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Wild animals are considered reservoirs for emerging and reemerging viruses, such as the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Previous studies have reported that bats and ticks harbored variable important pathogenic viruses, some of which could cause potential diseases in humans and livestock, while viruses carried by reptiles were rarely reported. Our study first conducted snakes' virome analysis to establish effective surveillance of potential transboundary emerging diseases. Consequently, Adenoviridae, Circoviridae, Retroviridae, and Parvoviridae were identified in oral samples from Protobothrops mucrosquamatus, Elaphe dione, and Gloydius angusticeps based on sequence similarity to existing viruses. Picornaviridae and Adenoviridae were also identified in fecal samples of Protobothrops mucrosquamatus. Notably, the iflavirus and foamy virus were first reported in Protobothrops mucrosquamatus, enriching the transboundary viral diversity in snakes. Furthermore, phylogenetic analysis revealed that both the novel-identified viruses showed low genetic similarity with previously reported viruses. This study provided a basis for our understanding of microbiome diversity and the surveillance and prevention of emerging and unknown viruses in snakes.
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Covid-19 is the most famous disease around the world due to its perniciousness. At present, more and more countries and institutions try to develop a new vaccine and find an antidote to Covid-19. However, SARS-CoV-2 possesses a characteristic of rapid variation. This paper mainly focuses on the spike protein D614G mutation in SARS-CoV-2, and concludes some clinical problems caused by D614G mutation. To conclude, the D614G mutation could enhance the dissemination of Covid-19 but does not enhance its severity. Vaccine development has not been affected. More and more detect methods are surging. Mutation has caused some influence in spike protein. And mutation will lead to Chemosensory Dysfunction. © 2023 SPIE.
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The marine transport companies have been experiencing intense competition with the supply increasing faster than the demand, making most of them face input congestion. This paper applies the input congestion data envelopment analysis (DEA) model proposed by Tone and Sahoo (2004) to compute efficiency scores and input congestions of 159 major marine transport companies in the world during 2010-2019. The inputs include em-ployees, total assets, and capital whereas the output is net sales. The base year for monetary values is 2010. It is found that the annual ratios of input-congested marine companies are between 20.9% and 65.7%, indicating that input congestion is not an unusual phenomenon among these companies. This paper also applies a BCG-like analysis to consider inefficiency and input congestion at the same time. The Mann-Whitney U test shows that most of the marine transport companies in Asia, Europe, and the Americas face both inefficiency and input congestion problems during the data period. This analysis is able to provide the implications for shipping companies to conduct more precise and efficient resource allocation and coordination in the post Covid-19 era.
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Adjusting for an unmeasured confounder is generally an intractable problem, but in the spatial setting it may be possible under certain conditions. We derive necessary conditions on the coherence between the exposure and the unmeasured confounder that ensure the effect of exposure is estimable. We specify our model and assumptions in the spectral domain to allow for different degrees of confounding at different spatial resolutions. One assumption that ensures identifiability is that confounding present at global scales dissipates at local scales. We show that this assumption in the spectral domain is equivalent to adjusting for global-scale confounding in the spatial domain by adding a spatially smoothed version of the exposure to the mean of the response variable. Within this general framework, we propose a sequence of confounder adjustment methods that range from parametric adjustments based on the Matern coherence function to more robust semiparametric methods that use smoothing splines. These ideas are applied to areal and geostatistical data for both simulated and real datasets.
