Rebozo Technique Effectively Reduces Maternal Pain during Childbirth Stage 1 Active Phase

Background: Pain is the main complaint felt by mothers during childbirth. Pain management can be done with non-pharma-cological techniques, one of which is using the Rebozo technique. Objective(s): This study aimed to determine the effectiveness of the rebozo technique for active phase 1 labour pain in primipa-rous women. Method(s): The study used a quasi-experimental design with a pretest and posttest control group. An accidental sampling technique divided a sample of 30 people into control and intervention groups. The intervention group received Rebozo therapy, a therapy using a traditional cloth wrapped around the pelvis and buttocks with the mother kneeling, then shaking it slowly. The pain was measured using the Visual Analogue Scale (VAS), ranging from 0-10. Bivariate test using Wilcoxon. Result(s): The majority of respondents were aged 21-29 years (56.7%), had high school education (83.3%) and were house-wives (50%). The majority of the control group showed moderate pain (53.3%), while the intervention group showed severe (60%). The reduction in pain in the intervention group was more significant than in the control group (2.27 > 0.73). Both the control group and the intervention group showed p < 0.001. Conclusion(s): The Rebozo technique effectively reduces labour pain in the active phase of the first stage in primiparous women. This technique is easy and inexpensive, so it can be an option for non-pharmacological therapy to treat labour pain.Copyright © 2023 Japan University of Health Sciences.

CHARACTERISTICS OF PATIENTS WHO RECEIVED BIOLOGICAL TREATMENT AFTER KIDNEY TRANSPLANTATION AND THE INCIDENCE OF SERIOUS INFECTIONS: A MULTICENTER STUDY

BackgroundKidney transplant patients due to both primary kidney involvement of chronic/autoimmune inflammatory diseases and end-stage kidney disease related to amyloidosis are followed up in rheumatology clinics. Biological agents one of the treatment options in kidney transplant recipients with chronic/autoimmune inflammatory disease.ObjectivesHowever, there is insufficient data on the development of infection in kidney transplant recipients who received biological treatment. Herein, we aimed to determine the incidence of serious infections in patients with kidney transplant recipients who are received biological therapy.MethodsKidney transplant recipients who are received biological agents due to rheumatologic disease were included in the study. Patients' demographic features, transplantation data, biological treatment, development of infection and severity of infection were screened retrospectively. Infections that requiring hospitalization were defined as severe infections.ResultsA total of 31 patients were included in the study, 14 (45%) of whom were female and mean age was 41 ±9 years. Twenty-five patients (80%) of them were non-preemptive kidney transplant and mean duration of hemodialysis before the transplantation was 40 ±40 months. Twenty-three patients (74%) had end stage kidney failure due to FMF-amyloidosis(Figure-1-). Seventeen patients (54%) received anakinra, 11 patients (35%) received canakinumab and 3 patients (10%) received etanercept with other immunosuppressive treatment. Mean treatment duration of biological agents was 4.2±2.6 years. Two patients developed solid organ malignancy and one patient developed hematological malignancy after transplantation. Sixteen of the patients (52%) were hospitalized at least once due to infection and 4 patients (13%) died due to infection. The cause of decease in two patients was COVID-19.ConclusionRheumatic diseases are an important cause of end-stage renal disease and definitive treatment is kidney transplantation. Kidney transplant recipients due to rheumatological disease also use biological agents in the post-transplantation period. Kidney transplant recipients have higher risk for the development of infection since they receive immunosuppressive therapy and use of biologic agents may further increase the risk for development infection. Meyer et al reported that infection developed in 54 of 187 solid organ transplant recipients using biological agents.[1] Mean treatment duration of biological agents was 12 months in this study. The incidence of infection was 54% in our study. Mean treatment duration of biological agent was 4.2 year was considered main reason for higher incidence of infection in our study.Reference[1]Meyer F, Weil-Verhoeven D, Prati C, Wendling D, Verhoeven F. Safety of biologic treatments in solid organ transplant recipients: A systematic review. Semin Arthritis Rheum. 2021 Dec;51(6):1263-1273. doi: 10.1016/j.semarthrit.2021.08.013. Epub 2021 Aug 26. Erratum in: Semin Arthritis Rheum. 2022 Aug;55:152015. PMID: 34507811.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Claim Extraction and Dynamic Stance Detection in COVID-19 Tweets

