Rapid exchange of a percutaneous gastrostomy tube during an early episode of COVID-19

We retrospectively report a case of rapid exchange of a percutaneous radiologic gastrostomy tube (balloon-occluded type catheter) via off-label use of a pigtail catheter for nutrition supply during a very early episode of coronavirus disease 2019 (COVID-19) in an outpatient clinic. This case demonstrates that minimally invasive percutaneous procedures might be provided safely and effectively under appropriate precautions for preventing COVID-19 transmission during the pandemic.Copyright © 2023, Society of Gastrointestinal Intervention.

Coronavirus murine hepatitis virus strain 3 induces intestinal injury via caspase 3 dependent apoptosis

Background: Diarrhea was typical symptoms of the coronavirus disease 2019 (COVID-19). However, the underlying mechanism had not been fully understood. Aim(s): The study aimed to explore the mechanism of intestinal injury during COVID-19 in a coronavirus murine hepatitis virus strain 3 (MHV-3) induced acute mouse model. Method(s): MHV-3 induced acute infection Balb/cJ mice model was established. Intestine samples were collected at indicated time points as 0 h, 24 h, 48 h and 60 h post infection. The mRNA and protein expression of IL1b, TNFalpha, IL6, caspase 3 and cleaved caspase 3 were examined by real-time quantitative PCR (qPCR) and western blot respectively. The intestine injury and apoptosis were measured by HE staining and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). Moreover, Z-DEVD-FMK (caspase 3 inhibitor) pre-treated MHV-3 infection mice model were established, in which the apoptosis of intestine was evaluated as well. Meanwhile, the murine intestinal cell MODE-K was infected by MHV-3 in vitro for evaluation of virus induced apoptosis. Result(s): Post MHV-3 infection, the histopathology of intestine tissue showed extraordinary injury with time dependence, as well as high level of TUNEL positivity. The mRNA levels of inflammatory cytokine IL1b, TNFalpha and IL6 were significantly increased. The protein expressions of caspase 3 and cleaved caspase 3 in the intestine was found significantly elevated from 24 to 48 h post MHV-3 infection. Z-DEVD-FMK pretreatment inhibited caspase 3 and cleaved caspase 3 expression and decreased TUNEL positivity. Meanwhile, alleviated gut injury and inhibited TNFalpha expression were observed. In vitro treated by MHV-3, intestinal cell line MODE-K showed nine-fold increase of apoptosis by comparison with saline treated ones. The expressions of apoptosis crucial protein caspase3 and cleaved caspase3 significantly elevated, as well as TNFalpha. Conclusion(s): Coronavirus murine hepatitis virus strain 3 induces intestinal injury via caspase 3 dependent apoptosis, which might shed light on the treatment of intestinal complications in COVID-19.

Human Anti-Ace2 Monoclonal Antibodies as Pan-Sarbecovirus Prophylactic Agents

Background: Human monoclonal antibodies from convalescent individuals that target the SARS-CoV-2 spike protein have been deployed as therapeutics against SARS-CoV-2. However, nearly all of these antibodies have been rendered obsolete by SARS-CoV-2 variants that evolved to resist similar, naturally occurring antibodies. Moreover, Most SARS-CoV-2 specific antibodies are inactive against divergent sarbecoviruses Methods: By immunizing mice that carry human immunoglobulin variable gene segments we generated a suite of fully human monoclonal antibodies that bind the human ACE2 receptor (hACE2) rather than the viral spike protein and were engineered to lack effector functions such as ADCC. Result(s): These ACE2 binding antibodies block infection by all hACE2 binding sarbecoviruses, including emergent SARS-CoV-2 variants, with a potency that of the most potent spike binding therapeutic antibodies. Structural and biochemical analyses revealed that the antibodies target an hACE2 epitope that engages SARS-CoV-2 spike. Importantly, the antibodies do not inhibit hACE2 enzymatic activity, nor do they induce ACE depletion from cell surfaces. The antibodies exhibit favorable pharmacology in human ACE2 knock in mice and provide near complete protection of hACE2 knock-in mice against SARS-CoV-2 infection. Conclusion(s): ACE2 binding antibodies should be useful prophylactic and treatment agents against any current and future SARS-CoV-2 variants, as well as hACE2-binding sarbecoviruses that might emerge as future pandemic threats.

