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Building a resilient and stable supply chain has become an important strategy for many countries. Studies have shown that the application of additive manufacturing (AM) technology in construction can help offset the negative impact of "black swan events” on supply chains. This study examines the construction industry based on AM technology and analyzes the impact of changes in the industry chain on the supply chains. The specific factors that affect the resilience of AM construction supply chains were identified through literature research and expert interviews, including 7 dimensions and 21 secondary indicators. An intuitionistic fuzzy analytic hierarchy process (IFAHP) evaluation model was established. Finally, an example of an AM construction manufacturer, YC Enterprise, was introduced to quantify the various factors and determine the weights. The results show that the essence of building a supply chain with AM is creating a closed-loop supply chain. The impact of AM construction manufacturers on supply chain resilience (SCR) is the most critical, followed by that of regulatory authorities and general contractors. The AM construction SCR assessment index system and evaluation method constructed in this paper have important significance in filling the gap in the quantitative evaluation of the impact of AM on supply chains.
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Background: Since initially detected in late December 2019, the novel coronavirus disease 2019 (COVID-19) outbreak rapidly swept the world, which has profoundly affected healthcare system and clinical practice in the management of gastrointestinal diseases. Objectives: We aimed to evaluate the impact of COVID-19 pandemic on the pattern of hospital admissions and healthcare services for acute pancreatitis (AP). Design: We conducted a retrospective observational cohort study using the anonymized electronic medical records. Methods: This single-center, retrospective observational study from a regional medical center in the northeast of China included all consecutively admitted patients with AP from 23 January to 10 June 2020 (during the COVID-19 outbreak in Harbin), compared with the equivalent period of the previous year, in terms of demographics, clinical characteristics, and in-hospital outcomes. Results: In this article, we observed a reduction in AP admissions after the beginning of COVID-19 outbreak. With the prolonged time from symptom onset to hospitalization [32.0 (22.0-72.0) versus 18.0 (12.0-24.0) h; p < 0.001], a higher proportion of AP patients developed acute renal failure (14.0% versus 7.4%, p = 0.004) and acute necrotic collection (16.5% versus 11.2%; p = 0.038) in the COVID-19 era. The percentage of alcohol etiology significantly decreased after the implementation of social restriction measures (11.5% versus 20.4%; p = 0.002), whereas biliary etiology was numerically more common amidst the COVID-19 era (41.6% versus 32.6%; p = 0.014). No significant differences were found in the rates of intensive care unit admission and mortality between the two groups. Conclusion: This study preliminarily demonstrated the descending trend and delay in hospital presentations for AP during the outbreak of COVID-19. Given that the pandemic may persist for several years, adjustments of medical services according to the varying degrees of local breakouts are imperative to provide appropriate care for AP patients and diminish the risk of viral transmission. Registration: ClincialTrials.gov number ChiCTR2100043350.
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Introduction: Since initially detected in late December 2019, the novel coronavirus disease (COVID-19) outbreak rapidly swept the world. We aimed to evaluate the impact of COVID-19 pandemic on the pattern of hospital admissions and healthcare services for acute pancreatitis(AP). Methods: This single-center, retrospective observational study from a regional medical center in the northeast of China included all consecutively admitted patients with AP from January 23 to June 10, 2020 (during the COVID-19 outbreak in Harbin), compared with the equivalent period of the previous year, in terms of demographics, clinical characteristics, and in-hospital outcomes. Results: In the present article, we observed a reduction in AP admissions after the onset of COVID-19. With the prolonged time from symptom onset to hospitalization (32.0 [22.0–72.0] versus 18.0 [12.0–24.0] hours; P <.001), a higher proportion of patients developed acute renal failure (39% versus 34%, P =.004) and acute necrotic collection (16.5% versus 11.2%; P =.038) in the COVID-19 era. The percentage of alcohol etiology significantly reduced after the implementation of social restriction measures (11.5% versus 22.4%; P <.001), whereas biliary etiology was numerically more common amidst the COVID-19 era (41.6% versus 32.6%; P = .014). No significant differences were found in the rates of intensive care unit admission and mortality between the two groups. Conclusions: The current study preliminarily demonstrated the descending trend and delay in hospital presentations for AP during the pandemic. The COVID-19 pandemic requires the modification of medical centers to optimize the management of AP and the containment of nosocomial viral transmission. Trial Registration: ClincialTrials.gov number, ChiCTR2100043350. Funding: None to declare Declaration of Interest: None to declare Ethical Approval: Ethical approval was obtained from the Ethics Committee of 1st HMU.<br>
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COVID-19 , Pancreatitis , Lesión Renal AgudaRESUMEN
BACKGROUND: COVID-19 is an extremely severe infectious disease. However, few studies have focused on the epidemiological and clinical characteristics of pediatric COVID-19. This study conducted a retrospective review of the epidemiological and clinical features of COVID-19 in children. METHODS: A retrospective study was conducted on children with a definite diagnosis of COVID-19 in mainland China using the web crawler technique to collect anonymous COVID-19 updates published by local health authorities. RESULTS: Three hundred forty-one children aged 4 days to 14 years with a median age of 7 years were included. Sixty-six percent of pediatric patients were infected via family members with COVID-19. The median incubation period was 9 days (interquartile range, 6 to 13). Asymptomatic cases accounted for 5.9%, of which 30% had abnormal chest radiologic findings. A majority of pediatric COVID-19 cases showed mild to moderate clinical features, and only a few developed severe or critical diseases (0.6% and 0.3%, respectively). Fever (77.9%) and cough (32.4%) were the predominant presenting symptoms of pediatric COVID-19. The pediatric patients had fewer underlying diseases and complications than adults. The treatment modalities for pediatric COVID-19 patients were not as complex as those of adult COVID-19 patients. The overall prognosis of pediatric COVID-19 was benign with a decent recovery. The median time from onset to cure was 16 days (interquartile range, 13 to 21). CONCLUSIONS: Compared to adults, COVID-19 in children has distinct features of epidemiology and clinical manifestations. The findings from this study might help to guide the development of measures to prevent and treat this ongoing global pandemic. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( chictr.org.cn ) identifier: ChiCTR2000030464.