The impact of dynamic adaptive teaching model on surgical education.

Objective To investigate the impact of dynamic adaptive teaching model on surgical education. Methods Due to the COVID-19 pandemic in 2020, we adopted dynamic adaptive teaching model in the Department of Breast Surgery, Peking Union Medical College Hospital, which divided the whole curriculum into several individual modules and recombined different modules to accommodate to student's levels and schedules. Meanwhile, adaptive strategy also increased the proportion of online teaching and fully utilized electronic medical resources. The present study included quantitative teaching score (QTS) recorded from January 2020 to June 2020, and used the corresponding data from 2019 as control. The main endpoint was to explore the impact of dynamic adaptive teaching model on overall QTS and its interaction effect with trainer's experience and student category. Results Totally, 20 trainers and 181 trainees were enrolled in the present study. With implementation of dynamic adaptive strategy, the overall QTS decreased dramatically (1.76+/-0.84 vs. 4.91+/-1.15, t=4.85, P=0.005). The impact was consistent irrespective of trainers' experience (high experience trainers: 0.85+/-0.40 vs. 2.12+/-0.44, t=4.98, P=0.004;medium experience trainers: 0.85+/-0.29 vs. 2.06+/-0.53, t=4.51, P=0.006;and low experience trainers: 0.10+/-0.16 vs. 0.44+/-0.22, t=2.62, P=0.047). For resident (including graduate) and undergraduate student teaching, both QTS was lower with dynamic strategy (residents: 0.18+/-0.34 vs. 0.97+/-0.14, t=4.35, P=0.007;undergraduate students 1.57+/-0.55 vs. 3.77+/-1.24, t=3.62, P=0.015), but dynamic strategy was effective for post-doc student subgroup and reached comparable QTS as traditional model (0.00+/-0.00 vs. 0.17+/-0.41, t=1.00, P=0.363). Conclusions Dynamic adaptive teaching strategy could be a useful alternative to traditional teaching model for post-doc students. It could be a novel effective solution for saving teaching resources and providing individualized surgical teaching modality.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

Converting an ED Fast Track to an ED Virtual Visit Track

ED patients with lower-acuity care needs often have long wait times for evaluation because of higher-acuity patients receiving priority for available beds. Challenges posed by the Covid-19 pandemic accelerated the launch in December 2020 of an already-developed and approved plan to integrate virtual visits into clinical care at Stanford. For both adult and pediatric EDs, Stanford extended this model into the emergency care environment by converting its existing Fast Track care unit into a Virtual Visit Track (VVT). This was done to speed the ability to evaluate lower-acuity patients in more than one ED with a single physician located at a satellite location. In the VVT, a remote physician provided care to lower-acuity patients who presented at either of the two sites, the pediatric ED or the adult ED. The physician is supported by virtual visit-enabling hardware, software, workflow development, and training, as well as by VVT-trained support staff. In the first 11 months, 2,232 patients received care through the VVT. Stanford met its resource investment break-even point of 12 patients seen during an 8-hour shift on day 6, but this patient volume was not sustained until 7.5 months into the program;this volume has remained constant since then. In a matched cohort of patients, the median ED length of stay (EDLOS) for VVT patients was 1.9 hours compared with 4.2 hours for patients cared for in the typical main ED workflow (P < .001). Also, 17 of 50 VVT physicians (34%) rated their ability to deliver a comparable level of care to in-person consultation as excellent, with the remaining 33 of 50 (66%) rating it as very good. The authors observed that the age range for VVT patients was 2-94 years, but overall, they were younger than a matched cohort of main ED patients. This may reflect generational differences in comfort with a virtual physician encounter. Within the matched cohort, they also found that the median return visit rate among VVT patients was lower than among those in the main ED for 72-hour revisits (6.7% vs. 7.2%;P = .60) and 7-day revisits (10.4% vs. 12.4%;P = .09), but the differences were not statistically significant. This suggests that VVT visit quality is not likely worse than main ED care for similarly lower-acuity patients. The aim was not to determine that the VVT model was superior, but rather that it was not inferior. Virtual care is a fast-growing method of care delivery. Although typically applied when a patient is outside of the care environment, a VVT program can be used in other situations in which options for in-person evaluation are limited. © 2022 NEJM Catalyst Innovations in Care Delivery. All right reserved.

