ABSTRACT
The sudden outbreak of COVID-19 in 2020 causes great impact on the economic development of all countries and even the whole world. Under the background of major public emergencies, a timely dynamic evaluation of regional economic resilience can provide an objective basis for economic regulation and control behavior. Based on the existing evaluation model, an improved dynamic evaluation model of grey incidence projection- fuzzy matter element is proposed in this study. The improved model is a universal evaluation model that can be used in different contexts. This model method can, not only limited to analyzing economic resilience, but also be applied to other different contexts. The evaluation indexes are selected (from the market, industry, investment, foreign trade and finance) to construct an evaluation index system of regional economic resilience under major public emergencies. The improved dynamic evaluation model of grey incidence projection- fuzzy matter element is applied to evaluate economic resilience of Hubei province (with its neighboring areas) in context of COVID-19. At the same time, the relative validity of the model is tested based on the empirical evaluation results.
ABSTRACT
Background: Conflicting evidence exists on the impact of the COVID-19 pandemic restrictions on stillbirth rates in developed countries. We aimed to examine and compare the incidence rates of stillbirth before and after the implementation of COVID-19 measures in Canada and Japan. Method(s): We conducted two populationbased studies using mother-infant linked data from JMDC hospitalizations database (JMDC Inc.) in Japan and administrative health databases in Manitoba, Canada, from October 2016 to March 2021. We used interrupted time series analysis (generalized linear models) to investigate the immediate change in level and rebound change in quarterly rates of stillbirth (fetal death > 20 weeks of gestation). We modeled the forecasted trends based on prepandemic data via autoregressive moving average models. Result(s): We included 70,931 and 169,883 pregnancies in Manitoba and Japan during the study period, respectively. On average, stillbirth rates were 0.66% in Manitoba and 0.31% in Japan. The pandemic restrictions were associated with an immediate relative increase in stillbirths in Japan by 19.19% (beta2=0.05;p=0.5693) and in Manitoba by 18.6% (beta2=0.12;p=0.4434). However, the quarterly stillbirth rates decreased (beta3=0.1625, p=0.5066) in Japan and Manitoba (beta3=0.011, p=0.8296) during the pandemic period. During the first quarter of 2021, the absolute differences in the observed and forecasted rates in Manitoba and Japan were 0.04% and -0.05%, respectively. Conclusion(s): Although various approaches were implemented to address the pandemic in Manitoba (Canada) and Japan, we found no evidence of a significant increase in the incidence of stillbirth rates during the first year of the pandemic. Healthcare services in Canada and Japan have experienced substantial changes since the start of the COVID-19 pandemic, with little influence on stillbirth rates at population level. This study will further examine the effect of the pandemic measures on other adverse pregnancy outcomes in both countries.
ABSTRACT
Background: Limited evidence exists on the pandemic's role in limiting access and use of prenatal care services and the quality of care for pregnant women. We aimed to investigate the impact of the pandemic restrictions on in-person prenatal care visits (PNCV) and the quality of prenatal care. Method(s): Using the mother-infant-linked administrative health databases in Manitoba, Canada, we conducted a province-wide population-based cohort study among independent pregnancies. We examined the quarterly rates of PNCV before (October 2016-March 2020) and during (April 2020-March 2021) the pandemic. Quality of prenatal care was categorized using the Revised Graduated Prenatal Care Utilization Index (R-GINDEX) into inadequate (<50% visits), intermediate (50%-80% visits), adequate (>80% visits), intensive (high-risk), and no care. Interrupted time series analyses were conducted to assess the immediate and lagged changes in PNCV and quality of care after the implementation of pandemic restrictions. Result(s): Amongst 70,931 pregnancies, we observed no significant mean difference in the overall numbers of PNCV during the pandemic compared to prepandemic (8.2 vs. 8.6,p=0.0837). Prenatal care utilization was 3.4% inadequate and 34.7% adequate before the pandemic and 4.8% and 26.6% during the pandemic, respectively. Restrictions were associated with an abrupt decline in adequate and intermediate care during the first trimester by 11.3% (p<0.001) and 11.98%, respectively, followed by non-significant change throughout the pandemic (beta3=-0.25,p=0.694 and beta3=-0.96,p=0.192, respectively). Moreover, restrictions were associated with an increased rate of inadequate care during the first (beta2=1.52,p=0.007) and second trimesters (beta2=0.78,p=0.208), and not among third trimesters (beta2=-0.44,p=0.094). During the pandemic, we found no significant differences in the rates of intensive prenatal care during the first (p=0.478), second (p=0.614), and third (p=0.608) trimesters compared to pre-pandemic. Conclusion(s): Our findings suggest a decline in adequacy levels of prenatal care services after COVID-19 restrictions were enacted, with a higher impact on pregnancies during their first and second trimesters. Although the overall adequacy of care decreased, there were no changes to the rates of intensive visits. This study will further investigate the impact of the pandemic on virtual PNCV and assess the association between the quality of prenatal care and adverse maternal and neonatal outcomes.
