Safety and Efficacy of Disulfiram in Hospitalized Patients with Moderate COVID-19: A Randomized, Double-Blind, Placebo-Controlled Trial. (preprint)

OBJECTIVESDisulfiram, a low-cost generic drug used for alcohol dependence, holds the potential to mitigate disease progression in patients with moderate COVID-19 by targeting inflammasomes. This study aimed to evaluate the clinical efficacy and safety of disulfiram when administered alongside standard of care for the treatment of hospitalized individuals with moderate COVID-19. DESIGNA randomized, double-blind, placebo-controlled trial. SETTINGConducted at four clinical sites in Brazil between December 2020 and August 2021. PARTICIPANTS140 participants aged 35 and older with laboratory-confirmed SARS-CoV-2 infection, hospitalized for [≤]5 days with moderate symptoms of COVID-19 were enrolled, 137 were randomized. INTERVENTIONParticipants were randomized in a 1:1 ratio to receive a daily dose of 500 mg of disulfiram (N=68) or placebo (N=69) for 14 days while receiving the current standard of care. Randomization was stratified by age and comorbidities (hypertension, diabetes, and BMI [≥]35). MEASUREMENTS AND MAIN RESULTSThe primary outcome, median time to clinical improvement [95% CI] did not significantly differ between groups (disulfiram: 3.5 [3.00, 4.00] days; placebo: 4 [3.00, 5.00] days; P=.73). Key secondary outcomes, such as mean days (SD) on supplemental oxygen [disulfiram: 4.4 (6.61) days; placebo: 3.7 (5.80) days, P=.34], median (95% CI) time to hospital discharge [disulfiram: 6.0 (5.00, 8.00) days, placebo: 5.0 (4.00, 7.00)], proportion of participants discharged by day 8 [disulfiram (68%), placebo (63%), odds ratio: 0.801], and proportion of participants who clinically worsened [disulfiram (21%), placebo (19%), P=.79], did not reveal significant differences. While the incidence of adverse events was higher in the disulfiram group, serious adverse events and 28-day mortality were comparable between the two groups. ConclusionsAlthough disulfiram was found to be safe in hospitalized patients with moderate COVID-19, it did not shorten the time to clinical improvement. These findings do not support the use of disulfiram alongside standard of care in this patient population. TRIAL REGISTRATIONClinicalTrials.gov Identifier: NCT04594343 Key PointsO_ST_ABSBackgroundC_ST_ABSDisulfiram has been proposed to mitigate disease progression in patients with COVID-19 by targeting the inflammasomes. QuestionDoes disulfiram, a generic drug used for alcohol use disorder, reduce the time to clinical improvement or reduce the risk of severe disease in hospitalized patients with moderate COVID-19 and with comorbidities when added to the standard of care? FindingsIn this double-blind, placebo-controlled randomized clinical trial of adults hospitalized with moderate COVID-19 in Brazil, the addition of an oral disulfiram treatment to the standard of care was safe. Still, it did not decrease the time to clinical improvement. MeaningThe study findings do not support the use of disulfiram in hospitalized patients with moderate COVID-19 in addition to the standard of care.

Study on site selection of emergency medical facilities for rural public health emergencies

In order to improve the scientificity of site selection decision⁃making of emergency medical facilities for rural public health emergencies, based on the characteristics of public health emergencies with rapid spread and strong harmfulness of corona virus disease 2019(COVID-19), according to the design standards of emergency medical facilities, taking into account the characteristics of small rural medical budget and rugged emergency roads, firstly, six influencing factors of engineering geological conditions, unit cost, infection rate, arrival time, site scale and service coverage area of alternative sites of facilities were selected. The Entropy value method(EVM) method and analytic hierarchy process(AHP) method were effectively combined to determine the weight of influencing factors. Secondly, a multi⁃objective location model considering the minimum sum of the distance from patients to emergency medical facilities and the optimal comprehensive evaluation value of the selected emergency medical facilities was established. Then, an IPSO algorithm was designed to solve the model and get the location decision. Finally, some villages in Tianmen city were selected for empirical analysis to verify the effectiveness of the model algorithm. The results show that infection rate and unit cost are the main influencing factors for the construction of emergency medical facilities. IPSO algorithm selects three emergency medical facilities, which can meet the treatment needs of patients in eight villages, and ensure that patients can seek medical treatment within 4-7 minutes,providing guarantee for efficient epidemic prevention and control activities. © 2023 China Safety Science Journal. All rights reserved.

