Clinical Characteristics and Outcomes of Type 2 Diabetes Patients Infected with COVID-19: A Retrospective Study

Diabetes and its related metabolic disorders have been reported as the leading comorbidities in patients with coronavirus disease 2019 (COVID-19). This clinical study aims to investigate the clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes in COVID-19 patients with or without diabetes. This retrospective study included 208 hospitalized patients (≥ 45 years old) with laboratory-confirmed COVID-19 during the period between 12 January and 25 March 2020. Information from the medical record, including clinical features, radiographic and laboratory tests, complications, treatments, and clinical outcomes, were extracted for the analysis. 96 (46.2%) patients had comorbidity with type 2 diabetes. In COVID-19 patients with type 2 diabetes, the coexistence of hypertension (58.3% vs 31.2%), coronary heart disease (17.1% vs 8.0%), and chronic kidney diseases (6.2% vs 0%) was significantly higher than in COVID-19 patients without type 2 diabetes. The frequency and degree of abnormalities in computed tomography (CT) chest scans in COVID-19 patients with type 2 diabetes were markedly increased, including ground-glass opacity (85.6% vs 64.9%, P < 0.001) and bilateral patchy shadowing (76.7% vs 37.8%, P < 0.001). In addition, the levels of blood glucose (7.23 mmol·L⁻¹ (interquartile range (IQR): 5.80–9.29) vs 5.46 mmol·L⁻¹ (IQR: 5.00–6.46)), blood low-density lipoprotein cholesterol (LDL-C) (2.21 mmol·L⁻¹ (IQR: 1.67–2.76) vs 1.75 mmol·L⁻¹ (IQR: 1.27–2.01)), and systolic pressure (130 mmHg (IQR: 120–142) vs 122 mmHg (IQR: 110–137)) (1 mmHg = 133.3 Pa) in COVID-19 patients with diabetes were significantly higher than in patients without diabetes (P < 0.001). The coexistence of type 2 diabetes and other metabolic disorders is common in patients with COVID-19, which may potentiate the morbidity and aggravate COVID-19 progression. Optimal management of the metabolic hemostasis of glucose and lipids is the key to ensuring better clinical outcomes. Increased clinical vigilance is warranted for COVID-19 patients with diabetes and other metabolic diseases that are fundamental and chronic conditions.     

Incidence and costs of bicycle-related traumatic brain injuries in the Netherlands

The main cause of death and serious disability in bicycle accidents is traumatic brain injury (TBI). The aim of this population-based study was to assess the incidence and costs of bicycle-related TBI across various age groups, and in comparison to all bicycle-related injuries, to identify main risk groups for the development of preventive strategies.Data from the National Injury Surveillance System and National Medical Registration were used for all patients with bicycle-related injuries and TBI who visited a Dutch emergency department (ED) between 1998 and 2012. Demographics and national, weighted estimates of injury mechanism, injury severity and costs were analysed per age group. Direct healthcare costs and indirect costs were determined using the incidence-based Dutch Burden of Injury Model.Between 1998 and 2012, the incidence of ED treatments due to bicycle-related TBI strongly increased with 54%, to 43 per 100,000 persons in 2012. However, the incidence of all bicycle-related injuries remained stable, from 444 in 1998 to 456/100,000 in 2012. Incidence of hospital admission increased in both TBI (92%) and all injuries from cycling (71%). Highest increase in incidence of both ED treatments and hospital admissions was seen in adults aged 55+. The injury rate of TBI per kilometre travelled increased (44%) except in children, but decreased (−4%) for all injuries, showing a strong decrease in children (−36%) but an increase in men aged 25+, and women aged 15+. Total costs of bicycle-related TBI were €74.5 million annually. Although bicycle-related TBI accounted for 9% of the incidence of all ED treatments due to cycling, it accounted for 18% of the total costs due to all bicycle-related injuries (€410.7 million). Children and adolescents (aged 0–24) had highest incidence of ED treatments due to bicycle-related injuries. Men in the working population (aged 15–64) had highest indirect costs following injuries from cycling, including TBI. Older cyclists (aged 55+) were identified as main risk group for TBI, as they had highest ED attendance, injury rate, injury severity, admission to hospital or intensive care unit, and costs.Incidence of ED treatments due to cycling are high and often involve TBI, imposing a high burden on individuals and society. Older cyclists aged 55+ were identified as main risk group for TBI to be targeted in preventive strategies, due to their high risk for (serious) injuries and ever-increasing share of ED visits and hospital admissions.     

