ABSTRACT
The low-carbon development of air transport industry is of great significance for China to achieve the commitment of carbon peak and carbon neutrality goals. In order to improve the basic data of aviation CO2 emissions, this study continuously collected full flight information in China from January 2017 to December 2020, and established a flight information database and an aircraft-engine parameter database. On the basis of IPCC's Tier 3B accounting method, this study established a long-term aviation CO2 emissions inventory of China from 2017 to 2020 by calculating and accumulating CO2 emissions of each flight. And aviation CO2 emissions of various provinces and cities in China were calculated combined with spatial allocation method. The results showed that aviation CO2 emissions in China was 104.1, 120.1, 136.9, and 88.3 Mt in 2017, 2018, 2019, and 2020, respectively, with annual growth rates of 15.4%, 14.0%, and −35.3% in 2018, 2019, and 2020, respectively. Affected by the COVID-19 pandemic, aviation CO2 emissions in all 31 provinces and 93% of cities decreased in 2020 compared with 2019. China is in the stage of rapid development of air transport industry, and aviation fossil energy consumption and CO2 emissions have continued to grow in recent years. © 2022 Elsevier Ltd
ABSTRACT
Background. Cefiderocol (CFDC) is a Gram-negative antibiotic (GNA) with a unique mode of cell entry against carbapenem resistance. This study described the initial use of CFDC in US hospitals since its approval in November 2019. Methods. This was a retrospective study of patients treated with CFDC consecutively for >=3 days in US hospitals, as captured in Premier Healthcare Data from January 2020 to June 2021. This study described the clinical characteristics, CFDC usage, and Post-CFDC initiation 14-day and 28-day in-hospital all-cause mortality (IH-ACM). For patients with microbiology results, the pathogen, susceptibility and culture site associated with CFDC use were described. Index culture was the culture(s) taken on the day closest to CFDC initiation. Results. Among 313 of 360 in-patients who received >=3 days CFDC, the median age was 58 years (range: 17 - 89 years), and 91% were hospitalized via emergency room, trauma, or urgent admission. The most common conditions were severe sepsis with septic shock, palliative care, and multi-drug resistant infection. Also 34% had a 'do not resuscitate order'. About 64% of patients received mechanical ventilation and 79% had ICU stay. Median length of hospital stay was 27 days (range: 3-310 days). Median days on CFDC was 8 days (range: 3 - 66 days). Over 58% received >=2 other GNAs within 14-days of initiatingCFDC.Among 187 patients withmicrobiology results, 75% had index cultures with one pathogen, and 73% had confirmed carbapenem resistant pathogens. The most common pathogens were Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Klebsiella pneumoniae and Acinetobacter baumannii. The most common index culture site was respiratory. The 14-day and 28-day crude IH-ACM from CFDC initiation was 16.3% (95%CI: 12.2%-20.4%) and 23.6% (95%CI: 18.9 - 28.4%), respectively. Among those with microbiology results, 14-day and 28-day IH-ACMwas 17.1% (95%CI: 11.7% - 22.5%) and 23.5%(95%CI: 17.4-29.6%), respectively. Among patients who died, 83% had severe sepsis with septic shock, 76% were in palliative care, 71% had a 'do not resuscitate order', and 44% had COVID-19. Conclusion. CFDC was used most frequently in critically ill patients. IH-ACM was comparable with other studies.
