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Since the emergence of the Coronavirus disease outbreak, the world has witnessed great changes that have impacted humanity. A study of the pattern of the pandemic would be of great importance to understand the trending behavior for the spreading of the disease within any country. Visualization of the outbreak progression - through accumulated records in the datasets - using statistical tools showed that the initial fast increase rate of the affected cases in the original province in China was followed by a stability period till the end of the reporting date. Hong Kong - which was next to Hubei province in the cases - showed a different surge of slow growth curve with distinct major wave levels. The remaining territories showed a much smaller magnitude of morbidities. However, investigating the similarity levels for the daily kinetics of cases showed a clustering tendency between different political regions suggesting a significant correlation. The technique would be useful for public health authorities work.
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The international multicentre study HBSC (Health Behaviour in Schoolaged Children) conducted since 1983 in collaboration with the World Health Organization, has been adopted in our country as the national adolescent health surveillance system since 2017. The main aim is to describe and understand health-related behaviour in 11-, 13- and 15-year-olds in approximately 50 countries between Europe and North America. The study investigated different aspects, such as nutrition, risk behaviors, school and family life and social media use. In addition, the latest survey involved 17-year-old adolescents and included a section on the impact of the COVID-19 pandemic.
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In preparation for the Fourth Industrial Revolution (IR 4.0) in Malaysia, the government envisions a path to environmental sustainability and an improvement in air quality. Air quality measurements were initiated in different backgrounds including urban, suburban, industrial and rural to detect any significant changes in air quality parameters. Due to the dynamic nature of the weather, geographical location and anthropogenic sources, many uncertainties must be considered when dealing with air pollution data. In recent years, the Bayesian approach to fitting statistical models has gained more popularity due to its alternative modelling strategy that accounted for uncertainties for all air quality parameters. Therefore, this study aims to evaluate the performance of Bayesian Model Averaging (BMA) in predicting the next-day PM10 concentration in Peninsular Malaysia. A case study utilized seventeen years' worth of air quality monitoring data from nine (9) monitoring stations located in Peninsular Malaysia, using eight air quality parameters, i.e., PM10, NO2, SO2, CO, O3, temperature, relative humidity and wind speed. The performances of the next-day PM10 prediction were calculated using five models' performance evaluators, namely Coefficient of Determination (R2), Index of Agreement (IA), Kling-Gupta efficiency (KGE), Mean Absolute Error (MAE), Root Mean Squared Error (RMSE) and Mean Absolute Percentage Error (MAPE). The BMA models indicate that relative humidity, wind speed and PM10 contributed the most to the prediction model for the majority of stations with (R2 = 0.752 at Pasir Gudang monitoring station), (R2 = 0.749 at Larkin monitoring station), (R2 = 0.703 at Kota Bharu monitoring station), (R2 = 0.696 at Kangar monitoring station) and (R2 = 0.692 at Jerantut monitoring station), respectively. Furthermore, the BMA models demonstrated a good prediction model performance, with IA ranging from 0.84 to 0.91, R2 ranging from 0.64 to 0.75 and KGE ranging from 0.61 to 0.74 for all monitoring stations. According to the results of the investigation, BMA should be utilised in research and forecasting operations pertaining to environmental issues such as air pollution. From this study, BMA is recommended as one of the prediction tools for forecasting air pollution concentration, especially particulate matter level.
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More than 220 countries and territories are globally affected by the recent pandemic COVID-19 which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is possibility of third wave of this pandemic as per epidemiological and public health experts. Besides that post-COVID-19 complications are alarming matter to look upon. Post-COVID-19 complications include several symptoms like as persistent fever;cough;fatigue;headache;attention disorder;dyspnea;anosmia;ageusia;chest pain discomfort;various respiratory illness;acute respiratory distress syndrome (ARDS) etc., and here the things to worry about is the development of pulmonary fibrosis after COVID-19. In some COVID-19 patients, hyper-inflammation in the form of 'cytokine storm' along with dysregulated immune response, alveolar epithelial tissue injury and wound repair collectively cause this secondary pulmonary fibrosis. Therefore, using anti-fibrotic agents e.g. pirfenidone, nintedanib and other natural compounds could be meaningful in these circumstances although their efficacy in treating COVID-19 is subject to more detailed laboratory research works. In this review article, we have discussed the progression of pulmonary fibrosis development which is triggered by COVID-19;probable solutions with anti-fibrotic agents including anti-fibrotic drugs, some well-known natural compounds, combined anti-fibrotic therapies;and the current challenges of this field.
