Research Trend Analysis About Child Abuse During Covid-19 Period

Through examination of trends in child abuse research published in academic journals from 2019 to 2021, the purpose of this study is to identify future research plans and options to address the problem of child abuse. In order to do this, we examined 288 publications on child abuse that were published in KCI-listed journals between 2019 and 2021, categorizing them into four groups: academic disciplines, research topics, research types, and research subjects. The Academy for Social Sciences, therefore, published more than 87.8% of the analysis papers in each academic field. The sequence in which the articles on each research topic were published was the influence of abuse, actual conditions and perceptions, institutions, laws, and policies. Among the empirical scientific studies, survey research accounted for most of the characteristics of each type of study, and research trends by research subjects were found to be the most common for general children. In summary, most of the topics related to child abuse during the COVID-19 period were found to be survey studies using questionnaires structured in the form of surveys on the impact of abuse on general children. Therefore, future research on child abuse should be approached at the social dimension, such as family and child protection agency workers, to intervene in the prevention of child abuse or come up with therapeutic alternatives © 2023, Journal for ReAttach Therapy and Developmental Diversities. All Rights Reserved.

Economic impact of COVID-19 on income and use of livelihoods related coping mechanisms in Chad

IntroductionImpacts of the economic slowdown due to COVID-19 were prevalent in SubSaharan African countries. Using four nationally representative surveys collected in 2020 (rural n = 13,208;urban n = 1736) and 2021 (n = 14,730;n = 2,231), this secondary analysis evaluates economic impacts of the pandemic on household income and use of livelihoods-related coping mechanisms in Chad. MethodsUnivariate and multivariate regression, accounting for the survey design and sampling weights, was used to examine risk factors for reported income reduction and coping mechanism use and the associations with food expenditures and food security. ResultsThe economic impact of COVID-19 was greater in urban areas than rural areas in 2020 with improvement in urban areas and deterioration in rural areas in 2021. The reported income reduction was associated with female and unmarried household heads, living in the Saharan zone, and in rural areas, non-agricultural income sources. In urban areas, having skilled/unskilled labor as the primary income source was protective. Risk factors for the adoption of livelihoods-related coping mechanisms were similar to those of income reduction, with findings related to poor living conditions. Income reduction due to COVID-19 was associated with the use of stress and crisis coping strategies and lower household expenditure in both years and poor food consumption in rural areas in 2020. DiscussionThis study elucidates the potential impact pathways of COVID-19 from a household economic downturn to limited food spending, poor food consumption, and increased use of coping mechanisms. Findings are relevant for informing the targeting of assistance in future economic shocks and suggest prioritizing socioeconomically vulnerable households.

Utilizing a Decentralized Clinical Study Approach for Expedited and Diverse Recruitment for Clinical Validation of a Novel Non-invasive Multitargeted Stool-based RNA Test

Introduction: Traditional clinical trials that utilize fixed sites often fail to recruit participants that are representative of the intended use population. Participants, particularly those from minority groups, cite geographical constraints, mistrust, miscommunication, and discrimination as barriers to successful recruitment. A decentralized clinical trial enrollment strategy offers reduced cost, reduced time requirements, and circumvents barriers associated with the recent pandemic outbreak. Method(s): After the mt-sRNA test system entered design-lock, a decentralized clinical trial (CRC-PREVENT) was launched through a digital campaign (https://www.colonscreeningstudy.com/;NCT04739722). Online advertisements were published on multiple social media sites, and engagement with materials directed patients to an online screener. Participants who completed the screener were eligible for enrollment if they met CRC-PREVENT inclusion and exclusion criteria and were willing to complete all clinical trial components, including providing a stool sample before an optical colonoscopy. Result(s): After 12 months of active enrollment, 276,400 individuals engaged with digital advertisements and completed pre-screener surveys to determine eligibility for the clinical trial. In total, 14,264 individuals consented to participate in the CRC-PREVENT clinical trial. Of these individuals, 58% were female (42% were male), and 65% were over 50. Regarding race and ethnicity, eligible individuals directly represented the intended use population: 16% were Black or African American, 0.2% were Native Hawaiian, Pacific Islander, American Indian, or Alaskan Native, and 7% were Hispanic or Latinx. Regarding socioeconomic status, the decentralized approach permitted access to individuals with healthcare inequities: 25% of participants had income under $29,999, 5% of participants were from rural areas (defined as a city center , 10,000 people), and 36.7% of participants were on public insurance. Individuals were derived from 7,644 unique zip codes across all 48 continental United States. (Table) Conclusion(s): A decentralized recruitment strategy permits highly successful enrollment in the face of screening burdens heightened by COVID-19 pandemic. This approach also offered a significantly more diverse population and could mitigate selection bias and attrition bias associated with the cohorts observed in traditional clinical studies.