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Background: Reliable methods to identify anaplastic lymphoma kinase (ALK) fusions are critical to matching patients to ALK tyrosine kinase inhibitors (TKIs) therapy, on or off trial. Various methods including FISH have been used, but immunohistochemistry (IHC) and next-generation sequencing (NGS) are most commonly employed. Evaluating the concordance of IHC and NGS is key, particularly in non-lung cancers where data is sparse. Method(s): NGS+ (MSK-IMPACT DNA hybrid capture NGS and/or RNA anchored multiplex PCR) and/or IHC+ (clone: D5F3) patients with cancers of any histology were identified as ALK+. ALK IHC was scored as negative (0), equivocal (e: 1+, 2+) or positive (3). Concordance of ALK detection (number of NGS+ and IHC+/total number of patients with NGS and IHC) was calculated. For patients with metastatic disease treated with any ALK TKI in the first-line (1L) setting, progression-free survival (PFS) was reported. Result(s): 347 ALK+ solid tumor patients were identified. As expected, the majority (96%, n=336) had lung cancer, however, 11 patients with 11 unique non-lung cancer histologies were found (3 gastrointestinal, 2 gynecologic, 1 breast, 1 thyroid, 1 primary brain tumor, 1 DLBCL, 1 PEComa, and 1 CUP). 57% had EML4-ALK fusions;36 non-EML4 ALK rearrangements were identified, including four novel fusions (PEKHA7-ALK, ZFPM2-ALK, TRIM24-ALK, ALK-MYO3B). ALK was evaluated by IHC alone in 83 patients (23.9%). The concordance rate between NGS and IHC was 85%. Among discordant cases, 11% (n=28) were IHC+/NGS-, 24% (n=63) were IHCe/NGS-, 3% (n=8) were IHCe/NGS+, and 0.4% (n=1) was IHC-/NGS+. The most frequent ALK TKIs were alectinib (n= 87, 58%) and crizotinib (n= 56, 38%). PFS on 1L ALK TKIs for patients with IHC+/NGS+ (n=134), IHC-/NGS+(n=1), IHC+/NGS- (n=8), IHCe/NGS+ (n=4), IHCe/NGS- (n=1) was 26 months, 26 months, 39 months, 41 months, 9 months respectively. Conclusion(s): In a population including multiple tumor types, NGS and IHC were highly concordant in ALK fusion detection. ALK TKI benefit may be observed in cases with discordant testing, in which only one assay detects a putative ALK fusion. Legal entity responsible for the study: The authors. Funding(s): NIH Cancer Center grant: P30CA008748. Disclosure: M.G. Kris: Financial Interests, Personal, Research Grant: Boehringer Ingelheim, National Lung Cancer Partnership, Pfizer, PUMA, Stand up to Cancer;Financial Interests, Personal, Advisory Role: Ariad, AstraZeneca, Bind Bioscience, Boehringer Ingelheim, Chug Pharma, Clovis, Covidien, Daiichi Sankyo, Esanex, Genentech;Financial Interests, Personal, Invited Speaker: Boehringer Ingelheim, Novartis, Millenium, Pfizer, Roche. A. Drilon: Financial Interests, Personal, Advisory Board: Ignyta/Genentech/Roche, Loxo/Bayer/Lilly, Takeda/Ariad/Millennium, TP Therapeutics, AstraZeneca, Pfizer, Blueprint Medicines, Helsinn, BeiGene, BerGenBio, Hengrui Therapeutics, Exelixis, Tyra Biosciences, Verastem Oncology, MORE Health, AbbVie, 14ner/Elevation Oncology, Remedica Ltd, ArcherDX, Monopteros, Novartis, EMD Serono, Melendi, Liberum, Repare RX, Amgen, Janssen, EcoR1, Monte Rosa;Financial Interests, Personal, Other, CME: Medscape, Onclive, PeerVoice, Physicians Education Resources, Targeted Oncology, Research to Practice, PeerView Institute, Paradigm Medical Communications, WebMD, MJH Life Sciences, Med Learning, Imedex, Answers in CME, Medscape, Clinical Care Options, AiCME;Financial Interests, Personal, Other, CME, Consulting: Axis;Financial Interests, Personal, Other, Consulting: Nuvalent, Merus, EPG Health, mBrace, Harborside Nexus, Ology, TouchIME, Entos, Treeline Bio, Prelude, Applied Pharmaceutical Science, Inc;Financial Interests, Personal, Invited Speaker: Chugai Pharmaceutical, Remedica Ltd, RV More;Financial Interests, Personal, Stocks/Shares: Treeline Biosciences;Financial Interests, Personal, Royalties: Wolters Kluwer;Financial Interests, Personal, Other, stocks: mBrace;Financial Interests, Institutional, Funding, Research funding: Pfizer, Exelixis, GlaxoSmithKline, Teva, Taiho, PharmaMar;Finan ial Interests, Personal, Funding, Research: Foundation Medicine;Non-Financial Interests, Personal, Member: ASCO, AACR, IASLC;Other, Personal, Other, Food/Beverage: Merck, PUMA, Merus;Other, Personal, Other, Other: Boehringer Ingelheim. All other authors have declared no conflicts of interest.Copyright © 2023 European Society for Medical Oncology