ABSTRACT
Background. Cefiderocol (CFDC) has a broad activity against Gram-negative (GN) pathogens. This study describes the usage of CFDC in US hospitals in patients with microbiology data during the initial phase of commercialization. Methods. This retrospective study included patients with laboratory-confirmed GN infections in US hospitals treated with CFDC consecutively for >=3 days between March 2020 to June 2021, as captured by Premier Healthcare data. This study describes the clinical characteristics, microbiology profile, CFDC usage, and post-CFDC initiation 14-day and 28-day in-hospital all-cause mortality (IH-ACM). Index culture was defined as the last day that culture sample(s) was taken before CFDC initiation or the first day the culture sample(s) was taken after CFDC initiation if no microbiology data before CFDC use was available. Index pathogens were all pathogens identified from the index culture(s). The index culture site was where the index culture was taken. Results. A total 187 in-patients received >=3 days CFDC and had >=1 microbiological result(s). The clinical characteristics of the patients and index culture results are provided in Table 1 and Table 2. About 60% of patients had at least one positive respiratory culture. The most frequent pathogens from the index culture were Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Klebsiella pneumoniae, and Acinetobacter baumannii. Nearly 75% of patients had one index pathogen, and 91% with one culture site. Almost 30% of patients had either one pathogen identified in multiple culture sites, or multiple pathogens from >=1 culture site. Crude 28-day IH-ACM for patients with any A. baumannii was 8.3% (95%CI: 0% -19.4%), any P. aeruginosa was 17.3% (95%CI: 9.9-24.8%), any S. maltophilia was 18.4%, (95%CI: 6.1%-44.0%) and any K. pneumoniae was 26.1% (95%CI: 8.1%-44.0%). Crude 28-day IH-ACM for patients with positive respiratory culture was five times higher in COVID patients than non-COVID patients. Conclusion. During the initial phase of CFDC availability, the most frequent pathogens treated using CFDC were non-fermenters, and the most frequent culture site was respiratory. IH-ACM appears to be affected by infection characteristics, especially COVID-19 status.
ABSTRACT
SESSION TITLE: Late Breaking Chest Infections Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/18/2022 01:30 pm - 02:30 pm PURPOSE: Cefiderocol is a siderophore cephalosporin that has broad activity against Gram-negative (GN) pathogens including carbapenem resistant isolates through its unique mode of cell entry. This study describes the usage of cefiderocol in US hospitals, in patients with microbiology confirmed respiratory infections, during its first 1.5 years following commercial availability. METHODS: This was a retrospective study of patients with microbiology confirmed GN respiratory infections in US hospitals, treated with cefiderocol consecutively for ≥3 days between January 2020 to June 2021, as captured by the Premier Healthcare database. This study describes the clinical characteristics, microbiology profile, and 14-day and 28-day in-hospital all-cause mortality (IH-ACM) amongst patients treated with cefiderocol. Index culture was defined as the last culture sample(s) obtained before cefiderocol initiation, or the first culture obtained after cefiderocol initiation if no microbiology evaluation was performed prior to cefiderocol use. Index pathogen(s) were the pathogen(s) identified from the index culture(s). RESULTS: Among 113 hospitalized patients who received ≥3 days cefiderocol and had ≥1 positive respiratory culture for GN pathogens, median age was 61 years with interquartile range (IQR) of 48-72 years, 57% were male, and 93% were admitted via emergency room or urgent care. The most common comorbidities were renal disease (37%), diabetes (36%), congestive heart failure (35%), and chronic pulmonary disease (33%). Seventy-seven percent of patients received mechanical ventilation and 89% were treated in an intensive care unit. The most frequent index pathogens were Pseudomonas aeruginosa (56%), Stenotrophomonas maltophilia (24%), Klebsiella pneumoniae (13%), and Acinetobacter baumannii (11%). Also 28% of patients had more than one pathogen from index cultures and over 10% also had positive GN index cultures from other sites such as blood, urine or wound. Among 96 pathogens tested for carbapenems, 87% were resistant. Median time from hospital admission to cefiderocol initiation was 14 days (IQR: 5-25). Median cefiderocol duration was 8 days (IQR: 6-14). Before initiating cefiderocol, 88% of patients received