Hydroxychloroquine for COVID-19: A Single Center, Retrospective Cohort Study

Introduction: The outbreak of coronavirus disease (COVID-19) in December 2019 called for a rapid solution, leading to repurposing of existing drugs. Due to its immunomodulatory effect and antiviral properties, hydroxychloroquine (HCQ) has been used in early 2020 for treatment of COVID-19 patients. This study was conducted to evaluate the treatment outcome of HCQ monotherapy in Malaysia. Methods: A retrospective cohort study was conducted in COVID-19 ward in Hospital Kuala Lumpur (HKL), from March to April 2020. A total of 446 COVID-19 patients were recruited, only 325 patients were finally included for analysis. Statistical analysis was done using SPSS, with a significant value set at p<0.05. Results: The mean age of the patients were 38.5 ±15.5. They were majority male, (n=210, 64.6%) Malaysian (n=239, 73.5%) and Malay ethnicity (n=204, 62.8%). Ninety-one (28%) patients received HCQ monotherapy. HCQ monotherapy was associated with worse outcome (OR: 10.29, 95% CI 1.17-90.80). There was a significant difference in mean length of stay between those with and without HCQ treatment (t323=5.868, p<0.001, 95% CI, 2.56-5.31). The average length of stay for HCQ treated group was 3.84 days longer than those without treatment. 6.6% of the patient receiving HCQ monotherapy encountered adverse drug effects. Conclusion: Similar to study reported worldwide, our study demonstrated that HCQ did not improve length of stay and the outcome of COVID-19 patients. © 2023 Authors. All rights reserved.

Why do ventilation strategies matter in controlling infectious airborne particles? A comprehensive numerical analysis in isolation ward

A proper ventilation strategy in an isolation ward could promote better indoor air quality for the occupants. This could also reduce the risk of immunocompromised patients contracting healthcare-associated infections (HAI) or airborne diseases such as COVID-19, tuberculosis, and measles among others. This study aims to propose and examine appropriate ventilation strategies in a single-patient isolation ward that can reduce particle settlement in patients. A simplified CFD model of the isolation ward was developed and well-validated against established data. An RNG k-ε model and discrete phase model (DPM) were used to simulate airflow and particle transportation. The study examined the airflow and particle dispersion under a baseline case and four proposed ventilation strategies. Results showed that the baseline case study, which used the ceiling-mounted air curtain was insufficient to prevent the particles from dispersing into the vicinity of the patient. Likewise, the dilution effect under the baseline case and case 4 (wall-mounted air supply diffuser) were relatively weak due to the low air change rate (ACH) of 4/hr and 9/hr respectively. The ventilation strategy in case 4 has a negligible effect on reducing the particles (14%) settling on the patient although the ACH in case 4 was 2-times the baseline case. The present finding ascertains that utilising the combination of ceiling-mounted air diffuser and air curtain jet (case 3) results in zero particle settlement on both patient's and the patient's bed. It also reduced 57% of particles in the vicinity of the medical staff's breathing zone compared to the baseline case. © 2023 Elsevier Ltd

The Surge of Nationalist Sentiment among Chinese Youth during the COVID-19 Pandemic

Since 2012, Beijing has been promoting a strain of populist nationalism which underscores both the institutional superiority of the ruling party and the cultural superiority of being Chinese. At the international level, however, the image of both the regime and the Chinese has been marred due to the coronavirus (COVID-19) outbreak in Wuhan (December 2019–January 2020). This study examines the extent and the form that the surge in nationalist sentiment of Chinese young people has taken during the COVID-19 pandemic. Based on a questionnaire survey of 1,200 students from a sample of 20 colleges/universities in China (June–July 2020), this study shows that the respondents express high satisfaction with the state's performance in tackling the pandemic, and that there is a substantial surge of nationalist sentiment with a high level of hostility towards other nations (e.g. the United States). Such nationalist sentiment, however, is found to express a bifurcated pattern in that young Chinese also tend to embrace the opportunity to work and study in the Western societies they ostensibly dislike. © China: An International Journal.

