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COVID-19 is currently a major global public health challenge. In the battle against the outbreak of COVID-19, how to manage and share the COVID-19 Electric Medical Records (CEMRs) safely and effectively in the world, prevent malicious users from tampering with CEMRs, and protect the privacy of patients are very worthy of attention. In particular, the semi-trusted medical cloud platform has become the primary means of hospital medical data management and information services. Security and privacy issues in the medical cloud platform are more prominent and should be addressed with priority. To address these issues, on the basis of ciphertext policy attribute-based encryption, we propose a blockchain-empowered security and privacy protection scheme with traceable and direct revocation for COVID-19 medical records. In this scheme, we perform the blockchain for uniform identity authentication and all public keys, revocation lists, etc are stored on a blockchain. The system manager server is responsible for generating the system parameters and publishes the private keys for the COVID-19 medical practitioners and users. The cloud service provider (CSP) stores the CEMRs and generates the intermediate decryption parameters using policy matching. The user can calculate the decryption key if the user has private keys and intermediate decrypt parameters. Only when attributes are satisfied access policy and the user's identity is out of the revocation list, the user can get the intermediate parameters by CSP. The malicious users may track according to the tracking list and can be directly revoked. The security analysis demonstrates that the proposed scheme is indicated to be safe under the Decision Bilinear Diffie-Hellman (DBDH) assumption and can resist many attacks. The simulation experiment demonstrates that the communication and storage overhead is less than other schemes in the public-private key generation, CEMRs encryption, and decryption stages. Besides, we also verify that the proposed scheme works well in the blockchain in terms of both throughput and delay.
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Since the outbreak of the COVID-19 pandemic, power generation and the associated CO2 emissions in major countries have experienced a decline and rebound. Knowledge on how an economic crisis affects the emission dynamics of the power sector would help alleviate the emission rebound in the post-COVID-19 era. In this study, we investigate the mechanism by which the 2008 global financial crisis sways the dynamics of power decarbonization. The method couples the logarithmic mean Divisia index (LMDI) and environmentally extended input-output analysis. Results show that, from 2009 to 2011, global power generation increased rapidly at a rate higher than that of GDP, and the related CO2 emissions and the emission intensity of global electricity supply also rebounded;the rapid economic growth in fossil power-dominated countries (e.g., China, the United States, and India) was the main reason for the growth of electricity related CO2 emissions;and the fixed capital formation was identified as the major driver of the rebound in global electricity consumption. Lessons from the 2008 financial crisis can provide insights for achieving a low-carbon recovery after the COVID-19 crisis, and specific measures have been proposed, for example, setting electricity consumption standards for infrastructure construction projects to reduce electricity consumption induced by the fixed capital formation, and attaching energy efficiency labels and carbon footprint labels to metal products (e.g., iron and steel, aluminum, and fabricated metal products), large quantities of which are used for fixed capital formation. © 2023 The Authors
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The spectacular nature of bitcoin price crashes baffles market spectators and prompts routine warnings from regulators cautioning that cryptocurrencies behave in contra to the fundamental properties that traditionally define what constitutes money. Arguably most concerning to the public is, first, bitcoin's unprecedented price volatility relative to other asset classes and, second, its seemingly detached price behavior relative to time-honored economic and market fundamentals. In an attempt to create an early warning system of bitcoin price crash risk using generalized extreme value (GEV) and logistic regression modeling, this study integrates order flow imbalance, along with several control factors which reflect blockchain activity and network value, in order to nowcast bitcoin's price crashes. From a data analysis perspective, and despite their dissimilar distributional underpinnings, the GEV and logistic models perform comparably. When evaluating the type I and type II errors which these models yield, it is shown that their performance is comparable in terms of accuracy. In addition, it is also shown how the proportion of type I and type II errors can shift dramatically across probability cutoff tolerances. Towards the end of this study, time varying probabilities of a price crash are shown and evaluated. The sample range in this study encompasses the SARS-CoV-2 (Covid-19) time period as well as the recent scandal and collapse of the FTX cryptocurrency exchange. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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Background: Novel coronavirus pneumonia COVID-19 has become a serious threat to human health. Traditional Chinese Medicine (TCM) has a good clinical effect in the treatment of COVID-19, with a high effective rate and a low rate of turning to the serious stage. Objective(s): We generated the web-accessed anti-COVID-19 TCM database to provide the anti-COVID-19 TCM information to develop effective drugs for the treatment of COVID-19. Method(s): Herein, we collected these prescriptions data by querying the CNKI and Wanfang Chinese da-tabases, the clinical guidance for COVID-19 pneumonia diagnosis and treatment, and further set up the web-accessible anti-COVID-19 TCM database. Result(s): Altogether, 293 different prescriptions are applied in four different COVID-19 stages of treat-ment, and the prevention of COVID-19 is composed of 452 TCM components. Conclusion(s): The database provides comprehensive information for anti-COVID TCM and thus would help to investigate novel ways to develop new anti-COVID-19 agents.Copyright © 2022 Bentham Science Publishers.
