Asymmetric Multifractal Analysis of the Chinese Energy Futures and Energy Stock Markets under the Impact of COVID-19

The volatility and cross-correlations of the energy market and the stock market during the COVID-19 pandemic have been paid close attention by scholars and investors. In this paper, we use the asymmetric multifractal analysis methods to study the fluctuation characteristics, market risks and cross-correlations of the Chinese energy futures market (EFM) and two energy stock markets before and after the COVID-19 outbreak, while the return series of Shanghai fuel oil futures, CSI Energy Index and CSI Mainland New Energy Theme Index are considered. The empirical evidences indicate that the auto- and cross-correlations of the three markets have the asymmetric multifractality, and that the multifractality of the cross-correlations is mainly caused by the fat-tailed distribution of the original series. After the COVID-19 outbreak, the risks of both the traditional energy stock market in the uptrend and the entire new energy stock market become larger, while those of the entire EFM become smaller. In addition, the COVID-19 pandemic has increased the multifractality of the cross-correlations between the energy futures and energy stock markets when the EFM is in downward trend.

Biphenyl furanocoumarin compounds inhibit SARS-CoV-2 spike pseudovirus infection by binding ACE2

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), is a highly infectious disease with a significant impact on global public health security, and the development of effective antiviral drugs is warranted. In this study, based on HEK293 membrane chromatography (CMC) model that overexpresses angiotensin-converting enzyme 2 (ACE2), we screened six compounds with long retention time on ACE2h/CMC, namely BU-1 to BU-6, from the biphenyl furanocoumarin compounds previously synthesized by our team. The binding properties of the screened compounds to ACE2 were investigated by frontier analysis. Cytotoxicity assay, virtual molecular docking assay and pseudo-viral invasion assay were used to examine the affinity and potential antiviral activity of the selected compounds towards ACE2 protein. The virtual molecular docking results showed that BU-1, BU-2 and BU-5 could form significant hydrogen bonds with hotspot amino acid residues on the ACE2 receptor. And BU-1, BU-2 and BU-5 significantly inhibited the ability of SARS-COV-2 pseudovirus to enter ACE2h cells. Therefore, BU-1, BU-2 and BU-5 have the potential to be used as lead compounds for further modification to develop more effective anti-SARS-CoV-2 drugs. [ FROM AUTHOR]

Asymmetric Multifractal Analysis of the Chinese Energy Futures and Energy Stock Markets under the Impact of COVID-19

The volatility and cross-correlations of the energy market and the stock market during the COVID-19 pandemic have been paid close attention by scholars and investors. In this paper, we use the asymmetric multifractal analysis methods to study the fluctuation characteristics, market risks and cross-correlations of the Chinese energy futures market (EFM) and two energy stock markets before and after the COVID-19 outbreak, while the return series of Shanghai fuel oil futures, CSI Energy Index and CSI Mainland New Energy Theme Index are considered. The empirical evidences indicate that the auto- and cross-correlations of the three markets have the asymmetric multifractality, and that the multifractality of the cross-correlations is mainly caused by the fat-tailed distribution of the original series. After the COVID-19 outbreak, the risks of both the traditional energy stock market in the uptrend and the entire new energy stock market become larger, while those of the entire EFM become smaller. In addition, the COVID-19 pandemic has increased the multifractality of the cross-correlations between the energy futures and energy stock markets when the EFM is in downward trend. [ FROM AUTHOR]

A review of the effectiveness of fever tent setup in COVID-19 pandemic from a radiology perspective.

INTRODUCTION: This paper describes our experience in setting up a dedicated imaging facility within a temporary fever tentage in an acute tertiary hospital in Singapore during the coronavirus disease 2019 (COVID-19) pandemic. We review the effectiveness of the setup and its role from the radiological perspective in detail. METHODS: The dedicated imaging facility within the temporary fever tentage was equipped with a computer-on-wheels (COWs) to access patients' medical records and a portable x-ray machine to allow for a smooth workflow. Radiation dose measurements were acquired around the imaging facility using phantoms and dosimeters to ensure radiation safety. RESULTS: Due to its rapid nature and availability as a screening tool, chest x-ray (CXR) is the most widely used imaging modality during the COVID-19 pandemic. Our dedicated fever tent setup minimizes possible in-hospital transmission between both patients and staff and provides a more streamlined workflow to tackle the high workload. It allowed us to reduce the time required for each radiograph, providing timely imaging services and radiological reports for expedient clinical screening. DISCUSSION: The close collaboration between Radiology and Emergency Departments in setting up the fever tentage is a crucial tool in managing the COVID-19 pandemic. The fever tentage imaging facility is a highly effective tool, providing the means to handle the increased patient load in a streamlined and safe manner during a pandemic. CONCLUSION: This paper provides insights and guidelines in setting up a dedicated imaging service within the fever tent for future infectious disease outbreak contingency plans.

