ABSTRACT
Sustainable development is central to the current societal functioning, whose complexity demands consideration on a regional scale. However, there are disparate methods to express sustainable development, many of which use qualitative analysis cumbersome for policy-makers. Previous studies focused on environmental, economic, and social impacts without fully considering the regulation mechanisms of the plethora of administrative bodies. To fill this research gap, this research establishes an integrated assessment framework involving four pillars: environment and ecology, society and culture, economics, and governance and policy. Further, indicator systems and quantitative analysis give comparable and objective results. The current study applied them to one of the most economically significant and developed Chinese regions, the Yangtze River Delta. The result shows a dynamic variation in regional sustainability from 2010 to 2019, indicating an annual increase. Although economic and societal development has been increasing steadily, environmental development has stagnated in the past two years, and the influencing policy has fluctuated dramatically. Our analysis was done in Shanghai, Jiangsu, Zhejiang, and Anhui. Even though all regions showed increasing sustainability, we observed an imbalance in regional sustainable development. Achieving a regional approach and enhanced regional coordination in the Yangtze River Delta is imperative and cannot be ignored by local, regional, and national policy-makers. More importantly, this study created a model capable of predicting the impact of the COVID-19 epidemic on regional sustainable development. The model showed that, compared with predicted values, a 6.65% decrease in the integrated sustainability index ensued, attributed to the pandemic in Zhejiang province. © 2022 Elsevier Ltd
ABSTRACT
International trade connections with COVID-19 impeding the development of the logistics industry in express delivery, the world has become an inseparable part of daily life. To improve protection competency, there is a need for effective research on logistics warehouse fire accident alarms. The goal of this study is to create a novel fire risk evaluation method for fire safety managers in logistics warehouses. The Gustav method is used to convert a plane model to a stereoscopic model. Hazards to construction, hazards to life, and fire rescue competency are all taken into account. The empirical study used JingDong Gu'an logistics park as a case study, and the evaluation results revealed differences in fire risk levels between the two warehouses. The results show that the transmit warehouse had a higher fire risk level than the sorting warehouse. The method describes the total risk of a warehouse fire. It is appropriate for the various types and processes found in modern logistics warehouses. The results of the developed 3D-Dynamic method demonstrate the model's feasibility and practicability even to laypeople with limited professional knowledge.
ABSTRACT
BACKGROUND: Cardiac rehabilitation for heart failure continues to be greatly underused worldwide despite being a Class I recommendation in international clinical guidelines and uptake is low in women and patients with mental health comorbidities. METHODS: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme was implemented in four UK National Health Service early adopter sites ('Beacon Sites') between June 2019 and June 2020. Implementation and patient-reported outcome data were collected across sites as part of the National Audit of Cardiac Rehabilitation. The change in key outcomes before and after the supervised period of REACH-HF intervention across the Beacon Sites was assessed and compared to those of the intervention arm of the REACH-HF multicentre trial. RESULTS: Compared to the REACH-HF multicentre trial, patients treated at the Beacon Site were more likely to be female (33.8% vs 22.9%), older (75.6 vs 70.1), had a more severe classification of heart failure (26.5% vs 17.7%), had poorer baseline health-related quality of life (MLHFQ score 36.1 vs 31.4), were more depressed (HADS score 6.4 vs 4.1) and anxious (HADS score 7.2 vs 4.7), and had lower exercise capacity (ISWT distance 190 m vs 274.7 m). There appeared to be a substantial heterogeneity in the implementation process across the four Beacon Sites as evidenced by the variation in levels of patient recruitment, operationalisation of the REACH-HF intervention and patient outcomes. Overall lower improvements in patient-reported outcomes at the Beacon Sites compared to the trial may reflect differences in the population studied (having higher morbidity at baseline) as well as the marked challenges in intervention delivery during the COVID-19 pandemic. CONCLUSION: The results of this study illustrate the challenges in consistently implementing an intervention (shown to be clinically effective and cost-effective in a multicentre trial) into real-world practice, especially in the midst of a global pandemic. Further research is needed to establish the real-world effectiveness of the REACH-HF intervention in different populations.
Subject(s)
COVID-19 , Cardiac Rehabilitation , Heart Failure , Female , Heart Failure/rehabilitation , Heart Failure/therapy , Humans , Male , Pandemics , Quality of Life , State MedicineABSTRACT
BACKGROUND: Low-dose chest CT (LDCT) showed high sensitivity and ability to quantify lung involvement of COVID-19 pneumopathy. The aim of this study was to describe the prevalence and risk factors for lung involvement in 247 patients with a visual score and assess the prevalence of incidental findings. METHODS: For 12 days in March 2020, 250 patients with RT-PCR positive tests and who underwent LDCT were prospectively included. Clinical and imaging findings were recorded. The extent of lung involvement was quantified using a score ranging from 0 to 40. A logistic regression model was used to explore factors associated with a score ≥ 10. RESULTS: A total of 247 patients were analyzed; 138 (54%) showed lung involvement. The mean score was 4.5 ± 6.5, and the mean score for patients with lung involvement was 8.1 ± 6.8 [1-31]. The mean age was 43 ± 15 years, with 121 males (48%) and 17 asymptomatic patients (7%). Multivariate analysis showed that age > 54 years (odds ratio 4.4[2.0-9.6] p < 0.001) and diabetes (4.7[1.0-22.1] p = 0.049) were risk factors for a score ≥ 10. Multivariate analysis including symptoms showed that only age > 54 years (4.1[1.7-10.0] p = 0.002) was a risk factor for a score ≥ 10. Rhinitis (0.3[0.1-0.7] p = 0.005) and anosmia (0.3[0.1-0.9] p = 0.043) were protective against lung involvement. Incidental imaging findings were found in 19% of patients, with a need for follow-up in 0.6%. CONCLUSION: The prevalence of lung involvement was 54% in a predominantly paucisymptomatic population. Age ≥ 55 years and diabetes were risk factors for significant parenchymal lung involvement. Rhinitis and anosmia were protective against LDCT abnormalities.