Combined Therapy of Lung and Intestine in Treatment of Lung Diseases: A Review.

The theoretical origin of the combined therapy of lung and intestine can be traced back to the Inner Canon of Huangdi, which explains the physiological and pathological interaction between the lung and the large intestine. In recent years, researchers have investigated the scientific essence of the "lung- intestine axis" theory from many aspects, which enriches the relevant theoretical basis, and applied it to the treatment of COVID-19, acute lung injury, and other lung diseases. The close relation between lung and intestine in many aspects embodies the holistic conception of traditional Chinese medicine and explains the holistic theory of interrelation between organs, which correlate to each other physiologically and pathologically. Intestinal microecological disorders can affect lung immune function and cause respiratory diseases, and respiratory diseases are usually accompanied by gastrointestinal symptoms. Lung diseases can be prevented and treated by regulating intestinal flora. According to histoembryology, the epithelial tissue of the lung and intestine comes from primitive foregut. In immunology, both lung and intestine contain mucosa-associated lymphoid tissue, and the pathological changes of the respiratory tract are also closely related to intestinal microorganisms. The tissue origin of lung and large intestine, the correlation of mucosal immunity, and the synchronization of ecological changes provide a scientific basis for the combined therapy of lung and intestine. Therefore, this paper summarizes the theoretical origin, modern research mechanism, and clinical application of combined therapy of lung and intestine, in order to provide a new direction for its application in clinical and scientific research.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Risk of autoimmune diseases in patients with COVID-19 a retrospective cohort study

Background There are a growing number of case reports of various autoimmune diseases occurring after COVID-19, yet there is no large-scale population-based evidence to support this potential association. This study provides a closer insight into the association between COVID-19 and autoimmune diseases and reveals discrepancies across sex, age, and race of participants.Methods This is a retrospective cohort study based on the TriNetX U.S. Collaborative Network. In the test-negative design, cases were participants with positive polymerase chain reaction (PCR) test results for SARS-CoV-2, while controls were participants who tested negative and were not diagnosed with COVID-19 throughout the follow-up period. Patients with COVID-19 and controls were propensity score-matched (1: 1) for age, sex, race, adverse socioeconomic status, lifestyle-related variables, and comorbidities. The primary endpoint is the incidence of newly recorded autoimmune diseases. Adjusted hazard ratios (aHRs) and 95% confident intervals (CIs) of autoimmune diseases were calculated between propensity score-matched groups with the use of Cox proportional-hazards regression models.Findings Between January 1st, 2020 and December 31st, 2021, 3,814,479 participants were included in the study (888,463 cases and 2,926,016 controls). After matching, the COVID-19 cohort exhibited significantly higher risks of rheumatoid arthritis (aHR:2.98, 95% CI:2.78-3.20), ankylosing spondylitis (aHR:3.21, 95% CI:2.50-4.13), systemic lupus erythematosus (aHR:2.99, 95% CI:2.68-3.34), dermatopolymyositis (aHR:1.96, 95% CI:1.47-2.61), systemic sclerosis (aHR:2.58, 95% CI:2.02-3.28), Sjogren's syndrome (aHR:2.62, 95% CI:2.29-3.00), mixed connective tissue disease (aHR:3.14, 95% CI:2.26-4.36), Behcet's disease (aHR:2.32, 95% CI:1.38-3.89), polymyalgia rheumatica (aHR:2.90, 95% CI:2.36-3.57), vasculitis (aHR:1.96, 95% CI:1.74-2.20), psoriasis (aHR:2.91, 95% CI:2.67-3.17), inflammatory bowel disease (aHR:1.78, 95%CI:1.72-1.84), celiac disease (aHR:2.68, 95% CI:2.51-2.85), type 1 diabetes mellitus (aHR:2.68, 95%CI:2.51-2.85) and mortality (aHR:1.20, 95% CI:1.16-1.24).Interpretation COVID-19 is associated with a different degree of risk for various autoimmune diseases. Given the large sample size and relatively modest effects these findings should be replicated in an independent dataset. Further research is needed to better understand the underlying mechanisms.Funding Kaohsiung Veterans General Hospital (KSVGH111-113).

Advance in human coronaviruses research of host interactions.