Hot and difficult issues related to prevention and control strategies of COVID-19.

The epidemic of COVID-19 has lasted for nearly a year, the number of confirmed cases worldwide is still rising, and the trend of the epidemic is unclear. How will be the further development of COVID-19 epidemic? What is the current status of research on new drugs for coronary virus disease? Will the vaccine currently used change the epidemic pattern? In the context of the normalization of the epidemic, whether the epidemiology of other respiratory viruses will change? This article will discuss and analyze these hot and difficult issues.Copyright © 2021 Chinese Medical Association

Hot and difficult issues related to prevention and control strategies of COVID-19.

The epidemic of COVID-19 has lasted for nearly a year, the number of confirmed cases worldwide is still rising, and the trend of the epidemic is unclear. How will be the further development of COVID-19 epidemic? What is the current status of research on new drugs for coronary virus disease? Will the vaccine currently used change the epidemic pattern? In the context of the normalization of the epidemic, whether the epidemiology of other respiratory viruses will change? This article will discuss and analyze these hot and difficult issues.Copyright © 2021 Chinese Medical Association

Applying a Hybrid MCDM Model to Evaluate Green Supply Chain Management Practices

The COVID-19 pandemic has prompted global supply chain managers to reassess their operations. Developing a green supply chain requires successfully integrating environmental responsibility principles and benchmarks into supply chain management practices. In the past, there have been few studies on the most effective strategies for reducing the environmental impact of supply chains and improving their sustainability. This study used the decision-making trial and evaluation laboratory (DEMATEL) method to construct a structural model evaluation system of the green supply chain management (GSCM) to evaluate the interdependent relationships among dimensions and criteria. A GSCM evaluation system was created after using the DEMATEL-based ANP (DANP) to convert the GSCM evaluation indicators and impact factors into degrees of importance. This study explores the obstacles and challenges that organizations face when implementing GSCM practices and how these challenges can be overcome. The results found that organizational changes had the most significant impact, given that they would also improve the other three dimensions. Among the 16 evaluation criteria, resource allocation and market expansion optimization were the most important. Based on these findings, the study proposed specific improvement strategies that corporations and other stakeholders could use to adopt GSCM practices. © 2023 by the authors.

Police Officers' Preferences for Enforcing COVID-19 Regulatory Violations: The Impact of Organizational Support, Psychological Conditions, and Public Compliance

The coronavirus has stirred a wave of studies on policing the pandemic. Nonetheless, officers' intentions to enforce COVID-related rules and regulations remain under-researched. Drawing upon survey data from 600 police officers in a major Chinese city, this study explores the associations between organizational support, behavioral and psychological conditions, and perceived public compliance and officers' willingness to intervene in rule violations. Organizational support in providing supervisory instructions, training, and PPE increased the likelihood of officers issuing tickets, whereas minimizing COVID-19 risks to officers reduced the probability of officers not taking any action against rule violations. Officers who perceive community residents as compliant with pandemic regulations are less likely to take no action or use more punitive sanctions of ticket/fine and detention/arrest. © The Author(s) 2023.

Changes in the intertemporal choice of people in or close to Chinese culture can predict their self-rated surviving achievement in the fight against COVID-19: A cross-national study in 18 Asian, African, European, American, and Oceanian countries

