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Mucormycosis is a progressive and life-threatening disease that has been increasingly reported in patients infected by coronavirus diseases 2019 (COVID-19). We describe a case of rhino-orbital mucormycosis with central nervous system involvement resulting in bilateral blindness and intracranial extension in a patient with uncontrolled diabetes mellitus (DM) and mild COVID-19 infection. A 35-year-old obese male, recently diagnosed with DM, presented to the emergency department suffering from dizziness, headache, speech difficulty, and facial weakness. His glycosylated hemoglobin was 10.4% and his reverse transcriptase-polymerase chain reaction (PCR) test came positive for COVID-19. Ocular examination revealed left eye proptosis, ophthalmoplegia, and lid edema with no ocular movement. Imaging studies showed pansinusitis and periorbital and orbital cellulitis with intracranial involvement. Histopathology and biopsy examination confirmed mucormycosis. Medical management included glucose control and liposomal amphotericin B therapy. Septoplasty and functional endoscopic sinus surgery was performed as emergency procedures. The patient survived with bilateral blindness. In this case, we described the importance of considering mucormycosis in COVID-19 patients with uncontrolled diabetes, particularly those presenting with sinusitis, headache, and orbital edema symptoms. Despite intensive antifungal therapy and surgical intervention, it is a serious opportunistic fungal infection associated with long-term complications.

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OBJECTIVE: To assess the effect and safety of Reyanning Mixture (RYN) in treating asymptomatic or mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents. METHODS: This is a prospective, open-label, randomized controlled trial. Patients aged 1-17 years and diagnosed with asymptomatic or mild coronavirus disease-2019 (COVID-19) were assigned to an intervention group (RYN plus standard care) and a control group (standard care) according to a randomization list. The primary outcomes were SARS-CoV-2 negative conversion time. Secondary outcomes included negative conversion rate on days 3 and 7, hospital length of stay, symptom relief rate, new-onset symptoms of asymptomatic infected patients, and progressive disease rate. The cycle threshold (Ct) values of ORF1ab or N genes were also tested. RESULTS: A total of 214 patients in the intervention group and 217 in the control group were analyzed. The SARS-CoV-2 negative conversion time was significantly shortened in the intervention group [5 days (interquartile range (IQR): 5-6) vs. 7 days (IQR: 6-7), P<0.01]. By days 3 and 7, the negative conversion rates were significantly higher in the intervention group (day 3: 32.7% vs. 21.2%, P=0.007; day 7: 75.2% vs. 60.8%, P=0.001). Ct values significantly increase on day 2 [ORF1ab gene: 35.62 (IQR: 29.17-45.00) vs. 34.22 (IQR: 28.41-39.41), P=0.03; N gene: 34.97 (IQR: 28.50-45.00) vs. 33.51 (IQR: 27.70-38.25), P=0.024] and day 3 [ORF1ab gene: 38.00 (IQR: 32.72-45.00) vs. 35.81 (IQR: 29.96-45.00), P=0.003; N gene: 37.16 (IQR: 32.01-45.00) vs. 35.26 (IQR: 29.09-45.00), P=0.01]. No significant difference was found in hospital length of stay between the two groups (P>0.05). Symptoms of cough were significantly improved (82.2% vs. 70.0%, P=0.02) and wheezing was significantly reduced (0.7% vs. 12.9%, P<0.01) in the intervention group compared with the control group. During the trial, no disease progression or serious adverse events were reported. CONCLUSION: Adding RYN to standard care may be a safe and effective treatment for children with asymptomatic and mild SARS-CoV-2 infection. (Registration No. ChiCTR2200060292).

