The impact of dynamic adaptive teaching model on surgical education.

Objective To investigate the impact of dynamic adaptive teaching model on surgical education. Methods Due to the COVID-19 pandemic in 2020, we adopted dynamic adaptive teaching model in the Department of Breast Surgery, Peking Union Medical College Hospital, which divided the whole curriculum into several individual modules and recombined different modules to accommodate to student's levels and schedules. Meanwhile, adaptive strategy also increased the proportion of online teaching and fully utilized electronic medical resources. The present study included quantitative teaching score (QTS) recorded from January 2020 to June 2020, and used the corresponding data from 2019 as control. The main endpoint was to explore the impact of dynamic adaptive teaching model on overall QTS and its interaction effect with trainer's experience and student category. Results Totally, 20 trainers and 181 trainees were enrolled in the present study. With implementation of dynamic adaptive strategy, the overall QTS decreased dramatically (1.76+/-0.84 vs. 4.91+/-1.15, t=4.85, P=0.005). The impact was consistent irrespective of trainers' experience (high experience trainers: 0.85+/-0.40 vs. 2.12+/-0.44, t=4.98, P=0.004;medium experience trainers: 0.85+/-0.29 vs. 2.06+/-0.53, t=4.51, P=0.006;and low experience trainers: 0.10+/-0.16 vs. 0.44+/-0.22, t=2.62, P=0.047). For resident (including graduate) and undergraduate student teaching, both QTS was lower with dynamic strategy (residents: 0.18+/-0.34 vs. 0.97+/-0.14, t=4.35, P=0.007;undergraduate students 1.57+/-0.55 vs. 3.77+/-1.24, t=3.62, P=0.015), but dynamic strategy was effective for post-doc student subgroup and reached comparable QTS as traditional model (0.00+/-0.00 vs. 0.17+/-0.41, t=1.00, P=0.363). Conclusions Dynamic adaptive teaching strategy could be a useful alternative to traditional teaching model for post-doc students. It could be a novel effective solution for saving teaching resources and providing individualized surgical teaching modality.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

Physical and mental condition and medicine consumption of frontline medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019.

Objective To investigate the physical and mental condition and medicine consumption of medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 144 frontline medical staff who fighting against the COVID-19 epidemic from a tertiary first-class hospital from Apr. 4 to May 12, 2022 were surveyed by questionnaires online. Their physical condition including body weight change before the medical work and one month later, sleep quality and the medicine consumption during the medical work were collected and analyzed. Results The mean body weight of frontline doctors before the medical work and one month later were (69.80+/-8.35) kg and (68.60+/-7.37) kg, while those of nurses were (55.36+/-8.27) kg and (53.80+/-7.38) kg, both showing a decreasing trend but without significant difference (all P0.05). A total of 63.89% (92/144) frontline medical staff suffered from insomnia, of which 27.08% (39/144) needed drug intervention. The top 5 common diseases among frontline medical staff were sleep disorder (63.89%, 92/144), skin injury (25.69%, 37/144), body pain (23.61%, 34/144), oral ulcer (13.19%, 19/144), and acute upper respiratory tract infection (9.72%, 14/144). A total of 155 medical staff used drugs, and the top 5 common drugs were skin application (16.77%, 26/155), Ganmao'an granule (12.26%, 19/155), zolpidem tartrate tablets (11.61%, 18/155), Kangfuxin liquid (11.61%, 18/155), and celecoxib capsules (8.39%, 13/155). Conclusion Frontline medical staff in shelter hospitals are prone to have body weight change, sleep disorder, skin injury, body pain, oral ulcer, acute upper respiratory tract infection and so on, which suggests that in future similar large-scale medical support, it is necessary to pay sufficient attention to the physical condition of frontline medical staff and provide them sufficient medicine.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Comparison of disinfection quality in nurseries of Nanjing during 2019 - 2021

