Comprehensive Control Measures Research Articles

Comprehensive infection control measures prevent hospital-acquired severe acute respiratory syndrome coronavirus 2 infection: A single-center prospective cohort study and seroprevalence survey.

BackgroundCoronavirus disease (COVID-19) is associated with a high mortality rate in older adults; therefore, it is important for medical institutions to take measures to prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission. This study aimed to assess the risk of SARS-CoV-2 infection among healthcare workers (HCWs) and the effectiveness of infection control measures.MethodsThis study had a cross-sectional component and a prospective cohort component. The cross-sectional component comprised an anti-SARS-CoV-2 antibody survey among HCWs at a medical center in Saitama City, Japan. In the prospective cohort component, HCWs at the same medical center were tested for anti-SARS-CoV-2 antibodies monthly over a 3-month period (May to July 2020) to assess the effectiveness of infection prevention measures, including personal protective equipment use. All participants in the cohort study also participated in the antibody survey. The primary outcome was anti-SARS-CoV-2 antibody (measured using Elecsys® Anti-SARS-CoV-2) positivity based on whether participants were engaged in COVID-19-related medical care. Other risk factors considered included occupational category, age, and sex.ResultsIn total, 607 HCWs participated in the antibody survey and 116 doctors and nurses participated in the cohort study. Only one of the 607 participants in the survey tested positive for anti-SARS-CoV-2 antibodies. All participants in the cohort study were anti-SARS-CoV-2 antibody negative at baseline and remained antibody negative. Engaging in the care of COVID-19 patients did not increase the risk of antibody positivity. During the study period, a total of 30 COVID-19 in-patients were treated in the hospital.ConclusionsThe infection control measures in the hospital protected HCWs from nosocomially acquired SARS-CoV-2 infection; thus, HCWs should engage in COVID-19-related medical care with confidence provided that they adhere to infectious disease precautions.

Characteristics and trends of HIV/AIDS cases with the non-martial and non-commercial heterosexual transmission in Henan province, 2015-2020

Objective: To analysis the characteristics and trends of non-martial and non-commercial heterosexual transmission of HIV/AIDS cases in Henan province between 2015 and 2020. Methods: Information of newly reported HIV/AIDS through non-martial and non-commercial heterosexual transmission was collected from National Comprehensive HIV/AIDS Information system, using SPSS 22.0 to analyze the characteristics and tend of cases. Results: During 2015-2020, a total of 10 877 HIV/AIDS cases infected by non-martial and non-commercial heterosexual transmission were newly reported in Henan province. This mode of infection increased from 32.6% in 2015 to 35.5% in 2020 (trend χ2=81.880,P<0.01). The male to female ratio was 1.9∶1 (7 105∶3 772). The mean age was (45.5±15.8) years, increasing annually (F=5.184,P<0.01). For female cases, the proportion of aged 15-50 years group was decreased annually (trend χ2=69.888, P<0.01). Most HIV/AIDS cases were distributed in the early HIV epidemic areas and Zhengzhou city, the same as the cases of the first CD4+T cells counts (CD4) below 200 cells/μl. The median (P25, P75) first CD4 count was 298 (143, 462) cells/μl. The proportion of the first CD4<200 cells/μl was no significant change annually, while the proportion of the first CD4≥500 cells/μl was decreasing annually (trend χ2=18.961,P<0.01). Conclusions: The reported cases through non-martial and non-commercial heterosexual transmission increased, with most of them were male, married, junior, farmer, migrant laborer, and aged 40-59 years. It is needed to focus on the rural district and the middle-aged population, combined with biological and social factors to control the prevalence of AIDS through comprehensive prevention and control measures.

