Design of upper limb rehabilitation evaluation system based on deep learning

The topic of non-contact diagnosis became a hot topic during COVID-19 and online consultation gained popularity. In this research, a deep learning-based autonomous limb evaluation system is developed for online consultation and remote rehabilitation training for people with physical limitations. Its main goal is to collect and analyze information about limb states. The patient can evaluate the limb state at home using the mobile app, and the doctor can view the data and connect with the patient via the web's chat module to offer diagnostic opinions. Deep learning is used for the Start/End Attitude Determination Model and OpenCV for the limb and hand evaluation model, with the results being uploaded to the server. © The Authors. Published under a Creative Commons Attribution CC-BY 3.0 License.

Characterization and Source Apportionment of PM in Handan—A Case Study during the COVID-19

Handan is a typical city affected by regional particulate pollution. In order to investigate particulate matter (PM) characterization, source contributions and health risks for the general populations, we collected PM samples at two sites affected by a pollution event (12–18 May 2020) during the COVID-19 pandemic and analyzed the major components (SNA, OCEC, WSIIs, and metal elements). A PCA-MLR model was used for source apportionment. The carcinogenic and non-carcinogenic risks caused by metal elements in the PM were assessed. The results show that the renewal of old neighborhoods significantly influences local PM, and primarily the PM10;the average contribution to PM10 was 27 μg/m3. The source apportionment has indicated that all other elements came from dust, except Cd, Pb and Zn, and the contribution of the dust source to PM was 60.4%. As PM2.5 grew to PM10, the PM changed from basic to acidic, resulting in a lower NH4+ concentration in PM10 than PM2.5. The carcinogenic risk of PM10 was more than 1 × 10−6 for both children and adults, and the excess mortality caused by the renewal of the community increased by 23%. Authorities should pay more attention to the impact of renewal on air quality. The backward trajectory and PSCF calculations show that both local sources and short-distance transport contribute to PM—local sources for PM10, and short-distance transport in southern Hebei, northern Henan and northern Anhui for PM2.5, SO2 and NO2. © 2023 by the authors.

[Establishment of early warning indicators of SARS-CoV-2 Omicron variant in Tianjin].

In this study, Delphi method was used to conduct a questionnaire survey on 12 experts to determine the indicators system and the corresponding weight for early warning features of SARS-CoV-2 Omicron in Tianjin.The positive indexes of experts in three rounds of consultations were both 100%. The experts' authority coefficient was 0.79. The Kendall's W coordination coefficients were 0.375, 0.356 and 0.385 respectively (all P<0.05). The indicators system for early warning features of 2019-nCoV Omicron variant had 5 first-level indicators, 10 second-level indicators and 52 third-level indicators. The weight of each indicator was also determined.

A bi-virus competing model with time-varying susceptibility and repeated infection

This paper introduces a bi-virus model with time-varying susceptibility. The model describes the case that there coexist two viruses and the time-varying susceptibility due to repeated infections. For different parameters, we investigate the stability of various equilibriums. Under appropriate conditions the two viruses show competitive relationship, that is, one virus will eventually become a pandemic, and the other virus will eventually disappear. For this case, we further study the dynamical behavior of virus transmission. The model shows some new phenomena, that is, the outbreak of the virus will be delayed appropriately, giving people an illusion. Finally, we present a numerical example to illustrate the effectiveness of the theoretical results. (c) 2022 Elsevier Ltd. All rights reserved.

Analysis of the characteristics of ocular trauma diseases during the novel coronavirus epidemic

