Spatial pattern of COVID-19 in Bangladesh: an ecological study

ObjectiveTo analyse the spatial clustering of COVID-19 case fatality risks in the districts of Bangladesh and to explore the association of sociodemographic indicators with these risks.Study designEcological study.Study settingSecondary data were collected for a total of 64 districts of Bangladesh.MethodsThe data for district-wise COVID-19 cases were collected from the Ministry of Health and Family Welfare, Bangladesh from March 2020 to June 2020. Socioeconomic and demographic data were collected from National Census Data, 2011. Retrospective spatial analysis was conducted based on district-wise COVID-19 cases in Bangladesh. Global Moran’s I was adopted to find out the significance of the clusters. Furthermore, generalised linear model was conducted to find out the association of COVID-19 cases with sociodemographic variables.ResultsTotal 87 054 COVID-19 cases were included in this study. The epidemic hotspots were distributed in the 11 most populous cities. The most likely clusters are primarily situated in the central, south-eastern and north-western regions of the country. High-risk clusters were found in Dhaka (Relative Risk (RR): 5.22), Narayanganj (RR: 2.70), Chittagong (RR: 1.69), Munshiganj (RR: 2.31) Cox’s Bazar (RR: 1.63), Faridpur (RR: 1.65), Gazipur (RR: 1.33), Bogra (RR: 1.35), Khulna (RR: 1.22), Barishal (RR: 1.07) and Noakhali (RR: 1.06). Weekly progression of COVID-19 cases showed spatially clustered by Moran’s I statistics (p value ranging from 0.013 to 0.436). After fitting a Poisson linear model, we found a positive association of COVID-19 with floating population rate (RR=1.542, 95% CI 1.520 to 1.564), and urban population rate (RR=1.027, 95% CI 1.026 to 1.028).ConclusionThis study found the high-risk cluster areas in Bangladesh and analysed the basic epidemiological issues; further study is needed to find out the common risk behaviour of the patients and other relative issues that involve the spreading of this infectious disease.

Uptake of COVID-19 vaccination among general hospital staff in Israel

Data from all general hospitals in Israel to April 2021 show mean hospital rate of staff vaccination was 84.4% for the first and 77.1% for the second doses – lower than general population rate – with mean 7% not completing vaccination. Healthcare workers have an important role in influencing the wider community. “Tweetable abstract” Staff uptake of COVID-19 vaccines in Israeli hospitals was lower than the population rate, with an average 7% missing the second dose.

Evaluation of Parking Demand and Future Requirement in the Urban Area

Whatever vehicle is traveling, it needs to stop in order to arrive road users their different goals. In most universities, parking becomes an important campus resource, for being as a place to come frequently and to spend long period. Now days parking problems increase with repaid growth of car ownership. So traffic and parking impact can be consider as a major source of contention within any community and can raise additional costs for universities, as well as urban areas facilities. The study aims to evaluate the current parking situation on the university campus in terms of the available supply and required demand of parking spaces in order to recommend future parking spaces need for the next five years. Data has had been collected according to field traffic and engineering survey, Videography method was used for this purpose. Inventories, Interviews and questionnaires included. Data analysis conducted with the aided of AASHTO and equation methods. The study concluded future parking required is 140 vehicle- spaces for the year 2026, according to population rate of growth also illegal parking leads to interference with the movements of pedestrians and their crossing, as well as reducing the capacity of the roads in the study area. Doi: 10.28991/cej-2021-03091767 Full Text: PDF

Racial and Ethnic Disparities in Discharge Opioid Prescribing From a Hospital Medicine Service

