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Objective To explore the causes and feelings of delayed experience of seeking medical treatment in patients with advanced lung cancer, and to provide new insights for more targeted health education and medical care services. Methods A semi-structured in depth interview based on the theory of planned behavior was conducted among 30 patients with advanced lung cancer who experienced medical delay from November to December in 2021 admitted to First Affiliated Hospital of Guangxi Medical University. The interview content was analyzed and ed by using Colaizzi phenomenological analysis method and Nvivo11.0 software. Results The delay duration of 30 patients with advanced lung cancer ranged from 90 to 213 days. Four subject groups were extracted by generic analysis: the cause of delay, the cause to seek medical help, the worry about the disease, and solutions. Conclusions The delay behavior of patients with advanced lung cancer is affected by external situational factors such as symptom severity, family economic capacity, social support, accessibility of health services, prevalence of novel coronavirus, and subjective psychological factors such as sense of stigma and burden of disease, it is necessary to reduce the occurrence of medical delay in patients with advanced lung cancer through the comprehensive management strategy of multiple channels. © 2023 Chinese Medical Journals Publishing House Co.Ltd. All rights reserved.
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The COVID-19 outbreak significantly affected the global economy and energy markets. To mitigate the shock, maintain financial market stability, and encourage economic recovery, this study investigates the influence of post-COVID-19 on monetary policy transmission to business practices and financial market indicators for green economic recovery. We utilised 37 Asian markets' panel data from 1 January 2020, through 30 December 2020. The empirical findings demonstrate that the pandemic's emergence impeded monetary policy transmission, business practices, and financial markets. Our empirical contribution is to examine the size, sectoral allocation, and implementation options of three leading countries' (China, Japan, and Thailand) green recovery spending plans, which range significantly. However, this effect mainly affects the medium-and-long-term effects, and short-term spillover effects are primarily unaffected by Asian monetary policy uncertainty. Our findings have significant implications for green economic recovery among market players and regulators in the Asian market.
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The economic downturns of 2007–09 and the COVID-19 pandemic affected most industries in the United States, including landscape services and equipment sales, and provoked both short-term disruptions and long-term changes. To understand how the landscaping industry has responded, we investigated patterns of consumer expenditures on landscape services and equipment from 2009 through 2021 using a representative sample of 76,895 US households. We categorized US households as detached single-family residents and townhouse residents to more fully articulate the factors that turned potential consumers into purchasers and the factors that affected purchasers' expenditures. We used a double-hurdle model to identify key factors that drive consumer demand for landscape services and equipment over time, including social-demographics, geographic characteristics, housing conditions, year and seasonal trends, and the COVID-19 pandemic. We found that during the studied period, the demand for landscape services declined in terms of both the percentage of consumers purchasing the services and the purchasers' average expenditures, while the demand for do-it-yourself (DIY) equipment remained relatively unchanged. In response to the COVID-19 pandemic, the percentage of consumers who purchased landscape services increased, while the expenditures on landscape services decreased in 2020 and then began to rebound in 2021, but not enough to reverse the overall downward trend. In contrast, purchases of DIY equipment were relatively stable in response to the COVID-19 pandemic and mainly relied on current consumers. © 2023, American Society for Horticultural Science. All rights reserved.
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Since the last century, animal viruses have posed great threats to the health of humans and the farming industry. Therefore, virus control is of great urgency, and regular, timely, and accurate detection is essential to it. Here, we designed a rapid on-site visual data-sharing detection method for the Newcastle disease virus with smartphone recognition-based immune microparticles. The detection method we developed includes three major modules: preparation of virus detection vectors, sample detection, and smartphone image analysis with data upload. First, the hydrogel microparticles containing active carboxyl were manufactured, which coated nucleocapsid protein of NDV. Then, HRP enzyme-labeled anti-NP nanobody was used to compete with the NDV antibody in the serum for color reaction. Then the rough detection results were visible to the human eyes according to the different shades of color of the hydrogel microparticles. Next, the smartphone application was used to analyze the image to determine the accurate detection results according to the gray value of the hydrogel microparticles. Meanwhile, the result was automatically uploaded to the homemade cloud system. The total detection time was less than 50 min, even without trained personnel, which is shorter than conventional detection methods. According to experimental results, this detection method has high sensitivity and accuracy. And especially, it uploads the detection information via a cloud platform to realize data sharing, which plays an early warning function. We anticipate that this rapid on-site visual data-sharing detection method can promote the development of virus selfchecking at home.