Lessons in family-centred pandemic care: the psychological outcomes of families admitted with covid-19 in Singapore

BackgroundChildren are mostly infected with SARS-CoV-2 through household transmission. All children diagnosed with COVID-19 in Singapore require hospital isolation in one of Singapore’s 2 paediatric units. Discharge was initially upon nasopharyngeal clearance. This was revised on 29 May 2020 to time-based discharge of well patients, regardless of viral clearance, after Day 21 of illness. Concerted efforts are made to admit infected children together with their caregivers as a family unit.ObjectivesThis study aims to explore the psychological experiences of children and their caregivers isolated in hospital due to COVID-19.MethodsA prospective mixed-methods design was used to evaluate the psychological status of hospitalised family units where at least one child < 18 years had SARS-CoV-2 infection.Patient medical records were reviewed for demographic and clinical information. Parents and children >7 years old underwent a telephone-based interview performed by a trained psychologist to explore their understanding of the infection, hospital isolation, and pandemic.Two self-reported questionnaire instruments were used to assess anxiety and depression – the Short Mood and Feelings Questionnaire (SMFQ) and Screen for Adult Anxiety Related Disorders (SCAARED) in adults;SMFQ for children with the Screen for Child Anxiety Related Disorders (SCARED) Questionnaire in children ≥7 years old.Parents were asked to score their opinion and emotions relating to their experience in isolation on a Likert scale of 1 to 5 on a series of qualitative questionnaires.ResultsFifteen family units were admitted in our institution between March-May 2020 and were invited to participate. 11 (73%) family units were recruited- 9 child-adult dyads, a triad of 2 children and 1 adult, and 1 child who was admitted alone. The mean length of hospitalization was 25.5 days (range 20–31 days). The mean age of children admitted was 5.1 years (8 months – 12.3 years). Five children were ≥7 years old and all completed interviews and questionnaires. All caregivers interviewed were positive for COVID-19. Nine parental questionnaires and 10 adult interviews were completed.Parents were overall more anxious for their children than themselves. Most common sources of anxiety were the frequency of swab tests, and uncertainty regarding swab results and duration of isolation. 44.4% of adults vs 60% of children had symptoms indicative of generalized anxiety disorder, and 66.7% of adults vs 80% of children had symptoms indicative of separation anxiety disorder. 80% of parents reported being sad about separation from other family members who were not admitted. None of the participants met criteria suggestive of depression on the SMFQ.ConclusionsFamilies were anxious about their admission despite being admitted as a family unit. Main sources of anxiety were procedural discomfort and prolonged isolation of the child. Children appeared more susceptible to separation anxiety, possibly due to limited understanding of the situation.Clear timely parental communications to provide information on clinical management and anticipated discharge should be encouraged. We recommend routine psychological assessment for all children and family units, with focus on reassurance and early recognition of evolving anxiety disorders. Time-based discharge criteria and alternative SARS-CoV-2 diagnostic sampling may ease anxiety during the pandemic.

Covid-19 and the cardiovascular system: a comprehensive review.

Cardiac injury in patients infected with the novel Coronavirus (COVID-19) seems to be associated with higher morbimortality. We provide a broad review of the clinical evolution of COVID-19, emphasizing its impact and implications on the cardiovascular system. The pathophysiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by overproduction of inflammatory cytokines (IL-6 and TNF-α) leading to systemic inflammation and multiple organ dysfunction syndrome, acutely affecting the cardiovascular system. Hypertension (56.6%) and diabetes (33.8%) are the most prevalent comorbidities among individuals with COVID-19, who require hospitalization. Furthermore, cardiac injury, defined as elevated us-troponin I, significantly relates to inflammation biomarkers (IL-6 and C-reactive protein (CRP), hyperferritinemia, and leukocytosis), portraying an important correlation between myocardial injury and inflammatory hyperactivity triggered by viral infection. Increased risk for myocardial infarction, fulminant myocarditis rapidly evolving with depressed systolic left ventricle function, arrhythmias, venous thromboembolism, and cardiomyopathies mimicking STEMI presentations are the most prevalent cardiovascular complications described in patients with COVID-19. Moreover, SARS-CoV-2 tropism and interaction with the RAAS system, through ACE2 receptor, possibly enhances inflammation response and cardiac aggression, leading to imperative concerns about the use of ACEi and ARBs in infected patients. Cardiovascular implications result in a worse prognosis in patients with COVID-19, emphasizing the importance of precocious detection and implementation of optimal therapeutic strategies.

