TASL, TADE, and DAROC consensus for the screening and management of hepatitis C in patients with diabetes.

Diabetes mellitus (DM) and hepatitis C virus (HCV) infection are prevalent diseases globally and emerging evidence demonstrates the bidirectional association between the two diseases. Direct-acting antivirals (DAAs) for HCV have a high treatment success rate and can significantly reduce the risks of short and long-term complications of HCV infection. However, despite the evidence of the association between diabetes and HCV and the benefits of anti-HCV treatment, previously published guidelines did not focus on the universal HCV screening for patients with diabetes and their subsequent management once confirmed as having HCV viremia. Nonetheless, screening for HCV among patients with diabetes will contribute to the eradication of HCV infection. Thus, the three major Taiwan medical associations of diabetes and liver diseases endorsed a total of 14 experts in the fields of gastroenterology, hepatology, diabetology, and epidemiology to convene and formulate a consensus statement on HCV screening and management among patients with diabetes. Based on recent studies and guidelines as well as from real-world clinical experiences, the Taiwan experts reached a consensus that provides a straightforward approach to HCV screening, treatment, and monitoring of patients with diabetes.

Emergent cesarean section in a preterm pregnant woman with severe COVID-19 pneumonia in Taiwan: A case report.

OBJECTIVE: The pandemic Coronavirus Disease 2019 (COVID-19) is a global public health crisis. Many maternity units worldwide are currently establishing the management protocols for these patients. CASE REPORT: We report the first critically ill pregnant woman with COVID-19-induced respiratory failure undergoing emergent caesarean delivery at 32 weeks of gestation, in the setting of a positive pressure operating room (OR) with negative pressure anteroom in Taiwan. CONCLUSION: Multidisciplinary planning and collaboration are necessary to achieve satisfactory clinical outcomes in pregnancies with critical COVID-19 pneumonia. The combinations of comprehensive evaluation, timely treatment as well as establishment of rigorous protocol and safe environment for the emergent delivery are important.

Hanshiyi Formula treatment in patients with COVID-19: study protocol and statistical analysis plan (SAP) of an open-label randomized controlled clinical trial (preprint)

Background As COVID-19 continues to spread rapidly in 2019, the risks to human health cannot be underestimated. There is still lack of antiviral drugs for COVID-19, and the development of effective treatments is urgent. Traditional Chinese Medicine (TCM) has been widely used in the treatment of epidemic infectious diseases, The purpose of this randomized controlled clinical trial will to evaluate the clinical efficacy and safety of Hanshiyi Formula (HSYF) in patients with COVID-19.Methods We will conduct this randomized, controlled, open, non-inferiority test clinical study in 240 COVID-19 subjects. Eligible patients will be divided into a control group ( LH granule ) or a treatment group ( HSYF ) in a 1:1 ratio. The intervention duration will be 14 days, and the medication could be stopped in advance if the discharge standard was reached. Clinical efficacy measures will be analyzed at baseline and on day 1–14 of enrollment, The occurrence of adverse events will be monitored throughout the trial. The statistical analysis plan included the treatment of missing data, the analysis of outcome measures, and the method of safety endpoints.Discussion To investigate the efficacy and safety of HSYF in the treatment of COVID-19, provide more sufficient high-quality evidence-based medical basis for TCM intervention in the diagnosis and treatment of COVID-19. To avoid selective reporting bias and data-driven analysis, the statistical analysis plan will standardize the statistical analysis of clinical trials.Trial registration: Chinese Clinical Trial Registry, ChiCTR2200058384. Version V1.2, created on April 11, 2022.https://www.chictr.org.cn/com/25/hvshowproject.aspx?id=159938.

Combining Direct PCR Technology and Capillary Electrophoresis for an Easy-to-Operate and Highly Sensitive Infectious Disease Detection System for Shrimp.

