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Objectives During the 2019 Coronavirus disease (COVID-19) outbreak, malnutrition may contribute to COVID-19 adverse outcomes. We conducted a clinical epidemiological analysis to investigate the association of malnutrition with hospitalized duration in patients with COVID-19. Design Retrospective survey study. Setting Taikang Tongji (Wuhan) hospital in Wuhan, China. Participants 139 patients with COVID-19. Methods In total, 139 patients with COVID-19 from patients in the Infection Department of Taikang Tongji (Wuhan) hospital from February 2020 to April 2020 were analyzed retrospectively. We used the “Global leadership Initiative on Malnutrition(GLIM)” assessment standard published in 2019 to assess nutritional status. Prolonged hospitalization was lasting more than the median value of the hospitalized days (17 days) in this population. Results According to the assessment results of GLIM nutrition assessment, the patients were divided into malnutrition group and normal nutrition group. Compared with the patients in the normal nutrition group, the hospitalization time was longer(15.67±6.26 days versus 27.48±5.04 days, P = 0.001). Kaplan-Meier analysis showed patients with malnutrition were more likely to be hospitalized longer compared with those normal nutrition (mean with 95% confidence interval [CI]: 28.91[27.52–30.30] versus 22.78[21.76–23.79], P = 0.001). COX regression analysis showed that malnutrition (hazard ratio [HR] = 3.773, P for trend = 0.001) was proportional associated with being discharged from hospital delayed. Conclusion and implications Present findings suggested that malnutrition contributed to predicting a probability of prolonged hospitalization in patients with COVID-19 infection, to whom extra attentions and precautions should be paid during clinical treatments. Based on the existing results, it is recommended that inpatients with nutritional risk or malnutrition start nutritional support treatment as soon as possible.

Novel coronavirus pneumonia (COVID-19) is rampant in many countries and regions and there is no time to delay the exploration of the scheme for its prevention and control. The pathogenic characteristics of novel coronavirus and the effect of moxibustion for warming up yang and strengthening the antipathogenic qi were analyzed in this paper. From the perspective of modern medical mechanism, during the prevention and treatment of novel coronaviral infection, moxibustion may be able to prevent and treat COVID-19 by improving the body's immunity so as to conquer virus, by anti-inflammation to alleviate the inflammatory response of COVID-19 and by improving lung function to inhibit pulmonary fibrosis.

Abstract Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude. The health care system is facing a tremendous challenge to provide ethical and quality care. The transformation of the patient-based care to population-based care during the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is to explore the consensus in modified standard urology care, that can be adopted and applied during COVID-19 and similar pandemic. Methods We adopted an exploratory study design using secondary data. The data were extracted from a web-based medical library using keywords “COVID-19,” “severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2),” and “urology.” We identify and extrapolate (screening, eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic standard urology care under four main themes: (1) general urology care, (2) choice of surgical modality, (3) triage, and (4) urology training. Result We identified 63 academic papers related to our research question. The majority are expert opinions and perspectives on urology care. The common consensus is triage-based urology care and surgeries. Life or organ threatening conditions need immediate attention. Universal protective measures (personal protective equipment, safe operative environment) and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection. Conservation of the resources and its rational distribution provide an ethical basis for population-based health care during a pandemic. Informed decision making serves best to patients, families, and society during the public health crisis. Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard population-based care. The consensus in crisis is drawn from evolving pieces of medical evidence and public health ethics. The provision of urology care during a pandemic is based on the availability of resources; severity of the disease, consequences of deferment of service, and dynamics of the pandemic.

Background Coronavirus disease 2019 (COVID-19) is already a pandemic. Few studies investigated the epidemic characteristics of the COVID-19 outbreak in the well-developed cities. Methods Epidemiological data of 136 confirmed COVID-19 cases were collected from the dataset of COVID-19 in Tianjin. All confirmed cases were categorized according to their potential infection sources. Daily numbers of confirmed cases of each category were plotted by date of onset, and the epidemic form of each category was inferred. Results Among the 136 confirmed COVID-19 cases, 48 cases were categorized as imported cases and their close contacts, which were the majority of early cases. A total of 43 cases were found an epidemiological link to the Baodi department store, and they were inferred to be a common-source outbreak. Additionally, 35 cases were considered as familial clusters of COVID-19 cases, and 10 cases were sporadic. The 45 cases were inferred to be a propagated epidemic. Conclusions Local transmission of COVID-19 mainly occurred within families and a poorly ventilated public place in Tianjin. Besides the imported cases, the pattern of local transmission of COVID-19 was a mixture of the propagated epidemic and the common-source outbreak in Tianjin. Highlights • Local transmission of COVID-19 is largely occurring in the well-developed cities. • The epidemic pattern was propagated combined with the common-source outbreak. • COVID-19 mainly occurred within families and a poorly ventilated public place.

