ABSTRACT
The growth of healthcare waste (HCW) was driven by the spread of COVID-19. Effective HCW eradication has become a pressing global issue that requires immediate attention. Selecting an effective healthcare waste treatment technology (HCWTT) can aid in preventing waste buildup. HCWTT selection can be seen as a complex multi-criteria group evaluation problem as the process involves multiple types of criteria and decision-makers (DMs) facing uncertain and vague information. The key objective of this study is to create a useful tool for the evaluation of HCWTT that is appropriate for the organization's needs. A novel index system for assessing the HCWTT during the decision-making evaluation process is first presented. Then a new approach based on entropy measure, decision-making trial and evaluation laboratory (DEMATEL), and game theory for the integrated weighting procedure (IWP) is presented under a Fermatean fuzzy environment. A multi-criteria group analysis based on IWP, a technique for order of preference by similarity to ideal solution (TOPSIS) and grey relational analysis (GRA), named IWP-TOPSIS-GRA framework suited to Fermatean fuzzy evaluation information, is developed. In a real-world case of HCWTT selection, through comparative analysis and sensitivity analysis, it is verified that the presented method is feasible and robust. © 2023 by the authors.
ABSTRACT
This study theoretically demonstrated an insight for designing a novel tunable plasmonic biosensor, which was created by simply stacking a twisted bilayer graphene (TBG) superlattice onto a plasmonic gold thin film. To achieve ultrasensitive biosensing, the plasmonic biosensor was modulated by Goos-Hänchen (GH) shift. Interestingly, our proposed biosensor exhibited tunable biosensing ability, largely depending on the twisted angle. When the relative twisted angle was optimized to be 55.3°, such a configuration: 44 nm Au film/1-TBG superlattice could produce an ultralow reflectivity of 2.2038 × 10-9and ultra-large GH shift of 4.4785 × 104μm. For a small refractive index (RI) increment of 0.0012 RIU (refractive index unit) in sensing interface, the optimal configuration could offer an ultra-high GH shift detection sensitivity of 3.9570 × 107μm/RIU. More importantly, the optimal plasmonic configuration demonstrated a theoretical possibility of quantitatively monitoring severe acute respiratory syndrome coronavirus (SARS-CoV-2) and human hemoglobin. Considering an extremely small RI change as little as 3 × 10-7RIU, a good linear response between detection concentration of SARS-CoV-2 and changes in differential GH shift was studied. For SARS-CoV-2, a linear detection interval was obtained from 0 to 2 nM. For human hemoglobin, a linear detection range was achieved from 0 to 0.002 g/L. Our work will be important to develop novel TBG-enhanced biosensors for quantitatively detecting microorganisms and biomolecules in biomedical application. © 2023 the author(s), published by De Gruyter, Berlin/Boston 2023.
ABSTRACT
Objective: To analyze the clinical characteristics of COVID‑19 in the patients with predominant digestive symptoms and to discuss related clinical issues. Methods: A retrospective clinical analysis was performed on 638 discharged patients with confirmed COVID‑19 from January 30, 2020 to March 10, 2020, to collect their basic information, first symptoms, laboratory results, nucleic acid test, disease severity, and outcomes. Results: Of the 638 patients with COVID‑19, fever was the most common first symptom. There were 87 cases (13.6%) with obvious digestive symptoms and 551 cases (86.4%) without digestive symptoms, of which, diarrhea was the most common (67.8%) one. As compared with those without predominant digestive symptoms, these COVID cases were younger in age, had higher rate of cough (65.5%), higher maximum body temperature, and higher proportion of WBC counts <4.0×109/L. However, patients without gastrointestinal symptoms had a higher level of ultra‑troponin I. There was no significant difference between the two groups in terms of gender composition, fever, sputum, chest pain, chest tightness, dyspnea, and basic diseases. Meanwhile, no statistical difference was found between the two groups in most laboratory results, duration of viral shedding, the production of specific antibodies, characteristics of chest CT imaging, disease severity, and death rate. Conclusion: The diarrhea‑mainly digestive symptoms were the first‑episode symptoms in some patients with COVID‑19, their clinical characteristics and the courses were generally similar to those without obvious digestive symptoms. In view of the fact that some patients have positive nucleic acid test on anal swab and there is a risk of gastrointestinal transmission, the clinical care requirements and difficulties have increased for such patients. © 2022, Editorial Board of Medical Journal of Wuhan University. All right reserved.