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BACKGROUND: Antibiotics are commonly prescribed for respiratory tract infections (RTIs) among older adults in long-term care facilities (LTCFs), and this contributes to the emergence of antimicrobial resistance. The objective of this study was to determine the antibiotic prescribing rate for RTIs among LTCF residents, and to analyse the antibiotic consumption patterns with the AwaRe monitoring tool, developed by the World Health Organization. METHODS: MEDLINE, EMBASE and CINAHL were searched from inception to March 2022. Original articles reporting antibiotic use for RTIs in LTCFs were included in this review. Study quality was assessed using the Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence Data. A random-effects meta-analysis was employed to calculate the pooled estimates. Subgroup analysis was conducted by type of RTI, country, and study start year. RESULTS: In total, 47 articles consisting of 50 studies were included. The antibiotic prescribing rate ranged from 21.5% to 100% (pooled estimate 69.8%, 95% confidence interval 55.2-82.6%). The antibiotic prescribing rate for lower respiratory tract infections (LRTIs) was higher than the rates for viral and general RTIs. Compared with Italy, France and the USA, the Netherlands had lower antibiotic use for LRTIs. A proportion of viral RTIs were treated with antibiotics, and all the antibiotics were from the Watch group. Use of antibiotics in the Access group was higher in the Netherlands, Norway, Switzerland and Slovenia compared with the USA and Australia. CONCLUSION: The antibiotic prescribing rate for RTIs in LTCFs was high, and AWaRe antibiotic use patterns varied by type of RTI and country. Improving antibiotic use may require coordination efforts.
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The COVID 19 pandemic has forced educators and students to embrace e-learning. It has become urgent that educators expedite their efforts in establishing criteria to assess the overall effectiveness of e-learning, in which student emotional intelligence (EI) cultivation and development play an increasingly centric role. However, a survey of the current literature shows that EI in e-learning appears to have received little attention. This study was thus designed to help fill this research void. Specifically, it set out to understand typical hospitality and tourism students' EI behaviors in the e-learning environment. To achieve this goal, this study applied a two-round Delphi approach. The findings show that in the e-learning environment, students commonly exhibit high self-awareness, low self-management, low social management, and low relationship-building competence. Prior EI studies mainly focus on employee performance and behavior but this study extends the effect of EI in education and offers significant implications for hospitality and tourism educators and researchers (word count: 155). © 2022 ICHRIE.
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Viruses are one of the main pathogens that endanger human health. The infectious diseases caused by virus infection and transmission seriously threaten human health. At present, viral diseases with high morbidity and low cure rate such as AIDS and viral hepatitis are still spreading around the whole world, and respiratory viruses such as influenza virus and corona virus are constantly mutating. Since 2019, the global epidemic caused by SARS-CoV-2 has brought severe challenges to the world, and there are still great uncertainties in the future course of the epidemic. Therefore, the development of safe and effective antiviral drugs has become an important means to deal with viral diseases. On the basis of summarizing the overall status of global antiviral drug research and development, this paper intends to analyze the progress of new drug research in key areas such as anti-HIV, hepatitis virus and SARS-CoV-2, and put forward suggestions to provide guidance and reference for the development of more efficient antiviral drugs in the future. © 2022, China Biotechnology Press. All rights reserved.
