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The United Nations Secretary-General Mechanism (UNSGM) for investigation of the alleged use of chemical and biological weapons is the only established international mechanism of this type under the UN. The UNGSM may launch an international investigation, relying on a roster of expert consultants, qualified experts, and analytical laboratories nominated by the member states. Under the framework of the UNSGM, we organized an external quality assurance exercise for nominated laboratories, named the Disease X Test, to improve the ability to discover and identify new pathogens that may cause possible epidemics and to determine their animal origin. The "what-if" scenario was to identify the etiological agent responsible for an outbreak that has tested negative for many known pathogens, including viruses and bacteria. Three microbes were added to the samples, Dabie bandavirus, Mammarenavirus, and Gemella spp., of which the last two have not been taxonomically named or published. The animal samples were from Rattus norvegicus, Marmota himalayana, New Zealand white rabbit, and the tick Haemaphysalis longicornis. Of the 11 international laboratories that participated in this activity, six accurately identified pathogen X as a new Mammarenavirus, and five correctly identified the animal origin as R. norvegicus. These results showed that many laboratories under the UNSGM have the capacity and ability to identify a new virus during a possible international investigation of a suspected biological event. The technical details are discussed in this report.Copyright © 2022
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Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05);age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05);and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Objective To investigate the mental health status of military healthcare workers in shelter hospitals in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant and its influencing factors. Methods A total of 540 military healthcare workers in shelter hospitals in Shanghai were investigated with patient health questionnaire-9 (PHQ-9), generalized anxiety disorder-7 (GAD-7) and Athens insomnia scale (AIS) to explore their mental health status, and logistic regression was used to analyze the influencing factors. Results A total of 536 valid questionnaires were collected, with an effective rate of 99.3% (536/540). The incidence of depression, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai was 45.5% (244/536), 26.1% (140/536) and 59.5% (319/536), respectively. Logistic regression analysis showed that whether people resided in Shanghai, the proportion of negative information in daily browsing information and diet status in shelter hospitals were the influencing factors of depression, anxiety and insomnia (all P<0.05);age and confidence in the future of Shanghai were the influencing factors of depression and insomnia (all P<0.05);and the time spent daily on epidemic-related information was an influencing factor of insomnia (P=0.021). Conclusion The incidence of depressive, anxiety and insomnia among military healthcare workers in shelter hospitals in Shanghai is high during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant. Psychological consequences of the epidemic should be monitored regularly and continuously to promote the mental health of military healthcare workers.Copyright © 2022, Second Military Medical University Press. All rights reserved.
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Objective: To provide a basis for the early identification and treatment of severe and critical coronavirus disease 2019 (COVID - 19) by analyzing the clinical characteristics of the death cases. Methods: We retrospectively analyzed the clinical characteristics of 71 COVID - 19 cases which died during hospitalization. The clinical data included general data, underlying disease, clinical manifestation, biochemical laboratory examination, imaging examination, complications, and treatment, then the influencing factors of in - hospital survival were analyzed. Results: Most of the 71 patients were ≥60 years old (78. 9%) and had underlying diseases (74. 6%), in which hypertension ranked first, and fever was the most common first symptom. Biochemical laboratory tests showed that D-Dimer and C-reactive protein maintained at high levels during hospitalization, and lymphocyte count declined. Leukocyte/neutrophil counts, neutrophil to lymphocyte ratio, procalcitonin, creatine kinase, and lactate dehydrogenase increased. The main imaging features of the dead cases were the multifocal ground glass changes and consolidation of the lungs. The most common complications were acute respiratory distress syndrome (89. 9%), shock (34. 3%), and acute myocardial injury (30. 4%). 90% of the patients received auxiliary ventilation, and the decrease of blood oxygen saturation and the increase of procalcitonin may be the risk factors for shorter in-hospital survival. Conclusion: Severe and critical COVID-19 patients show different characteristics in clinical manifestations, biochemical laboratory examination, imaging examination, complications, and treatment reactions, which need early identification and treatment, and bewaring of acute respiratory distress syndrome and multiple organs failure. © 2022 Editorial Board of Medical Journal of Wuhan University. All rights reserved.