2019-novel coronavirus (2019-nCoV) is a highly pathogenic human CoV that first emerged in Wuhan in 2019. 2019-nCoV has a zoonotic origin and poses a major threat to public health. However, little is known about the viral factors contributing to the high virulence of 2019-nCoV. Many animal viruses, including CoVs, encode proteins that interfere with host gene expression, including those involved in antiviral immune responses, and these viral proteins are often major virulence factors. Human coronaviruses (HCoVs) are known respiratory pathogens associated with a range of respiratory infection. In the past 17 years, the onset of 2019-nCoV, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) have thrust HCoVs into spotlight of the research community due to their high pathogenicity in humans. The recent study of HCoVs-host interactions has contributed extensively to our understanding of infection pathogenesis of 2019-nCoV. This review discuss various host physiopathologic mechanism, such as apoptosis, innate immunity, endoplasmic reticulum (ER) stress response, mitogen-activated protein kinase (MAPK) pathway and nuclear factor kappa B (NF-kappaB) pathway that may be modulated by HCoVs and provides evidence for the intensive investigate of 2019-nCoV infection.Copyright © 2020 by the Chinese Medical Association.

Medical Small-scale Transportation Object Detection Algorithm Based on Multimodal Data Fusion

The emergence of the Covid-19 pandemic has greatly impact transportation, and unmanned transportation has been widely used in medical. The average precision of object detection as an important part in unmanned medical transportation. Object detection mainly relies on sensors of vehicles to obtain information about the surrounding obstacles like camera and LIDAR. In this paper, we introduce a new fusion way to fuse data from different modalities, as 2D and 3D object detection encouraging performance, they are typically based on a single modality and are unable to leverage information from other modalities. We leverage the geometric semantic consistency of 2D and 3D detection to obtain more accurate fusion results, and address the weaknesses of IoU in fusion network by using a generalized version as both a new loss and a new metric. The experimental evaluation on the challenging KITTI object detection benchmark, shows significant improvements in average precision, especially at bird's eye view metrics, which shows the feasibility and applicability of the network. © 2022 IEEE.

Towards Remote Auscultation with Commodity Earphones

Virtual visits (a.k.a., telehealth) have been promoted in response to the COVID pandemic since early 2020. Despite its convenience, the current virtual visit practice barely relies on video observation and talking. The specialist, however, cannot accurately assess the patient's health condition by listening to acoustic cardiopulmonary signals emanating from the patient's heart with a stethoscope. In this poster, we explore the feasibility of remote auscultation in virtual visits settings by reusing the patient's earphones as a stethoscope. The proposed hardware-software system captures the minute heartbeats from the patient's ear canal. It then offloads these noisy cardiac signals to the pairing device (e.g., a smartphone or a laptop) to reconstruct fine-grained Phonocardiogram (PCG) signals. By listening to the reconstructed PCG signals, the specialist can easily assess the patient's health condition and make the most informed diagnosis. We describe the design challenges and explain our technical roadmap. © 2022 Owner/Author.

Applications of XAI for Decision Making in the Manufacturing Domain

This chapter discusses an important topic in factory management, that of improving the understandability of AI applications for group multi-criteria decision making in manufacturing systems. Due to its long-term and cross-functional impact, decision making may be more critical to the competitiveness and sustainability of manufacturing systems than production planning and control. This chapter uses the example of choosing the right smart and automation technologies for factories during the COVID-19 pandemic. This topic is of particular importance as many factories are forced to close or operate on a smaller scale (using a smaller workforce), thus pursuing further automation. Artificial intelligence and Industry 4.0 technologies have many applications in this area, most of which can also be applied for other decision-making purposes in manufacturing systems. First, a systematic procedure was established to guide the group multi-criteria decision-making process. Applications of AI and XAI to identify targets are first reviewed. Subsequently, the application of AI and XAI to selection factors and development of criteria is presented. Artificial intelligence techniques are widely used to derive criteria priorities. Therefore, it is particularly important to explain XAI techniques and tools for such AI applications. Aggregating the judgments of multiple decision makers is the next focus, followed by the introduction of AI and XAI applications to evaluate the overall performance of each alternative. Taking fuzzy ranking preference based on similarity to ideal solution (FTOPSIS) as an example, the application of XAI techniques and tools in explaining comparison results using FTOPSIS is illustrated. Another AI technology used for the same purpose is fuzzy VIKOR. XAI techniques and tools for interpreting fuzzy VIKOR are also presented. Finally, several metrics are proposed to evaluate the effectiveness of XAI techniques or tools for decision making in the manufacturing domain. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Barriers to Accessing Essential Medicines in Nephrology and Related Non-Communicable Diseases: A Scoping Review