The information ecosystem today is noisy, and rife with messages that contain a mix of objective claims and subjective remarks or reactions. Any automated system that intends to capture the social, cultural, or political zeitgeist, must be able to analyze the claims as well as the remarks. Due to the deluge of such messages on social media, and their tremendous power to shape our perceptions, there has never been a greater need to automate these analyses, which play a pivotal role in fact-checking, opinion mining, understanding opinion trends, and other such downstream tasks of social consequence. In this noisy ecosystem, not all claims are worth checking for veracity. Such a check-worthy claim, moreover, must be accurately distilled from subjective remarks surrounding it. Finally, and especially for understanding opinion trends, it is important to understand the stance of the remarks or reactions towards that specific claim. To this end, we introduce a COVID-19 Twitter dataset, and present a three-stage process to (i) determine whether a given Tweet is indeed check-worthy, and if so, (ii) which portion of the Tweet ought to be checked for veracity, and finally, (iii) determine the author's stance towards the claim in that Tweet, thus introducing the novel task of topic-agnostic stance detection. © 2023 ACM.

Management and standardization of hemodialysis centers in lockdown areas under the epidemic of coronavirus disease 2019.

Maintenance hemodialysis patients need to return to hospital 3 times a week for routine hemodialysis treatment. In the case of coronavirus disease 2019 (COVID-19) and regional lockdown, a set of management systems and standardizations has been established in our hemodialysis center, including forward movement of the critical nodes of treatment, specialists pooling program for hemodialysis technology, and dynamic bubble personnel management, to implement dynamic prevention and control strategies, precise management of inpatient wards and closed-loop management of outbreaks. While improving the management of our own hemodialysis center, it is recommended to strengthen multi-center collaboration to build a municipal grid management system for hemodialysis and explore different dialysis strategies for end-stage renal disease to meet the treatment needs and safety management of maintenance hemodialysis patients in lockdown areas under the epidemic.Copyright © 2022, Second Military Medical University Press. All rights reserved.

How the Pandemic Crisis May Affect Economic Systems: A Study on the Nexus Between COVID-19 and Entrepreneurial Activities

The world has experienced several great crises that have had a significant economic impact. The global crisis of the COVID-19 pandemic has affected economies and production chains, harming millions of businesses and entrepreneurs. Economic resilience, an ability to adapt to change and responsiveness to exogenous shocks, is a scientific strategy in the business and economy sectors to analyze and deal with these crises. Undoubtedly, entrepreneurship is one of the important factors influencing the economy as a striking pillar of economic resilience. This study tries to identify factors for enhancing economic resilience that will help countries to be more viable when encountering exogenous or indigenous crises. In this study, the impact of some entrepreneurship indicators, which have been created by applying the Global Entrepreneurship Monitor (GEM) dataset, on the economic resilience index has been examined. Then, based on regression analysis, it was shown that some entrepreneurial indicators, such as the rate of total early-stage entrepreneurial activities (TEA), the rate of established business ownership (EB), the rate of entrepreneurship intention, and the rate of entrepreneurial innovation, can be useful in estimating and scrutinizing the global resilience index. Following this indirect method, the optimal range of some entrepreneurial indicators for achieving the maximum amount of economic resilience was determined. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Examining the Impacts of a Developmentally Appropriate, Culturally Relevant Virtual School on Student Outcomes

The rapid shift to online learning due to COVID-19 provides an opportunity to examine at scale the feasibility and impact of addressing students' cultural and developmental needs within a virtual environment. Given limited knowledge of this type of virtual schooling, this mixed-method study examined third–fifth grade students' experiences attending a culturally responsive and developmentally appropriate virtual summer literacy program. Findings indicate that students were more receptive to the virtual programming than their traditional schooling (pre-COVID), which positively affected their racial-ethnic and learner identities. Given the findings, implications for educational stakeholders are discussed. [ FROM AUTHOR] Copyright of Urban Education is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Health-related quality of life, mental health and caregiver burden in children with autosomal recessive polycystic kidney disease (ARPKD)