AIM: To analyze the epidemiological characteristics of patients hospitalized for ocular trauma during the novel coronavirus (COVID-19) epidemic. METHODS: A retrospective case analysis. Totally 876 cases (905 eyes) of ocular trauma were analyzed in this study, including 545 cases (565 eyes) from January to June 2019 were enrolled ascontrol group, and 331 cases (340 eyes) from January to June 2020 were enrolled in the research group. Information regarding age, sex, location of injury, cause of injury, place of residence, and type of injury were collected and analyzed. RESULTS: The number of hospitalisation for ocular trauma in the research group decreased by 39.3% compared with the control group. The age distribution of patients showed a double peak, at 0-10 years (20.55%, 21.45%) and 41-50 years (17.98%, 19.03%) in the control group and research group, respectively. There was no statistically significant difference in the age distribution between the two groups (P=0.907). Men were predominantly injured in both the control and the research groups, accounting for 80.37% and 83.69%, respectively (P=0.219). The proportion of home injuries in the research group (28.40%) was higher than the control group (11.38%) (P<0.001). The proportion of mechanical eye injuries in the research group (98.19%) was higher than the control group (95.60%) (P=0.041), and the proportion of open globe injuries (85.54%) was also higher than the control group (76.58%) (P=0.001). The proportion of patients with no light perception in the research group (18.86%) was higher than that of the control group (9.53%) (P<0.001). CONCLUSION: During the COVID-19 epidemic period, the total number of ocular trauma cases was significantly reduced. Mechanical eye injuries are still the main type for hospitalisation of patients with eye injuries. The awareness of eye injury prevention should be strengthened during the period of epidemic. Copyright 2022 by the IJO Press.

Stemming the Rise in Antibiotic Prescription for Community Acquired Respiratory Infections (ARI) during COVID-19 Pandemic in Singapore General Hospital (SGH)

Background. In early months of COVID-19 pandemic, SGH recorded a year-on-year increase in antibiotic (ABx) use for community acquired acute respiratory infection (CA ARI) from Feb-Apr 2019 (48.7 defined daily doses (DDD)/100 bed-days) to 2020 (50.8 DDD/100 bed-days). To address concerns of misuse, the antibiotic stewardship unit (ASU) expanded prospective audit feedback (PAF) to CA ARI patients admitted to ARI wards, with low procalcitonin (PCT). PAF was conducted on day 2-3 of ABx, on weekdays. Doctors received feedback to stop/ modify when ABx was deemed inappropriate. Here, we describe the impact of ASU's adaptive approach to curb rising ABx use in patients admitted for ARI during COVID-19 pandemic. Methods. A Pre- & Post-intervention study was conducted. All patients started on ABx (ceftriaxone/co-amoxiclav/piptazo/carbapenems/levofloxacin) for CA ARI & PCT < 0.5μg/L were analysed. Those who died ≤48h of admission;admitted to intensive care;required ABx escalation;>1 infective sites;complex lung infection were excluded. Primary objective was to compare the proportion of ABx stopped ≤4 days (time to final infection diagnosis) Pre (22/3-18/4/20) & Post (21/4-13/7/20). Results. 184 (Pre) & 528 (Post) ABx courses were analysed. ASU audited 51 (Pre) & 380 (Post) courses with the rest discontinued/discharged before review. Patients were largely similar in both periods;a third had low likelihood of bacterial infection (C reactive protein < 30mg/L). In Post, 73 feedback was given to stop ABx (often because symptoms suggested viral/fluid overload) & 18 to switch to oral ABx. 82 (90%) feedback was accepted. No ABx was restarted ≤48h or deaths ≤30 days due to ARI. 1 patient had C. difficile diarrhoea a day after ABx cessation as per ASU feedback. Proportion of all ABx stopped ≤4 days was higher in Post than Pre [27/184 (15%) vs 152/528 (29%), p< 0.01]. Median duration of therapy of IV ABx was reduced (6.5 vs 3 days, p< 0.01), with corresponding shorter median length of stay (10.5 vs 6 days, p< 0.01). Conclusion. PAF directly and indirectly reduced ABx duration in patients treated for CA ARI as prescribers become more conscious about stopping ABx when investigations show low likelihood of bacterial infection. ASU must remain agile during pandemics to detect emerging problems and adapt processes to counter early.

