How do hotel star ratings affect the relationship between environmental CSR and green word-of-mouth?

Hotels have increasingly engaged in environmentally responsible initiatives to demonstrate their commitment to environmental concerns and sustainable hospitality and tourism. These initiatives are expected to become even more popular in the context that the COVID-19 crisis has driven people to further acknowledge the importance of the ecosystem. This study aims to examine how hotels' environmental corporate social responsibility (CSR) affects customers' green word-of-mouth (WOM). Structural equation modeling was employed to analyze data from an online survey of 749 Chinese respondents. The findings reveal that hotels' environmental CSR indirectly enhances customers' green WOM intention via green perceived value (i.e., cognitive route) and green hotel pride (i.e., emotional route). Furthermore, the indirect effects of hotels' environmental CSR on customers' green WOM are more substantial for hotels with higher star ratings. These findings offer valuable insights for hoteliers to develop genuine environmentally responsible initiatives that can generate positive customer responses.

Predictive value of C-reactive protein-to-albumin ratio for risk of 28-day mortality in patients with severe pneumonia

Objectives: To explore the predictive value of C-reactive protein (CRP)-to-albumin (ALB) ratio (CAR) for the risk of 28-day mortality in patients with severe pneumonia.Methods: A total of 152 patients with severe pneumonia treated from January 2020 to January 2022 were enrolled and assigned into survival group (n=107) and death group (n=45) according to their survival status after treatment for 28 d. Their clinical data were compared, and the influencing factors for 28-day mortality were explored by multiple logistic regression analysis. The receiver operating characteristic (ROC) curve was plotted to assess the value of CAR for predicting 28-day mortality risk. A risk prediction model was constructed, and its prediction efficiency was evaluated.Results: The death group had significantly older age, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Murray Lung Injury Score, Sequential Organ Failure Assessment score, white blood cell count, neutrophil count, red cell volume distribution width, neutrophil-to-lymphocyte ratio (NLR), fibrinogen, procalcitonin, blood lactic acid (Lac), CRP and CAR and significantly lower oxygenation index and ALB than those of the survival group (p<0.05). APACHE II score, NLR, Lac and CAR were independent risk factors for 28-day mortality (p<0.05). AUC of the established prediction model was 0.826, with sensitivity of 88.45 % and specificity of 87.32 %, indicating high discrimination. The nomogram model had clinical value when the risk threshold probability was 11-93 %.Conclusions: CAR is an independent risk factor that shows a high predictive value for the 28-day mortality risk in patients with severe pneumonia.

Stability Analysis of COVID-19 SEIQR Model with Infectivity in Latent Period

In this paper, COVID-19 SEIQR model which can cause death is studied. The virus has infectivity in both latent period and infectious period, the existence, local stability and global asymptotic stability of disease-free equilibrium point and local equilibrium point are proved. © 2022 IEEE.

Epidemiological characteristics and disease spectrum analysis of outpatients in the dermatology department of a hospital in Wuhan during the COVID-19 epidemic.

Objective: To investigate epidemiological characteristics of outpatients and disease spectrum in the dermatology department during the COVID-19 epidemic Methods: A retrospective comparison of outpatient visits, gender, age and disease types in the dermatology department of Wuhan No.1 Hospital was performed between COVID-19 epidemic period (from 23th January 2020 to 15th April 2020) and the same period in 2019. Enumeration data were analyzed by Pearson's chi-square test. Result(s): During the COVID-19 epidemic, the number of outpatient visits to the dermatology department of the hospital decreased markedly, and the average daily number of outpatient visits (236 visits/day) was only 8.81% of that during the same period in 2019 (2 678 visits/day) ;the ratio of male to female patients was reversed from 1:1.37 in 2019 to 1.16:1 in 2020;the proportions of patients aged 0-6, 7-12, 13-17 and 18-45 years significantly decreased compared with those in 2019 (all P < 0.001), and the proportions of patients aged 46-69 and > 69 years significantly increased (both P < 0.001). During the COVID-19 epidemic, there were 171 types of skin diseases in the dermatology outpatient department, and the number of disease categories decreased compared with that during the same period in 2019 (442 types) ;the number of patient visits for allergic skin diseases, erythematous papulosquamous skin diseases, viral infectious skin diseases and bacterial infectious skin diseases significantly increased compared with that during the same period in 2019 (all P < 0.001), while the number of patient visits for sebaceous and sweat gland disorders, pigmented skin diseases and physical skin diseases significantly decreased (all P < 0.001). Conclusion(s): Compared with the same period in 2019, the number of outpatient visits, patient sex ratio, age distribution and disease types in the dermatology department have undergone marked changes during the COVID-19 epidemic, and this study provides a reference for healthcare workers in dermatology department to respond to various epidemics and natural disasters in the future.Copyright © 2021 by the Chinese Medical Association.