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This paper discusses the design of a net-zero single-family house in Chattanooga, Tennessee, which was proposed for the 2022 Solar Decathlon Design Challenge entry. The site was in a 100-year flood zone and registered as a national and local historic district. The interdisciplinary team consisted of University of Tennessee Chattanooga (UTC) students from the interior architecture and engineering departments who embraced the challenges of the local climate and the restrictions of the historic district guidelines. This entry, Moc House, focused on the integration of passive design and active HVAC systems including photovoltaic systems in the process. In responding to recent housing market changes in Chattanooga due to the COVID-19 pandemic, a young professional couple in their 30s who have two children was identified as the target market which guided the space planning. Market analysis, including ROI, was conducted in addition to construction cost calculations. Building materials were selected to enhance the durability and resilience of the house structure. Finally, energy analysis was conducted to check the project's Home Energy Rating using Ekotrope and found it less than zero. © 2023, College Publishing. All rights reserved.
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Pickering emulsions were prepared by phacoemulsification in an ice water bath with squalene as the oil phase and an aluminum adjuvant as the particle stabilizer. The effects of formulation and process conditions on the size and distribution of the Pickering emulsions were investigated. Pickering emulsions prepared under the optimal prescription and process conditions were mixed with a peptide antigen to obtain a peptide vaccine. The optimal prescription and process condition of the Pickering emulsion is as follows: squalene as the oil phase, ultra-pure water as the water phase with 5 mg/ml aluminum adjuvant, and an ultrasonication time of 4 min at 200 W power. BALB/c mice were immunized with the peptide vaccine, and the ability of the Pickering emulsion as an immunological adjuvant to improve the efficacy of the peptide vaccine was evaluated. Under optimal conditions, a Pickering emulsion with a small particle size (430.8 nm), uniform distribution (polydispersion index of 16.9%), and zeta potential of 31.5 mV, was obtained. Immunological results showed that the serum specific antibody level in the vaccinated group reached 1×104 after three immunizations. The proportion of CD4+T cells and CD4/CD8 cells was significantly higher (P < 0.05) in the vaccinated groups than the blank control group. Further, cytokine (TNF-α) secretion decreased in the aluminum adjuvant and Pickering emulsion groups but increased in the Freund's adjuvant group. All three vaccinated groups of mice exhibited low but detectable levels of IFN-γ secretion. © 2023
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The use of the internet in education has been greatly encouraged by the COVID-19 epidemic. Studying students' internet-specific epistemic beliefs (ISEB) and possible correlates would benefit online teaching and learning. However, little research has been conducted in this field. Therefore, we investigated the current status of ISEB among college students and considered the impact of self-regulated learning (SRL) and e-academic dishonesty (e-AD) on ISEB. A survey research method and convenience sampling were employed. A total of 538 Chinese college students completed the self-reported questionnaire. Our results indicate that although no significant differences were found in ISEB in terms of gender and academic major, students with different backgrounds also differed in e-AD experience and SRL. Three dimensions of ISEB were negatively correlated with SRL, while one had a significant positive correlation. In addition, the latter dimension of ISEB was negatively correlated with e-AD. Finally, SRL and e-AD jointly significantly predicted students' different ISEB, with explanatory power ranging from 14% to 36%. Study techniques of SRL were common predictors that could negatively predict the certainty, simplicity, and source of ISEB and positively predict justification. Based on the results, specific methods for schools, teachers and librarians to enhance students' ISEB are provided. © 2023