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BACKGROUND: Streptococcus pneumoniae carriage is a prerequisite for clinical infections and is used to make public health decisions on vaccine licensure. Pneumococcal carriage data among high-risk Thai adults are needed before national vaccine program introduction. The association between coronavirus disease 2019 (COVID-19) and pneumococcal carriage were also investigated. METHODS: During the COVID-19 pandemic, a multi-center cross-sectional study was conducted among high-risk Thai adults from September 2021 to November 2022. Pneumococcal carriage and serotypes were investigated using both conventional and molecular methods. Demographics and co-morbidities were determined for carriage while accounting for case clustering from various study sites. RESULTS: A total of 370 individuals were enrolled. The prevalence of pneumococcal carriage, as determined by the molecular method, was 30.8 % (95 % confidence interval (CI): 26.1-35.8), while after excluding non-typeable pneumococci from the oropharyngeal sample, the carriage prevalence was 20.8 % (95 % CI: 16.79-25.31). The serotype coverage rates by pneumococcal vaccine were 12.3 %, 13.1 %, and 16.4 % for PCV13, PCV15 or PCV20, and PPSV23, respectively, while the non-vaccine type was the majority (45.1 %). The most common serotype was 19B/C (35.5 %), followed by 6 A/B/C/D (10.7 %). The age group under 65 years was associated with a higher pneumococcal carriage rate than the age group 85 and older (odds ratio (OR): 5.01, 95 % CI: 1.75-14.36). There was no significant difference between SARS-CoV-2 and carriage status. CONCLUSIONS: The prevalence of pneumococcal carriage in Thais was high. The majority of serotypes were not covered by the vaccine. Further studies on the link between carriage serotypes and disease are required. The magnitude and serotype distribution of carriage were comparable in the SARS-CoV-2 positive and negative groups.

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OBJECTIVE@#To assess the effect and safety of Reyanning Mixture (RYN) in treating asymptomatic or mild severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents.@*METHODS@#This is a prospective, open-label, randomized controlled trial. Patients aged 1-17 years and diagnosed with asymptomatic or mild coronavirus disease-2019 (COVID-19) were assigned to an intervention group (RYN plus standard care) and a control group (standard care) according to a randomization list. The primary outcomes were SARS-CoV-2 negative conversion time. Secondary outcomes included negative conversion rate on days 3 and 7, hospital length of stay, symptom relief rate, new-onset symptoms of asymptomatic infected patients, and progressive disease rate. The cycle threshold (Ct) values of ORF1ab or N genes were also tested.@*RESULTS@#A total of 214 patients in the intervention group and 217 in the control group were analyzed. The SARS-CoV-2 negative conversion time was significantly shortened in the intervention group [5 days (interquartile range (IQR): 5-6) vs. 7 days (IQR: 6-7), P<0.01]. By days 3 and 7, the negative conversion rates were significantly higher in the intervention group (day 3: 32.7% vs. 21.2%, P=0.007; day 7: 75.2% vs. 60.8%, P=0.001). Ct values significantly increase on day 2 [ORF1ab gene: 35.62 (IQR: 29.17-45.00) vs. 34.22 (IQR: 28.41-39.41), P=0.03; N gene: 34.97 (IQR: 28.50-45.00) vs. 33.51 (IQR: 27.70-38.25), P=0.024] and day 3 [ORF1ab gene: 38.00 (IQR: 32.72-45.00) vs. 35.81 (IQR: 29.96-45.00), P=0.003; N gene: 37.16 (IQR: 32.01-45.00) vs. 35.26 (IQR: 29.09-45.00), P=0.01]. No significant difference was found in hospital length of stay between the two groups (P>0.05). Symptoms of cough were significantly improved (82.2% vs. 70.0%, P=0.02) and wheezing was significantly reduced (0.7% vs. 12.9%, P<0.01) in the intervention group compared with the control group. During the trial, no disease progression or serious adverse events were reported.@*CONCLUSION@#Adding RYN to standard care may be a safe and effective treatment for children with asymptomatic and mild SARS-CoV-2 infection. (Registration No. ChiCTR2200060292).