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During the COVID-19 pandemic, urban forest parks are becoming increasingly significant for recreation and relaxation, not just for urban residents but also for tourists. This study empirically examined the structural relationships among first-time visitors' perceptions of destination image, perceived value and destination loyalty through structural equation modeling. Additionally, the mediating influence of perceived value and the moderating effect of gender were investigated as well. The Grand Canal Forest Park in Beijing was selected as the case study. In total, 486 questionnaires that were considered to be legitimate were gathered and afterwards analyzed. The results revealed that first-time visitors' perceptions of destination image can positively and significantly affect their perceived value and destination loyalty. In addition, perceived value partially mediates the relationship between first-time visitors' perceptions of destination image and destination loyalty. Moreover, the findings of the examination of the moderating effects showed that gender has substantial moderating effects on the relationships described above. The theoretical and practical implications, limitations and future research of the current study are also discussed. © 2023 by the authors.
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In this interview, Prof. Lin Lu introduced ways to improve sleep and relieve stress, influences of sleep on the heart and mental health, essential qualities of psychiatrists, etc. His major viewpoints are: (a) sleep deprivation disrupts physiological functions, (b) prevalence of mental health problems in the general population, health-care workers, and students showed an increasing trend following COVID-19, and (c) it is a tendency for doctors to develop a comprehensive and integrated treatment plan from the physical and mental perspectives. © 2022 Heart and Mind ;Published by Wolters Kluwer - Medknow.
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Mental stress has been recognized as an essential risk factor for hypertension. Therefore, experts specializing in cardiology, psychiatry, and Traditional Chinese Medicine organized by the Psycho-cardiology Group, College of Cardiovascular Physicians of Chinese Medical Doctor Association, and Hypertension Group of the Chinese Society of Cardiology proposed the expert consensus on the diagnosis and treatment of adult mental stress-induced hypertension in March 2021, which includes the epidemiology, etiology, diagnosis, and treatment of the mental stress-induced hypertension. This consensus will hopefully facilitate the clinical practice of this disorder. In addition, the COVID-19 pandemic has become one of the primary global sources of psychosocial stressors since the beginning of 2020, and the revision of this expert consensus in 2022 has increased the relevant content. This consensus consists of two parts. The sections of Part A include (I) Background and epidemiological characteristics, (II) Pathogenesis, and (III) Diagnosis. The sections of Part B contain (IV) Treatment recommendations, and (V) Prospects. This article presents Part B of the consensus. © 2022 Heart and Mind ;Published by Wolters Kluwer - Medknow.
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Mental stress has been recognized as an essential risk factor for hypertension. Therefore, experts specializing in cardiology, psychiatry, and Traditional Chinese Medicine organized by the Psycho-Cardiology Group of College of Cardiovascular Physicians of Chinese Medical Doctor Association and Hypertension Group of Chinese Society of Cardiology proposed the expert consensus on the diagnosis and treatment of adult mental stress-induced hypertension in March 2021, which includes the epidemiology, etiology, diagnosis, and treatment of the mental stress-induced hypertension. This consensus will hopefully facilitate the clinical practice of this disorder. In addition, the COVID-19 pandemic has become one of the primary global sources of psychosocial stressors since the beginning of 2020, and the revision of this expert consensus in 2022 has increased the relevant content. This consensus consists of Part A and Part B. Part A includes (I) Background and epidemiological characteristics, (II) Pathogenesis, and (III) Diagnosis and Part B includes (IV) Treatment recommendations and (V) Prospects. This part presents the content of Part A. © 2022 Heart and Mind ;Published by Wolters Kluwer - Medknow.
