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                  <text>Dominio científico: Coronavirus</text>
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                <text>Comparing South Korea and Italy’s healthcare systems and initiatives to combat COVID-19</text>
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                <text>Ashwin Palaniappan, Udit Dave, Brandon Gosine</text>
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                <text>Italy and South Korea have two distinctly different healthcare systems, causing them to respond to public health crises such as the COVID-19 pandemic in markedly different ways. Differences exist in medical education for both countries, allowing South Korean medical graduates to have a more holistic education in comparison to their Italian counterparts, who specialize in medical education earlier on. Additionally, there are fewer South Korean physicians per 1000 people in South Korea compared to Italian physicians per 1000 people in Italy. However, both countries have a national healthcare system with universal healthcare coverage. Despite this underlying similarity, the two countries addressed COVID-19 in nearly opposite manners. South Korea employed technology and the holistic education of its physician community, despite having a smaller proportion of physicians in society, to its advantage by implementing efficacious drive-through centers that test suspected individuals rapidly and with little to no contact with healthcare staff, decreasing the possibility of transmission of COVID-19. Conversely, Italy is presently considered the epicenter of the outbreak in Europe and has recorded the highest death toll of any country outside of mainland China. This is partially due to the reactionary nature of Italy’s public health measures compared to South Korea’s proactive response. The different healthcare responses of South Korea and Italy can inform decisions made by public health bodies in other countries, especially in countries across the Americas, which can selectively adopt policies that have worked in curtailing the spread of COVID-19 and learn from mistakes made by both countries.</text>
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                <text>DOI: 10.26633/RPSP.2020.53</text>
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                <text>Revista Panamericana de Salud Pública</text>
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                <text>The Lessons and Experiences That Can Be Learned From China in Fighting Coronavirus Disease 2019</text>
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                <text>Feng Zhang, Jian-Li Liu, Guang-Ming Zhang, Chunjuan Song</text>
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                <text>DOI: 10.3389/fpubh.2020.00227</text>
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                <text>Frontiers in Public Health</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>Organizational Reliability Model Verification in the Crisis Escalation Phase Caused by the COVID-19 Pandemic</text>
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                <text>Agnieszka Bieńkowska, Katarzyna Tworek, Anna Zabłocka-Kluczka</text>
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                <text>This article concerns the Organizational Reliability Model (ORM) verification in the crisis escalation phase caused by critical conditions of organization functioning induced by the COVID-19 pandemic. ORM is constituted by three reliabilities, human resources, information technology, and management, which are mediators through which Type-1 and Type-2 reliability capabilities influence organizational reliability. Organizational reliability is a prerequisite for sustainability of contemporary organizations. The model was developed and verified for a variety of operating conditions. However, crisis induced by a Black Swan type of event creates conditions so critical that it calls for verification of known paradigms and models, as an element of crisis-state theory building. This is why this paper’s aim was to verify the ORM and explain the mechanisms of shaping organizational reliability in such conditions in order to contribute to both theory (verifying the organizational reliability paradigm among organizations in crisis) and practice (proposing mechanisms, potentially helping them survive). The ORM is empirically verified based on the sample of 115 employees from Italy operating under critical conditions of the COVID-19 pandemic (research carried out in the week of 18–22 March 2020). In order to verify the hypothesis, the path analysis was executed using SPSS AMOS. The results confirmed that in the extreme critical conditions causing crisis escalation for the organizations, there is a need to redefine the existing paradigms, including ORM. The results show that the HR reliability role in the ORM has drastically changed and the mechanism of its influence on organizational reliability is significantly different in crisis influenced by critical conditions of organization functioning. They also confirmed that IT together with HR is dependent on management to change the way of working and until that, its reliability may be counterproductive for the reliability of organizational as a whole. Therefore, obtaining sustainability in the crisis escalation phase requires redefining the mechanisms for securing organizational reliability.</text>
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                <text>2020</text>
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                <text>crisis, Management, organizational sustainability, COVID-19 pandemic, paradigm verification, organizational reliability</text>
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                <text>DOI: 10.3390/su12104318</text>
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                <text>Sustainability</text>
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                <text>MDPI AG</text>
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            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
