Food plants have been recognized for their medicinal properties for millennia, a concept supported by epidemiological studies indicating long-term health benefits for people consuming greater amounts of fruits and vegetables. As our technology and instrumentation advance, researchers have the ability to identify promising phytochemicals, and examine their potential benefits, or detriments, to human health. While results from trials investigating single chemical supplementation have sometimes produced negative health results, studies investigating the synergistic action of phytochemicals—either within our diet or as an adjuvant to radiation or chemotherapy—appear promising. Utilizing phytochemicals as synergistic agents may lower the chemotherapeutic doses needed to incur physiological results, while also using chemicals with fewer toxic effects. This review investigates a variety of plant-produced chemicals humans typically ingest, their impacts on overall health patterns, molecular mechanisms associated with their health impacts, and the potential of their synergistic use for therapeutic purposes. Full article

Recent studies suggest that improper resolution of acute neuroinflammation may lead to long-lasting low-grade chronic neuroinflammation and drive progressive neurodegeneration. However, the molecular mechanism underlying the transition from acute to chronic neuroinflammation remains unclear. The main purpose of this study was to search for potential pathways mediating LPS-elicited chronic neuroinflammation and resultant neurodegeneration. Using microglia cultures prepared from C57BL/6J, MAC1-deficient, and MyD88-deficient mice, the initial study showed that activation of TLR-4 is not sufficient for maintaining chronic neuroinflammation despite its essential role in LPS-initiated acute neuroinflammation. Opposite to TLR-4, our studies showed significantly reduced intensity of chronic neuroinflammation, oxidative stress, and progressive loss of nigral dopaminergic neurons in MAC1-deficient neuron/glial cultures or mice stimulated with LPS. Mechanistic studies revealed the essential role ERK1/2 activation in chronic neuroinflammation-elicited neurodegeneration, which was demonstrated by using an ERK1/2 inhibitor in neuron-glial cultures. Taken together, we propose a key role of the MAC1-NOX2-ERK1/2 signaling pathway in the initiation and maintenance of low-grade chronic neuroinflammation. Continuing ERK1/2 phosphorylation and NOX2 activation form a vicious feedforward cycle in microglia to maintain the low-grade neuroinflammation and drive neurodegeneration. Full article

Recurrent cystitis (RC) is a common disease, especially in females. Anatomical, behavioral and genetic predisposing factors are associated with the ascending retrograde route, which often causes bladder infections. RC seems to be mainly caused by agents derived from the intestinal microbiota, and most frequently by Escherichia coli. Intestinal contiguity contributes to the etiopathogenesis of RC and an alteration in intestinal permeability could have a major role in RC. The aim of this pilot study is to assess gut microbiome dysbiosis and intestinal permeability in female patients with RC. Patients with RC (n = 16) were enrolled and compared with healthy female subjects (n = 15) and patients with chronic gastrointestinal (GI) disorders (n = 238). We calculated the Acute Cystitis Symptom Score/Urinary Tract Infection Symptom Assessment (ACSS/UTISA) and Gastrointestinal Symptom Rating Scale (GSRS) scores and evaluated intestinal permeability and the fecal microbiome in the first two cohorts. Patients with RC showed an increased prevalence of gastrointestinal symptoms compared with healthy controls. Of the patients with RC, 88% showed an increased intestinal permeability with reduced biodiversity of gut microbiota compared to healthy controls, and 68% of the RC patients had a final diagnosis of gastrointestinal disease. Similarly, GI patients reported a higher incidence of urinary symptoms with a diagnosis of RC in 20%. Gut barrier impairment seems to play a major role in the pathogenesis of RC. Further studies are necessary to elucidate the role of microbiota and intestinal permeability in urinary tract infections. Full article

In the field of integrated circuits, the computational cost has always been a crucial design metric. In recent years, with the continuous development in the field of computing, the requirements for computation have been growing rapidly. Reducing the computational cost and improving computational efficiency have become the key issues in the field. There are many error-tolerant applications in the multimedia field where approximate computing techniques can be applied to improve computational efficiency and reduce computational costs at the cost of acceptable computational errors. This paper proposed a piecewise linear Mitchell algorithm based on Mitchell logarithmic approximation multiplication algorithm. Additionally, the Pwl-Mit multiplier is designed according to the improved algorithm combined with the data truncation technique. The proposed approximate multiplier has better statistical performance compared with the state-of-the-art multipliers. The design is simulated and synthesized at the TSMC 65 nm process, and its reliability is verified using discrete cosine transform (DCT) transform. Full article