Objective To analyze the disinfection quality and influencing factors of nurseries in Nanjing during 2019-2021 so as to provide a scientific basis for optimizing preventive disinfection strategies and measures in nurseries. Methods Environmental samples from 389 nurseries in Nanjing from January 2019 to December 2021 were tested and the change of disinfection quality qualification rate was compared. Results The overall disinfection qualification rate of nurseries of year 2019-2021 were 96.32% 95.85% and 94.60% respectively showing a downward trend χ2trend = 8.67 P<0.05 . Specifically disinfection qualification rate of object surfaces staff hands and tableware showed a downward trend while the disinfection qualification rate of dynamic air showed an upward trend and the differences were statistically significant χ2trend = 23.17 12.32 5.37 21.48 P<0.05 . The total qualification rate of disinfection in Jiangning and Liuhe districts increased during 2019-2021 χ2trend = 21.46 24.05 P<0.05 . Conclusion Disinfection quality of nurseries in Nanjing has declined by year during 2019-2021 especially the object surfaces and staff hands. It is urgent to optimize and refine the strategies and measures for preventive disinfection in nurseries strengthen the training of personnel on disinfection knowledge and ensure the quality of disinfection in nurseries. © 2023 Chinese Journal of General Surgery. All rights reserved.

Research progress of ulinastatin in treatment of COVID-19.

Coronavirus disease 2019 (COVID-19) is still spreading worldwide. At present, no specific drug has been developed for the virus. Ulinastatin plays an important role in anti-inflammatory. Clinically, it is mainly used in acute pancreatitis, shock and disseminated intravascular coagulation. It also has the effects of antioxidant stress, anticoagulation and immune regulation, which may be of great significance to reduce the severity and mortality of COVID-19. Combined with the pharmacological effect of ulinastatin and its clinical application in the treatment of COVID-19 complications such as acute respiratory distress syndrome and sepsis lung injury, this paper discusses the feasibility of its application in COVID-19, so as to provide help for the clinical treatment and new drug research and development of this disease.Copyright © 2022 Tianjin Press of Chinese Herbal Medicines. All Rights Reserved.

[Improvement of China's legal system for public health emergency management from the perspective of lifecycle management].

A crucial lesson gained through the pandemic preparedness and response to COVID-19 is that all measures for epidemic control must be law-based. The legal system is related not only to public health emergency management per se but also to all aspects of the institutional supporting system throughout the lifecycle. Based on the lifecycle emergency management model, this article analyses the problems of the current legal system and the potential solutions. It is suggested that the lifecycle emergency management model shall be followed to establish a more comprehensive public health legal system and to gather the intelligence and consensus of experts with different expertise, including epidemiologists, sociologists, economists, jurist and others, which will collaboratively promote the science-based legislation in the field of epidemic preparedness and response for the establishment of a comprehensive legal system for public health emergency management and with Chinese characteristics.

How do institutional investors react to local shocks during a crisis? A test using the COVID-19 pandemic

We examine how institutional investors reacted to geographically dispersed local shocks during the early stages of the COVID-19 pandemic. A sample of real estate investment trusts (REITs) enables us to link two layers of geography: the locations of the assets in which the REITs were invested and the headquarters locations of institutional investors who owned REIT shares. We find that the institutional ownership of firms with an economic interest in the investors' home markets declined more if those markets were heavily affected by the pandemic. In addition, the ownership responses to the COVID-19 shock were larger in those markets in which REITs had larger portfolio allocations and in markets that were home to the investors. Importantly, we find that nonpassive and short-term investors may have overreacted to the local shocks because their REIT portfolios subsequently underperformed relative to passive and long-term investors. Our study highlights the importance of geography in the formation of investors' expectations during market crises. © 2023 American Real Estate and Urban Economics Association.

Governor's political affiliation and stringent COVID-19 policy

The political affiliation of governors has been highlighted as the most important predictor of a state's aggressiveness in responding to the pandemic, that is, Democratic governors advocated for more stringent policies than their Republican counterparts. However, of the 39 states that issued a statewide stay-at-home order (SAHO) mandate, nearly half were led by Republican governors. Using a qualitative comparative analysis, we find that gubernatorial partisanship alone cannot explain SAHO mandates. If partisanship played a role at all, it did so only in states with large metropolitan areas or with fewer public health resources. Regardless of the governor's partisanship, the combination of problem severity and public health resources was sufficient to produce a stringent policy outcome. Emphasis on gubernatorial decisions as purely political overlooks material needs relevant for future pandemic response and the potential for evidence and future coordination. © 2023 American Society for Public Administration.