Abstract Background There has been a surge in coronavirus disease 2019 admissions to intensive care units (ICUs) in Asia-Pacific countries. Because ICU healthcare workers are exposed to aerosol-generating procedures, ensuring optimal personal protective equipment (PPE) preparedness is important. Objective The aim of the study was to evaluate PPE preparedness across ICUs in six Asia-Pacific countries during the initial phase of the coronavirus disease 2019 pandemic, which is defined by the World Health Organization as guideline adherence, training healthcare workers, procuring stocks, and responding appropriately to suspected cases. Methods A cross-sectional Web-based survey was circulated to 633 level II/III ICUs of Australia, New Zealand (NZ), Singapore, Hong Kong (HK), India, and the Philippines. Findings Two hundred sixty-three intensivists responded, representing 231 individual ICUs eligible for analysis. Response rates were 68–100% in all countries except India, where it was 24%. Ninety-seven percent of ICUs either conformed to or exceeded World Health Organization recommendations for PPE practice. Fifty-nine percent ICUs used airborne precautions irrespective of aerosol generation procedures. There were variations in negative-pressure room use (highest in HK/Singapore), training (best in NZ), and PPE stock awareness (best in HK/Singapore/NZ). High-flow nasal oxygenation and noninvasive ventilation were not options in most HK (66.7% and 83.3%, respectively) and Singapore ICUs (50% and 80%, respectively), but were considered in other countries to a greater extent. Thirty-eight percent ICUs reported not having specialised airway teams. Showering and “buddy systems” were underused. Clinical waste disposal training was suboptimal (38%). Conclusions Many ICUs in the Asia-Pacific reported suboptimal PPE preparedness in several domains, particularly related to PPE training, practice, and stock awareness, which requires remediation. Adoption of low-cost approaches such as buddy systems should be encouraged. The complete avoidance of high-flow nasal oxygenation reported by several intensivists needs reconsideration. Consideration must be given to standardise PPE guidelines to minimise practice variations. Urgent research to evaluate PPE preparedness and severe acute respiratory syndrome coronavirus 2 transmission is required.

In this study, we investigated the occurrence of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) RNA in primary influent (n = 42), secondary effluent (n = 24) and tertiary treated effluent (n = 34) collected from six wastewater treatment plants (WWTPs A–F) in Virginia (WWTP A), Florida (WWTPs B, C, and D), and Georgia (WWTPs E and F) in the United States during April–July 2020. Of the 100 wastewater samples analyzed, eight (19%) untreated wastewater samples collected from the primary influents contained SARS-CoV-2 RNA as measured by reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) assays. SARS-CoV-2 RNA were detected in influent wastewater samples collected from WWTP A (Virginia), WWTPs E and F (Georgia) and WWTP D (Florida). Secondary and tertiary effluent samples were not positive for SARS-CoV-2 RNA indicating the treatment processes in these WWTPs potentially removed SARS-CoV-2 RNA during the secondary and tertiary treatment processes. However, further studies are needed to understand the log removal values (LRVs) and transmission risks of SARS-CoV-2 RNA through analyzing wastewater samples from a wider range of WWTPs.

Background Health campaign interventions, particularly those tailored to the target audience’s needs and preferences, can cost-effectively change people’s attitudes and behaviors towards better health decision-making. However, there is limited research on how to best tailor seasonal influenza vaccination campaigns for young adults. Vaccination is vital in protecting young adults and their social circles (vulnerable populations like older adults) from the influenza virus and critical in shaping these emerging adults’ vaccination habits in the long run. However, amid the prevalence of easily-accessible, attention-grabbing, and often malicious false and misinformation (e.g., COVID-19 vaccine conspiracy theories), it may be more challenging to develop vaccination messages that resonate with young adults well enough to attract their attention. Therefore, to bridge the research gap, this study examines young adults’ preferences for seasonal influenza vaccination campaigns to inform effective intervention design and development. Methods Qualitative survey questions were developed to gauge young adults’ preferences for seasonal influenza vaccination campaigns. A total of 545 young adults (73.9% female, Mage ​= ​19.89, SD ​= ​1.44) from a large University offered complete answers to a cross-sectional online survey. Braun and Clarke’s thematic analysis procedures were adopted to guide the data analysis process. Results Thematic analysis revealed that young adults prefer seasonal influenza vaccination campaigns that rely on (1) quality and balanced information from (2) credible information sources, positioned in the (3) relevant health contexts, (4) emphasize actionable messages, and incorporate (5) persuasive campaign design. Interestingly, while many participants underscored the importance of fear-appeal messages in persuading them to take health actions, some young adults also suggested avoiding fear campaigns due to discomfort. Conclusions Insights of the study can inform seasonal influenza vaccination design and development, and have the potential to shed light on vaccination messaging in other vaccine contexts, such as COVID-19 vaccines. Results also underscore the need for health experts and government officials to adopt a more nuanced approach when selecting persuasive campaign appeals. While some young adults may resonate well with fear appeals, others may not. Future research could examine the underlying mechanisms that drive young adults’ preference for vaccination campaign intervention to enrich the literature further. Highlights • Vaccination is vital in protecting young adults and their social circles from the influenza virus and shaping their vaccination habits in the long run. However, vaccination rates in young adults are suboptimal. • This study aims to investigate young adults’ preferences for seasonal influenza vaccination campaigns to inform effective intervention design and development (e.g., COVID-19 vaccination). • Thematic analysis revealed that young adults prefer vaccination campaigns that rely on 1) quality and balanced information from 2) credible information sources, positioned in the 3) relevant health contexts, 4) emphasize actionable messages, and incorporate 5) persuasive campaign design. • Interestingly, while many young adults underscored the importance of fear-appeal messages in persuading them to take health actions, some young adults also suggested avoiding fear campaigns due to discomfort.