In this study, we investigate the characteristics of atmospheric parameters before, during, and after rain events in Bern, Switzerland. Ground-based microwave radiometer data of the TROpospheric WAter RAdiometer (TROWARA) with a time resolution of 7 s, observations of a weather station, and the composite analysis method are used to derive the temporal evolution of rain events and to identify possible rainfall precursors during a 10-year period (1199 available rain events). A rainfall climatology is developed using parameters integrated water vapor (IWV), integrated liquid water (ILW), rain rate, infrared brightness temperature (T${}_{\mathrm{IR}}$), temperature, pressure, relative humidity, wind speed, and air density. It was found that the IWV is reduced by about 2.2 mm at the end of rain compared to the beginning. IWV and T${}_{\mathrm{IR}}$ rapidly increase to a peak at the onset of the rainfall. Precursors of rainfall are that the temperature reaches its maximum around 30 to 60 min before rain, while the pressure and relative humidity are minimal. IWV fluctuates the most before rain (obtained with a 10 min bandpass). In 60% of rain events, the air density decreases 2 to 6 h before the onset of rain. The seasonality and the duration of rain events as well as the diurnal cycle of atmospheric parameters are also considered. Thus, a prediction of rainfall is possible with a true detection rate of 60% by using the air density as a precursor. Further improvements in the nowcasting of rainfall are possible by using a combination of various atmospheric parameters which are monitored by a weather station and a ground-based microwave radiometer. Full article

Obesity has become a serious public health epidemic because of its associations with chronic conditions such as type 2 diabetes mellitus, hypertension, cardiovascular disease, and cancer. Obesity triggers inflammation marked by the secretion of low-grade inflammatory cytokines including interleukin-6, C-reactive protein, and tumor necrosis factor-α, leading to a condition known as “meta-inflammation”. Currently, there is great interest in studying the treatment of obesity with food-derived bioactive compounds, which have low toxicity and no severe adverse events compared with pharmacotherapeutic agents. Here, we reviewed the beneficial effects of the bioactive compounds known as anthocyanins on obesity-induced inflammation. Foods rich in anthocyanins include tart cherries, red raspberries, black soybeans, blueberries, sweet cherries, strawberries and Queen Garnet plums. These anthocyanin-rich foods have been evaluated in cell culture, animal, and clinical studies, and found to be beneficial for health, reportedly reducing inflammatory markers. One factor in the development of obesity-related inflammation may be dysbiosis of the gut microbiome. Therefore, we focused this review on the in vitro and in vivo effects of anthocyanins on inflammation and the gut microbiota in obesity. Full article

Patients with non-small cell lung cancer (NSCLC) develop bone metastasis (BoM) in more than 50% of cases during the course of the disease. This metastatic site can lead to the development of skeletal related events (SREs), such as severe pain, pathological fractures, spinal compression, and hypercalcemia, which reduce the patient’s quality of life. Recently, the treatment of advanced NSCLC has radically changed due to the advent of immunotherapy. Immune checkpoint inhibitors (ICI) alone or in combination with chemotherapy have become the main therapeutic strategy for advanced or metastatic NSCLC without driver gene mutations. Since survival has increased, it has become even more important to treat bone metastasis to prevent SRE. We know that the presence of bone metastasis is a negative prognostic factor. The lower efficacy of immunotherapy treatments in BoM+ patients could be induced by the presence of a particular immunosuppressive tumor and bone microenvironment. This article reviews the most important pre-clinical and clinical scientific evidence on the reasons for this lower sensitivity to immunotherapy and the need to combine bone target therapies (BTT) with immunotherapy to improve patient outcome. Full article

Rational eigenvalue problems (REPs) have important applications in engineering applications and have attracted more and more attention in recent years. Based on the theory of low-rank modification, we discuss the spectral properties and distribution of the symmetric rational eigenvalue problems, and present two numerical iteration methods for the above REPs. Numerical experiments demonstrate the effectiveness of our proposed methods. Full article

