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Objectives: Potential cutaneous adverse drug reactions (cADRs) associated with COVID-19 vaccinations are well-known. However, comprehensive evaluation including detailed patient characteristics, vaccine types, signs and symptoms, treatments and outcomes from such cADRs are still lacking in Taiwan. Method(s): A cross-sectional study was conducted from December 2019 to October 2022 to analyze spontaneous ADR reporting data from Taiwan's largest multi-institutional healthcare system. Physicians and pharmacists initially ensured the data quality and completeness of the reported ADR records. Subsequently, we applied descriptive statistics to analyze the patient cohort based on demographic characteristics, administered COVID-19 vaccines, clinical manifestations, and patient management. Result(s): We identified 242 cADRs from 759 reported COVID-19 vaccine-related ADRs, 88.3% of which were judged as "possible" using the Naranjo Scale. The mean age of patients with cADRs was 48.1+/-17.5 years, with the majority (44.2%) of cADRs reported in the 40-64yr old age group. cADRs were more common in women (68.2%) and most of the patients had no history of allergy to vaccines (99.6%). Oxford/AstraZeneca (58.6%) accounted for the most reported brand of COVID-19 vaccines. Patients developed cADRs within 1 to 198 days (median = 5.5 days), and mostly after first-dose vaccination (77.8%). The most frequently reported cADR was rash/eruption (18.7%), followed by itchiness/pruritus (11.7%) and urticaria (9.2%), mainly affecting the lower limbs (23.8%) and upper limbs (22.6%). Medications were prescribed for 65.1% of the cADRs, and signs and symptoms were resolved within 1 to 167 days (median = 7 days) after treatment with oral antihistamines (23.0%), topical corticosteroids (14.6%) or oral corticosteroids (14.4%). Conclusion(s): Our findings provide comprehensive details regarding COVID-19 vaccine-related cADRs in Taiwan. Certain groups, especially women and the middle-aged, who reported a relatively higher rate of cADRs, may benefit from pre-vaccination counseling about the risks of cADRs and the use of appropriate medications.Copyright © 2023
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Due to the COVID-19 pandemic in Taiwan, many construction sites must limit the number of people on the jobsite or conduct work independently to avoid the spread of COVID-19. The quality of construction may be in doubt with unclear job handover, especially when workers have COVID-19 infection that should be isolated immediately. On top of that, first-level subcontractor self-inspections are crucial parts of construction process management, and neglecting inspec-tion processes can lead to construction errors and poor quality. To improve current quality inspection methods for private projects, a literature analysis was conducted to identify construction quality management issues that are faced in private housing projects. In-depth interviews with small and medium-sized subcontractors of private housing projects were per-formed to understand the quality management methods that they use in practice. Next, improvement measures for quality management were formulated and a simplified checklist for private project subcontractors, based on the practical feedback obtained, was created. Finally, the AppSheet platform was used to develop an inspection application for construction, and a subcontractor was invited to confirm its feasibility. The paperless design avoids redundant human contact, and the re-sults of this study greatly facilitate construction practice, particularly during the pandemic. The main contribution of this study is its investigation of the procedures that are used by private project subcontractors to inspect their work for quality management;its results can serve as a reference for academics in evaluating construction quality management levels and improving the management of work by subcontractors to promote safety and health.
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In the post-pandemic era, two issues including the currency competition between BTC and the US dollar and the competition between the commodity and monetary medium functions of BTC are critical. By applying the Markov switching model, the cyclical nature of the numbers of additional confirmed COVID-19 cases and deaths are verified on daily basis. So, these two factors are assumed to follow the Ornstein–Uhlenbeck process. Then, we estimate parameters to establish the structural characteristics of post-pandemic era and the start of post-pandemic era. In order to clarify these two issues, we use vector autoregression for testing the related macrocosmic and financial variables and BTC. Systematic evidences are provided regarding the relationships among BTC, related macrocosmic, related financial variables, related COVID-19 variables. Our findings provide a useful insight into currency competition and commodity competition on the basis of the impulse response of BTC to US dollar fluctuation and the impulse response of BTC to expected inflation and volatility in the post-pandemic era. These findings indicate increased currency competition between Bitcoin and the US dollar in the post-pandemic era. Therefore, currency competition should be more valued than Commodity Competition in the post-pandemic era. This provides a useful guideline for Bitcoin's management. © 2023, Online Academic Press. All rights reserved.