Humans are facing an unprecedented historical crisis and challenge. To identify the strategies that we can use to cope with historical crisis and challenge, we should investigate two well-studied strategies: "slow strategy, ” which is essentially an investment in the future, and "fast strategy” or "live fast, die young.” According to "The Ant and the Grasshopper, ” Aesop's fable, which is under the pretext of intertemporal choice of social insects, the "slow” rather than the "fast” strategy is recommended for those who want to survive the environmental crisis. Intertemporal choice requires tradeoffs among outcomes whose effects occur at different times. In the commonly accepted language of intertemporal choice, the Ant, whose choice is the "larger but later” (LL) option, is more likely to survive the harsh winter than the Grasshopper, whose choice is the "smaller but sooner” (SS) option. To determine the optimal intertemporal choice strategy that can help us to cope with the COVID-19 pandemic, we included 26, 355 participants from 18 Asian, African, European, American, and Oceanian countries in the present study. We investigated the participants' preferences in intertemporal choice with double-dated mixed outcomes, evaluated the degree of change in their intertemporal choice by differentiating the common currency in peacetime and epidemic time (i.e., two kinds of change indicators used for differentiating currencies and stages, respectively). We then asked them to rate their self-rated surviving achievement in the fight against COVID-19. Considering that individuals' surviving achievements were affected by individual-and religious-level factors, we analyzed all data by using multilevel linear analysis to reflect the data's hierarchical structure. After considering individual differences in personal factors and religious factors, we constructed two-level models to explore the effects of the change in intertemporal choice on self-rated surviving achievement, and measured the moderating role of cultural orientation in terms of Hofstede's six culture dimensions. The findings of the cross-national survey revealed that Change Indicator 1 (∆ currency) and Change Indicator 2 (∆ stage) of Chinese/Singaporeans could jointly predict their self-rated surviving achievement. Meanwhile, only Change Indicator 2 (∆ stage) alone could predict the self-rated surviving achievement of people in the cultural circle that included the India, Malaysia, Philippines, and Nigeria. Neither Change Indicator 1 (∆ currency) nor Change Indicator 2 (∆ stage) of the people in other cultures could significantly predict their self-rated surviving achievement. On the basis of the gist of The Book of Change and the resulting findings, we suggested that 1) how you differentially (flexibly) made an intertemporal choice in peacetime and epidemic time would reflect the extent to which you would survive the war against COVID-19. In addition, 2) the mindset of change might shape the competitive advantage of a nation, such as China, in response to the historical crisis. The closer the cultural distance of a country or nation from China, the greater the possibility of benefitting from a similar competitive advantage. It is our hope that our findings would contribute to answer the question of what are "Psychological Characteristics and Behaviors of Chinese People in Response to Historical Crisis?”. © 2023, Science Press. All rights reserved.

Resource distribution under spatiotemporal uncertainty of disease spread: Stochastic versus robust approaches

We consider the problem of optimizing locations of distribution centers (DCs) and plans for distributing resources such as test kits and vaccines, under spatiotemporal uncertainties of disease spread and demand for the resources. We aim to balance the operational cost (including costs of deploying facilities, shipping, and storage) and quality of service (reflected by demand coverage), while ensuring equity and fairness of resource distribution across multiple populations. We compare a sample-based stochastic programming (SP) approach with a distributionally robust optimization (DRO) approach using a moment-based ambiguity set. Numerical studies are conducted on instances of distributing COVID-19 vaccines in the United States and test kits, to compare SP and DRO models with a deterministic formulation using estimated demand and with the current resource distribution plans implemented in the US. We demonstrate the results over distinct phases of the pandemic to estimate the cost and speed of resource distribution depending on scale and coverage, and show the "demand-driven” properties of the SP and DRO solutions. Our results further indicate that if the worst-case unmet demand is prioritized, then the DRO approach is preferred despite of its higher overall cost. Nevertheless, the SP approach can provide an intermediate plan under budgetary restrictions without significant compromises in demand coverage. © 2022 Elsevier Ltd

Local Housing Market Sentiments and Returns: Evidence from China

This paper examines the impacts of local housing sentiments on the housing price dynamics of China. With a massive second-hand transaction dataset, we construct monthly local housing sentiment indices for 18 major cities in China from January 2016 to October 2020. We create three sentiment proxies representing the local housing market liquidity and speculative behaviors from the transaction dataset and then use partial least squares (PLS) to extract a recursive look-ahead-bias-free local housing sentiment index for each city considered. The local housing sentiments are shown to have robust predictive powers for future housing returns with a salient short-run underreaction and long-run overreaction pattern. Further analysis shows that local housing sentiment impacts are asymmetric, and housing returns in cities with relatively inelastic housing supply are more sensitive to local housing sentiments. We also document a significant feedback effect between housing returns and market sentiments, indicating the existence of a pricing-sentiment spiral which could potentially enhance the ongoing market fever of Chinese housing markets. The main estimation results are robust to alternative sentiment extraction methods and alternative sentiment proxies, and consistent for the sample period before COVID-19.