The quality of the interaction between mothers and their children with an Intellectual Disability (ID) plays a crucial role in their development and in particular during adolescence. This qualitative study was designed to provide a better understanding of aspects of the relationships between mothers and their adolescents with ID through an art-based tool, the Joint Painting Procedure. The qualitative analysis of six dyads of mothers and adolescents with severe, moderate and mild ID was based on the principles of narrative and phenomenological inquiry. The findings yielded three key themes that emerged from the relational dynamics during the JPP: (1) from dependency to autonomy, (2) the joint painting as a way to foster verbal communication, and (3) playfulness and enjoyment. The JPP appeared to serve as a meaningful art-based assessment of the implicit and explicit aspects of the relationships which evolved during the interaction. The findings underscore the potential of the JPP as a non-verbal, art-based tool that allows researchers and clinicians to learn more about the dynamics of relationships between mothers and their adolescents with ID. It also enables a context where the expression of relational issues can be communicated and even transformed. Full article

The main aim of this work is to improve the structure and properties of the magnesium alloy ML5 by modifying it with alkaline earth metals (ALM). The separate and joint influence of calcium and barium on the macrostructure and microstructure of the alloy of Mg-Al-Zn system was investigated. The qualitative and quantitative estimation of the structural components was carried out. Alkali earth metals were included in complex intermetallic phases and serve as additional crystallization centers. Modification of magnesium alloys with alkaline earth metals is established in an amount of 0.05 to 0.1 wt. % increased the bulk percentage of intermetallic phases by ~1.5 times, shifting them towards smaller size groups while simultaneously forming spherical intermetallic phases located in the grain centre and serving as additional crystallization centers. In this case, grain size reduction and significant refinement of the alloy structural components were provided. The dependency of the separate and joint influence of alkali earth metals on the castings complex of properties of the magnesium alloy has been established. Thus, a separate modification of the ML5 alloy provided the maximum level of its strength and ductility with the addition of 0.1% Ca or Ba. The modification of the complex (0.1% Ca + 0.1% Ba) of the magnesium alloy decreased the dimensions of its structural components 1.5 times and increased the strength of the alloy by 20%, the ductility by 2 times and the long-term heat resistance 1.5 times due to the formation of the intermetallic phases of the complex composition. Linear dependences were obtained that describe the influence of the characteristics of the structural components of the modified magnesium alloy on its mechanical properties. The developed technology for modifying cast magnesium alloys with alkaline earth elements provides an improvement in casting quality and allows the reliability and durability of responsible casting operation. Full article

Background: Percutaneous coronary intervention (PCI) is associated with a short hospital stay and fast recovery. However, it might be related to insufficient implementation of lifestyle changes after the procedure. Conversely, coronary artery bypass grafting (CABG) is a highly invasive technique that requires a prolonged hospital stay and long rehabilitation with more opportunities for education. This study aimed to evaluate the impact of CABG on adherence to lifestyle modifications and knowledge about coronary artery disease (CAD) in comparison with PCI. We also evaluated the level of education and tried to define groups of patients that might require targeted education. Methods: Data was collected using a self-designed 56-item questionnaire. Questions assessed the knowledge of CAD risk factors and the level of their control. Results: The study group consisted of 155 consecutive patients admitted to the Cardiology Department. Patients with a history of PCI (68%) (at least 8 weeks before) were included in the prior-PCI group, and patients with previous surgical revascularization (also at least 8 weeks before) were assigned to the prior-CABG group (32%). The knowledge score was higher in the prior-CABG group. The median (IQR) results in the prior-PCI vs. prior-CABG group were, respectively: 20 (12–24) vs. 22 (19–25) [points, per 31 max.]; p = 0.01. Similar results were obtained in the level of risk control (prior-PCI vs. prior-CABG, respectively: 6 (4–7) vs. 7 (6–8) [points, per 15 max.]; p = 0.002). Conclusions: The method of treatment of CAD might impact the implementation of lifestyle modifications after the procedure. More effort is required to improve secondary prevention, especially in PCI patients. Full article