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Objective: To find out the existing problems and provide reference for further improving the quality of report information by analyzing the report cards of COVID-19 and the positive report cards of primary screening reported in Ningxia. Methods All COVID-19 case cards from 2020 to 2021 and initial screening positive cards were derived from the Chinese Information System for Disease Control and Prevention according to final review date. The timeliness of case reporting, timeliness of case review, completeness and accuracy of the case cards were analyzed. Results In Ningxia, the first case of COVID-19 was reported on January 20, 2020, and as of December 31, 2021, 122 confirmed cases and 4 symptomatic infected cases were reported. In 2021, the timely reporting rate of COVID-19 was 98.00%, which increased by 8.24% compared with 2020 (90.54%). Compared with 2020, the average time limit for diagnosis to reporting of COVID-19 in 2021 was shortened by 83.12%;in 2021, the timely review rate of COVID-19 was 100.00%, which increased by 13.84% compared with 2020 (87.84%). Compared with 2020, the time from reporting to final review was shortened by 98.91%. In 2021, the timely rate of positive reports in COVID-19 in Ningxia was 90.00%, among which the timely rate of reports by county (district) nucleic acid detection institutions was the highest (92.31%), followed by municipal (91.67%) and autonomous region (81.82%). Conclusions At the beginning of the epidemic in 2020, the timeliness of COVID-19 in Ningxia was poor, and through the implementation of measures such as technical training, supervision and inspection to continuously optimize the staffing of medical institutions and disease control institutions, the timeliness of reporting COVID-19 in Ningxia in 2021 was substantially improved, but there were still some weak links. In the future work, technical guidance and training should be carried out for weak links, and efforts should be made to improve the quality of reports.
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eHealth or digital health innovations expanded tremendously during the COVID-19 pandemic. Innovation and digitalization offer creative solutions to build up a healthy society. The eHealth technologies are quickly taken up by Southeast Asia countries and continue to flourish to alleviate the burden of healthcare challenges. This study is the first review exploring and analyzing the whole literature of eHealth, specifically in the Southeast Asia region. The objective of this study is to document the size, growth trajectory, and geographical distribution of eHealth in Southeast Asia research, identify high-impact authors and documents, explore the intellectual knowledge structure, and analyze the topical trends of the field. The bibliometric analysis was used to analyze a data set of 1405 Scopus-indexed documents between 1976 and 2021. Descriptive analysis, citation, co-citation, and keyword co-occurrence analyses were conducted to gain insights into eHealth in the Southeast Asia knowledge base. The growth rate of literature has rocketed up since 2018, reflecting the significant increase in demand for eHealth in Southeast Asia. Among the eleven Southeast Asian countries, Indonesia, Malaysia, Singapore, and Thailand were the top four countries where the most eHealth-related research was conducted. The intellectual structure of eHealth in Southeast Asia literature comprises four schools of thought (i.e., four groups of similar theoretical perspectives and research interests): (1) analysis and adoption of hospital information system/eHealth records, (2) user intention and acceptance of information technology, (3) technology for healthcare and disease management, and (4) mobile health technology (m-Health). Mobile applications, social networks, the COVID-19 pandemic, patient referral, follow-up, self-care, quality of life, psychology, diabetes mellitus, and hypertension are the recent emerging research themes in the field of study. The eHealth development should consider long-term sustainable management along with the rapid evolution of the field. Additionally, eHealth systems should be holistic and pay attention to technology adoption, data security, and ethical issues involved in medical practices. This bibliometric review delivers reference points for scholars interested in Southeast Asia eHealth, reveals the emerging intellectual structure of this interdisciplinary field, and provides guidance to future research on this domain. © 2023 by the authors.