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With the increased cost of living, exacerbated by COVID-19, thousands in New Jersey lack secure access to nutritious food. Given the importance of the issue, this research aims to produce an accurate metric using accessible data to quantify food insecurity. 16 potential explanatory variables, such as median household income and homeless population, were chosen as their values were defined across all NJ counties from 2015-2019. Using multiple linear regression, 14 unique metrics were created after four different variable pruning methods. The leading metric, with an adj. R2 value of 0.932, demonstrates the correlation between food insecurity, population, median household income, total population with health insurance, and population with private health insurance. The implementation of this metric could serve as a tool in predicting areas of food insecurity, highlighting affiliated factors, and revealing connections between racial populations. © 2021 IEEE.
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The outbreaks of SARS and COVID-19 have had a serious impact on public health, social economy and so on in China, in order to reveal the common law and difference characteristics of space-time transmission of respiratory infectious diseases and the reasons behind them, using space-time statistical methods, systematically analyzed and compared the difference characteristics of space-time transmission between SARS and COVID-19, and combined with the transmission characteristics of the virus itself and temperature, traffic and other factors to analyze the causes. The study shows that, ① SARS experiences two stages, the rising period-flat phase, and the COVID-19 experiences three stages, the rising period-sharp rise-slow up period. ② In the mode of spatial transmission, the transmission intensity and range of COVID-19 is greater than that of SARS, and the overall connectivity of COVID-19 is greater and the provinces are more closely related to the outbreak of the virus. Both SARS and COVID-19 transmission have obvious spatial aggregation characteristics. They are based on proximity propagation and long-range leaps, and SARS has a secondary communication center, and COVID-19 diffusion center has not been relocated. ③ In the direction of space communication, SARS is centered in Beijing, Hong Kong and Guangdong, the direction of spatial communication is stronger, and COVID-19 is only spread outwards with Hubei as the center. ④ In terms of spatial transmission speed, the spread time of the first case in each province of SARS is relatively large, and the spread time of the first case in each province of COVID-19 is roughly divided by Hu Huanyong Line, showing a phenomenon of "fast in the east and slow in the west", and the spread time span is relatively short. ⑤ R0 is the main reason for the difference between the spatial transmission range of SARS and COVID-19 and the speed of spatial transmission. The temperature suitability of SARS and COVID-19 viruses is different, but spatial aggregation transmission and adjacent area transmission are occurring in areas with similar temperatures. Besides the virus transmission capacity and temperature impact, traffic is the main reason affecting SARS and COVID-19 space long-range leap transmission, and the spatial transmission speed of both is negatively related to the density of the road network. 2021, Science Press. All right reserved.
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Aim: To report pathologic findings in the gastrointestinal (GI) tract of coronavirus disease 2019 (COVID-19) patients. Material and Methods: we evaluated clinical and GI tract histologic findings in six COVID-19 patients that presented with GI symptoms like diarrhea, and abdominal pain. This study includes surgical resection specimens from five patients and two sets of biopsy specimens from one patient. Results: Idiopathic inflammatory bowel disease was considered in three of six cases based on clinical, radiologic, and endoscopic presentation. Histologically, the enteric mucosa had a spectrum of histologic changes, including active enteritis, chronic active enteritis, and transmural necrosis. Extensive thrombi in vessels and/or vasculitis were identified in three out of the six cases. The presence of extensive vascular thrombi is associated with poor prognosis, and the three patients deceased in a short period of time (ranges from 7-67 days, median 14 days) after admission for GI symptoms. Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) RNA was detected in bowel tissue of one case. The other three patients recovered and were discharged and free of GI symptoms (follow-up period ranges from 235 days to 270 days, median 237 days). Conclusion: COVID-19 associated enteritis may mimic Crohn's disease clinically, radiologically and endoscopically, and these two entities can be differentiated by pathologic findings. COVID-19 patients with GI symptoms may warrant a workup to evaluate for pathologic changes, as the presence of vasculitis and microthrombi may predict poor clinical outcome.