Study on site selection of emergency medical facilities for rural public health emergencies

In order to improve the scientificity of site selection decision⁃making of emergency medical facilities for rural public health emergencies, based on the characteristics of public health emergencies with rapid spread and strong harmfulness of corona virus disease 2019(COVID-19), according to the design standards of emergency medical facilities, taking into account the characteristics of small rural medical budget and rugged emergency roads, firstly, six influencing factors of engineering geological conditions, unit cost, infection rate, arrival time, site scale and service coverage area of alternative sites of facilities were selected. The Entropy value method(EVM) method and analytic hierarchy process(AHP) method were effectively combined to determine the weight of influencing factors. Secondly, a multi⁃objective location model considering the minimum sum of the distance from patients to emergency medical facilities and the optimal comprehensive evaluation value of the selected emergency medical facilities was established. Then, an IPSO algorithm was designed to solve the model and get the location decision. Finally, some villages in Tianmen city were selected for empirical analysis to verify the effectiveness of the model algorithm. The results show that infection rate and unit cost are the main influencing factors for the construction of emergency medical facilities. IPSO algorithm selects three emergency medical facilities, which can meet the treatment needs of patients in eight villages, and ensure that patients can seek medical treatment within 4-7 minutes,providing guarantee for efficient epidemic prevention and control activities. © 2023 China Safety Science Journal. All rights reserved.

Systematic evaluation of emergency management capacity for rural public health emergencies

Rural areas' emergency response capacities are generally weaker when compared to tier one cities and this can have an adverse effect on residents' livelihood and health. Evaluation of rural emergency management is of great significance for improving the rural emergency management capacity. This paper innovatively constructs an evaluation system for the emergency management capabilities with the rural public health emergencies, which includes four dimensions: emergency subject, mechanism, resources and concept. A Projection Pursuit model for objectively processing high-dimensional is constructed, and data from 2010 to 2020 in the rural areas of Xiantao City are selected as samples for empirical research. The results show that: (1) Each dimension of emergency management of public health emergencies contributes more than 20% to the ability. Compared with the other three dimensions, contribution of the emergency concept accounted for the lowest proportion, which was 21.69%, and indicates that this dimension is the key factor restricting the improvement of the emergency management capabilities. (2) From 2010 to 2019, the average annual growth rate of comprehensive emergency management capacity in the rural areas of Xiantao City was 14.9%, and by 2020, the rural emergency management capacity, impacted by the COVID-19 epidemic, grew very rapidly with an annual growth rate of 33.8%. (3) The development of an effective rural emergency management capacity system is not sufficient and unbalanced, which leads to the "barrel effect.” This study can provide theoretical guidelines for the evaluation of rural emergency management capabilities, and provide methodological support for similar research in other regions. © 2022 Elsevier Ltd

Motivations and barriers to using high-speed rail: An application of conjoint analysis – Insights from Vietnam

