Pathogens inactivation in nutrient recovery from urine: A review

Urine source separation, a kind of new sewage management concept, has made great progress in technology development and application in the past 30 years. However, understanding of the potential microbial risks in reuse of urine derived fertilizer products (UDFPs) in agriculture is still lacking. Outbreak of pandemic of Coronavirus Disease 2019 and more deadly disease caused by Monkeypox strongly sounds the alarm bell to the attention on pathogens in urine and their fate in UDFPs. Therefore, this study presented a comprehensive review on pathogens inactivation in nutrient recovery technologies. The review suggests that technologies using alkaline or heating treatment can effectively reduce pathogens in UDFPs. However, technologies with characteristics such as membrane rejection of nutrients or nutrient adsorption may even concentrate pathogens in their fertilizer products. Based on an overall assessment, connections of technologies and the pathogens inactivation in their UDFPs have been established. This would help to provide a perspective on development of urine treatment technology and management of microbial risks in reusing urine nutrients in agriculture.

Telemedicine Implementation in Solid Organ Transplant (SOT) Clinics is Associated with Satisfaction Among Patients and Providers but Increased Burden on Staff

Purpose: Telemedicine is an essential part of healthcare delivery and has grown exponentially during the COVID-19 pandemic. Data on optimal utilization and implementation of telemedicine in SOT care remain limited. We aimed to evaluate patient, provider and clinic staff perspectives on telemedicine use and potential barriers in SOT clinics. Method(s): We prospectively enrolled adults seen via telemedicine (video or telephone) in SOT clinics at a single academic transplant center between 9-10/2021. Patients completed a survey administered either online or phone following their visit. Providers and clinic staff involved in telemedicine completed online surveys. Surveys were tailored to patient, provider and clinic staff to assess specific concerns, barriers and satisfaction with telemedicine. Result(s): Survey response rate was 21% (175/853) for patients, 57% (70/122) for providers and 31% (20/64) for clinic staff. 95% of visits were video and seen in liver (39%), kidney (40%), lung (16%) and heart transplant (5%) clinics. Patients were male (51%) with a median age of 62, English-speaking (95%) and had some college experience (84%). Patient and provider descriptions of telemedicine use are shown in Figure 1. Patients were not concerned with privacy (86%), lack of physical exam (76%), audio/video difficulties (89% and 93%) or help with setup (82%). Most were satisfied with the ease of video visit (85%) and quality of care (80%). Compared to in-person visits, patients felt their telemedicine visit was similar (66%) if not better (16%). Among providers, most were satisfied with ease of video visits (74%) and quality of care (60%), but 48% were dissatisfied with telephone visits. Providers spent time assisting patients (72%) or required help from staff to aid patients (7%) with visits;90% noted functioning of software/hardware before visits as crucial to improving telemedicine use. Among clinic staff, 50% reported additional time spent aiding patients with initial visit setup due to needing to instruct how to use telemedicine software (60%) and providing additional instructions to caregiver(s) (20%). Conclusion(s): Telemedicine via video is an effective and convenient method of healthcare delivery across the continuum of SOT care according to patients, providers and clinic staff. However, concerns about time assisting with setup were noted by providers and staff. Additional resources and support are needed to improve navigation of telemedicine for patients and to improve efficiency with telemedicine for providers and staff. (Figure Presented).

Identifying Risk Transmission in Carbon Market With Energy, Commodity and Financial Markets: Evidence From Time-Frequency and Extreme Risk Spillovers

The carbon market is a vital tool to achieve carbon neutrality. This paper uses daily closing price data of Shenzhen carbon trading market, energy, commodity and financial markets from 18 October 2018 to 19 August 2021, examining the transmission of risk/information from the perspective of market volatility spillover and tail risk transmission based on quantile spillover. The stock market crash and COVID-19 have increased the volatility of the system substantially. Next, the increase in trading frequency is accompanied by an increase in total volatility connectivity, and the carbon market transforms into a recipient of systemic shocks. Finally, the results of tail risk transmission reveal that the net effect of carbon reception increases significantly. These findings have implications for policymakers to improve the carbon market and provide important insights for investors to trade in turbulent periods.

