Preoperative evaluation and timing of surgery for adult patients after covid-19 infection: Recommendations of peking union medical college hospital (2023).

With the adjustment of China's epidemic prevention and control guidelines regarding coronavirus disease of 2019(COVID-19), the preoperative evaluation and timing of surgery for patients after COVID-19 infection have become the focus of attention for both healthcare workers and patients. Based on the latest study and related clinical experience, Peking Union Medical College Hospital (PUMCH) has therefore compiled this multidisciplinary, evidence-based recommendation for concise, individualized, and practical preoperative evaluation and timing of surgery for patients after COVID-19 infection. The recommendations emphasize patients' COVID-19 infection history, the severity of symptoms, and medical/physiologic recovery status during preoperative evaluation. The determination of appropriate length of time between recovery from COVID-19 and surgery/procedure should take into account of patients' underlying health conditions, the severity of the COVID-19 infection course, and the types of surgery and anesthesia scheduled, to minimize postoperative complications. The recommendations are intended to aid healthcare workers in evaluating these patients, scheduling them for the optimal timing of surgery, and optimizing perioperative management and postoperative recovery.Copyright © 2023, Peking Union Medical College Hospital. All rights reserved.

COVID-19 Vaccine and Booster Shots Compatibility Analyzer using CMOS-based Monochrome Encoding

The continuous increase in COVID-19 positive cases in the Philippines might further weaken the local healthcare system. As such, an efficient system must be implemented to further improve the immunization efforts of the country. In this paper, a contactless digital electronic device is proposed to assess the vaccine and booster brand compatibility. Using Logisim 2.7.1, the logic diagrams were designed and simulated with the help of truth tables and Boolean functions. Moreover, the finalized logic circuit design was converted into its equivalent complementary metal-oxide semiconductor (CMOS) and stick diagrams to help contextualize how the integrated circuits will be designed. Results have shown that the proposed device was able to accept three inputs of the top three COVID-19 vaccine brands (Sinovac, AstraZeneca, and Pfizer) and assess the compatibility of heterologous vaccinations. With the successful results of the circuit, it can be concluded that this low-power device can be used to manufacture a physical prototype for use in booster vaccination sites. © 2022 IEEE.

Indications and Recommendations for Tracheostomy in Trauma Population With COVID-19 Infection: A Review of the Literature.

This review explores the current body of evidence pertaining to tracheostomy placement in COVID-19 seropositive patients and summarizes the research by tracheostomy indications, timing, and procedure. Literature review was performed in accordance with the 2020 PRISMA guidelines and includes 12 papers discussing protocols for adult patients seropositive for COVID-19. The studies demonstrated high mortality rates after tracheostomy, especially in geriatric patients, and suggested a multifactorial determination of whether to perform a tracheostomy. There was inconclusive data regarding wait time between testing seropositive, tracheostomy, and weaning off of ventilation. COVID-19 generally reaches highest infectivity between days 9 and 10; furthermore, high early mortality rates seen in COVID-19 may confound mortality implicated by tracheostomy placement. Due to the aerosol-generating nature of tracheostomy placement, management and maintenance, techniques, equipment, and personnel should be carefully considered and altered for COVID-19 patients. With surgical tracheostomy, literature suggested decreased usage of electrocautery; with percutaneous tracheostomy, single-use bronchoscope should be used. The nonemergent exchange of tracheostomy should be done only after the patient tested negative for COVID-19. Placement of tracheostomy should only be considered in COVID-19 patients who are no longer transmissible, with rigorous attention to safety precautions. Understanding procedures for airway maintenance in a respiratory disease like COVID-19 is imperative, especially due to current shortages in ventilators and PPE. However, because of a lack of available data and its likelihood of change as more data emerges, we lack complete guidelines for tracheostomy placement in COVID-19 seropositive patients, and those existing will likely evolve with the disease.

Imprecision in adverse event reports following immunization against HPV in Japan and COVID-19 in the USA, UK, and Japan-and the effects of vaccine hesitancy and government policy.