[Moxibustion therapy in prevention and treatment of coronavirus disease 2019 (COVID-19): construction and application of non-contact diagnosis and treatment mode].

OBJECTIVE: To establish and promote the non-contact doctor-patient interactive diagnosis and treatment mode based on mobile internet for the treatment of coronavirus disease 2019 (COVID-19) with moxibustion therapy, and to observe the feasibility and effectiveness of the model in the pandemic. METHODS: A total of 43 first-line medical staff and 149 suspected and confirmed cases with COVID-19 [18 cases in medical observation period, 17 cases of mild type (cold dampness and stagnation in the lung), 24 cases of ordinary type (cold-dampness accumulated in the lung) and 90 cases in recovery period (qi deficiency of spleen and lung)] were included. A non-contact doctor-patient interactive diagnosis and treatment platform was established for the treatment of COVID-19 with indirect moxibustion plaster based on mobile internet. By the platform, the patients were instructed to use indirect moxibustion plaster in treatment. For the first-line medical staff and patients in the medical observation period, Zusanli (ST 36), Qihai (CV 6) and Zhongwan (CV 12) were selected. For the mild cases (cold dampness and stagnation in the lung) and the cases of ordinary type (cold-dampness accumulated in the lung), Hegu (LI 4), Taichong (LR 3), Zusanli (ST 36) and Guanyuan (CV 4) were selected. In the recovery period (qi deficiency of spleen and lung), Dazhui (GV 14), Feishu (BL 13), Geshu (BL 17), Zusanli (ST 36) and Kongzui (LU 6) were used. The treatment was given once daily for 40 min each time. The intervention lasted for 10 days. After intervention, the infection rate and the improvement in the symptoms and psychological status of COVID-19 were observed in clinical first-line medical staff and COVID-19 patients. RESULTS: In 10 days of intervention with indirect moxibustion plaster, there was "zero" infection among medical staff. Of 43 first-line physicians and nurses, 33 cases had some physical symptoms and psychological discomforts, mainly as low back pain, poor sleep and anxiety. After treatment, regarding the improvements in the symptoms and psychological discomforts, the effective rate was 78.8% (26/33) and the curative rate was 36.4% (12/33). Regarding the improvements in psychological discomforts, the effective rate was 58.3% (14/24) and the curative rate was 37.5 (9/24). Of 149 patients, 133 cases had the symptoms and psychological discomforts. After treatment, regarding the improvements in the symptoms and psychological discomforts, the effective rate was 81.2% (108/133) and the curative rate was 34.6% (46/133). Regarding the improvements in psychological discomforts, the effective rate was 76.5% (52/68) and the curative rate was 57.4 % (39/68). CONCLUSION: It is feasible to apply the indirect moxibustion plaster technique based on mobile internet to the treatment COVID-19. This mode not only relieves the symptoms such as cough and fatigue, improves psychological state, but also possibly prevents the first-line medical staff from COVID-19.

Critical Coronavirus Disease 2019 in a Hemodialysis Patient: A Proposed Clinical Management Strategy.

The coronavirus disease 2019 (COVID-19) pandemic has caused a catastrophic global health crisis. There is a lack of mitigation and clinical management strategies for COVID-19 in specific patient cohorts such as hemodialysis (HD) patients. We report our experience in treating the first case of COVID-19 in a HD patient in Singapore who had a severe clinical course including acute respiratory distress syndrome and propose a clinical management strategy. We propose a clinical workflow in managing such patients based on available evidence from literature review. We also highlight the importance of early recognition and intervention for disease control, dialysis support in an acute hospital isolation facility, deisolation protocol, and discharge planning due to prolonged viral shedding. The case highlights important points specific to a HD patient with a COVID-19 diagnosis, tailored interventions for each stage of the disease, and deisolation considerations in the recovery phase.