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The development of new and novel drugs starts following a path of targeting possible candidate drug, elucidation their mechanism of action, animal studies, and finally after the completion of phases I/II and III clinical trials. The fundamental raw materials of drugs may be synthetic substances or plants. Many plants are habitually used in many countries as food or for the remedy of diseases. We found that a tribal population of Bangladesh use an herbal plant regularly and this plant has been shown to have potential positive effect for management of coronavirus disease-2019 (COVID-19). The present observation assessed the incidence and fatality of this community inhabitants due to COVID-19. Although a conclusion cannot be reached due to small sample size, this approach and theological concept may be helpful for the development, discovery, and innovation of new drugs for different pathological conditions. How to cite this article: Rahim MA, Singha SK, Foez SA, et al. Scientific Insights for Drug Development Based on Normal Habitat of Tribal Population of Manipur: An Observational Study Regarding the Implication of "Houttuynia cordata". Euroasian J Hepato-Gastroenterol 2023;13(2):142-144.

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BACKGROUND: During the recent Coronavirus pandemic, many universities realized that the traditional delivery of educational content was not adequate in the context of imposed restrictions. Adoption of e-learning was one obvious way to foster continuity of learning. Despite its rapid implementation during the lockdown in Uganda, it was not known whether health professional students were willing to adopt e-learning as a way to foster continuity of learning. We, therefore, adopted a Technology Acceptance Model to determine the predictors for the adoption of e-learning using learner and information technology variables. METHODS: A cross-sectional study among 109 health professional students ≥18 years of age at Clarke International University was conducted. Adoption of e-learning was measured as a self-report. Data were obtained using a smart survey and descriptively summarized. The differences in the study outcome were compared using the chi-square test. The factors that independently influenced the adoption of e-learning were determined using binary logistic regression and reported as adjusted odds ratios (aORs) with a 95% confidence interval (CI). RESULTS: Of the 109 respondents, 71 (65.1%) adopted e-learning. Our data showed low odds of adoption of e-learning among participants in first year (aOR, 0.34: 95%CI, 0.14-0.79), low e-learning expectations (aOR, 0.01: 95%CI, 0.01-0.34), no confidence in using IT devices (aOR, 0.16: 95%CI, 0.00-0.77), no prior experience in e-learning (aOR, 0.11: 95%CI, 0.02-0.68), not considering e-learning flexible (aOR, 0.25:95%CI, 0.08-0.86) and high cost of internet (aOR, 0.13: 95%CI, 0.02-0.84). CONCLUSION: We identified predictors of e-learning adoption which include having completed at least 1 year of study, high e-learning expectations, confidence in using IT devices, prior experience in e-learning, considering e-learning to be flexible and internet access. This information can be used by universities to enhance infrastructure and prepare potential e-learners.

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Acute respiratory distress syndrome (ARDS) in COVID-19 has been associated with catastrophic inflammation. We present measurements in humans and a new animal model implicating a role in danger-associated molecular patterns. Calprotectin (S100A8/A9) and high-mobility group box 1 (HMGB1) were measured in patients without/with ARDS, and admission calprotectin was associated with soluble urokinase plasminogen activator receptor (suPAR). An animal model was developed by intravenous injection of plasma from healthy or patients with COVID-19 ARDS into C57/BL6 mice once daily for 3 consecutive days. Mice were treated with one anti-S100A8/A9 antibody, the IL-1 receptor antagonist anakinra or vehicle, and Flo1-2a anti-murine anti-IL-1α monoclonal antibody or the specific antihuman IL-1α antibody XB2001 or isotype controls. Cytokines and myeloperoxidase (MPO) were measured in tissues. Calprotectin, but not HMGB1, was elevated in ARDS. Higher suPAR indicated higher calprotectin. Animal challenge with COVID-19 plasma led to inflammatory reactions in murine lung and intestines as evidenced by increased levels of TNFα, IL-6, IFNγ, and MPO. Lung inflammation was attenuated with anti-S100A8/A9 pre-treatment. Anakinra treatment restored these levels. Similar decrease was found in mice treated with Flo1-2a but not with XB2001. Circulating alarmins, specifically calprotectin, of critically ill COVID-19 patients induces tissue-specific inflammatory responses through an IL-1-mediated mechanism. This could be attenuated through inhibition of IL-1 receptor or of IL-1α.

