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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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Background: Recent research suggests that COVID-19 is associated with acute kidney dysfunction. Effect of COVID-19 infection on downstream kidney function is unknown. We investigated this using the BC Interdisciplinary COVID-19 Care Network data. Method(s): This retrospective cohort study analyzed a 2,212 COVID-19 patient cohort, aged >=18 years, referred to the Post COVID Recovery Clinic (PCRC) in BC, Canada between July 9, 2020 & April 21, 2022. COVID-19 diagnosis date was the index date. Patients with history of kidney transplantation or dialysis before index date were excluded. Patients who deceased within 3 months of cohort entry were excluded. eGFR values were retrieved from the Provincial Laboratory Information System. We examined change in eGFR at 3-, 6-, 12-months after COVID-19 infection among the same study individuals using linear mixed model. Subgroup analysis included comparison between hospitalized vs. non-hospitalized, & diabetics vs. non-diabetics. Result(s): Analytic cohort included 457 patients (median age 59 years, 50% male) for whom eGFR was recorded at 3-, 6-, 12-months from index date. Prevalence of reduced eGFR (<=59ml/min/1.73m2) was 16%, 16%, 17% at 3-, 6-and 12-months post-index date, respectively. Median (IQR) eGFR at baseline was 90 (73, 102) that was reduced to 85 (70, 101) at 6-months & remained stable or <previous value at 12 months postindex date, 86 (69, 101). Results from linear mixed model indicated a 0.23 ml/min decrease in eGFR in each month after COVID-19 infection (intercept 85.51, slope -0.23, p-value=0.0003). In subgroup analyses, similar trends of decreasing eGFR over time were observed among diabetic (n=188, intercept 83.08, slope -0.42, p-value=0.0001) & nondiabetic patients (n=269, intercept 87.33, slope -0.12, p-value=0.13). Interestingly, eGFR appeared to improve over time in non-hospitalized patients (n=133, intercept 88.34, slope 0.24, p-value=0.03) compared to a decreasing trend among hospitalized patients (n=324, intercept 83.94, slope -0.41, p-value=<0.001). Conclusion(s): One in 6 COVID-19 patients who were referred to PCRC had reduced eGFR. COVID-19 was associated with a statistically significant decrease in eGFR, particularly in diabetic & hospitalized patients that warrants ongoing monitoring following COVID-19 infection.
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In contemporary China, the rapidly urbanized cities are exposed to a broad range of natural and human-made emergencies, such as COVID-19. Responding to emergencies successfully requires widespread participation of local government sectors that engages in diversified collaboration behav-iors across organizational boundaries for achieving sustainability. However, the multi-organizational collaborative process is highly dynamic and complex, as well as its outcomes are uncertain under-lying the emergency response network. Examining characteristics of the collaborative process and exploring how collaborative behaviors local governmental sectors engaging in the impact their perceived outcomes is essential to understand how disastrous situations are addressed by collaborative efforts in emergency management. This research investigates diversified collaborative behaviors in emergency response and then examines this using a multi-dimensional model consisting of joint decision making, joint implementation, compromised autonomy, resource sharing, and trust building. We surveyed 148 local governments and their affiliated sectors in China in-depth understanding how collaborative processes contribute to perceived outcomes from perspectives of participating sectors in the context of a centralized political-administrative system. A structural equation model (SEM) is employed to encode multiple dimensions of the collaborative process, perceived outcomes, as well as their relationships. The empirical finding indicates that joint decision making and implementation positively affect the perceived outcomes significantly. The empirical results indicate that joint decision making and joint implementation affect perceived outcomes significantly. Instead, resource sharing and trust building do not affect the outcomes positively as expected. Additionally, compromised autonomy negatively affects the collaborative outcomes. We also discuss the institutional advantages for achieving successful outcomes in emergency management in China by reducing the degree of compromised autonomy. Our findings provide insight that can improve efforts to build and maintain a collaborative process to respond to emergencies. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
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By studying the use of Multimedia and Database in Chinese liberal arts education, this paper argues that science and technology have a significant impact on the fairness of liberal arts education in China apart from those universities in developed regions. Through analyzing the use of two academic tools provided by universities in different regions, it can be concluded that in the field of liberal arts, the quantity and quality of resources available to liberal arts students in various universities are basically equal. This suggests that the use of these two technological tools could help universities narrow a range of serious inequalities caused by uneven educational classes and geographical disparities. However, for the three regions, all universities in the developed regions, at any level, are significantly better than those in the other regions in the number of traditional paper archives and technological tools. That is to say, with the help of science and technology, the differences for universities in developed regions can be largely ignored, but the gap between universities in developed regions and other regions, west and middle of China, has not been narrowed by the use of technological tools. Therefore, this paper argues that the government should invest more in big data and multimedia in universities in the middle and western regions, which will help realize the relative fairness of education in all regions and at all levels with the minimum cost. © 2021, The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG.