Impact of Universal Masking Precautions during COVID-19 Pandemic on Surgical Site Infection in General Surgery Procedures

Introduction: Increasing evidence demonstrates the effectiveness of universal masking precautions in reducing the transmission of COVID-19. Whether these precautions have an impact on surgical site infections (SSI), currently remains unknown. This study assesses whether implementation of universal masking precautions altered the rates of SSI. Method(s): We performed a single-institution, retrospective cohort study using the NSQIP database, evaluating all patients undergoing most performed general surgery procedures from June 2018 to December 2021. SSI rates were compared between patients who underwent operation before and after implementation of universal masking precautions at our institution in March 2020. Statistical analyses were performed using Fisher's exact test. Result(s): A total of 1,539 patients were included;721 patients were in the pre-masking cohort, while 818 in post-masking cohort. During this time period, a total of 143 (9.3%) patients developed SSI, 3.6% incisional and 5.7% deep organ space infections (OSI) (p=0.6601). Incisional and OSI rates did not differ significantly between the two groups (incisional 3.47% vs 3.67%, p=0.891;OSI 5.41% vs 5.99%, p=0.6608). Sub-analysis of top 5 procedures (by volume - laparoscopic cholecystectomy, hepatectomy, thromboendarterectomy, colectomy with anastomosis, and colectomy with ileocolostomy) demonstrated a significant decrease in incisional infections (3.7% vs 1.62%, p=0.0354). Conclusion(s): While the incidence of SSI did not differ significantly in the overall cohort after implementation of universal masking precautions, there was a decrease in incisional infections in commonly performed procedures at our institution. Future research is needed to identify whether continued masking precautions may minimize the risk of SSI in specific patient populations.

Loneliness and Maladjustment in Young Adults: The Protective Effects of High Respiratory Sinus Arrhythmia and Sleep Quality

Loneliness is a pervasive concern among young adults that has been exacerbated by the COVID-19 pandemic. Identifying factors that mitigate the negative impact of loneliness is important for protecting young adults' mental health and well-being. Among 188 undergraduates (71.8% women;77.1% White), the present study examined physiological regulation and sleep quality as moderators of the association between loneliness and adjustment. Physiological regulation was assessed via resting respiratory sinus arrhythmia (RSA), a measure of parasympathetic activity. Participants self-reported loneliness, sleep quality, mental health symptoms, and positive affect/well-being. Three-way interactions were significant, such that at higher levels of loneliness, the combination of high resting RSA and high sleep quality was protective against elevated anxiety and depressive symptoms and low positive affect/well-being. Multi-pronged, tailored interventions that target improvement in loneliness, physiological regulation, and sleep quality based on an individual's unique risk factors may best promote young adults' adjustment. © 2023 Society for the Study of Emerging Adulthood and SAGE Publishing.

Advances in the evolution and immune escape of SARS-CoV-2 variants

Although most of the mutations in the genome of SARS-CoV-2 are ineffective, rapidly eliminated, or relatively neutral, a small number of mutations will affect its functional characteristics and may change its infectivity, pathogenicity, or interaction with host immunity. Since the emergence of SARS-CoV-2 at the end of 2019, there has been a relative evolution stagnation period lasting about 11 months. However, since the end of 2020, a series of spike protein mutations have occurred in SARS-CoV-2, which affect the characteristics of the virus. The variants of concern (VOC) ranged from Alpha to Omicron. These variants will affect the infectivity and antigenicity of the virus. The evidence has shown that the neutralization effect of serum on some SARS-CoV-2 variants is weakened after vaccination, but a deeper understanding of the relevant factors of protection is still required to assess how this may affect the effectiveness of the vaccine. In this review, we described the evolution of SARS-CoV-2, summarized the literatures on the mutations of SARS-CoV-2 spike protein, and discussed the effects of different variants on the protective effects of vaccines and their coping strategies. © 2023 Editorial Board of Medical Journal of Wuhan University. All rights reserved.

Impact of chronic airway inflammatory diseases on COVID‑19

The COVID‑19 pandemic causes an overwhelming number of hospitalization and deaths with a significant socioeconomic impact. Several studies have linked the severity of COVID‑19 to risk factors such as age, male, hypertension, diabetes, obesity, cardiovascular disease, liver and kidney disease, cancer, and pregnancy. The association between chronic obstructive pulmonary disease (COPD) and asthma, the most common chronic airway inflammatory diseases in the population, and SARS‑CoV‑2 infection is not yet clear. This article will review the comorbidity rates of COPD and asthma in COVID‑19 patients, their effects on COVID‑19, and the possible mechanisms, in order to provide scientific data for clinical practice. © 2022 Editorial Board of Medical Journal of Wuhan University. All rights reserved.

Ergonomics-oriented operation, maintenance and control of indoor air environment for public buildings

In response to the construction process of Healthy China. it is rather important to create a safe, healthy and energy-efficient indoor environment for public buildings. The public building space is often densely populated, with a large flow of people and many types of air pollution, which presents non-uniform dynamic distribution characteristics. This brings great challenges to the control of indoor air safety, especially during the pandemic period of COVID-19. Excessive ventilation may not only cause large energy waste. but also lead to cross-contamination and even a cluster of infection. In this paper, an operation and maintenance (O&M) control system for indoor air safety is developed based on the core concepts and basic methods of human ergonomics. In this system, one of the important human environmental variables is focused for control, i.e.. indoor air pollution level. Especially after the outbreak of COVID-19. droplets and droplet nuclei from respiration are the most significant air pollution categories required for mitigation. Towards the efficient control of air pollution in large public buildings. it should further take into account the interaction of human, equipment and machines (i.e., ventilation_ air purification and disinfection and intelligent control system) and building environment. Firstly, on the basis of the online monitoring of indoor air pollution concentration and personnel flow, the non-uniform dynamic distribution of indoor pollutants and personnel can be obtained by using the non-uniform and low-dimensional rapid prediction models and computer vision processing. Then, the optimal setting results of ventilation parameters (e.g., ventilation modes, supply air rate. etc.) can be outputted by the environmental control decision system. Finally, based on a combination of monitoring sensors, controllers and actuator hardware equipment (at the location of fans or dampers), the intelligent regulation and control of ventilation system can be realized, aimed at minimizing energy consumption and reducing pollutant concentration and exposure level. Meanwhile, the air purification and disinfection system (especially for the disinfection of virus particles) are operated under the condition of the ventilated environment, which can serve as a powerful auxiliary to the maintenance of indoor air safety. The workflow and effect of the O&M control system are demonstrated by an engineering application case of the front hall in the International Convention and Exhibition Center. The results indicate that the non-uniform and low-dimensional rapid prediction model for pollutant concentration is effective for the ventilation control with the average prediction difference of 11.9%. The implementation of the intelligent ventilation system can reduce the risk of human infection to less than 4%. and its energy-saving ratio for the ventilation can be as high as about 45%. Through optimizing the layout strategies of disinfection devices based on the intelligent ventilation control, the space accessibility of negative oxygen ions can be well accepted, to further increase the removal efficiency of air pollution. The calculated value of space disinfection rate is more than 99%, which can further reduce the risk of infection by 1-2 orders of magnitude. This study can provide an important reference for the promotion and upgrading of O&M control system for indoor air safety.

Sense of Community among Event Stakeholders during the COVID-19 Pandemic: The Case of the Illinois Marathon

This study investigated the ways in which event stakeholders perceived and actively secured their sense of community (SOC) in the wake of an event cancellation during the COVID-19 pandemic. We conducted document analysis and semi-structured interviews with 31 event stakeholders, including 14 runners, 9 volunteers, 4 business owners, and 4 charitable organization managers. Findings revealed that SOC among event stakeholders went through three key stages: leaving a hole in the community, getting a glimpse of normalcy, and living in a new normal. The findings extend the existing literature that has mainly focused on how hosting sport events contributes to SOC, rather than on SOC related to event cancellation, by highlighting how personal and contextual factors contribute to the unique trajectory of SOC among event stakeholders. This study also proposes strategies for keeping socially connected in the absence of in-person sport events, such as increasing media outlets and using interactive apps. © 2023 Global Alliance of Marketing & Management Associations (GAMMA).

Preliminary Recommendations on the Timing of Lung Surgery after Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer.

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contract-ing COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.Copyright © 2023, Chinese Journal of Lung Cancer. All rights reserved.