Objective: To examine whether established patient-reported outcome measures are suitable for capturing the impact of ARPKD in children and their families. Method(s): We assessed 44 children with ARPKD (40 families) with respect to patients' health-related quality of life ((hr- QOL) using PedsQLTM ESRD module) and mental health (strength and difficulties questionnaire (SDQ)) as well as family and caregiver burden (Impact on family score (IFS) und Ulm inventory of parental caregiver QOL (ULQIE)) and compared them to published data and 36 healthy control children matched for age and time. Result(s): Patients were aged 9.5 +/- 5.9 years (vs. controls 8.8 +/- 5.0, p = ns) and 21 (48%) were female (vs. 19 controls (53%), p = ns). Mean eGFR was 81 ml/min*1.73m2 (range 4 - 165);7 received dialysis and 11 had functioning kidney transplants (KTX, 2 combined with liver transplants). Eight patients had developmental delay secondary to medical complications, while chronic illness was an exclusion criterion for healthy controls. 61 caregivers of affected children had same gender-distribution (61% vs. 60% mothers) and age (both 42 +/- 7 years) and number of dependent children (1.8 +/- 0.9 vs. 2.0 +/- 0.8) as 57 caregivers of healthy children. The mean proxy reported PedsQL Total score was 77.5 +/- 10.6 (range 59 - 96). It correlated significantly to eGFR (r = 0.5, p < 0.01, (also within the subpopulations pre- and post-KTX)). Parents reported greater mental health problems in affected than in control children with a higher SDQ total score mainly due to higher scores in the hyperactivity and peerinteraction subscales. ULQIE revealed that parents of affected children had significantly lower levels of physical functioning, self-fulfillment and general QOL, but despite higher emotional burden scores they indicated similar satisfaction with family life. Impact on family scores were in a similar range to those of children with moderate to severe disabilities. Conclusion(s): The good spread of PedsQLTM ESRD-scores and their correlation to renal function indicates that it captures significant aspects of ARPKD, however, it may need further adjustment to include liver complications. All four chosen instruments revealed significant impact of ARPKD on hrQOL and mental health of affected children as well as family life and parental wellbeing in comparison to healthy controls. More problems with peer-interactions may also be due to more stringent shielding of chronically ill children from social contacts during the COVID pandemic compared to healthy children.

Trends in Covid-19 and Atrial Fibrillation: A National Inpatient Sample Trend from 2020

Background: Atrial fibrillation (AF) is the most common arrhythmia in the United States. Concomitant Covid-19 infection and the outcomes of AF are unknown. Objective(s): The study's goals were to analyze the outcomes of AF during the Covid-19 pandemic. Method(s): We conducted a retrospective cohort study based on the 2020 National Inpatient Sample (NIS) of Adults (>18 years) hospitalized for AF as the primary admitting diagnosis based on the ICD-10 codes and stratified these groups into concomitant covid-19 infection vs. non-covid-19 infection. All-cause mortality was our primary outcome, while the rate of ICU admission, length of stay, hospital charges were our secondary outcomes. Temporal trends were assessed using logistic regression. Result(s): In 2020, there were 1,994,985 admissions for atrial fibrillation, out of whom 104,495 (5.3%) had concomitant Covid-19. In the 104,495 AF admissions with covid-19, the mean age was 75y and 56.8% were males. Our results, image 1, showed AF with and without concomitant Covid-19 had similar rates of comorbid conditions including HTN, DM, OSA, CAD. HFrEF, and ESRD. AF patients with Covid-19 infection had a lower prevalence of smoking (31.83% vs. 39.4%, p<.001) and alcohol use (2% vs. 4.2%, p<.001). AF patients from both groups had similar rates of stroke (1.6% vs. 1.0%, p<.001). New AF patients with concomitant Covid-19 had worsening in-hospital outcomes such as shock (12.8% vs. 3.7%, p<.001), admission to the ICU (18.1% vs. 6.4%, p<0.001), higher all-cause mortality (21.8% vs. 3.9%, p<0.001), a longer length of stay (9.96 days vs 6.08 days, p<.001), and total hospital costs ($114,387 vs. $85,830, p<.0001). The incidence of AF catheter ablation on initial hospital admission for AF Covid-19 was lower compared to the AF non-covid-19 patients (.08% vs. 1.39%, p<.001). Conclusion(s): In 2020, Covid-19 infection was an independent predictor of higher all-cause mortality, length of stay, and costs in patients admitted for atrial fibrillation. In addition, these patients were less likely to get catheter ablation on hospital admission. [Formula presented]Copyright © 2023