ABSTRACT
COVID-19 is the most severe global epidemic in recent years. Although the risk factors that influence the outbreak are unknown, it is known from the factors influencing past respiratory pandemics that ageing is one of the common factors affecting the spread of the disease. Therefore, this study uses R and SAS software to analyze the collected COVID-19 data from 191 different countries around the world in a progressive linear relationship, so as to explore whether ageing is one of the factors affecting the prevalence of COVID-19 in different countries around the world. According to the results, the factors affecting ageing are discussed, the limitations of the research method are analyzed, and advice on how older people can avoid getting COVID-19 is given. © 2021 ACM.
ABSTRACT
Background: Host factors such as angiotensin-converting enzyme 2 (ACE2) and the transmembrane protease, serine subtype 2 (TMPRSS2) are important factors for SARSCoV-2 infection. Clinical and pre-clinical studies demonstrated that RAAS-blocking agents can be safely used during a SARS-CoV-2 infection but it is unknown if DPP-4 inhibitors or SGLT2-inhibitors may promote COVID-19 by increasing the host viral entry enzymes ACE2 and TMPRSS2. Methods: We investigated telmisartan, linagliptin and empagliflozin induced effects on renal and cardiac expression of ACE2, TMPRSS2 and key enzymes involved in RAAS (REN, AGTR2, AGT) under high-salt conditions in a non-diabetic experimental 5/6 nephrectomy (5/6 Nx) model. In the present study, the gene expression of Ace2, Tmprss2, Ren, Agtr2 and Agt was assessed with qRT-PCR and the protein expression of ACE2 and TMPRSS2 with immunohistochemistry in the following experimental groups: Sham+normal diet (ND)+placebo (PBO);5/6Nx+ND+ PBO;5/6Nx+2% salt-diet (HSD)+PBO;5/6Nx+HSD+telmisartan;5/6Nx+HSD+linagliptin;5/6Nx+HSD+empagliflozin. Results: In the kidney the expression of Ace2 was not altered on mRNA level under disease and treatment conditions. The renal TMPRSS2 levels (mRNA and protein) was not affected, whereas the cardiac level was significantly increased in 5/6 Nx rats. Intriguingly, the elevated TMPRSS2 protein expression in the heart was significantly normalized after treatment with telmisartan, linagliptin and empagliflozin. Conclusions: Overall, our study indicated that there is no upregulation regarding host factors potentially promoting SARS CoV-2 virus entry into host cells when the SGLT2 inhibitor empagliflozin, telmisartan and the DPP4 blocker linagliptin are used. The results obtained in a preclinical, experimental non-diabetic kidney failure model need confirmation in ongoing interventional clinical trials.
ABSTRACT
The COVID-19 has spread in more than 200 countries and regions around the world. China, as the first country to fight the epidemic, took measures such as social isolation, regional blockade, and traffic control, which had a positive effect on preventing the spread of the epidemic, but the agricultural supply chain in the control area received a great impact;in terms of international epidemic prevention, all countries are strengthening their border blockade, safeguarding their own food demand, and strict import and export quarantine measures [1], which has a huge impact on the global flow of agricultural products, and the lack of imported agricultural products to supplement the supply security of China's agricultural products is under certain threat. In this paper, by sorting out the paths of the epidemic affecting the supply chain of agricultural products and the characteristics of China's agricultural supply chain, we deeply analyze the sources of risks in China's agricultural supply chain under the epidemic, and put forward suggestions such as strengthening the collaborative management of the agricultural supply chain, building a response mechanism and prevention mechanism for the quality and safety of agricultural products, constructing a logistics network suitable for the storage and transportation requirements of agricultural products, and accelerating the construction of a big data platform for the agricultural supply chain. © 2021 The Authors, published by EDP Sciences.