Physical and mental condition and medicine consumption of frontline medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019

Objective To investigate the physical and mental condition and medicine consumption of medical staff of shelter hospitals in Shanghai during the fight against the epidemic of coronavirus disease 2019 (COVID-19). Methods A total of 144 frontline medical staff who fighting against the COVID-19 epidemic from a tertiary first-class hospital from Apr. 4 to May 12, 2022 were surveyed by questionnaires online. Their physical condition including body weight change before the medical work and one month later, sleep quality and the medicine consumption during the medical work were collected and analyzed. Results The mean body weight of frontline doctors before the medical work and one month later were (69.80+/-8.35) kg and (68.60+/-7.37) kg, while those of nurses were (55.36+/-8.27) kg and (53.80+/-7.38) kg, both showing a decreasing trend but without significant difference (all P>0.05). A total of 63.89% (92/144) frontline medical staff suffered from insomnia, of which 27.08% (39/144) needed drug intervention. The top 5 common diseases among frontline medical staff were sleep disorder (63.89%, 92/144), skin injury (25.69%, 37/144), body pain (23.61%, 34/144), oral ulcer (13.19%, 19/144), and acute upper respiratory tract infection (9.72%, 14/144). A total of 155 medical staff used drugs, and the top 5 common drugs were skin application (16.77%, 26/155), Ganmao'an granule (12.26%, 19/155), zolpidem tartrate tablets (11.61%, 18/155), Kangfuxin liquid (11.61%, 18/155), and celecoxib capsules (8.39%, 13/155). Conclusion Frontline medical staff in shelter hospitals are prone to have body weight change, sleep disorder, skin injury, body pain, oral ulcer, acute upper respiratory tract infection and so on, which suggests that in future similar large-scale medical support, it is necessary to pay sufficient attention to the physical condition of frontline medical staff and provide them sufficient medicine.Copyright © 2022, Second Military Medical University Press. All rights reserved.

An observational cohort study to examine SPUR, a patient-reported outcome measure of medication adherence, as a predictor of admission and early readmission in patients living with Type 2 Diabetes

Introduction: Conservative estimates suggest that the cost of poor medication adherence (MA) to healthcare systems in the UK is close to 800Mn annually, however figures may be as high as 920Mn to 224Bn across larger parts of Europe and the US.(1) This may be attributed to the relationship between poor MA and an increased risk of hospital admission.(2) Often, cases are preventable and hence present an opportunity for avoidable costs if appropriately identified and managed, such as in the case of early readmissions (admissions occurring within 30 days of discharge). However, despite the association between MA and admissions, to date no predictive model has been developed that integrates a holistic Patient-Reported Outcome Measure (PROM) of MA. This study evaluated one such PROM, known as SPUR, as a predictor of general admission and early readmission in patients living with Type 2 Diabetes (T2D). Aim(s): This study sought to develop a predictive model of early readmission and general admission risk using the SPUR tool as a PROM of MA in patients living with T2D. Method(s): Using an observational study design, 6-month retrospective and prospective patient monitoring were conducted to assess the number of admissions and early readmissions during the observational period. Outcomes were reported as binary and count variables. Patients were previously recruited from a large London NHS Trust as part of a cross-sectional study to validate SPUR. Covariates of interest included: age, ethnicity, gender, education level, income, the number of medicines and medical conditions, and Covid-19 diagnoses. A Poisson or negative binomial model was employed for count outcomes, with the exponentiated coefficient indicating incident ratios (IR) [95% CI]. For binary outcomes (Coefficient, [95% CI]), a logistic regression model was developed. Result(s): Data were available for 200 patients. The modal age range was 70-79 years (n=74/200, 37.0%). Most participants were GCSE educated (42.5%), white (76.0%), and over a third female (36.0%) identified as female. For general admission risk as a count variable, a higher SPUR score (increased adherence) was significantly associated with a lower number of admissions (IR = 0.98, [0.96, 1.00]). Other factors associated with an increased risk of admission included: age >=80 years (IR = 5.18, [1.01, 26.55]), GCSE education (IR = 2.11, [1.15 - 3.87]), number of medical conditions (IR = 1.07, [1.01, 1.13]), and a positive Covid- 19 diagnosis during follow-up (IR = 1.83, [1.11, 3.02]). SPUR remained significant when modelled as a binary variable (-0.048, [-0.094, -0.003]). For early readmission, only the SPUR score was significantly predictive of the outcome as a binary variable (-0.051, [-0.094, -0.007]), indicating that those with a higher SPUR score were at less risk of an early readmission. Conclusion(s): The study successfully developed a predictive model for both general admission and early readmissions in patients living with T2D using the SPUR tool and several covariates of clinical relevance. However, a small sample size is noted as a limitation. Future work may look to integrate SPUR as a holistic PROM of MA to support the development of tailored interventions to reduce patients' risk of admission.