Annual and regional variations of aflatoxin B1 levels seen in grains and feed coming from Croatian dairy farms over a 5-year period

The aim of the study was to investigate annual and regional differences in the level of aflatoxin B₁ (AFB₁) in grains and dairy cattle feed. Maize (n = 972), wheat (n = 201), barley (n = 147), oat (n = 136), grain mixtures (n = 168), and dairy cattle feed (n = 325) were sampled from 2009 to 2013 on different farms and in different farm factories situated in four Croatian regions. The samples were analysed for AFB₁ using the validated ELISA immunoassay. AFB₁ was determined in 16.4% of all investigated samples, among which maize was proven to be the most contaminated, with 21.7% of the samples recovered during 2013 harbouring AFB₁ in concentrations over the permissible ones. Levels higher than permitted were observed in 17.9% and 12.3% of grain mixtures and dairy cattle feed, respectively, whereas concentrations of AFB₁ determined in other crops throughout the investigated period met the stipulated requirements. The results revealed the AFB₁ occurrence to be significantly (p < 0.05) dependent on the cultivation region, with the highest levels generally found in maize harvested in 2013 and consequently in grain mixtures and cattle feed that can most likely be associated with climatic conditions as the most critical factor for mould formation, and thus also AFB₁ production.     

The relationship between centrality and land use patterns: Empirical evidence from five Chinese metropolises

The relationship between location and land use patterns is one of the classic theoretical issues in urban studies. Classic models based on the monocentricity hypothesis have limitations in the interpretation of modern urban structure. China has experienced institutional transformation in recent decades, and the interaction of national government policy, market forces and the natural environment has influenced urban planning in Chinese metropolises, resulting in urban structures with special characteristics. This paper examines the distribution of location and land use intensity, and tested the Alonso model by the relationship between them in five Chinese metropolises using Point of Interest data, space syntax methodology, the grid weighted statistical method and the Geographically Weighted Regression (GWR) model. Universal patterns about the scaling relation between intensity of land use types and the centrality of location are revealed. The elasticity of land use types to location, from high to low sensitivity, is commercial, residential then industrial land in most of the five metropolises studied. The sensitivity sequence of land use studied suggests that the hypothetical model based on the classical Alonso model can explain the spatial structure of modern metropolises in China to some extent, especially for the commercial land. But the order of sensitivity of residential land and industrial land to location does not conform to the model. The spatial heterogeneity in land use intensity and centrality were explored and the factors embedded were discussed. It can be found that the relation between centrality and land use intensity conforms to power law. In most of the metropolises studied, when the scaling relation between land use intensity and centrality is super linear, the sequence of the frequency value from high to low are commercial, residential and industrial land; when the scaling relation is sublinear, the sequence of the frequency value is industrial, residential and commercial land.     

Prediction of risk factors of cyberbullying-related words in Korea: Application of data mining using social big data

The study examined a decision tree analysis using social big data to conduct the prediction model on types of risk factors related to cyberbullying in Korea. The study conducted an analysis of 103,212 buzzes that had noted causes of cyberbullying and data were collected from 227 online channels, such as news websites, blogs, online groups, social network services, and online bulletin boards. Using opinion-mining method and decision tree analysis, the types of cyberbullying were sorted using SPSS 25.0. The results indicated that the total rate of types of cyberbullying in Korea was 44%, which consisted of 32.3% victims, 6.4% perpetrators, and 5.3% bystanders. According to the results, the impulse factor was also the greatest influence on the prediction of the risk factors and the propensity for dominance factor was the second greatest factor predicting the types of risk factors. In particular, the impulse factor had the most significant effect on bystanders, and the propensity for dominance factor was also significant in influencing online perpetrators. It is necessary to develop a program to diminish the impulses that were initiated by bystanders as well as victims and perpetrators because many of those bystanders have tended to aggravate impulsive cyberbullying behaviors.     