Effects of social media empowerment on COVID-19 preventive behaviors in China

Purpose: During the coronavirus disease 2019 (COVID-19) pandemic, ubiquitous social media has become a primary channel for information dissemination, social interactions and recreational activities. However, it remains unclear how social media usage influences nonpharmaceutical preventive behavior of individuals in response to the pandemic. This paper aims to explore the impacts of social media on COVID-19 preventive behaviors based on the theoretical lens of empowerment. Design/methodology/approach: In this paper, survey data has been collected from 739 social media users in China to conduct structural equation modeling (SEM) analysis. Findings: The results indicate that social media empowers individuals in terms of knowledge seeking, knowledge sharing, socializing and entertainment to promote preventive behaviors at the individual level by increasing each person's perception of collective efficacy and social cohesion. Meanwhile, social cohesion negatively impacts the relationship between collective efficacy and individual preventive behavior. Originality/value: This study provides insights regarding the role of social media in crisis response and examines the role of collective beliefs in the influencing mechanism of social media. The results presented herein can be used to guide government agencies seeking to control the COVID-19 pandemic. © 2023, Emerald Publishing Limited.

Preliminary Recommendations on the Timing of Lung Surgery after Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer.

In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contract-ing COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.Copyright © 2023, Chinese Journal of Lung Cancer. All rights reserved.

Research on the Spatiotemporal Evolution of China's Intercity Network Structure from the Perspective of the Relationship between Listed Companies and Customers

The connection between enterprises is an important part of urban connection. Strengthening the analysis of urban functional network based on the connection between enterprises is of great significance to enrich the theoretical research of urban network. Based on the trade relationship data between listed companies and their top five customers from 2010 to 2020, this paper constructs China's urban network, and analyzes the spatio- temporal evolution characteristics of urban network based on the perspective of trade links between enterprises. The research shows that: ① From 2010 to 2020, the urban network scale shows the characteristics of first rising and then falling, and the overall network density is low, ranging from 0.014 to 0.018. The center of gravity of the network presents the trend of "S" - shaped spatial trajectory change and overall southward movement.This feature is consistent with the trend of China's economic center moving southward in recent years. The overall spatial structure of the network changes from coastal to "T" - shaped structure. This feature is consistent with the "T" strategy of China's land development. ② The network traffic is concentrated in a few node cities. The total amount of capital in and out of the top 20 cities accounts for 71.9% of the total capital flow. Beijing and Shanghai are the absolute core of the network. The provincial capitals or sub provincial cities such as Hangzhou, Wuhan, Shenzhen and Guangzhou assume the function of regional centers. Foshan, Qiqihar, Nantong and other manufacturing developed cities are important nodes. It indicates that trade links are more likely to occur in cities with high administrative levels or developed industries. ③ The Pearl River Delta has the highest network density, which is between 0.324 and 0.334. The Yangtze River Delta has the highest total trade flow, which is 78.35 billion yuan. Although the networking level of urban agglomeration in the middle reaches of the Yangtze River and Chengdu Chongqing urban agglomeration is relatively low, they have become an important force to promote the evolution of network structure. ④ The COVID-19 has had a significant impact on the trade flow and network structure of the overall network. The network associations have been further divided and reorganized. The Guangzhou Shenzhen associations have been significantly strengthened. It shows that Guangzhou and Shenzhen have a strong combination effect. The Shanghai associations have been significantly weakened. The research results have a certain reference value for promoting the construction of domestic big cycle and unified big market. © 2023 Journal of Geo-Information Science. All rights reserved.

Feature Adaptation Predictive Coding for Quantized Block Compressive Sensing of COVID-19 X-Ray Images

With the development of remote X-ray detection for Corona Virus Disease 2019 (COVID-19), the quantized block compressive sensing technology plays an important role when remotely acquiring the chest X-ray images of COVID-19 infected people and significantly promoting the portable telemedicine imaging applications. In order to improve the encoding performance of quantized block compressive sensing, a feature adaptation predictive coding (FAPC) method is proposed for the remote transmission of COVID-19 X-ray images. The proposed FAPC method can adaptively calculate the block-wise prediction coefficients according to the main features of COVID-19 X-ray images, and thus provide the optimal prediction candidate from the feature-guided candidate set. The proposed method can implement the high-efficiency encoding of X-ray images, and then swiftly transmit the telemedicine-oriented chest images. The experimental results show that compared with the state-of-the-art predictive coding methods, both rate-distortion and complexity performance of our FAPC method have enough competitive advantages. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Chemo- and Regioselective Construction of Functionalized Isocoumarin, Flavone, and Isoquinolinedione via a One-pot Reaction of o-Quinol Acetate and Soft Nucleophiles