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The COVID-19 pandemic lockdowns led to a sharp drop in socio-economic activities in China in 2020, including reductions in fossil fuel use, industry productions, and traffic volumes. The short-term impacts of lockdowns on China's air quality have been measured and reported, however, the changes in anthropogenic emissions have not yet been assessed quantitatively, which hinders our understanding of the causes of the air quality changes during COVID-19. Here, for the first time, we report the anthropogenic air pollutant emissions from mainland China by using a bottom-up approach based on the near-real-time data in 2020 and use the estimated emissions to simulate air quality changes with a chemical transport model. The COVID-19 lockdown was estimated to have reduced China's anthropogenic emissions substantially between January and March in 2020, with the largest reductions in February. Emissions of SO2, NOx, CO, non-methane volatile organic compounds (NMVOCs), and primary PM2.5 were estimated to have decreased by 27ĝ€¯%, 36ĝ€¯%, 28ĝ€¯%, 31ĝ€¯%, and 24ĝ€¯%, respectively, in February 2020 compared to the same month in 2019. The reductions in anthropogenic emissions were dominated by the industry sector for SO2 and PM2.5 and were contributed to approximately equally by the industry and transportation sectors for NOx, CO, and NMVOCs. With the spread of coronavirus controlled, China's anthropogenic emissions rebounded in April and since then returned to the comparable levels of 2019 in the second half of 2020. The provinces in China have presented nearly synchronous decline and rebound in anthropogenic emissions, while Hubei and the provinces surrounding Beijing recovered more slowly due to the extension of lockdown measures. The ambient air pollution presented much lower concentrations during the first 3 months in 2020 than in 2019 while rapidly returning to comparable levels afterward, which have been reproduced by the air quality model simulation driven by our estimated emissions. China's monthly anthropogenic emissions in 2020 can be accessed from 10.6084/m9.figshare.c.5214920.v2 (Zheng et al., 2021) by species, month, sector, and province. © Copyright:
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Background: The SARS-CoV-2 B.1.1.7 variant which was first identified in the United Kingdom (U.K.) has increased sharply in numbers worldwide and was reported to be more contagious. On January 17, 2021, a COVID-19 clustered outbreak caused by B.1.1.7 variant occurred in a community in Daxing District, Beijing, China. Three weeks prior, another non-variant (lineage B.1.470) COVID-19 outbreak occurred in Shunyi District, Beijing. This study aimed to investigate the clinical features of B.1.1.7 variant infection. Methods: A prospective cohort study was conducted on COVID-19 cases admitted to Ditan hospital since January 2020. Data of 74 COVID-19 cases from two independent COVID-19 outbreaks in Beijing were extracted as study subjects from a Cloud Database established in Ditan hospital, which included 41 Shunyi cases (Shunyi B.1.470 group) and 33 Daxing cases (Daxing B.1.1.7 group) that have been hospitalized since December 25, 2020 and January 17, 2021, respectively. We conducted a comparison of the clinical characteristics, RT-qPCR results and genomic features between the two groups. Findings: Cases from Daxing B.1.1.7 group (15 [45.5%] male; median age, 39 years [range, 30.5, 62.5]) and cases from Shunyi B.1.470 group (25 [61.0%] male; median age, 31 years [range, 27.5, 41.0]) had a statistically significant difference in median age (P =0.014). Seven clinical indicators of Daxing B.1.1.7 group were significantly higher than Shunyi B.1.470 group including patients having fever over 38 (14/33 [46.43%] in Daxing B.1.1.7 group vs. 9/41 (21.95%) in Shunyi B.1.470 group [P = 0 .015]), C-reactive protein ([CRP, mg/L], 4.30 [2.45, 12.1] vs. 1.80, [0.85, 4.95], [P = 0.005]), Serum amyloid A ([SAA, mg/L], 21.50 [12.50, 50.70] vs. 12.00 [5.20, 26.95], [P = 0.003]), Creatine Kinase ([CK, U/L]), 110.50 [53.15,152.40] vs. 70.40 [54.35,103.05], [P = 0.040]), D-dimer ([DD, mg/L], 0.31 [0.20, 0.48] vs. 0.24 [0.17,0.31], [P = 0.038]), CD4+ T lymphocyte ([CD4+ T, mg/L], [P = 0.003]) , and Ground-glass opacity (GGO) in lung (15/33 [45.45%] vs. 5/41 [12.20%], [P =0.001]). After adjusting for the age factor, B.1.1.7 variant infection was the risk factor for CRP (P = 0.045, Odds ratio [OR] 2.791, CI [1.025, 0.8610]), SAA (0.011, 5.031, [1.459, 17.354]), CK (0.034, 4.34, [0.05, 0.91]), CD4+ T ( 0.029, 3.31, [1.13, 9.71]), and GGO (0.005, 5.418, [1.656, 17.729]) of patients. The median Ct value of RT-qPCR tests of the N-gene target in the Daxing B.1.1.7 group was significantly lower than the Shunyi B.1.470 group (P=0.036). The phylogenetic analysis showed that only 2 amino acid mutations in spike protein were detected in B.1.470 strains while B.1.1.7 strains had 3 deletions and 7 mutations. Interpretation: Clinical features including a more serious inflammatory response, pneumonia and a possible higher viral load were detected in the cases infected with B.1.1.7 SARS-CoV-2 variant. It could therefore be inferred that the B.1.1.7 variant may have increased pathogenicity.