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Background. Acinetobacter baumannii typically causes infections in debilitated, hospitalized patients and is difficult to treat due to multiple virulence factors and the presence of intrinsic and acquired antibiotic resistance mechanisms leading to frequent isolation of multi-drug resistant (MDR) phenotypes. Due to problematic pharmacokinetics and/or dose-limiting toxicities of salvage agents, combination therapy with aminoglycosides, ampicillin/sulbactam, polymyxins, minocycline, or tigecycline, is often used. Eravacycline has demonstrated greater in-vitro potency against A. baumannii compared to other tetracycline derivatives making it potentially the more appealing option. However, its utility is hindered by a lack of data supporting pharmacodynamic targets and adequate dosing strategies for CRAB. The goal of this case series was to describe our experience with the use of combination eravacycline therapy for the treatment of CRAB pneumonia. Methods. This case series included all patients >= 18 years of age, diagnosed with SARS-CoV-2, >= 1 sputum culture positive for CRAB and a clinical diagnosis of new bacterial pneumonia, who received at least one dose of eravacycline between April 1st and October 1st, 2020. The primary outcome was clinical resolution of CRAB pneumonia. Secondary outcomes evaluated microbiological resolution, need for extended durations of therapy, and frequency of re-starting CRAB therapy within 48 hours of completion. Results. In total, 25 patients were included in this case series. The median duration of combination therapy was 10 days. Most patients (96%) received eravacycline + ampicillin/sulbactam, with 7 of those patients also receiving inhaled colistin (Table 2). In total, 17 (68%) patients achieved clinical resolution of CRAB pneumonia. Post-treatment sputum cultures were collected in 18 patients, of which 13 (72%) achieved microbiological resolution. One patient received > 14 days of therapy and no patients re-initiated therapy within 48 hours of eravacycline completion. Table 1: Baseline Characteristics Table 2: Study Outcomes Conclusion. In this small case series, eravacycline showed favorable clinical outcomes in patients with CRAB pneumonia. In light of limited treatment options, this agent can be considered for CRAB pneumonia salvage therapy.
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Since the outbreak of COVID-19, an alternative way to keep students on the track, meanwhile, prevent them from being at the risk of infection is in highly demand. Many education providers had made a move in trial of delivering knowledge and learning materials remotely. Along with this trend, learning management systems, open educational resources (OERs) and OER platforms, mini applications in social media and video-conference software were combined in a rush to create a multi-channel delivery mode to make learning resources openly available round-the-clock. Learning activities in this fast migration to online were regularly found to be carried out in gradual and fragmented time spans. Due to the little-known learner information along with the continuously released new OERs, the cold start problem still hinders the innovative mode of delivery and adaptive micro learning. To overcome the data sparsity, an online computation is proposed to benefit OER providers and instructors. A lightweight learner-micro-OER profile and two algorithmic solutions are provided to tackle the new user and new item cold start problem, respectively. Learning paths are generated and optimized in terms of heuristic rules to form the initial recommendation list. By adopting the same set of rules, newly released micro OERs are inserted into established learning paths to increase their discoverability. IEEE
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Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, continues to be a global concern. Traditional Chinese medicines (TCMs) are an important element of the fight against COVID-19 in China. The combined application of TCMs and conventional medicines in the treatment of COVID-19 has achieved beneficial results, including the resolution of symptoms, prevention of disease progression, and reduced mortality. In this review, we summarize and discuss the current applications of TCMs with respect to COVID-19, as well as update the preclinical and clinical research, including chemical analysis, molecular mechanisms, quality control, drug development, and studies of clinical efficacy. The expectation is that a better understanding of the roles of TCMs against COVID-19 will improve the response to COVID-19, both in China and globally. © 2022 World Journal of Traditonal Chinese Medicine Published by Wolters Kluwer - Medknow.