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Objective: To analyze the epidemiological characteristics of a local cluster of corona virus disease 2019 (COVID-19) pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron BA.2, and thus provide scientific evidence for the formulation of scientific prevention and control measures. Method: Descriptive epidemiological methods were used to analyze the causes, transmission, vaccination effects and prevention measures of 12 local clustered outbreaks in Haizhu district in March and April 2022 by retrospective investigation. Results: A total of 12 infected patients were reported, all of which were confirmed infected with SARS-CoV-2 Omicron BA.2. Clinical manifestations: 10 cases had fever (83.33%), 7 cases had sore throat (58.33%), 7 cases had cough (58.33%), 5 cases had fatigue (41.67%), and 4 cases had headache or dizziness (33.33%), 2 cases had gastrointestinal symptoms (16.67%), and 1 case had muscle soreness (8.33%). The clinical classification is as follows: 10 cases of mild disease (83.33%), 2 cases of common type (16.67%), no severe disease and no death. The earliest infection time was March 27, and the last case was April 15. The peak incidence was concentrated on April 8 and April 10, with a total of 5 cases (41.67%). The shortest incubation period was 2 days and the longest was 14 days, with an average of 6.55 days. The geographical distribution indicated that 7 cases from Yangyang Clothing Company (58.33%), 3 cases from Guangzhou No. 3 Middle School (25.00%), and 2 cases of family clusters (16.67%). The sex ratio of all patients was 1:3. The youngest age was 18 years old and the oldest was 59 years old. The 12 cases were young adults;of which, 9 cases were 21- < 60 years old (accounting for 75.00%), and 3 cases were 18- < 21 years old (25.00%). Occupational distribution;employees were accounting for 58.33%, followed by unemployed accounting for 25.00%, and students accounting for 16.67%. A 1:3+ matched case-control analysis in 58 high-risk close contacts was conducted, and found that infection and vaccination were not statistically correlated (X2 = 0.861, P > 0.05). Similarly, by conducting a 1:1+ matched case-control analysis, we failed to observed a statistically significantly in the effect of sex on infection (X2 = 0.325, P > 0.05). Conclusions: The outbreak was caused by SARS-CoV-2 Omicron BA.2;the source of infection was still unknown, and there was hidden transmission. Therefore, strengthening personal protection and giving full play to the role of medical units and pharmacies as sentinel points and industry monitoring should be necessary for the normalization of COVID-19 pneumonia prevention and control.
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PurposeCOVID-19 highlighted the potential value of improving knowledge sharing (KS) processes among hospital estates and facilities management (HEFM) departments. Organisational trust (OT) is a recognised predictor of KS interactions, but the interplay of impersonal and interpersonal OT components is yet to be investigated fully. In response to recent calls, this study aims to explore the effect of organisational features on personal trust and OT components required for KS episodes, in the context of the English National Health Service (NHS).Design/methodology/approachA qualitative, exploratory grounded theory approach was selected, using primary data from 22 semi-structured interviews and secondary data from grey literature. A model of trust for KS among employees from geographically distributed units with pooled interdependence was synthesised from a review of the literature and used to connect the organisational features to different trust mechanisms.FindingsThis study identifies four organisational features with a compound barrier-effect on impersonal-based OT, interpersonal-based OT and personal trust for KS interactions: lack of professional development, inappropriate reward and incentive systems, reorganisations/organisational change and benchmarking.Research limitations/implicationsThis study sought to generate theory about the interplay of organisational barriers and trust components required for KS, not to describe HEFM KS across the entire NHS. Future studies with more comprehensive data collections can build on this exploratory study by quantitatively testing the compound barrier effect of the organisational features.Practical implicationsPractitioners can benefit from the insights into the barriers inhibiting trust mechanisms required for effective KS processes. These can inform policymakers in English and potentially other health-care systems in designing enhanced collaborative arrangements, which are required as future crises, e.g. pandemics and climate change hazards, will require increasingly complex solutions.Originality/valueThis study addresses the interplay between personal trust, impersonal OT and interpersonal OT for KS by identifying the compound barrier effects of underlying organisational barriers common to personal trust and OT.