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                <text>Environmental sciences, Renewable energy sources, Environmental effects of industries and plants</text>
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              <name>Title</name>
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              <description>An account of the resource</description>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>Early Phylogenetic Diversification of SARS-CoV-2: Determination of Variants and the Effect on Epidemiology, Immunology, and Diagnostics</text>
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                <text>Rene Kaden</text>
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                <text>The phylogenetic clustering of 95 SARS-CoV-2 sequences from the first 3 months of the pandemic reveals insights into the early evolution of the virus and gives first indications of how the variants are globally distributed. Variants might become a challenge in terms of diagnostics, immunology, and effectiveness of drugs. All available whole genome sequence data from the NCBI database (March 16, 2020) were phylogenetically analyzed, and gene prediction as well as analysis of selected variants were performed. Antigenic regions and the secondary protein structure were predicted for selected variants. While some clusters are presenting the same variant with 100% identical bases, other SARS-CoV-2 lineages show a beginning diversification and phylogenetic clustering due to base substitutions and deletions in the genomes. First molecular epidemiological investigations are possible with the results by adding metadata as travelling history to the presented data. The advantage of variants in source tracing can be a challenge in terms of virulence, immune response, and immunological memory. Variants of viruses often show differences in virulence or antigenicity. This must also be considered in decisions like herd immunity. Diagnostic methods might not work if the variations or deletions are in target regions for the detection of the pathogen. One base substitution was detected in a primer binding site.</text>
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                <text>2020</text>
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                <text>molecular epidemiology, SARS-CoV-2, COVID-19, virus variant detection</text>
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                <text>DOI: 10.3390/jcm9061615</text>
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                <text>Journal of Clinical Medicine</text>
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                <text>MDPI AG</text>
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                <text>Medicine</text>
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                  <text>Dominio científico: Coronavirus</text>
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                <text>Core Outcome Set for Clinical Trials of COVID-19 Based on Traditional Chinese and Western Medicine</text>
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                <text>Min Li, Xiaoyu Zhang, Yang Sun, Jing Chen, Chen Zhao, Ya Huang, Hongcai Shang, Zhao Chen, Jiayuan Hu, Mengzhu Zhao, Ruijin Qiu, Tianmai He, Songjie Han, Changming Zhong, Xue-Zeng Hao, Tengxiao Liang, Xuxu Wei</text>
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                <text>BackgroundDevelopment of a core outcome set (COS) for clinical trials for COVID-19 is urgent because of the pandemic wreaking havoc worldwide and the heterogeneity of outcomes in clinical trials.MethodsA preliminary list of outcomes was developed after a systematic review of protocols of clinical trials for COVID-19. Then, two rounds of the Delphi survey were conducted. Stakeholders were traditional Chinese medicine (TCM) experts, Western medicine (WM) experts, nurses, and the public. Patients with confirmed COVID-19 were also invited to participate in a questionnaire written in understandable language. Then different stakeholders participated in a consensus meeting by video conference to vote.ResultsNinety-seven eligible study protocols were identified from 160 clinical trials. Seventy-six outcomes were identified from TCM clinical trials and 126 outcomes were identified from WM clinical trials. Finally, 145 outcomes were included in the first round of the Delphi survey. Then, a COS for clinical trials of TCM and WM was developed. The COS included clinical outcomes (recovery/improvement/progression/death), etiology (SARS-CoV-2 nucleic-acid tests, viral load), inflammatory factor (C-reactive protein), vital signs (temperature, respiration), blood and lymphatic-system parameters (lymphocytes, virus antibody), respiratory outcomes (pulmonary imaging, blood oxygen saturation, PaO2/FiO2 ratio, arterial blood gas analysis, mechanical ventilation, oxygen intake, pneumonia severity index), clinical efficacy (prevalence of preventing patients with mild-to-moderate disease progressing to severe disease), and symptoms (clinical symptom score). Outcomes were recommended according to different types of disease. Outcome measurement instruments/definitions were also recommended.ConclusionThough there are some limitations for the research, such as insufficient patients and the public involvement, and the unbalanced stakeholders' region, the COS for COVID-19 may improve consistency of outcome reporting in clinical trials. It also should be updated with research progression.</text>
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                <text>2020</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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                <text>methodology, traditional Chinese medicine, core outcome set, western medicine, COVID-19</text>
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            </elementTextContainer>
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            <name>Identifier</name>
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              <elementText elementTextId="31686">
                <text>DOI: 10.3389/fphar.2020.00781</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="31687">