I-deals as a Human Resource Initiative: Exciting Innovation or Passing Fad?

As the workplace continuously reinvents itself due to advances in technology, changes in society, and unexpected events like COVID-19, both employers and employees are employing idiosyncratic deals (i-deals) to allow for flexibility for both sides. This chapter addresses i-deals from a human resources (HR) perspective, by focusing on three critical themes. First, we discuss how organizations effectively institutionalize i-deals, and how such i-deals impact human resource philosophy and practices, given that HR departments often lead the effort to institutionalize such deals through individualized and fair HR practices. Next, we explore how supervisors can make sure that i-deals are fair and effective. Following this, we discuss where i-deals fit in the international human resource management (IHRM) context. A total of fourteen future research directions are identified with particular emphasis on practical HR perspectives. Finally, this chapter constructs a bridge between the two disciplines through drawing upon established literatures from i-deals and IHRM, to extending our current knowledge through both theoretical and practical lenses. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

SARS-CoV-2 infections in patients enrolled on the Children's Oncology Group standard-risk B-cell acute lymphoblastic leukemia trial, AALL1731

Hematologic malignancy is a risk factor for severe coronavirus disease 2019 (COVID-19) in adults;however, data specific to children with leukemia are limited. High-quality infectious adverse event data from the ongoing Children's Oncology Group (COG) standard-risk B acute lymphoblastic leukemia/lymphoma (ALL/LLy) trial, AALL1731, were analyzed to provide a disease-specific estimate of SARS-CoV-2 infection outcomes in pediatric ALL. Of 253 patients with reported infections, the majority (77.1%) were asymptomatic or mildly symptomatic (CTCAE grade 1/2) and there was a single COVID-19-related death. These data suggest SARS-CoV-2 infection does not confer substantial morbidity among young patients with B-lymphoblastic leukemia/lymphoma (B-ALL/LLy).Copyright © 2023 The Authors. eJHaem published by British Society for Haematology and John Wiley & Sons Ltd.

A Novel Machine Learning-assisted Pairs Trading Approach for Trading Risk Reduction

The cryptocurrency market has been growing rapidly in recent years. The volume of transactions and the number of participants in the cryptocurrency market makes it huge enough that we cannot ignore it. At the same time, the global stock market has also reached a new height in the past two years. However, due to the COVID epidemic and other political and economic-related factors in the last two years, the uncertainty in the capital market remains high, and short-term large fluctuations occur frequently;thus, many investors have suffered substantial losses. Pairs trading, an advanced statistical arbitrage method, is believed to hedge the risk and profit off the market regardless of market condition. Amongst the vast literature on pairs trading, there have been investors trading a pair of cryptocurrencies or a pair of stocks using machine learning or empirical methods. This research probes the boundary of utilizing machine learning methods to do pairs trading with one stock asset and another cryptocurrency. Briefly, we built an assets pool with both stocks and cryptocurrencies to find the best trading pair. In addition, we applied mainstream machine learning models to the trading strategy. We finally evaluated the accuracy of the proposed method in prediction and compared their returns based on the actual U.S. Stock and Cryptocurrency Market data. The test results show that our method outperforms other state-of-the-art methods. © 2022 IEEE.

Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and threatened human's health. With the passing of time, the epidemiology of coronavirus disease 2019 evolves and the knowledge of SARS-CoV-2 infection accumulates. To further improve the scientific and standardized diagnosis and treatment of maternal SARS-CoV-2 infection in China, the Chinese Society of Perinatal Medicine of Chinese Medical Association commissioned leading experts to develop the Recommendations for the Diagnosis and Treatment of Maternal SARS-CoV-2 Infection under the guidance of the Maternal and Child Health Department of the National Health Commission. This recommendations includes the epidemiology, diagnosis, management, maternal care, medication treatment, care of birth and newborns, and psychological support associated with maternal SARS-CoV-2 infection. It is hoped that the recommendations will effectively help the clinical management of maternal SARS-CoV-2 infection.Copyright © Wolters Kluwer Health, Inc. All rights reserved.

Impact of air transportation on the spread of Covid-19 between countries based on system dynamics

For the spread COVID-19 between countries through air transportation, the influencing factors are analyzed, a system dynamics model which passes the validity test is established. Then, three key indicators, Basic Reproduction Rate, Initial Infection Individuals and Transfer Rate, are selected as independent variables to analyze the system changes through computer simulation. Based on the analysis, the infectivity of COVID-19 and the number of people transferred by air transportation are important factors affecting the import of epidemics for non-epidemic countries, and the sooner or later control of infectious diseases by epidemic countries has little effect on non-epidemic countries.