Telemedicine as a new platform of care: assessing quality of care for the endocrine surgical patient—a narrative review

Background and Objective: Expansion of reimbursement for telehealth under the Center for Medicare and Medicaid Services emergency COVID-19 pandemic waiver has allowed for wider implementation of telehealth as an accepted modality for delivering and receiving healthcare. In a specialty such as endocrine surgery, where complications are rare and recovery after surgery is usually uneventful, telemedicine is a viable option for postoperative visits and may be an acceptable alternative for in-person preoperative consultation in select cases. Therefore, our objective was to construct a narrative review describing the developing role of telemedicine in endocrine surgery, i.e., thyroidectomy and parathyroidectomy, and its current utilization and perception in the peri-COVID-19 pandemic era. Methods: A PubMed search was conducted with the terms "telemedicine” and "endocrine surgery”. All articles reviewed were in English, published between 2000–2022, and studies conducted within the United States. Each article was screened for relevance based on title and abstract. Key Content and Findings: Since the 1970s, the use of telemedicine has grown and become more accessible in the early 2000s, allowing for a greater number of patients to access specialist care despite technological barriers and regulatory requirements. With the COVID-19 pandemic and the increased need for virtual healthcare, new concerns regarding patient privacy, confidence, and physician utility and reimbursement have evolved. Within endocrine surgery, patient surveys for established and postoperative visits show satisfaction with telehealth visits in terms of privacy, duration of the physician encounter, interaction with physicians, and completeness of care. However, several accessibility factors need to be addressed to lower the no-show rate of telehealth visits. Conclusions: Telemedicine has been shown to have a valuable role in the endocrine surgery clinic, which has been forced to expand due to the COVID-19 pandemic. In order to continue to grow with the needs of patients, increased accessibility, improvements in new patients' perceptions of their care, and physician revenue loss due to decreased in-office procedures are sources of further research. © Annals of Thyroid. All rights reserved.

A Reinforcement Learning Variable Neighborhood Search for the Robust Dynamic Bayesian Network Optimization Problem under the Supply Chain Ripple Effect

Due to the impact of the global COVID-19, numerous industries have suffered from the disruption propagating along the supply chain, i.e. the ripple effect. To reduce adverse impact of the ripple effect, supply chain (SC) risk management under it is becoming an increasingly hot topic in both practice and research. In our former research, a robust dynamic bayesian network (DBN) approach has been developed for disruption risk assessment, whereas the solution methods adopted before (commercial solvers and simulated annealling algorithm) are not efficient enough, especially for large-size instances. For this reason, a new reinforcement learning variable neighborhood search (QVNS) is developed for solving the robust DBN optimization model, where the Q-learning algorithm is implemented to select the most efficient neighborhood structure in different stages of the search process. We conduct computational experiments on randomly generated instances, which indicates that Q-learning algorithm can improve significantly the performance of the VNS on large-size instances of the robust DBN optimization problem. Copyright (C) 2022 The Authors.

