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Purpose of Study The detrimental long-term effects of obesity are well-described in literature;however, there has been recently emerging evidence describing a possible mortality benefit in obese patients with acute injury. The scope of this review is to provide an overview of the ongoing debate surrounding this observation. We focused our discussion on evaluating the evidences suggesting an impact of obesity and overweight on multiple acute medical conditions. Methods Used We searched the PubMed database with the keywords 'obesity', 'paradox', 'trauma', 'mortality', 'BMI', 'cancer', 'sepsis', 'lung injury', 'stroke', 'COVID', and 'myocardial infarct' from inception to 2020 and selected 40 relevant papers discussing the relationship between mortality and BMI in the setting of these stressors, and the mechanisms behind them. Summary of Results Amongst the fields of blunt trauma, cardiovascular disease, cancer, and critical care admissions for sepsis and lung injury, there are a growing amount of evidences supporting the existence of a paradoxical mortality benefit with overweight and mild obesity compared to normal and lean BMI. These findings must be attenuated with study design and BMI limitations, as well as biases prevalent throughout these studies. Although several hypotheses have been proposed, the exact mechanisms behind this relationship are largely unknown. Conclusions This survey of the obesity paradox shows promise in regard to overweight and mild obesity helping with survival post-acute illness, possibly due to metabolic reserves, antiinflammatory, and anti-oncogenic conditions seen in obesity. We recommend addressing current major limitations by having future studies prospectively designed to evaluate alternative body weight metrics such as waist-to-hip ratio or waist circumference, with special attention to the timing of body weight measurements and its progression in the patient's life. In the future, elucidating the biological mechanisms of this relationship may allow us to adapt our recommendations to the patients and help direct optimal therapeutic approach in the management of certain acute pathologies.
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Nucleic acid detection has been one of the most valued tools in point-of-care diagnostics from life science, agriculture, food safety and environmental surveillance, because of its high sensitivity, great specificity and simple operation. Since polymerase chain reactions (PCR) were discovered, more and more researchers attach importance to exploring ultrafast nucleic acid amplification methods for further expediting the process of detection and curbing infectious diseases' high spread rate, especially after the coronavirus disease 2019 (COVID-19) worldwide pandemic event. Nowadays, nanotechnology as one of the most cut-ting-edge technologies has aroused growing attention. In this review, we describe new advances in na-notechnology research for ultrafast nucleic acid amplification. We have introduced commonly used nanotechnologies, namely nanofluidics, nanoporous materials, nanoparticles and so on. Recent advances in these nanotechnologies for ultrafast sample pretreatments, accelerated enzymatic amplification and rapid heating/cooling processes was summarized. Finally, challenges and perspectives for the future applications of ultrafast nucleic acid amplification are presented.(c) 2022 Elsevier Ltd. All rights reserved.
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The outbreak of coronavirus disease (COVID-19) represents a major public health challenge and a serious threat to sustainable social development. A consideration of animal welfare is clearly justified, given the potential contribution of animals to the spread of the disease. The present study, therefore, sought to investigate the concern the Chinese people have for animal welfare (PCAW) and how their 'ethical ideology' (idealism and relativism) determines PCAW after COVID-19, through comparison with the same study, carried out in China in 2015. Our results demonstrated a significant improvement in Chinese PCAW after COVID-19. The adverse impact of COVID-19 may have resulted in a lowered idealism score and this decreased score served to neutralise significant correlations between idealism and PCAW, compared to the 2015 results. The global pandemic did not increase people's relativism score and a significant correlation was found between relativism and PCAW. Gender, age, educational level, public perception of animals after COVID-19, zoo and aquarium visiting were all shown to be predictor variables for PCAW. This study is one of the first to investigate Chinese PCAW after COVID-19 and can therefore provide knowledge that will potentially increase Chinese PCAW.
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Background and Aims: Mobile health management platform is a potential way to achieving effective glycemic control in type 2 diabetesmellitus (T2DM) patients, especially during the Covid-19 pandemic. Lilly Connected Care Program (LCCP) is a smartphone-based app providing blood glucose monitoring and diabetes education services to improve diabetes management. This study aimed to evaluate the real-world effectiveness of LCCP platform in glycemic control among Chinese T2DM patients. Methods: This retrospective study included Chinese T2DM patients (age ≥18 years) from January 1, 2015, to January 31, 2020. Data was drawn from mobile app and electronic medical records. Propensity score matching (PSM) was used to match LCCP group and non-LCCP group to reduce confounding, with covariates including age, sex, duration of diabetes, baseline HbA1c, and number of oral diabetes medication classes. We analyzed HbA1c reduction within an average of 4 months and compared the proportions of patients achieving HbA1c reduction ≥0.5% or ≥1% between LCCP and non-LCCP groups. Comparisons were made using independent t-test and Chi-square test. Results: A total of 923 patients were included, among whom 303 pairs of patients were well-matched after PSM (Standardized Mean Difference of covariates <15%). The HbA1c reduction during 4-month follow-up was significantly larger in LCCP group than non-LCCP group (Mean±SD: 2.21 ± 2.37% vs. 1.65 ± 2.29%, P = 0.003). LCCP group had higher proportions of patients with HbA1c reduction ≥1% (69.0% vs. 57.4%, P = 0.003) and ≥0.5% (75.6% vs. 68.0%, P = 0.038). Conclusions: LCCP mobile platform was effective in glycemic control among Chinese T2DM patients in the real world.
