15 April, 2021

Emotional representations of space vary as a function of peoples’ mental health and interoceptive awareness -

As people interact in extensive environments, their space becomes intertwined with emotions. Yet, beyond the study of spatial appraisal and navigation1–3, the emotional representation of space remains elusive. Here we developed a method that, even without mobility (during Covid-19 lockdown), allows examining participants’ emotional representation of space and psychophysiological correlates. We gave participants blank maps of the region where they lived and asked them to apply shade where they had happy/sad memories, and where they wanted to go after the lockdown. They also completed self-reports on mental health and interoceptive awareness (appraisal of inner bodily sensations). By adapting neuroimaging methods, we examined shaded pixels instead of brain voxels to quantify where and how strong emotions are represented in space. The results revealed that happy memories were consistently associated with similar spatial locations. Yet, this mapping response varied as a function of participants’ mental health and interoceptive awareness. Interestingly, maps of happy memories and desired locations after lockdown overlay significantly with natural environments (vs. non-natural). These results suggest that our relationship with the environment relates to how we feel and appraise bodily sensations (i.e., allostasis in space). Our method may provide a spatially ecological marker for physical and mental disorders.

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Gender role attitudes cannot explain how British couples responded to increased housework demands during the COVID-19 pandemic -

Previous research has shown that gender role attitudes can predict changes in couples’ housework division over critical life events, but these studies might have suffered from endogeneity because the occurrence of such life events is anticipated and may be affected by gender role attitudes. In contrast, the COVID-19 pandemic was a truly exogenous shock that hit couples unexpectedly. This study examines the role of gender ideologies in how couples adjusted their division of housework during the COVID-19 pandemic in 2020 compared to a pre-pandemic baseline observation. The data cover 3,219 couples from the UK Household Longitudinal Study, with a baseline wave and four COVID-19 panel waves between April and September 2020. We found no evidence that individuals’ or couples’ pre-crisis gender role attitudes affected changes in men’s and women’s absolute or relative contributions to housework at any time during the lockdown. However, both partners spent substantially more time on housework throughout the COVID-19 crisis than before, especially in the early stages, and in relative terms, the pandemic seems to have contributed to at least a temporary, modest increase in gender equality in housework. We discuss our results against the background of previous research whose results may have suffered from endogeneity problems and argue that the COVID-19 ‘shock’ was likely perceived as a merely temporary disruption of couples’ established housework arrangements.

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COVID-19 and Small-scale fisheries in Africa: Impacts on livelihoods and the fish value chain in Cameroon and Liberia -

This study explores the emerging impacts of the COVID-19 pandemic on coastal small-scale fishing communities in Cameroon and Liberia, where we conducted qualitative interviews with small-scale fish harvesters, fish processors, traders, and consumers. We found that the implementation of COVID-19 safety and health protocol initiatives impacted the entire fish value chain, which contributed to social anxiety and negatively affected social well-being for those who depend on small-scale fisheries for employment and livelihoods. Fisheries in both nations saw a reduction in fish catch, widened supply and demand gap and a significant spike in fish price. Drawing on the Sustainable Livelihoods literature, we discuss how COVID-19 interacted with other existing aspects of community vulnerability and lack of capacity, despite communities finding ways to respond safely to the challenges of the pandemic. Moving forward, these small-scale fisheries will require a holistic assessment of the long-term social, ecological and economic impacts of the pandemic. Better fish processing and storage facilities and more robust institutional structures around markets and fisheries management will improve the adaptive capacity of people in these communities, who will no doubt face future challenges related to issues such as climate change.

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A comprehensive analysis of outcomes between COVID-19 patients with an elevated serum lipase compared to those with pancreatitis. -