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Objective: To summarize and analyze the epidemiological and clinical characteristics of COVID-19 Omicron variant cases in makeshift hospital, and the influence of age, sex and vaccination status on the disease duration, so as to provide reference for the prevention and control of the COVID-19 epidemic. Methods: The epidemiological and clinical characteristics of COVID-19 cases admitted to makeshift hospital of National Convention and Exhibition Center (Shanghai) from April 9 to May 31, 2022 were retrospectively described and analyzed, and further cohort analysis was conducted to determine the influence of age, sex and vaccination status on the disease duration of COVID-19 cases in the author's branch hospital. Results: Among the 174 466 COVID-19 cases in makeshift hospital, most of them were male, accounting for 59.38%. The infected cases were mainly young and middle-aged people aged 18-59 years old, accounting for 83.50%, followed by 12.30% of the elderly group over 60 years old;the average hospital stay was 7.40 days;the proportion of patients with fever was less than 27.79%;15.37% (26 817/174 466) of the patients complicated with underlying diseases, and the top three were hypertension, diabetes and coronary heart disease. The proportion of people who received COVID-19 vaccine accounted for 79.56% (13 799/17 956), of which the highest proportion of three doses was 44.09%. The disease duration of 17 956 COVID-19 cases in the author's branch of makeshift hospital was 10.18 (7.34, 13.05) days. The disease duration in the elderly group was the longest with 11.34 (8.35, 14.37) days, followed by 11.17 (9.07, 14.33) days in the preschool group, 10.37 (8.14, 13.34) days in the middle-aged group, 10.07 (7.37, 12.37) days in the school-age group, and 9.34 (7.05, 12.16) days in the young group. There was significant difference in the overall distribution of disease duration among the five groups (H=550.479 P < 0.01). The disease duration in each age group basically showed a V-shaped distribution. The disease duration was 10.27 (7.34, 12.57) days in males and 10.10 (7.25, 13.09) days in females, and there was no significant difference (Z=-1.505 P > 0.05). The disease duration of vaccinated patients was 10.24 (7.35, 13.05) days, and that of unvaccinated patients was 9.47 (7.09, 12.47) days. There was significant difference between the two groups (Z=-4.338 P < 0.01). Conclusions: COVID-19 Omicron variant cases have a high proportion of males, mainly young and middle-aged, and the proportion of fever patients is less than 30%. The disease duration is significantly lower than that of the original strain in Wuhan, and shows "V" distribution with each age group. Sex had no effect on the disease duration. COVID-19 vaccination did not have a clinical effect on the disease duration.
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Objective: To understand the epidemiological and etiological characteristics of influenza in Mianyang City from 2019 to 2021, so as to provide a basis for the prevention and control of influenza. Methods: Influenza surveillance data in Mianyang City from 2019 to 2021 were collected and analyzed statistically. Results: A total of 55 970 cases of influenza were reported in Mianyang City from 2019 to 2021, with an average annual incidence of 388.08/100 000. A total of 103 723 cases of influenza-like illness cases (ILI) were reported, with an average annual ILI% of 3.58%. The incidence, ILI%, and positive detection rates of influenza were all far higher than those in the corresponding period in 2019. The classification of the population is mainly composed of students under the age of 15. The top three reported cases were Fucheng District (20 118, 35.94%), Youxian District (6 394, 11.42%) and Jiangyou District (5 800, 10.36%). 10 126 samples of ILI were received and detected, with a positive rate of 19.53%, the positive rate of ILI samples was mainly students under 15 years old. The dominant strains of influenza viruses showed an alternating trend over the years, and A (H3) was the predominant type in 2019. Except for 2 A (H9) strains detected in 2021, the rest were all BV strains. Due to the impact of COVID-19 in 2020, the positive detection rate was low throughout the year. 43 outbreaks of ILI were reported, which were mainly occurred in winter, and most of them were in primary schools. Conclusion: From 2019 to 2021, the characteristics of cases, ILI, pathogen surveillance and outbreak events of influenza in Mianyang City are basically the same, with students under 15 years of age and schools remaining the key population and sites of concern. the importance of non-pharmaceutical interventions for influenza prevention and control is further evidenced by the low incidence of influenza during the COVID-19 pandemic.