INTRODUCTION: Erroneous reports of adverse events following immunization (AEFIs) likely exacerbated the 2013 collapse of Japan's HPV immunization program. A similar phenomenon characterized the first months of COVID-19 immunization programs in the USA, UK, and Japan with high rates of reported anaphylaxis. These reports illustrate the susceptibility of supposedly objective medical judgments to public anxiety. PURPOSE AND METHODS: This study documents inaccuracies in reported AEFIs using three quantitative methods. RESULTS: One of these quantitative methods revealed that false-positive rates for anaphylaxis reports following HPV and later COVID-19 vaccination ranged from 74 to 91 percent. However, unlike HPV vaccinations in Japan, anaphylaxis reports following COVID-19 vaccines fell in Japan, the USA and the UK in the latter months of 2021. Nevertheless, false-positive rates for anaphylaxis reports remained high, suggesting a high degree of imprecision in serious AEFI reports from many countries for many vaccines. Japan's HPV immunization program indicates that media reports, patient hesitancy, healthcare providers' perspectives on vaccine safety, and consistency of government messaging, all influence report number and accuracy. A parallel publication analyzes in depth how such factors affect AEFI reports. CONCLUSION: Confidence in the safety of the COVID-19 vaccines may have been bolstered trough rapid monitoring of AEFI reports and communication of these findings. This may partly explain the different trajectories of serious AEFI following HPV immunizations in Japan and COVID-19 immunizations in the USA, UK, and Japan.

The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study.

BACKGROUND: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The "timing in acute care surgery" (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. METHODS: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4-5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. RESULTS: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. CONCLUSION: The new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a "safe" timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.

Practice Changing Updates in Perioperative Medicine Literature 2022. A Systematic Review.

Perioperative medicine is a rapidly growing multidisciplinary field with significant advances published each year. In this review, we highlight important perioperative publications in 2022. A multi-database literature search from January to December of 2022 was undertaken. Original research articles, systematic reviews, meta-analyses, and guidelines were included. Abstracts, case reports, letters, protocols, pediatric and obstetric articles, and cardiac surgery literature were excluded. Two authors reviewed each reference using the Distiller SR systematic review software (Evidence Partners Inc., Ottawa, Ont, Canada). A modified Delphi technique was used to identify 8 practice-changing articles. We identified another 10 articles for tabular summaries. We highlight why these articles have the potential to change clinical perioperative practice and areas where more information is needed.

Capturing complexity over space and time via deep learning: An application to real-time delay prediction in railways

Predictive analytics is an increasingly popular tool for enhancing decision-making processes but is in many business settings based on rule-based models. These rule-based models reach their limits in complex settings. This study compares the performance of a rule-based system with a customised LSTM encoder-decoder deep learning model for predicting train delays. For this, we use a purposefully built real-world dataset on railway transportation, where trains' interdependence over the network makes delay prediction more difficult. Results show that the deep learning model, which incorporates rich spatiotemporal interdependency information in real-time, outperforms the rule-based system by 18%, with the difference increasing to above 23% with higher complexity. The study also dissects the performance difference across different settings: dense versus rural areas, peak versus off-peak hours, low versus high delay, and before versus during the COVID-19 pandemic. The deep learning model is implemented as a proof of concept for decision support within Belgium's railway infrastructure company Infrabel. © 2023 Elsevier B.V.

A Low-cost Handheld Reconfigurable Impedimetric Readout System for Diagnostics of Viral Infections

This paper presents a portable impedimetric biosensor for detecting infectious diseases such as SARS-CoV-2 Infections. A bio-ready sensing electrode functionalized with SARS-CoV-2 nucleocapsid antibody was employed to quantitatively convert the concentration of nucleocapsid protein (N-protein) into impedance changes. In this paper, we proposed a readout system with a dynamic input range of 200 Ωto 1 MΩmagnitude and 0 to 180°phase. The resolution of this device is 1% and 6.5°for measuring the magnitude and phase, respectively. Herein we demonstrate and discuss the proposed system’s functionality, sensitivity, and selectivity using the clinical swab samples. As per these results, this readout system is suitable for the detection of N-protein ranging up to 10,000 pg/mL with a resolution of 56 fg/mL. The proposed impedimetric sensing system can be adopted for the detection of infectious diseases in the future. This low-cost (<$80) device using off-the-shelf is a unique candidate for batch production purposes during urgent pandemic situations. IEEE

Timing of intubation and ICU mortality in COVID-19 patients: a retrospective analysis of 4198 critically ill patients during the first and second waves.