Barriers to incorporation of indoor environmental quality (IEQ) principles into building designs

PurposeThis research presents a comprehensive review of the literature on the barriers to incorporating indoor environmental quality (IEQ) principles into building designs. The aim was to identify these barriers in the literature and subsume them under broad categories for the development of a framework showing the interrelationships among the barriers.Design/methodology/approachThe research design used a systematic desktop review which comprised of three levels of screening. The first level allowed for a broad selection of papers;the second level of screening was done to limit the results to papers within the construction industry, and the third level of screening limited the documents strictly to the publication period of 2000–2021.FindingsTwenty-four (24) barriers were identified in the literature, including lack of integrated design teams, which ranked the highest in appearance, high initial costs, poor market for IEQ buildings and higher design charges among others. The identified barriers were classified into six (6) categories namely capacity barriers, economic barriers, process-related barriers, cultural barriers, client-related barriers and steering barriers.Practical implicationsThe findings of this study would enable practitioners and policymakers to better understand what is preventing the widespread adoption of IEQ designs in the built environment and devise actionable strategies to overcome them. It adds to the body of knowledge on IEQ research by categorizing the various barriers that prevent the delivery of IEQ projects.Social implicationsThe developed barriers in this research can serve as a useful checklist to future researchers who may want to validate the barriers to IEQ designs in empirical studies and in different settings.Originality/valueThe interconnectivity revealed by the web-like framework allows for an appreciation of the various barriers of IEQ adoption which would help in expanding the current knowledge on IEQ beyond the narrow scope of isolated barriers. The fact that the papers selected in this study are not limited geographically, underscores the wide applicability of the findings in the global construction industry.

A data-driven optimization model to response to COVID-19 pandemic: a case study.

COVID-19 is a highly prevalent disease that has led to numerous predicaments for healthcare systems worldwide. Owing to the significant influx of patients and limited resources of health services, there have been several limitations associated with patients' hospitalization. These limitations can cause an increment in the COVID-19-related mortality due to the lack of appropriate medical services. They can also elevate the risk of infection in the rest of the population. The present study aims to investigate a two-phase approach to designing a supply chain network for hospitalizing patients in the existing and temporary hospitals, efficiently distributing medications and medical items needed by patients, and managing the waste created in hospitals. Since the number of future patients is uncertain, in the first phase, trained Artificial Neural Networks with historical data forecast the number of patients in future periods and generate scenarios. Through the use of the K-Means method, these scenarios are reduced. In the second phase, a multi-objective, multi-period, data-driven two-stage stochastic programming is developed using the acquired scenarios in the previous phase concerning the uncertainty and disruption in facilities. The objectives of the proposed model include maximizing the minimum allocation-to-demand ratio, minimizing the total risk of disease spread, and minimizing the total transportation time. Furthermore, a real case study is investigated in Tehran, the capital of Iran. The results showed that the areas with the highest population density and no facilities near them have been selected for the location of temporary facilities. Among temporary facilities, temporary hospitals can allocate up to 2.6% of the total demand, which puts pressure on the existing hospitals to be removed. Furthermore, the results indicated that the allocation-to-demand ratio can remain at an ideal level when disruptions occur by considering temporary facilities. Our analyses focus on: (1) Examining demand forecasting error and generated scenarios in the first phase, (2) exploring the impact of demand parameters on the allocation-to-demand ratio, total time and total risk, (3) investigating the strategy of utilizing temporary hospitals to address sudden changes in demand, (4) evaluating the effect of disruption to facilities on the supply chain network.

A paced multi-stage block-wise approach for object detection in thermal images.

The growing advocacy of thermal imagery in applications, such as autonomous vehicles, surveillance, and COVID-19 detection, necessitates accurate object detection frameworks for the thermal domain. Conventional methods could fall short, especially in situations with poor lighting, for instance, detection during night-time. In this paper, we propose a paced multi-stage block-wise framework for effectively detecting objects from thermal images. Our approach utilizes the pre-existing knowledge of deep neural network-based object detectors trained on large-scale natural image data to enhance performance in the thermal domain constructively. The employed, multi-stage approach drives our model to achieve higher accuracies. And the introduction of the pace parameter during domain adaption enables efficient training. Our experimental results demonstrate that the framework outperforms previous benchmarks on the FLIR ADAS dataset on the person, bicycle, and car categories. We have also illustrated further analysis of the framework, such as the effect of its components on accuracy and training efficiency, its generalizability to other thermal datasets, and its superior performance on night-time images in contrast to state-of-the-art RGB object detectors.