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In light of global climate change and the biodiversity crisis, making cities more resilient through an adjusted design of urban green and blue spaces is crucial. Nature-based solutions help address these challenges while providing opportunities for nature experiences, and providing cultural ecosystem services that support public health. The COVID-19 pandemic and its associated stressors highlighted the interrelated socio-ecological services provided by nature-based solutions like urban green and blue spaces.This pan-European study therefore aimed to enhance the socio-ecological understanding of green and blue spaces to support their design and management. Using an online survey, green and blue space preferences, usage, and pandemic-related changes in greenspace visit and outdoor recreation frequencies were examined.Greenspace visit and outdoor recreation frequencies were associated with respondents' (N = 584 from 15 countries) geographical location, dominant type of neighbourhood greenspace and greenspace availability during the pandemic, but not greenspace perceptions or sociodemographic background.Greenspace visit and outdoor recreation frequencies were generally high;however, Southern Europeans reported lower greenspace visit and outdoor recreation frequencies both before and during the pandemic than Northern Europeans. Many Southern Europeans also reported having few neighbourhood greenspaces and low greenspace availability during the pandemic.The most common outdoor recreational activity among respondents before the pandemic was walking or running with the most frequently stated purpose of time spent outdoors being restorative in nature (i.e. relaxing or calming down). Most Europeans had positive perceptions of green and blue spaces with preferences for structurally diverse and natural or unmanaged green elements.This highlights the importance of accessible green and blue spaces both in everyday life and during times of crisis. Stakeholders, their preferences, and regional and cultural differences should be included in the co-design of urban green and blue spaces to maximize their potential for both people and nature.Read the free Plain Language Summary for this article on the Journal blog.
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Viruses are one of the main reasons that cause healthy cells to proliferate and become cancerous. Several viruses have been identified as causative factors for various forms of cancer. Tumor occurrence can be caused by viral oncoprotein activity, persistent infection or inflammation. The molecular process is still complicated to be understood. In recent decades, Homo sapiens cell microRNA (hsa-miRNA) has been discovered by small non-coding RNAs that affect post-transcriptional gene expression. hsa-miRNA is a key control factor for several key biological processes and has a much greater impact on the target gene group. even though they occupy a small part of the genome, they play a great role in the development of cancer. Several viruses produce this tiny RNA, which can regulate their gene expression or affect the host's gene expression. A new hypothesis is that Epstein-Barr virus (EBV) is the first cancer causing virus that is found to produce microRNAs (v-miRNAs). In addition, evidence shows that miRNA encoded by EBV contributes to the occurrence and progression of EBV-related malignancies. Generally, these compounds reduce messenger RNA (mRNA) instability, such as genes that regulate tumorigenesis mechanisms like inflammation, cell cycle control, stress response, differentiation, apoptosis, invasion, and immune pathways. Therefore, EBV-miRNAs are important in the complex interaction between host, virus and EBV tumorigenesis. In terms of malignant tumors, the combinatorial process behind EBV-miRNA still needs further study. In this article, we will introduce EBV-miRNA, including the cellular processes affected by the virus, and their ability to promote cancer.