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The COVID 19 pandemic has forced educators and students to embrace e-learning. It has become urgent that educators expedite their efforts in establishing criteria to assess the overall effectiveness of e-learning, in which student emotional intelligence (EI) cultivation and development play an increasingly centric role. However, a survey of the current literature shows that EI in e-learning appears to have received little attention. This study was thus designed to help fill this research void. Specifically, it set out to understand typical hospitality and tourism students’ EI behaviors in the e-learning environment. To achieve this goal, this study applied a two-round Delphi approach. The findings show that in the e-learning environment, students commonly exhibit high self-awareness, low self-management, low social management, and low relationship-building competence. Prior EI studies mainly focus on employee performance and behavior but this study extends the effect of EI in education and offers significant implications for hospitality and tourism educators and researchers (word count: 155). © 2022 ICHRIE.
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Background: Current literature on virtual cases illustrates increased student self-directed learning and satisfaction. Yet, the use of virtual cases has not been explored in the context of patient or medication safety. Description: The Virtual Interactive Case (VIC) System allows educators to create online clinical reasoning scenarios with a bridge between theory and practice. We aimed to share our experience in the development and evaluation of 3 VIC teaching modules on patient or medication safety. Action: We created VIC training modules on medication incident disclosure, root cause analysis (RCA), and failure mode and effects analysis (FMEA). We piloted tested them during the COVID-19 pandemic. Evaluation: We administered a 16-item online questionnaire from May 22, 2020, to June 8, 2020 and obtained feedback from pharmacy students and practitioners in Ontario, Canada. Most of our 18 respondents had 1-5 years of practice experience. Their practice settings ranged from associations, academia, to community pharmacies and hospitals. Respondents found the VIC platform easy to navigate. They perceived the content to be relevant and easy to implement in patient care settings. Majority of them indicated that they were confident in carrying out incident disclosure, RCA, and FMEA at their practice settings. Implications: The VIC System can be used to educate students and practitioners on patient or medication safety. It is a safe and user-friendly platform to support patient safety in virtual pharmacy care.
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The multiscale rock physics of unconventional reservoirs have drawn increasing attention in recent years, which involves several essential issues, including measuring method, transport property, physics model, characteristic scale, and their application. These issues vastly affect science and engineering regarding the exploration and development of unconventional reservoirs. To encourage communication on the advances of research on the rock physics of unconventional reservoirs, a conference on Multiscale Rock Physics for Unconventional Reservoirs was jointly organized by the journals Energies and Advances in Geo-Energy Research. Due to the limitations of movement caused by COVID-19, 21 experts introduced their work online, and the conference featured the latest multiscale theories, experimental methods and numerical simulations on unconventional reservoirs. © 2022, Yandy Scientific Press. All rights reserved.