ABSTRACT
Background: In response to the COVID-19 outbreak in China, we opened the hospital-based video consultation service that allows virtual visits for outpatients with any illness. Although telemedicine used widely during the pandemic, there is lack of data to estimate the demand and effect in an outbreak. Here we retrospectively evaluate the effect of virtual service in a tertiary hospital and breakdown the whole volume data. Method(s): Between Jan30,2020 and Mar12,2020, the video-consultation station was set up in the hospital and specialists staffed the service equivalent to previous in-person care service for outpatients. The service fielded calls for fever triage and other complaints to a total of 122 specialists from 34 branches of medicine, each consultation was recorded. Result(s): Over 41 days, 570 called to report fever, 16 (3%) of whom were asked to the facility for further care. None was addmited to hospital. The remaining 554 (97%) were followed up at home by telemedicine. Among the 4811 patients who called for other illnesses, 568(11.8%) were asked to visit the clinic for further care. Among these present to hospital after calling, 35.6% got further care in Reproductive medicine, 11.8% in Obstetrics, 6.5% in Endocrinology, 5.6% in Gynecology, 40.5% in other divisions. The remained 4243(88.2%) were followed up at home through the telemedicine service. The average recovery course was 3.2 days by self-report. Conclusion(s): We found the telemedicine service reduced the potential in-person visits volume by 90%. Adjusting the panel of hybrid specialists scheduel to meet different volume demand of branches is needed to rebuild a more resilient hospital strategy for outpatient care in the pandemic.
ABSTRACT
Background: The effect of time to surgery after completion of neoadjuvant chemotherapy and outcomes in breast cancer patients remains poorly defined and unclear. Acceptable time to surgery has frequently been arbitrarily defined as between four to eight weeks. Various factors including resource limitation, scheduling conflicts, complications after chemotherapy, patient hesitation or interruptions from major events such as the recent Covid-19 pandemic can delay time to surgery, raising concern of an adverse impact on recurrence and survival outcomes. This study aims to ascertain if time to surgery after completion of neoadjuvant chemotherapy impacts disease free survival (DFS) and overall survival (OS). Material(s) and Method(s): This single-institution retrospective study included patients who underwent neoadjuvant therapy and subsequent surgery from 2006 to 2017. Demographic, clinicopathological factors and surgical data from 250 patients were analysed. 105 patients received surgery within 28 days (group 1). 119 patients received surgery within 29 to 56 days (group 2), and 26 patients received surgery after 57 days or more (group 3). DFS and OS among the three groups were compared. Result(s): Age, race, pre-chemotherapy stage, tumour type, grade, hormone receptor status, Her2 status, focality, lymphovascular invasion (LVI), radiological response to chemotherapy, type of surgery, pathological response to chemotherapy, and receipt of adjuvant radiotherapy were not significantly different between the three groups. Receipt of adjuvant chemotherapy was statistically significant (p = 0.0248) with 39 patients (37.1%) in group 1, 32 patients (26.9%) in group 2 and 3 patients (11.5%) in group 3 receiving further chemotherapy after surgery. Mean follow-up duration was 44.5 months. DFS and OS between the three groups were not found to be significantly different (p = 0.5920 and p = 0.6133 respectively). Conclusion(s): Time to surgery after completion of neoadjuvant chemotherapy did not appear to affect recurrence or survival outcomes. This result was demonstrated despite fewer patients in the group with the longest duration to surgery receiving adjuvant chemotherapy. This may be due to the efficacy of neoadjuvant chemotherapy in decreasing or eliminating micro-metastatic disease, an important factor in cancer recurrence and survival. Limitations of this study includes its retrospective nature and small sample size. Findings from this study may allow more flexibility and reduce the burden of scheduling patients for surgery within the usual four to eight week window in centres with resource and scheduling constraints. Further studies examining a larger population over a wide range of time durations could help clinicians better tailor time to surgery after neoadjuvant therapy. No conflict of interest. Copyright © 2022 Elsevier Ltd. All rights reserved
