The coronavirus disease 2019 (COVID-19) pandemic increased the burden on many healthcare systems and in the process, exposed the need for medical resources and physical space. While few studies discussed the efficient utilization of medical resources and physical space so far. Therefore, this study aimed to summarize experiences related to facilities used for centralized isolation for medical observation and
treatment during the COVID-19 pandemic in China and to provide suggestions to further improve the management of confirmed cases, suspected cases, and close contacts. In China, three types of facilities for centralized isolation (Fangcang shelter hospitals, refitted non-designated hospitals, and quarantine hotels) underwent retrofitting for the treatment and isolation of confirmed and suspected cases. These
facilities mitigated the immediate high demand for space. Moreover, in order to minimize infection risks in these facilities, regulators and governmental agencies implemented new designs, management measures, and precautionary measures to minimize infection risk. Other countries and regions could refer to China's experience in optimally allocating social resources in response to the COVID-19 pandemic.
As a conclusion, government should allocate social resources and construct centralized isolation and quarantine facilities for an emergency response, health authorities should issue regulations for centralized isolation facilities and pay strict attention to the daily management of these facilities, a multidisciplinary administration team is required to support the daily operation of a centralized isolation facility, in-depth studies and international collaboration on the centralized isolation policy are encouraged.
Travel restrictions and physical distancing have been implemented across the world to mitigate the coronavirus disease 2019 (COVID-19) pandemic, but studies are needed to understand their effectiveness across regions and time. Based on the population mobility metrics derived from mobile phone geolocation data across 135 countries or territories during the first wave of the pandemic in 2020, we built a metapopulation epidemiological model to measure the effect of travel and contact restrictions on containing COVID-19 outbreaks across regions. We found that if these interventions had not been deployed, the cumulative number of cases could have shown a 97-fold (interquartile range 79–116) increase, as of May 31, 2020. However, their effectiveness depended upon the timing, duration, and intensity of the interventions, with variations in case severity seen across populations, regions, and seasons. Additionally, before effective vaccines are widely available and herd immunity is achieved, our results emphasize that a certain degree of physical distancing at the relaxation of the intervention stage will likely be needed to avoid rapid resurgences and subsequent lockdowns.
Given the scarcity of safe and effective COVID-19 vaccines, a chief policy question is how to allocate them among different sociodemographic groups. This paper evaluates COVID-19 vaccine prioritization strategies proposed to date, focusing on their stated goals; the mechanisms through which the selected allocations affect the course and burden of the pandemic; and the main epidemiological, economic, logistical, and political issues that arise when setting the prioritization strategy. The paper uses a simple, agestratified susceptible–exposed–infectious–recovered model applied to the United States to quantitatively assess the performance of alternative prioritization strategies with respect to avoided deaths, avoided infections, and life-years gained. We demonstrate that prioritizing essential workers is a viable strategy for reducing the number of cases and years of life lost, while the largest reduction in deaths is achieved by prioritizing older adults in most scenarios, even if the vaccine is effective at blocking viral transmission. Uncertainty regarding this property and potential delays in dose delivery reinforce the call for prioritizing older adults. Additionally, we investigate the strength of the equity motive that would support an allocation strategy attaching absolute priority to essential workers for a vaccine that reduces infectionfatality risk.
Coronavirus disease 2019 (COVID-19) deaths per million population in the countries of the West had often exceeded those in the countries of the East by factor of 100 by May 2021. In this paper, we refer to the West as represented by the United States plus the five most populous countries of Western Europe (France, Germany, Italy, Spain, and the United Kingdom), and the East as the 15 countries in East Asia and Oceania that are members of the Regional Comprehensive Economic Partnership, RCEP (Australia, Brunei, Cambodia, China, Indonesia, Japan, the Republic of Korea, Laos, Malaysia, Myanmar, New Zealand, Philippines, Singapore, Thailand, and Vietnam). This paper argues that currently available information points to the factors most responsible for the East–West divide. Warnings by early January
2020 about an atypical viral pneumonia in Wuhan, China, prompted rapid responses in many jurisdictions in East Asia. Publication of the virus's genome on 10 January 2020 provided essential information for making diagnostic tests and launching vaccine development. China's lockdown of Wuhan on 23 January 2020 provided a final, decisive signal of the danger of the new disease. By late March 2020, China had fully controlled its epidemic, and many other RCEP countries had taken early and decisive measures, including restrictions on travel, that aborted serious outcomes. Inaction during the critical month of February 2020 in the United States and most other Western countries allowed the disease to take hold and spread. In both the East and the West, stringent population-wide non-pharmaceutical interventions were widely implemented at great cost to societies, economies, and school systems. Without these measures, the outcomes could have been even worse. Most countries in the East also implemented tightly focused policies to isolate infectious individuals. Even today, most countries in the West allow infectious individuals to mingle with their families, coworkers, and communities. Much of the East–West divide plausibly results from failure in the West to implement the basic public health policies of early action and the isolation of infectious individuals. Widespread immunization in some RCEP and high-income countries will soon attenuate their outbreaks, while the slow rollout of vaccines in lower income countries is replacing the East–West divide in outcomes with a North–South one. The South is thus replacing the West as the breeding ground for more dangerous variants as exemplified by the highly contagious Delta variant, which may undermine hitherto successful control strategies in many countries.