                <text>Frontiers in Pharmacology</text>
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            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="31688">
                <text>Frontiers Media S.A.</text>
              </elementText>
            </elementTextContainer>
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            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
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                <text>Therapeutics. Pharmacology</text>
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              <description>A name given to the resource</description>
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                  <text>Dominio científico: Coronavirus</text>
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            <description>A name given to the resource</description>
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                <text>The covid-19 outbreak: a Chinese school student’s life in isolation for 73 days</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31675">
                <text>Surong Duan</text>
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            <name>Date</name>
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                <text>2020</text>
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            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
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                <text>DOI: 10.1136/bmjpo-2020-000699</text>
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            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="31678">
                <text>BMJ Paediatrics Open</text>
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            </elementTextContainer>
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            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="31679">
                <text>BMJ Publishing Group</text>
              </elementText>
            </elementTextContainer>
          </element>
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            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="31680">
                <text>Pediatrics</text>
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            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="1">
                  <text>Coronavirus</text>
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              </elementTextContainer>
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              <name>Description</name>
              <description>An account of the resource</description>
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                <elementText elementTextId="2">
                  <text>Dominio científico: Coronavirus</text>
                </elementText>
              </elementTextContainer>
            </element>
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    <itemType itemTypeId="1">
      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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    <elementSetContainer>
      <elementSet elementSetId="1">
        <name>Dublin Core</name>
        <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31665">
                <text>Guideline-Based Chinese Herbal Medicine Treatment Plus Standard Care for Severe Coronavirus Disease 2019 (G-CHAMPS): Evidence From China</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31666">
                <text>Yongan Ye, The G-CHAMPS Collaborative Group</text>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Background: In January, national guidelines were developed and recommended for use throughout China to fight coronavirus disease 2019 (COVID-19). Chinese herbal medicine (CHM) was also included as part of the treatment plans at various stages of COVID-19.Methods: We conducted a pilot randomized, controlled trial in patients with severe COVID-19 in Wuhan, China. Eligible adult patients were randomly assigned in a 2:1 ratio to receive either CHM plus standard care or standard care alone for 7 days. The primary outcome was the change in the disease severity category of COVID-19 after treatment.Results: Between Jan 31, 2020, and Feb 19, 2020, 42 out of 100 screened patients were included in the trial: 28 in the CHM plus standard care group and 14 in the standard care alone group. Among 42 participants who were randomized (mean [SD] age 60.43 years [12.69 years]), 21 (21/42, 50%) were aged ≥65 years, 35 (35/42, 83%) were women, and 42 (42/42, 100%) had data available for the primary outcome. For the primary outcome, one patient from each group died during treatment; the odds of a shift toward death was lower in the CHM plus group than in the standard care alone group (common OR 0.59, 95% CI 0.148–2.352, P = 0.454). Three (two from the CHM plus group and one from the standard care alone group) patients progressed from severe to critical illness. After treatment, mild, moderate, and severe COVID-19 disease accounted for 17.86% (5/28) vs. 14.29% (2/28), 71.43% (20/28) vs. 64.29% (9/28), and 0% (0) vs. 7.14% (1/28) of the patients treated with CHM plus standard care vs. standard care alone.Conclusions: For the first time, the G-CHAMPS trial provided valuable information for the national guideline-based CHM treatment of hospitalized patients with severe COVID-19. The effects of CHM in COVID-19 may be clinically important and warrant further consideration and studies.Clinical Trial Registration:http://www.chictr.org.cn/index.aspx. Uniqueidentifier: ChiCTR2000029418.</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="31668">
                <text>2020</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31669">
                <text>Randomized Controlled Trial, Chinese herbal medicine, guideline, pilot study, COVID-19</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="43">
            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
            <elementTextContainer>
              <elementText elementTextId="31670">
                <text>DOI: 10.3389/fmed.2020.00256</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="31671">