Introduction: Access to safe, effective, quality, and affordable essential medicines (EM) for all is one of the World Health Organization's Sustainable Development Goals for health. However, access to EM for the treatment of non-communicable diseases (NCDs) is lacking in many low-income (LICs) and lower-middle income countries (LMICs). Chronic kidney disease (CKD) is often a downstream consequence of other NCDs, such as diabetes (DM) and cardiovascular disease (CVD), further exacerbating the economic burden on healthcare systems and societies. In nephrology, access to EM is especially important to reduce the risk of CKD progression because kidney replacement therapy is unavailable or cost-prohibitive in many regions of the world. As members of the International Society of Nephrology (ISN) Emerging Leaders Program 2021 cohort, we conducted a scoping review to assess the breadth of evidence regarding EMs for management of CKD and related NCDs, with identification of barriers to EM access as one of our main aims. Method(s): We included English-language articles of any study design that addressed barriers to accessing essential medicines in populations with CKD (all stages, causes, and ages), CVD, hypertension, and/or DM. All ISN geographical regions and World Bank income categories were considered. We searched MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials to May 2021. Titles and abstracts were screened, and full texts were retrieved for potentially relevant publications. Each full-text article was assessed for inclusion. For included articles, data extraction was performed with a standardized form using Covidence software. Each step was performed by one reviewer and checked by a 2nd reviewer. Applying an ecological model, barriers were categorized as occurring at the national/health policy level, regional level, organization level, provider level, or patient level. Result(s): Ninety-six publications addressed barriers to access to essential medicines, including LICs (16 articles), LMICs (43 articles), upper-middle income countries (25 articles), high-income countries (10 articles), plus 21 articles which did not specify countries. Most publications assessed barriers at the health policy-level, which included high EM prices in the setting of current patent laws;lack of effective systems for public procurement of EM, resulting in large out-of-pocket household expenditure for medicines in LIC/LMIC;inefficient distribution systems with multiple price mark-ups;and lack of regulatory systems, giving rise to counterfeit medications. Regional-level barriers included lack of governance of supply chain logistics, lack of regional coordination, and poor transportation infrastructure, especially in rural settings. Organization-level barriers included medication stock-outs at facilities, and health care worker shortages. Provider-level barriers included irrational prescribing, lack of CKD identification, and poor communication with patients. Patient-level barriers included poverty, informational barriers/health literacy, and negative perception of generic medicines (Figure). [Formula presented] Conclusion(s): Barriers to accessing EM exist at several levels, particularly the health system-level, and affect LICs and LMICs disproportionately. This scoping review serves as an initial step towards designing implementation studies to address barriers to improve EM access. Conflict of interest Potential conflict of interest: MMMY has a consultancy agreement with George Clinical and served on a CKD advisory board sponsored by AstraZenecaCopyright © 2023

Semantic Segmentation Algorithms for Ground AGV and UAV Medical Transport Scenes

The outbreak of the Covid-19 pandemic in recent years and the epidemics of infectious diseases that have occurred around the world over the years, there are problems of lack of medical supplies and difficulties in personnel scheduling. Intelligent medical transportation through modern technology is an effective means to solve this problem. AGV(Automated Guided Vehicle) transportation and UAV(Unmanned Aerial Vehicle) transportation are important ways for intelligent transportation of medical materials. This paper investigates semantic segmentation as a key technology for AGV transport and UAV transport. This paper compares other traditional semantic segmentation networks, and at the same time considers the characteristics of all-weather, all-terrain, and complex transportation of materials in medical transportation, and proposes SSMMTNet(Semantic segmentation of medical material transportation Net). Among them, we propose a Scaling Transformer Block that can extract depth features of point clouds to enrich contextual information. At the same time, the network is validated on the benchmark Semantic3D dataset, obtaining 71.5% mIoU and 90.6% OA. © 2022 IEEE.