BACKGROUND: The optimal time to intubate patients with SARS-CoV-2 pneumonia has not been adequately determined. While the use of non-invasive respiratory support before invasive mechanical ventilation might cause patient-self-induced lung injury and worsen the prognosis, non-invasive ventilation (NIV) is frequently used to avoid intubation of patients with acute respiratory failure (ARF). We hypothesized that delayed intubation is associated with a high risk of mortality in COVID-19 patients. METHODS: This is a secondary analysis of prospectively collected data from adult patients with ARF due to COVID-19 admitted to 73 intensive care units (ICUs) between February 2020 and March 2021. Intubation was classified according to the timing of intubation. To assess the relationship between early versus late intubation and mortality, we excluded patients with ICU length of stay (LOS) < 7 days to avoid the immortal time bias and we did a propensity score and a cox regression analysis. RESULTS: We included 4,198 patients [median age, 63 (54‒71) years; 71% male; median SOFA (Sequential Organ Failure Assessment) score, 4 (3‒7); median APACHE (Acute Physiology and Chronic Health Evaluation) score, 13 (10‒18)], and median PaO2/FiO2 (arterial oxygen pressure/ inspired oxygen fraction), 131 (100‒190)]; intubation was considered very early in 2024 (48%) patients, early in 928 (22%), and late in 441 (10%). ICU mortality was 30% and median ICU stay was 14 (7‒28) days. Mortality was higher in the "late group" than in the "early group" (37 vs. 32%, p < 0.05). The implementation of an early intubation approach was found to be an independent protective risk factor for mortality (HR 0.6; 95%CI 0.5‒0.7). CONCLUSIONS: Early intubation within the first 24 h of ICU admission in patients with COVID-19 pneumonia was found to be an independent protective risk factor of mortality. TRIAL REGISTRATION: The study was registered at Clinical-Trials.gov (NCT04948242) (01/07/2021).

The association among circadian rhythm, circadian genes and chrononutrition, its effect on obesity: a review of current evidence

Circadian rhythms, also known as circadian clocks, are cyclic endogenous biological patterns of an approximately 24-hour cycle which regulate the timing of physiology, metabolism, and behavior. Recent research in the field of circadian science has suggested that the timing of food intake may also play a role in markers of health, in addition to food choice and food quantity. There is emerging evidence suggesting that the timing of dietary intake, so-called chrono-nutrition, may be influenced by an individual<apos;>s chronotype. For example, the evening type has been linked to unhealthy diet, which could indicate a higher possibility of obesity. On the other hand, the continuum of chronotype diversity is largely mediated by genes. The presence of single nucleotide polymorphisms (SNP) of clock genes have been associated with obesity, chronotype, metabolic disturbances, and dietary habits (e.g., breakfast skipping, meal timing, energy/macronutrient intake). In this review, we outline the current knowledge of the interactions between clock genes, chronotype, dietary intake and chrono-nutrition.Additionally, it is emphasized that the COVID-19 pandemichas had a significant impact on the circadian system, dietary choices and meal timing. For this reason, the current review aims to focus on how chronotype/sleep and chrono-nutrition are affected during the COVID-19 pandemic.Copyright © 2022 Informa UK Limited, trading as Taylor & Francis Group.

Following the Science? Examining the Issuance of Stay-At-Home Orders Related to COVID-19 by U.S. Governors

Informed by the public health policymaking literature, this study's objective is to identify scientific, political, social, economic, and external factors related to U.S. governors' decisions to issue stay-at-home orders (SAHOs) in response to the first wave of the COVID-19 pandemic. Public health experts advocate for social distancing to slow the spread of infectious diseases, but government mandates to social distance can impose substantial social and economic costs. This study uses event history analysis to investigate the issuance of COVID-19-related gubernatorial SAHOs during a 41-day period in the 50 U.S. states. The findings indicate that scientific, political, and economic factors were associated with the issuance of SAHOs, but that external considerations played the largest role, particularly those related to the timing of other governors' decisions. This study offers evidence about how some U.S. political leaders balance public health concerns against other considerations and, more broadly, how state governments address crisis-level issues.

A parallel approach to the fractional time delay model for predicting the spread of COVID-19

Due to the importance of forecast accuracy for diseases such as COVID-19, the existence of a mathematical model is particularly important. In this research, first, a model to describe the spread of the COVID-19 pandemic is examined. This model is based on a fractional ordinary differential equation. Then the predictor-corrector numerical method is presented to solve this model. Due to the computational challenge of numerically solving fractional models, a task-parallel approach with coarse granularity is presented to solve this model on shared memory systems. The initial data for testing the proposed approach is the data reported on December 31, 2019 by the Wuhan Municipal Commission of the outbreak of the COVID-19 pandemic in the city of Wuhan, China. The numerical results obtained from the proposed parallel approach show that the speedup of the parallel method compared to the sequential method reaches 2.76 in the prediction of 1000 days. © 2022 IEEE.