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The increased severity of the COVID-19 infection due to new SARS-CoV-2 variants has resonated pandemic impact which made health experts to re-evaluate the effectiveness of pandemic management strategies. This becomes critical owing to the infection in large population and shortcomings in the existing global healthcare system worldwide. The designing of high-performance nanosystems (NS) with tunable performances seems to be the most efficient method to tackle infectious SARS-CoV-2 variants including recently emerged omicron mutation. In this direction, experts projects the versatile functionalized NS and their capabilities to mitigate SARS-CoV-2 propagation pathways by sensitization, antipathogenicity, photocatalysis, photothermal effects, immune response, developing efficient diagnostics assays or associated, selective biomarkers detection, and targeted drug delivery systems. To achieve these tasks, this opinion article project the importance of the fabrication of nano-enabled protective gear, masks, gloves, sheets, filtration units, nano-emulsified disinfectants, antiviral/bacterial paints, and therangostics to facilitate quarantine strategies via protection, detection, and treatment needed to manage COVID-19 pandemic in personalized manners. These functional protective high-performance antibacterial and antiviral NS can efficiently tackle the SARS-CoV-2 variants transmission through respiratory fluids and pollutants within water droplets, aerosols, air, and particulates along with their severe infection via neutralizing or eradicating the virus.

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Various variants of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began emerging worldwide from the end of 2020 to the beginning of 2021. The variants GRY/VOC202012/01 (B1.1.7), GH/N501Y.V2 (B1.351), and GR/N501Y.V3 (P1) are characterized by N to Y amino acid substitution at position 501 in the S protein. The variant containing L to R substitution at position 452 in the S protein G/L452R.V3 (B1.617) was endemic to India. The heightened concern regarding these variants is related to their increased viral infectivity. Information about nucleotide mismatch(es) on the primer/probe sequence is important for maintaining good performance of real-time PCR assays. In this study, real-time RT-PCR assays developed by the National Institute of Infectious Diseases, Japan (NIID-N2 and NIID-S2 assays), were reviewed to analyze nucleotide mismatches of variants in primer/probe sequences. The frequency of mismatched sequences in three variants (GRY/VOC202012/01, GH/N501Y.V2, and GR/N501Y.V3) was lower than that in all SARS-CoV-2 sequences. The mismatch, that G to C substitution at nucleotide 8 in reverse primer of S2 set, elevated to about 16.3% in G/L452R.V3, however the substitution did not affect the analytical sensitivity of assay. Therefore, the study indicates that the NIID-N2 and NIID-S2 sets detect VOCs of SARS-CoV-2 with reliable efficiency.

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BACKGROUND: Neurologic, pulmonary, cardiac and gastrointestinal functional disorders can persist in the post-acute phase and constitute a long COVID syndrome, also known as post-acute sequelae of SARS-CoV­2 infection (PASC). Some patients develop persistent and debilitating symptoms despite a relatively mild illness at onset and they are known as COVID-19 long haulers. OBJECTIVE: Presentation of symptoms, signs and biomarkers present in patients previously affected by COVID-19 and discussion of possible underlying mechanisms and consequences. METHODS: Existing literature and reported cases as well as expert opinions are analyzed and discussed. RESULTS: Long COVID affects survivors of COVID-19 at all levels of disease severity, even in mild to moderate cases and younger adults who did not require respiratory support, hospitalization or intensive care. A challenging aspect is that many long haulers never had laboratory confirmation of COVID-19, raising skepticism that the persistent symptoms have a physiological basis. On the other hand, some symptoms seen in post-acute COVID-19 may occur as a consequence of critical illness or as a side effect of treatment. CONCLUSION: Given that COVID-19 is a new disease, it is not possible to determine how long these effects will last. Long-term monitoring of post-acute COVID-19 symptoms and screening for frequent comorbid conditions are essential.