The coronavirus disease 2019 (COVID-19) pandemic is a global crisis, and medical systems in many countries are overwhelmed with supply shortages and increasing demands to treat patients due to the surge in cases and severe illnesses. This study aimed to assess COVID-19-related essential clinical resource demands in China, based on different scenarios involving COVID-19 outbreaks and interventions. We used a susceptible–exposed–infectious–hospitalized/isolated–removed (SEIHR) transmission dynamics model to estimate the number of COVID-19 infections and hospitalizations with corresponding essential healthcare resources needed. We found that, under strict non-pharmaceutical interventions (NPIs) or mass vaccination of the population, China would be able to contain community transmission and local outbreaks rapidly. However, under scenarios involving a low intensity of implemented NPIs and a small proportion of the population vaccinated, the use of a peacetime–wartime transition model would be needed for medical source stockpiles and preparations to ensure a normal functioning healthcare system. The implementation of COVID-19 vaccines and NPIs in different periods can influence the transmission of COVID-19 and subsequently affect the demand for clinical diagnosis and treatment. An increased proportion of asymptomatic infections in simulations will not reduce the demand for medical resources; however, attention must be paid to the increasing difficulty in containing COVID-19 transmission due to asymptomatic cases. This study provides evidence for emergency preparations and the adjustment of prevention and control strategies during the COVID-19 pandemic. It also provides guidance for essential healthcare investment and resource allocation.
The longitudinal immunologic status of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients and its association with the clinical outcome are barely known. Thus, we sought to analyze the temporal profiles of specific antibodies, as well as the associations between the antibodies, proinflammatory cytokines, and survival of patients with coronavirus disease 2019 (COVID-19). A total of 1830 laboratory-confirmed COVID-19 cases were recruited. The temporal profiles of the virus, antibodies, and cytokines of the patients until 12 weeks since illness onset were fitted by the locally weighted scatter plot smoothing method. The mediation effect of cytokines on the associations between antibody responses and survival were explored by mediation analysis. Of the 1830 patients, 1435 were detectable for
SARS-CoV-2, while 395 were positive in specific antibodies only. Of the 1435 patients, 2.4% presented seroconversion for neither immunoglobulin G (IgG) nor immunoglobulin M (IgM) during hospitalization. The seropositive rates of IgG and IgM were 29.6% and 48.1%, respectively, in the first week, and plateaued within five weeks. For the patients discharged from the hospital, the IgM decreased slowly, while high levels of IgG were maintained at around 188 AU·mL 1 for the 12 weeks since illness onset. In contrast, in the patients who subsequently died, IgM declined rapidly and IgG dropped to 87 AU mL 1 at the twelfth week. Elevated interleukin-6, interleukin-8, interleukin-10, interleukin-1b, interleukin-2R, and tumor necrosis factor-a levels were observed in the deceased patients in comparison with the discharged patients, and 12.5% of the association between IgG level and mortality risk was mediated by these cytokines. Our study deciphers the temporal profiles of SARS-CoV-2-specific antibodies within the 12 weeks since illness onset and indicates the protective effect of antibody response on survival, which may help to guide prognosis estimation.
Three-dimensional (3D) bioprinting based on traditional 3D printing is an emerging technology that is used to precisely assemble biocompatible materials and cells or bioactive factors into advanced tissue engineering solutions. Similar technology, particularly photo-cured bioprinting strategies, plays an important role in the field of tissue engineering research. The successful implementation of 3D bioprinting
is based on the properties of photopolymerized materials. Photocrosslinkable hydrogel is an attractive biomaterial that is polymerized rapidly and enables process control in space and time. Photopolymerization is frequently initiated by ultraviolet (UV) or visible light. However, UV light may cause cell damage and thereby, affect cell viability. Thus, visible light is considered to be more biocompatible than UV light for bioprinting. In this review, we provide an overview of photo curing-based bioprinting technologies, and describe a visible light crosslinkable bioink, including its crosslinking mechanisms, types of visible light initiator, and biomedical applications. We also discuss existing challenges and prospects of visible light-induced 3D bioprinting devices and hydrogels in biomedical areas.
