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The mutations in the SARS-CoV-2 virus genome during COVID-19 dissemination are unclear. selleck chemical In 788 COVID-19 patients from Zhejiang province, we observed decreased rate of severe/critical cases compared with patients in Wuhan. For mechanisms exploration, we isolated one strain of SARS-CoV-2 (ZJ01) from a mild COVID-19 patient. Thirty-five specific gene mutations were identified. Phylogenetic and relative synonymous codon usage analysis suggested that ZJ01 may be a potential evolutionary branch of SARS-CoV-2. We classified 54 global virus strains based on the base (C or T) at positions 8824 and 28247 while ZJ01 has T at both sites. The prediction of the Furin cleavage site (FCS) and sequence alignment indicated that the FCS may be an important site of coronavirus evolution. ZJ01 mutations identified near the FCS (F1-2) caused changes in the structure and electrostatic distribution of the S surface protein, further affecting the binding capacity of Furin. Single-cell sequencing and ACE2-Furin co-expression results confirmed that the Furin expression was especially higher in glands, liver, kidneys, and colon. The evolutionary pattern of SARS-CoV-2 towards FCS formation may result in its clinical symptom becoming closer to HKU-1 and OC43 caused mild flu-like symptoms, further showing its potential in differentiating into mild COVID-19 subtypes.Objective We examined the association between care recipient's physical, mental, and cognitive health conditions and caregivers' psychological distress in Vietnamese older care recipients and their caregivers. Methods The Vietnamese Aging and Care Survey was developed for care recipients, and adult-child and spousal caregivers, and inquired about their sociodemographics and health-related variables. Results Data were collected on 58 caregiver-care recipient dyads. Adult-child and spousal caregivers were on average 43 and 70 years-old respectively. The vast majority were female (76%) and born in Vietnam (97%). Adult-child caregivers reported more caregiver burden than spousal caregivers. Care recipients were on average 75 years-old. Care recipients of adult-child caregivers reported more depressive symptoms than care recipients of spousal caregivers and were more likely to have mild dementia. Care recipients' health had no effect on caregiver depressive symptoms but their educational attainment was associated with caregiver burden and depressive symptoms. Conclusions This study showed care recipients and caregivers' years of education were positively associated with caregivers' psychological distress. Vietnamese families lived in ethnic enclaves and shared caregiving responsibilities within the family. However, using available outside resources may alleviate psychological distress of not only caregivers but also families as a whole. Clinical implications Healthcare professionals should encourage educated caregivers and educated care recipients to use outside resources to ease caregiving duties.Objective Spinal cord injury often leads to the loss of penile sensation, and severely affects the individual's sexual function. The present study aimed to restore the penile sensory pathway through end-to-side dorsal root (DR) transfer neurorrhaphy in rats, and preliminarily verified the feasibility of the operation. Design 40 male adult Sprague-Dawley rats were divided into three groups. In the model (n = 20) and resection (n = 10) groups, the right L6 DR, S1 DR, and the contralateral branch of the dorsal nerve of the penis (DNP) were transected. The distal stump of L6 DR in the model group was then anastomosed to the intact L4 DR. The sham group (n = 10) was not subjected to neural damage. Four months later, retrograde and transganglionic neural labeling, morphological examination, immunofluorescence (IF), and ultrastructural observation were carried out to test the reconstruction of the afferent pathway. Reflective erection (RE) was assessed by detecting the intracavernous pressure elicited by DNP stimulation. Results The neural labeling tests indicated the integrity of the entire rebuilt penile afferent pathway. The morphological studies, IF, and ultrastructural observation showed that the regeneration of L6 axons in the model group was significantly better than that in the resection group; however, it had not reached the level of the sham group. The sham group rats exhibited typical RE following DNP stimulation, while the model and resection groups produced negative results. Conclusion Our studies demonstrated the feasibility of end-to-side DR transfer neurorrhaphy for restoring the penile sensory pathway in rats.A higher drug burden index (DBI) is known to be associated with pre-admission falls leading to hospitalization. We investigated whether a mean difference in DBI (ΔDBI) between the events of in-hospital falls and hospital admission was associated with 30-day readmission in 113 patients ≥50 years who fell during their hospital stays between 2007 and 2014. A greater ΔDBI (≥0.09) was positively associated with higher 30-day readmission rates (incident rate ratio 2.02; 95% confidence interval 1.49-2.74). An effort to keep DBI low may thus decrease 30-day readmissions for older in-hospital fallers.Background The workload is the impinged stress due to several inter-related factors, including the competence of the intensive care unit nurse. Objectives The objective of this study was to investigate the workload-related psychological changes in intensive care nurses. Methods The study had a two-phase explanatory mixed method design. Data were collected through in-depth personal interviews and with other instruments. The obtained data were analyzed with SPSS 18.0 and MAXQDA plus10. Results The workload of intensive care nurses was 315.8 per minute and the mean TISS 28 score was as high as 65.00. The in-depth interviews with intensive care nurses revealed that participants experienced professional stress due to high workload and went through psychological changes. Conclusion The study findings demonstrate that psychological symptoms seen in intensive care nurses relate to a high workload. Impact Statement The results of this study can be used by hospital administrators to create a healthy work environment with a moderated workload and optimized shift schedules so that the mental well-being of nurses can be promoted.
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