Investigating Financial Toxicity among Breast Cancer Patients Diagnosed during the Pandemic: The Role of Cancer Care Disruptions and Social Isolation

Background: Financial toxicity (FT) is a multi-faceted construct, encompassing material hardship, psychological responses, and coping behaviors. FT adversely impacts patient-reported outcomes by decreasing mental health, affecting health-related quality of life (HRQOL), and deteriorating healthcare adherence. Few studies have assessed the relationship between financial toxicity, distress, coping, self-efficacy, and HRQOL within the context of cancer care disruptions resulting from the pandemic. Method(s): In the COVID-19 Breast Cancer Care Survey, 46 women with primary breast cancer were cross-sectionally evaluated for financial hardship (FACIT-COST), distress (Perceived Stress Scale), coping behaviors (Brief COPE), self-efficacy (Cancer Behavior Inventory-Brief) and HRQOL using the Functional Assessment of Cancer Therapy General (FACT-G) measure. Cancer care disruptions were measured with a series of questions investigating the impact of COVID-19 guidelines on access to healthcare services, treatment, and transition to telemedicine. Given the role of informal caregivers for patients' outcomes, social isolation was additionally included (PROMIS Social Isolation Scale). Descriptive statistics were computed, and bivariate correlations examined. Then, a subsequent regression model investigated predictors of FT in the present sample. Statistical analyses were performed using SAS 9.4 and significance level was set at p< 0.05. Result(s): Overall, participants were adult (Mage= 46.3+/-10.9) women diagnosed with early-stage breast cancer (75.61% Stage I/II). Approximately half of the participants were in active treatment (51.2%) and received multiple types of treatment (85.4% surgery;61% chemotherapy, and 36.5% radiation). Although all participants were insured at time of the study, the mean score of FT was 22.75 (SD=4.10, range: 0-44). Correlation analyses indicated that cancer care disruptions (r= -0.57, p<.001), health-related quality of life (r=-0.51, p=0.0007), coping behaviors (r=-0.33, p=0.037), well-being (r=0.56, p=0.0001), social isolation (r=-0.40, p=0.0096), and psychological distress (r=-0.42, p=0.0064) were significantly correlated with FT. That is, women who reported greater disrupted cancer care delivery, greater difficulties managing the illness, reduced physical and mental health, and those experiencing more social isolation reported worse financial toxicity. Results of the final regression model showed that women who experienced greater COVID19-related cancer care disruptions (beta=-2.82, p=0.0013) and isolation (beta=-0.44, p=0.0196) from supportive networks were more likely to indicate elevated FT scores. Conclusion(s): A multidisciplinary and patient-centered FT management approach can be implemented to extend current financial navigation models to address psychosocial and behavioral factors exacerbated by altered care delivery protocols.

[Current research in liver transplantation during the Covid-19 pandemic].

The coronavirus disease (Covid-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has drastically changed our daily life and clinical practice.Due to the reduction of liver transplantation and the liver injury caused by SARS-CoV-2 infection during the pandemic,the prognosis of waitinglisted liver transplant candidates is worse.Due to the long-term immunosuppressive therapy of liver recipients,their risk of infection is higher than the general population.Although some studies suggested that immunosuppressive therapy seems to have a protective effect in infected patients,it also leads to chronic infection.Due to the concerns about the risk of virus transmission,expert consensus does not recommend the utilization of donor livers with the history of Covid-19.Currently,published articles do not support the argument that virus can be transmitted to recipients through donor livers.Therefore,the feasibility of liver transplantation utilizing donor livers with SARS-CoV-2 infection remains controversial.In this article,current advances in liver transplantation during the Covid-19 pandemic are reviewed to provide a new perspective for liver transplantation in the future.

'Pandem-icons' - exploring the characteristics of highly visible scientists during the Covid-19 pandemic

The Covid-19 pandemic escalated demand for scientific explanations and guidance, creating opportunities for scientists to become publicly visible. In this study, we compared characteristics of visible scientists during the first year of the Covid-19 pandemic (January to December 2020) across 16 countries. We find that the scientists who became visible largely matched socio-cultural criteria that have characterised visible scientists in the past (e.g., age, gender, credibility, public image, involvement in controversies). However, there were limited tendencies that scientists commented outside their areas of expertise. We conclude that the unusual circumstances created by Covid-19 did not change the phenomenon of visible scientists in significant ways.