Immunogenicity and safety of COVID-19 BNT162b2 booster vaccine in end-stage kidney disease patients receiving haemodialysis in Yogyakarta, Indonesia: a cohort prospective study.

BACKGROUND: A significant decrease in antibody titres several months after COVID-19 primary vaccination in end-stage kidney disease (ESKD) patients receiving maintenance haemodialysis has recently been reported. The waning in antibody titres has led to the recommendations for a booster dose to increase the antibody titres after vaccination. Consequently, it is crucial to analyse the long-term humoral immune responses after COVID-19 primary vaccination and assess the immunogenicity and safety of booster doses in haemodialysis (HD) patients. METHODS: Patients on maintenance haemodialysis who received the primary vaccine of CoronaVac (Sinovac) vaccine were administered with BNT162b2 (Pfizer-BioNTech) as the booster dose. The immunogenicity was assessed before (V1), one month (V2) and eight months (V3) after the primary vaccination, as well as one month after the booster dose (V4). Patients were followed up one month after the booster dose to assess the adverse events (AEs). RESULTS: The geometric mean titre (GMT) of anti-SARS-CoV-2 S-RBD IgG antibody at 8 months after the primary vaccination increased significantly to 5,296.63 (95%CI: 2,930.89-9,571.94) U/mL (p = < 0.0001) compared to before the primary vaccination. The GMT also increased significantly to 19,142.56 (95% CI: 13,489.63-27,227.01) U/mL (p < 0.0001) 1 month after the booster vaccine. Meanwhile, the median inhibition rate of neutralizing antibodies (NAbs) at 8 months after the primary vaccine and 1 month after the booster dose were not significantly different (p > 0.9999). The most common AEs after the booster dose included mild pain at the injection site (55.26%), mild fatigue (10.53%), and swelling at the injection site (10.53%). No serious AEs were reported. CONCLUSIONS: The majority of ESKD patients on haemodialysis mounted a good antibody response to the BNT162b2 booster vaccination with tolerable adverse events.

Dialysis Patient Experiences During the COVID-19 Pandemic: A Survey Study.

Rationale & Objective: The coronavirus disease 2019 (COVID-19) pandemic imposed several changes in the care of patients with kidney failure receiving dialysis. We explored patient care experiences during the pandemic. Study Design: The study team verbally administered surveys including Likert scale multiple-choice questions and open-ended questions and recorded responses. Setting & Participants: Surveys were administered to adults receiving dialysis through an academic nephrology practice after the first wave of the COVID-19 pandemic. Exposure: Outpatient dialysis treatment during the COVID-19 pandemic. Outcomes: Perceptions of care and changes in health. Analytical Approach: Multiple-choice responses were quantified using descriptive statistics. Thematic analysis was used to code open-ended responses and derive themes surrounding patient experiences. Results: A total of 172 patients receiving dialysis were surveyed. Most patients reported feeling "very connected" to the care teams. Seventeen percent of participants reported transportation issues, 6% reported difficulty obtaining medications, and 9% reported difficulty getting groceries. Four themes emerged as influencing patient experiences during the pandemic: 1) the COVID-19 pandemic did not significantly affect participants' experience of dialysis care; 2) the COVID-19 pandemic significantly impacted other aspects of participants' lives, which in turn were felt to affect mental and physical health; 3) regarding dialysis care experience more generally, participants valued consistency, dependability, and personal connection to staff; and 4) the COVID-19 pandemic highlighted the importance of external social support. Limitations: Surveys were administered early in the COVID-19 pandemic, and patient perspectives have not been reassessed. Further qualitative analysis using semi-structured interviews was not performed. Survey distribution in additional practice settings, using validated questionnaires, would increase generalizability of the study. The study was not powered for statistical analysis. Conclusions: Early in the COVID-19 pandemic, perceptions of dialysis care were unchanged for most patients. Other aspects of participants' lives were impacted, which affected their health. Subpopulations of patients receiving dialysis may be more vulnerable during the pandemic: those with histories of mental health conditions, non-White patients, and patients treated by in-center hemodialysis. Plain-language summary: Patients with kidney failure continue to receive life-sustaining dialysis treatments during the coronavirus disease 2019 (COVID-19) pandemic. We sought to understand perceived changes in care and mental health during this challenging time. We administered surveys to patients receiving dialysis after the initial wave of COVID-19, asking questions on topics including access to care, ability to reach care teams, and depression. Most participants did not feel that their dialysis care experiences had changed, but some reported difficulties in other aspects of living such as nutrition and social interactions. Participants highlighted the importance of consistent dialysis care teams and the availability of external support. We found that patients who are treated with in-center hemodialysis, are non-White, or have mental health conditions may have been more vulnerable during the pandemic.

