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Epidemiologic characteristics and differential management strategies of seven case series with COVID-19 outbreaks caused by asymptomatic carriers from June 2020 to May 2021 in China
Get PDFWith the COVID-19 epidemic quickly under control in China in the early stage of 2020, global cooperation/ communications may pose great challenges to epidemic control and prevention in the country. Large-scale spread by asymptomatic carriers was a concern. We obtained data on new cluster outbreak regions with COVID-19 caused by asymptomatic carriers from June 2020 to May 2021 in China, and reported the epidemiological characteristics, the possible routes of viral transmission and infection, and different control strategies. These results show the importance of regular screening for high-risk populations and differential management strategies for epidemic control, which provide an objective basis for suppressing the spread of the SARS-CoV-2 virus. These experiences can be used as a reference to minimize the subsequent spread of virus mutants in various places
Differentials in health and wellbeing in older adults with obesity in England: a cross-sectional analysis using the English longitudinal study of ageing
Get PDFObjectives
The aim of the study is to explore the association of obesity by body mass index (BMI) measurements with subjective health status (SHS), objective health status (OHS) and wellbeing status among older adults in England.
Methods
The sample of 5640 participants (aged 50 years and over) are considered from the English Longitudinal Study of Ageing Wave 8 dataset. Multivariate logistic regression analysis is performed to explore the cross-sectional relationship of the study variables.
Results
The statistical analyses explored those overweight and obese older adults are progressively vulnerable to increasing odds of poor SHS, OHS and poor wellbeing in an adjusted model compared to their normal-weight counterparts.
Conclusions
The outcome of the present study would enable policymakers and healthcare providers to have greater insight into the effects of socio-demographic and lifestyle factors and the effect of high BMI on older adults’ health and wellbeing
An Imperfect Usage-Based Preventive Maintenance Planning Model for Railway Track Superstructures.
No full textRailway transport is considered one of the most reliable, comfortable and safest modes of travel for both freight and passengers. Rail infrastructure assets (such as tracks, bridges, earthworks, tunnels and drainage systems) must be inspected and maintained on a regular basis in order to ensure that transport services are delivered in compliance with contractual and legal obligations. The maintenance of railway track structures is preventive in nature and includes the repair or replacement of certain components at pre-determined time intervals (in terms of years of operation) and/or usage rates (in terms of gross tonnage). Maintenance actions such as grinding and stone-blowing either restore the track profile to its original condition, i.e., “as good as new (AGAN)”, leave the track in almost the same condition as it was in prior to the inspection, i.e., “as bad as old (ABAO)”, or restore the track condition to a state somewhere between AGAN and ABAO, i.e., the so-called imperfect maintenance. The effect of an imperfect maintenance is often characterized by two classes of models, namely, failure-intensity reduction and age-reduction. However, the impact of imperfect repair on assets’ usage has not yet been addressed in the literature. In this paper, a usage-based imperfect preventive maintenance (PM) planning model is proposed for railway track superstructures, where the effect of an imperfect maintenance is described by a reduced amount of total accumulated million gross tons (MGT) passed over the rail line. A constrained nonlinear programming model is formulated to optimize the maintenance interval (i.e., usage rate between consecutive PMs) and the degree (quality) of repair actions. The total mean maintenance cost for a Weibull failure distribution model is derived and, then, the conditions required to make PM actions beneficial are discussed. A numerical case example is provided to show the effectiveness of the proposed PM planning method over the track renewal and replacement policy
The Philosophy of Person-Centred Healthcare
No full textThis book sets out a philosophical basis for person-centred healthcare, primarily using work by Heidegger and Gadamer, but drawing on ideas derived from Aristotle and process philosophy, in order to show how practice can be improved and how examples of person-centred practice can be transferred between individuals and institutions involved in the commissioning and provision of healthcare. By providing an underlying architectonic, this work will help to enable practitioners to understand the benefits of person-centred healthcare practice in promoting autonomy in those who are suffering from chronic and other illnesses. The text takes a phenomenological approach to healthcare because it offers a rich and subtle way of thinking about how we know what we know, and this applies to our knowledge and understanding of how healthcare works just as much as it does to all other kinds of knowledge. For those in clinical practice, this book provides a guide to the thinking behind person-centred healthcare
Cerrado and Pantanal fruit flours affect gut microbiota composition in healthy and post-COVID-19 individuals: An in vitro pilot fermentation study
Get PDFCerrado and Pantanal plants can provide fruits with high nutritional value and antioxidants. This study aims to evaluate four fruit flours (from jatobá pulp, cumbaru almond, bocaiuva pulp and bocaiuva almond) and their effects on the gut microbiota in healthy (HD) and post-COVID-19 individuals (PC). An in vitro batch system was carried out, the microbiota was analysed by 16S rRNA amplicon sequencing and the short-chain fatty acids (SCFAs) ratio was determined. Furthermore, the effect of jatobá pulp flour oil (JAO) on cell viability, oxidative stress and DNA damage was investigated in a myelomonocytic cell line. Beyond confirming a microbiota imbalance in PC, we identified flourspecific effects: i) reduction of Veillonellaceae with jatobá extract in PC samples;decrease in Akkermansia with jatoba and cumbaru flours; iii) decreasing trend of
Faecalibacterium and Ruminococcus with all flours tested, with the exception of the bocaiuva almond in HD samples for Ruminococcus; and iv) increase in Lactobacillus and Bifidobacterium in PC samples with bocaiuva almond flour. JAO displayed antioxidant properties protecting cells from daunorubicin-induced cytotoxicity, oxidative stress, and DNA damage. The promising microbiota modulating abilities of some flours and the chemopreventive effects of JAO deserve to be further explored in human intervention studies
Correction: Danner et al. It More than Adds Up: Interaction of Antibiotic Mixing and Temperature. Life 2021, 11, 1435
Get PDFThe Authors wish to make the following corrections to this paper [1]:
In the original article, there were mistakes in Figure 1, Figure 3 and Figure 5.