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As the COVID-19 pandemic continued unabatedly, many global supply chains involved in manufacturing and distributing personal protective equipment often failed to meet surge demand due to production capacity limits. Before the COVID-19 pandemic, the existing medical mask supply chain in Taiwan was decentralized, but immediately following the outbreak in 2020, the government of Taiwan established a centralized virtual company that integrated production, distribution, and sales. We use an exploratory empirical case study to gain insights into Taiwan's innovative public-private collaboration and the relationship between collaborative activities and supply chain resilience. This paper examines how a ten-fold growth, from 1.88 million to 20 million, in the daily production of medical masks, and their equitable distribution was achieved within four months of the onset of the COVID-19 pandemic. The results indicate that the public-private collaboration through a government-led centralized supply chain mitigated the impacts of unpredictable disruptions, built supply chain resilience, and ensured mask availability to the public. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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The current epidemic of Corona Virus Disease 2019 (COVID-19) poses a serious threat to people's health and lives. Following the national policies and deployment, medical community in China invests large amounts of medical resources to help Hubei. However, some hospitals nationwide have suspended outpatient and inpatient services. The authors analyze the underlying causes of suspension of medical services and its harm to patients, and summarize the optimization of disease diagnosis and treatment during the COVID-19 outbreak. In further, they propose reasonable suggestions on safe medical management in general hospitals outside the epidemic area, in order to attract the attention of medical institutions and medical colleagues.Copyright © 2020 by the Chinese Medical Association.
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Clinical data and follow-up of a case of congenital disorder of glycosylation type Ia (CDG-Ia) combined with dilated cardiomyopathy admitted to the Department of Cardiology, Children's Hospital of Nanjing Medical University were analyzed retrospectively.The 5-year-old female patient was admitted in December 2016 due to recu-rrent shortness of breath for 2 months.Clinical symptoms and signs included repeated attacks of shortness of breath, physical retardation, malnutrition, binocular esotropia, multiple episodes of hypoglycemia, hepatosplenomegaly, hypotonia and other multi-system damages.Cardiac echocardiography suggested the feature of dilated cardiomyopathy, including the significant enlargement of the left ventricle, and decreased systolic function.Genetic testing revealed a compound heterozygous mutation in the PMM2 gene, and as a result, the patient was diagnosed as CDG-Ia.The patient's condition improved after symptomatic treatments such as Cedilanid, Dopamine, Dobutamine, Furosemide, as well as support treatments like myocardium nutrition, blood sugar maintenance, liver protection, etc.After discharge, the patient was given oral Digoxin, Betaloc, Captopril and diuretics, and hypoglycemia-controlling agents.The patient was followed up every 3-6 months.After more than 2 years of follow-up, the heart function and heart enlargement gradually returned to normal.During the Corona Virus Disease 2019 outbreak, self-withdrawal continued for 2 months.Re-examinations showed decreased cardiac function and enlarged left ventricle again.Medications were resumed again, and the patient was followed up closely.This case report suggested that CDG-Ia may be associated with dilated cardiomyopathy, and the cardiac phenotype may be improved by symptomatic supportive treatment.Copyright © 2021 by the Chinese Medical Association.