Background Rural Australian oncology patients are known to have inferior mortality rates compared to metropolitan patients, possibly related to access to appropriate healthcare services and treatments. Electronic systems improve the safety of chemotherapy administration and allow easily accessible patient information and data collection. Aim To integrate the electronic healthcare delivery systems at a metropolitan hospital and a rural outreach haematology clinic to facilitate streamlined and safe outpatient care. Method The MOSAIQ v2.64(Elekta) system utilized at St Vincent's Hospital was introduced at a linked rural outreach haematology clinic. The two separate comprehensive practice management systems incorporating all patient information were consolidated into one, becoming accessible from both sites. Results The electronic systems were successfully integrated between the two sites in October 2017. Electronic chemotherapy prescribing at the Griffith site is now guided by inbuilt, pharmacist-reviewed protocols thereby improving the safety and flexibility of remote prescribing. The centralised EHR has improved streamlined care during patient transitions between the two hospitals with enhanced continuity of documentation and management. Increases in total clinic patients and appointment numbers are demonstrable since implementation, and sustained during the COVID-19 pandemic. Conclusion Our study provides a novel example of the successful implementation of a centralised electronic healthcare record and chemotherapy prescribing system in a haematology setting shared between a metropolitan service and a rural outreach hospital clinic. This has positive implications for the safety and efficiency of healthcare delivery at the rural site applicable to all linked rural Australian clinics, as well as allowing data collection to assist future planning of the service. This article is protected by copyright. All rights reserved.

AbstractWith the rapid development of mobile Internet in China, the information of the epidemic is full-time and holographic, and the role of information diffusion in epidemic control is increasingly prominent. At the same time, the publicity of all kinds of big data also provides the possibility to explore the impact of media information diffusion on disease transmission. This paper explores the mechanism of the influence of information diffusion on the spread of the novel coronavirus, develops a model of the interaction between information diffusion and disease transmission based on the SIR model, and empirically tests the role and mechanism of information diffusion in the spread of COCID-19 by using econometric method. The result shows that there was a significant negative correlation between the information diffusion and the spread of the novel coronavirus; The result of robust test shows that the spread of both epidemic information and protection information hindered the further spread of the epidemic.

The disasters caused by epidemic outbreaks is different from other disasters due to two specific features: their long-term disruption and their increasing propagation. Not controlling such disasters brings about severe disruptions in the supply chains and communities and, thereby, irreparable losses will come into play. Coronavirus disease 2019 (COVID-19) is one of these disasters that has caused severe disruptions across the world and in many supply chains, particularly in the healthcare supply chain. Therefore, this paper, for the first time, develops a practical decision support system based on physicians' knowledge and fuzzy inference system (FIS) in order to help with the demand management in the healthcare supply chain, to reduce stress in the community, to break down the COVID-19 propagation chain, and, generally, to mitigate the epidemic outbreaks for healthcare supply chain disruptions. This approach first divides community residents into four groups based on the risk level of their immune system (namely, very sensitive, sensitive, slightly sensitive, and normal) and by two indicators of age and pre-existing diseases (such as diabetes, heart problems, or high blood pressure). Then, these individuals are classified and are required to observe the regulations of their class. Finally, the efficiency of the proposed approach was measured in the real world using the information from four users and the results showed the effectiveness and accuracy of the proposed approach. Highlights • Developed a practical decision support system for COVID-19 healthcare supply chain. • Grouped people and provided an independent classification method for each group. • Evaluated the efficiency of the proposed approach using real-world data.