An umbrella review of Lianhua Qingwen combined with Western medicine for the treatment of coronavirus disease 2019

Lianhua Qingwen combined with Western medicine (LHQW+WM) has been proposed as a viable treatment for coronavirus disease 2019 (COVID-19). Interestingly, umbrella reviews of systematic reviews (SRs), which provide the most comprehensive evidence, are the best evidence in evidence-based medicine. Therefore, an umbrella review of SRs that summarizes and evaluates the efficacy of LHQW+WM for COVID-19 is urgently required.Methods:: Overall, 6 databases were used to conduct a comprehensive literature search from inception to January 22, 2022. The corrected covered area (CCA) was used to analyze the overlapping between SRs. Meta-analysis was conducted when that of the included SRs was inappropriate. A MeaSurement Tool to Assess Systematic Reviews (AMSTAR-2) was also employed to assess the quality of the included SRs. Results:: In total, 12 SRs were identified, which included 12 unique primary studies. The included SRs ranged in quality from moderate to critically low and had an extremely high CCA (36.4%). Compared to conventional treatment, LHQW+WM showed efficacy concerning fatigue recovery [risk ratio (RR) = 1.69, 95% confidence interval (CI): 1.04–2.73, n = 2, I2 = 0%], cough recovery (RR = 1.65, 95% CI: 1.09–2.51, n = 3, I2 = 39.1%), and overall effective rates (RR = 1.17, 95% CI: 1.07–1.28, n = 3, I2 = 17.5%). Conclusion:: LHQW+WM may improve the clinical symptoms of patients with COVID-19;however, the results should be interpreted cautiously because of the rigorous processes in the included SRs. Graphical :: http://links.lww.com/AHM/A32.

Microfluidics: Simulating the gut microbiome for early cancer detection

Background: Cancer is the second leading cause of death globally and ∼39.5% of people will be diagnosed with cancer at some point during their lifetimes. Thus, there is an unmet need to identify novel strategies for early cancer detection and prevention. The emerging evidence suggests that the gut microbiome has a role in promoting cancer. This microbiome including bacteria plays a vital role in maintaining homeostasis in the body. An imbalance in bacterial composition may cause diseases including cancer. Here we developed a microfluidic chip that can accurately simulate the gut microbiome to test the effects of bacteria and therapies on cancer cells. Methods and Results: To test the causal effect of bacteria on cancer, we developed a new highthroughput microfluidic device for simulating the environment of the gut. Initially, we used the photolithography technique where we designed the chip in AutoCAD and fabricated using photoresist resins and Polydimethylsiloxane (PDMS). Next, we tested the effect of bacteria on the growth of colorectal cancer cells. For this, we cultured colorectal cancer cells (HCT-116) with lipopolysaccharide (LPS), which is found in the outer membrane of bacteria, as well as the Bacillus bacteria in our microfluidics. Our data show that both LPS and Bacillus significantly accelerate the growth of cancer cells 2.02 times (p value = 0.012) and 1.58 times (p value = 0.011), respectively, over a 4 day culture period. These results show that the increased presence of certain bacteria can promote cancer cell growth and that our chip can be used to test the specific correlation between bacteria and cancer cell growth. The previously described method was inefficient and time-consuming. To overcome this limitation, we designed a new chip that allows running 16 samples at once with improved efficiency and accuracy. The template of the device that had 16 microfluidic channels was printed by a 3D printer and used for PDMS replica molding. The PDMS device was attached to the modified multiwell plate to feed media to and collect waste from each channel in a high-throughput manner. In the initial design, the bacteria grew faster than cancer cells taking over the chips. Our new design has dual layered chambers to keep bacteria and cancer cells separated by a membrane, allowing only bacterial secretions to pass through the membrane to cancer cells, mimicking the human gut. The new design also allowed the chip to maintain continuous microfluidic flow and a hypoxic environment. Conclusion: Our research demonstrates that the new microfluidic device has broader implications including simulating other body organs such as the lung and liver, and testing the impact of viruses such as influenza and COVID-19 on human cells. This device can be used to test both the effect of bacteria and new treatment on clinical samples for the identification of personalized therapy, thus reducing the need for mouse model testing, which is a lengthy and expensive process.