Establishing Online Meeting Climate Types and Developing Measurements: Impact on Meeting Satisfaction

In the post covid-19 era, organizations will experience a new environment. Advances in technologies such as AI and big data, and new experiences such as online meetings and lectures, will increase the use of online communication. Businesses will increasingly engage in online-based information sharing, virtual team operations, and online meetings. This study focuses on meeting climate and satisfaction, to improve the performance of online meetings. Existing studies on meeting climate presuppose off-line situations. Offline and online communication methods and meeting formats are different. This paper proposes new climate types to develop an appropriate climate for online-based meetings. To apply these climates in online meetings, a measurement scale was developed and the impact on online meeting satisfaction was verified. As a result of the study, it was found that the creativity-oriented meeting climate was the most important, and relation-oriented and participation-oriented meeting climates also had a significant effect, while the direction-oriented and task-oriented climates were relatively less important. This study develops new variables and measurements for online meeting climates, and explains their importance. Companies will be able to leverage the appropriate climates for online meetings to improve performance. Copyright © 2022 KSII.

Nomogram Prediction of Severe Risk in Patients with COVID-19 Pneumonia

COVID-19 elicits a range of different responses in patients and can manifest into mild to very severe cases in different individuals, depending on many factors. We aimed to establish a prediction model of severe risk in COVID-19 patients, to help clinicians achieve early prevention, intervention, and aid them in choosing effective therapeutic strategy. We selected confirmed COVID-19 patients who admitted to First Hospital of Changsha city between January 29 and February 15, 2020 and collected their clinical data. Multivariate logical regression was used to identify the factors associated with severe risk. These factors were incorporated into the nomogram to establish the model. The ROC curve, calibration plot and decision curve were used to assess the performance of the model. 228 patients were enrolled and 33 (14.47%) patients developed severe pneumonia. Univariate and multivariate analysis showed that shortness of breath, fatigue, creatine kinase, lymphocytes and h CRP were independent factors for severe risk in COVID-19 patients. Incorporating age, COPD and these factors, the nomogram achieved good concordance indexes of 0.89 (95% CI: 0.832-0.949), and well-fitted calibration plot curves (Hosmer-Lemeshow test: P=0.97). The model provided superior net benefit when clinical decision thresholds were between 15-85% predicted risk. Using the model, clinicians can intervene early, improve therapeutic effects and reduce the severity of COVID-19, thus ensuring more targeted and efficient use of medical resources.

Stochastic Integrated Supplier Selection and Disruption Risk Assessment Under Ripple Effect

The impact of the COVID-19 pandemic in the supply chain (SC) evokes the need for valid measures to cope with the SC disruption risk. Supplier selection and disruption risk assessment, as valid measures, have received increasing attentions from academia. However, most of existing works focus on supplier selection and disruption risk assessment separately. This work investigates an integrated supplier selection and disruption risk assessment problem under ripple effect. The objective is to minimize the weighted sum of the disrupted probability and the total cost for the manufacturer. For the problem, a new stochastic programming model combined with Bayesian network (BN) is formulated. Then, an illustrative example is conducted to demonstrate the proposed method. © 2021, IFIP International Federation for Information Processing.

A Tabu Search Heuristic for the Robust Dynamic Bayesian Network Optimisation Problem Under the Supply Chain Ripple Effect

Due to the impact of the global COVID-19, supply chain (SC) risk management under the ripple effect is becoming an increasingly hot topic in both practice and research. In our former research, a robust dynamic bayesian network (DBN) approach has been developed for disruption risk assessment, whereas there still exists a gap between the proposed simulated annealing (SA) algorithm and commercial solver in terms of solution quality. To improve the computational efficiency for solving the robust DBN optimisation model, a tabu search heuristic is proposed for the first time in this paper. We design a novel problem-specific neighborhood move to keep the search in feasible solution space. The computational experiments, conducted on randomly generated instances, indicate that the average gap between our approach and commercial solver is within 0.07 %, which validates the performance of the proposed method. © 2021, IFIP International Federation for Information Processing.