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Fever , Pneumonia , COVID-19ABSTRACT
Background: Coronovirus disease 2019 (COVID-19) first broke out in Wuhan, Hubei Province, China, in 2019, and now it spreads in more than 100 countries around the world. On January 30th, the World Health Organization (WHO) declared COVID-19 a public health emergency of international concern. It was classified as a pandemic by the WHO on March 11, 2020. With the increase in the number of cases reported by various countries every day, the COVID-19 pandemic has attracted more and more attention around the world. At the same time, this public health emergency has caused a variety of psychological problems, such as panic disorder, anxiety, and depression. In addition, the Wuhan Mental Health Center's analysis of 2144 calls from the psychological hotline from February 4 to February 20, 2020, showed that the general public accounted for 70%, medical workers accounted for 2.2%, patients with mental disorders accounted for 19.5%, and other personnel accounted for 8.3% (https://mp.weixin.qq.com/s/kmff1vnaLsT2d9xQkK5pwg). Conclusion: Therefore, while controlling the pandemic, the government should also pay attention to the mental health of the general public, medical workers, and patients with mental disorders. Community mental health service systems, online mental health services, telemedicine, and other measures for patients with mental disorders may play a vital role during the pandemic.
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OBJECTIVE: To determine the environmental contamination degree of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corona virus disease 2019 (COVID-19) wards, to offer gui-dance for the infection control and to improve safety practices for medical staff, by sampling and detecting SARS-CoV-2 nucleic acid from the air of hospital wards, the high-frequency contact surfaces in the contaminated area and the surfaces of medical staff's protective equipment in a COVID-19 designated hospital in Wuhan, China. METHODS: From March 11 to March 19, 2020, we collected air samples from the clean area, the buffer room and the contaminated area respectively in the COVID-19 wards using a portable bioaerosol concentrator WA-15. And sterile premoistened swabs were used to sample the high-frequency contacted surfaces in the contaminated area and the surfaces of medical staff's protective equipment including outermost gloves, tracheotomy operator's positive pressure respiratory protective hood and isolation clothing. The SARS-CoV-2 nucleic acid of the samples were detected by real-time fluorescence quantitative PCR. During the isolation medical observation period, those medical staff who worked in the COVID-19 wards were detected for SARS-CoV-2 nucleic acid with oropharyngeal swabs, IgM and IgG antibody in the sera, and chest CT scans to confirm the infection status of COVID-19. RESULTS: No SARS-CoV-2 nucleic acid was detected in the tested samples, including the 90 air samples from the COVID-19 wards including clean area, buffer room and contaminated area, the 38 high-frequency contact surfaces samples of the contaminated area and 16 surface samples of medical staff's protective equipment including outermost gloves and isolation clothing. Moreover, detection of SARS-CoV-2 nucleic acid by oropharyngeal swabs and IgM, IgG antibodies in the sera of all the health-care workers who participated in the treatment for COVID-19 were all negative. Besides, no chest CT scan images of medical staff exhibited COVID-19 lung presentations. CONCLUSION: Good ventilation conditions, strict disinfection of environmental facilities in hospital wards, guidance for correct habits in patients, and strict hand hygiene during medical staff are important to reduce the formation of viral aerosols, cut down the aerosol load, and avoid cross-infection in isolation wards. In the face of infectious diseases that were not fully mastered but ma-naged as class A, it is safe for medical personnel to be equipped at a high level.