A hybrid model for daily air quality index prediction and its performance in the face of impact effect of COVID-19 lockdown.

Accurate and dependable air quality forecasting is critical to environmental and human health. However, most methods usually aim to improve overall prediction accuracy but neglect the accuracy for unexpected incidents. In this study, a hybrid model was developed for air quality index (AQI) forecasting, and its performance during COVID-19 lockdown was analyzed. Specifically, the variational mode decomposition (VMD) was employed to decompose the original AQI sequence into some subsequences with the parameters optimized by the Whale optimization algorithm (WOA), and the residual sequence was further decomposed by the complete ensemble empirical mode decomposition with adaptive noise (CEEMDAN). On this basis, a deep learning method bidirectional long short-term memory coupled with added time filter layer and attention mechanism (TFA-BiLSTM) was employed to explore the latent dynamic characteristics of each subsequence. This WOA-VMD-CEEMDAN-TFA-BiLSTM hybrid model was used to forecast AQI values for four cities in China, and results verified that the accuracy of the hybrid model outperformed other proposed models, achieving R2 values of 0.96-0.97. In addition, the improvement in MAE (34.71-49.65%) and RMSE (32.82-48.07%) were observed over single decomposition-based model. Notably, during the epidemic lockdown period, the hybrid model had significant superiority over other proposed models for AQI prediction.

Stereotactic Ablative radiotherapy before resection to avoid delay for early-stage lung cancer or oligometastases during the COVID-19 pandemic: Pathologic outcomes from the SABR-BRIDGE protocol.

BACKGROUND: During coronavirus disease 2019 (COVID-19)-related operating room closures, some multidisciplinary thoracic oncology teams adopted a paradigm of stereotactic ablative radiotherapy (SABR) as a bridge to surgery, an approach called SABR-BRIDGE. This study presents the preliminary surgical and pathological results. METHODS: Eligible participants from four institutions (three in Canada and one in the United States) had early-stage presumed or biopsy-proven lung malignancy that would normally be surgically resected. SABR was delivered using standard institutional guidelines, with surgery >3 months following SABR with standardized pathologic assessment. Pathological complete response (pCR) was defined as absence of viable cancer. Major pathologic response (MPR) was defined as ≤10% viable tissue. RESULTS: Seventy-two patients underwent SABR. Most common SABR regimens were 34 Gy/1 (29%, n = 21), 48 Gy/3-4 (26%, n = 19), and 50/55 Gy/5 (22%, n = 16). SABR was well-tolerated, with one grade 5 toxicity (death 10 days after SABR with COVID-19) and five grade 2-3 toxicities. Following SABR, 26 patients underwent resection thus far (13 pending surgery). Median time-to-surgery was 4.5 months post-SABR (range, 2-17.5 months). Surgery was reported as being more difficult because of SABR in 38% (n = 10) of cases. Thirteen patients (50%) had pCR and 19 (73%) had MPR. Rates of pCR trended higher in patients operated on at earlier time points (75% if within 3 months, 50% if 3-6 months, and 33% if ≥6 months; p = .069). In the exploratory best-case scenario analysis, pCR rate does not exceed 82%. CONCLUSIONS: The SABR-BRIDGE approach allowed for delivery of treatment during a period of operating room closure and was well-tolerated. Even in the best-case scenario, pCR rate does not exceed 82%.