Economic Uncertainty and Value Relevance of Accounting Information

Uncertainty, unlike risk, is hard to be predicted and measured. When economic uncertainty increases, it becomes difficult for policy makers and investors to respond and come up with the ambiguous economic situation. The uncertainty not only reduces consumption, investment and employment but also increases volatility of stock price. As an example, recent COVID-19 has increased uncertainty in the global economy. Governments have tried to resolve the uncertainty through active monetary and financial policies, but these policies are not successful but result in widening the gap between the real market and capital market. A few economists recently have developed economic uncertainty index to diagnose and resolve the economic difficulties. They applied textual analysis to measure the index using mass media articles and economic reports of EIU(Economic Intelligence Unit). This study investigates whether the uncertainty affects the value relevance of accounting information using WUI(World Uncertainty Index) developed by Ahir et al. (2018). The results show that EPS and BV of equity lose their value relevance significantly as economic uncertainty increases during the period from 1999 to 2020. The value relevance of accruals and operating cash flow also decrease significantly during high uncertainty period although they have different characteristics. These results show that the economic uncertainty lowers the usefulness of accounting information. © 2022, Korean Accounting Association. All rights reserved.

Passenger management strategy and evacuation in subway station under Covid-19

Under the background of Covid-19 sweeping the world, safe and reasonable passenger flow management strategy in subway stations is an effective means to prevent the spread of virus. Based on the social force model and the minimum cost model, the movement and path selection behavior of passengers in the subway station are modeled, and a strategy for passenger flow management to maintain a safe social distance is put forward. Take Qingdao Jinggangshan Road subway station of China as the simulation scene, the validity of the simulation model is verified by comparing the measured value and simulation value of the time required for passengers from getting off the train to the ticket gate. Simulation results indicate that controlling the time interval between incoming passengers at the entrance can effectively control the social distance between passengers and reduce the risk of epidemic infection. By comparing the evacuation process of passengers under different initial densities, it is found that the greater the initial density of passengers is, the longer the passengers are at risk social distance. In the process of passenger emergency evacuation, the stairs/escalators and ticket gates are bottleneck areas with high concentration of passenger density, which should be strictly disinfected many times on the basis of strictly checking the health code of incoming passengers and controlling the arrival time interval. The simulation results of this paper verify the harmfulness of passenger emergency evacuation without protective measures, and provide theoretical support for the operation and management of subway station under the epidemic situation.

Corona Virus Disease 2019 Respiratory Cycle Detection Based on Convolutional Neural Network

Corona virus disease 2019 (COVID-19) is a kind of acute infectious pneumonia that causes dyspnea and slow breathing for severe patients. Since respiratory cycle can be analyzed for auxiliary diagnosis, an automatic respiratory detection system can replace a stethoscope for measuring a patients' respiratory cycle in the isolation ward, which ensures real-time monitoring. In this paper, we propose a convolutional neural network (CNN) model that can effectively detect the cycle of breath sounds in COVID-19 patients. The Mel-spectrogram features were extracted from the data collected from hospital patients, and convolutional neural network is then used for training. After testing in different cases, the result shows that the sensitivity of this method is 90.03%, and the average accuracy is 91.32%. © 2021 IEEE.

Framing Digital Reality Technology Applications Among Museums During COVID-19 Pandemic: A Comparative Text Mining Research