A one-pot strategy for the synthesis of substituted isocoumarin, flavone, and isoquinolinedione derivatives through a switchable C-arylation/lactonization or SNAr reaction from a wide range of soft nucleophiles and o-quinol acetates has been developed. This base-mediated protocol proceeds under transition-metal-free conditions and selectively affords various heteroarenes in 13–98% yields from readily prepared or commercially available 1,3-dicarbonyl and α-EWG-substituted carbonyl compounds. The synthetic utility is further demonstrated in the synthesis of potential anti-HIV and anti-coronavirus derivatives and COX-2 inhibitors. In addition, detailed experimental and computational studies are performed to provide an intensive understanding and strong support of the reaction mechanism. © 2023 Wiley-VCH GmbH.

Spatial-Slice Feature Learning Using Visual Transformer and Essential Slices Selection Module for COVID-19 Detection of CT Scans in the Wild

Computed tomography (CT) imaging could be convenient for diagnosing various diseases. However, the CT images could be diverse since their resolution and number of slices are determined by the machine and its settings. Conventional deep learning models are hard to tickle such diverse data since the essential requirement of the deep neural network is the consistent shape of the input data in each dimension. A way to overcome this issue is based on the slice-level classifier and aggregating the predictions for each slice to make the final result. However, it lacks slice-wise feature learning, leading to suppressed performance. This paper proposes an effective spatial-slice feature learning (SSFL) to tickle this issue for COVID-19 symptom classification. First, the semantic feature embedding of each slice for a CT scan is extracted by a conventional 2D convolutional neural network (CNN) and followed by using the visual Transformer-based sub-network to deal with feature learning between slices, leading to joint feature representation. Then, an essential slices set algorithm is proposed to automatically select a subset of the CT scan, which could effectively remove the uncertain slices as well as improve the performance of our SSFL. Comprehensive experiments reveal that the proposed SSFL method shows not only excellent performance but also achieves stable detection results. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Shared genetic architecture between type 2 diabetes and COVID-19 severity.

PURPOSE: Patients with type 2 diabetes (T2D) have demonstrated a higher risk for developing more severe cases of COVID-19, but the complex genetic mechanism between them is still unknown. The aim of the present study was to untangle this relationship using genetically based approaches. METHODS: By leveraging large-scale genome-wide association study (GWAS) summary statistics of T2D and COVID-19 severity, linkage disequilibrium score regression and Mendelian randomization (MR) analyses were utilized to quantify the genetic correlations and causal relationships between the two traits. Gene-based association and enrichment analysis were further applied to identify putative functional pathways shared between T2D and COVID-19 severity. RESULTS: Significant, moderate genetic correlations were detected between T2D and COVID-19 hospitalization (rg = 0.156, SE = 0.057, p = 0.005) or severe disease (rg = 0.155, SE = 0.057, p = 0.006). MR analysis did not support evidence for a causal effect of T2D on COVID-19 hospitalization (OR 1.030, 95% CI 0.979, 1.084, p = 0.259) or severe disease (OR 0.999, 95% CI 0.934, 1.069, p = 0.982). Genes having pgene < 0.05 for both T2D and COVID-19 severe were significantly enriched for biological pathways, such as response to type I interferon, glutathione derivative metabolic process and glutathione derivative biosynthetic process. CONCLUSIONS: Our findings further confirm the comorbidity of T2D and COVID-19 severity, but a non-causal impact of T2D on severe COVID-19. Shared genetically modulated molecular mechanisms underlying the co-occurrence of the two disorders are crucial for identifying therapeutic targets.