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Exploring the temporal and spatial clustering characteristics of the new type of corona virus pneumonia(corona virus disease 2019, COVID-19) in Hubei Province and the socio-economic influencing factors have essential reference value for epidemic prevention and control. This paper conducted a spatiotemporal cluster analysis of the COVID-19 epidemic data in Hubei Province. According to the clustering results, different epidemic development stages were divided. Spearman correlation analysis was used to analyze the economic and social factors affecting the epidemic development in Hubei Province (except Wuhan City). The results of spatiotemporal cluster analysis showed that the first level spatiotemporal cluster area was Wuhan City from January 31 to February 20, 2020, and the relative risk was 29.08. The second level spatiotemporal cluster areas were Xiaogan, Suizhou, Xiantao, Jingzhou, Jingmen, Yichang, Tianmen, and Qianjiang cities from January 31 to February 6, 2020, and the average relative risk was 1.60. Relative risk(RR) can quantitatively reflect the degree of epidemic risk in a region, help classify risk levels, allocate resources rationally, and formulate epidemic prevention measures. Exploring the socio-economic factors affecting the spread of the epidemic in stages has a great significance to studying the spread of the epidemic. Population density, gross domestic product(GDP) per capita, the proportion of Wuhan's immigrant population, and the intensity of travel within the city have an important impact on the spread of the epidemic. Per capita GDP is the main factor affecting the incidence rate of the epidemic. During the rapid development period, the proportion of the immigrant population and the intensity of travel in Wuhan are important indicators. The "primary transmission" of close contact between the incoming population and the local population in Wuhan plays a major role in the spread of the epidemic. The population density and the proportion of the immigrant population in Wuhan during the outbreak period are the important influencing factors of the epidemic. The community family gathering transmission is the main transmission mode of the epidemic at this stage. In the process of epidemic prevention and control, targeted measures should be implemented according to the differences of epidemic transmission modes in different periods, such as strengthening the publicity of epidemic prevention and control in the early stage of the epidemic, improving personal awareness of epidemic prevention, paying attention to the prevention and control of the imported population, and controlling population flow. In the middle and late stages of the epidemic, we should focus on preventing and controlling local transmission, strengthening the prevention and control of community and gathering activities, maintaining social distance in public places, and effectively preventing the rebound of the epidemic.
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The national and global restrictions in response to the COVID-19 pandemic led to a sudden, albeit temporary, emission reduction of many greenhouse gases (GHGs) and anthropogenic aerosols, whose near-term climate impact were previously found to be negligible when focusing on global- and/or annual-mean scales. Our study aims to investigate the monthly scale coupled climate-and-circulation response to regional, COVID-19-related aerosol emission reductions, using the output from 10 Earth system models participating in the Covid model intercomparison project (CovidMIP). We focus on January–February and March–May 2020, which represent the seasons of largest emission changes in sulfate (SO2) and black carbon (BC). During January–February (JF), a marked decrease in aerosol emissions over eastern China, the main emission region, resulted in a lower aerosol burden, leading to an increase in surface downwelling radiation and ensuing surface warming. Regional sea-level pressure and circulation adjustments drive a precipitation increase over the Maritime Continent, embedded in a negative Pacific Decadal Oscillation (PDO)- and/or El Niño–Southern Oscillation (ENSO)-like response over the Pacific, in turn associated with a northwestward displacement and zonal shrinking of the Indo-Pacific Walker cell. Remote climate anomalies across the Northern Hemisphere, including a weakening of the Siberian High and Aleutian Low, as well as anomalous temperature patterns in the northern mid-latitudes, arise primarily as a result of stationary Rossby wave trains generated over East Asia. The anomalous climate pattern and driving dynamical mechanism reverse polarity between JF and MAM (March–May) 2020, which is shown to be consistent with an underlying shift of the dominant region of SO2 emission reduction from eastern China in JF to India in MAM. Our findings highlight the prominent role of large-scale dynamical adjustments in generating a hemispheric-wide aerosol climate imprint even on short timescales, which are largely consistent with longer-term (decadal) trends. Furthermore, our analysis shows the sensitivity of the climate response to the geographical location of the aerosol emission region, even after relatively small, but abrupt, emission changes. Scientific advances in understanding the climate impact of regional aerosol perturbations, especially the rapidly evolving emissions over China and India, are critically needed to reduce current uncertainties in near-future climate projections and to develop scientifically informed hazard mitigation and adaptation policies.
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At the end of 2019, a new form of Coronavirus (later dubbed COVID-19) emerged in China and quickly spread to other regions of the globe. Despite the virus's unique and unknown characteristics, it is a widely distributed infectious illness. Finding the geographical distribution of the virus transmission is therefore critical for epidemiologists and governments in order to respond to the illness epidemic rapidly and effectively. Understanding the dynamics of COVID-19's spatial distribution can help to understand the pandemic's scope and effects, as well as decision-making, planning, and community action aimed at preventing transmission. The main focus of this study is to investigate the geographic patterns of COVID-19 dissemination in Iraq from May 1 to July 29, 2021. The analysis was primarily based on using spatial analysis tools such as standard deviational ellipse (SDE) with in GIS environment, in addition to incidence rates calculations. The results revealed that the direction of COVID-19 spread is NW-SE. Furthermore, the findings showed that the rate of COVID-19 infections is greater at the middle and south of Iraq. This may aid decision-makers in identifying priority areas for emergency efforts. © 2022 The Author(s). Published by Vilnius Gediminas Technical University.