Manufacturing Repurposing: A Literature Review

Manufacturing repurposing was a rapid response strategy to overcome shortages of critical healthcare products during the Covid-19 pandemic. Many companies repurposed facilities to manufacture products such as ventilators and hand sanitizers in response to the skyrocketing demand. Manufacturing repurposing was a widespread practice during the early months of the Covid-19 pandemic. This systematic literature review consolidates the fragmented literature on manufacturing repurposing and identifies potential research opportunities in production and operations management. Using a systematic approach, we identified and reviewed 29 articles on manufacturing repurposing and report the findings from both descriptive and thematic analyses. We identified four main themes in the manufacturing repurposing literature: (1) barriers and success factors (2) role of the supply chain, (3) role of innovation, and (4) role of digital technologies. We conclude with a research agenda that suggests three promising lenses for future research on manufacturing repurposing: (1) dynamic capabilities, (2) supply chain resilience, and (3) network perspectives.

Post COVID-19 catatonia: Stuporous state in COVID-19 infection

Catatonia is a common, highly treatable but often unrecognized neuro-behavioral condition that is associated with a wide range of psychiatric and medical etiologies. We present a case report of a 41-year-old female with no prior medical, substance use, or psychiatric history who was brought to the emergency department due to bizarre behavior. History revealed she had fever and cough 1 week prior to onset of the symptoms and was tested positive for COVID-19 infection. She was admitted for COVID-19 infection with encephalopathy. During admission, the patient was found to be in a stuporous state with mutism and slow in response. Physical examination revealed rigidity, posturing and catalepsy. Urine toxicology, computed tomography (CT) brain, magnetic resonance imaging (MRI) brain and lumbar puncture were done and all revealed normal findings. Electroencephalogram (EEG) was performed and showed diffuse slowing of waves. Patient was seen by a neurologist and clinically diagnosed and treated as post COVID-19 catatonia. Her symptoms responded rapidly with benzodiazepine, and she was subsequently discharged home well. This case shows catatonia as the presentation of encephalopathy in association with COVID-19 infection. Saddawi et al concludes that post COVID-19 catatonia pathogenesis is related to systemic inflammation and cytokine storm. Treatment with benzodiazepines results in notable and rapid resolution of catatonia. Therefore clinician should have a high level of suspicion of possible diagnosis of catatonia when a patient in para-infectious or post-infectious states of COVID-19 infection presented with neuropsychiatric symptoms and rigidity. Catatonia is readily treatable and if left untreated, it poses significant risk of morbidity and mortality.

Clinical presentation and in-hospital prognosis of lung cancer patients presenting with suspected and confirmed COVID-19.

We sought to compare the clinical presentation and prognosis of patients with lung cancer and confirmed COVID-19 infection to those with negative RT-PCR SARS-CoV-2 results. We included patients with confirmed lung cancer and suspected COVID-19 who presented to the emergency department. The primary outcome was in-hospital mortality and secondary outcomes included admission to intensive care unit (ICU) or mechanical ventilation. We analyzed the characteristics according to RT-PCR results and primary outcome. We constructed a logistic regression for each RT-PCR result group to find potential predictors of the primary outcome. Among 110 individuals with confirmed lung cancer (65±9 years, 51% male), 38 patients had positive RT-PCR and 72 patients had negative RT-PCR. There was no difference between groups for any clinical characteristic or comorbidities though individuals with confirmed COVID-19 had higher functionality in the ECOG scale. Leucocytes and lymphocytes were lower in individuals with positive tests. The primary outcome occurred in 58 (53%) individuals, 37 (34%) were admitted to the ICU, and 29 (26%) required mechanical ventilation. Although mortality was similar between the two groups, individuals with confirmed COVID-19 were significantly more likely to be admitted to the ICU or receive mechanical ventilation. Only lower lymphocytes and higher CRP were significantly associated with higher mortality. The clinical presentation of COVID-19 in lung cancer is not sufficient to identify higher or lower probability groups among symptomatic individuals, the overall mortality is high irrespective of RT-PCR results, and lymphopenia on admission was associated with the diagnosis and prognosis for COVID-19.