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The COVID-19 broke out in December 2019 has brought severe challenges to medical institutions and health security in China. During the control and prevention of this epidemic, various problems in the healthcare system, including shortage of healthcare resources and medical workers, and poor public health awareness, have been revealed. General practitioners, one of the main providers of primary care, play an extremely important role in the control and management of the epidemic in conjunction with physicians from higher level hospitals. We analyzed the problems and weak links in fighting against COVID-19 epidemic, summarized the development of general practice, and the weaknesses of general practice care revealed in combating the epidemic, with recommendations for improvement, hoping to enhance the role of general practice in the management of major public health events. Copyright © 2020 by the Chinese General Practice.
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Objective: To identify problems and demands for antenatal care (ANC) among pregnant women in different trimesters of pregnancy in Shanghai for optimizing ANC service during the epidemic of COVID-19. Method: s Organized by maternal and child health care institute in the 16 districts of Shanghai, a cross sectional study was conducted among pregnant women who came to pregnancy registration in the community health centers or attended ANC in midwifery hospitals from February 7 to February 12, 2020. Consented participating women completed a semi-structured online questionnaire voluntarily. Data was analyzed using frequency,chi-square test and scoring. Result: s A total of 2 002 valid questionnaires were collected from 183 community health centers and 67 midwifery hospitals. About 94.6%(1 894/2 002) of the pregnant women worried about being infected during the COVID-19 epidemic, and 14.7% (294/2 002) demanded for psychological consultation. Time-lapse appointments for ANC were requested by 87.7% (1 756/2 002) of the participants for avoiding presenting themselves in people-density places. Compared with other pregnancy trimesters, pregnant women in the second trimester were more willing to reduce the frequency of ANC (35.2% versus 39.5% versus 48.1%, P<0.01). Compared with multiparas, primiparas were more willing to have online consultation and guidance (49.2% versus 63.8%, P<0.01). Regarding the needs for health knowledge on COVID-19, personal protection against 2019 novel coronavirus (2019-nCoV) was the most concerned for pregnant women, and 71.0% (1 421/2 002) of them preferred to obtain knowledge through health applications, official Weibo and WeChat. Conclusions: Pregnant women in Shanghai critically concern about the risk of 2019-nCoV infections, and highly demand knowledge and measures on prevention and protection from COVID-19. They ask for having time-lapse appointments for ANC and online access to health information and services. Maternal and child care institutes should understand the demands of pregnant women, optimize the means of ANC service, and provide tailored and accessible health education and service for the safety of mother and child.
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Betacoronavirus , Coronavirus Infections , Pandemics , Pneumonia, Viral , Pregnant Women , Prenatal Care , COVID-19 , China , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Female , Humans , Pneumonia, Viral/epidemiology , Pregnancy , SARS-CoV-2Subject(s)
Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Disease Outbreaks/prevention & control , Emergency Medical Services/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Pneumonia, Viral/therapy , Betacoronavirus , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Humans , Pneumonia, Viral/epidemiology , SARS-CoV-2ABSTRACT
Previous studies on the pneumonia outbreak caused by the 2019 novel coronavirus disease (COVID-19) were mainly based on information from adult populations. Limited data are available for children with COVID-19, especially for infected infants. We report a 55-day-old case with COVID-19 confirmed in China and describe the identification, diagnosis, clinical course, and treatment of the patient, including the disease progression from day 7 to day 11 of illness. This case highlights that children with COVID-19 can also present with multiple organ damage and rapid disease changes. When managing such patients, frequent and careful clinical monitoring is essential.