Background and Aims: COVID-19 patients may have asymptomatic hyperlipasemia without abdominal imaging findings or abdominal pain. In addition, primary and secondary pancreatitis have been described in COVID-19 patients. There is limited information on how the groups compare in outcomes. The aim is to compare outcomes among these groups. Methods: This is a retrospective study from 12 hospitals within one healthcare system examining outcomes between hospitalized COVID-19 patients with a lipase <3x upper limit of normal (ULN), asymptomatic hyperlipasemia (>3x ULN), secondary pancreatitis (typical respiratory COVID-19 symptoms and found to have pancreatitis), and primary pancreatitis (presenting with pancreatitis). Results: Of 11,883 patients admitted with COVID-19, 1,560 patients were included: 1,155 COVID-19 patients with a normal serum lipase (control group), 270 with an elevated lipase <3x ULN, 46 patients with asymptomatic hyperlipasemia with a lipase 3xULN, 57 patients with secondary pancreatitis, and 32 patients with primary pancreatitis. On adjusted multivariate analysis, the elevated lipase <3x ULN and asymptomatic hyperlipasemia groups had worse outcomes. The mortality was OR1.6 (95% CI 1.2-2.2) and 1.1 (95% CI 0.5-2.3), respectively. The need for mechanical ventilation was OR 2.8 (95% CI 1.2-2.1) and 2.8 (95% CI 1.5-5.2), respectively. Longer length of stay was OR 1.5 (95%CI 1.1-2.0) and 3.16 (95%CI 1.5-6.5), respectively. Conclusion: COVID-19 patients with an elevated lipase< 3x ULN and asymptomatic hyperlipasemia have generally worse outcomes than those with pancreatitis. This could be attributed to extrapancreatic causes (liver failure, renal failure, enteritis, etc), which may signify a more severe course of clinical disease. Key words: pancreas; SARS-CoV-2; pancreatitis

🖺 Full Text HTML: A comprehensive analysis of outcomes between COVID-19 patients with an elevated serum lipase compared to those with pancreatitis.

You’re just there, alone in your room with your thoughts: A qualitative study about the impact of lockdown among young people during the COVID-19 pandemic -

Background Adolescents and young adults have been greatly affected by quarantine measures during the coronavirus-19 pandemic. Quantitative evidence has shown that many young people have struggled with their mental health, but little is understood about the qualitative impact of social distancing restrictions on mental health, wellbeing and social lives. We therefore sought to elicit the views and experiences of adolescents and young adults living in the UK during the pandemic. Methods Semi-structured qualitative interviews were undertaken with 37 participants aged 13-24. Results We identified 4 superordinate themes most commonly described by participants about their experiences during the pandemic, including: a) missing social contact during lockdown, b) disruption to education, c) changes to social relationships, and d) improved wellbeing during lockdown. Although we identified some positive experiences during the pandemic, including an increased awareness of mental health and stronger relationship ties, many said they struggled with loneliness, a decline in mental health, and anxiety about socialising after the pandemic. Conclusions Findings suggest that some young people may have felt less stigma talking about their mental health now compared to before the COVID-19 pandemic. However, many are worried about how the pandemic has affected their education and social connections and may require additional psychological, practical and social support. Our findings highlight the important role that education providers play in providing a source of information and support to adolescents and young adults during times of uncertainty.

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Behavioral nudges increase COVID-19 vaccinations: Two randomized controlled trials -

Fighting the COVID-19 pandemic requires quick and effective strategies to maximize vaccine uptake. We present two sequential randomized controlled trials (RCTs) that tackle this challenge with behavioral science insights. We deliver text-based nudges to UCLA Health patients one day (first RCT; N=113,229) and eight days (second RCT; N=90,662) after they receive notifications of vaccine eligibility. In the first RCT, text messages designed to make vaccination salient and easy to schedule boost appointment and vaccination rates by 86% and 26%, respectively. Nudges that make patients feel endowed with the vaccine heighten these effects, but addressing vaccine hesitancy via a video-based information intervention does not yield benefits beyond simple text. These results hold across ethnicity and age groups. By contrast, online experiments (N=2,003) soliciting hypothetical responses to the same messages reveal the opposite patterns, underscoring the importance of pilot-testing behavioral nudges in the real world before scaling them up. In the second RCT, we further find that receiving a second reminder boosts appointment and vaccination rates by 52% and 16%, respectively. Our findings suggest that text-based nudges can substantially increase and accelerate COVID-19 vaccinations at almost zero marginal cost, highlighting the promising role of behavioral science in addressing a critical component of the COVID-19 pandemic response.