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The challenge of widespread misinformation has expanded during the COVID-19 pandemic. Governments worldwide have adopted or are designing a variety of information policies and tools to cope with the exacerbated challenge of misinformation. To understand the complexity and nuanced realities of government misinformation regulatory practices, we developed an analytical framework, drawing from policy design studies and the social informatics perspectives, which emphasize two aspects of misinformation policies. First, we identified agents, actions, and target groups as the essential components of policy design. We then incorporated three sociotechnical dimensions related to misinformation regulation—the context from which misinformation policies originate;the specific issues, topics, and forms of misinformation;and the channels for its creation and spread. We applied this framework to 139 policy documents systematically collected from the federal government of the United States and the central government of China, for the purpose of understanding and comparing misinformation regulations in two distinct contexts. Beyond those well-known political narratives in each country, this chapter identified the nuanced differences in their misinformation policies and the different stages or maturity of misinformation policymaking. The empirical findings showcase the analytical power of this framework and shed light on policy practices and the direction of future research. © 2023 selection and editorial matter, Shengnan Yang, Xiaohua Zhu and Pnina Fichman;individual chapters, the contributors.
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Objective To analyze the potential factors influencing the viral shedding time (duration of nucleic acid positivity) in elderly patients with mild and asymptomatic infection. Methods The clinical data of 1141 elderly (>=60 years) patients with mild and asymptomatic Omicron infection who were admitted to National Exhibition and Convention Center (Shanghai) Cabin Hospital from April 14, 2022 to May 1, 2022 were retrospectively collected, viral shedding time of patients were compared between different groups (age, gender, number of vaccination, hypertension, diabetes). Pearson analysis was adopted to analyze the relationship between age and viral shedding time. Kaplan-Meier curve and Log-rank test were used to evaluate the viral shedding time in elderly patients with different clinical characteristics. Multivariate Cox proportional-hazards regression model was adopted to analyze the factors influencing viral shedding time in elderly patients with Omicron. Results Among 1441 patients, 791(54.9%) males and 650(45.1%) females. There were 513(35.6%) patients receiving 0 dose of vaccine, 29(2.0%) patients received 1 dose of vaccine, 405(28.1%) patients received 2 doses of vaccine, 494(34.3%) patients received 3 doses of vaccine. Compared with patients aged 60 to 70 years, patients aged 70 to 80 years had longer viral shedding time (P<0.001). The viral shedding time in patients with hypertension and diabetes was longer than that in patients without hypertension and diabetes (P<0.05). In terms of vaccination, the viral shedding time of patients receiving 2 or 3 doses of vaccine was significantly shorter than that of patients receiving 1 dose of vaccine or none (P<0.05). There was a positive correlation between patient age and viral shedding time, with an R2=0.029 (P<0.001). Kaplan-Meier curve showed that there existed significant difference in viral shedding time between the patients with different vaccination doses (P<0.001), and patients with age >=70, hypertension and diabetes were all associated with prolonged viral shedding time (P<0.05). Cox regression analysis showed that the age >=70 years was a risk factor for prolonged viral shedding time, and 2 or 3 doses of vaccine was a protective factor for prolonged viral shedding time (P<0.05). Conclusions Among the elderly population, the viral shedding time would gradually increase with age. Patients who received >=2 doses of vaccine would have reduced viral shedding time compared with those who received <2 doses of vaccine.Copyright © 2022 Authors. All rights reserved.
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With the abrupt and significant drop of PM2.5 concentrations during the lockdown in 2020, hourly direct radiation (Rdir) at surface substantially increased in East China, such as Zhengzhou, Wuhan and Baoshan, with the maximum enhancement of 86% at Wuhan. Most of these stations had decreased diffuse radiation (Rdif) except Zhengzhou. Zhengzhou had both enhanced Rdir and Rdif, as well as reduced but still high PM2.5 concentrations, indicating atmospheric particles were more scattering in this region. At Beijing and Harbin in North and Northeast China, intensification of aerosol pollution led to hourly Rdir (Rdif) falling (rising) up to −28% (59%) and −23% (40%), respectively. By contrast, surface solar radiation (SSR) in West China was also greatly influenced by the elevated dust/smoke layers, revealed by aerosol layer vertical distribution and the reduction of SSR and PM2.5 concentrations. This study highlighted the importance of aerosol optical properties and vertical structures in aerosol–radiation interactions. © 2023. The Authors.