Can Masks Be Reused After Hot Water Decontamination During the COVID-19 Pandemic?

Masks have become one of the most indispensable pieces of personal protective equipment and are important strategic products during the coronavirus disease 2019 (COVID-19) pandemic. Due to the huge mask demand-supply gap all over the world, the development of user-friendly technologies and methods is urgently needed to effectively extend the service time of masks. In this article, we report a very simple approach for the decontamination of masks for multiple reuse during the COVID-19 pandemic. Used masks were soaked in hot water at a temperature greater than 56 °C for 30 min, based on a recommended method to kill COVID-19 virus by the National Health Commission of the People's Republic of China. The masks were then dried using an ordinary household hair dryer to recharge the masks with electrostatic charge to recover their filtration function (the so-called "hot water decontamination + charge regeneration" method). Three kinds of typical masks (disposable medical masks, surgical masks, and KN95-grade masks) were treated and tested. The filtration efficiencies of the regenerated masks were almost maintained and met the requirements of the respective standards. These findings should have important implications for the reuse of polypropylene masks during the COVID-19 pandemic. The performance evolution of masks during human wear was further studied, and a company (Zhejiang Runtu Co., Ltd.) applied this method to enable their workers to extend the use of masks. Mask use at the company was reduced from one mask per day per person to one mask every three days per person, and 122 500 masks were saved during the period from 20 February to 30 March 2020. Furthermore, a new method for detection of faulty masks based on the penetrant inspection of fluorescent nanoparticles was established, which may provide scientific guidance and technical methods for the future development of reusable masks, structural optimization, and the formulation of comprehensive performance evaluation standards.

Responding to COVID-19: how an academic infectious diseases division mobilized in Singapore.

BACKGROUND: On January 30, COVID-19 was declared a Public Health Emergency of International Concern-a week after Singapore's first imported case and 5 days before local transmission. The National University Hospital (NUH) is Singapore's third largest hospital with 1200 beds, heavy clinical workloads, and major roles in research and teaching. MAIN BODY: With memories of SARS still vivid, there was an urgent requirement for the NUH Division of Infectious Diseases to adapt-undergoing major reorganization to face rapidly changing priorities while ensuring usual essential services and standards. Leveraging on individual strengths, our division mobilized to meet the demands of COVID-19 while engaging in high-level coordination, strategy, and advocacy. We present our experience of the 60 days since the nation's first case. During this time, our hospital has managed 3030 suspect cases, including 1300 inpatients, 37 confirmed cases, and overseen 4384 samples tested for COVID-19. CONCLUSION: Complex hospital adaptations were supported by an unprecedented number of workflows and coordination channels essential to safe and effective operations. The actions we describe, aligned with international recommendations and emerging evidence-based best practices, may serve as a framework for other divisions and institutions facing the spread of COVID-19 globally.

Practical Approach to Acute Coronary Syndrome in Patients with COVID-19

Abstract Acute cardiac injury is associated with higher mortality in patients with the novel coronavirus disease-2019 (COVID-19) and the exact etiology can be challenging to diagnose in the emergency setting during the pandemic. From a pathophysiological perspective, SARS-CoV-2 infection is characterized by an overproduction of inflammatory cytokines (IL-6, TNF-alpha) that leads to systemic inflammation and consequent increased risk of acute myocardial infarction (AMI) caused by atheromatous plaque rupture and significant myocardial oxygen supply-demand imbalance. Moreover, SARS-CoV-2 tropism to the renin-angiotensin-aldosterone system through the ACE2 receptor induces myocarditis that may rapidly progress to left ventricular dysfunction and hemodynamic instability. Myocardial inflammation with pericardial involvement, i.e. , myopericarditis, can progress to cardiac tamponade and obstructive shock. These cardiovascular complications, which are associated with a worse prognosis and higher mortality, can be associated with clinical manifestations, electrocardiographic changes, and troponin values similar to AMI. Thus, the diagnosis and treatment of patients with acute chest pain and dyspnea admitted to the emergency department is a significant challenge during the COVID-19 pandemic. Here, we provide a review of the literature focusing on a practical approach to acute coronary syndrome patients with confirmed or suspected COVID-19.