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An international, inter-laboratory ring trial confirms the feasibility of an open source, extraction-less “direct” RT-qPCR method for reliable detection of SARS-CoV-2 RNA in clinical samples -

RT-qPCR is used world-wide to test and trace the spread of SARS-CoV-2. Extraction-less or direct RT-PCR is an open-access qualitative method for SARS-CoV-2 detection from nasopharyngeal (NP) or oral pharyngeal (OP) samples with the potential to generate actionable data more quickly, at a lower cost, and with fewer experimental resources than full RT-qPCR. This study engaged ten global testing sites, including laboratories currently experiencing testing limitations due to reagent or equipment shortages, in an international inter-laboratory ring trial. Participating labs were provided a common protocol, common reagents, aliquots of identical pooled clinical samples and purified nucleic acids, and used their existing in-house equipment. We observed 100% concordance across labs in the correct identification of all positive and negative samples, with highly similar Ct values observed. The test also performed well when applied to locally collected patient NP samples, provided the viral transport media did not contain charcoal or guanidine, both of which appeared to potently inhibit the RT-PCR reaction. Our results suggest that open access, direct RT-PCR assays are a feasible option for more efficient COVID-19 testing as demanded by the continuing pandemic.

🖺 Full Text HTML: An international, inter-laboratory ring trial confirms the feasibility of an open source, extraction-less “direct” RT-qPCR method for reliable detection of SARS-CoV-2 RNA in clinical samples

An Ecological Study to Investigate Links Between Atmospheric Pollutants From Farming and SARS-CoV-2 Mortality -

Exposure to atmospheric particulate matter and nitrogen dioxide has been linked to SARS-CoV-2 infection and death. We hypothesized that an interaction between SARS-CoV-2 infection and exposure to farming-related atmospheric pollutants worsens the effect of SARS-CoV-2 on mortality. Our objective was investigate this hypothesis by performing an ecological study in five Italian Regions (Piedmont, Lombardy, Veneto, Emilia-Romagna and Sicily) linking all-cause mortality, by province (administrative entities within regions), to atmospheric particulate matter (PM2.5 and PM10) nitrous oxide (N2O), ammonia (NH3) and methane (CH4) mainly produced by agricultural activities. Study outcome was change in all-cause mortality during March-April 2020, compared to March-April 2015-2019 (period) as assessed by mortality rate ratios (MRRs) estimated using multivariate negative binomial regression models that adjusted for air temperature, humidity and population density. The MRR for the interaction of period with NH3 exposure, considering all pollutants together was 1.133, equivalent to a 13.3% increase in mortality over and above that due to period (proxy for COVID-19 mortality) for each ton/km2 increase in NH3 emissions. Although the study was ecological, and did not provide evidence of a causal link between SARS-CoV-2 and farming-related pollutants, in accord with the precautionary principle we recommend application of measures to limit NH3 exposure particularly while the COVID-19 pandemic continues.

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Reliability of Spike Gene Target Failure for ascertaining SARS-CoV-2 lineage B.1.1.7 prevalence in a hospital setting -

The appearance of the SARS-CoV-2 lineage B.1.1.7 in the UK in late 2020, associated with faster transmission, sparked the need to find effective ways to monitor its spread. The set of mutations that characterise this lineage include a deletion in position 69 and 70 of the spike protein, which is known to be associated with Spike Gene Target Failure (SGTF) in a commonly used three gene diagnostic qPCR assay. The lower cost and faster turnaround times compared to whole genome sequencing make the use of qPCR for monitoring of the variant spread an attractive proposition. However, there are several potential issues with this approach. Here we use 826 SARS-CoV-2 samples collected in a hospital setting as part of the Hospital Onset COVID Infection (HOCI) study where qPCR was used for viral detection, followed by whole genome sequencing (WGS), to identify the factors to consider when using SGTF to infer lineage B.1.1.7 prevalence in a hospital setting, with potential implications for locations where this variant has recently been introduced.