A Bibliometric Analysis of Digital Literacy Research from 1990 to 2022 and Research on Emerging Themes during the COVID-19 Pandemic

Due to the rapid advancement of digital technology and its contribution to sustainable development, digital literacy has become an increasingly significant research topic. However, the uneven distribution of new technologies has caused emerging inequalities, which have been exacerbated by the COVID-19 pandemic, one of the most significant public health crises of the century. This paper aims to conduct an in-depth analysis of scientific production using bibliometric methods to comprehend the current research status of digital literacy studies and evaluate the pandemic's impact on such research. In total, 7523 documents published between 1990 and 2022 were identified and analyzed using bibliometric research methods in the Web of Science database. These methods included growth trend analysis, network analysis, highly cited literature analysis, factor analysis, and time-series-based analysis of frequently discussed topics. Additionally, a word cloud analysis of the keywords in digital literacy literature from 2020 to 2022, during the COVID-19 pandemic, was created. The study's outcomes explore digital literacy research, including current trends, significant publications, and institutions involved in the field. This study emphasizes the importance of digital literacy in today's society, particularly during the COVID-19 pandemic. It also highlights the potential of bibliometric analysis as a tool for identifying research gaps. © 2023 by the authors.

Characteristics of immune response profile in patients with immediate allergic and autoimmune urticarial reactions induced by COVID-19 vaccines

Allergic and hypersensitivity reactions induced by COVID-19 vaccines are increasingly reported and some patients may develop prolonged urticarial reactions following COVID-19 vaccination. Herein, we investigated the risk factors and immune mechanisms for patients with COVID-19 vaccines-induced immediate allergy and chronic urticaria (CU). We prospectively recruited and analyzed 129 patients with COVID-19 vaccine-induced immediate allergic and urticarial reactions as well as 115 COVID-19 vaccines-tolerant individuals from multiple medical centers during 2021-2022. The clinical manifestations included acute urticaria, anaphylaxis, and delayed to chronic urticaria developed after COVID-19 vaccinations. The serum levels of histamine, IL-2, IL-4, IL-6, IL-8, IL-17A, TARC, and PARC were significantly elevated in allergic patients comparing to tolerant subjects (P-values=4.5x10-5-0.039). Ex vivo basophil revealed that basophils from allergic patients could be significantly activated by COVID-19 vaccine excipients (polyethylene glycol 2000 and polysorbate 80) or spike protein (P-values from 3.5x10-4 to 0.043). Further BAT study stimulated by patients' autoserum showed positive in 81.3% of patients with CU induced by COVID-19 vaccination (P=4.2x10-13), and the reactions could be attenuated by anti-IgE antibody. Autoantibodies screening also identified the significantly increased of IgE-anti-IL-24, IgG-anti-FceRI, IgG-anti-TPO, and IgG-anti-thyroid-related proteins in COVID-19 vaccines-induced CU patients comparing to SARS-COV-2 vaccines-tolerant controls (P-values= 4.6x10-10-0.048). Patients with COVID-19 vaccines-induced recalcitrant CU patients could be successfully treated with anti-IgE therapy. In conclusion, our results revealed that multiple vaccine components, inflammatory cytokines, and autoreactive IgG/IgE antibodies contribute to COVID-19 vaccine-induced immediate allergic and autoimmune urticarial reactions (Minor revision in Journal of Autoimmunity [IF=14.551]).Copyright © 2023

Coronavirus disease 2019 vaccination in patients with autoimmune diseases.

Benifits outweigh the risks for patients with autoimmune disease (AID) in remission period to be vaccinated with coronavirus disease 2019 (COVID-19) vaccines. The mRNA vaccines, inactivated vaccines, and recombinant protein subunit vaccines are safe for AID patients, whereas the safety of recombinant adenovirus vector-based vaccines is still uncertain. Some drugs for the treatment of AID may reduce the immune response of the body to the COVID-19 vaccines and affect the immune efficacy of the vaccine, which may be related to the timing of vaccination. Based on several published relevant guidelines and recommendations for the COVID-19 vaccines in AID patients, this article elaborates on vaccination problems to be paid attention to in patients with AID treated with different drugs.Copyright © 2021 by the Chinese Medical Association.