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BACKGROUND: The rapid process of research and development and lack of follow-up time post-vaccination aroused great public concern about the safety profile of COVID-19 vaccine candidates. To provide comprehensive overview of the safety profile of COVID-19 vaccines by using meta-analysis technique. METHODS: English-language articles and results posted on PubMed, Embase, Web of Science, PMC, official regulatory websites, and post-authorization safety surveillance data were searched through June 12, 2021. Publications disclosing safety data of COVID-19 candidate vaccines in humans were included. A meta-analysis of proportions was performed to estimate the pooled incidence and the pooled rate ratio (RR) of safety outcomes of COVID-19 vaccines using different platforms. RESULTS: A total of 87 publications with safety data from clinical trials and post-authorization studies of 19 COVID-19 vaccines on 6 different platforms were included. The pooled rates of local and systemic reactions were significantly lower among inactivated vaccines (23.7%, 21.0%), protein subunit vaccines (33.0%, 22.3%), and DNA vaccines (39.5%, 29.3%), compared to RNA vaccines (89.4%, 83.3%), non-replicating vector vaccines (55.9%, 66.3%), and virus-like particle vaccines (100.0%, 78.9%). Solicited injection-site pain was the most common local reactions, and fatigue and headache were the most common systemic reactions. The frequency of vaccine-related serious adverse events was low (< 0.1%) and balanced between treatment groups. Vaccine platforms and age groups of vaccine recipients accounted for much of the heterogeneity in safety profiles between COVID-19 vaccines. Reporting rates of adverse events from post-authorization observational studies were similar to results from clinical trials. Crude reporting rates of adverse events from post-authorization safety monitoring (passive surveillance) were lower than in clinical trials and varied between countries. CONCLUSIONS: Available evidence indicates that eligible COVID-19 vaccines have an acceptable short-term safety profile. Additional studies and long-term population-level surveillance are strongly encouraged to further define the safety profile of COVID-19 vaccines.

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Coronavirus Disease 2019 (COVID-19) manifests as extreme acute respiratory conditions caused by a novel beta coronavirus named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) which is reported to be the seventh coronavirus to infect humans. Like other SARS-CoVs it has a large positive-stranded RNA genome. But, specific furin site in the spike protein, mutation prone and phylogenetically mess open reading frame1ab (Orf1ab) separates SARS-CoV-2 from other RNA viruses. Since the outbreak (February-March 2020), researchers, scientists, and medical professionals are inspecting all possible facts and aspects including its replication, detection, and prevention strategies. This led to the prompt identification of its basic biology, genome characterization, structural and expression based functional information of proteins, and utilization of this information in optimizing strategies to prevent its spread. This review summarizes the recent updates on the basic molecular biology of SARS-CoV-2 and prevention strategies undertaken worldwide to tackle COVID-19. This recent information can be implemented for the development and designing of therapeutics against SARS-CoV-2.

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BACKGROUND: The spread of novel coronavirus diseases-2019 (COVID-19) across the world and its associated morbidity and mortality confronted the nations by various means. COVID19 pandemic had significant psychological effects not only on the general population but also on health-care workers (HCWs). Hence, we aimed to found the level of anxiety and depression among health-care professionals amidst coronavirus. MATERIALS AND METHODS: This is a cross-sectional study conducted on 829 participants including doctors and nurses and other medical staff who were posted in the COVID ward and COVID intensive care unit using a well-structured questionnaire through the Google Forms. The two scales used to measure anxiety and depression among the HCWs were the Hamilton anxiety scale (HAM-A) and the Patient Health Questionnaire (PHQ-9), Cronbach's alpha of HAM A is 0.921 and Cronbach's alpha of PHQ 9 is 0.851. Data analysis was done using SPSS 26, Chi-square test and Fisher's exact test were used to establish the association between categorical independent and dependent variables. RESULTS: The results of this study demonstrate that anxiety and depression were significantly higher in doctors and staff nurses as compared to other medical staff. According to HAM-A, 65.1% of respondents were in the mild category, 22.0% mild to moderate, and 12.9% moderate to severe. The HAM-A (P = 0.022) and PHQ-9 (P = 0.001) for anxiety and depression respectively were significantly higher in females. The means of the scales got increased after postings in the corona wards. CONCLUSION: Concerning the high occurrence of anxiety and fear among health-care professionals, appropriate psychological/psychiatric intervention necessitates and emphasizes the need to implement urgent measures to prevent further progress to severe mental health disorder.