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One-Seq: A Highly Scalable Sequencing-Based Diagnostic for SARS-CoV-2 and Other Single-Stranded Viruses -

The management of pandemics such as COVID-19 requires highly scalable and sensitive viral diagnostics, together with variant identification. Next-generation sequencing (NGS) has many attractive features for highly multiplexed testing, however current sequencing-based methods are limited in throughput by early processing steps on individual samples (e.g. RNA extraction and PCR amplification). Here we report a new method, “One-Seq”, that eliminates the current bottlenecks in scalability by enabling early pooling of samples, before any extraction or amplification steps. To enable early pooling, we developed a one-pot reaction for efficient reverse transcription (RT) and upfront barcoding in extraction-free clinical samples, and a “protector” strategy in which carefully designed competing oligonucleotides prevent barcode crosstalk and preserve detection of the high dynamic range of viral load in clinical samples. This method is highly sensitive, achieving a limit of detection (LoD) down to 2.5 genome copy equivalent (gce) in contrived RT samples, 10 gce in multiplexed sequencing, and 2-5 gce with multi-primer detection, suggesting an LoD of 200-500 gce/ml for clinical testing. In clinical specimens, One-Seq showed quantitative viral detection against clinical Ct values with 6 logs of linear dynamic range and detection of SARS-CoV-2 positive samples down to ~360 gce/ml. In addition, One-Seq reports a number of hotspot viral mutations at equal scalability at no extra cost. Scaling up One-Seq would allow a throughput of 100,000-1,000,000 tests per day per single clinical lab, at an estimated amortized reagent cost of $1.5 per test and turn-around time of 7.5-15 hr.

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Analysis on Action Tracking Reports of COVID-19 Informs Control Strategies and Vaccine Delivery in Post-Pandemic Era -

Understanding the spread of SARS-CoV-2 provides important insights for control policies such as social-distancing interventions and vaccine delivery in the post-pandemic era. In this work, we take the advantage of action tracking reports of confirmed COVID-19 patients, which contain details regarding the mobility trajectory of a patient, along with the people with whom the patient has interacted, the timing of diagnosis, and personal information (e.g., age and sex). We analyzed reports of 4,410 patients from April 2020 to February 2021 in China, a country where the residents are well-prepared for the “new normal” world following COVID-19 spread. We developed natural language processing (NLP) tools to transform the unstructured text of action-tracking reports to a structured network of social contacts. A SEIR model was built on top of the network, and was able to capture important aspects regarding coronavirus transmissions such as location category, age, sex and socioeconomic status. Our analysis provides important insights for the development of control policies. Under the “new normal” conditions, we find that restaurants, locations less protected by mask-wearing, have a greater risk than any other location categories, including locations where people are present at higher densities (e.g., flight). We find that discouraging railway transports is crucial to avoid another wave of breakout during the Chunyun season (a period of travel in China with extremely high traffic load around the Chinese New Year). By formalizing the challenge of finding the optimal vaccine delivery among various different population groups (e.g., sex, age and socioeconomic groups) as an optimization problem, our analysis helps to maximize the efficiency of vaccine delivery under the general situation of vaccine supply shortage. We are able to reduce the numbers of infections and deaths by 7.4% and 10.5% respectively with vaccine supply for only 1% of the population. Furthermore, with 10% vaccination rate, the numbers of infections and deaths further decrease by 52.6% and 78.1% respectively. Our work will be helpful in the design of effective policies regarding interventions, reopening, contact tracing and vaccine delivery in the “new normal” world following COVID-19 spread.

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Occupational risks of COVID-19 in NHS workers in England -

Abstract Objective To quantify occupational risks of Covid-19 among healthcare staff during the first wave of the pandemic in England Methods Using pseudonymised data on 902,813 individuals continuously employed by 191 National Health Service trusts during 1.1.19 to 31.7.20, we explored demographic and occupational risk factors for sickness absence ascribed to Covid-19 during 9.3.20 to 31.7.20 (n = 92,880). We estimated odds ratios (ORs) by multivariate logistic regression. Results With adjustment for employing trust, demographic characteristics, and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in additional clinical services (a group that included care assistants) (OR 2.31), registered nursing and midwifery professionals (OR 2.28) and allied health professionals (OR 1.94), and intermediate in doctors and dentists (OR 1.55). Differences in risk were higher after the employing trust had started to care for documented Covid-19 patients, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged Covid-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater. Conclusions After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for Covid-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. Covid-19 may meet criteria for compensation as an occupational disease in some healthcare occupations.