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Objective To study the epidemic characteristics and causes of pertussis cases in Ankang from 2010 to 2019, and to provide basis for prevention and control of pertussis. Methods The pertussis cases in Ankang from 2010 to 2019 were analyzed by descriptive epidemiology, and ARIMA(Autoregressive Integrated Moving Average model) was used to predict the forecast of pertussis from July 2020 to June 2021. Results Pertussis cases in Ankang showed an increasing trend from 2020 to 2019. The incidence rate hits the maximum value in 2019, and increased by 299.00% when compared to 2018. The case with the age distribution under 6 years were dominated by children, accounting for 94.07% of the total onset cases. The incidence was concentrated in three populations including scattered children (75.42%),childcare children(15.25%) and students(9.32%). In 2019,there were 25 on-campus students and 15 scattered children in Hanyin, and some cases have developed aggregated epidemics. According to the prediction model, the incidence of pertussis in Ankang might decrease from July 2020 to June 2021. Conclusion The incidence of pertussis in children in Ankang is on the rise from 2010 to 2019,and they are key points of prevention and control of pertussis to ensure the quality of vaccine production, improve the quality of vaccination, and proper implementation of infectious disease monitoring. Influenced by COVID-19 epidemic in early 2020, China adopted a series of effective measures to control respiratory infectious diseases, and the incidence of whooping cough also declined. © 2022, Editorial Department of Medical Pest Control. All rights reserved.
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Background: Several studies have demonstrated immunogenicity after COVID-19 vaccination in patients with autoimmune rheumatic diseases (AIRD) [1], but the differences between mRNA-based and vector vaccines and the cellular responses to COVID-19 vaccines according to distinct immunogenicity in AIRD patients are still unclear. Objectives: To investigate the differences in efficacy and safety between the vector vaccine ChAdOx1 nCoV-19/AZD1222 (Oxford-AstraZeneca) and mRNA-based vaccine mRNA-1273 (Moderna) in patients with AIRD, and to explore the cell-cell interactions between high and low anti-SARS-CoV-2 IgG levels in patients with rheumatic arthritis (RA) by single-cell RNA sequencing (scRNA-seq). Methods: From September 16 to November 15, 2021, we consecutively enrolled 243 participants aged ≥20 years with AIRD who received COVID-19 vaccination, of whom 113 were immunized with AZD1222 and 130 with mRNA-1273. The level of serum IgG antibodies to the SARS-CoV-2 receptor-binding domain on the spike protein S1 subunit was quantifed by electrochemiluminescence immuno-assay at 4-6 weeks after vaccination. Moreover, peripheral blood mononuclear cells were isolated from two RA patient with high anti-SARS-CoV-2 IgG level and four RA patients with low level for scRNA-seq and cell-cell communication signal was analyzed by CellChat. Results: The anti-SARS-CoV-2 IgG seropositivity rate was 78.8% (89/113) for AZD1222 and 83.1% (108/130) for mRNA-1273. The level of anti-SARS-CoV-2 IgG was higher in patients who received mRNA-1273 than in those who received AZD1222 (β: 30.15, 95% CI: 11.67-48.63, p=0.002) (Table 1). Prednisolone-equivalent dose >5 mg/day and methotrexate (MTX) use in AIRD patients, and non-anti-tumor necrosis factor (TNF)-α biologics and Janus kinase (JAK) inhibitor use in RA patients were associated with inferior immunogenicity. ScRNA-seq revealed CD16-monocytes were predominant in RA patients with high anti-SARS-CoV2-IgG antibody level, and enriched pathways related to antigen presentation via major histocompatibility complex class II (MHC class II) were found (Figure 1). HLA-DRA and CD4 interaction was vigorous among all identifed MHC-II pathway and was enhanced in high anti-SARS-CoV2-IgG antibody group. Conclusion: mRNA-1273 and AZD1222 vaccines exhibited differential immunogenicity in patients with AIRD. Enriched pathways related to antigen presentation via MHC class II in CD16-monocytes might be associated with higher anti-SARS-CoV2-IgG level in RA patients and further study is warranted.
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This paper studies the distributed link removal problem for controlling epidemic spreading in a networked meta-population system. A deterministic networked susceptible-infected-recovered (SIR) model is considered to describe the epidemic evolving process. To curb the spread of epidemics, we reformulate the original topology design problem into a minimization program of the Perron-Frobenius eigenvalue of the matrix involving the network topology and transition rates. A modified distributed link removal strategy is developed such that it can be applied to the SIR model with heterogeneous transition rates on weighted digraphs. The proposed approach is implemented to control the COVID-19 pandemic by using the infected and recovered data reported by the German federal states. The numerical experiment shows that the infected percentage can be significantly reduced by employing the distributed link removal strategy.