Management and standardization of hemodialysis centers in lockdown areas under the epidemic of coronavirus disease 2019

Maintenance hemodialysis patients need to return to hospital 3 times a week for routine hemodialysis treatment. In the case of coronavirus disease 2019 (COVID-19) and regional lockdown, a set of management systems and standardizations has been established in our hemodialysis center, including forward movement of the critical nodes of treatment, specialists pooling program for hemodialysis technology, and dynamic bubble personnel management, to implement dynamic prevention and control strategies, precise management of inpatient wards and closed-loop management of outbreaks. While improving the management of our own hemodialysis center, it is recommended to strengthen multi-center collaboration to build a municipal grid management system for hemodialysis and explore different dialysis strategies for end-stage renal disease to meet the treatment needs and safety management of maintenance hemodialysis patients in lockdown areas under the epidemic.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Dual-stage day-ahead optimized performance of renewable-based microgrids

In distributed networks, wind turbine generators (WTGs) are to be optimally sized and positioned for cost-effective and efficient network service. Various meta-heuristic algorithms have been proposed to allocate WTGs within microgrids. However, the ability of these optimizers might not be guaranteed with uncertainty loads and wind generations. This paper presents novel meta-heuristic optimizers to mitigate extreme voltage drops and the total costs associated with WTGs allocation within microgrids. Arithmetic optimization algorithm (AOA), coronavirus herd immunity optimizer, and chimp optimization algorithm (ChOA) are proposed to manipulate these aspects. The trialed optimizers are developed and analyzed via Matlab, and fair comparison with the grey wolf optimization, particle swarm optimization, and the mature genetic algorithm are introduced. Numerical results for a large-scale 295-bus system (composed of IEEE 141-bus, IEEE 85-bus, IEEE 69-bus subsystems) results illustrate the AOA and the ChOA outperform the other optimizers in terms of satisfying the objective functions, convergence, and execution time. The voltage profile is substantially improved at all buses with the penetration of the WTG with satisfactory power losses through the transmission lines. Day-ahead is considered generic and efficient in terms of total costs. The AOA records costs of 16.575M$/year with a reduction of 31% compared to particle swarm optimization. © 2023 The Authors. IET Renewable Power Generation published by John Wiley & Sons Ltd on behalf of The Institution of Engineering and Technology.

COVID-19 in hemodialysis patients

Objective. Evaluation of clinical observation, the course, the risk factors, and treatment options for SARS-CoV-2 infection in hemodialysis patients with end-stage chronic kidney disease. Material and methods. The retrospective, single-center, uncontrolled study involved 231 patients (132 M/99 W) aged 61.7+/-14.7 years with COVID-19 diagnosed. The SPSS software package was used for statistical analysis. Results. 72 (31.2%) of patients died, 68 (94.4%) of them had ARDS as the main cause of death. Comparative analysis in groups with favorable and unfavorable outcomes of the disease showed that age (68.1+/- 13.2 years vs 58.7+/-14.5 years, p<0.0001) and the comorbidity index (8.8+/-2.2 vs 6.2+/-2.6, p<0.0001) were significantly higher in those who have died compared to survivors. According to CT data, they were more likely to have 3rd or 4th-degree lung damage (72.2 vs 36.5%, p<0.0001), and the minimum oxygen saturation index: 67.6+/-12.8 and 87.8+/-10.9%, respectively (p<0.0001). Somorbidity index and the need for invasive ventilation were independent predictors of the fatal outcome of COVID-19. Early administration of monoclonal antibodies to IL-6 (in the first 3 days after hospitalization) in patients with a low prevalence of the pulmonary process (CT stage 1-2) was associated with a significantly lower frequency of fatal outcome. Conclusions. SARS-CoV-2 infection in HD patients is characterized by a high rate of mortality. Predictors of severe disease in this population are comorbidity index and the need for invasive ventilation.Copyright © Infectious Diseases: News, Opinions, Training.