Background: Nowadays, a gradual change in customers’ attitudes towards transport service makes it more challenging to understand the reasons behind customers’ travel decisions. High-speed rail (HSR) has been mentioned recently and is expected as the best and most modern transport option in long-distance trips in Vietnam. However, research studies have paid scant regard to how HSR’s attributes may affect potential users, and therefore the motivations and barriers to adopting HSR are still unknown. Objectives: This study aimed at examining motivations and barriers to take-up HSR for considering customers’ preference on the proper attributes and levels of HSR. Method: This study drew on a nationwide survey and conjoint analysis to investigate customers’ behaviour. Results: In Vietnam’s context, HSR ticket was found to be the principal barrier to adoption, whereas the speed of HSR was identified as the least important behavioural driver amongst potential HSR users. The results show that HSR design and planning should provide a combination of minimum check-in and waiting time, a 20-min frequency, average speed of 250 km/h, all add-on services and facilities, ticketing of approximately VND 500–700 thousand per 300–500 km and nearby all-day parking. Conclusion: This investigation has demonstrated the value of conjoint analysis to compare a wide range of attributes associated with consumers’ decision to use HSR. The findings indicate that in countries such as Vietnam, in particular, where train usage is low, policymakers and transportation agencies seeking to boost the use of HSR must take attributes other than fare into consideration.

Comparative evaluation of oral health attitudes and behaviors among dental and medical students during COVID-19 pandemic in Saudi Arabia.

OBJECTIVE: The purpose of the study was to compare the oral health attitudes and behaviors of medical and dental students/interns during the Corona pandemic in Saudi Arabia using Hiroshima University Dental Behavioral Inventory (HU-DBI). SUBJECTS AND METHODS: This cross-sectional study was conducted to assess the oral health attitudes and behaviors of dental and medical students/interns in Saudi Arabia using an online Hiroshima University-Dental Behavioral Inventory (HUDBI). An English version of the questionnaires consisting of personal information and 20 HUDBI items were responded by the 638 (46.8%) dental and 726 (53.2%) medical students/interns. The mean score of oral health attitude and behavior of the study participants was calculated based on 12 point scale of the HUDBI items. The Mann-Whitney U and Kruskal-Wallis tests compared the HUDBI scores across different groups. RESULTS: The study sample's overall mean HUDBI score was 6.44±1.80 (Median 7). Dental students/interns (825.60) demonstrated a significantly higher HUDBI mean score than medical students/interns (556.75) (p<0.001). Similarly, female students (712.25) than the male students (712.25 vs. 642, p=0.001), and those studying in private universities compared to government universities (741.56 vs. 673.52, p=0.028) showed significantly higher HUDBI mean scores. CONCLUSIONS: During the COVID-19 pandemic, dental students/interns displayed a better oral health attitudes and behaviors than medical students/interns. Therefore, oral health promotion programs aimed at medical and dental students/interns are essential for improving oral health attitudes and behaviors.

Challenges and obstacles of distance learning in higher education: Example of faculty of economics, Matej Bel University, Slovakia

The chapter characterizes the transformation of the learning process from full-time to distance learning on the example of Faculty of Economics, Matej Bel University in Slovakia, during the COVID-19 epidemic in the form of case study. The chapter analyses the strengths and weaknesses of this process during the summer semester 2019/2020 based on the secondary data and results of a questionnaire survey among faculty students realized in 2 rounds - in the first stage of transformation (April 2020) and after the end of summer semester (June 2020). It identifies the key steps that have (or had) to be taken to overcome the second wave of the COVID-19 pandemic and the key challenges for the future development of virtual learning as a full compensation of full-time form of study from the students' and faculty's perspective. This case is an example of smart education in crisis situations. The results show that distance learning can be a suitable complement to the fully presence learning process, and temporarily, it can replace it in emergency situations. © 2021 by IGI Global. All rights reserved.

Fast Food Industry in the Post-pandemic Era - A Case Study of KFC

The global spread of the Covid-19 pandemic exerts great influence on the global economies, and among the economic sectors which are suffering losses, the service industry, especially fast food restaurants, are greatly impacted. Before the outbreak of the Covid-19 pandemic, the fast food restaurant benefits a lot from the process of globalization, while t ay lose the benefit w an the pandemic causes a lot of limitations on the cross-boarder flow of commodities and people. By taking KFC as an example, based on the analysis, it is found that the reasons behind such impact include slowed globalization, customer's reducing income and government bans. To alp the fast food restaurants get through the difficulties amid pandemic, several possible solutions are proposed in this paper. © The Authors, publis ad by EDP Sciences, 2020.