Changes in the intertemporal choice of people in or close to Chinese culture can predict their self-rated surviving achievement in the fight against COVID-19: A cross-national study in 18 Asian, African, European, American, and Oceanian countries

Humans are facing an unprecedented historical crisis and challenge. To identify the strategies that we can use to cope with historical crisis and challenge, we should investigate two well-studied strategies: "slow strategy, ” which is essentially an investment in the future, and "fast strategy” or "live fast, die young.” According to "The Ant and the Grasshopper, ” Aesop's fable, which is under the pretext of intertemporal choice of social insects, the "slow” rather than the "fast” strategy is recommended for those who want to survive the environmental crisis. Intertemporal choice requires tradeoffs among outcomes whose effects occur at different times. In the commonly accepted language of intertemporal choice, the Ant, whose choice is the "larger but later” (LL) option, is more likely to survive the harsh winter than the Grasshopper, whose choice is the "smaller but sooner” (SS) option. To determine the optimal intertemporal choice strategy that can help us to cope with the COVID-19 pandemic, we included 26, 355 participants from 18 Asian, African, European, American, and Oceanian countries in the present study. We investigated the participants' preferences in intertemporal choice with double-dated mixed outcomes, evaluated the degree of change in their intertemporal choice by differentiating the common currency in peacetime and epidemic time (i.e., two kinds of change indicators used for differentiating currencies and stages, respectively). We then asked them to rate their self-rated surviving achievement in the fight against COVID-19. Considering that individuals' surviving achievements were affected by individual-and religious-level factors, we analyzed all data by using multilevel linear analysis to reflect the data's hierarchical structure. After considering individual differences in personal factors and religious factors, we constructed two-level models to explore the effects of the change in intertemporal choice on self-rated surviving achievement, and measured the moderating role of cultural orientation in terms of Hofstede's six culture dimensions. The findings of the cross-national survey revealed that Change Indicator 1 (∆ currency) and Change Indicator 2 (∆ stage) of Chinese/Singaporeans could jointly predict their self-rated surviving achievement. Meanwhile, only Change Indicator 2 (∆ stage) alone could predict the self-rated surviving achievement of people in the cultural circle that included the India, Malaysia, Philippines, and Nigeria. Neither Change Indicator 1 (∆ currency) nor Change Indicator 2 (∆ stage) of the people in other cultures could significantly predict their self-rated surviving achievement. On the basis of the gist of The Book of Change and the resulting findings, we suggested that 1) how you differentially (flexibly) made an intertemporal choice in peacetime and epidemic time would reflect the extent to which you would survive the war against COVID-19. In addition, 2) the mindset of change might shape the competitive advantage of a nation, such as China, in response to the historical crisis. The closer the cultural distance of a country or nation from China, the greater the possibility of benefitting from a similar competitive advantage. It is our hope that our findings would contribute to answer the question of what are "Psychological Characteristics and Behaviors of Chinese People in Response to Historical Crisis?”. © 2023, Science Press. All rights reserved.

Implementation and Evaluation of Exercise and Performance Learning Assistant System Platform for Yoga Pose Practices Using Node.js

To support people enjoying exercises or learning performances at home such as Yoga poses or traditional dances, we have developed Exercise and Performance Learning Assistant System (EPLAS). In EPLAS, the user can practice it by following the model performance of the instructor in the video. Then, the key poses of the user will be rated as the feedback by comparing the keypoints between the instructor and the user that are extracted by OpenPose. We have provided the platform using the web browser. However, OpenPose needs to run on OS directly. We developed the EPLAS platform in this paper using Node.js as the web application server. When a user requests it via the browser, the rating function is immediately executed on the server. Furthermore, we employ use Docker to simply distribute the platform. We invited 10 Okayama University students to do various Yoga positions using the EPLAS for assessments, and the results verified the success of the deployment. © 2022 IEEE.