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The battle between pathogens and hosts is an ongoing phenomenon that has been studied for centuries. Although multicellular organisms have developed sophisticated immune systems to defend against pathogens, pathogens are often able to successfully infect their hosts. To enhance their chance of survival, pathogens can hijack the host's metabolism, which serves as a critical control point that can potentially impact infections. Mammalian target of rapamycin (mTOR) is the nutrient sensor and central regulator of metabolism in innate and adaptive immune cells. Rapamycin, a drug targeting the mTOR pathway, has been widely used in clinical practice for decades and is relatively safe. However, some unexpected infections occur after long-term administration of rapamycin, indicating the presence of a close relationship between mTOR signaling and the infection process. In this manuscript, we briefly review the mTOR pathway and the current clinical use of rapamycin;we also summarize the role of the mTOR pathway in immune cell death, including apoptosis, necroptosis, pyroptosis, and ferroptosis, and its impact on anti-infection immunity. Finally, potential application of mTOR inhibitor in coronavirus disease 2019 clinical therapy is discussed.
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At the beginning of the coronavirus outbreak in late 2019 (COVID-19), the procedure of epidemic prevention for each student in most campuses in Taiwan included taking the temperature of the forehead and disinfecting hands by use of alcohol or hand sanitizer;there was an obvious need for many operators to help in the epidemic-prevention process. In our campus, a scan of the QR code is also required to register on the campus cloud system for a footprint record. Therefore, before class, many students are waiting in line, and each student needs to spend about 10 minutes for the entire process. Hence, we designed a new campus epidemic-prevention system against the threat of COVID-19. The system can automatically perform the forehead temperature measurement, hand sanitizing, and ID registration on each user. The manually operated issues, such as infection risk of operators, manpower requirement of epidemic-prevention stations, and the entire process times, can all be reduced.
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Session Description: Themes of inequity, injustice, and health disparities are woven through the history of medicine. The national and specialty-wide conversation about these critical problems has evolved in the past year in parallel with major social movements around the world. In combination with the COVID-19 pandemic, these conversations have shed light on ways in which privilege, disadvantage, and systemic biases have contributed to diminished quality of medical care and exacerbated disparities in health outcomes. This panel, sponsored by the American Academy of Otolaryngology- Head and Neck Surgery Patient Safety and Quality Improvement Committee and featuring national experts in health care quality, value, and diversity, justice, and inclusion will complement other sessions at this meeting addressing inequities in health care. In this panel, we will focus specifically on how systemic bias and workforce inequity directly contributes to disparate, low-quality, and low-value health care. We will focus on racism, sexism, and anti-LGBTQ+ bias in both the workforce and in treatment of patients, providing a review of current knowledge on the effects of these biases on the quality of surgical care in the United States, including effects on provider-patient interaction, treatment recommendations, and adherence to these recommendations. We will then address ways in which inequities in the otolaryngology workforce further limit opportunities for patient-physician racial concordance and exacerbate disparities in patient outcomes and strategies to begin addressing workforce diversity and inclusion problems. These issues will be examined for both academic and nonacademic practice settings. We will connect quality to costs of care to discuss how systemic bias affects the value of surgical care delivered to patients of different privilege and how this difference in value perpetuates injustice in health care. Outcome Objectives: (1) Define privilege, bias, equality, equity, inclusion, and justice as individual constructs in the context of medical, and specifically otolaryngologic, care. (2) Summarize current knowledge of the effects of systemic racism, sexism, and anti-LGBTQ+ bias on workforce equity and quality of care in otolaryngology. Demonstrate specific examples in otolaryngology. (3) Relate the effects of these biases to the value of otolaryngologic care.
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In 2020, the global COVID-19 outbreak came out of the blue and caught people and businesses by surprise, including the education sector. In order to ensure the "suspension of classes", schools at all levels in China implement online teaching. How to ensure the quality of online teaching is an important issue. Based on the big data of online teaching, it is of great practical significance to analyze the factors affecting the quality of online teaching, so as to improve the path of improving the quality of online teaching. With the help of big data analysis, the index system of online teaching quality improvement is constructed and applied. Through questionnaire survey and SPSS software analysis, it can be concluded that the teaching quality of online teaching can be improved from three aspects: the behavior level of school, the learning level of students and the behavior level. Therefore, the following Suggestions are put forward: improve the hardware environment, perfect the teaching organization, strengthen the teaching supervision, strengthen students' mastery of knowledge and skills, strengthen students' active inspection and team learning. It is hoped that the implementation of such recommendations will further improve the quality of online teaching in the context of COVID-19. © Published under licence by IOP Publishing Ltd.