Epidemiological characteristics of close contacts of COVID-19 cases and infection-related risk factors in Beijing

Objective: To analyze the epidemiological characteristics of close contacts of COVID-19 cases and infection-related risk factors in Beijing and provide evidences for COVID-19 prevention and control. Methods: A total of 20 681 close contacts of COVID-19 cases, who had exposures during January 6, 2020 to February 15, 2021, were traced in Beijing. The information about their demographic characteristics, exposure history, and quarantine outcomes were collected and analyzed with descriptive statistics. The logistic regression analysis was used to identify the risk factors for COVID-19. Results: The infection rate SARS-CoV-2 in close contacts was 2.16% (447/20 681). The age M(P25, P75) was 35 (27, 49) years. The majority of the close contacts were aged 20-59 years, accounting for 81.77% (16 912/20 681). Centralized isolation was the major type of medical observation, accounting for 82.15% (16 989/20 681). Among the exposure types, working and studying in the same room (16.06%, 3 322/20 681), sharing same transport vehicle (12.88%, 2 664/20 681), performing diagnosis and treatment nursing (7.80%,1 612/20 681), and living together (7.23%,1 495/20 681), accounting for 43.96% (9 093/20 681). The index cases included staff (19.34%, 3 999/20 681), the unemployed (17.34%, 3 586/20 681), people engaged in business service (13.85%, 2 864/20 681), people engaged in food service (10.77%, 2 228/20 681), their close contacts accounted for 61.30% (12 677/20 681). Multivariate logistic regression analysis showed that compared with other types of exposure, the risk factors for infection were having meal together (OR=3.96, 95%CI: 2.30-6.83) and living together (OR=6.41, 95%CI:4.48-9.17); Compared with the other occupations, the index case being engaged in food service (OR=3.06, 95%CI:1.29-7.25) and teacher (OR=4.94, 95%CI:1.43-17.08) were risk factors for the infection. Conclusions: The main environmental exposure types of SARS-CoV-2 infection in close contacts were having meal together and living together. Contact with the index case being engaged in food service and teacher increased the risk for COVID-19. Comprehensive prevention and control measures such as centralized isolation and vaccination should be continued.

Inhalation and ingestion of Synthetic musks in pregnant women: In silico spontaneous abortion risk evaluation and control

Synthetic musks (SMs) are odor additives commonly used in the personal care products. Their wide existence in the environment and the recently reported adverse impact on the production and activity of progesterone and estrogen have raised pregnancy red flags and even lead to a pregnancy loss. Apart from the suggestion of limiting SM contact and exposure, effective abortion risk control measures for SMs remain to be blank. Facing the above challenges, this study tried to establish a new theoretical circumvention strategy to reduce the abortion risk of SMs to pregnant women by designing the supplementary diet plan and environmentally friendly SMs derivatives using molecular docking and three-dimensional quantitative structure–activity relationship (3D-QSAR) models. According to the supplementary diet plan, the diet combination of vitamin E, vitamin B2, niacin, vitamin A, and vitamin B6 were confirmed to not only provide essential nutrients for human health, but also reduce the abortion risk in pregnant women in daily life. The multi-activity (binding ability of SMs with progesterone-estrogen) 3D-QSAR model was constructed to screen SMs derivatives. The LibDock score, a parameter reflecting the binding ability between SMs’ Derivative-24 with progesterone-estrogen, decreased as much as 137.67% compared with its precursor galaxolide (HHCB). The 3D-QSAR models assisted screening indicated that Derivative-24 had lower environmental impacts (i.e., bioconcentration and mobility) and improved functional properties (odor stability, musky scent, and odor intensity). The integration of the optimum candidate, Derivative-24, with optimum three supplementary diet plans exhibited a much lower abortion risk than HHCB, demonstrating the effectiveness of the proposed theoretical circumvention strategy as a comprehensive abortion risk control measure. It also shed light on the design of new pharmaceutical and personal care products using advanced computing tools.

The resilience of Dwarf goats to environmental stress: A review

Goat plays a vital role in the rural village economy and are critical for food security and livelihood. The contributions of goats to the economy of millions of rural people notwithstanding are hindered by severe heat stress due to the global climate change. Prediction of climate change impact indicate that heat stress is the overriding factor influencing native habitats of different species of domestic animals and is an important determinant for either survival of each species in its current state with consequent decline in performance or in more severe conditions, species extinction. However, West African Dwarf (WAD) goats surpass other ruminants and have optimally adapted to harsh environmental conditions because of their unique adaptive traits. The goats can adapt to heat stress through a combination of morphological, behavioral, physiological and genetic traits. This review paper therefore, provides an update of integrative facts of potential impact of global climate change, and unique adaptive traits of WAD goats responsible for their resilience to environmental stress. The elucidation of the mechanisms involve in WAD goats’ adaptation may facilitate adoption of comprehensive control measures to ameliorate the impact of environmental stress in domestic animals.