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The outbreak of COVID-19 provides a rare opportunity for the implementation of the carbon tax. To determine which stage is the most appropriate for introducing the policy, a simulation model based on China's panel data is established to analyze the impact of the carbon tax on government revenue and residents' income from five scenarios. A new GM-SD modeling method is proposed to ensure the accuracy of the model. The results show that the impact of the carbon tax on the government and the public is significantly different at different stages, and even the implementation of the carbon tax in the early stage of COVID-19 will reduce the government's tax revenue. The score analysis of government tax revenue, residents' surplus disposable income, residents' emotional value, and government administrative power finds that the middle period of COVID-19 is the best time to implement the policy. In addition, a more detailed analysis of five aspects, including total population, energy consumption, and national income, shows that the best time to implement the carbon tax policy is when the damage degree of COVID-19 is moderate. The analysis results can provide a reference and basis for China to introduce the carbon tax in the event of similar events as COVID-19, and have reference significance for other countries that have not implemented a carbon tax. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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Coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Traditional Chinese Medicine (TCM) was considered important by Chinese health authorities in the fight against COVID-19. This review systematically analyzed and evaluated the safety and efficacy of TCM combined with Western Medicine (WM) for the treatment of COVID-19. We sought to provide summary evidence for clinicians when using TCM. We searched for studies in PubMed, Web of Science, Embase, Medline, the Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data from database inception to June 1, 2021. Overall, 31 studies (14,579 participants) were involved in the final systematic review, including 15 randomized controlled trials and 16 observational studies. TCM combined with WM showed main outcomes of a higher clinical efficacy rate (odds ratio [OR] =2.48, 95% confidence interval [CI] =1.90-3.24, I 2 = 4%) and lower case fatality rate (OR = 0.31, 95% CI = 0.19-0.49, I 2 = 80%) compared with WM treatment alone. No significant overall adverse events were found between TCM plus WM group and WM group (OR = 1.43, 95% CI = 0.63-2.23, I 2 = 75%). Some larger randomized control trials would assist in defining the effect of TCM combined with WM on the treatment of COVID-19 complications such as cardiac injury. TCM combined with WM may be safe and effective for the treatment of COVID-19. © 2022 Heart and Mind ;Published by Wolters Kluwer - Medknow.
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This cross-sectional survey evaluated well-being and family dynamics before and during the COVID-19 pandemic in 1287 (16 + years of age, 68.3% female) Chinese participants. Structural equation modeling was used to test the association of well-being and systemic family dynamics, and related moderating factors. Results indicated some subscales of well-being and systemic family dynamics significantly worsened during the pandemic. A modified model fits well for both data before and during the pandemic in which well-being was significantly associated with systemic family dynamic and by family income. Age also positively related systemic family dynamics. The relationship between family income and well-being and the relationship between systemic family dynamics and well-being were moderated by the pandemic. The results suggest that well-being and systemic family dynamics and their associations are impacted by the COVID-19 pandemic. Systemic family dynamics could be a potential resource for enhancing well-being during the COVID-19 pandemic by some interventions. © The Author(s) 2023.
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Small and medium enterprises (SMEs) are continuing to be impacted by the COVID-19 pandemic as it moves into its third year. The 'dynamic COVID-zero' policy adopted in China from August 2021 to the end of 2022 has inevitably put pressure on local SMEs, which makes the situation in Chinese SMEs not only different from the situation during the initial outbreak, but also unique in the world. In July 2022, an online follow-up questionnaire was conducted on SMEs in Sichuan Province to assess their performances, pressures, and requirements in this particular period of time and compare the results with our findings from 2020 to reveal the longer-term impacts of COVID-19. It was found that: (1) most SMEs had poorer revenue and profit performances;(2) while the pressure of increasing production cost and declining market demand has increased significantly, normal productions and operations are no longer as strongly disturbed;(3) SMEs require more financial support but less operating and employment subsidies;(4) and the SMEs' overall confidence has recovered and the willingness to invest is rising. The situation in different sectors was also analysed and compared, with the results revealing problems within the tertiary industrial sector (wholesale and retail businesses).