                <text>Frontiers in Medicine</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="31672">
                <text>Frontiers Media S.A.</text>
              </elementText>
            </elementTextContainer>
          </element>
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            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="31673">
                <text>Medicine (General)</text>
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            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
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                <elementText elementTextId="1">
                  <text>Coronavirus</text>
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              <name>Description</name>
              <description>An account of the resource</description>
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                <elementText elementTextId="2">
                  <text>Dominio científico: Coronavirus</text>
                </elementText>
              </elementTextContainer>
            </element>
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      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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      <elementSet elementSetId="1">
        <name>Dublin Core</name>
        <description>The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31656">
                <text>Analysis of the healthcare-seeking intention of eye patients during COVID-19 outbreak</text>
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          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31657">
                <text>Yi Zhang, Li Cai, Hua Feng, Shu Jiang, Yueming Wu</text>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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              <elementText elementTextId="31658">
                <text>AIM: To obtain the healthcare-seeking intention of eye patients during COVID-19 outbreak in China. METHODS: Questionnaire survey was conducted from 2020-02-10 to 2020-02-20, with the combination form of convenience sampling and “Link-tracking related sampling”. We designed the questionnaires, forwarded them to individuals or WeChat group chats, and had the participants fill out the questionnaires on mobile phones, to evaluate their healthcare seeking time and intention, as well as their sense of trust towards online consultation when they had ocular discomforts or trauma.RESULTS: Totally 458 males(51.3%)and 435 females(48.7%)responded and a total of 893 questionnaires were included. Our data shows that 26.5%, 33.3%, and 40.2% of the respondents respectively from low, medium and high risk area chose online consultation during the COVID-19 outbreak, and the hospital visiting rates were 45.1%, 30.3%, 24.6% in corresponding area. We also demonstrated that gender, age, education level, regional economic development, and the region-level risk classifications have impacts on the consultation methods of the population. Compared to females(39.3%), more males(60.7%)intended to accept online medicine, and the participants from highly developed area preferentially chose virtual medical advisory service(68.2%),while the hospital visiting rates of less developed area(65.2%)was much higher than that in developed area(34.8%). Interestingly, geographic risk level had dramatic influence on the participants' sense of trust towards online consultation.CONCLUSION: Virtual online consultations were more favorable among Chinese population during COVID-19 outbreak, and were potential to facilitate clinician-patient communication. However, a balance should be achieved between online consultations and face-to-face communication, to avoid human-to-human coronavirus transmission, and to resolve patients' problems.</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="31659">
                <text>2020</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31660">
                <text>-, Questionnaire, Ophthalmology, novel coronavirus, healthcare-seeking intention</text>
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            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
            <elementTextContainer>
              <elementText elementTextId="31661">
                <text>DOI: 10.3980/j.issn.1672-5123.2020.6.39</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="31662">
                <text>Guoji Yanke Zazhi</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="31663">
                <text>Press of International Journal of Ophthalmology (IJO PRESS)</text>
              </elementText>
            </elementTextContainer>
          </element>
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            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="31664">
                <text>Ophthalmology</text>
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              <name>Title</name>
              <description>A name given to the resource</description>
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              <description>An account of the resource</description>
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                <elementText elementTextId="2">
                  <text>Dominio científico: Coronavirus</text>
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              </elementTextContainer>
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      <name>Text</name>
      <description>A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.</description>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
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              <elementText elementTextId="31648">
                <text>The Role of Transthoracic Ultrasound in the novel Coronavirus Disease (COVID-19): A Reappraisal. Information and Disinformation: Is There Still Place for a Scientific Debate?</text>
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            </elementTextContainer>
          </element>
          <element elementId="39">
            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31649">
                <text>Marco Sperandeo, Donato Lacedonia, Gaetano Rea, Maria Pia Venuti, Carla Maria Irene Quarato, Anna Simeone, Lucia Maria Cecilia Dimitri, Beatrice Ferragalli</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="31650">