Epidemiological characteristics and disease spectrum analysis of outpatients in the dermatology department of a hospital in Wuhan during the COVID-19 epidemic

Objective: To investigate epidemiological characteristics of outpatients and disease spectrum in the dermatology department during the COVID-19 epidemic Methods: A retrospective comparison of outpatient visits, gender, age and disease types in the dermatology department of Wuhan No.1 Hospital was performed between COVID-19 epidemic period (from 23th January 2020 to 15th April 2020) and the same period in 2019. Enumeration data were analyzed by Pearson's chi-square test. Results: During the COVID-19 epidemic, the number of outpatient visits to the dermatology department of the hospital decreased markedly, and the average daily number of outpatient visits (236 visits/day) was only 8.81% of that during the same period in 2019 (2 678 visits/day) ;the ratio of male to female patients was reversed from 1:1.37 in 2019 to 1.16:1 in 2020;the proportions of patients aged 0-6, 7-12, 13-17 and 18-45 years significantly decreased compared with those in 2019 (all P < 0.001), and the proportions of patients aged 46-69 and > 69 years significantly increased (both P < 0.001). During the COVID-19 epidemic, there were 171 types of skin diseases in the dermatology outpatient department, and the number of disease categories decreased compared with that during the same period in 2019 (442 types) ;the number of patient visits for allergic skin diseases, erythematous papulosquamous skin diseases, viral infectious skin diseases and bacterial infectious skin diseases significantly increased compared with that during the same period in 2019 (all P < 0.001), while the number of patient visits for sebaceous and sweat gland disorders, pigmented skin diseases and physical skin diseases significantly decreased (all P < 0.001). Conclusion: Compared with the same period in 2019, the number of outpatient visits, patient sex ratio, age distribution and disease types in the dermatology department have undergone marked changes during the COVID-19 epidemic, and this study provides a reference for healthcare workers in dermatology department to respond to various epidemics and natural disasters in the future. Copyright © 2021 by the Chinese Medical Association.

Spatiotemporal analysis on the impact of COVID-19 pandemic on NO2 emission in China

Based on the high-resolution TROPOMI data, this paper analyzed the spatial distribution of NO2 column density during the COVID-19 outbreaking period in China, and revealed the spatial variations in the NO2 changes during the year-on-year and month-on-month COVID-19 pandemic. The analysis showed that during the pandemic, the nationwide decline in NO2 column density compared to the NO2 level during the same period in 2019 (year-on-year) and during one-month before (month-on-month) the pandemic reached 40.46% and 50.09%, respectively. The economically developed and populous urban agglomerations had a significant decrease in emissions. Specifically, provinces with high historical NO2 emissions, including Jiangsu, Henan, Shandong, Zhejiang, etc., were more affected by the epidemic. Hubei showed the lowest NO2 column density (1.63×1015molec/cm2) during the epidemic period among the central and eastern provinces, with the NO2 decrease compared to the NO2 level during the same period in 2019 and during one-month before the pandemic greater than 50%. Regarding different cities in Hubei, the influence of the COVID-19 pandemic on the surrounding cities, e.g. Wuhan and Xiaogan, was much greater than that on the western mountainous cities, e.g. Shiyan and Enshi. The measurements of NO2 concentration at the ground-based national air quality monitoring stations also showed a consistent spatiotemporal trend with satellite observations, indicating that the "top-down" remote sensing method can efficiently reflects the intensity of air pollution emissions and the level of socio-economic activities in different regions. © 2021, Editorial Board of China Environmental Science. All right reserved.