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The COVID-19 pandemic has been accelerating digital transformation around the globe since the beginning of the COVID-19 outbreak in early 2020. Individuals, organizations, and governments have experienced unprecedented information and communication technologies (ICT) adoption and use, willingly or not. The backdrop of the pandemic provides a unique opportunity for us to reflect on and reexamine our relationships with ICTs, as we envision the postpandemic future. This chapter introduces the entire book, especially the core idea of "social informatics” that serves as the underlying theoretical foundation of the book and its chapters to echo the concerns about ICT use and consequences during the pandemic. This edited volume presents empirical cases from different countries and our theoretical exploration of ICT usage and consequences by covering four major themes—governance, information behavior, community, and everyday life. These chapters shed light on the importance of ICTs and unpack the complexity of technology-related practices during the global crisis. We hope to intrigue other researchers to examine the emerging social changes and evolving use of digital tools in a still-unfolding pandemic era. © 2023 selection and editorial matter, Shengnan Yang, Xiaohua Zhu and Pnina Fichman;individual chapters, the contributors.
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This book takes a holistic view of the roles of ICTs during the pandemic through the lens of social informatics, as it is critical to our understanding of the relations between society and technology. Specific attention is given to various stakeholders and social contexts, with analysis at the individual, group, community, and society levels. Pushing the boundaries of information science research with timely and critical research questions, this edited volume showcases information science research in the context of COVID-19, by specifically accentuating sociotechnical practices, activities, and ICT interventions during the pandemic. Its social informatics focus appeals to a broad audience, and its global and international orientation provides a timely, innovative, and much-needed perspective to information science.This book is unique in its interdisciplinary nature as it consists of research studies on the intersections between ICTs and health, culture, social interaction, civic engagement, information dissemination, work, and education.Chapters apply a range of research methods, including questionnaire surveys, content analyses, and case studies from countries in Asia, Europe, and America, as well as global and international comparisons.The book's primary target audience includes scholars and students in information and library science, particularly those interested in the social aspect of the information society. It may be of interest to information professionals, library practitioners, educators, and information policymakers, as well as scholars and students in science and technology studies, cultural studies, political science, public administration, sociology, and communication studies © 2023 selection and editorial matter, Shengnan Yang, Xiaohua Zhu and Pnina Fichman;individual chapters, the contributors.
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The outbreak of the coronavirus disease 2019 (i.e. COVID-19) pandemic has made an extremely serious impact on the world, and the false positive rate of X-ray images in the diagnosis of COVID-19 is a challenge for the management of the pandemic. To better assist doctors in the rapid detection of patients with COVID-19 patients, 9, 208 chest X-Ray images in 4 types of pneumonia patients, including'COVID-19','Normal','Viral-caused Pneumonia' and'Bacterial-caused Pneumonia' are implemented to build the models via DenseNet and Random Forest to classify whether a patient has signs of infection. The accuracy of the Densenet and Random Forest models is 82.03% and 88% separately according to the experimental results. Based on it, a conclusion can be summarized that when the sample size is very small, random forest is a better model than the DenseNet (i.e. Convolution Neural Network Model), which demonstrates the potential of traditional machine learning methods. © 2022 Association for Computing Machinery.