other GN antibiotics. Median length of hospital stay was 28 days (IQR: 16-45). Crude 14-day and 28-day IH-ACM were 21.2% (95%CI: 13.7%-28.8%) and 27.4% (95%CI: 19.2-35.7%), respectively. IH-ACM was higher in COVID patients than non-COVID patient (53.1% vs. 8.6% for 14-day ACM and 65.6% vs. 12.3% for 28-day ACM, respectively). CONCLUSIONS: During the initial phase of availability, the most frequent use of cefiderocol was to treat critically ill patients with non-fermenter pathogen infections.IH-ACM appears to be affected by infection characteristics, especially COVID-19 status. CLINICAL IMPLICATIONS: Real-world data supports that Cefiderocol is effective in treating GN respiratory infections as shown in IH-ACM DISCLOSURES: Employee relationship with Shionogi Inc Please note: 2015 - present Added 06/02/2022 by Bin Cai, value=Salary No relevant relationships by Andrew Cooper Employee relationship with Shionogi, Inc Please note: 3 years Added 06/03/2022 by Stephen Marcella, value=Salary No relevant relationships by Yun Zhou
ABSTRACT
Background. The COVID-19 pandemic is associated with significant number of complications and mortality and a burden on the healthcare system. In 10–15% of hospitalized patients, the invasive and non-invasive mechanical ventilation (IMV/NIMV) is required. At the same time, it is important to stratify the risk of mechanical ventilation upon admission to the hospital. Aims — to identify clinical and laboratory risk factors for transfer to IMV and NIMV in hospitalized patients with COVID-19-associated pneumonia. Methods. A retrospective one-center nonrandomized study of 386 consecutive hospitalized patients with COVID-19-associated pneumonia was performed. The primary endpoints were IMV (n = 22) and NIMV (n = 28). Risk factors of artificial ventilation were considered for periods up to 14 and 28 days for both variants. To select a risk predictor, a univariate analysis based on Cox survival regression was performed, followed by multivariate analysis to determine risk factors at these time points. Results. After 28 days from admission the mortal exit was registered in 20 patients from 386 patients (5.2%). 22 patients (5.7%) were transferred to IMV, and 28 patients (7.3%) — to NIV, and 9 of the latter were transferred later to IMV. As a result of univariate and multivariate analyzes, the risk factors for transfer to mechanical ventilation on 14th day were: age > 65 years (OR = 5.91), a history of stroke (OR = 17.04), an increased serum level of urea (OR = 6.36), LDH (OR = 7.39), decreased sodium (OR = 12.32), GFR < 80 mL/min/1.73 m2 (OR = 13.75) and platelets (OR = 4.14);on the 28th day — age > 65 years (OR = 4.58), J-wave on the ECG (OR = 2.98), an increase of LDH (OR = 9.99) and a decrease in albumin (OR = 2.77) in serum. Predictors of the transfer of patients with COVID-19 to NIV within the period up to 14 days from the beginning of hospitalization were the age > 65 years (OR = 5.09), procalcitonin level in the blood > 0.25 ng/ml (OR = 0.19), leukocytes > 11×109 (OR = 19.64) and increased LDH (OR = 3.9). Conclusions. In patients with COVID-19, the risk factors for transfer to IMV/NIVL in the period of 14 and 28 days from the beginning of hospitalization were identified, which enable patient’s mechanical ventilation stratification and to plan respiratory support resources.
ABSTRACT
To make informative public policy decisions in battling the ongoing COVID-19 pandemic, it is important to know the disease prevalence in a population. There are two intertwined difficulties in estimating this prevalence based on testing results from a group of subjects. First, the test is prone to measurement error with unknown sensitivity and specificity. Second, the prevalence tends to be low at the initial stage of the pandemic and we may not be able to determine if a positive test result is a false positive due to the imperfect test specificity. The statistical inference based on a large sample approximation or conventional bootstrap may not be valid in such cases. In this paper, we have proposed a set of confidence intervals, whose validity doesn't depend on the sample size in the unweighted setting. For the weighted setting, the proposed inference is equivalent to hybrid bootstrap methods, whose performance is also more robust than those based on asymptotic approximations. The methods are used to reanalyze data from a study investigating the antibody prevalence in Santa Clara County, California in addition to several other seroprevalence studies. Simulation studies have been conducted to examine the finite-sample performance of the proposed method.