Taiwan's national strategies and actions toward HCV elimination before 2025

In 1990, the seroprevalence of antibody against hepatitis C virus (anti- HCV) in Taiwan was first documented to be 0.95% in volunteer blood donors, 90% in hemophiliacs, and 81% in parenteral drug abusers. The risk factors for HCV infection in Taiwan include iatrogenic transmission (medical injection, hemodialysis, acupuncture, and blood transfusion), tattooing, and sexual transmission. The long-term risk of hepatic and non-hepatic diseases has been well-documented by REVEL-HCV study. A national program of antiviral therapy for chronic viral hepatitis was launched in Taiwan in 2003. Mortality rates of end-stage liver diseases decreased continuously from 2000-2003 to 2008-2011 in all age and gender groups. When the World Health Assembly adopted the Global Health Sector Strategy on Viral Hepatitis in 2016, National program to eliminate hepatitis C was very carefully evaluated. It became a consensus to reach the WHO's 2030 goals in 2025. Taiwan Hepatitis C Policy Guideline 2018-2025 was approved and published at the beginning of 2019. There are triple focuses of hepatitis C elimination in Taiwan including (1) therapy spearheads prevention, (2) screening supports therapy, and (3) prevention secures outcome. A total of US$1.7 billion will be allocated from 2017 to 2025 for the elimination of HCV. The coverage of HCV screening and treatment has been increasing significantly since 2017. The HCV screening coverage was almost 100% for dialytic patients, 96% for HIV-infected patients, 65% for patients under opioid substitution treatment, 63% for patients in the pre-end-stage renal disease care program, 57% for patients in the early chronic kidney disease care program, 52% for patients in diabetes care program, 39% for prisoners, and 38% for adults aged 45-79 years old in the general population by April 30, 2020. The budget to cover the cost of DAA increased from US$101 million in 2017 to US$219 million in 2019. The number of chronic hepatitis C patients receiving DAA therapy increased from 9,538 in 2017, 19,549 in 2018, to 45,806 in 2019. However, the number of DAA-treated CHC patients reduced to 36,159 in 2020 and 20,559 in 2021 due to the COVID-19 pandemic. The cure rate based on SVR12 was 96.8% in 2017, 97.4% in 2018, over 98.6% after 2019. It is expected that Taiwan will achieve WHO's HCV elimination goal by 2025.

Changes in Disease Etiology of Deceased Donor Liver Transplantations Following Acuity Circles Policy Implementation

Introduction: The Acuity Circles (AC) allocation policy was implemented on February 4, 2020, with the primary intent of reducing disparities in access to deceased donor liver transplants (DDLTs). Overall, it has been successful at achieving this goal. However, changes in end-stage liver disease etiology following the policy change have not been well-characterized. Our goal was to understand how primary etiology of disease in DDLTs has changed since implementation of AC. Method(s): Data from the Organ Procurement Transplantation Network (OPTN) and United Network of Organ Sharing (UNOS) were analyzed to compare the primary classified etiologies of liver disease for DDLTs overall and based on allocation Model-for-end-stage-liver-disease (aMELD) categories used for AC sharing: aMELD>=37, aMELD 33-36, aMELD 29-32, aMELD 15-28, and aMELD<=14 DDLTs. Time was divided into four equivalent "eras" of 256 days duration by date of transplantation: 1) 9/10/18-5/23/19 (Era 1);2) 5/24/19-2/3/20 (Era 2);3) 2/4/20-10/16/20 (Era 3);and 4) 10/17/20-6/29/21 (Era 4). Result(s): The percentage of all DDLTs for alcohol-related liver disease (ARLD) increased from 32.3% pre-AC to 38.7% of DDLTs post AC. This was met with a corresponding decrease in the relative percentage of DDLTs related to Hepatitis C Virus (from 17.0% of DDLTs pre-AC to 12.2% post-AC), with the relative differences of other etiologies being a less than 1% difference pre- vs post- AC. There is a consistent increase in the share of DDLTs due to ARLD across each Era. The rise in adult DDLTs for ARLD was most pronounced among aMELD >=37 recipients, although similar trends were seen among aMELD 33-36 and aMELD 29-32 groups, but not aMELD 15-28 and aMELD <=14 groups. The median age of adult DDLTs for ARLD decreased consistently over time for the aMELD >=37 group, but not for the aMELD 33-36 and aMELD 29-32 groups. (Figure) (Table) Conclusion(s): Following implementation of AC, there was a relative increase in DDLTs due to ARLD. The younger age and high aMELD scores of these patients suggests these may be largely among patients with acute alcoholic hepatitis. This would align with published data on the overall increase in liver transplantation due to ARLD during the COVID-19 pandemic. (Figure Presented).