This paper investigates a pervasive phenomenon in video-mediated interaction (VMI), namely, simultaneous start-ups, which happen when two speakers produce a turn beginning in overlap. Based on the theoretical and methodological tenets of conversation analysis and interactional linguistics, the present study offers a multimodal and sequential account of how simultaneous start-ups are oriented to and solved in the context of English as an additional language (L2) tutoring. The micro- and sequential analysis of ten hours of screen-recorded video-mediated data from tutoring sessions between an experienced tutor and an advanced-level tutee reveals that the typical overlap resolution trajectory results in the tutor withdrawing from the interactional floor. The same analysis uncovered a range of resources, such as lip pressing and the verbal utterance ‘go ahead’, employed in what we call enhanced explicitness, through which the withdrawal is done. The orchestration of these resources allows the tutor to exploit the specific features of the medium to resolve simultaneous start-ups while also supporting the continuation of student talk. We maintain that this practice is used in the service of securing the learner’s interactional space, and consequently in fostering the use of the language being learned. The results of the study help advance current understandings of L2 instructors’ specialized work of managing participation and creating learning opportunities. Being one of the first studies to detail the practices involved in overlap resolution in the micro-context of simultaneous talk on Zoom-based L2 instruction, this study also makes a significant contribution to research on video-mediated instruction and video-mediated interaction more generally. Full article

Game theory includes a rich source of methods for analysing strategic interactions where there are a small number of agents, each having only a few choices. In more complex settings though, where there are many choices over indefinite time horizons involving large social groups, these methods are unlikely to fully capture the causes of agent behaviour. If agents are able to simplify the task of understanding what others might do by modelling the constraints of others, particularly unobservable cognitive constraints, then the possible behavioural outcomes can be similarly restricted, thereby reducing the complexity of a social interaction. Having a cognitive representation of the unobserved causal states of others is an aspect of a ‘Theory of Mind’ and it plays a central role in the psychology of social interactions. In this article I examine a selection of results on the theory of mind and connect these with the ‘game theory of mind’ to draw conclusions regarding the complexity of one-on-one and large-scale social coordination. To make this explicit, I will illustrate the relationship between the two psychological terms ‘introspection’ and ‘theory of mind’ and the economic analysis of game theory, while retaining as much as possible of the richness of the psychological concepts. It will be shown that game theory plays an important role in modelling interpersonal relationships for both biological and artificial agents, but it is not yet the whole story, and some psychological refinements to game theory are discussed. Full article

Mathematical modelling of visco-elastic plate breaking and consequent deflection of the plate are studied using the simplified formulation. The plate is modelled as a thin visco-elastic plate of constant thickness. The edges of the plate are clamped. The plate deflection is caused by a uniform aerodynamic pressure, which slowly increases in time. The plate deflection before breaking is approximated as quasi-static. The plate breaks instantly then and there, when and where the modified fracture criterion by Petrov and Morozov is achieved. Both the deflections and velocities of the plate before and after breaking are assumed equal.The motion of the plate parts after breaking are highly unsteady and dependent on the viscous properties of the plate. If the viscosity of the plate material is negligible compared with the elastic characteristics of the plate, then the velocity of the plate deflection is discontinuous at the time instant of the plate breaking. This feature of the plate motion after its breaking should be taken into account in interpretation of the numerical results within the linearised model of plate deflection with sudden breaking. It is shown that the plate can break in a cascade way. Each part after the first breaking breaks again. The configuration studied in this paper is specially tailored to highlight the behaviour of the numerical solutions of the plate breaking problems in applications. Full article

Free-space continuous-variable quantum key distribution based on atmospheric laser communications is expected to play an important role in the global continuous-variable quantum key distribution network. The practical homodyne detector model is applied in free-space continuous-variable quantum key distribution which models the imperfect characteristics including the detection efficiency and the electronic noise. In the conventional model, we must calibrate them simultaneously. In the modified model, only one of the imperfections needs to be calibrated to simplify the calibration process of the practical experiments, also known as one-time calibration. The feasibility of the modified detector model against the fast-fading channel is proved. The results of the symmetry operations are considered when presenting detailed security analysis. Some remarkable features of the uniform fast-fading channel were found from the simulation results. The performances of the conventional model and the modified model are similar but the modified model has the advantage of achieving one-time calibration. Full article