Basic Reproduction Number of the 2019 Novel Coronavirus Disease in the Major Endemic Areas of China: A Latent Profile Analysis.

Objective: The aim of this study is to analyze the latent class of basic reproduction number (R0) trends of the 2019 novel coronavirus disease (COVID-19) in the major endemic areas of China.Methods: The provinces that reported more than 500 cases of COVID-19 till February 18, 2020 were selected as the major endemic areas. The Verhulst model was used to fit the growth rate of cumulative confirmed cases. The R0 of COVID-19 was calculated using the parameters of severe acute respiratory syndrome (SARS) and COVID-19. The latent class of R0 was analyzed using the latent profile analysis (LPA) model.Results: The median R0 calculated from the SARS and COVID-19 parameters were 1.84–3.18 and 1.74–2.91, respectively. The R0 calculated from the SARS parameters was greater than that calculated from the COVID-19 parameters (Z = −4.782 to −4.623, p < 0.01). Both R0 can be divided into three latent classes. The initial value of R0 in class 1 (Shandong Province, Sichuan Province, and Chongqing Municipality) was relatively low and decreased slowly. The initial value of R0 in class 2 (Anhui Province, Hunan Province, Jiangxi Province, Henan Province, Zhejiang Province, Guangdong Province, and Jiangsu Province) was relatively high and decreased rapidly. Moreover, the initial R0 value of class 3 (Hubei Province) was in the range between that of classes 1 and 2, but the higher R0 level lasted longer and decreased slowly.Conclusion: The results indicated that the overall R0 trend is decreased with the strengthening of comprehensive prevention and control measures of China for COVID-19, however, there are regional differences.

Analysis of comprehensive surveillance results of respiratory tract infectious diseases in Taizhou, 2012-2019

Objective To understand the epidemiological characteristics of influenza-like illness (ILI) cases and severe acute respiratory infection (SARI) cases in Taizhou, so as to provide a basis for scientific prevention and control strategies. Methods The basic information of ILI and SARI cases and throat swab specimens were collected from the sentinel hospital and 13 respiratory pathogens were detected by RT-PCR method.χ2 test was used as statistical analysis method. Results From April 2012 to December 2019, with epidemic peaks in autumn and winter, the percentages of ILI visits (ILI%) and SARI visits (SARI%) were 7.27% and 2.44%, respectively. Finally, 956 ILI case specimens and 557 SARI case specimens were detected. The positive detection rates of the two types of cases were 50.84% (486/956) and 39.14% (218/557), separately. Streptococcus pneumoniae (SP), influenza virus (Flu), Haemophilus influenzae (HI) and Human rhinovirus (HRV) were the dominant pathogens in Taizhou city from April 2012 to December 2019, and their detection rates were 14.81%, 9.25%, 9.39% and 7.73%, respectively. The total mixed infection rate was 30.11% (212/704), which was mainly caused by SP complicated with other pathogenic infections. The positive rate of pathogen detection in the low-age group was higher than that in the high-age group, and the detection rate of children under 5 years old was 34.83% (χ2=54.47, P Conclusions The incidence of comprehensive respiratory tract surveillance in sentinel hospitals in Taizhou City showed that the peak of the epidemic was in autumn and winter, and SP, Flu, HI, and HRV were main pathogens in this area. In the age group under 15 years old, the detection rate was higher. Comprehensive respiratory disease prevention and control measures should be taken for key populations.

Gap analysis on Thailand’s regulatory framework vis-à-vis Framework Convention on Tobacco Control towards the policy development on more comprehensive tobacco control measures

Gap analysis on Thailand’s regulatory framework vis-à-vis Framework Convention on Tobacco Control towards the policy development on more comprehensive tobacco control measures

Water management for industrial development, energy conservation, and subjective attitudes: a comprehensive risk-oriented model to explore the tolerance of unbalanced allocation problem

Abstract In this study, a new concept concerning comprehensive characteristics of water resources utilization as an index for risk modeling within the water allocation management model is proposed to explore the tolerance of unbalanced allocation problem under the water–energy nexus. The model is integrated with interval two-stage stochastic programming for reflecting system uncertainties. These uncertainties are associated with the industrial production feature and the decision-making process. With respect to the water–energy nexus, energy proposed is mainly focused on the consumption intensity of water purification and transportation from different water sources. The developed model is applied for industrial water resources allocation management in Henan province, China. Multiple scenarios related to disparate energy consumption control and the comprehensive risk levels are simulated to obtain a reasonable trade-off among system profit, comprehensive risk, and energy consumption. The results indicated that the strict comprehensive risk management or energy consumption control measures could cause damage to system benefit owing to decreasing the flexibility of industrial water resources distributions, and the preliminary energy consumption or the comprehensive risk control would be beneficial to moderate the conflict between industrial sectors and water resources, and accelerate industrial structure transformation in the future.