ABSTRACT
With the emergence of COVID-19 at the end of year 2019, movement restricting policies have been implemented worldwide to curb the spread of this disease. Most controls have been imposed to prohibit the operation of non-essential services, even including the closures of workplaces and schools. University students have been facing an even higher level of uncertainty as remote learning becomes the main medium of transferring knowledge. This research has identified the effects of COVID-19 on the sentiment and relationships of university students. The methods used in analysis will include sentiment analysis, topic modelling, and community detection on data collected from the Reddit social media platform for two universities located in different countries. Based on the obtained analysis results, it is determined that COVID-19 does have an impact on the sentiment and relationships between university students. The change of behaviors has some similarity that includes a higher range of sentiment expressed during the pandemic, and a social network structure of communities with similar sizes between universities. Some difference has also been noticed, where the changes in sentiment is expressed in different topics that is based on local events, and the change of structure for smaller communities during the pandemic. It is concluded that changes in the sentiment and relationships of the student community can be identified through the proposed methods, and therefore can be used as a guideline for local authorities and higher education institutions to take the measures to ensure the problems faced by students can be properly addressed. © 2021 IEEE.
ABSTRACT
Background: The thoracic surgery team of the Shanghai Chest Hospital has been publishing its annual report since 2018, summarizing the services and major progress over the last year. Methods: All patients receiving thoracic surgery services at the Department of Thoracic Surgery and the Department of Oncological Surgery at the Shanghai Chest Hospital in 2020 were enrolled. The number of surgical resections, types of surgical procedures, disease histological types, and perioperative outcomes were collected and compared with the results from previous years. Results: In the year 2020, the thoracic team of the Shanghai Chest Hospital faced the unprecedented challenge of the coronavirus disease 2019 (COVID-19) epidemic. A total of 15,664 patients received thoracic surgeries at the Shanghai Chest Hospital, only an 8.0% decrease compared with the previous year of 2019. These included 13,493 pulmonary procedures, 1,075 esophageal procedures, 969 mediastinal procedures, 66 tracheal procedures, 2 lung transplantations, and 59 other procedures. The rate of minimally invasive surgeries among all procedures was 91.1%, including 721 robotic-assisted thoracic surgeries, both of which increased from the year before. In addition, the average length of hospital stay continuously decreased, being only 3.82 days after pulmonary surgery and 10.96 days after esophageal surgery. Meanwhile, the quality of thoracic surgery has improved, with continuously lower rates of perioperative complications and an in-hospital mortality rate of only 0.14%. Conclusions: The services provided and progress made in 2020 by the thoracic surgery team of the Shanghai Chest Hospital were reviewed in this annual report, reflecting a consistent effort to help our patients with high-standard services and state-of-the-art surgical techniques. © 2022 Shanghai Chest. All rights reserved.