Figure 1: picture was not clear enough
Figure 3: layering was hiding symbols and the legend
Figure 5: layering was hiding the data points
The mistakes were caused during copy-editing. The caption in Figure 1 “are shown as numbers in cursive print” should be replaced with “are shown in the light grey boxes”
A novel active building envelope with reversed heat flow control through coupled solar photovoltaic-thermoelectric-battery systems
Get PDFHeat transmit between ambient and indoor space passively through building envelope. This heat flow intensity can be reduced by using insulations and eliminated by conventional air conditioner, which causes huge amount of energy. In this study, a new concept is proposed for a new active building envelope system that can realize heat gain/loss control and in some senses the conventional air conditioner system could be saved, because it is shown that the building envelope itself could be an air conditioner. It should be specially noted that, we can set parameter Qw in this system to determine how much extra thermal energy you want from the new building envelope. It is based on the combination of photovoltaic (PV), thermoelectric modules (TEM), energy storage and control algorithms. Five types of systems, namely PV + TE (S1), Grid + TE (S2), PV + Grid + TE (S3), PV + Battery + TE (S4) and PV + Grid + Battery + TE (S5) are studied. It is found that in all the five systems, there is a typical optimum setting of thermal load for each one of them with minimum annual power consumption
Antimicrobial prescribing
No full textAntimicrobials have revolutionised clinical care, but their use and misuse has contributed to the current drug-resistance emergency. The prescription of antimicrobials demand that prescribers demonstrate technical skills such as knowledge about pharmacokinetic and pharmacodynamics, up-to-date awareness of emerging infections and understanding of local and national drug susceptibility. In addition to these skills, prescribers must also demonstrate optimal and effective communication with patients, particularly when antibiotics are not warranted. These ‘softer’ skills are essential to balance the influence of social or cultural factors on decisions by all stakeholders involved in antibiotic usage. To balance these demands, prescribers can engage in systematic decision making that reflects upon the need and benefits of using antimicrobials. This will ensure that optimal diagnostic and imaging tests inform such decisions; following recognised guidance and best practice, whilst acknowledging the local drug susceptibilities and available resources; and engage and support patients and families to share decisions about antibiotic use and follow-up care
Children, futility and parental disagreement: the importance of ethical reasoning for clinicians in the paediatric intensive care setting
Get PDFThe provision of intensive care enables the lives of neonates, infants and children to be sustained or extended in circumstances previously regarded as impossible. However, as well as benefits, such care may confer burdens that resultingly frame continuation of certain interventions as futile, conferring more harm than or any, benefit. Subsequently, clinicians and families in the paediatric intensive care unit are often faced with decisions to withdraw, withhold or limit intensive care in order to act in the best interests of the child. An integral consideration in respect of these decisions is that futility is a concept that has to be contextualised for all those involved. Recent high-profile legal cases highlight the professional, clinical, legal and social conflicts that can arise when parents and clinicians have different interpretations of futility. In acknowledging the complexity of these conflicts for clinicians, this paper aims to support a better understanding of futility as an integral concept in such difficult and emotive decisions within professional practice. We utilise the concept of futility to frame how these decisions to withdraw or withhold certain invasive life-prolonging interventions are ethically and legally justifiable, even when they disagree or conflict with parental views. To support clinicians in understanding these decisions, we in part use the familiar bioethical framework of Principlism developed by Beauchamp and Childress. We suggest that understanding legal and ethical analysis of futility ultimately will help clinicians in approaching and reflecting on such decision-making
Practical musicology
No full textPractical Musicology outlines a theoretical framework for studying a broad range of current musical practices to provoke discussion about key issues in the rapidly expanding area of practical musicology: the study of how musicians can make ‘better music'. The book explores various forms of practice, from performance and composition to sequencing and record production, from Okinawan rock to an electric Shostakovich quartet. Drawing on neuroscience, cognitive psychology and the social construction of technology and creativity, Zagorski-Thomas uses a series of case studies and examples to investigate how practice research is already being conducted and to suggest principles for how it might continue to develop, based around the assertion that musicking cannot be treated as a culturally or ideologically neutral phenomenon