Risk of autoimmune diseases in patients with Covid-19

Background: There are a number of emerging case reports of various autoimmune diseases occurring after Covid-19, yet there is still no large-scale population-based evidence to support this potential association. This study provides a closer insight into the association between Covid-19 and autoimmune diseases and reveals discrepancies across sex, age and race of participants. Method(s): This is a retrospective cohort study based on the TriNetX US Collaborative Network. In the test-negative design, cases (N = 1,118,682) were participants with positive polymerase chain reaction (PCR) test results for severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2), while controls were participants who tested negative and were not diagnosed Covid-19 throughout the follow-up period. The primary end points are incidence of newly-recorded autoimmune diseases. Hazard ratios (HRs) and 95% CIs of autoimmune diseases were calculated between propensity score-matched groups. We set osteoporosis as a negative control outcome to examine possible unmeasured confounders. We used another TriNetX database called Global Network for cross-validation to mitigate regional bias. Result(s): After propensity score matched for age, sex, race, socioeconomic status, and lifestyles variables, Covid-19 group exhibited significant higher risk of rheumatoid arthritis (HR:1.190, 95% CI:1.144-1.237), polymyalgia rheumatic (HR:1.147, 95% CI:1.016-1.296), vasculitis (HR:1.524, 95% CI:1.407-1.651), psoriasis (HR:1.264, 95% CI:1.203-1.329), and type 1 diabetes (HR:1.144, 95%CI:1.100-1.190), whereas it was associated with lower risk of systemic sclerosis (HR:0.767, 95% CI:0.668-0.881) and inflammatory bowel disease (HR:0.914, 95% CI:0.890-0.939). In general, age, sex, race and sensitivity analysis showed consistent trends in all strata. Conclusion(s): Covid-19 appears to be associated with a different degree of risk for various autoimmune diseases. Our preliminary findings have implications for clinical services and further research for mechanism is mandatory.

CAPRL Scoring System for Prediction of 30-day Mortality in 949 Patients with Coronavirus Disease 2019 in Wuhan, China: A Retrospective, Observational Study

Background:Coronavirus disease 2019 (COVID-19) is a serious and even lethal respiratory illness. The mortality of critically ill patients with COVID-19, especially short term mortality, is considerable. It is crucial and urgent to develop risk models that can predict the mortality risks of patients with COVID-19 at an early stage, which is helpful to guide clinicians in making appropriate decisions and optimizing the allocation of hospital resoureces.Methods:In this retrospective observational study, we enrolled 949 adult patients with laboratory-confirmed COVID-19 admitted to Tongji Hospital in Wuhan between January 28 and February 12, 2020. Demographic, clinical and laboratory data were collected and analyzed. A multivariable Cox proportional hazard regression analysis was performed to calculate hazard ratios and 95% confidence interval for assessing the risk factors for 30-day mortality.Results:The 30-day mortality was 11.8% (112 of 949 patients). Forty-nine point nine percent (474) patients had one or more comorbidities, with hypertension being the most common (359 [37.8%] patients), followed by diabetes (169 [17.8%] patients) and coronary heart disease (89 [9.4%] patients). Age above 50 years, respiratory rate above 30 beats per minute, white blood cell count of more than10 × 109/L, neutrophil count of more than 7 × 109/L, lymphocyte count of less than 0.8 × 109/L, platelet count of less than 100 × 109/L, lactate dehydrogenase of more than 400 U/L and high-sensitivity C-reactive protein of more than 50 mg/L were independent risk factors associated with 30-day mortality in patients with COVID-19. A predictive CAPRL score was proposed integrating independent risk factors. The 30-day mortality were 0% (0 of 156), 1.8% (8 of 434), 12.9% (26 of 201), 43.0% (55 of 128), and 76.7% (23 of 30) for patients with 0, 1, 2, 3, ≥4 points, respectively.Conclusions:We designed an easy-to-use clinically predictive tool for assessing 30-day mortality risk of COVID-19. It can accurately stratify hospitalized patients with COVID-19 into relevant risk categories and could provide guidance to make further clinical decisions. © 2021 The Chinese Medical Association, Published by Wolters Kluwer Health, Inc.