A Model-based Multi-agent Framework to Enable an Agile Response to Supply Chain Disruptions

Due to the COVID-19 pandemic, the global supply chain is disrupted at an unprecedented scale under uncertain and unknown trends of labor shortage, high material prices, and changing travel or trade regulations. To stay competitive, enterprises desire agile and dynamic response strategies to quickly react to disruptions and recover supply-chain functions. Although both centralized and multi-agent approaches have been studied, their implementation requires prior knowledge of disruptions and agent-rule-based reasoning. In this paper, we introduce a model-based multi-agent framework that enables agent coordination and dynamic agent decision-making to respond to supply chain disruptions in an agile and effective manner. Through a small-scale simulated case study, we showcase the feasibility of the proposed approach under several disruption scenarios that affect a supply chain network differently, and analyze performance trade-offs between the proposed distributed and centralized methods. © 2022 IEEE.

[Obesity and hypertriglyceridemia: high risks for disease severity and mortality in COVID-19 patients]

As COVID-19 pandemic approaching its third year, more data have shown that obesity and hypertriglyceridemia are the high-risk factors for the major complications such as acute respiratory distress syndrome, thromboembolism, coagulopathy and cytokine storm, which are responsible for the majority of disease severity and mortality. In this review article, we have analyzed the public available clinical reports and laboratory research results of the COVID-19 studies by researchers and clinicians of many nations around the world. Many of these reports covered COVID-19 patients of different ethnic groups. We suggested that obesity and high triglycerides are high risks for severe COVID-19 and death. We also summarized the possible underlying molecular mechanism likely connecting the severe COVID-19 with obesity and hypertriglyceridemia. From public health perspective, we highlight the importance of the healthy diet and lifestyle in fighting against SARS-CoV-2 virus in long period of time.

Spatiotemporal patterns of the daily relative risk of COVID-19 in China

The coronavirus disease 2019 (COVID-19) pandemic continues to threaten lives and the economy around the world. Estimating the risk of COVID-19 can help in predicting spreading trends, identifying risk areas, and making public health decisions. In this study, we proposed a comparative risk assessment method to estimate comprehensive and dynamic COVID-19 risks by considering the pandemic severity and the healthcare system pressure and then employing the z-order curve and fractal theory. We took the COVID-19 cases from January 19–March 10, 2020 in China as our research object. The results and analysis revealed that (1) the proposed method demonstrated its feasibility to assess and illustrate pandemic risk;(2) the temporal patterns of the daily relative risk indices of 31 provinces were clustered into four groups (high-value, fluctuating-increase, inverted U-shaped, and low-stable);(3) the spatial distribution of the relative pandemic risk indicated a significant circular pattern centered on Hubei Province;and (4) healthcare system capacity is the key to reducing relative pandemic risk, and cases imported from abroad should be given more attention. The methods and results of this study will provide a methodological basis and practical guidance for regional pandemic risk assessment and public health decision-making. © 2021, Science in China Press.

An Implementation of Exercise and Performance Learning Assistant System Platform Using Node.js

To assist practicing exercises or learning performances by themselves at home under pandemic of COVID-19, we have studied the Exercise and Performance Learning Assistant System (EPLAS) and implemented the user interface using a web browser for practicing Yoga poses. EPLAS offers a video content of model actions by an instructor to be followed by the user, and automatically takes the photos of the critical poses. Then, it rates each critical pose by differences of body key points extracted by OpenPose between the user photo and the instructor one. In this paper, we implement the EPLAS platform using Node.js as the web application server to run the rating function automatically on the server when it is requested on the browser. For evaluations, we asked 10 students in Okayama University to practice 10 Yoga poses using the interface, and confirmed its correctness. © 2022 IEEE.

Mid-semester Pandemic-driven Course Rescheduling with Integer Programming

As universities begin the return to in-person course work, uncertainty remains about the future of SARS-CoV-2 virus and its variants. In the years to come, other novel pathogens may emerge. Pandemic-driven social distancing requirements reduce the number of students in classrooms, and when these requirements are instituted mid-semester, universities must make quick changes to classroom assignments and course delivery mode. In this work, we introduce two integer programs to optimize mid-semester changes: (i) a conflict-matrix-based model that determines new classroom capacities and designs the corresponding seat map, and (ii) a hierarchical model that optimizes room assignment and course delivery mode according to prioritized objectives. We test our methods with University of Michigan's engineering course schedule for Fall 2021, under a hypothetical 3-foot social distancing requirement. We compare the performance of the models under different hierarchical objectives and room assignment assumptions and discuss the managerial implications of our results. © 2022 IISE Annual Conference and Expo 2022. All rights reserved.