Subject(s)
COVID-19 , Students, Medical , Career Choice , Humans , Pandemics/prevention & control , SARS-CoV-2ABSTRACT
Purpose One of the most significant threats of COVID-19 in the world is the closure of universities, schools, training courses and even companies and organizations. In such a situation and with the free time that has arisen, this threat of education closure can become a golden opportunity for learning and progress in virtual education. E-learning uses information technology (IT) to distribute knowledge and information for training and education. Also, cloud computing is a technology utilized in the IT domain. It can be employed in performing e-learning. Therefore, the main goal of this study is to assess the impact of cultural characteristics, economic situations, skills and knowledge on the development and success of CELS in the COVID-19 era. Design/methodology/approach Cloud-based e-learning system (CELS) provides all e-learning requirements like software and hardware resources to promote conventional e-learning technologies. The CELS stands on several factors of diverse aspects that have been of high significance in CELS success. So, these systems must be checked to analyze their significance rate and successfully carry out their effectiveness. On the other hand, these days, the 2019 coronavirus disease (COVID-19) changes our daily lifestyles. Therefore, the present investigation provides a new model investigating the development and success of CELS in the COVID-19 era. Also, an online questionnaire was used to gather the data. The content validity of the questionnaire was obtained by applying the opinions of ten experts from e-learning specialists. The collected data are analyzed using LISREL and Smart PLS software. Findings The results from the path coefficient and the sample t-test have implied that skills and knowledge positively influence CELS in the COVID-19 era. In addition, the relationship between cultural characteristics and CELS in the COVID-19 era has been positive and significant. The relationship between the economic situations and the CELS in the COVID-19 era is positive and significant. Practical implications The proposed model helps managers get a big picture of CELS necessities and more effectively in the COVID-19 era. This research has a unique impact on universities to develop an e-learning platform to facilitate the education process in the COVID-19 era. It provides guidelines for educational institutions to effectively implement the learning management system to facilitate students' education. Originality/value CELS are getting increasingly essential to offer training courses more efficiently in educational institutions. Although the intersection between cloud computing and e-learning has increasingly grown in both practical and academic contexts, few studies on the impact of cultural characteristics, economic situations, skills and knowledge on the development and success of CELS in the COVID-19 era. This paper explores the ignored but critically important subject of CELS. This paper's main contribution is to present a new and integrated model containing the essential aspects of the development and success of CELS in the COVID-19 era. The proposed framework comprises cultural characteristics, economic situations, skills and knowledge aspects simultaneously, as well as sub-criteria denoting each element.
ABSTRACT
BACKGROUND: Vietnam has emerged as one of the world's leading success stories in responding to COVID-19. After a prolonged period of little to no transmission, there was an outbreak of unknown source in July, 2020, in the Da Nang region, but the outbreak was quickly suppressed. We aimed to use epidemiological, behavioural, demographic, and policy data from the COVID-19 outbreak in Da Nang to calibrate an agent-based model of COVID-19 transmission for Vietnam, and to estimate the risk of future outbreaks associated with reopening of international borders in the country. METHODS: For this modelling study, we used comprehensive data from June 15 to Oct 15, 2020, on testing, COVID-19 cases, and quarantine breaches within an agent-based model of SARS-CoV-2 transmission to model a COVID-19 outbreak in Da Nang in July, 2020. We applied this model to quantify the risk of future outbreaks in Vietnam in the 3 months after the reopening of international borders, under different behavioural scenarios, policy responses (ie, closure of workplaces and schools), and ongoing testing. FINDINGS: We estimated that the outbreak in Da Nang between July and August, 2020, resulted in substantial community transmission, and that higher levels of symptomatic testing could have mitigated this transmission. We estimated that the outbreak peaked on Aug 2, 2020, with an estimated 1060 active infections (95% projection interval 890-1280). If the population of Vietnam remains highly compliant with mask-wearing policies, our projections indicate that the epidemic would remain under control even if a small but steady flow of imported infections escaped quarantine into the community. However, if complacency increases and testing rates are relatively low (10% of symptomatic individuals are tested), the epidemic could rebound again, resulting in an estimated 2100 infections (95% projected interval 1050-3610) in 3 months. These outcomes could be mitigated if the behaviour of the general population responds dynamically to increases in locally acquired cases that exceed specific thresholds, but only if testing of symptomatic individuals is also increased. INTERPRETATION: The successful response to COVID-19 in Vietnam could be improved even further with higher levels of symptomatic testing. If the previous approaches are used in response to new COVID-19 outbreaks, epidemic control is possible even in the presence of low levels of imported cases. FUNDING: Ministry of Science and Technology (Vietnam). TRANSLATION: For the Vietnamese translation of the abstract see Supplementary Materials section.