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Purpose: This paper aims to contribute to the literature investigating hotel customers' preventive behavior during the COVID-19. Because there is no timely research discussing cleaning and disinfection services as a premium service in China, the authors conducted research to examine customers' perceptions based on the information–motivation–behavioral skills (IMB) model and to explore potential marketing exits. Moreover, based on the price-sensitive measurement, this study reveals the price range and optimal price of the service, which could assess the feasibility of the service and balance the operation cost. Design/methodology/approach: An internet-based, self-reported survey was designed to collect the data during the outbreak of COVID-19 in April 2020. The yield was 874 usable and valid responses, which were purposefully analyzed using confirmatory factor analysis and structural equation modeling. Findings: The results indicate a significant influence of dimensions (information, motivation, health behavior skills) on hotel customers' preventive behavior regarding purchase intention of cleaning and disinfection service. The optimal price of this service is 20% of the average room rate, and the range of acceptable prices is 15% of the average room rate. Originality/value: The present study represents academic attempts to contribute to the literature by applying the IMB model to consumer behavior in a hotel industry context, emphasizing the importance of each dimension in behavioral intention during the current ongoing global issue. Additionally, the results indicate that the hotel industry could consider satisfying the needs of this market based on the suggested price. © 2020, Emerald Publishing Limited.
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PurposeThe lockdown of schools to control the spread of Coronavirus Disease 2019 (COVID-19) has adversely affected elementary and secondary school students in China. However, little evidence is available that documents their perceptions toward the use of e-learning under the pandemic context. This study aims to explore (1) the underlying determinants influencing the students' intentions to continue e-learning and (2) the role that the COVID-19 pandemic plays in this decision. This study extends the expectation-confirmation model (ECM) through a mixed-methods study.Design/methodology/approachThis study uses a mixed-methods approach. Phase 1 draws conclusions and extracts significant elements related to e-learning during the pandemic by analyzing students' user reviews from platforms. Based on the findings, the authors identify the relevant variables and develop an extended ECM by integrating attitudes and the perceived threat of COVID-19. In Phase 2, the research model is empirically validated using data collected from 36,920 elementary and secondary school students in China. This study uses a mixed-methods approach. Phase 1 draws conclusions and extracts significant elements related to e-learning during the pandemic by analyzing students' user reviews from platforms. Based on the findings, the authors identify the relevant variables and develop an extended ECM by integrating attitudes and the perceived threat of COVID-19. In Phase 2, the research model is empirically validated using data collected from 36,920 elementary and secondary school students in China.FindingsIn Phase 1, the results reveal that students' most concern elements in the COVID-19 pandemic are user perceptions toward e-learning and threat perceptions of COVID-19. In Phase 2, the results reveal that perceived usefulness and attitude are the most significant factors in students' intention to continue. The perceived threat of COVID-19 indirectly influences their intention to continue.Originality/valueThe study extends the ECM with a mixed-methods study to understand students' perceptions toward e-learning during the COVID-19 pandemic. This study can be helpful in related studies in the context of COVID-19-related diseases or other novel scenarios.
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INTRODUCTION: The COVID-19 pandemic disrupted access and delivery of routine continuing care for sepsis recovery, including provision of postacute services like skilled nursing facility (SNF) discharge, home healthcare (HH), and outpatient follow up. We hypothesized pandemic-related precautions and care disturbances would disparately impact postacute care for adults with sepsis due to COVID-19 vs non-COVID-19 pneumonia. METHOD(S): ENCOMPASS is an ongoing hybrid trial to test implementation of a multidisciplinary postsepsis transitional care program at 8 diverse hospitals (NCT04495946). In the current study, we analyzed community-dwelling trial participants (i.e., adults with clinically defined sepsis) enrolled July 2020-Nov 2021 with discharge diagnoses of COVID-19 (ICD10 U07.1) or non-COVID-19 pneumonia (ICD10 J13-18). Using EHR data, we examined discharge care setting (SNF or inpatient rehab, HH, or home with self care) and outpatient follow up within 14 days (in-person, virtual, or none) as primary and secondary outcomes. For each outcome, we fit multinomial regression models adjusted for patient (age, insurance), clinical (comorbidity burden, organ failure, length of stay) and community factors (rurality by zip code). RESULT(S): Among 410 participants with COVID-19 (n=151) or non-COVID-19 (n=259) pneumonia (median, at enrollment: age=70, CCI=5, SOFA score=4), 52 (13%) died in hospital and 18 (4%) discharged to hospice. of remaining patients, 134 (39%) were discharged to home with self care, 118 (35%) to HH, and 88 (26%) to SNF or inpatient rehab. Survivors with vs without COVID-19 had similar adjusted odds of discharge to HH (OR=1.17 95%CI=0.65-2.10) and SNF or inpatient rehab (OR=1.60 95%CI=0.81-3.14) compared to home. Outpatient visit completion was similar for COVID-19 and non-COVID-19 survivors (26% vs 30%, p=0.43), but patients with vs without COVID-19 had higher odds of virtual (OR=4.76 95%CI=2.11-10.75) compared to no completed follow-up. CONCLUSION(S): In an ongoing postsepsis care trial, COVID-19 and non-COVID-19 survivors had similar provision of postacute services. COVID-19 was associated with increased virtual outpatient follow up, highlighting the value of telehealth to reduce exposure risk while maintaining close follow up of patients recovering from serious illness during the pandemic.