TELEMEDICINE IMPLEMENTATION IN SOLID ORGAN TRANSPLANT CLINICS IS ASSOCIATED WITH SATISFACTION AMONG PATIENTS AND PROVIDERS BUT INCREASED BURDEN ON STAFF

BACKGROUND: Telemedicine is an essential part of healthcare delivery and has grown exponentially as a result of the COVID-19 pandemic. However, data on optimal utilization and implementation of telemedicine in solid organ transplant care remains limited. We aimed to evaluate patient, provider, and clinic staff perspectives on telemedicine use and potential barriers in solid organ transplant clinics. METHODS: We prospectively enrolled adults seen via telemedicine (video or telephone) in solid organ transplant clinics at a single academic transplant center between 9-10/2021. Patients completed a survey administered either online or via phone following their visit. Providers and clinic staff involved in telemedicine completed online surveys. Surveys were customized to patient, provider, and clinic staff to assess specific concerns, barriers, and satisfaction with telemedicine. RESULTS: Survey response rate was 21% for patients (175 of 853), 57% for providers (70 of 122) and 31% for clinic staff (20 of 64). 95% of telemedicine visits were video and were from liver (39%), kidney (40%), lung (16%) and heart transplant (5%) clinics. The majority of patients were male (51%) with a median age of 62, English-speaking (95%), and had some college experience (84%). Descriptions of telemedicine use among patients and providers are shown in Figure 1. Most patients were not concerned about privacy (86%), lack of physical exam (76%), audio/video difficulties (89% and 93%), or assistance with setup (82%). The majority were satisfied with the ease of video visit (85%) and quality of care (80%). Compared to traditional in-person visits, most patients felt their telemedicine visit was similar (66%) if not better (16%). Among providers, the majority were satisfied with ease of video visits (74%), quality of care (60%), and overall use of video visits (64%), but 48% were dissatisfied with telephone visits. Most providers reported spending time assisting patients (72%) with 7% requiring assistance from clinic staff to aid patients with video visits. 90% of providers identified appropriate software/hardware functioning prior to visits as a key feature to improve telemedicine use. Among clinic staff, 50% reported spending additional time assisting patients with setting up their initial visit due to needing to instruct how to use telemedicine software (60%) and providing additional instructions to caregiver(s) (20%). CONCLUSION: Telemedicine via video is an effective and convenient method of healthcare delivery across the continuum of solid organ transplant care according to patients, providers and clinic staff. However, concerns about time assisting with setup were highlighted by providers and clinic staff. Additional resources and support are needed to improve navigation of telemedicine for patients and to improve efficiency with telemedicine for providers and clinic staff. (Figure Presented)