Presently, autonomous systems have gained considerable attention in several fields such as transportation, healthcare, autonomous driving, logistics, etc. It is highly needed to ensure the safe operations of the autonomous system before launching it to the general public. Since the design of a completely autonomous system is a challenging process, perception and decision-making act as vital parts. The effective detection of objects on the road under varying scenarios can considerably enhance the safety of autonomous driving. The recently developed computational intelligence (CI) and deep learning models help to effectively design the object detection algorithms for environment perception depending upon the camera system that exists in the autonomous driving systems. With this motivation, this study designed a novel computational intelligence with a wild horse optimization-based object recognition and classification (CIWHO-ORC) model for autonomous driving systems. The proposed CIWHO-ORC technique intends to effectively identify the presence of multiple static and dynamic objects such as vehicles, pedestrians, signboards, etc. Additionally, the CIWHO-ORC technique involves the design of a krill herd (KH) algorithm with a multi-scale Faster RCNN model for the detection of objects. In addition, a wild horse optimizer (WHO) with an online sequential ridge regression (OSRR) model was applied for the classification of recognized objects. The experimental analysis of the CIWHO-ORC technique is validated using benchmark datasets, and the obtained results demonstrate the promising outcome of the CIWHO-ORC technique in terms of several measures. Full article

With the exponential growth in the amount of available data, traditional meteorological data processing algorithms have become overwhelmed. The application of artificial intelligence in simultaneous prediction of multi-parameter meteorological data has attracted much attention. However, existing single-task network models are generally limited by the data correlation dependence problem. In this paper, we use a priori knowledge for network design and propose a multitask model based on an asymmetric sharing mechanism, which effectively solves the correlation dependence problem in multi-parameter meteorological data prediction and achieves simultaneous prediction of multiple meteorological parameters with complex correlations for the first time. The performance of the multitask model depends largely on the relative weights among the task losses, and manually adjusting these weights is a difficult and expensive process, which makes it difficult for multitask learning to achieve the expected results in practice. In this paper, we propose an improved multitask loss processing method based on the assumptions of homoscedasticity uncertainty and the Laplace loss distribution and validate it using the German Jena dataset. The results show that the method can automatically balance the losses of each subtask and has better performance and robustness. Full article

A single crystal of l-phenylalanine l-phenylalanininum malonate (LPPMA) was synthesized by slow evaporation and was subjected to nonlinear optical examination and physio-chemical characterization. Studies on single X-ray diffraction confirm the arrangement of monoclinic space group P21 which is a vital criterion for the NLO phenomenon. The assessment of functional groups and diverse vibration modes responsible for the characteristics of the material was performed with an FTIR analysis. The UV-visible spectral examination found the wavelength of UV-cutoff at 233 nm and various optical parameters were evaluated. The mechanical strength and different criteria associated with it were assessed. The electric field response of the material was examined in terms of the dielectric constant, dielectric loss, ac conductivity and activation energy. The spectra of emission were detailed. The efficacy of second harmonic generation was studied. The parameters of nonlinearity were investigated to analyse the third-order acentric optical response in the LPPMA by Z-scan procedure. Full article

In industrial production, accidents caused by the unsafe behavior of operators often bring serious economic losses. Therefore, how to use artificial intelligence technology to monitor the unsafe behavior of operators in a production area in real time has become a research topic of great concern. Based on the YOLOv5 framework, this paper proposes an improved YOLO network to detect unsafe behaviors such as not wearing safety helmets and smoking in industrial places. First, the proposed network uses a novel adaptive self-attention embedding (ASAE) model to improve the backbone network and reduce the loss of context information in the high-level feature map by reducing the number of feature channels. Second, a new weighted feature pyramid network (WFPN) module is used to replace the original enhanced feature-extraction network PANet to alleviate the loss of feature information caused by too many network layers. Finally, the experimental results on the self-constructed behavior dataset show that the proposed framework has higher detection accuracy than traditional methods. The average detection accuracy of smoking increased by 3.3%, and the average detection accuracy of not wearing a helmet increased by 3.1%. Full article

Cognitive function is affected by low pressure and hypoxia in high-altitude environments, and is regulated by altitude and exposure time. With the economic development in the Qinghai-Tibet Plateau, the increase in work and study activities, as well as the development of plateau tourism, mountaineering, and other activities, the number of plateau immigrants is increasing daily. Long-term hypoxia challenges human physical and mental health, restricts work efficiency, and thus affects plateau economic development and human wellbeing. Therefore, it is of scientific and social significance to study how long-term exposure to the hypoxic plateau environment affects the physical and mental health of lowlanders as part of the ongoing development of the current plateau region. In this paper, we reviewed the research progress and mechanism of the effects of long-term (≥1 year) high-altitude (>2500 m) hypoxia exposure on the cognitive function of lowlanders, and suggested that the scope and sample size of the research should be expanded in the future, and that follow-up studies should be carried out to explore the time threshold of cognitive impairment and its compensatory or repair mechanism. Full article

