amplified from HAdV positive specimens, then sequenced. For HAdV typing, phylogenetic trees were built by MEGA X. Then clinical data of HAdV positive cases were collected. All data were evaluated using SPSS Statistics 22.0 software. RESULTS: A total of 16,097 children were enrolled and 466 (2.89%, 466/16,097) were HAdV-positive. The positive rates of HAdV varied, ranging from 4.39% (151/3,438) in 2018 to1.25% (26/2,081) in 2021, dropped from 3.19% (428/13,408) to 1.41% (38/2,689) from before to after NPIs launched (P < 0.001). There were 350 cases typed into nine types of species B, C, or E and 34 recorded as undetermined. Among them, HAdV-B3 (51.56%, 198/384) was the most prevalent types from 2015 to 2017, and HAdV-B7 (29.17%, 112/384) co-circulated with HAdV-B3 from 2018 to 2019. After NPIs launched, HAdV-B3 and B7 decreased sharply with HAdV-B7 undetected in 2021, while HAdV-C1 became the dominant one and the undetermined were more. CONCLUSIONS: The endemic pattern of HAdV changed in Beijing because of the NPIs launched for COVID-19. Especially, the dominant types changed from HAdV-B to HAdV-C.

The Association of Short-Video Problematic Use, Learning Engagement, and Perceived Learning Ineffectiveness among Chinese Vocational Students.

Short videos are very popular among students, but the immersive nature of the software makes them prone to problematic use and even addiction. Internet addiction, including short-video problematic use, has been a hot topic in recent years due to the COVID-19 epidemic. However, there are few empirical studies that have explored the effects of short-video problematic use on students. Thus, vocational colleges in China were recruited to participate in this study. There were 1089 effective participants, with a valid recall rate of 90.8%. This included 466 male students (42.8%) and 623 female students (57.2%), with a mean age of 19.19 years (standard deviation of 1.07 years). Five hypotheses were proposed and validated by structural equation modeling within the framework of ecological systems theory and engagement theory to explore the association of short-video problematic use, three types of learning engagement, and perceived learning ineffectiveness. Research findings showed that: (1) short-video problematic use has a negative effect on behavioral engagement; (2) behavioral engagement has a positive effect on both emotional and cognitive engagement; and (3) emotional and cognitive engagement have a negative effect on perceived learning ineffectiveness. According to the results, it can be seen that short-video problematic use has a detrimental effect on students' learning experiences, so teachers and parents need to pay attention to the negative effects of excessive use among students.

A Nitrocellulose Paper-Based Multi-Well Plate for Point-of-Care ELISA.

Low-cost diagnostic tools for point-of-care immunoassays, such as the paper-based enzyme-linked immunoassay (ELISA), have become increasingly important, especially so in the recent COVID-19 pandemic. ELISA is the gold-standard antibody/antigen sensing method. This paper reports an easy-to-fabricate nitrocellulose (NC) paper plate, coupled with a desktop scanner for ELISA, which provides a higher protein immobilization efficiency than the conventional cellulose paper-based ELISA platforms. The experiments were performed using spiked samples for the direct ELISA of rabbit IgG with a limit of detection (LOD) of 1.016 µg/mL, in a measurement range of 10 ng/mL to 1 mg/mL, and for the sandwich ELISA of sperm protein (SP-10) with an LOD of 88.8 ng/mL, in a measurement range of 1 ng/mL to 100 µg/mL. The described fabrication method, based on laser-cutting, is a highly flexible one-step laser micromachining process, which enables the rapid production of low-cost NC paper-based multi-well plates with different sizes for the ELISA measurements.

Schizophyllum commune Reduces Expression of the SARS-CoV-2 Receptors ACE2 and TMPRSS2.