Situation Awareness Based Smart Contract for Modular Construction

Modular construction has been implemented to achieve shorter project duration, lower cost, and higher productivity for construction projects. This option is especially helpful to reduce on-site activities and interaction under and after COVID impact. However, additional planning and support in engineering, procurement, and delivery are required to facilitate modular construction. Unreliable prefabrication and delivery can deteriorate subsequent activity productivity and overall project performance. This research aims to develop an automatic incentive—penalty enforcement system for modular construction based on the situation awareness of delivery tracking. The research selected a high-rise residential project in Singapore as a case study. The project used modular construction for making and installing 120 Prefabricated Bathroom Units. Based on the empirical data of delivery, on-site lifting, and installation, we built STROBOSCOPE simulation models to understand the impact on productivity and schedule from five scenarios at various delivery reliability levels of the Prefabricated Bathroom Units. Smart Contract rules were developed based on the impact. A Blockchain platform was established so that once a real-time delivery is identified and the information is entered into the Smart Contract, the associated incentive or penalty can be triggered instantly. The Smart Contract based incentive—penalty enforcement system will be beneficial for construction projects to monitor and track modular delivery, motivate reliable supply, reduce payment disputes, and improve productivity. © 2023, Canadian Society for Civil Engineering.

A Pilot Survey: Retention in Pain Medicine Among Fellowship Trained Anesthesiologists

Background: We aim to explore the factors related to job satisfaction among pain physicians and identify the reasons why individuals minimize or stop practicing outpatient pain medicine.Objectives/Study Design: This is a survey-based study with the primary goal to identify factors determining job satisfaction and dissatisfaction among pain medicine fellowship graduates who continue to practice and those who are no longer practicing interventional pain. A secondary goal is to elucidate reasons for anesthesiologists trained in pain medicine to leave pain medicine, despite an additional year of training, and to work as general anesthesiologists.Methods: In this study, all 114 pain program directors listed on the Accreditation Council for Graduate Medical Education (ACGME) website, or their administrative assistants were directly contacted via email. All email addresses were obtained from the ACGME website. The survey opened in September 2021, with reminder emails sent before the closing of the survey in December 2021. A final reminder email was sent 4 weeks prior to the closing of the survey.Results: Of all the respondents, 79 (89.77%) were currently practicing pain medicine, and 9 (10.23%) were no longer practicing pain medicine.Limitations: Our study has a major limitation as we are unable to determine the response rate and are limited in the data points gathered.Conclusion: We hope this study will allow for pain medicine fellowship program directors to improve recruitment and retention of pain fellows in the field while addressing the pros and cons of future career aspirations with anesthesiology residents prior to fellowship selection. A larger, more thorough study with an exact response rate can compare the various outcomes based upon different types of settings, such as private practice, partnership, and academia, as well as geographical locations.

Influences of obstacle factors on the transmission trends of respiratory infectious diseases in indoor public places

Public facilities are important transmission places for respiratory infectious diseases (e.g., COVID-19), due to the frequent crowd interactions inside. Usually, changes of obstacle factors can affect the movements of human crowds and result in different epidemic transmissions among individuals. However, most related studies only focus on the specific scenarios, but the common rules are usually ignored for the impacts of obstacles' spatial elements on epidemic transmission. To tackle these problems, this study aims to evaluate the impacts of three spatial factors of obstacles (i.e., size, quantity, and placement) on infection spreading trends in two-dimension, which can provide scientific and concise spatial design guidelines for indoor public places. Firstly, we used the obstacle area proportion as the indicator of the size factor, gave the mathematical expression of the quantity factor, and proposed the walkable-space distribution indicator to represent the placement factor by introducing the Space Syntax. Secondly, two spreading epidemic indicators (i.e., daily new cases and people's average exposure risk) were estimated based on the fundamental model named exposure risk with the virion-laden particles, which accurately forecasted the disease spreading between individuals. Thirdly, 120 indoor scenarios were built and simulated, based on which the value of independent and dependent variables can be measured. Besides, structural equation modeling was employed to examine the effects of obstacle factors on epidemic transmissions. Finally, three obstacle-related guidelines were provided for policymakers to mitigate the disease spreading: minimizing the size of obstacles, dividing the obstacle into more sub-ones, and placing obstacles evenly distributed in space. © 2022 Elsevier Ltd

Impact of decreased aerosols during the COVID-19 pandemic on winter wheat gross primary productivity and water use efficiency