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INTRODUCTION: Prior data indicate that sepsis survivors face persistent health challenges and fail to receive adequate support after hospital discharge. Delivery of high-quality transition care may be exacerbated by the COVID-19 pandemic. We assessed patient reported satisfaction with transitional care and health outcome status for survivors of respiratory sepsis (due to COVID-19 and non-COVID-19 pneumonia) during the pandemic. METHOD(S): We enrolled patients (or surrogate caregivers) from both usual care and intervention arms of ENCOMPASS, an ongoing clinical trial evaluating the effectiveness of a multicomponent sepsis transition program. Individuals who consented to participate completed health related quality of life (HRQoL;EQ-5D-5L) and other outcomes measures (Mini-MOCA, IES-6, mMRC) 3 months after hospital discharge and responded to questions about post-discharge support. Interviews were conducted via telephone. Data were collected in REDCap (Research Electronic Data Capture) and analyzed with SAS. RESULT(S): Among 18 participants (14 patients, 4 caregivers [non-overlapping]), 56% were female, median patient age was 67 years, median Charlson index was 4, median SOFA was 4, and 2 patients were recovering from COVID-19. Most reported being satisfied/very satisfied with their transitional care (15, 83%) and were able to get all of the healthcare services needed during the pandemic (14, 78%). Many participants reported persistent problems at 3 months after discharge (mobility [17, 94%], self-care [17, 94%], usual activities [18, 100%], pain or discomfort [17, 94%], and anxiety or depression [15, 83%]), independent of coexisting chronic disease burden. The median EQ-5D visual analog scale was 65 (IQR=40-80). 12 (86%) patients reported persistent dyspnea, 2 (14%) had cognitive impairment by mini-MOCA, and 3 (21%) had symptoms of post-traumatic stress by IES-6. CONCLUSION(S): Sepsis survivors experience multidimensional HRQoL problems 3 months after discharge. Despite concerns about the provision of transitional support during the pandemic, most patients in this small study were satisfied with the transitional support received. Our findings reinforce the need for high-quality transitional support that addresses the new or worsening health problems experienced after sepsis.
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This study analyzes the impact of Industry 4.0 and SARS-CoV-2 on the manufacturing industry, in which manufacturing entities are faced with insufficient resources and uncertain services;however, the current study does not fit this situation well. A multi-service composition for complex manufacturing tasks in a cloud manufacturing environment is proposed to improve the utilization of manufacturing service resources. Combining execution time, cost, energy consumption, service reliability and availability, a quality of service (QoS) model is constructed as the evaluation standard. A hybrid search algorithm (VS-ABC algorithm) based on the vortex search algorithm (VS) and the artificial bee colony algorithm (ABC) is introduced and combines the advantages of the two algorithms in search range and calculation speed. We take the customization production of automobiles as an example, and the case study shows that the VS-ABC algorithm has better applicability compared with traditional vortex search and artificial bee colony algorithms.
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AI THEME ISSUE: How can health care organizations ensure that there is accountability of algorithms for accuracy, bias, and the wide range of unintended consequences when deployed in real-world settings? A machine-learning system for Covid-19 contact tracing serves as a model to scope out, develop, interrogate, and assess an algorithmic solution that produces improvements in care, mitigates risk, and enables evaluation by many stakeholders.