BACKGROUND: Differential opioid prescribing patterns have been reported in non-White patient populations. However, these disparities have not been well described among hospitalized medical inpatients. OBJECTIVE: To describe differences in opioid prescribing patterns among inpatients discharged from the general medicine service based on race/ethnicity. DESIGN, SETTING, AND PARTICIPANTS: For this retrospective study, we performed a multivariable logistic regression for patient race/ethnicity and whether patients received an opioid prescription at discharge and a negative binomial regression for days of opioids prescribed at discharge. The study included all 10,953 inpatients discharged from the general medicine service from June 2012 to November 2018 at University of California San Francisco Medical Center who received opioids during the last 24 hours of their hospitalization. MAIN OUTCOMES AND MEASURES: We examined two primary outcomes: whether a patient received an opioid prescription at discharge, and, for patients prescribed opioids, the number of days dispensed. RESULTS: Compared with White patients, Black patients were less likely to receive an opioid prescription at discharge (predicted population rate of 47.6% vs 50.7%; average marginal effect [AME], −3.1%; 95% CI, −5.5% to −0.8%). Asian patients were more likely to receive an opioid prescription on discharge (predicted population rate, 55.6% vs 50.7%; AME, +4.9; 95% CI, 1.5%-8.3%). We also found that Black patients received a shorter duration of opioid days compared with White patients (predicted days of opioids on discharge, 15.7 days vs 17.8 days; AME, −2.1 days; 95% CI, −3.3 to −0.9). CONCLUSION: Black patients were less likely to receive opioids and received shorter courses at discharge compared with White patients, adjusting for covariates. Asian patients were the most likely to receive an opioid prescription.

Evaluating the Appropriateness of Free Text Notes in Electronic Prescriptions Across Time and Electronic Prescribing Version (Preprint)

BACKGROUND The free-text note field of the NCPDP SCRIPT schema allows prescribers to communicate information which the schema does not otherwise accommodate. Including inappropriate (could be sent in a dedicated field) or unnecessary (provides no value to the prescription) notes has a negative impact on patient care, ranging from wasted clinician time to introducing error risk by including conflicting, or incorrect information. OBJECTIVE The research team hypothesized that appropriate usage of the notes field would improve using NCPDP SCRIPT version 2017071 (V2017071) in comparison to NCPDP SCRIPT version 10.6 (V10.6). METHODS As a follow up to the study “Analysis of Prescribers’ Notes in Electronic Prescriptions in Ambulatory Practice”, a qualitative analysis was performed on 5 000 randomly selected prescriptions for which the note field was populated. Notes were classified as appropriate, inappropriate, or unnecessary and then sub-categorized based on content. The team performed three analyses: 1) Comparing the original study to current results 2) Comparing current notes in V10.6 to V2017071, and 3) An updated evaluation of V2017071 notes with reclassified sub-categories. RESULTS No difference was found in the rate of inappropriate and unnecessary notes from the original study (71.45%) to the present-day sample (71.64%), nor when comparing current V10.6 (71.28%) to current V2017071 (72.00%). A 3.23% lower note population rate for V2017071 did reduce the normalized rate of inappropriate and unnecessary notes when comparing V10.6 (11.62%) to V2017071 (9.41%). Lastly, when reclassifying V2017071 sub-categories, the rate of inappropriate and unnecessary notes increased to 89.24%. CONCLUSIONS For most prescriptions containing a note, the note is either inappropriate or unnecessary. This highlights a need to develop e-prescribing and pharmacy software to better utilize available schema elements and influence users to reduce the overall note population rate.

Exploring the spatial-temporal distribution and evolution of population aging and social-economic indicators in China

Background China is one of the world’s fastest-aging countries. Population aging and social-economic development show close relations. This study aims to illustrate the spatial-temporal distribution and movement of gravity centers of population aging and social-economic factors and thier spatial interaction across the provinces in China. Methods Factors of elderly population rate (EPR), elderly dependency ratio (EDR), per capita gross regional product (GRPpc), and urban population rate (UPR) were collected. Distribution patterns were detected by using global spatial autocorrelation, Kernel density estimation, and coefficient of variation. Further, Arc GIS software was used to find the gravity centers and their movement trends yearly from 2002 to 2018. The spatial interaction between the variables was investigated based on bivariate spatial autocorrelation analysis. Results The results showed a larger variety of global spatial autocorrelation indexed by Moran’s I and stable trends of dispersion degree without obvious convergence in EPR and EDR. Furthermore, the gravity centers of the proportion of EPR and EDR moved northeastward. In contrast, the economic and urbanization factors showed a southwestward movement, which exhibited an reverse trend compared to population aging indicators. Moreover, the movement rates of EPR and EDR (15.12 and 18.75 km/year, respectively) were higher than that of GRPpc (13.79 km/year) and UPR (6.89 km/year) annually during the study period. Further, the bivariate spatial autocorrelation variation is in line with the movement trends of gravity centers which showed a polarization trend of population aging and social-economic factors that the difference between southwest and northeast directions and exhibited a tendency to expand in China. Conclusions In sum, our findings revealed the difference in spatio-temporal distribution and variation between population aging and social-economic factors in China. It further indicates that the opposite movements of gravity centers and the change of the BiLISA in space which may result in the increase of the economic burden of the elderly care in northern China. Hence, future development policy should focus on the social-economic growth and distribution of old-aged supporting resources, especially in northern China.