Effective COVID-19 Control: A Comparative Analysis of the Stringency and Timeliness of Government Responses in Asia.

Aim: Many governments in East and Southeast Asia responded promptly and effectively at the onset of the COVID-19 pandemic. Synthesizing and analyzing these responses is vital for disease control evidence-based policymaking. Methods: An extensive review of COVID-19 control measures was conducted in selected Asian countries and subregions, including Mainland China, Hong Kong, Taiwan, South Korea, Singapore, Japan, and Vietnam from 1 January to 30 May 2020. Control measures were categorized into administrative, public health, and health system measures. To evaluate the stringency and timeliness of responses, we developed two indices: the Initial Response Index (IRI) and the Modified Stringency Index (MSI), which builds on the Oxford COVID-19 Government Response Tracker (OxCGRT). Results: Comprehensive administrative, public health, and health system control measures were implemented at the onset of the outbreak. Despite variations in package components, the stringency of control measures across the study sites increased with the acceleration of the outbreak, with public health control measures implemented the most stringently. Variations in daily average MSI scores are observed, with Mainland China scoring the highest (74.2), followed by Singapore (67.4), Vietnam (66.8), Hong Kong (66.2), South Korea (62.3), Taiwan (52.1), and Japan (50.3). Variations in IRI scores depicting timeliness were higher: Hong Kong, Taiwan, Vietnam, and Singapore acted faster (IRI > 50.0), while Japan (42.4) and Mainland China (4.2) followed. Conclusions: Timely setting of stringency of the control measures, especially public health measures, at dynamically high levels is key to optimally controlling outbreaks.

Global high-throughput genotyping of organellar genomes reveals insights into the origin and spread of invasive starry stonewort (Nitellopsis obtusa)

Aquatic invasive species are damaging to native ecosystems. Preventing their spread and achieving comprehensive control measures requires an understanding of the genetic structure of an invasive population. Organellar genomes (plastid and mitochondrial) are useful for population level analyses of invasive plant distributions. In this study we generate complete organellar reference genomes using PacBio sequencing, then use these reference sequences for SNP calling of high-throughput, multiplexed, Illumina based organellar sequencing of fresh and historical samples from across the native and invasive range of Nitellopsis obtusa (Desv. in Loisel.) J.Groves, an invasive macroalgae. The data generated by the analytical pipeline we develop indicate introduction to North America from Western Europe. A single nucleotide transversion in the plastid genome separates a group of five samples from Michigan and Wisconsin that either resulted from introductions of two closely related genotypes or a mutation that has arisen in the invasive range. This transversion will serve as a useful tool to understand how Nitellopsis obtusa moves across the landscape. The methods and analyses described here are broadly applicable to invasive and native plant and algae species, and allow efficient genotyping of variable quality samples, including 100-year-old herbarium specimens, to determine population structure and geographic distributions.

The New Porcine Epidemic Diarrhea Virus Outbreak May Mean That Existing Commercial Vaccines Are Not Enough to Fully Protect Against the Epidemic Strains.

Background: On October 30, 2020, piglets and sows in the farrowing house of a pig farm in Jiangxi showed clinical symptoms such as anorexia, watery diarrhea, and vomiting. Epidemiological test, clinical necropsy, and RT-PCR test were carried out on the pig farm for diagnosis. After comprehensive considerations, the disease was judged as porcine epidemic diarrhea virus infection.Results: Thereafter, a series of comprehensive prevention and control measures such as emergency vaccination with autogenous vaccines were adopted. Half a month after inoculation with autogenous vaccines for the farm, the mortality rate of newborn piglets in the farrowing house began to decline, and production gradually returned to being stable. The second-generation sequencing analysis and phylogenetic analysis showed that the porcine epidemic diarrhea virus (PEDV) sequence obtained from the stool and small intestine samples of the diseased pigs on the farm was 97.8% homologous to the vaccine strain. At the same time, antibody testing found that the vaccinated pigs on the pig farm had satisfactory immune response.Conclusion: This case indicated that the PEDV outbreak on the pig farm might aggravate owing to the strain being mutated and could escape the immune protection of the existing vaccine. This case has accumulated technical data for the clinical prevention and control of porcine epidemic diarrhea.

Pain-related Prescribing Patterns and Associated Factor in Breast Cancer Patients

Other SectionsAbstractBody대상 및 방법연구 결과고 찰결 론감사의 말씀이해상충TableReferenceBackground: With an increase in the number of breast cancer survivors, greater importance is attached to health-related quality of life, particularly pain and symptom control. This study aimed to identify the factors that are associated with pain in cancer patients based on the patterns of prescribing opioid, non-opioid, and adjuvant analgesics. Methods: This analysis included new patients who had developed breast cancer between 2003 and 2012. The degree of pain was analyzed based on the socio-demographic (age, income quintile, number of hospitalizations, and duration of disease), indicator (Body Mass Index; BMI, Charlson Comorbidity Index; CCI, Cumulative Analgesic Consumption Score; CACS), operation (mastectomy, lymph node dissection), and therapy (chemotherapy, radiation therapy), as well as complication-related variable (lymphedema). Results: As for the patterns of prescribing analgesics by stages, non-opioid and opioid analgesics constituted 30.7 and 69.3%, respectively. The mean value and variance of CACS were 5.596 and 12.567, respectively. The factors that significantly affected the degree of pain were age (≥50; IRR: 1.848, 95% CI 1.564- 2.184, p=0.000), income quintile (IRR: 0.964, 95% CI 0.938-0.991, p=0.008), BMI (≥ 25; IRR: 1.479, 95% CI 1.222-1.795, p= 0.000), CCI (≥ 4; IRR: 1.649, 95% CI 1.344-2.036, p=0.000), and lymphedema (yes; IRR: 1.267, 95% CI 1.006-1.610, p=0.047). Conclusions: It is necessary to develop systematic and comprehensive pain control measures to improve the quality of life for breast cancer survivors, especially for those who are 50 years or older, lie in the lower-income quintile, have BMI of ≥25 and CCI score ≥ 4, or have lymphedema.Keywords : Breast neoplasms, cancer pain, comorbidity, analgesics, prescriptions

Violence and abuse experiences and associated risk factors during the COVID-19 outbreak in a population-based sample of Norwegian adolescents

BackgroundThe lockdowns occurring across society because of the COVID-19 pandemic have had far-reaching consequences for children and adolescents. One immediate concern was what the impact of the comprehensive disease control measures on rates of violence and abuse against children and adolescents would be. ObjectiveWe aimed to establish rates of child abuse and degree of family conflict during the first COVID-19 lockdown spring 2020. Additionally, we aimed to investigate associations between preexisting and concurrent risk factors and abuse during these unique times. Participants and settingA total of 3545 Norwegian 13- to 16-year-olds participated in this study. A total of 1944 of these had provided data 1 year before the lockdown. MethodsWe used a web survey format to assess abuse exposure and associated risk factors. The survey was administered in schools during school hours in June 2020, shortly after the reopening of schools after the first lockdown. ResultsIn this sample 8.2% reported psychological abuse during lockdown, 2.4% had experienced physical abuse and 1.4% sexual abuse. For online sexual abuse, the rate was 5.6% during this time period. Adolescents did not report an increase in family conflict. Concurrently perceived family affluence and family risk factors were most strongly associated with physical abuse during lockdown (OR = 11.01(95% CI 5.32–22.84); OR = 5.36 (95% CI 2.69–10.67)), but also other types of child maltreatment. Analyses across assessment points suggested that prior victimization was the most accurate predictor of abuse experiences during lockdown (OR = 3.84 (95% CI 2.85–5.20)). ConclusionsThe negative consequences of the COVID-19 preventative measures struck the adolescent population unevenly. The findings underscore the need for targeted measures to mitigate the negative outcomes of health-related crises for adolescents in risk groups such as those with low family affluence and prior abuse experiences.

Catastrophic Mechanism and Stability Analysis of Jiangdingya Landslide in Zhouqu County, Gansu Province, China

On July 12, 2018, a large-scale landslide occurred in the Jiangdingya area, Nanyu Town, Gansu Province, China. According to remote sensing interpretation and field investigation, the landslide volume is about 480×104 - 550×104m3, which caused the Bailongjiang River to be blocked and the water level to rise, forming a dammed lake, flooding Nanyu Town. The landslide is characterized by chain disasters, which poses a serious threat to the ecological security of the upper reaches of the Yangtze River. In this paper, the catastrophic mechanism of Jiangdingya landslide is analyzed, and the stability of the slope is studied. According to the disaster characteristics, comprehensive safety control measures are put forward. The research results of this paper are of great significance to the prevention and control of chain disasters and the comprehensive treatment of slopes.

Study on Gas Comprehensive Control Technology in Steep and Extra Thick Coal Seam

In order to improve the gas drainage amount and drainage rate of steeply inclined and extra thick coal seam and realize the safe and efficient mining of coal mine, the distribution and evolution law of surrounding rock stress field and fracture field of horizontal slicing mining face in steeply inclined coal seam were revealed by using numerical simulation method, and the gas flow process and law from lower pressure relief gas to slicing mining face were analyzed The comprehensive control measures of the combination of pressure relief gas interception and drainage and buried pipe drainage in the goaf of this layer have realized the effective gas control of the mining face in the mine production process. The research results play a typical demonstration role for the comprehensive control of rock burst and gas in steep and extra thick coal seam in Xinjiang and even in the whole country, and have promotion significance.

Research on Mechanism of Rock Burst in Key Working Faces under Thick Magmatite in Deep Mine

The rock burst of key working faces under the thick hard rock in deep mine significantly threatens the mining safety of deep mine. In this study, the key working faces under typical deeply buried thick magmatite were adopted as the engineering background. The mine pressure characteristics during the mining in key working faces under thick magmatite in deep mine were measured and analyzed. Then, the evolution of overburden strata structure under the control of thick magmatite was explored based on the theory of mine pressure to conclude that the horizontal “carrier” load of broken rock beam, the vertical “loader” load, and the shock bump load from thick magmatite fracture are main sources of force behind the burst. Finally, the mechanism of rock burst was studied on the basis of the balanced relationship between loading and bearing. According to the results of research, the burst in key working faces under thick magmatite in deep mine was actually the instability burst of the key working face block. The bearing capacity and load of key working face block were constantly changing during the unstable movement of thick magmatite. The rock burst would occur in the event of any instability during the dynamic confrontation of “loading-bearing”. As per different burst sources, it could be divided into flexural loading burst of thick magmatite and shock bump burst of thick magmatite fracture. The mechanical conditions for each of the two bursts and the width calculation formula for the key working face free from overall instability burst were deduced. The research results were applied to key working face 12310. Meanwhile, the purpose of safe production following the principle of “No disaster in bumps, no harm under burst” was realized by implementing the “Four Keys” comprehensive prevention and control measures of “key monitoring + key speed reduction + key pressure relief + key support”.

Effects of medical resource capacities and intensities of public mitigation measures on outcomes of COVID-19 outbreaks

BackgroundThe COVID-19 pandemic is complex and is developing in different ways according to the country involved.MethodsTo identify the key parameters or processes that have the greatest effects on the pandemic and reveal the different progressions of epidemics in different countries, we quantified enhanced control measures and the dynamics of the production and provision of medical resources. We then nested these within a COVID-19 epidemic transmission model, which is parameterized by multi-source data. We obtained rate functions related to the intensity of mitigation measures, the effective reproduction numbers and the timings and durations of runs on medical resources, given differing control measures implemented in various countries.ResultsIncreased detection rates may induce runs on medical resources and prolong their durations, depending on resource availability. Nevertheless, improving the detection rate can effectively and rapidly reduce the mortality rate, even after runs on medical resources. Combinations of multiple prevention and control strategies and timely improvement of abilities to supplement medical resources are key to effective control of the COVID-19 epidemic. A 50% reduction in comprehensive control measures would have led to the cumulative numbers of confirmed cases and deaths exceeding 590,000 and 60,000, respectively, by 27 March 2020 in mainland China.ConclusionsMultiple data sources and cross validation of a COVID-19 epidemic model, coupled with a medical resource logistic model, revealed the key factors that affect epidemic progressions and their outbreak patterns in different countries. These key factors are the type of emergency medical response to avoid runs on medical resources, especially improved detection rates, the ability to promote public health measures, and the synergistic effects of combinations of multiple prevention and control strategies. The proposed model can assist health authorities to predict when they will be most in need of hospital beds and equipment such as ventilators, personal protection equipment, drugs, and staff.