Digital reality technologies and their applications have become a truly global phenomenon, attracting enormous interest among museum researchers and professionals. The COVID-19 pandemic in 2020 has drastically changed contemporary human behaviors by forcing people to “shelter in place.” To deter the spread of the COVID-19 virus from adjacent human contacts and indoor congregations has prompted over 90% museums around the world to close their doors to the public. As a result, the COVID-19 also expedites the adoption of a variety of technologies by offering their services virtually. The objectives of this study are to investigate the impacts of digital reality technologies on museums around the world at this critical historical juncture. We employed a global text mining research to examine the current integration of digital reality technologies among museums and to examine how the affordances of these technologies have impacted on the museum sector as described by these media. This text mining study provides empirical data and best practice examples how museums around the world have integrated digital reality technologies in response to the challenges and opportunities due to COVID-19. Results find that virtual reality is still the most commonly used digital reality technology by museums for online viewing and exhibitions. In spite of the hype about extended reality technology, augmented and mixed reality technologies fall behind the popularity of VR. Additionally, the use of these reality-creating technologies among museums in different countries often echoes their economy and technology status. Discussion and implications are provided. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Mitigating Influence of Institutional Differences on International Project Performance by Knowledge Management

Under the pandemic of COVID-19, each country urgently restores its economies, and international project development has large marketing demand. Contractors need to understand the institutional differences between delivering domestic and international projects to fulfill the project implementation tasks. Existing studies on institutional differences mainly focuses on qualitatively describing the impact of institutional differences on project implementation. However, how institutional differences have influenced on international project performance is still unclear. With the data collected from 47 construction projects in 41 countries through questionnaires and interviews, this study has established and tested a theoretical model that incorporates knowledge management, institutional differences, project implementation problems, and project performance. The results show that institutional differences significantly increase project implementation problems, thereby influencing project performance;knowledge management can considerably reduce the project implementation problems arising from institutional differences, resulting in better project performance. The study results can theoretically help understand the relationships among institutional differences, knowledge management, and project performance, and practically guide contractors to appropriately mitigate the influence of institutional differences on international project performance by knowledge management approach. © ASCE.

Identifying the Drivers of PM(2.5 )Concentration Changes between December 2019 and December 2020 in South Korea

The observed monthly mean PM2.5 concentration in South Korea during December 2020 has decreased by 2.3 mu g/m(3), compared to that during the same month in the previous year, but the drivers of the change have been veiled yet.This study quantitatively examines the roles of the potential drivers of the PM2.5 decrease during December 2020. Air quality simulations for December 2019 and December 2020 show that the change in meteorology conditions have increased the PM2.5 concentrations by 1.4 mu g/m(3) in South Korea, but the changes in the Northeast Asian emissions have decreased the PM(2.5 )concentrations by 3.7 mu g/m(3) in the country. In addition, foreign emission impact on the nationwide PM2.5 concentrations estimated from a set of the sensitivity simulations with the Community Multi-scale Air Quality model and adjusted with the surface observations in China has increased by 1.9 mu g/m(3) in December 2020, compared to that for December 2019. It means that the upwind foreign emission condition was not helpful in the downwind PM2.5 decrease. On the contrary, the domestic impact has decreased by 4.2 mu g/m(3) over the country, which compensated the increase in the foreign impact for the month. The observed monthly mean NO2 concentrations have decreased by 5% and 8% for South Korea and the Seoul Metropolitan Area, respectively, compared to the same month in 2019. When a simple observation-based emission adjustment was applied, a 5% decrease in the national total NO, emissions for the month was estimated. The causality of NO2 decrease still needs further investigations, but the seasonal PM2.5 management and social distancing after the COVID-19 re-outbreak at the end of November might have led to the reduction in the anthropogenic emissions (i.e., NOx) and thus the PM2.5 concentrations during the month.

Roles of interleukin-17 and th17 responses in covid-19

The ongoing coronavirus disease-2019 (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus-2. COVID-19 severity is related to the cytokine storm phenomenon, which is amplified by pro-inflammatory cytokines and chemokines;it may cause extensive pulmonary damage. Among these cytokines, interleukin (IL)-17, produced mainly by T helper 17 (Th17) cells, is responsible for the immunopathological responses present in acute respiratory distress syndrome. This review discusses the roles of IL-17 and Th17 responses in the pathophysiology of COVID-19. Dysregulated Th17-responses, linked to various risk factors, may contribute to pathological inflammation through the amplification of multiple inflammatory cytokines and chemokines, as well as augmentation of neutrophil infiltration in the lungs of severe COVID-19 patients. A more detailed understanding of the roles of Th17 responses, as well as the mechanisms underlying altered IL-17 production and signaling, may improve therapeutic strategies for severe or critically ill COVID-19 patients by targeting the IL-17 pathway. © 2021 Journal of Bacteriology and Virology.