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Background: COVID-19 pandemic has caused more than 4.7 million deaths worldwide to date and still continues globally unabated. Numerous studies have linked the mortality in COVID-19 to aggressive immune response and cytokine storm. However, little is known about the cytokine profiles of individual immune cells that are directly involved in tissue damage. Here we investigate intracellular cytokines in individual T and NK cells of COVID-19 patients. Design: We studied 50 blood samples from 22 COVID-19 patients, 4 with mild, 6 moderate and 12 severe disease. There were 6 healthy controls. We performed high-dimensional 30-color spectral flow cytometry to characterize the immune cell subsets. For cytokine study, cells were stimulated for 6 hours, and stained for surface antigens and intracellular cytokines (IL1b, IL2, IL4, IL6, IL8, IL10, IL12, IL17a, IL21, INFg, GnzB, TNFa, and GMCSF). Data ware acquired on FACSymphony 50-parameter analyzer and analysis performed using FlowJo. Results: Our studies revealed significant differences in lymphocyte cytokine profiles between COVID+ and healthy controls (Fig 1). CD4+ and CD8+ T-cells exhibited increased percentages of IL2+ and IFNg+ cells, indicating a shift towards Th1 reaction. Granzyme B is highly upregulated in all T and NK cell subsets, demonstrating highly armed cytotoxic cells in COVID patients. The most prominent changes were noted in NK cells, 7 cytokines were highly expressed, most are proinflammatory cytokines. Of particular interest are IL-21 and GMCSF, both are known to play important roles in inflammatory cell recruitment, activation and renewal, which can lead to augmented tissue inflammation and injury. These changes were already evident in patients with mild disease, but there is heightened cytokine production in severe cases. Conclusions: Using high-dimensional flow cytometry we demonstrated for the first time significantly increased production of multiple proinflammatory cytokines and cytotoxic molecules in individual T and NK cells of COVID-19 patients. NK cells are most drastically activated. It is conceivable that when recruited to the target tissue such as lung, these highly primed cells will play a major role in tissue injury and ultimately organ failure via their direct cytotoxicity and cytokine secretion. This is consistent with previous reports of increased NK cells in the COVID lungs. Analysis of NK cell cytokine profiles may serve to predict disease progression, and reveal new targets for immune-therapy for severe COVID patients. (Table Presented).
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This study explores why a developing country may fall into the privacy trap of digital transformation after Covid-19. The privacy trap is that, when the developing country executes its digital transformation policy, the government inevitably compromises their civilian privacy and often have no way of knowing when/why/how the service will use or leak the privacy. To date, little scholarly literature has examined the existence and implication of the privacy trap in a developing country. Therefore, we analyze data from 306 respondents in Taiwan based on descriptive and inferential statistics. The results show the privacy trap exists and may be derived by that the bandwagon effect overriding the effects of privacy concerns on the willingness to provide personal information. These findings implicate that, based on the in-depth expert interview, one possible way but also the biggest challenge to escaping the privacy trap is to transform from the current economic system of cost-oriented labor to the economic system of a risk-oriented education system supporting breakthroughs in science and technology. This study could ultimately contribute to the developing countries to protect their civilian's privacy when executing digital transformation especially from a digital minority to a digital beneficiary.
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According to the discussion of the design method and operational effect for Wuhan Huoshenshan Hospital, this paper summarized the design control points of indoor and outdoor environment of COVID-19 emergency hospital. Based on the design of Wuhan Huoshenshan Hospital, this paper analyzed and discussed the site design, building layout, three-zones and two-passages, the design scheme of the ventilation and air conditioning system for negative pressure ward and negative pressure isolation ward, air distribution, as well as some other key designs for COVID-19 emergency hospital. The design points were summarized and refined. The design methods and technology requirements of the COVID-19 emergency hospital were provided in this study, such as ventilation and air conditioning system setting, ventilation quantity of wards, pressure gradient control measures among different areas, upper and lower air distribution, filter setting mode and distance of air inlet and outlet, which could benefit to provide references for the design of similar projects in the future.