Inherent drawbacks associated with drug-eluting stents have prompted the development of bioresorbable cardiovascular stents. Additive manufacturing (3-dimentional (3D) printing) has been widely applied in medical devices. In this study, we develop a novel screw extrusion-based 3D printing system with a new designed mini-screw extruder to fabricate stents. A stent with a zero Poisson's ratio (ZPR) structure is designed, and a preliminary monofilament test is conducted to investigate appropriate fabrication parameters. 3D-printed stents with different geometric structures are fabricated and analyzed by observation of the surface morphology. An evaluation of the mechanical properties and a preliminary biological evaluation of 3D-printed stents with different parameters are carried out. In conclusion, the screw extrusion-based 3D printing system shows potential for customizable stent fabrication.
Semiconductor photocatalysis is a potential pathway to solve the problems of global energy shortage and environmental pollution. Black phosphorus (BP) has been widely used in the field of photocatalysis owing to its features of high hole mobility, adjustable bandgap, and wide optical absorption range. Nevertheless, pristine BP still exhibits unsatisfactory photocatalytic activity due to the low separation efficiency of photoinduced charge carriers. In recent years, the construction of heterostructured photocatalysts based on BP has become a research hotspot in photocatalysis with the remarkable improvement of photoexcited charge-separation efficiency. Herein, progress on the design, synthesis, properties, and applications of BP and its corresponding heterostructured photocatalysts is summarized. Furthermore, the photocatalytic applications of BP-based heterostructured photocatalysts in water splitting, pollutant degradation, carbon dioxide reduction, nitrogen fixation, bacterial disinfection, and organic synthesis are reviewed. Opportunities and challenges for the exploration of advanced BP-based heterostructured photocatalysts are presented. This review will promote the development and applications of BP-based heterostructured photocatalysts in energy conversion and environmental remediation.
Infectious keratitis is the most common condition of corneal diseases in which a pathogen grows in the cornea leading to inflammation and destruction of the corneal tissues. Infectious keratitis is a medical emergency for which a rapid and accurate diagnosis is needed to ensure prompt and precise treatment to halt the disease progression and to limit the extent of corneal damage; otherwise, it may develop a sight threatening and even eye-globe-threatening condition. In this paper, we propose a sequentiallevel deep model to effectively discriminate infectious corneal disease via the classification of clinical images. In this approach, we devise an appropriate mechanism to preserve the spatial structures of clinical images and disentangle the informative features for clinical image classification of infectious keratitis. In a comparison, the performance of the proposed sequential-level deep model achieved 80% diagnostic accuracy, far better than the 49.27% ± 11.5% diagnostic accuracy achieved by 421 ophthalmologists over 120 test images.
The detection of abnormal regions in complex structures is one of the most challenging targets for underground space engineering. Natural or artificial geologic variations reduce the effectiveness of conventional exploration methods. With the emergence of real-time monitoring, seismic wave velocity tomography allows the detection and imaging of abnormal regions to be accurate, intuitive, and quantitative. Since tomographic results are affected by multiple factors in practical small-scale applications, it is necessary to quantitatively investigate those influences. We adopted an improved three-dimensional (3D) tomography method combining passive acoustic emission acquisition and active ultrasonic measurements. By varying individual parameters (i.e., prior model, sensor configuration, ray coverage, event distributions, and event location errors), 37 comparative tests were conducted. The quantitative impact of different factors was obtained. Synthetic experiments showed that the method could effectively adapt to complex structures. The optimal input parameters based on quantization results can significantly improve the detection reliability in abnormal regions.
Microseismic (MS) event locations are vital aspect of MS monitoring technology used to delineate the damage zone inside the surrounding rock mass. However, complex geological conditions can impose significantly adverse effects on the final location results. To achieve a high-accuracy location in a complex cavern-containing structure, this study develops an MS location method using the fast marching method (FMM) with a second-order difference approach (FMM2). Based on the established velocity model with three-dimensional (3D) discrete grids, the realization of the MS location can be achieved by searching the minimum residual between the theoretical and actual first arrival times. Moreover, based on the calculation results of FMM2, the propagation paths from the MS sources to MS sensors can be obtained using the linear interpolation approach and the Runge–Kutta method. These methods were validated through a series of numerical experiments. In addition, our proposed method was applied to locate the recorded blasting and MS events that occurred during the excavation period of the underground caverns at the Houziyan hydropower station. The location results of the blasting activities show that our method can effectively reduce the location error compared with the results based on the uniform velocity model. Furthermore, the obtained MS location was verified through the occurrence of shotcrete fractures and spalling, and the monitoring results of the in-situ multipoint extensometer. Our proposed method can offer a more accurate rock fracture location and facilitate the delineation of damage zones inside the surrounding rock mass.