Comparison of spatio-temporal transmission characteristics of COVID-19 and its mitigation strategies in China and the US

Investigating the spatio-temporal transmission features and process of novel coronavirus disease 2019 (COVID-19) mitigation strategies are of great practical significance to understand the development of COVID-19 and establish international cooperation for prevention and control. In this paper, the cumulative number of confirmed cases, number of confirmed cases per day and cumulative number of deaths, were used to compare transmission paths, outbreaks timelines, and coping strategies of COVID-19 in China and the US. The results revealed that: first, the COVID-19 outbreaks in both China and the US exhibited a 6-week initiation stage. In China, the COVID-19 erupted in late January. It lasted only a short period of time and was almost completely contained within 6–8 weeks. But the COVID-19 erupted in early March in the US and was still in the peak or post-peak stage. Second, in China, the COVID-19 emerged in Wuhan and spread to other regions of Hubei Province and then nationwide, exhibiting a cross(“+”)-shaped of spread with Wuhan city as the center. Importantly, the COVID-19 in China had a large concentration and there were no national outbreaks. In contrast, the COVID-19 in the US first spread through New York and the western and eastern coasts but has since emerged throughout the entire country. Third, the lack of emergency response planning in both countries in the early stage (about 6-week) hampered COVID-19 prevention. However, actively high-pressure prevention and control measures were used to basically control COVID-19 in early March in China. And then China has gradually resumed business and production activities. Unfortunately, the US government missed the best opportunity to contain the epidemic. Faced with the choice between economic recovery and coronavirus containment, the US removed the quarantine and restriction measures too early. The COVID-19 is continuing to spread in the country and blossom everywhere, still showing no signs of receding. © 2020, Science in China Press.

Investigation on and Protective Measures and Exposure Risks for the People Related to Medical Waste Disposal during the COVID-19 Epidemic

During the COVID-19, the production of medical waste increased sharply, which brought a challenge to the capacity of China's medical waste disposal and the protection of the group that received, transported and disposed of medical waste. In order to study the potential risks and protection measures against exposure for the workers in the collection, transportation, temporary storage, and disposal of medical waste, ninety staff members from a typical medical waste disposal center in Zhejiang Province were selected as the research objects to study the personal protection level of staff in different types of work, as well as the influence of items or locations at risk of infection on their choice of protective measures. The results show that among the 90 surveyed people, 98.9% of the staff wore medical respirators or full-face masks and half-masks during the work, 87.5% of the staff wore work clothes, 79.6% of the staff wore labor protection cap, 64.8% of workers chose to wear rubber gloves and protective boots for protection, and goggles (55.7%) and protective clothing (33.0%) were also worn when they were closely contact with medical waste. At the end of a single task, 100% of the respondents chose to wash their hands with running water, soap, quick disinfectant or 0.3%-0.5% iodophor disinfectant or bathe, and 94.3% of the respondents disinfected their personal work items;all respondents would take protective measures such as washing hands, disinfecting items, ventilating after returning home. The personal protection measures taken by different staff were mainly related to the items or locations that were exposed to risk of infection during the work process. Among them, the staff who were in contact with high-risk items, turnover containers (barrels) or the outer surface and inner wall of disposable packaging containers were more inclined to a higher level of protective measures. This research indicates that there is a significant difference between the qualified rate of protection and the type of work for the staff in this survey (P0.05). In the future, more detailed and specific policies and regulations should be formulated, and the management and training of the employees should be strengthened to increase their awareness of prevention and reduce the risk of occupational exposure. © 2020, Editorial Board, Research of Environmental Sciences. All right reserved.