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Respiratory supporting, as an important medical treatment for new coronavirus pneumonia patients, must be effectively guaranteed by medical oxygen supply. However, the medical oxygen system designed and configured by the existing hospitals according to the current specifications cannot meet the oxygen needs for patients with new coronavirus pneumonia. This paper aimed to study the design of medical oxygen system in new coronavirus pneumonia emergency hospital. By investigating the oxygen treatment plan for the novel coronavirus pneumonia patients in the health emergency hospital, the oxygen treatment characteristics of different patients were studied. The oxygen characteristics of different respiratory support terminals were explored to study the oxygen demands of new coronavirus pneumonia emergency hospitals. Through calculating flow rates of medical gas system air source referring to 'technical code for medical gases engineering', the proportion coefficient of severe patients converted into respiratory distress patients was introduced, and the model of calculating flow rates of medical oxygen system air source in emergency hospital was proposed. The cases were verified in a typical health emergency hospital that the developed calculation flow model of medical oxygen source met the demands of hospital oxygen. The outcomes provide a reference for the design and construction of medical oxygen in such health emergency hospitals.
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The highly infectious and serious nature of coronavirus disease 2019 (COVID-19) has highlighted the need for hospital space disinfection technology and the prevention of human exposure to pathogenic environments. This research developed novel chlorine dioxide (ClO2) sterilization technology to reduce bacteria and viruses in the air and on surfaces. A smart sterilization robot system was also developed to spray disinfectants in operating theaters or patients' rooms, designed according to the results of controlled experiments and the requirements for hospital disinfection. The system was built incorporated a semi-automatic remote-controlled module and an automatic intelligent disinfection function;that is, it could operate independently according to specific epidemic prevention strategies, which were implemented using a combination of Internet of Things (IoT) applications and a gesture recognition function. The elimination of Escherichia coli (E. coli) bacteria on sample plates was 99.8 % effective. This paper reviews the evolution of various disinfection technologies and describes a disinfection robot system in detail.
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In this paper, the susceptible-exposed-infected-recovered (SEIR) model is applied to the novel coronavirus disease. With the actual data in Georgia, USA, we obtained the related parameters such as the recovery rate and mortality rate. Then, the development of the novel coronavirus is investigated. For more accuracy, we consider the parameters in this model as the functions of the infected number and disease duration. These parameters’ functions are used to reflect the impact of disease development on parameters. Furthermore, the coefficients in these functions are regarded as uncertainties. To obtain these uncertain coefficients, the fuzzy set theory and confidence index theory are adopted. Thus, the fuzzy SEIR model is proposed. © 2021, Taiwan Fuzzy Systems Association.
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Tourism is relatively high profit, low-cost and high work opportunity industry. Medical tourism is special kind of business type in tourism industry. The characteristic of medical tourism is high threshold and high profit for hospital and government. But, fewer literatures research about competitiveness of medical tourism industry until now. Especially, medical tourism industry faces big challenge when COVID-19 occurs which stop patient to go abroad for treating in the world. This research arranges relative literatures and invite some expert's opinion to design criteria for evaluating competitiveness of medical tourism industry in each area. After that, linguistic VIKOR and Entropy will be integrated to analyze and evaluate performance of medical tourism industry among China, Taiwan, Japan and South Korea. Finally, some reasonable suggestion will be provided for Taiwan government and hospital. © 2020 ASTES Publishers. All rights reserved.
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The pandemic and efforts to control it are causing sharp reductions in global economic activity and associated fossil energy use, with unknown influence on longer-term efforts to limit greenhouse gas emissions under the Paris Climate Agreement. To explore this effect, estimates of economic recession and recovery in near-term months are extended to cover a return to full employment in future years, to be compared with an estimate of growth had COVID-19 not occurred. On the assumption that the Paris emissions pledges for 2020 will be met in any case, projection of global emissions with and without the pandemic show that, through its growth impact alone, it will yield only a small effect on emissions in 2030 and beyond. Other COVID legacies may include residual influences in patterns of consumption and travel, and the direction of recovery funds to low carbon investments. Most important, however, will be the effect of the economic shocks on the willingness of nations to meet (or augment) their existing Paris emissions pledges. The main effect of the pandemic on the threat of climate change, therefore, will be not its growth impact but its influence on national commitments to action.
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Taiwan had been using many important public health management strategies to beat Coronavirus disease 2019 (COVID-19) without a lockdown. Mask wearing by the general public was thought to be the major factor for the success of Taiwan to stop the spread of COVID-19. We share our experience in Taiwan as an example for other countries to safely reopen from a lockdown.
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Tourism is a high profit and low-cost industry. Medical tourism is one kind of tourism type. This kind of tourism type is high threshold and can bring more profit for government. However, a few of literatures research about competitive ability of medical tourism. This study collects relative literature and interview some expert to design the criteria to evaluate competitive ability of medical tourism. And then, linguistic VIKOR and Entropy are used to evaluate competitive ability of medical tourism among China, Taiwan, Japan, South Korea. © 2020 IEEE.