The current global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of COVID-19 has infected hundreds of millions of people, killed millions, and continues to pose a threat. It has become one of the largest epidemics in human history, causing enormous damage to people's lives and economies in the whole world. However, there are still many uncertainties and continued attention to the impact of SARS-CoV-2 on human health. The entry of SARS-CoV-2 into host cells is facilitated by the binding of the spike protein on the virus surface to the cell surface receptor angiotensin-converting enzyme 2 (ACE2). Furthermore, transmembrane protease serine 2 (TMPRSS2) is a host surface protease that cleaves and proteolytically activates its S protein, which is necessary for viral infection. Thus, SARS-CoV-2 uses the ACE2 receptor for cell entry and initiates the S protein using the protease TMPRSS2. Schizophyllum commune (SC) is one of the most widely distributed fungi, often found on the rotten wood of trees that has been found to have various health benefits, including anticancer, antimicrobial activity, antiparasitic, and immunomodulatory function. In this article, SC significantly diminished the expression ACE2 and TMPRSS2 protein in vitro and in vivo without cell damage. In addition, adenosine from SC was also proven in this experiment to reduce the ACE2 and TMPRSS2 expression. Thus, our findings suggest that SC and adenosine exhibit potential for the repression of SARS-CoV-2 infection via the ACE2 and TMPRSS2 axis.

Electrothermal sterilization and self-powered real-time respiratory monitoring of reusable mask based on Ag micro-mesh films.

Since the COVID-19 pandemic outbreaks, the utilization of medical masks plays a critical role in reducing the infected risk. However, constructing multifunctional masks to achieve simultaneously self-sterilization, reusability, and respiratory monitoring capability remains still a huge challenge. Herein, a reusable Ag micro-mesh film-based mask is proposed, which enables the capabilities of electrothermal sterilization and self-powered real-time respiratory monitoring. Highly conductive Ag micro-mesh films prepared by continuous draw spinning method demonstrate excellent electrothermal performances for thermal sterilization and serve as working electrode to fabricate triboelectric nanogenerator (TENG) for real-time respiratory monitoring, respectively. Under a low driving voltage of 3.0 V, the surface temperature of Ag micro-mesh film enables a quick increase to over 60 °C within 30 s, which endows thermal sterilization against S. aureus with antibacterial efficiency of 95.58 % within 20 min to achieve the self-sterilization of medical masks. Furthermore, a self-powered alarm system based on the fabricated TENG as respiratory monitor is developed for real-time respiratory monitoring to render a timely treatment for patients in danger of tachypnea and apnea. Consequently, this work has paved a new and practical avenue to achieve reusable multifunctional masks with capabilities of electrothermal sterilization and real-time respiratory monitoring in clinical medicine.

A novel antibacterial and antifouling nanocomposite coated endotracheal tube to prevent ventilator-associated pneumonia.

BACKGROUND: The endotracheal tube (ETT) is an essential medical device to secure the airway patency in patients undergoing mechanical ventilation or general anesthesia. However, long-term intubation eventually leads to complete occlusion, ETTs potentiate biofilm-related infections, such as ventilator-associated pneumonia. ETTs are mainly composed of medical polyvinyl chloride (PVC), which adheres to microorganisms to form biofilms. Thus, a simple and efficient method was developed to fabricate CS-AgNPs@PAAm-Gelatin nanocomposite coating to achieve dual antibacterial and antifouling effects. RESULTS: The PAAm-Gelatin (PAAm = polyacrylamide) molecular chain gel has an interpenetrating network with a good hydrophilicity and formed strong covalent bonds with PVC-ETTs, wherein silver nanoparticles were used as antibacterial agents. The CS-AgNPs@PAAm-Gelatin coating showed great resistance and antibacterial effects against Staphylococcus aureus and Pseudomonas aeruginosa. Its antifouling ability was tested using cell, protein, and platelet adhesion assays. Additionally, both properties were comprehensively evaluated using an artificial broncho-lung model in vitro and a porcine mechanical ventilation model in vivo. These remarkable results were further confirmed that the CS-AgNPs@PAAm-Gelatin coating exhibited an excellent antibacterial capacity, an excellent stain resistance, and a good biocompatibility. CONCLUSIONS: The CS-AgNPs@PAAm-Gelatin nanocomposite coating effectively prevents the occlusion and biofilm-related infection of PVC-ETTs by enhancing the antibacterial and antifouling properties, and so has great potential for future clinical applications.