ABSTRACT
A range of shortcomings was exposed in China's medical waste disposal capabilities in responding to public health emergencies under outbreak of the novel coronavirus pneumonia (COVID-19) epidemic. Especially, the traditional medical waste disposal capacity allocation and the prevention and control mechanism oriented to 'a single city' have been far from meeting the needs of medical waste disposal and management during the emergency period. Therefore, suggestions on establishing the regional joint prevention, control and disposal mechanism of medical waste were put forward in this paper with reference to the ideas of China's existing regional joint prevention and control mechanism for air and water pollution, which covered the aspects of establishment of coordinating agencies, cross-regional collaborative disposal, cross-regional joint response to emergencies, cross-regional collaborative management and effectiveness evaluation. © 2021 The authors and IOS Press.
ABSTRACT
The COVID-19 pandemic has had a huge impact on the health of millions of people around the world on an unprecedented scale. Unfortunately, the process of creating effective antiviral drugs and vaccines is being delayed. Therefore, drugs that are already available and may have an effect on COVID-19 are being investigated. Due to the fact that viral infection often affects the cardiovascular system, causing myocardial infarction, viral myocarditis, tachyarrhythmias and stress cardiomyopathies, a theory was put forward that HMG-CoA reductase (3-hydroxy-3-methyl-glutaryl-CoA reductase) inhibitors (statins) can reduce the risk of cardiovascular complications in these patients. In recent years, this class of drugs has been proposed, including for viral infections, such as the influenza virus or MERS-CoV. The review discusses both the latest clinical data on the efficacy of statins in COVID-19 and the pleotropic mechanisms of statins that can limit the pathogenic effect of viruses. In particular, statins can act on lipid cell rafts (subdomains of the plasma membrane), decreasing their lipid concentration;limiting the interaction of the virus with the receptors of angiotensin-converting enzyme-2 and CD-147. Statins have an anti-inflammatory effect (blocking the molecular mechanisms of inflammation, including NF-?B and NLRP3), limit the development of a "cytokine storm" in severe patients with COVID-19;can inhibit SARS-CoV-2 basic protease;influence coagulation, limit sympathetic activity and have other effects. In two large cohort observational studies (n = 96032 and n = 13981), hospitalized patients with COVID-19 who were taking statins showed a decrease in hospital mortality and mortality 28 days after the admission to the hospital. Thus, statins can play a role in the treatment of COVID-19. © 2020 All-Russian Public Organization Antihypertensive League. All rights reserved.
ABSTRACT
Novel coronavirus pneumonia was a novel coronavirus infection that has dominated pulmonary infection since December 2019. The main manifestations were fever, dry cough, shortness of breath, normal or leukopenia in peripheral blood and changes in chest CT and in severe cases, multiple organ failure might occur. The National Health Commission, PRC has revised the consensus on diagnosis and treatment seven times in a short period of time, indicating the growing understanding of the disease. Patients with novel coronavirus pneumonia usually had history of travelling or living in the epidemic area including Wuhan within 14 days before onset, or have been exposed to patients who had fever or respiratory symptoms from the epidemic area, or had clustering diseases. However, novel coronavirus pneumonia was becoming more and more blurred after vanishing epidemic. The diagnosis and differential diagnosis of novel coronavirus pneumonia were challenges not only because of large number of tourists increasing dramatically after the relieving of epidemic, but also patients with other diseases from different areas to search for medical care. In this article, the clinical and chest imaging features of the novel coronavirus pneumonia were reviewed and compared with other infections and non-infectious diffuse pulmonary diseases. We try to find the similarities and differences among them, and to identify clues to the diagnosis of novel coronavirus pneumonia, so as to ensure accurate diagnosis and treatment.