Identification of Potential Inhibitors Against SARS-CoV-2 Using Computational Drug Repurposing Study

Background: SARS-Cov-2 is a newly emerged coronavirus and causes a severe type of pneumonia in the host organism. So, it is an urgent need to find some inhibitors against SARS-Cov-2. Therefore, drug repurposing study is an effective strategy for treating pneumonia to find the inhibitors of SARS-Cov-2 proteins. Methods: For this purpose, a library of 2500 verified drug chemical compounds was generated and the compounds were docked against Nucleocapsid, Membrane and Envelope protein structures of SARS-Cov-2 to determine the binding affinity of the chemical compounds against targeting binding pockets. Moreover, cheminformatics properties and ADMET of these compounds were assessed to find the druglikeness behavior of compounds. The chemical compounds with the lowest S-score were identified as potential inhibitors. Results: Our findings showed that the compound ids 1212, 1019 and 1992 could interact inside the active sites of membrane protein, nucleocapsid protein and envelope protein. Conclusion: This in silico knowledge will be helpful for the design of novel, safe and less expensive drugs against the SARS-Cov-2.

[Epidemiological characteristics of imported COVID-19 cases in Tianjin].

Objective: To understand the epidemiological characteristics of imported COVID-19 cases in Tianjin, and provide references for risk assessment and control of imported COVID-19 cases. Methods: The information of imported COVID-19 cases were obtained from National Notifiable Disease Report System of China CDC. The data of imported COVID-19 cases reported from Tianjin airport and epidemiological surveys by CDCs at all levels from March 15, 2020 to August 31, 2021 were collected and analyzed by using software Excel 2010, SPSS 25.0 and R. Results: From March 15, 2020 to August 31, 2021, a total of 606 imported cases of COVID-19 were reported in Tianjin, in which 552 cases were finally included in the analysis. The male to female ratio of the cases was 1.8∶1, the age of the cases ranged from 3 to 77 years, and the cases were mainly reported in age group 20-39 years (59.8%). The areas where the imported case sojourned within 14 days included Europe (242 cases, 43.8%), Africa (139 cases, 25.2%), Americas (85 cases, 15.4%) and Asia (86 cases, 15.6%). The proportion of confirmed cases in autumn and winter was relatively high. During the study period, the proportion of infected persons found in custom entry quarantine decreased, and the proportion of persons with personal health declaration and under medical isolation observation increased. The interval between entry and diagnosis of infected persons tended to increase. Conclusion: The proportion of imported COVID-19 cases detected on the first day of entry at Tianjin airport decreased, and the interval to detect the infected persons trended to increase, to which close attention must be paid.

The rise of a new anchor currency in RCEP? A tale of three currencies

We propose a flow-based criterion (intensity of use) and a stock-based criterion (stability of value) for choosing an anchor currency. This conceptual framework is applied to analyzing the RCEP region. According to the estimated TVP-VAR model, the influence of the US dollar in the region was weakened during the global financial crisis and the COVID pandemic, creating an opportunity for both Chinese Yuan and Japanese Yen to compete for the anchor currency. In terms of the intensity criterion, China accounts for the largest share in the regional share, but Yen seems to have an upper hand in the stability criterion. The sophisticated cooperative-competitive relationship between China and Japan may prolong the birth of a new anchor currency. Before then, US dollar still holds the role and the RCEP regional trade is subject to excessive volatility. © 2021 Elsevier B.V.

Impact of the COVID-19 Pandemic on Diabetic Macular Edema Patient Outcomes at a Tertiary Care Veterans Affairs Hospital