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The COVID-19 pandemic significantly destructs the rhythm of global modern human civilization but worldwide lockdown radically recovers the health of the total environment. The Himalayan trans-boundary rivers provide huge provisional, regulatory and cultural ecosystem services to millions of people throughout the year but in the recent years the water quality is being deteriorated due to multiple reasons. In the last decade, India-Bangladesh political relationship has been slightly broken down due to water sharing and environmental flow of rivers.The COVID-19 lockdown offered a great scope to execute the comparative study among pre, lockdown and unlock phase. The research attempts to investigate the spatiotemporal water quality of trans-boundary rivers through WAWQI and irrigation water quality indices such as Sodium absorption ratio, Soluble sodium percentage, Potential salinity, Magnesium hazard and Kelly's index considering eighteen water quality parameters (pH, EC, TDS, TSS, Ca²âº, Mg²âº, Na²âº, K⁺, F-, Cl-, NO3-, SO4²-, PO43-, DO, T, TUR, COD and BOD). The result shows the strong positive correlation between EC and TDS during three phases. Significant reduction of BOD, COD and TUR has been noticed almost 70% stations during lockdown compared with prelockdown while augmentation of DO has been recorded around 40% stations. WQI of most of the stations shows around 80% improvement of water quality during lockdown period. Moreover, worst kind of WQI was found in the Mathabhanga-Churni river followed by Mahananda. During lockdown, the striking results show that SAR and MH were significantly amplified in most of the stations due to agricultural run-off.

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In present study, the variation in concentration of key air pollutants such as PM 2.5, PM 10, NO 2, SO 2 and O 3 during the pre-lockdown and post-lockdown phase has been investigated. In addition, the monthly concentration of air pollutants in March, April and May of 2020 is also compared with that of 2019 to unfold the effect of restricted emissions under similar meteorological conditions. To evaluate the global impact of COVID-19 on the air quality, ground-based data from 162 monitoring stations from 12 cities across the globe are analysed for the first time. The concentration of PM 2.5, PM 10 and NO 2 were reduced by 20-34%, 24-47% and 32-64%, respectively, due to restriction on anthropogenic emission sources during lockdown. However, a lower reduction in SO 2 was observed due to functional power plants. O 3 concentration was found to be increased due to the declined emission of NO. Nevertheless, the achieved improvements were temporary as the pollution level has gone up again in cities where lockdown was lifted. The study might assist the environmentalist, government and policymakers to curb down the air pollution in future by implementing the strategic lockdowns at the pollution hotspots with minimal economic loss.

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OBJECTIVE: To study the working experience of COVID-19 care nurses. METHODS: Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software. RESULTS: Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life. CONCLUSIONS: s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.

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The novel coronavirus (SARS-CoV-2) infection which has been known as Coronavirus diseases 2019 COVID-19 has become an endemic emergent situation by the World Health Organization. So far, no successful specific treatment has been found for this disease. As has been reported, most of non-survivor patients with COVID-19 (70%) had septic shock which was significantly higher than survived ones. Although the exact pathophysiology of septic shock in these patients is still unclear, it seems to be possible that part of it would be due to the administration of empiric antibiotics with inflammatory properties especially in the absence of bacterial infection. Herein, we have reviewed possible molecular pathways of septic shock in the patients who have received antibiotics with inflammatory properties which mainly is release of interleukin 1ß (IL-1ß), IL-6, and tumor necrosis factor α (TNF- α) through different routes. Altogether, we highly recommend clinicians to look after those antibiotics with anti-inflammatory activity for both empiric antibiotic therapy and reducing the inflammation to prevent septic shock in patients with diagnosed COVID-19.