The Early Impacts of COVID-19 on Food Security and Livelihood in Vietnam

In April 2020, Vietnam initiated a country-wide lockdown to curb the spread of COVID-19. This secondary data analysis evaluates whether NGO-supported households (n = 3,431) reporting to be severely impacted by the lockdowns differ from those reporting a lesser impact, regarding food availability within households and at markets and affordability. 19.2% of respondents indicated that the pandemic had severely impacted their livelihoods. In the severely impacted group, there was a higher percentage of urban residents (25.3 vs. 8.6%;p < 0.001), households reporting decreased income (85.4 vs. 39.9%), and females (56.4 vs. 45.6%;p < 0.001) than in the less impacted group. Both groups reported similar availabilities of staple food groups at the household-level, but the availability of green vegetables was lower in the severely affected group (Adjusted OR [aOR] = 0.62, 95% CI: 0.38, 1.00) than in the less affected group. However, local market availability of hygiene items (aOR = 1.64, 95% CI: 1.13, 2.39) and essential medicines (aOR = 1.80, 95% CI: 1.29, 2.50) were higher for the more impacted group relative to the less impacted group. While the self-reported livelihood impact of COVID-19 was associated with a loss of income, the association of indicators of food availability within households and at markets, and essential item affordability, did not frequently differ. Self-determination of a severe economic impact may represent a relative change in the household's socioeconomic status from before the pandemic.

Towards a Poetics of Disaster: Chinese Poetry in Combatting COVID-19

China’s campaign against the COVID-19 epidemic has triggered an upsurge in literary creation and animated discussions on writing about disaster. This essay explores the emergence of a disaster poetics in the COVID-19 war which considers poetry as revelatory, ameliorative and cathartic in both personal and national terms. This strand of poetry, which blends humanism, philosophical exploration, and a skeptical impulse, reexamines the isolated state of being, resists glorification, concerns individual lives and redefines heroism as quiet courage, love and compassion in despair among ordinary people, displaying a Chinese forbearance, wisdom and wry humor in facing grim reality. These poetic voices register admirable artistic courage, spiritual depth, self-critical reflection and stylistic ingenuity. © 2021 University of the Witwatersrand.

Psychosocial impact of COVID-19 pandemic on patients with ESKD on peritoneal dialysis

Background: The mortality rate from COVID-19 is remarkably high in elderly patients and those with chronic conditions. Increases in physical and mental stress among patients with chronic conditions, especially end-stage kidney disease, were expected to have occurred in response to the COVID-19 pandemic. This study reports that the psychosocial impact of the COVID-19 pandemic on patients receiving peritoneal dialysis. Methods: During the pandemic, we surveyed the mental health of patients with endstage kidney disease on peritoneal dialysis at a single center. Depression using with BDI scoring was evaluated and then compared in peritoneal dialysis patients between before and the pandemic declaration. We also surveyed patient satisfaction with the self-care services associated with peritoneal dialysis under the pandemic period. Results: One-third of the survey respondents (n=176) were moderately to extremely worried about their physical health being impacted by the pandemic, while 20% moderately to extremely worried about their mental and emotional health being impacted. About half of participant reported feeling that they were unable to handle their personal problems and that things were out of their control. However, most felt that they could retain control over the important things and overcome their difficulties. Despite COVID-19 pandemic, no significant changes in depression scores were apparent between before and during the pandemic. Most participants were satisfied with the in-home selfcare services delivered by either telephone or remote monitoring. Conclusions: Many participants reported that they were afraid of COVID-19, but most patients with PD felt that they could overcome the crisis. The COVID-19 pandemic did not affect the depression of patients receiving peritoneal dialysis.

A survey study of compliance with mask-wearing to prevent coronavirus infections among korean adults

Purpose: The purpose of this study was to determine the actual situation of mask wearing by adults in the early stages of the coronavirus epidemic and to identify factors that influence the transition to mask wearing and establish a management plan for more effective infectious disease prevention. Methods: This study was a multinational study conducted in ten countries. Data collected in Korea were analyzed. Adults over the age of 18 in the Seoul and Gyeonggi areas were targeted, and data for 657 adults were analyzed. Results: The average score for mask-wearing compliance was 16.25, ranging from 0 to 24. There was a significant positive correlation between anxiety and depression, as well as anxiety and mask-wearing compliance. There was a significant negative correlation between depression and mask-wearing compliance. Multiple linear regression revealed that mask-wearing compliance was predicted by levels of the anxiety, depression, and education. These explanatory variables explaining the dependent variable mask-wearing compliance was 12%. Conclusion: To identify and improve factors influencing mask-wearing compliance, general characteristics including educational background of participants were identified. Psychosocial factors such as anxiety and depression should also be considered. In addition, as the level of anxiety and depression will differ for each person, differentiated interventions according to psychological state should be provided. © Journal of Cognition 2021.