Handwashing Behavior of Chinese Population during the COVID-19 Epidemic

Direct contact and droplet transmission are the main routes of novel coronavirus transmission. Reasonable handwashing behavior is an effective prevention and control measure to cut off the exposure routes and reduce the risk of virus infection, which may play an important role in the prevention and control of novel coronavirus pneumonia (COVID-19) epidemic. In this study, an electronic questionnaire was used to investigate the handwashing behavior and handwashing time of 8330 adults in 31 provinces in China during February 25th to March 14th, 2020, and the factors affecting hand-washing behavior in different exposure scenarios were then analyzed. The results show that the proportion and duration of hand-washing by women and urban residents were higher than that of men and rural residents, respectively. People were more likely to wash their hands in general exposure scenarios, while in scenarios with high risk of viral infections, such as after coughing or sneezing and after touching others, the proportion of handwashing was the lowest, 73.6% and 83.9%, respectively, indicating that the virus transmission routes and protection measures of this population need to be understood in depth. In terms of handwashing time, according to the standards of handwashing time (20 s) stipulated by WHO, only 41.7% of the population could reach the qualified level (that is more than 20 s), and the passing rate of urban residents' handwashing time was significantly higher than that in rural areas (42.0% vs. 39.7%). In general, the handwashing proportion of the people who went out was higher than those who never went out. Whether there were suspected and confirmed cases in the residential areas during the epidemic period had a significant impact on residents' handwashing behavior. However, the passing rate of handwashing time for the residents in the regions with the most severe epidemic was the lowest (37.2%), while the passing rate of handwashing time for the residents in the regions with the least epidemic was the highest (43.6%), indicating that the residents' hand-washing behavior may be affected by the epidemic and other factors. This study indicates that compared with non-epidemic period, the incidence of handwashing behavior among Chinese residents during the epidemic period increased, and the qualified rate of handwashing time was improved. However, the rate was still low. Thus, people's awareness of handwashing behavior should be improved, and the protective measures should be implemented scientifically. More attention should be paid to the anti-epidemic effect of handwashing when formulating relevant polices and personal protection. © 2020, Editorial Board, Research of Environmental Sciences. All right reserved.

"Optimization of Surgical Resident Safety and Education During the COVID-19 Pandemic - Lessons Learned".

The COVID-19 pandemic has engendered rapid and significant changes in patient care. Within the realm of surgical training, the resultant reduction in clinical exposure and case volume jeopardizes the quality of surgical training. Thus, our general surgery residency program proceeded to develop a tailored approach to training that mitigates impact on resident surgical education and optimizes clinical exposure without compromising safety. Residents were engaged directly in planning efforts to craft a response to the pandemic. Following the elimination of elective cases, the in-house resident complement was effectively decreased to reduce unnecessary exposure, with a back-up pool to address unanticipated absences and needs. Personal protective equipment availability and supply, the greatest concern to residents, has remained adequate, while being utilized according to current guidelines. Interested residents were given the opportunity to work in designated COVID ICUs on a volunteer basis. With the decrease in operative volume and clinical duties, we shifted our educational focus to an intensive didactic schedule using a teleconferencing platform and targeted areas of weakness on prior in-service exams. We also highlighted critical COVID-19 literature in a weekly journal club to better understand this novel disease and its effect on surgical practice. The long-term impact of the COVID-19 pandemic on resident education remains to be seen. Success may be achieved with commitment to constant needs assessment in the changing landscape of healthcare with the goal of producing a skilled surgical workforce for public service.

Clinical characteristics of 161 cases of corona virus disease 2019 (COVID-19) in Changsha.

OBJECTIVE: In December 2019, a new type of coronavirus-infected pneumonia broke out in Wuhan and spread rapidly to other parts of the country. The purpose of this study was to investigate the clinical features of coronavirus disease 2019 (COVID-19). MATERIALS AND METHODS: A retrospective analysis was performed on the confirmed cases of COVID-19, who were admitted to the North Hospital of Changsha first Hospital (Changsha Public Health treatment Center) from January 17 to February 7, 2020. RESULTS: The median age of COVID-19 patients was 45 years (range 33.5-57). The male patients accounted for 49.7%, 64.6% of the patients had a history of exposure in Wuhan, and 31.7% had family aggregation. The median days of onset were six, and the incidence of severe illness was 18.6%. Compared with the non-severe group, the severe group showed statistical significance in older age, hypertension, bilateral lung plaque shadow, decrease in lymphocyte count, increase in C-reactive protein (CRP), aspartate aminotransferase (AST), lactate dehydrogenase, and creatine kinase. CONCLUSIONS: Age, combined hypertension, oxygenation index, double lung patch, decreased lymphocyte count, and elevated levels of C-reactive protein, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase can be used as predictors of the disease severity.