Purpose : Retina clinic volumes declined during the COVID-19 pandemic, and there have been limited studies on how this impacted patient outcomes. Optimal management of diabetic macular edema (DME) requires adherence to regular treatment schedules. We aimed to evaluate the impact of the pandemic on visual and anatomic outcomes in patients with DME requiring anti-VEGF injections at our institution. Methods : Data was collected from the retina clinic at the Michael E. DeBakey VA Medical Center in Houston, Texas. Patient charts from April 2020 were compared to April 2019 to determine changes in attendance. To evaluate outcomes, we reviewed DME patients with appointments scheduled from April 1 - 30, 2020. Data from the last visit prior to April 1, 2020 was compared to the first follow-up visit between April 1, 2020 to December 1, 2020. Ocular surgery or absence of injections within the 3 months prior to scheduled appointment excluded patients from this study. Central foveal thickness (CFT) was measured from optical coherence tomography images and Snellen visual acuity (VA) measurements were obtained from the medical record. Poor outcome was defined as VA decrease of one or more lines or a CFT increase of 10% or more. Analysis included the eye with the worse VA from each patient. Results : Total visits to the retina injection clinic decreased by 54% from 533 patient visits in April 2019 to 247 visits in April 2020. Of 562 unique patients scheduled for April 2020, 185 patients were on anti-VEGF injection schedules for DME treatment. 51 patients were excluded. Of the remaining 134 patients, the mean age was 64.7 ± 8.8 years. 86% (115/134) were rescheduled, and of these, 26/115 were lost to follow-up until the end of our study period. The remaining 89/115 were seen with an average follow-up interval of 115.2 ± 50.0 days. At follow-up, 37/89 (42%) had worsened vision, 24/89 (27%) had worsened edema, and 54% (48/89) had a poor outcome of either worsened vision or worsened edema. Conclusions : Pandemic related rescheduling of patients with DME delayed follow-up care and treatment. On average, patients were rescheduled to a visit that was 2.4 months later than their usual visit and about half the patients experienced worsening of vision or edema. Additional studies are needed to identify patients at highest risk of vision loss so that those patients can be triaged and evaluated appropriately.

Impacts of COVID-19 on the electric vehicle industry: Evidence from China.

Electric vehicle development is critical to achieve the sustainable goals, while the hit of COVID-19 strikes the market and brings challenges to the whole industry. China, among one of the earliest regions affected by COVID-19 and takes a great part in the global electric vehicle market, is attracting growing attention on its post-pandemic trends in the electric vehicle industry. This paper provides a comprehensive analysis of COVID-19 impacts on China's electric vehicle industry from both the demand side and the supply side. Both challenges and opportunities for China's electric vehicle development are revealed with emerging trend analysis. It is found that the COVID-19 outbreak has reduced electric vehicle sales in the short-term, but may also stimulate future electric vehicle demand especially for large electric cars with better performance. Meanwhile, travel restrictions caused by COVID-19 have interrupted electric vehicle material supplies that relying on imports, accelerating domestic substitute exploitation and inventory improvement for critical parts. Additionally, massive lockdowns for controlling COVID-19 have disrupted productions and operations, which tends to expel small brands out of the competitive market, concentrating China's electric vehicle industry to the leading brands. Finally, the social distancing trend after pandemic is bringing challenges to traditional EV distribution channels with dealers, pushing automakers to develop innovative online selling channels. These impacts are likely to lead to a reformation of China's electric vehicle industry towards a more advanced and reliable future.

[The analysis of clinical characteristics of 34 novel coronavirus pneumonia cases in Ningxia Hui autonomous region].

Objective: To analyze the clinical characteristics of 34 COVID-19 cases and to provide the basis for the prevention and control of the epidemic disease. Methods: Thirty-four COVID-19 patients diagnosed with RT-PCR in the isolation ward of the Fourth People's Hospital of Ningxia Hui autonomous region (infectious diseases hospital) from the January 22 to February 4, 2020 were selected as the research subjects. The clinical data were collected. Excel was used to describe the relationship between clinical classification and age distribution, contact history and date of onset. SPSS 25.0 statistical software was used for analysis. The general information, clinical symptoms, blood test, virus nucleic acid test results, epidemiology, CT imaging, treatment and prognosis were analyzed. Results: There were 5 mild cases (5/34), 24 ordinary cases (24/34), 5 severe cases (5/34). The elderly was more common in severe patients. The main clinical symptoms were fever (27/34)and dry cough(26/34). The peripheral blood showed normal or decreased leukocyte count (33/34), decreased lymphocyte count (12/34). The increase of C-reactive protein (CRP) and D-dimer was related to the severity of the disease. Some patients had mild liver and kidney damage. Six patients were diagnosed through 3 or more times of nucleic acid tests. Sixteen cases had Wuhan related history,13 cases were close contacts, 5 cases had no confirmed route. The clustered infections were found in 6 families. In typical cases, CT showed single or multiple patchy ground glass shadow with thickening of interlobular septum. In severe cases, diffuse lesions of both lungs were found, with ground glass shadow, consolidation shadow and strip shadow coexisting. Thirty-four patients were treated with interferon-α and Lopinavir/Ritonavir with good prognosis. Conclusions: The clinical characteristics of COVID-19 were similar to that of general viral pneumonia but with strong infectivity. Close contact and family aggregation caused disease outbreaks. COVID-19 could not be excluded if two nucleic acid tests were negative and high-resolution CT was helpful for differential diagnosis. Early detection, early isolation, early diagnosis and early treatment are important for good prognosis. The effectiveness of antiviral drugs needs to be further verified.