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CONTEXT: About 19% of COVID-19-patients undergo hypoxic breathing problems, approximately 14% require intensive oxygen therapy, and 5% require mechanical ventilation and ICU admission. These patients can deteriorate rapidly, so nurses must closely watch them. OBJECTIVE: The study intended to examine the role of emergency nurses as care providers in intensive care units (ICUs). DESIGN: The research team performed a narrative review by searching the Mendeley, Medline, Google Scholar, ScienceDirect, Springer, and PubMed databases. The search used the keywords COVID-19 infection, epidemiology of respiratory failure pathology in COVID-19 infection, involvement of viral spike protein S of SARSCoV-2, SARS CoV2 transmission, pathophysiology of SARSCoV-2 attack-mediated ARDS, transmission of viral particles of SARSCoV-2 in lungs, mechanism of cytokines in lungs, immunomodulatory response changes in lung physiology, and involvement of nursing officer in nursing patient care management in ICU respiratory failure. SETTING: This study were conducted at The First Affiliated Hospital of Nanchang University, China. RESULTS: Nurses are necessarily not only responsible for adequate oxygen management but also for other critical health services to benefit patients, such as control of oxygen saturation and vital signs, to reduce respiratory failure in the ICU. CONCLUSIONS: The diagnosis of the root cause of respiratory failure and its treatment are complex because a variety of pulmonary and extrapulmonary conditions can cause respiratory failure. Methods of treating acute respiratory failure and other respiratory illness require a multidisciplinary, collaborative approach. Nurses are in the best position to determine patients' risks for respiratory distress, observe them during hospitalizations, and evaluate their treatments.
ABSTRACT
Background: COVID-19 patients requiring treatment with blockers of the reninangiotensin- aldosterone system (RAAS) are at highest risk of developing pneumonia and dying. ACE2 is the functional receptor for SARS-CoV-2. Animal studies suggest that RAAS blocking agents might increase the expression of ACE2 and hence potentially increase the risk of SARS-Cov-2 infection. Methods: We conducted a systematic review and meta-analysis of published studies on the association of RASS blocking agents with lung disease related outcomes. Results: The effect of ACE inhibitor treatment on the incidence of pneumonia in non-COVID-19 patients was analyzed in 25 studies (330,780 patients). ACE inhibitor use was associated with a 27% reduction of pneumonia risk (OR: 0.73, p<0.001). Pneumonia related death cases in ACE inhibitor treated non-COVID-19 patients were reduced by 27% (OR: 0.73, p=0.004). ARB treatment was analyzed in 10 studies (275,621 non- COVID-19 patients). The risk of pneumonia was not different between patients who did or did not use ARBs. Pooled result from 13 studies (27,704 COVID-19 patients) showed that COVID-19 related severe adverse clinical outcomes were not different between patients who did or did not use RAAS blocking agents (OR: 0.87, p=0.28). All-cause mortality risk in COVID-19 patients was reduced by 27% (p=0.04). Conclusions: Given the weak evidence coming from animal studies and the clear beneficial data of ACE inhibition in non-COVID-19 patients and the limited but promising data in COVID-19 patients, the use of RAAS blocking agents in patients with SARSCoV- 2 infection is justified. Further clinical studies analysing ARBs and ACE inhibitors separately in COVID-19 patients are needed.
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This article was published ahead of print on the official website of Chinese Journal of Ophthalmology on April 16,2020. Objective: To screen for novel coronavirus related conjunctivitis among patients with coronavirus disease 2019. Methods: Prospective series case study. Eighty-one patients diagnosed as coronavirus disease 2019 in Guangxi Zhuang Autonomous Region People's Hospital were enrolled with ophthalmological consultation and screening for novel coronavirus related conjunctivitis, including the inquiring of eye symptoms and checking for conjunctivitis-related signs. Novel coronavirus nucleic acid testing of conjunctival swabs was performed on patients with clinical manifestations of conjunctivitis. Results: Only 3 of the 81 patients (3.70%) complained of eye discomfort, which appeared on day 16.67±9.29 after the diagnosis of coronavirus disease 2019. The eye signs were not typical of viral conjunctivitis. Novel coronavirus nucleic acid tests of conjunctival swabs were negative in both eyes. There was no evidence to support the diagnosis of novel coronavirus related conjunctivitis. The remaining 78 patients showed no clinical symptoms or signs of conjunctivitis. Conclusions: The occurrence of novel coronavirus related conjunctivitis may be low in patients with coronavirus disease 2019.(Chin J Ophthalmol, 2020, 56: 433-437).