Modified Porro’s Operation in Ovarian Cancer: a Clinical Case

Background. Ovarian cancer in pregnancy is quite rare having a top 5th incidence among other pregnancy-associated tumours [1]. Due to a low population rate in pregnant women, the lack of standardised management of such patients and the paucity of relevant randomised and cohort studies, analyses of individual clinical cases acquire particular importance.Materials and methods. This article presents a clinical case of de novo diagnosed ovarian cancer in pregnancy tackled with a modified Porro’s operation of peritonectomy, para-aortic and parametric lymphadenectomy and greater omentum resection at a gynaecology unit of the Kuvatov Republican Clinical Hospital of Ufa.Results and discussion. This clinical case is special in terms of a rare occurrence of ovarian cancer in pregnancy. The choice of this radical surgical technique is considered optimal for inspecting most plausible metastatic foci and ensuring a life-preserving prognosis.Conclusion. In the absence of standardised management protocols in pregnancy-associated ovarian cancer, further analyses and discussions of routine clinical case evidence are imperative.

Sustainable Manufacturing Technologies: A Systematic Review of Latest Trends and Themes

Meeting current needs while not sacrificing the future ability to do so as a key sustainability concept is becoming more challenging than ever, with the increasing population rate, energy poverty, global warming, and surging demand for products and services. Manufacturing is in a prime position to address this challenge, with its significant economic contribution to the global GDP and its high influence over the environment and humanity. Sustainable manufacturing technologies research is growing to support our journey towards sustainable development. This article undertook the systematic review of state-of-the-art sustainable manufacturing technologies literature, evidencing the latest themes and trends in this important research avenue. Descriptive and thematic analyses were performed, synthesising the latest advancements in the field. Sustainable manufacturing processes, especially sustainable machining, was established as a key theme, including research endeavours of elimination of lubricants. Various manufacturing systems and process sustainability assessment technologies were noted. Sustainability indicators addressed were critically evaluated. As an outcome, a conceptual framework of sustainable manufacturing technology research was constructed to structure the knowledge acquired and to provoke future thinking. Finally, challenges and future directions were provided for both industrial and academic reader base, stimulating growth in this fruitful research stream.

Modelling of Future Water Use Scenarios Using WEAP Model: A Case Study in Baghdad City, Iraq

Iraq is one of the Middle East countries that suffer from water scarcity. In addition to the water policy of the upstream riparian countries; rapid population increase, economic growth, and climate changes are the major stressors of water resources available for domestic and agricultural sectors in this country. Therefore, it is of importance to determine the optimal water management methodology. This study aims to identify the optimal water allocation among the domestic, agricultural, and industrial sectors of Baghdad city under present and potential future scenarios. As such, the WEAP model was used to assess and analyze the current and projected balance of water resource management. The model was firstly calibrated and validated using the monthly streamflow data at Sarai station on the Tigris River. Subsequently, the calibrated model was fed with different future scenarios over the period 2020-2040. The employed future scenarios included normal growth population rate (I), high growth population rate (II), halved river discharges (III), combined scenario of the high population with halved water flow (ΙV) and the simulated future water year type scenario (V). Results proved that the WEAP model satisfactorily modeled the water supply/demand in Baghdad with R2 and Pbias of 0.73 and 2.43%, respectively during the validation period. Also, it was found that the water demand and supply were unmet under all proposed future scenarios which implies that there is a swift need for sustainable water management in Iraq and in Baghdad.