Infectious diseases are considered the greatest threat to the modern high-density shrimp aquaculture industry. Specificity, rapidity, and sensitivity of molecular diagnostic methods for the detection of asymptomatic infected shrimp allows preventive measures to be taken before disease outbreaks. Routine molecular detection of pathogens in infected shrimp can be made easier with the use of a direct polymerase chain reaction (PCR). In this study, four direct PCR reagent brands were tested, and results showed that the detection signal of direct PCR in hepatopancreatic tissue was more severely affected. In addition, portable capillary electrophoresis was applied to improve sensitivity and specificity, resulting in a pathogen detection limit of 25 copies/PCR-reaction. Juvenile shrimp from five different aquaculture ponds were tested for white spot syndrome virus infection, and the results were consistent with the Organization for Animal Health's certified standard method. Furthermore, this methodology could be used to examine single post larvae shrimp. The overall detection time was reduced by more than 58.2%. Therefore, the combination of direct PCR and capillary electrophoresis for on-site examination is valuable and has potential as a suitable tool for diagnostic, epidemiological, and pathological studies of shrimp aquaculture.

An odd crisis: COVID-19 and UK food prices. (Special Issue:Covid-19 pandemic impacts on agri-food systems.)

The Covid-19 pandemic will have impacts that will vary across countries and commodity sectors, reflecting factors such as the importance of trade, differences in the functioning of supply chains and the market which producers and farmers supply. Some of these effects will be relatively short-lived;others will be longer-lasting. In this context, we set out the channels through which food prices will be affected by the Covid-19 pandemic, emphasising the short- and longer-term nature of the main effects. We focus on the UK but the insights extend to other (importing) countries. Drawing on a recent econometric model of UK retail food prices that accounts for both domestic and international factors, we show that the key drivers have potentially off-setting effects, suggesting that the Covid-19 shock to the food sector is likely to be different from previous shocks, particularly the commodity price crises of 2007-2008 and 2011. In many European countries, the Covid-19 pandemic may manifest itself as something of an 'odd crisis', in which lower world and farm-gate prices co-exist with higher domestic retail prices. These off-setting factors will frame policy responses targeted at different stages of the food chain across countries.

Sustainable Ambient Environment to Prevent Future Outbreaks: How Ambient Environment Relates to COVID-19 Local Transmission in Lima, Peru

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), universally recognized as COVID-19, is currently is a global issue. Our study uses multivariate regression for determining the relationship between the ambient environment and COVID-19 cases in Lima. We also forecast the pattern trajectory of COVID-19 cases with variables using an Auto-Regressive Integrated Moving Average Model (ARIMA). There is a significant association between ambient temperature and PM10 and COVID-19 cases, while no significant correlation has been seen for PM2.5. All variables in the multivariate regression model have R2 = 0.788, which describes a significant exposure to COVID-19 cases in Lima. ARIMA (1,1,1), during observation time of PM2.5, PM10, and average temperature, is found to be suitable for forecasting COVID-19 cases in Lima. This result indicates that the expected high particle concentration and low ambient temperature in the coming season will further facilitate the transmission of the coronavirus if there is no other policy intervention. A suggested sustainable policy related to ambient environment and the lessons learned from different countries to prevent future outbreaks are also discussed in this study.

Risk factors influencing the prognosis of elderly patients infected with COVID-19: a clinical retrospective study in Wuhan, China.

The mortality rate of elderly patients with Coronavirus Disease 2019 (COVID-19) was significantly higher than the overall mortality rate. However, besides age, leading death risk factors for the high mortality in elderly patients remain unidentified. This retrospective study included 210 elderly COVID-19 patients (aged ≥ 65 years), of whom 175 patients were discharged and 35 died. All deceased patients had at least one comorbidity. A significantly higher proportion of patients in the deceased group had cardiovascular diseases (49% vs. 20%), respiratory diseases (51% vs. 11%), chronic kidney disease (29% vs. 5%) and cerebrovascular disease (20% vs. 3%) than that in the discharged group. The median levels of C-reactive protein (125.8mg/L vs. 9.3mg/L) and blood urea nitrogen (7.2mmol/L vs. 4.4mmol/L) were significantly higher and median lymphocyte counts (0.7×109/L vs. 1.1×109/L) significantly lower in the deceased group than those in the discharged group. The survival curve analysis showed that higher C-reactive protein (≥5mg/L) plus any other abnormalities of lymphocyte, blood urea nitrogen or lactate dehydrogenase significantly predicted poor prognosis of COVID-19 infected elderly patients. This study revealed that the risk factors for the death in these elderly patients included comorbidities, increased levels of C-reactive protein and blood urea nitrogen, and lymphopenia during hospitalization.