Rapid and comprehensive lockdowns to contain the coronavirus 2019 (COVID-19) pandemic reduced anthropogenic emissions and, thereby, decreased the aerosol optical depth (AOD) in Xiangyang, Hubei Province. However, their complicated interactions make quantifying the contribution of decreased aerosols to crop growth challenging. Here, we explored the indirect effects of decreased aerosol concentrations on the gross primary productivity (GPP) and water use efficiency (WUE) of winter wheat by quantifying the contributions of key environmental factors. Our results showed high temporal and spatial associations between aerosols (represented by AOD), GPP, and WUE before, during, and after the COVID-19 pandemic. AOD decreased by 23.8% +/- 10.1%, whereas GPP and WUE increased by 16.5% +/- 5.8% and 17.0% +/- 15.3%, respectively. The GeoDetector model revealed that photosynthetically active radiation (PAR) had a major impact on GPP and WUE, followed by precipitation, surface soil moisture, subsurface soil moisture, and surface temperature. Moreover, causality analysis showed a causal relationship between AOD and the dominant factors (PAR and precipitation) during the lockdown, thereby indicating a positive effect of decreased aerosols on GPP and WUE changes of winter wheat. Our findings assist in understanding the mechanisms causing GPP and WUE changes, given the environmental factors that changed significantly during the pandemic. (c) 2022 Society of Photo-Optical Instrumentation Engineers (SPIE)

Assessing health-related quality-of-life in Australian Multiple Sclerosis Longitudinal Study participants using six multi-attribute utility instruments: implications for healthcare decision-making

Background: Despite important discoveries/advances in treating multiple sclerosis (MS), people with MS (pwMS) can experience delays in accessing new treatments if decision-makers lack robust health economic evidence including health-related quality-of-life (HRQoL) benefits of the intervention. Health state utilities (HSU) are a HRQoL input for cost-utility analysis. Objective(s): Several multi-attribute utility instruments (MAUIs) are available from which HSUs can be derived, but the most appropriate MAUI for use in MS has not been identified. We aimed to determine the preferentially sensitive MAUI(s) that capture the full impact of MS on HRQoL. Method(s): Participants in this study came from a comprehensive HRQoL survey (mid-2020) of the Australian MS Longitudinal Study. The survey included six MAUIs (EQ-5D-5L/ EQ-5D5LPsychosocial, SF-6D versions 1 and 2, AQoL-8D and PropR), and sociodemographic, Covid19-related and subjective wellbeing data. HSUs were generated from Australian value sets. Ceiling and floor effects were investigated. Bland-Altman plots and Shannon's Indices were examined. Minimal important differences and population norms were sourced from the literature. Result(s): N=1,683 pwMS completed the survey (67% response). HSUs were derived for >97% of respondents. Mean age 58.6 years, 80% female, 19% reported severe disease and 63% had relapsing-remitting MS. Mean (SD) HSUs ranged from 0.45+/-0.29 (SF-6Dv1) to 0.63+/-0.22 (AQoL-8D). EQ-5D-5L revealed the highest ceiling (HSU=1.0;n=157,10%) and floor (HSU<=0;n=113,7%) effects. PwMS with EQ-5D-5L HSU<=0/HSU=1 reported mean HSUs of 0.37/0.91, 0.35/0.90, and 0.08/0.85 for the AQoL-8D, EQ-5D5LPsychosocial and SF-6D, respectively. Conclusion(s): While the EQ-5D is the most commonly cited MAUI (in 85% of health technology assessment guidelines), our preliminary comparison results suggest the EQ-5D-5L is not preferentially sensitive in assessing the complex HRQoL domains for pwMS.

Data Mining and Analysis of Prescription Rules for Plague in Ancient Books of Case Records of Qing Dynasty

Objective To analyze the prescription rules for pestilence in ancient books of case records, and provide reference for treatment of coronavirus disease 2019 (COVID19);Methods The medical cases of warm diseases in ancient times were selected as the source before data extraction rules were made. TCM Miner was used to conduct the counts and analysis of association rules, and Cloud Platform of Ancient and Modern Medical Cases was used for complex network analysis. Results A total of141 medical cases were found in the 14 ancient books of case records, involving 66 formulae and 142 Chinese medicinals. The formulae mainly included Xiao Chaihu Tang (Minor Bupleurum Decoction), Dayuan Yin (Membrane Source-Opening Beverage), and JiuweiQianghuo Tang (Nine Ingredients Notopterygium Decoction), while the medicinals mainly included Lianqiao (Fructus Forsythiae), Fuling (Poria), and Shichangpu (RhizomaAcoriTatarinowii). Conlusion The prescriptions against pestilence in ancient times highlight clearing heat and toxins, cooling the blood, resolving dampness and opening the orifices, which is also combined with releasing the exterior. © 2022 IEEE.