Quality of and Recommendations for Relevant Clinical Practice Guidelines for COVID-19 Management: A Systematic Review and Critical Appraisal

Background: The morbidity and mortality of coronavirus disease 2019 (COVID-19) are still increasing. This study aimed to assess the quality of relevant COVID-19 clinical practice guidelines (CPGs) and to compare the similarities and differences between recommendations.Methods: A comprehensive search was conducted using electronic databases (PubMed, Embase, and Web of Science) and representative guidelines repositories from December 1, 2019, to August 11, 2020 (updated to April 5, 2021), to obtain eligible CPGs. The Appraisal of Guidelines for Research and Evaluation (AGREE II) tool was used to evaluate the quality of CPGs. Four authors extracted relevant information and completed data extraction forms. All data were analyzed using R version 3.6.0 software.Results: In total, 39 CPGs were identified and the quality was not encouragingly high. The median score (interquartile range, IQR) of every domain from AGREE II for evidence-based CPGs (EB-CPGs) versus (vs.) consensus-based CPG (CB-CPGs) was 81.94% (75.00–84.72) vs. 58.33% (52.78–68.06) in scope and purpose, 59.72% (38.89–75.00) vs. 36.11% (33.33–36.11) in stakeholder involvement, 64.58% (32.29–71.88) vs. 22.92% (16.67–26.56) in rigor of development, 75.00% (52.78–86.81) vs. 52.78% (50.00–63.89) in clarity of presentation, 40.63% (22.40–62.50) vs. 20.83% (13.54–25.00) in applicability, and 58.33% (50.00–100.00) vs. 50.00% (50.00–77.08) in editorial independence, respectively. The methodological quality of EB-CPGs were significantly superior to the CB-CPGs in the majority of domains (P < 0.05). There was no agreement on diagnosis criteria of COVID-19. But a few guidelines show Remdesivir may be beneficial for the patients, hydroxychloroquine +/– azithromycin may not, and there were more consistent suggestions regarding discharge management. For instance, after discharge, isolation management and health status monitoring may be continued.Conclusions: In general, the methodological quality of EB-CPGs is greater than CB-CPGs. However, it is still required to be further improved. Besides, the consistency of COVID-19 recommendations on topics such as diagnosis criteria is different. Of them, hydroxychloroquine +/– azithromycin may be not beneficial to treat patients with COVID-19, but remdesivir may be a favorable risk-benefit in severe COVID-19 infection; isolation management and health status monitoring after discharge may be still necessary. Chemoprophylaxis, including SARS-CoV 2 vaccines and antiviral drugs of COVID-19, still require more trials to confirm this.

A Quantitative Method for the DNS Isolation Management Risk Estimation

The domain name system (DNS) is an important infrastructure of the Internet, providing domain name resolution services for almost all Internet communication systems. However, the current DNS is centrally managed, leading to unfair sovereignty of the Internet among countries. A domestic DNS is unable to work normally, noted as isolated management risk (IMR), especially when the national network is isolated from the rest of the Internet. To improve understanding of the DNS isolated management risk for better DNS resource deployment, it is critical to determine how serious the IMR is among various countries. In order to quantify DNS isolated management risk, this paper proposed an effective approach to collect DNS resolution demand data from the network used by various intelligent devices and to conduct data analysis to estimate isolated management risk of certain country’s domestic DNSs. Our idea is to quantify the domain name resolution demand and its relationship with the overseas resolution processes. We further used our quantitative method to compare the IMR of the USA and China and analyzed the difference between them.

An Interim Report on the Dental Practice Management: COVID-19

There is a new public health crisis threatening the world with the emergence and spread of 2019 novel coronavirus (2019-nCoV). Due to the specialty of oral healthcare settings, the risk of cross infection is severe among patients and oral healthcare practitioners as they work in close proximity to their patients employing droplet and aerosol generating procedures. The transmission modes of SARS-coronavirus appear to be through droplet spread and close contact. Although the principle of universal precautions is widely advocated and followed throughout the dental community, it is not sufficient to help control the spread of this highly contagious disease. Management protocols must be modified to minimize public health risks. This includes the identification, isolation, management and report of possible and probable cases and contacts. Patient assessment should include questions on recent travel to infected areas and, contacts of patients, fever and symptoms of respiratory infections. Hence, there is a need for strict and efficient infection control protocols as the patient may be symptomatic as well as asymptomatic.

Multi-Device Health Management Based on Elman Neural Network

For fault forecast and information exchange problems in multi-device health management, the paper proposed a multi-device and multi-parameter fault forecast technology based on Internet of Things, and improved fault prediction algorithm based on Elman neural network feedback. Therefore, it can implement approximating nonlinear functions by arbitrary accuracy, and use the feedback reference to historical data. Thereby, it can provide early detection, isolation, management and forecasting for component failure warning, the initial issuance of the fault condition and ancillary component failure and other states multi-device health management. It also improves self-learning and adaptive capacity of the system, and effectively improves the robustness of the fault prediction system.