Dombi Bonferroni Mean Operators under Bipolar Complex Fuzzy Environment and Their Applications in Internet World

Internet is almost a necessary facility and tool to solve daily life problems in every field life. Whether at the individual level or national and international level sale purchase of any kind of object has always been of much importance, especially after Corona Pandemic, when online business is at its peak. Because of the enhancement of online sales and purchases, various businessmen are looking for suitable internet websites for their businesses, and the selection of the most suitable internet websites is one of the multi-attribute decision-making (MADM) dilemmas. Thus, in this script, we take benefits of three various concepts that are Bonferroni mean (BM) operator which is a significant technique to catch the interrelatedness among any number of inputs, Dombi operations which are based on Dombi t-norm and t-conorm and the ability to create an aggregation procedure more flexible because of the parameter, bipolar complex fuzzy set (BCFS) which is an outstanding model for tackling two-dimensional information with negative aspect and interpret bipolar complex fuzzy (BCF) Dombi Bonferroni mean (BCFDBM), BCF weighted Dombi Bonferroni mean (BCFWDBM), BCF Dombi geometric Bonferroni mean (BCFDGBM), and BCF weighted Dombi geometric Bonferroni mean (BCFWDGBM) operators. After ward, in this script, for tackling MADM dilemmas in the setting of BCFS, we investigate a MADM procedure based on the investigated operators and solve a MADM dilemma (selection of a suitable internet website for businessmen). Further, to display the superiority and efficiency of our work, we compare our approach and operators with a few current approaches and operators. Author

Parenting Without Predictability: Precarious Schedules, Parental Strain, and Work-Life Conflict

Against the backdrop of dramatic changes in work and family life, this article draws on survey data from 2,971 mothers working in the service sector to examine how unpredictable schedules are associated with three dimensions of parenting: difficulty arranging childcare, work-life conflict, and parenting stress. Results demonstrate that on-call shifts, shift timing changes, work hour volatility, and short advance notice of work schedules are positively associated with difficulty arranging childcare and work-life conflict. Mothers working these schedules are more likely to miss work. We consider how family structure and race moderate the relationship between schedule instability and these dimensions of parenting. Unstable work schedules, we argue, have important consequences for mothers working in the service industry.

COVID-19 Impact and Policy Response: A General Equilibrium Approach for Egypt

The economic impacts of COVID-19 were negative across nations but with different degrees depending on the timing, degree of containment measures and the extent of dependency on the world economy. Moreover, the policy response has been heterogeneous across different countries, but mainly addressing urgent and short-term problems without addressing the structural problems that led to the vulnerability of these countries in crisis times. Thus, the objective of this paper is threefold. First, it distinguishes between the supply and demand effects of COVID-19. Second, we examine the key differences between the short and long terms effects of the policies that were adopted. Finally, we modify the model to include the informal labor that was highly affected by the pandemic, and we relax the assumption of perfect competition and replicate the simulations under an imperfect competitive framework in order to see how reforms pertaining to competition policies can alter the adopted policies. To do so, we use a dynamic CGE model calibrated on the Egyptian Social Accounting Matrix of 2014/2015. Our findings show how the Egyptian economy has been relatively vulnerable to external shocks that affect its sources of foreign currency. Yet, most of the effects are temporary and vanish in the long run. Imperfect competition in commodity markets would increase the adverse effects of the pandemic and undermine the effectiveness of public policies.

Is There a First Mover Advantage in Lobbying? A Comparative Analysis of How the Timing of Mobilization Affects the Influence of Interest Groups in 10 Polities

The first mover advantage is a critical factor for the productivity of firms that enter new markets. Surprisingly, however, the importance of timing is rarely explored in studies of interest groups and their influence on new policy agendas. In this article, we therefore develop a theory of first mover advantages in lobbying. We argue that especially more resourceful and more highly affected organizations should be able to benefit from early lobbying. Using granular survey data on the timing of lobby efforts by interest groups on Covid-19 related policies in 10 European democracies, we test this novel theory. Our results show that timing is an important predictor of lobbying influence, but that interest groups which are hardly affected by a new policy cannot benefit from early mover advantages in the same way as affected organizations. Moreover, we give evidence for differences in first mover advantages depending on organizational staff resources.

Accountability, governance, and institutional change in intergovernmental relations: A theoretical framework

This article develops an explanatory framework of institutional change in intergovernmental relations. Using new institutionalism, we focus on a main explanatory factor—the players' perceptions of their own accountability and that of others. Integrating the concepts of multiple accountability and felt accountability, we develop the concept of an accountability gap, meaning differences between the perceptions of players in the central government about their responsibility to provide local services and the perceptions of players at the local level about their responsibilities. Our claim is that perceptual gaps concerning accountability in a two-tiered or multi-tiered system may influence their interests, strategies, and behavior and hence determine the timing and pace of specific institutional changes. We illustrate the theoretical framework by examining how Spain managed the COVID-19 pandemic. Related Articles: Aguado, N. Alexander. 2018. "Mayor-Council Form of Government and Policy Responses in Times of Economic Travail.” Politics & Policy 46(5): 714–30. https://doi.org/10.1111/polp.12273. French, Edward P., and Doug Goodman. 2011. "Local Government Human Resource Management Past, Present, and Future: Revisiting Hays and Kearney's Anticipated Changes a Decade Later.” Politics & Policy 39(5): 761–85. https://doi.org/10.1111/j.1747-1346.2011.00312.x. Kwon, Sung-Wook, and Sylvia Gonzalez-Gorman. 2019. "Influence of Local Political Institutions on Policy Punctuation in Three Policy Areas.” Politics & Policy 47(2): 300–25. https://doi.org/10.1111/polp.12295. © 2023 The Authors. Politics & Policy published by Wiley Periodicals LLC on behalf of Policy Studies Organization.