The Impact of Government Behavior on the Development of Cross-Border E-Commerce B2B Export Trading Enterprises Based on Evolutionary Game in the Context of "Dual-Cycle" Policy

In 2020, the COVID-19 pandemic had a major impact on China's foreign trade. Therefore, the Chinese government has proposed a "dual cycle" policy to promote economic development. In 2021, China's cross-border e-commerce B2B exports accounted for 60 percent. Therefore, this paper studies the impact of government actions on the development of cross-border e-commerce B2B export enterprises under the background of "dual cycle" policy. First, the policies related to the cross-border e-commerce industry in the "dual circulation" policy are screened, and the LDA topic model is used to classify them, i.e., sorting by topic intensity as "fiscal policy", "tax policy", "customs clearance policy", "payment policy" and "talent policy". After that, based on the analysis results of the LDA topic model, a theoretical basis for the impact of different policies on cross-border e-commerce B2B export companies is established;then an evolutionary game model between the government and cross-border e-commerce B2B export enterprises is constructed. This article also carried out experiments to verify our analysis. The simulation results show that: (1) The government's appropriate increase in subsidies, tax incentives, infrastructure investment, talent introduction and cultivation, optimized payment system, and supervision can promote enterprises to participate in cross-border e-commerce B2B export trading;(2) excessive government supervision reduces enterprises' enthusiasm to participate in cross-border e-commerce B2B export trading;(3) the government's subsidies, tax incentives, and supervision strength have the greatest impact on whether enterprises participate in cross-border e-commerce B2B export trading, followed by the government's investment in cross-border e-commerce infrastructure, the introduction and cultivation of cross-border e-commerce talents, and the improvement of the payment system. Finally, this paper puts forward relevant policy recommendations to promote the development of cross-border e-commerce B2B export enterprises.

Boosting the Electrochemical Detection Response Toward Hydroxychloroquine via Tungsten Trioxide Nanorods/Nitrogen-Doped Carbon Nanofiber Nanocomposite

The overusage of hydroxychloroquine (HQ) amidst the outbreak of coronavirus disease has contributed to increased fatalities concerning HQ poisoning. Hence, there is an utmost requirement to develop accurate and onsite methodologies for monitoring HQ in biological samples and water bodies. Metal-oxide-decorated carbon nanomaterials present excellent electrocatalytic properties, contributing to improved sensor responses. This study introduces tungsten trioxide nanorods/ nitrogen-doped carbon nanofiber (WO3/N-CNF) nanocomposite, capable of detecting HQ electrochemically. The conjunction of WO ;with N-CNF offers accelerated charge transfer kinetics with an abundance of surface-active sites that benefit the sensing mechanism. Furthermore, synergistic effects arising from the nanocomposite augment the conductivity and promote faster ion diffusion. The WO3/N-CNF-based electrochemical sensor deliver high performance in the working concentration range of 0.007-480 mu M and provides a detection limit of 2.0 nM for HQ The fabricated sensor has excellent operational stability and reproducibility and is also able to show a superb selectivity toward HQin comparison to various interfering compounds. This indicates that the designed WO3/N-CN.F nanocomposite can be used as a potential electrocatalyst for the real-time monitoring of HQ.

Formation of hotel employees' service innovation performance: Mechanism of thriving at work and change-oriented organizational citizenship behavior

Building upon self-determination theory and social exchange theory, this study proposes a research framework and examines the formation of service innovation performance. Data was collected during the COVID-19 pandemic in 2021. A total of 374 hotel employees from 92 departments were collected in Taiwan. The results revealed that both leader-member exchange (LMX) and coworker support exert positive effects on thriving at work and change-oriented organizational citizenship behavior (OCB). Besides, thriving at work exerted positive effects on change-oriented OCB, and change-oriented OCB exerted positive effects on service innovation performance. Furthermore, thriving at work partially mediated (1) the relationship between LMX and change-oriented OCB, and (2) the relationship between coworker support and change-oriented OCB. © 2022 The Authors

Examining the Interplay between Social Media Usage, Happiness, and Academic Performance with Data Science

There are numerous separate studies between social media usage and happiness, or social media and academic performance. However, the triangular relationship hasn't been thoroughly scrutinized. We set out our study wondering about the deep logic behind this interplay and its lessons on helping people make better decisions. We used correlation, linear regression, cosine similarity, random forest prediction, and aided visualization to analyze the data set collected. A strong association was found but the exact model of the trigonal relationship remained a mystery. COVID impacts people's happiness and GPA were also studied. © 2022 IEEE.