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OBJECTIVE@#To study the working experience of COVID-19 care nurses.@*METHODS@#Twenty two nurses taking care of COVID-19 patients were interviewed by means of descriptive phenomenology. All the data were transcribed and recorded, and then processed into WORD documents. The Colaizzi 7 footwork was used to classify, encode, establish nodes and extract themes based on Nvivo11.0 software.@*RESULTS@#Two main themes were extracted: one is the positive feelings of nurses, including the sense of professional mission and pride, the sense of achievement and happiness, the improvement of self-worth and ability, the powerful support system and the power of role models; the other is the negative experience of nurses, including the worry and anxiety at work, the lack of experience and trust, the difficulty of work, and the inconvenience of isolating life.@*CONCLUSIONS@#s While fully affirming the work value of nurses, it is necessary for the society, hospitals and patients to give extensive and continuous support, care and respect to nurses, so as to stimulate their working enthusiasm and sense of professional achievement. Hospital managers need to implement all kinds of security work, meet the safety needs of nurses, pay attention to the physical and mental health of nurses, strengthen the training of nursing talents for critical and severe diseases and infectious diseases, improve the allocation of human resources, and enhance the ability of material allocation and reserve for major health events, so as to make adequate preparations for coping with public health events in the future.

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Objective To learn about the current situation and trends of novel coronavirus diseases 2019 (COVID-2019) in foreign countries. Methods The data on confirmed COVID-2019 cases were collected between January 20, 2020 and February 18, 2020 and by age, sex, nationality, contact history, region, and country were performed stratified analysis and onset time analysis. Results From January 20th to February 18th, the cumulative number of confirmed cases of COVI D-2019 abroad was 804. Excluding the 454 cases on the 'Diamond Princess' cruise ship in Japan, the daily number of new cases fluctuated, showed a trend of rising first and then maintaining a steady trend. The peak date for new cases was on February 1, with the number of cases reaching 26. The confirmed cases were mainly concentrated in Asian countries, but also distributed in Europe, North America, Oceania and Africa. As of February 15, there was no more increase reported in the number of countries where confirmed cases occurred after reaching 25. Among these countries, Singapore, Japan, and Thailand were with the highest number of cases, with 77, 65, and 35 cases, respectively. In accordamce to available information on confirmed cases, the cases with history of exposure to confirmed cases were more than those with history of living or traveling in Hubei. And more cases were non-Chinese nationalities, 40 years old and above, and males . Conclusion The novel coronavirus has transmitted abroad, and produced second-generation cases. Although the incidence is low abroad , its trend fluctuates greatly, so sufficient attention must be paid to the possibility of further transmission.

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Objective To analyze the development and changes of novel coronavirus diseases 2019 (COVID-19) in the six neighboring provinces of Hubei. Methods The COVID-19 epidemic data of Hubei and its six neighboring provinces released by the National Health and Health Commission and local governments from January 11, 2020 to March 22, 2020 was collected. Joinpoint regression model was used to analyze the trend of cumulative confirmed cases, daily new confirmed cases and daily average confirmed cases according to the daily change percentage (DPC) and average daily percentage change (ADPC). Results As of March 22, 2020, a total of 5,036 confirmed cases were reported in the six neighboring provinces of Hubei, among which Henan, Hunan and Anhui ranked the top three, with 1,272, 1,018, and 990 cases, respectively, accounting for 65.13% of the total cases. The inflection points of the cumulative number of confirmed cases in the six provinces were January 24 and February 5, with an average growth rate of 5.27% [ADPC (95% CI) = 5.27% (3.71%, 6.85%), P < 0.05)], which was different from Hubei where the inflection points of the cumulative diagnosis number were February 2 and February 15, with an average growth rate of 10.77 % [ADPC 9995% CI) = 10.77% (9.12%, 12.44%), P < 0.05]. The average number of new cases per day in 28 days, 21 days, 14 days and 7 days from the last case report (February 28, Hunan) was 116.93, 55.48, 12.93 and 1.86, respectively, showing a significant downward trend (DPC 95%CI = -79.04（-88.95, -43.62）%, P<0.05). The peak number of new cases per day in the six neighboring provinces occurred on February 4 (309 cases), and the inflection point was February 5, showing a sharp increase (DPC = 25.53%, P < 0.05), and then a rapid decline (DPC = - 28.46%, P < 0.05). The total case fatality rate of the six provinces was 0.79%, which was lower than that of Hubei (4.65%). Conclusion The measures taken by the six provinces and cities adjacent to Hubei Province in the prevention and control of domestic imported risks are active and effective. It is necessary to summarize and optimize the strategies in time to prevent possible second transmission in the future.