The Psychological Effect of 2019 Coronavirus Disease Outbreak on Nurses Living in Islamic Culture Dominant Region, China (preprint)

Background: The outbreak of Coronavirus Disease (COVID-19) in Wuhan, owing to the uncertain nature of COVID-19, can cause concerns about the potential health risks and may engender fear, anxiety, depression and so on. China is a multi-ethnic society, and Linxia Hui Autonomous Prefecture is a multi-ethnic residential city and is influenced profoundly by Islamic culture. Culture can influence perceptions, but it is unknown how much it affects frontline nurses’ perceptions of the emerging infectious disease outbreak. The aim of this study was to investigate the psychological characteristics of nurses with minority ethnic backgrounds in response to the public health crisis and to explore its related factors. Methods: We undertook a cross-sectional online survey in the Linxia Hui Autonomous Prefecture, Gansu province, China. There were eight secondary-level hospitals and one tertiary-level hospital, six of which were COVID-19-designated hospitals. The structured questionnaire consisted of demographic questionnaire, COVID-19 related questionnaire, Self-Rating Anxiety Scale, and Self-rating Depression Scale. Results: A total of 1569 nurses enrolled in our online survey. The majority of the nurses were women (98.8%), aged younger than 40-year-old (90.3%), holders of a junior college degree (59.5%), married (74.6%), needed to care for children (63.9%) or elders (84.6%), with working years of less than 10 years (61.9%), and worked at non-high exposure departments(75%) in secondary hospital (66.9%) or COVID-19-designated hospital (85.4%). The anxiety and depression level (M± SD) were 42.56±8.95 and 46.52 ±11.883, respectively. The factors associated with psychological variables were social support, family role, fear of contagion, the desire to learn knowledge about COVID-19, and so on. Conclusion: Nurses who are of the Islamic culture are affected slightly by the COVID-19 outbreak, but their concern and factors associated with psychological variables are in keeping with the common nursing groups.

Evaluating the secondary transmission pattern and epidemic prediction of the COVID-19 in metropolitan areas of China (preprint)

Understanding the transmission dynamics of COVID-19 is crucial for evaluating its spread pattern, especially in metropolitan areas of China, as its spread can lead to secondary outbreaks outside Wuhan, the center of the new coronavirus disease outbreak. In addition, the experiences gained and lessons learned from China have the potential to provide evidence to support other metropolitan areas and large cities outside China with emerging cases. We used data reported from January 24, 2020, to February 23, 2020, to fit a model of infection, estimate the likely number of infections in four high-risk metropolitan areas based on the number of cases reported, and increase the understanding of the COVID-19 spread pattern. Considering the effect of the official quarantine regulations and travel restrictions for China, which began January 23~24, 2020, we used the daily travel intensity index from the Baidu Maps app to roughly simulate the level of restrictions and estimate the proportion of the quarantined population. A group of SEIR model statistical parameters were estimated using Markov chain Monte Carlo (MCMC) methods and fitting on the basis of reported data. As a result, we estimated that the basic reproductive number, R0, was 2.91 in Beijing, 2.78 in Shanghai, 2.02 in Guangzhou, and 1.75 in Shenzhen based on the data from January 24, 2020, to February 23, 2020. In addition, we inferred the prediction results and compared the results of different levels of parameters. For example, in Beijing, the predicted peak number of cases was approximately 466 with a peak time of February 29, 2020; however, if the city were to implement different levels (strict, mild, or weak) of travel restrictions or regulation measures, the estimation results showed that the transmission dynamics would change and that the peak number of cases would differ by between 56% and ~159%. We concluded that public health interventions would reduce the risk of the spread of COVID-19 and that more rigorous control and prevention measures would effectively contain its further spread but that the risk will increase when businesses and social activities return to normal before the end of the epidemic. Besides, the experiences gained and lessons learned from China are potential to provide evidences supporting for other metropolitan areas and big cities with emerging cases outside China.