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Effect of COVID-19 on Lipid Profile and its Correlation with Acute Phase Reactants -

Background and Objective Coronavirus disease 2019 (COVID-19) manifests as multiple clinical and pathological organ dysfunctions. It also disrupts metabolic profile due to the release of pro-inflammatory cytokines causing a systemic inflammation reaction. However, the development and correlation of dyslipidemia with acute phase reactants is unknown. This investigation was performed to assess the pathological alterations of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein (HDL), triglycerides, and total cholesterol levels in COVID-19 patients. Methods This was a prospective study performed on real-world patients to assess serum levels of LDL-C, HDL, TG, TC on COVID-19 patients (mild: 319; moderate: 391; critical: 357) hospitalized at our center between April 2020 through January 2021. Age- and gender-matched controls who had their lipid profiles in the same period were included as the control group. Results LDL-C, HDL, TG, and TC levels were significantly lower in COVID-19 patients when compared with the control group (P < 0.001, 0.047, 0.045, < 0.001, respectively). All parameters decreased gradually with COVID-19 disease severity (LDL-C: median (IQR), mild: 98 (91,134); moderate: 97 (81,113); critical: 68 (68,83); HDL: mild: 45 (37,50); moderate: 46 (41,50); critical: 40 (37,46); TG: mild: 186 (150,245); moderate: 156 (109,198); critical: 111 (98,154); TC: mild: 224 (212,238); moderate: 212 (203,213); critical: 154 (125,187)). LDL-C, TC, and TG were inversely correlated with acute phase reactants (interleukin-6 (IL-6), Procalcitonin, C-reactive protein (CRP), and D-dimers). Logistic regression demonstrated lipid profile, thyroid profile, and acute phase reactants as predictors of severity of COVID-19 disease. Conclusion Hypolipidemia develops in increasing frequency with severe COVID-19 disease. It inversely correlates with levels of acute-phase reactants, indicating SARS-COV-2 as the causative agent for alteration in lipid and thyroid levels.

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An mRNA SARS-CoV-2 vaccine employing a novel delivery vehicle with a TLR-9 agonist induces neutralizing antibodies and T cell memory -

The SARS-CoV-2 pandemic has necessitated the rapid development of prophylactic vaccines. Two mRNA vaccines have been approved for emergency use by the FDA and have demonstrated extraordinary effectiveness. The success of these mRNA vaccines establishes the speed of development and therapeutic potential of mRNA. These authorized vaccines encode full-length versions of the SARS-CoV-2 spike protein. They are formulated with Lipid Nanoparticle (LNP) delivery vehicles that have inherent immunostimulatory properties. Different vaccination strategies and alternative mRNA delivery vehicles would be desirable to ensure flexibility of future generations of SARS-CoV-2 vaccines and the development of mRNA vaccines in general. Here, we report on the development of an alternative mRNA vaccine approach using a novel delivery vehicle called Charge-Altering Releasable Transporters (CARTs). Using these inherently nonimmunogenic vehicles we are able to tailor the vaccine immunogenicity by inclusion of co-formulated adjuvants such as oligonucleotides with CpG motifs. Mice vaccinated with our mRNA-CART vaccine developed therapeutically relevant levels of RBD-specific neutralizing antibodies in both the circulation and in the lung bronchial fluids. In addition, our vaccine elicited strong and long lasting RBD-specific TH1 T cell responses including CD4+ and CD8+ T cell memory.

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INO-4800 DNA Vaccine Induces Neutralizing Antibodies and T cell Activity Against Global SARS-CoV-2 Variants -

Global surveillance has identified emerging SARS-CoV-2 variants of concern (VOC) associated with broadened host specificity, pathogenicity, and immune evasion to vaccine induced immunity. Here we compared humoral and cellular responses against SARS-CoV-2 VOC in subjects immunized with the DNA vaccine, INO-4800. INO-4800 vaccination induced neutralizing antibodies against all variants tested, with reduced levels detected against B.1.351. IFN{gamma} T cell responses were fully maintained against all variants tested.

🖺 Full Text HTML: INO-4800 DNA Vaccine Induces Neutralizing Antibodies and T cell Activity Against Global SARS-CoV-2 Variants

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