Proposition for LMS Integration for Share, Exchange, and Spread of Online Lectures under Covid-19 Environment

There has been a movement to share and spread online lectures through OCW and MOOC systems. This movement would have been spread widely and adopted widely if those courses could be easily exchangeable with other platforms or services. If this function is available, learning activities, resources, learning outcomes can be accessed between different platforms and services. With this function, the credit exchange between different platforms or services will be easier. It also facilitates course sharing and circulation. Because the LMS is the basic platform for online classes, providing sharable and reusable learning activities, resources, and learning outcomes across the different LMSs is very demanding for online education. Analyzing LMS use in Korean universities, Moodle, Canvas, and domestic LMSs are founded to be the significant three kinds that are widely used in Korea. In this paper, a method of integrating Moodle, Canvas, and domestic LMS services is proposed. A central Moodle server is installed as the main LMS server, and the method to connect or complement with a central Moodle server is proposed for each different kind of LMS. LMS users can easily access a different kind of LMS as a form of imported course, tightly connected service, or log in as SSO. This proposition can be applied to various service fields such as KMOOC, KOCW, credit exchange, lecture exchange between universities, regional unification of online educational centers as a practical problem-solver. © 2021, Politeknik Negeri Padang. All rights reserved.

Implementation of an Integrated Online Class Model using Open-Source Technology and SNS

—Before Covid-19, the class model was divided into online, offline, and blended learning. Due to Covid-19, we have the only online class environment. We need a new online class model under the new circumstances. In the new model, all technology and educational methods need to be well-adapted, organized and harmonized to compensate for the absence of offline learning sessions. In this paper, we propose a new online class model. Because of the absence of offline sessions, the model emphasizes the integration of synchronous and asynchronous activities seamlessly and effectively. The model also emphasizes the instructor's role as a content prosumer because the instructor in the new model is either reusing other's and the one's own contents or supplying those contents for others. This model uses open-source solutions or free services like Moodle, OBS, Tubestory, and Snap Camera for both budget-saving and stability purposes. It actively uses Moodle's monitoring capability and adopts various learning technologies. It consists of three activity sessions: a pre-Zoom session, a Zoom session, and a post-Zoom session. Each session is composed of modules that describe the process and action for the class. The process, methods, and techniques for each module are explained in this paper. The official students survey for class evaluation held by Kongju national university showed that the new class model's application obtained a higher score than the same class of the previous year that is performed by conventional teaching. © 2021, Politeknik Negeri Padang. All rights reserved.

The time-space tactics of Chinese Buddhist and Taoist believers under state-religion tension

This study explores the experience of elderly rural Buddhist and Taoist believers in communist China where the ruling party has maintained decades-long regulatory control over religion. Based on ethnographic observation and oral histories, the analysis begins with how the actors made sense of and coped in their relationship with the state during the fieldwork period (May-June 2020) when state regulations restricted public religious practice because of COVID-19. The analysis then looks back on how practitioners experienced tightening state ideological control from the early 2010s to before COVID-19;further back at the religious revival during the opening and reform (1980s-2010s);and finally, the Cultural Revolution period (1960s-70s) when strict atheistic measures were imposed. Their narratives reveal the practical logic (habitus) which practitioners used to mediate their resistance against and compromise with the authoritarian state. Specifically, four logical modes that involve actors' different time-space tactics were identified, namely state-religion disengagement, state-religion enhancement, religious (dis)enlightenment, and karma. The implications of these ostensibly conflicting modes of thinking in mediating the actors' resistance-compliance interface in contemporary China are discussed.