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This analysis of the Kyrgyz health system reviews developments in its organization and governance, financing, provision of services, health reforms and health system performance. A mandatory health insurance is in place, with the Mandatory Health Insurance Fund (MHIF) under the Ministry of Health acting as single public payer for almost all hospitals and providers of primary care. The benefits package of publicly covered services is defined in the State-Guaranteed Benefits Programme (SGBP). However, many services require co-payments and in 2019 only 69% of the population was covered by mandatory health insurance. Health expenditure per capita is one of the lowest in the WHO European Region, due to the country's small GDP per capita. Private spending, almost entirely in the form of out-ofpocket expenditure and including informal payments, accounted for 46.3% of health expenditure in 2019. Financial protection is undermined by low levels of public spending for health, resulting in financial hardship for people using health services. While there is a well-developed network of health facilities, the geographical distribution of health workers is uneven and there is an overall shortage of family doctors. Access to health services remains a challenge, which has been exacerbated by the COVID-19 pandemic. While improvements have been made in recent years, communicable and noncommunicable diseases still pose a major problem and life expectancy prior to the COVID-19 pandemic was one of the lowest in the WHO European Region.
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OBJECTIVE To estimate diabetes-related mortality in Mexico in 2020 compared with 2017–2019 after the onset of the coronavirus disease 2019 (COVID-19) pandemic. RESEARCH DESIGN AND METHODS This retrospective, state-level study used national death registries of Mexican adults aged ≥20 years for the 2017–2020 period. Diabetes-related death was defined using ICD-10 codes listing diabetes as the primary cause of death, excluding certificates with COVID-19 as the primary cause of death. Spatial and negative binomial regression models were used to characterize the geographic distribution and sociodemographic and epidemiologic correlates of diabetes-related excess mortality, estimated as increases in diabetes-related mortality in 2020 compared with average 2017–2019 rates. RESULTS We identified 148,437 diabetes-related deaths in 2020 (177 per 100,000 inhabitants) vs. an average of 101,496 deaths in 2017–2019 (125 per 100,000 inhabitants). In-hospital diabetes-related deaths decreased by 17.8% in 2020 versus 2017–2019, whereas out-of-hospital deaths increased by 89.4%. Most deaths were attributable to type 2 diabetes (130 per 100,000 inhabitants). Compared with 2018–2019 data, hyperglycemic hyperosmolar state and diabetic ketoacidosis were the two contributing causes with the highest increase in mortality (128% and 116% increase, respectively). Diabetes-related excess mortality clustered in southern Mexico and was highest in states with higher social lag, rates of COVID-19 hospitalization, and prevalence of HbA1c ≥7.5%. CONCLUSIONS Diabetes-related deaths increased among Mexican adults by 41.6% in 2020 after the onset of the COVID-19 pandemic, occurred disproportionately outside the hospital, and were largely attributable to type 2 diabetes and hyperglycemic emergencies. Disruptions in diabetes care and strained hospital capacity may have contributed to diabetes-related excess mortality in Mexico during 2020.
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Objective: To assess the global epidemic of Coronavirus disease 2019 (COVID-19) in August 2022 and the risk of importation.
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Objective: To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in March 2022.
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Aim: The aim of the present study was to compare the data and epidemiological characteristics of orthopedic trauma patients who presented to the emergency room in the period of pandemic year with the year before the pandemic. Materials and Methods: In the present study, epidemiological characteristics of patients with orthopedic trauma who applied to the emergency department during the COVID-19 year (March 24-July 1, 2020) and the same period of the previous year (March 24-July 1, 2019) were compared. The patients were divided into two groups as pandemic period patients and pre-pandemic group patients (control group). Demographic characteristics, injury mechanisms, fracture types, fracture areas, simultaneous fractures, the locations where the fracture occurred, open fracture types, trauma scores and osteoporosis characteristics were evaluated.