[Investigation on a cluster epidemic of COVID-19 in a supermarket in Liaocheng, Shandong province].

Objective: To explore clustered epidemic of COVID-19 in Liaocheng city and analyze infection status and chain of transmission of the cases. Methods: A joint investigation team of emergency response for COVID-19 epidemic by CDC professional workers of Liaocheng city and district at two levels on January 30, 2020. According to a indicator case from ZH supermarkets, close contacts and related subjects were tracked and screened on February 1, including ZH supermarket employees, family members having contact history with related cases during January 13-26, supermarket clients during January 16-30 and family members of related cases. an epidemiological investigation was carried on and their swab of nose/throat were collected and were sent to Liaocheng CDC laboratory, real-time fluorescence quantitative RT-PCR was used to detect nucleic acids of SARS-CoV-2. Results: a total of 8 437 people were screened during January 30 to February 9, 2020 (120 employees of supermarket, 93 family members, and 8224 clients of supermarket). The epidemic was caused by ZH cases and brought clustered cases in four families. A total 25 cases of SARS-CoV-2 infection, the total infection rate of subjects was 0.30% (25/8 437) with 22 confirmed cases (0.26%, 22/8 437) and 3 asymptomatic patients (0.04%, 3/8 437), asymptomatic patients accounted for 12.00% (3/25) of all infection cases. The infection rates of supermarket employees, family members of confirmed cases and supermarket clients were 9.17% (11/120), 12.90% (12/93) and 0.02% (2/8 224). Conclusions: This was a cluster epidemic caused by one imported case of COVID-19 in a supermarket of Liaocheng city. Prevention and control of cluster epidemic should be focused on chain of community transmission and family cluster cases. It must also be an attention for transmission risk of asymptomatic patients.

[Analysis of selective endoscopy results during the epidemic of coronavirus disease 2019 (COVID-19)].

Objective: To explore the necessity and safety of selective endoscopy to detect gastrointestinal (GI) malignancy during the outbreak of coronavirus disease 2019 (COVID-19). Methods: A retrospective cohort study was carried out to analyze the clinical data of selective endoscopy performed at the Endoscopic Center, Zhongshan Hospital of Fudan University from February 20 to March 6, 2020. Clinical data included epidemiological questionnaire, chief complaints, endoscopic findings and biopsy pathology results, etc. All medical staff had blood test for IgM/IgG antibodies of COVID-19. Patients and their families were followed up by phone to determine whether they were infected with COVID-19. Meanwhile, the clinical data of selective endoscopy during the same period from February 20 to March 6, 2019 were collected as the control group to compare the overall results of endoscopy examinations during the epidemic and the detection rate of GI malignancy. Results: A total of 911 patients underwent endoscopy in the epidemic period group, and a total of 5746 cases in the control group, which was 6.3 times over the epidemic period group. In the epidemic period group, 544 cases received gastroscopy and 367 cases received colonoscopy, while 3433 cases received gastroscopy and 2313 cases received colonoscopy in the control group, which were both 6.3 times of epidemic period group. Gastroscopy revealed that 39 patients (7.2%) were diagnosed with upper GI malignancies in the epidemic period group and 77 patients (2.2%) in the control group with significant difference (χ(2)=40.243, P<0.001). The detection rate of gastric cancer in these two groups was 3.3% (n=18) and 1.7% (n=59) respectively with significant difference (χ(2)=6.254,P=0.012). The detection rate of esophageal cancer was 3.7% (n=20) and 0.5% (n=18) respectively with significant difference (χ(2)=49.303,P<0.001). Colonoscopy revealed that colorectal cancer was found in 32 cases (8.7%) of the epidemic period group and 88 cases (3.8%) of the control group with significant difference (χ(2)=17.888, P<0.001). During the epidemic period, no infection of medical staff was found through the blood test of IgM/IgG antibodies on COVID-19. No patient and family members were infected with COVID-19 by phone follow-up. Conclusion: Compared with the same period in 2019, the number of selective endoscopy decreases sharply during the epidemic period, while the detection rate of various GI malignant tumors increases significantly, which indicates that patients with high-risk symptoms of GI malignancies should still receive endoscopy as soon as possible. Provided strict adherence to the epidemic prevention standards formulated by the state and professional societies, it is necessary to carry out clinical diagnosis and treatment as soon as possible.