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Objectives: With the COVID-19 epidemic, more and more schools are choosing online education and electronic devices for learning. Due to the uniqueness of the VR model, many teachers are introducing the use of VR in educational teaching activities. Generally speaking, virtual reality is widely used in the field of education and training because of its potential to promote interactivity and motivation. It also offers a new approach to teaching and learning due to the increasing number of online learners sharing and presenting educational content, and the technological possibilities of spreading knowledge over the global web and allowing students to participate in educational courses remotely. Therefore, this study focuses on relevant design factors through the study of teaching scenarios such as VR experience teaching training in the field of product design. In the preliminary questionnaire survey, we concluded that the three key words that students care most about VR teaching tools are user interface, usability and interaction design, but from the questionnaire survey we cannot accurately understand the specific preferences of students for these three factors. Therefore, we want to understand specifically whether students care more about user interface, usability, or interaction design for VR teaching tools, that is, which of these three factors will be more preferred and valued by students, in order to consider how to weigh the three factors in the VR design and production process. By studying the design factors of VR teaching and learning experiences, VR educational content developers can better understand the factors to be considered in this field. It can also guide VR content producers to produce more content that meets students’ needs. Methods: In this study, firstly, 80 questionnaires were mainly used to organize and collect the key words of relevant factors, and after the key words were obtained, the AHP tool was used to obtain the hierarchical model, and then according to the 1–9 scale method, 10 experts in the design field and 10 students were invited to score the three design factors of VR teaching tools in a two-by-two comparison, and finally the weight values were analyzed and organized according to the AHP calculation formula. Finally, the weight values were analyzed and sorted according to the AHP formula to determine the ranking of the weight values of the design factors of VR teaching tools. Results: The AHP method is used to study the factors that influence students in the design and production of VR courses and software, and to form a hierarchy in which different factors are sequentially generated. Designers and content producers can determine the relative importance of each factor in the hierarchy through pairwise comparisons. Based on the results, we can find that user interface is the most important VR design factor that students are concerned about, followed by interactivity. The findings can be used as a framework tool to design VR content according to students’ needs and make the product a better experience. Conclusions: According to the results, we can find that the user interface is the VR design factor that students are most concerned about, followed by interactivity, which also gives us a hint that when we are making VR teaching tools, we should pay more attention to the design and presentation of VR content, choosing appropriate VR materials, materials that are closer to the real world, and at the same time designing more beautiful, simpler, and more obvious buttons or The interface should be designed with more beautiful, simple and obvious buttons or prompts. The user interface is also important, when students enter the virtual reality, they want to be as in the real world in general scenes, rather than poor quality 3D production of animation graphics, virtual reality to provide students with a realistic reproduction of the world, where they can operate, learn, practice and even experiment, and designers to do is to provide them with as much as possible to meet the needs of the VR tools. Similarly, interactivity is also important in this process. If you can only watch, but not effectively interact with VR as if it were reality, then VR is obviously inappropriate. Therefore, the weighting of these three factors will hopefully provide some meaningful inspiration to the designers of VR teaching tools. When students use VR educational products, it is very important for VR content providers and VR designers to improve the actual value of the product content, as it can help them design VR educational products that better meet the market demand. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background: The impact of disease characteristics and androgen deprivation therapy (ADT) or other treatments for prostate cancer (PC) on severity of infection with Covid-19 has not been elucidated. We report results from our PC patients (pts) with Covid-19 in our registry of Covid-19 treated cancer patients at the Cleveland Clinic Foundation. Methods: We performed a retrospective analysis of PC pts who tested positive for Covid-19 between 3/16/2020 and 5/21/2020 at the Cleveland Clinic. Additional information including prostate specific antigen (PSA), Gleason score, disease extent, and current treatment were also obtained. Severe Covid-19 infection was defined as any pt requiring hospitalization, ICU care, and/or death. PSA values from prior to Covid-19 infection or first available after Covid-19 infected were collected. Analysis was carried out with Fisher's exact test and Wilcoxon rank sum test, as applicable, and overall survival (OS) by log rank test. Results: A total of 54 pts with prostate cancer that tested positive for Covid-19 were identified, of which 4 were receiving active treatment (2 with metastatic disease and 2 with localized disease). Of the 2 pts with metastatic disease, 1 was on docetaxel with ADT and other on abiraterone/prednisone with ADT. Of the 2 pts with localized disease, 1 was on ADT and bicalutamide and other on ADT alone. A total of 40 patients had severe Covid-19 disease. There was no correlation with ADT and Covid-19 disease severity (p=0.67). There were 22 pts with Gleason 6, 20 pts with Gleason 7, 6 pts with Gleason 8, 4 pts with Gleason 9, 1 pt with Gleason 10, and 1 pt with Gleason unknown PC. There was no correlation between absolute (p=0.21) or divided (p=0.65) Gleason score with disease severity. There were 4 pts with metastatic disease and 46 with localized disease and no correlation was seen with extent of disease and Covid-19 severity (p>0.99). Fifty pts had PSA data available, and there was no correlation of PSA with Covid-19 disease severity (p=0.28). The mortality from Covid-19 was 26% (14 out of 54 pts) in our cohort. Out of the 14 pts who died, 2 were on active treatment that included ADT. There was no association between Gleason score (p=0.2649), extent of disease (p=0.9642), or treatment (p=0.5998) and OS. Conclusions: In our registry of Covid-19 treated cancer patients, we did not see any correlation between PC disease-risk factors and treatment with Covid-19 severity. While the results are limited by small patient population, they provide valuable information that PC treatment did not affect severity of Covid-19.