Identifying the Drivers of PM2.5Concentration Changes between December 2019 and December 2020 in South Korea

The observed monthly mean PM2.5concentration in South Korea during December 2020 has decreased by 2.3 μg/m3, compared to that during the same month in the previous year, but the drivers of the change have been veiled yet. This study quantitatively examines the roles of the potential drivers of the PM2.5decrease during December 2020. Air quality simulations for December 2019 and December 2020 show that the change in meteorology conditions have increased the PM2.5concentrations by 1.4 μg/m3in South Korea, but the changes in the Northeast Asian emissions have decreased the PM2.5concentrations by 3.7 μg/m3in the country. In addition, foreign emission impact on the nationwide PM2.5concentrations estimated from a set of the sensitivity simulations with the Community Multi-scale Air Quality model and adjusted with the surface observations in China has increased by 1.9 μg/m3in December 2020, compared to that for December 2019. It means that the upwind foreign emission condition was not helpful in the downwind PM2.5decrease. On the contrary, the domestic impact has decreased by 4.2 μg/m3over the country, which compensated the increase in the foreign impact for the month. The observed monthly mean NO2concentrations have decreased by 5% and 8% for South Korea and the Seoul Metropolitan Area, respectively, compared to the same month in 2019. When a simple observation-based emission adjustment was applied, a 5% decrease in the national total NOxemissions for the month was estimated. The causality of NO2decrease still needs further investigations, but the seasonal PM2.5management and social distancing after the COVID-19 re-outbreak at the end of November might have led to the reduction in the anthropogenic emissions (i.e., NOx) and thus the PM2.5concentrations during the month. © 2021. All Rights Reserved.

A Review of Spatial Network Insights and Methods in the Context of Planning: Applications, Challenges, and Opportunities

With the rise of geospatial big data, new narratives of cities based on spatial networks and flows have replaced the traditional focus on locations. While plenty of research that have empirically analyzed network structures, there lacks a state-of-the-art synthesis of applicable insights and methods of spatial networks in the planning context. In this chapter, we reviewed the theories, concepts, methods, and applications of spatial network analysis in cities and their insights for planners from four areas of concerns: spatial structures, urban infrastructure optimizations, indications of economic wealth, social capital, and residential mobility, and public health control (especially COVID-19). We also outlined four challenges that planners face when taking the planning knowledge from spatial networks to actions: data openness and privacy, linkage to direct policy implications, lack of civic engagement, and the difficulty to visualize and integrate with GIS. Finally, we envisioned how spatial networks can be integrated into a collaborative planning framework. © 2021, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Impact of COVID-19 pandemic in 2020 on the diagnosis and management of breast cancer in Korea: A multi-institutional study