Subject(s)
COVID-19/epidemiology , Communicable Diseases, Imported/epidemiology , Epidemics , Travel/legislation & jurisprudence , Humans , Internationality , Models, Theoretical , Risk Assessment , Vietnam/epidemiologyABSTRACT
The pandemic of coronavirus disease 2019 (COVID-19) is continually worsening. Clinical treatment for COVID-19 remains primarily supportive with no specific medicines or regimens. Here, the development of multifunctional alveolar macrophage (AM)-like nanoparticles (NPs) with photothermal inactivation capability for COVID-19 treatment is reported. The NPs, made by wrapping polymeric cores with AM membranes, display the same surface receptors as AMs, including the coronavirus receptor and multiple cytokine receptors. By acting as AM decoys, the NPs block coronavirus from host cell entry and absorb various proinflammatory cytokines, thus achieving combined antiviral and anti-inflammatory treatment. To enhance the antiviral efficiency, an efficient photothermal material based on aggregation-induced emission luminogens is doped into the NPs for virus photothermal disruption under near-infrared (NIR) irradiation. In a surrogate mouse model of COVID-19 caused by murine coronavirus, treatment with multifunctional AM-like NPs with NIR irradiation decreases virus burden and cytokine levels, reduces lung damage and inflammation, and confers a significant survival advantage to the infected mice. Crucially, this therapeutic strategy may be clinically applied for the treatment of COVID-19 at early stage through atomization inhalation of the NPs followed by NIR irradiation of the respiratory tract, thus alleviating infection progression and reducing transmission risk.
ABSTRACT
BACKGROUND: Simulation exercises can functionally validate World Health Organization (WHO) International Health Regulations (IHR 2005) core capacities. In 2018, the Vietnam Ministry of Health (MOH) conducted a full-scale exercise (FSX) in response to cases of severe viral pneumonia with subsequent laboratory confirmation for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) to evaluate the country's early warning and response capabilities for high-risk events. METHODS: An exercise planning team designed a complex fictitious scenario beginning with one case of severe viral pneumonia presenting at the hospital level and developed all the materials required for the exercise. Actors, controllers and evaluators were trained. In August 2018, a 3-day exercise was conducted in Quang Ninh province and Hanoi city, with participation of public health partners at the community, district, province, regional and national levels. Immediate debriefings and an after-action review were conducted after all exercise activities. Participants assessed overall exercise design, conduction and usefulness. RESULTS: FSX findings demonstrated that the event-based surveillance component of the MOH surveillance system worked optimally at different administrative levels. Detection and reporting of signals at the community and health facility levels were appropriate. Triage, verification and risk assessment were successfully implemented to identify a high-risk event and trigger timely response. The FSX identified infection control, coordination with internal and external response partners and process documentation as response challenges. Participants positively evaluated the exercise training and design. CONCLUSIONS: This exercise documents the value of exercising surveillance capabilities as part of a real-time operational scenario before facing a true emergency. The timing of this exercise and choice of disease scenario was particularly fortuitous given the subsequent appearance of COVID-19. As a result of this exercise and subsequent improvements made by the MOH, the country may have been better able to deal with the emergence of SARS-CoV-2 and contain it.
Subject(s)
Disease Outbreaks/prevention & control , Public Health Surveillance/methods , COVID-19/epidemiology , COVID-19/prevention & control , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Humans , Middle East Respiratory Syndrome Coronavirus/isolation & purification , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Vietnam/epidemiology , World Health OrganizationABSTRACT
This paper summarizes the infection control practice in coronavirus disease 2019 (COVID-19) wards of Wuhan Huoshenshan Hospital. By closely focusing on the three key elements of infectious diseases and strictly following the general prevention principles, we implement systematic management, including ward design, personnel management, disinfection measures, protection management, diagnosis and treatment path, clinical specimens, redisinfection of medical equipment and clearance of garbage. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid was detected in samples from critical patients and their surrounding environments, so as to indentify the possible contamination path to guide the prevention and control. During the mission, the systematic and meticulous infection control management in the wards effectively controlled cross infections, ensured the effective and safe treatment of COVID-19 patients, with no medical staff infections occurred, providing references for infection control of wards in similar epidemics in the future.
ABSTRACT
In this paper, the mechanism of destroying human alveolar epithelial cells and pulmonary tissue by 2019 novel coronavirus (2019-nCoV) was discussed firstly. There may be multiple mechanisms including killing directly the target cells and hyperinflammatory responses. Secondly, the clinical features, CT imaging, short-term and long-term pulmonary function damage of the 2019 coronavirus disease (COVID-19) was analyzed. Finally, some suggestions for thoracic surgery clinical practice in non-epidemic area during and after the epidemic of COVID-19 were provided, to help all the thoracic surgery patients receive active and effective treatment.