Monitoring of the Social Distance between Passengers in Real-time through Video Analytics and Deep Learning in Railway Stations for Developing the Highest Efficiency

Near the end of December 2019, the globe was hit with a major crisis, which is nothing but the coronavirus-based pandemic. The authorities at the train station should also keep in mind the need to limit the spread of the covid virus in the event of a global pandemic. When it comes to controlling the COVID-19 epidemic, public transportation facilities like train stations play a pivotal role because of the proximity of so many people who may be exposed to the virus. Using common place CCTV cameras and deep learning with simple online and real-time (DeepSORT) methods, this study develops social distance monitoring using a YOLOv4 identification of a Surveillance Object Model. Based on experiments conducted with a minicomputer equipped with an Intel 11th Gen Intel(R) Core(TM) i3-1115G4 at 3.00GHz, 2995 Mhz, two Core(s), four Logical processor, four gigabytes of random-access memory (RAM), this paper makes use of CCTV surveillance, which was put into practice at the Guindy railway station, Chennai, Tamilnadu in India in order to detect the violation of social distancing. © 2022 IEEE.

Flexible Printed Circuitry on Fabric for Wearable Electronics Applications

Health awareness has increased worldwide since the COVID 2019 pandemic, creating a strong demand for wearable electronics. Wearable sensors for monitoring a patient's health are prevalent to reduce medical costs and decrease in-person clinic visits. Integrating electronics into clothes is challenging because most fabrics are porous and incompatible with the existing manufacturing methods, such as screen printing. The indirect printing method was employed to fabricate electrical circuitry on a textile substrate by printing it on a heat transfer polymer (HTP) and attaching it to the target cloths by stitching or glueing. Such a fabrication process has the potential to lead the way in developing new intelligent clothes. However, the durability of the printed circuitry in this manufacturing process on a cloth is still unknown and requires investigation. Therefore, this paper's objective is to study the durability of printed circuitries on fabric by applying constant cyclic loading. The test vehicle is a printed conductive silver interdigitating circuitry on fabric. Another test vehicle on a polyethylene terephthalate (PET) substrate was fabricated for a benchmark. A constant cyclic loading at 1Hz at a 50% duty cycle was applied to the test vehicles 100,000 times. The printed circuitry was monitored by logging the voltage in an electrical voltage divider configuration while the sensor was pressed and released. The result indicates that the fabric test vehicle can still function after the 100,000 cycles of the cyclic loading test and is comparable to that on the PET substrate. The recorded voltage-to-force values of the printed sensor on the fabric drifted upward and downward up to 3% over the loading cycles. The optical microscope observation on the cyclic loading samples showed signs of shear stresses on the printed silver and electrically conductive films, which could cause the tips of the silver interdigitating fingers to shatter. The study indicates that the properly manufactured circuits on fabric can be reliable and utilized for wearable applications. © 2022 IEEE.

Stability and Bifurcation Analysis of the Caputo Fractional-Order Asymptomatic COVID-19 Model with Multiple Time-Delays

Throughout the last few decades, fractional-order models have been used in many fields of science and engineering, applied mathematics, and biotechnology. Fractional-order differential equations are beneficial for incorporating memory and hereditary properties into systems. Our paper proposes an asymptomatic COVID-19 model with three delay terms τ1,τ2,τ3 and fractional-order α. Multiple constant time delays are included in the model to account for the latency of infection in a vector. We study the necessary and sufficient criteria for stability of steady states and Hopf bifurcations based on the three constant time-delays, τ1, τ2, and τ3. Hopf bifurcation occurs in the addressed model at the estimated bifurcation points τ10, τ20, τ30, and τ10*. The numerical simulations fit to real observations proving the effectiveness of the theoretical results. Fractional-order and time-delays successfully enhance the dynamics and strengthen the stability condition of the asymptomatic COVID-19 model. © 2023 World Scientific Publishing Company.