Characterization of Carbapenem-Resistant Klebsiella pneumoniae ST15 Clone Coproducing KPC-2, CTX-M-15 and SHV-28 Spread in an Intensive Care Unit of a Tertiary Hospital.

ObjectiveNosocomial infection caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) is a great threat to severely ill patients. Here we report an outbreak of K. pneumoniae ST15 isolates co-producing KPC-2, CTX-M-15, and SHV-28 in the cardiac surgery intensive care unit (CSICU) of a tertiary hospital.Materials and MethodsFrom November 2019 to August 2020, all non-duplicated CRKP isolates were collected from the CSICU. The VITEK-2 compact system was used for bacterial identification and antimicrobial susceptibility testing. Clinical data were retrieved from electronic case records. All strains were also subjected to antibiotic resistance genes detection. Clonal relationships were analyzed by multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE).ResultsA total of 28 non-duplicated CRKP isolates were collected, including 23 strains belonging to ST15 and 5 strains belonging to ST11. All ST15 isolates were susceptible to amikacin, tigecycline, polymyxin B and ceftazidime/avibactam, but resistant to carbapenems, cephalosporins, quinolones, tobramycin and gentamicin. The detection of resistant determinants showed that 21 strains of ST15 CRKP co-harboured blaKPC-2, blaCTX-M-15, blaSHV-28, blaTEM-1, blaOXA-1 and aac(6ʹ)-Ib-cr. All the 28 CRKP isolates were classified into five PFGE patterns (A, B, C, D and E), of which type A and B belonged to ST15 and type C, D and E belonged to ST11. PFGE type A was the predominant clonotype of this nosocomial infection and belonged to ST15.ConclusionK. pneumoniae ST15 co-producing KPC-2, CTX-M-15, SHV-28, TEM-1, OXA-1 and aac(6ʹ)-Ib-cr is the predominant clone spread in the CSICU. Surveillance and comprehensive infection control measures should be strengthened in clinical practice.

Structural Elements, Synergy Mechanism and System Optimization of Atmospheric Environmental Self-cleaning Capability

On the basis of defining the connotation and structural elements of atmospheric environmental self-cleaning capability, this paper systematically analyses the synergy mechanism of atmospheric environment self-cleaning capability, and puts forward the system optimization of atmospheric environmental self-cleaning capability. The self-cleaning ability of the atmospheric environment mainly includes nature’s ability to cleanse itself and rationality of human design. The synergy mechanism of self-cleaning capability of nature mostly refers to the fact that pollutants in the atmosphere can be transformed chemically or scavenged by means of the dry deposition, wet deposition, transportation and dispersion of atmospheric hydrometeors, such as rain, snow, wind, geography, humidity and the like. The synergy mechanism of rationality of human design chiefly refers to the human ability to take a variety of comprehensive prevention and control measures such as reasonable urban planning, wind tunnel design, hydraulic facilities, pollution source layout and others to make the most of nature’s self-cleaning capability and the ability to reduce the impact of the atmospheric pollutants. On this basis, seven measures have been proposed system optimization of atmospheric environmental self-cleaning capability. First, we should quicken the construction of artificial wetlands in areas with lower atmospheric self-cleaning capability; second, we should rapidly improve the vegetation coverage rate in the areas with low atmospheric self-cleaning capability; third, we should systematically plan urban construction in areas with lower atmospheric self-cleaning capability; fourth, we should scientifically construct urban air ducts in the area with low atmospheric environment self-cleaning capability; fifth, we should work out scientific production plans for the pollution intensive industries and gradiently transferring pollution intensive industries; sixth, we should vigorously propel the ecological migration work in areas with lower atmospheric self-cleaning capability; seventh, we should strengthen the construction of a linkage system of atmospheric environment self-cleaning capability.