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Objective. An outbreak of pneumonia named COVID-19 caused by a novel coronavirus in Wuhan is rapidly spreading worldwide. The objective of the present study was to clarify further the clinical characteristics and blood parameters in COVID-19 patients. Materials and Methods. Twenty-three suspected patients and 64 patients with laboratory-confirmed SARS-Cov-2 infection were admitted to a designated hospital. Epidemiological, clinical, laboratory, and treatment data were collected and analyzed. Results. Of the 64 patients studied, 47 (73.4%) had been exposed to a confirmed source of COVID-19 transmission. On admission, the most common symptoms were fever (75%) and cough (76.6%). Twenty-eight (43.8%) COVID-19 patients showed leukopenia, 10 (15.6%) showed lymphopenia, 47 (73.4%) and 41 (64.1%) had elevated high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR), respectively, and 30 (46.9%) had increased fibrinogen concentration. After the treatment, the counts of white blood cells and platelets, and the level of prealbumin increased significantly, while aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and hsCRP decreased. COVID-19 patients with the hospital stay longer than 12 days had higher body mass index (BMI) and increased levels of AST, LDH, fibrinogen, hsCRP, and ESR. Conclusions. Results of blood tests have potential clinical value in COVID-19 patients.Copyright © 2020 by the Association of Clinical Scientists, Inc.
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Background: A major consequence of the COVID-19 pandemic on the U.S. healthcare system has been the rapid transition away from in-person healthcare visits to telehealth. This study analyzed patient and surgeon satisfaction in the utilization of telehealth within the hand surgery division during the COVID-19 pandemic. Methods: All hand surgery patients who completed a telemedicine visit from March 30th, 2020 through April 30th, 2020 completed a 14-question survey via e-mail. Hand surgeons who participated in telemedicine completed a separate 14-question survey. Survey results were presented descriptively (mean ± standard deviation) and patient factors influencing satisfaction were determined using univariate and multivariate proportional modeling. Results: 89 patients and five surgeons completed the surveys. Patients were very satisfied with their telemedicine visits (4.21/5.00 ± 0.89). Multivariate proportional modeling determined patients who found it "very easy" (5/5) to arrange telemedicine visits had greater satisfaction (OR = 4.928; 95% CI = 0.94 to 25.84) compared to those who found it "difficult" (2/5) (p = 0.059). Patients who believed they could ask/relay questions/concerns "extremely effectively" (5/5) had greater satisfaction (OR = 55.236; CI = 11.39 to 267.80) compared to those who asked/relayed questions only "slightly effective" to "moderately effectively" (p < 0.001). Surgeons were similarly satisfied with their telemedicine experience (4.00/5.00 ± 0.89) and were confident in their diagnoses (4.20/5.00 ± 0.84). All surgeons responded they will continue using telemedicine. 30.7% of patients would choose telemedicine over an inperson visit. Conclusions: Telemedicine provides a viable platform for healthcare delivery with high patient and surgeon satisfaction. Most patients still prefer in-person visits for the post-pandemic future.
Subject(s)
COVID-19 , Telemedicine , Hand/surgery , Humans , Pandemics , Patient Satisfaction , SARS-CoV-2ABSTRACT
In sparsely occupied large industrial and commercial buildings, large-diameter ceiling fans1 (LDCFs) are commonly utilized for comfort cooling and destratification;however, a limited number of studies were conducted to guide the operation of these devices during the COVID-19 pandemic. This study conducted 223 parametrical computational-fluid-dynamics (CFD) simulations of LDCFs in the U.S. Department of Energy warehouse reference building to compare the impacts of fan operations, index-person, and worker-packing-line locations on airborne exposures to infectious aerosols under both summer and winter conditions. The steady-state airflow fields were modeled while transient exposures to particles of varying sizes (0.5–10 μm) were evaluated over an 8-h period. Both the airflow and aerosol models were validated by measurement data from the literature. It was found that it is preferable to create a breeze from LDCFs for increased airborne dilution into a sparsely occupied large warehouse, which is more similar to an outdoor scenario than a typical indoor scenario. Operation of fans at the highest feasible speed while maintaining thermal-comfort requirements consistently outperformed the other options in terms of airborne exposures. There is no substantial evidence that fan reversal is beneficial in the current large space of interest. Reversal flow direction to create upward flows at higher fan speeds generally reduced performance compared with downward flows, as there was less airflow through the fan blades at the same rotational speed. Reversing flow at lower fan speeds decreased airflow speeds and dilution in the space and, thus, increased whole-warehouse concentrations. © 2023 Elsevier Ltd