[Analysis on cluster cases of COVID-19 in Tianjin].

Objective: To understand the characteristics of clusters of COVID-19 cases in Tianjin, and provide epidemiological evidence for the prevention and control of COVID-19. Methods: The data of all the COVID-19 cluster cases in Tianjin, reported by 22 February 2020, were collected to analyze the characteristics of different types of the clusters. Results: A total of 115 COVID-19 cases were reported in 33 clusters in Tianjin included 28 family clusters (71 cases), 1 work place cluster (10 cases), 3 transport vehicle clusters (8 cases) and 1 public place cluster (26 cases). Family clusters were caused by the cases from the working place or public place clusters. Numbers of secondary cases of family clusters was between 1 to 7, the median number was 2. The interval from onset to diagnosis for the first case was longer than those of other cases in the familial clusters (Z=-2.406, P=0.016). The median of incubation period of the public place clusters was 2 days. The intervals from onset to diagnosis were significant different among the family, working place and public place clusters (H=8.843, P=0.012), and also significant differences in onset time among the secondary cases (H=16.607, P=0.000). Conclusions: In the surveillance of COVID-19 epidemic, special attention should be paid to places where clustering are prone to occur, and the epidemiological investigation should be carried out timely to confirm the cluster. To prevent the transmission of COVID-19, the close contacts of the patients should be transferred to an assigned observation place on time for single room isolation. The awareness of COVID-19 prevention is low in some rural areas, reflected by many mass gathering activities and delayed medical care seeking after onset. It is necessary to strengthen the health education and take control measures in early period of epidemic.

[Epidemiological characteristics of confirmed COVID-19 cases in Tianjin].

Objective: To investigate the clinical and epidemiological characteristics of 135 confirmed cases of COVID-19 in Tianjin. Methods: The clinical and epidemiological data of 135 cases of COVID-19 in Tianjin were collected, and the data were analyzed with descriptive method. The factors influencing the severity of the illness were analyzed. Results: Among the 135 COVID-19 cases, 72 were males and 63 were females, the age of the cases was (48.62±16.83) years, and the case fatality rate was 2.22%. Local transmission caused 74.81% of the cases. A total of 33 clusters occurred, involving 85.92% of all COVID-19 cases. The median of the incubation period of COVID-19 was 6.50 days, the average generation interval was 5 days, and the household secondary transmission rate was 20.46%. Fever was the main symptom (78.63%), followed by cough (56.48%). Multivariate regression analysis indicated that age (OR=1.038, 95%CI: 1.010-1.167) and the number of chronic underlying diseases (OR=1.709, 95%CI: 1.052-2.777) were the risk factors of severe illness. Conclusions: Fever was the main symptom at the early phase of COVID-19 in Tianjin, and the local cluster cases accounted for high proportion in confirmed COVID-19 cases reported in Tianjin. Severe illness was prone to occur in people with old age and multi underlying diseases. Strict isolation of close contacts and intensive care of high-risk groups are the main measures to reduce the morbidity and case fatality of COVID-19.