Strategies for screening, occupational prevention, and management of COVID-19 in outpatient clinics in Shandong

Objective We hope to analyze the information of outpatients in a tertiary care hospital during the epidemic of COVID-19, so as to formulate effective regulations for the prevention and control of COVID-19. Methods We collected information from outpatients from January 28, 2020 to March 2, 2020 and performed the statistical analysis. Results During the study period, there were more than 60,000 outpatients. Among them, 404 patients with a body temperature above 37.3°C who had not been to Wuhan and had no contact with people from Wuhan. There were 8 people who had contact with people from Wuhan, such as 4 people with fever, 3 people with normal body temperature but cough symptoms, and 1 person with normal body temperature and no other discomfort. There were 2 patients with high body temperature from the epidemic area in Wuhan, and one novel Coronavirus patient was confirmed as the final result. Conclusion During the COVID-19 pandemic, outpatient medical staff should enhance their awareness of protection, hospitals should standardize the outpatient COVID-19 prevention and control system, improve the prevention and emergency system, and reduce occupational exposure hazards and the occurrence of post-exposure infections.

The Relationship between Exercise Behavior and Mental Health during the COVID-19 Epidemic: Research Based on the Weibo Exercise Behavior User Dictionary

In the context of COVID-19, people face conditions of great stress and are susceptible to negative emotions such as worry, fear, and doubt. Therefore, the focus of epidemic prevention should be on mental health as well as physical health. It is important to pay attention to people's mental health while mitigating and controlling the epidemic. As an intervention to improve mental health, exercise behavior has attracted increasing attention from scholars due to its convenience and low cost. Therefore, the goal of this paper was to investigate the differences between characteristics related to linguistic expression and mental health indicators among different groups of Weibo users by constructing a Weibo exercise behavior user lexicon to explore the influence of exercise behavior on mental health. This study developed a user dictionary of exercise behavior, classified Sina Weibo users' exercise behavior, and established relevant systems to uncover the expressive characteristics of psychological vocabulary and behavioral vocabulary to explore the differences in expressive features related to psychological and behavioral vocabulary and mental health indicators among users who engage in different forms of exercise behavior during the period of COVID-19. As a result of an analysis of variance (ANOVA) conducted during the COVID-19 epidemic, (1) based on the constructed user lexicon of motion behavior in Weibo, the classification program exhibited good performance;(2) there were significant differences in the expressions of some lexical features among users who exhibited different motor behaviors;and (3) both nonphysical exercise and physical exercise behavior had positive relationships with some mental health indicators, but the mechanism associated with nonphysical exercise requires further exploration. This study provides a scientific online evaluation methodology and support for research concerning exercise and mental health during the COVID-19 epidemic.

Analysis of mechanisms of Shenhuang Granule in treating severe COVID-19 based on network pharmacology and molecular docking.

OBJECTIVE: Severe cases of coronavirus disease 2019 (COVID-19) are expected to have a worse prognosis than mild cases. Shenhuang Granule (SHG) has been shown to be a safe and effective treatment for severe COVID-19 in a previous randomized clinical trial, but the active chemical constituents and underlying mechanisms of action remain unknown. The goal of this study is to explore the chemical basis and mechanisms of SHG in the treatment of severe COVID-19, using network pharmacology. METHODS: Ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry was employed to screen chemical constituents of SHG. Putative therapeutic targets were predicted by searching traditional Chinese medicine system pharmacology database and analysis platform, SwissTargetPrediction, and Gene Expression Omnibus (GEO) databases. The target protein-protein interaction network and enrichment analysis were performed to investigate the hub genes and presumptive mechanisms. Molecular docking and molecular dynamics simulations were used to verify the stability and interaction between the key chemical constituents of SHG and COVID-19 protein targets. RESULTS: Forty-five chemical constituents of SHG were identified along with 131 corresponding therapeutic targets, including hub genes such as HSP90AA1, MMP9, CXCL8, PTGS2, IFNG, DNMT1, TYMS, MDM2, HDAC3 and ABCB1. Functional enrichment analysis indicated that SHG mainly acted on the neuroactive ligand-receptor interaction, calcium signaling pathway and cAMP signaling pathway. Molecular docking showed that the key constituents had a good affinity with the severe acute respiratory syndrome coronavirus 2 protein targets. Molecular dynamics simulations indicated that ginsenoside Rg4 formed a stable protein-ligand complex with helicase. CONCLUSION: Multiple components of SHG regulated multiple targets to inhibit virus invasion and cytokine storm through several signaling pathways; this provides a scientific basis for clinical applications and further experiments.