Background: Since the COVID-19 pandemic began in early 2020, there have been many reports that it has had a significant impact on screening, case identification and referral in cancer diagnosis. We investigated the diagnostic and therapeutic status of breast malignancy before and after the COVID-19 pandemic at the multi-institution level. Methods: We have reviewed the records of patients with breast cancer from February 2019 to July 2020 in six university hospitals in Korea. The patients were divided into two groups according to the initial date of cancer diagnosis: Period A, from February to April and Period B, from May to July in 2020. The two groups were compared for the same periods in 2019. The goals were to determine whether breast cancer screening and diagnosis have been delayed and thus resulted in stage migration. We also examined the difference in the number of surgeries in patients diagnosed with breast cancer during those periods. Results: The total of 1,669 breast malignancy diagnosis was made in the grouped periods of 2019, and 1,369 diagnoses in 2020. All patients were screened by PCR test for COVID-19 prior to hospitalization, and none of them tested positive. Overall, there was a 9.9% reduction in the number of diagnoses than in 2019 and the decrease was more significant in Period A (11.1% vs. 8.7%). According to the age, there was no difference until the 30s but decreased from those in their 40s and above. The decline was more pronounced in the elderly. The COVID-19 pandemic has affected breast cancer screening (decreased by 27.4%) and more diminished in Period A (41.0% vs. 19.0%). Invasive breast cancer stage was not statistically different in Period A compare with 2019 (p = 0.170). But the stage in Period B was different (p = 0.032), and more patients were observed in advanced stages in 2020. The decrease in surgery was noticeably observed in Period A (4.6%, from 480 to 438 surgeries) and not in Period B. The analysis of reconstruction surgery was similar. Conclusions: Patients with COVID-19 increased exponentially from late February in Korea. However, the number of patients per day decreased to less than 100 on March 15 and then flattened. The health care system for cancer was not overloaded and restrictions on visiting hospital were minimal. Analysis in the pandemic period of the 6-month showed that the number of breast cancer screening, diagnosis and surgeries decreased compared with the previous year. Those decreases were prominent in Period A when the COVID-19 patient surged. The upstage migration of breast cancer was generally insignificant but slightly occurred in Period B. The outbreak of infectious disease makes patients reluctant to come to the hospital, especially in the elderly. We need to discuss the potential long-lasting deleterious effect of the COVID-19 pandemic on cancer diagnosis and management. And we should prepare for how to deal with the backlog caused by the COVID-19 pandemic.

Management of fibromyalgia patients insecondary care: A retrospective audit

Background/AimsTo examine the management of fibromyalgia patients referred tosecondary care with respect to 2017 European Alliance ofAssociations for Rheumatology (EULAR) guidelines.MethodsEighty-two patients referred to the Complex Musculoskeletal Clinic inthe Rheumatology Department with a resulting diagnosis of fibromyalgia were included in the audit. Data was collected retrospectively viaElectronic Patient Records over the study period of December 2017 toMarch 2020. Variables assessed included patient demographics, clinical presentation at assessment and management. Statisticalanalyses were conducted using Excel 2019 and the Excel AnalysisToolPak.ResultsThe majority of the patients were female 77/82(94%), and the meanage was 43.2yrs (SD = 12.6). Co-morbidities were common: 31/82(38%) had a further painful musculoskeletal condition, 40/82 (49%)were obese and 46/82 (56%) had an active mental health problem.Alongside chronic widespread pain, patients reported fatigue 64/82(78%), waking unrefreshed 69/82 (84%), and cognitive disturbance 31/82 (38%). Compared to a 2014 audit conducted in the samepopulation and department, more patients had received pharmacological treatment (71/82 [87%] vs 34/50 [68%];z = 2.64, p = 0.008), hadreceived physiotherapy (28/82 [34%] vs 5/50 [10%];z = 3.0, p = 0.002)and psychological input (16/82 [20%] vs 3/50 [6%];z = 2.20, p = 0.03)prior to referral to secondary care. At secondary care consultation, allpatients received an assessment of their pain and function, and 64/82(78%) were assessed for psychosocial context. Fifty-three (65%)patients received information in the form of a website recommendation, leaflet or verbal education. After clinician assessment, themajority were referred to a multidisciplinary pain managementprogramme, in a significant increase from 2014 (64/82 [78%] vs 4/50[8%];z = 8.04, p < 0.0001). All medication recommendations weremade according to 2017 EULAR guidelines. Alongside multidisciplinary pain rehabilitation, patients were referred to physiotherapy 21/82(26%), physical activity 26/82 (26%), sleep hygiene 9/82 (11%) andpsychological 7/82 (9%) treatment options.ConclusionMultidisciplinary treatment and first-line, non-pharmacologicalapproaches have become the standard management approach insecondary care, alongside EULAR compliant pharmacological recommendations. EULAR's non-pharmacological recommendations ofassessing not only pain, but function and psychosocial contextoccurs for the majority of patients. The limitation of consultationduration likely plays a role in whether psychosocial context isadequately assessed. Providing patients with information about theircondition, though occurring for approximately 2/3 of patients, wasrecognized as an area for improvement. The high rate of comorbidities combined with the demographics of Fibromyalgia patientsemphasizes the importance of early, multimodal management. Followup audits are warranted to examine the effects of the COVID-19pandemic, and the impact of the upcoming 2021 NICE guidance forchronic pain.