Association of solid fuel use with risk of stunting in children living in China

Stunting adversely affects physical and mental outcomes of children. It has not been examined whether household air pollution from solid fuel combustion is a risk factor for stunting in children. In a total of 41,439 children aged 6-17 across China, height was measured using a unified protocol. Multivariable linear regression models and logistic regression models were used to assess the associations of solid fuel use for cooking/heating with stunting in children. Adjusted for covariates, cooking/heating with solid fuel was significantly associated with a lower z-score for height for age and sex (β = −0.21 [−0.32 to −0.09] and −0.17 [−0.31 to −0.03], respectively) and an increased risk of stunting with an estimated ORs of 1.34 [1.07~1.68] and 1.37 [1.02~1.83], respectively. The risk of stunting associated with solid fuel use was statistically significant in high-age children. And the effect was greater on girls than on boys, though the difference was not statistically significant. Our study suggested that Chinese children living in households using solid fuel had a significantly higher risk of stunting than those living in households using cleaner fuel.     

Why do small business butcher shops fail to fully implement HACCP?

This study aims to assess the degree of HACCP implementation in small business butcher shops and understand which factors most influence butchers' intention to fully implement it, through the application of the Theory of Planned Behaviour. One hundred and one butchers managing or owning small butcher's responded to the interview regarding their Attitudes, Subjective Norm, Perceived Behavioural Control, Personal Norm, and Knowledge with regard to their Intention to fully implement a HACCP system in their shops. Before the interviews, a certified veterinarian visited all the shops. Visits included an inspection of the establishments using the Official Portuguese Control Plan checklist for meat retailers. Conformance level measured past performance regarding food safety practices. Based on past performance, butchers were divided into “high performers” and “low performers”. “High performers” yielded high values of Attitude and Intention towards the Behaviour. For these, Attitude and Personal Norm emerge as predictors of the Intention to fully implement a HACCP system. For “low performers”, Personal Norm was the strongest predictor of Intention, with results pointing to the need for an intervention from the authorities to promote increased conformance to food safety practices. For both groups, neither Social Norm nor Perceived Behavioural Control acted as significant predictors of Intention.     

Postural strategy identification during drilling task for different materials and heights: Ergonomic risk assessment

Drilling is an activity carried out in both professional and domestic environments. In this context, knowing the postural strategies used by users is a challenge. The objective of this study is twofold: 1) to identify the different possible strategies for performing a piercing while characterizing them through quantitative biomechanical parameters related to the task; 2) to propose an evaluation of the ergonomic risks incurred by the users for each of the observed strategies. Thus, fourteen subjects carried out a drilling activity at two different heights and for two types of materials. The position of the gravity center projection in relation to the sustentation polygon as well as the angle between the axis connecting the two feet and the antero-posterior axis (drilling axis) were used to identify the different postural strategies. Three strategies respectively called “Inter-feet”, “Left foot” and “External strategy” and three sub-strategies were identified. Each has been characterized through the duration and the average and maximum forces applied during the drilling phase. Two of them, 0–30° and 30–60° Inter-feet strategies covered about 75% of the trials. Despite the presence of a lower score for the 30–60° and 60–90° External strategies, the ergonomic analysis through the Rapid Upper Limb Assessment revealed that regardless of the strategy used, the postures adopted presented risks of developing musculoskeletal disorders. Thus, the drilling activity must be considered with care.Relevance to industryThe identification and characterization of postural strategies is particularly interesting to better understand the organization of the drilling task and thus optimize productivity while ensuring operator safety.