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At present, novel Coronavirus is spreading wordwide, with rapid speed, strong transinissibility and many spreading channels. On January 31, 2020, WHO declared the pneumonia (COVID-19) outbreak caused by novel Coronavirus to be "an public health emergency of international concern". As of May 31, 2020, Beijing time, the cumulative number of confirmed COVID-19 cases worldwide had exceeded 6.21 million, and the cumulative number of deaths had exceeded 370 000. The outbreak of COVID-19 has prompted Chinese medical and health prevention researchers to carry out a large number of studies on COVID-19, and the important achievements have been published in many medical journals at home and abroad. Through CNKI, this study analyzed and summarized COVID-19 related articles published by Chinese scholars in domestic medical journals from January to April 2020. It was found that COVID-19 related articles were published in a wide range of journals and research institutions, including hospitals, universities, research institutes and pharmaceutical companies. The research content is comprehensive, including pathogenesis, virus antibody detection, COVID-19 diagnosis, epidemic prevention and control strategies, vaccine development and treatment drug development, etc. The treatment of COVID-19 is multipath,including anti-virus, improving the body' s immunity. Western medicine treatment, TCM conditioning and integrated treatment of traditional Chinese and Western medicine. These research findings and diagnosis and treatment experience provide important references for the prevention and treatment of COVID-19 around the world.
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Background. Dalbavancin is a long-acting second-generation lipoglycopeptide antibiotic with potent activity against Gram-positive organisms. Dalbavancin is currently FDA approved for acute bacterial skin and soft tissue infections (ABSSTIs). Growing evidence suggests that patients can be successfully treated with dalbavancin for indications outside of skin and soft tissue infections which include bacteremia and osteomyelitis (OM) with significant cost savings and reduced length of stay. We developed a protocol for the use of dalbavancin in patients who required intravenous antibiotics for serious bacterial infections but did not qualify for outpatient parenteral antibiotic therapy (OPAT). During the COVID-19 pandemic, we expanded the protocol to reduce the amount of clinical contact required for all patients. Methods. In this retrospective observational study, we reviewed all patients that received at least one dose of dalbavancin in either inpatient or outpatient setting at Parkland Hospital from July 2019 through February 2021. Patient demographics, type of infection, and rationale for dalbavancin were collected at baseline. Clinical response was measured by avoidance of Emergency Department (ED) visits or hospital readmission at 30, 60, and 90 days. In addition, a separate analysis was conducted to estimate hospital, rehabilitation, or nursing home days saved based on their diagnosis and projected length of treatment. Results. Twenty-eight patients (24 inpatient, 4 outpatient) were included in the study. The majority were uninsured (89%), homeless (64%), or had active intravenous drug use (IDU) (60%). Indications for use included SSTI (42.9%), bacteremia (64.3%), and OM (42.6%). Clinical failure was observed in 4 (14%), 1 (3.5%), and 2 (7.1%) patients at 30, 60, or 90 days (respectively). Nonadherence to medical recommendations, lack of source control, and ongoing IDU increased risk of returning to the hospital. Dalbavancin use saved a total of 381 days of inpatient/rehab/facility stay. Conclusion. Dalbavancin showed similar rates of success with improved length of stay and cost savings. The use of long acting lipoglycopeptides are desirable alternatives to traditional OPAT for patients that otherwise would not qualify for OPAT or desire less hospital contact.