IMPACT OF THE COVID-19 PANDEMIC ON ENDOSCOPY CANCELLATIONS

Background: The coronavirus disease 19 (COVID-19) pandemic has disrupted healthcare delivery including cancellation of elective endoscopy. Despite the implementation of safety protocols to limit COVID-19 spread in endoscopy units, significant fear of infection remains among patients. We aimed to determine the prevalence of endoscopy cancellations in the COVID-19 era and identify patient characteristics associated with cancellation due to the pandemic. Methods: Medical charts were reviewed for adults who cancelled a scheduled endoscopic procedure from 5/2020-8/2020 at a tertiary care academic center. Inpatient endoscopies were excluded. Reasons for cancellation were categorized as COVID-19 related, non-COVID-19 related, or unclear. COVID-19 related cancellations were further categorized as COVID-19 testing logistics related, COVID-19 fear related, or other. The association of patient characteristics with cancellation of endoscopy due to COVID-19 were assessed using logistic regression. Results: 652 patient charts were reviewed. Median age was 58, with55% female, 61% non-Hispanic white, 11% had IBD, and 16% were immunosuppressed.Procedure types included 120 (18%) upper endoscopies (EGD), 362 (56%) colonoscopies, 93 (14%) EGD/colonoscopies, 20 (3%) sigmoidoscopies, and 57 (9%) advanced endoscopic procedures. 211 (32%) cancellations were due to COVID-19, 384 (59%) were due to non-COVID-19 reasons, and 57 (9%) were undetermined. Among COVID-19 related cancellations, 75 (36%) were COVID-19 testing logistics related, 121 (57%) were COVID-19 fear related, and 15 (7%) were other. On multivariate analysis, the odds of cancellation due to COVID-19 was significantly higher for black patients (OR 2.01, 95% CI 1.05-3.86, p=0.04), while patients undergoing EGD (OR 0.50, 95% CI 0.28-0.89, p=0.02) or advanced endoscopy (OR 0.18, 95% CI 0.07-0.49, p=0.001) had lower odds of cancellation [Table 1]. The odds of cancelling due to COVID-19 testing was significantly higher among black patients (OR 3.12, 95% CI 1.03-9.46, p=0.05), patients with Medi-Cal insurance (OR 2.89, 95% CI 1.21-6.89, p=0.02), and patients undergoing sigmoidoscopy (OR 11.6, 95% CI 1.23-108.5, p=0.03) and diagnostic indications (OR 2.96, 95% CI 1.22-7.21, p=0.02). Patients with older age (≥65) had higher odds of COVID-19 fear related cancellation (OR 0.29, 95% CI 0.10-0.81, p=0.02) [Table 2]. Conclusion: COVID-19 has negatively impacted endoscopy scheduling. Diagnostic or therapeutic procedures are associated with a lower risk of cancellation related to COVID-19. Black race is associated with an increased risk of COVID-19 related cancellation. Specifically, black patients and those with Medi-Cal are at increased risk of cancellation related to COVID-19 testing logistics. Racial and socioeconomic disparities in access to endoscopy may be further amplified by the COVID-19 pandemic and warrant further study.(Table Presented)(Table Presented)

Screening coronavirus and human proteins for sialic acid binding sites using a docking approach

The initial step of interaction of some pathogens with the host is driven by the interaction of glycoproteins of either side via endcaps of their glycans. These end caps consist of sialic acids or sugar molecules. Coronaviruses (CoVs), including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), are found to use this route of interaction. The strength and spatial interactions on the single molecule level of sialic acids with either the spike (S) protein of SARS coronaviruses, or human angiotensin-converting enzyme 2 (ACE2) and furin are probed and compared to the binding modes of those sugar molecules which are present in glycans of glycoproteins. The protocol of using single molecules is seen as a simplified but effective mimic of the complex mode of interaction of the glycans. Averaged estimated binding energies from a docking approach result in preferential binding of the sialic acids to a specific binding site of the S protein of human coronavirus OC43 (HCoV-OC43). Furin is proposed to provide better binding sites for sialic acids than ACE2, albeit outweighed by sites for other sugar molecules. Absolute minimal estimated binding energies indicate weak binding affinities and are indifferent to the type of sugar molecules and the proteins. Neither the proposed best binding sites of the sialic acids nor those of the sugar molecules overlap with any of the cleavage sites at the S protein and the active sites of the human proteins. © 2021, AIMS Biophysics. All rights reserved.

Impacts of the COVID-19 pandemic on vegetable production and countermeasures from an agricultural insurance perspective

In the face of the corona virus disease 2019 (COVID-19) pandemic, it is essential to stabilize the security of urban "shopping baskets". Through a survey and interviews with 46 agricultural cooperatives in Shanghai, this paper analyzes the impact of the pandemic on vegetable production and offers suggestions on agricultural insurance. The research results show that: (1) the pandemic has impacted almost all stages of the vegetable supply chain but has had a greater impact on the sales stage;(2) the market risks of vegetable production have increased significantly, and the gap between the field price and the market price has widened. The sales price difference between traditional channels and e-commerce is notable;(3) farmers' incomes have generally declined due to the COVID-19 pandemic, and traditional small-scale farmers have suffered more losses;and (4) agricultural insurance plays an important role in stabilizing the supply of vegetables to the city. To minimize the impact of the pandemic on vegetable production and to stabilize both urban "shopping baskets" and farmers' incomes, it is necessary to further improve agricultural insurance, especially to provide insurance against market risks.