                <text>2020</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="31651">
                <text>diagnostic accuracy, lung imaging, Transthoracic ultrasound, COVID-19, ultrasound artifacts</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="43">
            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
            <elementTextContainer>
              <elementText elementTextId="31652">
                <text>DOI: 10.3389/fmed.2020.00271</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="31653">
                <text>Frontiers in Medicine</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="31654">
                <text>Frontiers Media S.A.</text>
              </elementText>
            </elementTextContainer>
          </element>
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            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="31655">
                <text>Medicine (General)</text>
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              <description>A name given to the resource</description>
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                  <text>Coronavirus</text>
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              <name>Description</name>
              <description>An account of the resource</description>
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                  <text>Dominio científico: Coronavirus</text>
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          <element elementId="50">
            <name>Title</name>
            <description>A name given to the resource</description>
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                <text>Sterilization plan of the used metered dose inhalers (MDI) to avoid wastage amid COVID-19 pandemic drug shortage</text>
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          <element elementId="39">
            <name>Creator</name>
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              <elementText elementTextId="31640">
                <text>Ali Elbeddini</text>
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          <element elementId="41">
            <name>Description</name>
            <description>An account of the resource</description>
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                <text>Abstract Background Coronavirus is causing a shortage of critical inhalers needed by patients with Asthma and respiratory illness. Patients with Asthma are at higher risk if they tract the novel Coronavirus. As the coronavirus continues to spread, hospitals are turning to use more salbutamol MDI. Salbutamol MDI has become the line of defence for physicians in the emergency room who are treating patients with Corona Virus Disease 2019 (COVID-19) and have respiratory distress .[Hui et al 2020 ,and Center for Drug Evaluation and Research 2020] During the COVID pandemic, there has been a drastic increase in the use of MDI inhalers; therefore, it led to a decrease in availability and a break in the supply chain. Patients with Asthma are at higher risk if they tract the novel Coronavirus, and an inhaler could be a life or death for them. As the coronavirus continues to spread, hospitals are turning to use more salbutamol Metered Dose inhaler (MDI). Salbutamol MDI is now on short supply as the COVID-19 continues to spread. Salbutamol MDI has become the line of defence for physicians in the emergency room who are treating patients with COVID-19 and have respiratory distress. The current shortage of salbutamol MDI could be a result of stockpiling and hoarding of this life-saving inhaler. That had led to a critical shortage of Salbutamol MDI, and even the case shortage continues with some other alternatives such as Ipratropium MDI and even with long-acting B-agonists such as Salmeterol and Formoterol which also starting to have a limitation on ordering these agents. Coronavirus sparks fear of medication shortage. Coronavirus panic-buying also may have led to a shortage of critical inhalers. We have also got elderly patients with COPD who may need Ventolin MDI and also premature babies who may have caught Respiratory Syncytial Virus (RSV) and need salbutamol MDI to support their lungs have since been compromised, and they rely heavily on Asthma inhalers. Finding a safe and creative strategy is essential during the COVID-19 pandemic.</text>
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            <name>Date</name>
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              <elementText elementTextId="31642">
                <text>2020</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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              <elementText elementTextId="31643">
                <text>sterilization, drug shortage, COVID-19, Metered Dse inhalers (MDI)</text>
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            <name>Identifier</name>
            <description>An unambiguous reference to the resource within a given context</description>
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              <elementText elementTextId="31644">
                <text>DOI: 10.1186/s40545-020-00224-4</text>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="31645">
                <text>Journal of Pharmaceutical Policy and Practice</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="31646">
                <text>BMC</text>
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            </elementTextContainer>
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            <name>Coverage</name>
            <description>The spatial or temporal topic of the resource, the spatial applicability of the resource, or the jurisdiction under which the resource is relevant</description>
            <elementTextContainer>
              <elementText elementTextId="31647">
                <text>Therapeutics. Pharmacology, Pharmacy and materia medica</text>
              </elementText>
            </elementTextContainer>
          </element>
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