International student perceptions of online medical education during the COVID-19 epidemic.

This study aimed to investigate how international students enrolled on medical and surgical bachelor's degree programs (MBBS) in China perceived online medical education course, compared to native Chinese students during the Covid-19 pandemic. The perceptions of 38 MBBS and 31 Chinese sophomores were surveyed using the Chaoxing platform. The international student group's mean satisfaction with online teaching was 2.737 on a 5-point scale, much lower than the Chinese students' mean score of 4.355 (p < 0.05). Similarly, the international students expressed less satisfaction than the Chinese learners with other aspects of the course, including the teacher's level, at 3.964 ± 0.818 versus 4.445 ± 0.548 (p < 0.05); curriculum organization, at 3.651 ± 0.848 versus 4.333 ± 0.568 (p < 0.05); and self-learning level, at 3.634 ± 0.996 versus 3.686 ± 0.949 (p > 0.05), respectively. There were also noteworthy differences between the progress made by the international students in Chinese language learning, which was positively correlated with satisfaction with teaching on the online medical education (p < 0.05). The results suggest that, while online teaching was a necessary response to the Covid-19 pandemic, satisfaction with this mode of education is lower among international students than their Chinese counterparts.

Distinct gut microbiota and health outcomes in asymptomatic infection, viral nucleic acid test re-positive, and convalescent COVID-19 cases

Gut microbiota composition is suggested to associate with coronavirus disease 2019 (COVID-19) severity, but the impact of gut microbiota on health outcomes is largely unclear. We recruited 81 individuals from Wuhan, China, including 13 asymptomatic infection cases (Group A), 24 COVID-19 convalescents with adverse outcomes (Group C), 31 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) re-positive cases (Group D), and 13 non-COVID-19 healthy controls (Group H). The microbial features of Groups A and D were similar and exhibited higher gut microbial diversity and more abundant short-chain fatty acid (SCFA)-producing species than Group C. Group C was enriched with opportunistic pathogens and virulence factors related to adhesion and toxin production. The abundance of SCFA-producing species was negatively correlated, while Escherichia coli was positively correlated with adverse outcomes. All three groups (A, C, and D) were enriched with the mucus-degrading species Akkermansia muciniphila, but decreased with Bacteroides-encoded carbohydrate-active enzymes. The pathways of vitamin B6 metabolic and folate biosynthesis were decreased, while selenocompound metabolism was increased in the three groups. Specifically, the secondary bile acid (BA) metabolic pathway was enriched in Group A. Antibiotic resistance genes were common among the three groups. Conclusively, the gut microbiota was related to the health outcomes of COVID-19. Dietary supplementations (SCFAs, BA, selenium, folate, vitamin B6) may be beneficial to COVID-19 patients.

Comparison of the Characteristics and Outcomes of COVID-19 Patients Treated by a Hospital-at-Home Service in Japan during the Alpha and Delta Waves.

Coronavirus infections occurred in repeated waves caused by different variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the number of patients increasing during each wave. A private after-hours house-call (AHHC) service provides hospital-at-home (HaH) services to patients in Japan requiring oxygen when hospital beds are in short supply. This retrospective study aimed to compare the characteristics of COVID-19 patients treated by the AHHC service during the COVID-19 waves caused by the Alpha (March-June 2021) and Delta (July-December 2021) SARS-CoV-2 variants. All patients with COVID-19 treated by the AHHC service from March to December 2021 while awaiting hospitalization were included. The data were collected from medical records and follow-up telephone interviews. The AHHC service treated 55 and 273 COVID-19 patients during the Alpha and Delta waves, respectively. The patients treated during the Delta wave were significantly younger than those treated during the Alpha wave (median: 63 years and 47 years, respectively; p < 0.001). Disease severity did not differ significantly between the two waves, but the crude case-fatality rate was significantly higher during the Alpha wave (10/55, 18.2%) than during the Delta wave (4/273, 1.4%; p < 0.001). The patient characteristics and outcomes differed between the Alpha and Delta waves.