Knowledge and love, as well as intellect and will, while remaining distinct, must be understood in man as being intrinsically related on account of his being ordained to a single ultimate end. This responds to the substantial inclination that every human being has for synthesis, for intimate unity. One of the clearest examples of this spirit of synthesis can be recognized in the teaching of Saint Thomas Aquinas; for example, in his attitude of assimilation of the doctrines of many authors, mainly Aristotle and Saint Augustine. We will try to show how, in the thought of Aquinas, faithful to his Augustinian heritage, will and intellect find their rootedness in the memory of oneself, based on the doctrine of the created good according to mode, species, and order. In this the mind is the image of God, to which man is ordered by knowledge and love. Therefore, we can conclude that the memory of oneself is memory of God. We will follow the teachings of the main representatives of the Thomistic School of Barcelona. Full article

The aim of this work was to determine advanced the oxidative protein products (AOPPs), total antioxidant capacity (TAC), and myeloperoxidase activity (MPO) in the saliva of patients undergoing orthodontic treatment with clear removable aligners in comparison with another group in treatment with fixed passive self-ligating brackets applying light forces, before treatment, after 30 days, and after 90 days of treatment. This non-randomized clinical trial recruited patients consecutively, all of which were over 18 years of age and due to undergo orthodontic treatment. They were divided into two groups according to treatment type: Group A, 48 patients treated with clear aligners (Invisalign^®); and Group B, 19 patients treated with Damon System^® 0.22″ self-ligating brackets applying light forces. Saliva samples were collected by a single clinician following the same protocol and underwent three analyses—AOPPs, TAC, and MPO levels–at baseline before placing the apparatus, after 30 days, and after 90 days treatment. Orthodontic treatment, whether with clear aligners or fixed self-ligating brackets and light forces, increased AOPPs after the first 30 days of treatment. During the initial phases of orthodontic treatment, neither clear aligners nor fixed self-ligating brackets applying light forces showed changes in TAC and MPO. Orthodontic treatment with both clear aligners and fixed apparatus self-ligating brackets applying light forces increases oxidative stress (AOPPs) after the first 30 days of treatment. There are no differences in AOPP levels between treatment with clear aligners and self-ligating brackets during the first 90 days of treatment. The antioxidative capacity of saliva during the initial phases of orthodontic treatment, whether with self-ligating brackets or clear aligners, does not undergo significant changes. With either orthodontic technique, the patients’ salivary antioxidant capacity is similar. Full article

Severe traumatic injury is one of the main global health issues which annually causes more than 5.8 million worldwide deaths. Uncontrolled haemorrhage is the main avoidable cause of death among severely injured individuals. Management of trauma patients is the greatest challenge in trauma emergency care, and its proper diagnosis and early management of bleeding trauma patients, including blood transfusion, are critical for patient outcomes. Aim: We aimed to describe the epidemiology of transfusion practices in severe trauma patients admitted into Spanish Intensive Care Units. Material and Methods: We performed a multicenter cross-sectional study in 111 Intensive Care Units across Spain. Adult patients with moderate or severe trauma were eligible. Distribution of frequencies was used for qualitative variables and the mean, with its 95% CI, for quantitative variables. Transfusion programmes, the number of transfusions performed, and the blood component transfused were recorded. Demographic variables, mortality rate, hospital stay, SOFA-score and haemoglobin levels were also gathered. Results: We obtained results from 109 patients. The most transfused blood component was packet red blood cells with 93.8% of total transfusions versus 43.8% of platelets and 37.5% of fresh plasma. The main criteria for transfusion were analytical criteria (43.75%), and acute anaemia with shock (18.75%) and without haemodynamic impact (18.75%). Conclusion: Clinical practice shows a ratio of red blood cells, platelets, and Fresh Frozen Plasma (FFP) of 2:1:1. It is necessary to implement Massive Transfusion Protocols as they appear to improve outcomes. Our study suggests that transfusion of RBC, platelets and FFP in a 2:1:1 ratio could be beneficial for trauma patients. Full article

The COVID-19 pandemic has affected emergency department (ED) usage. This study examines changes in the number of ED visits for gastrointestinal (GI) bleeding and nonemergency GI conditions, such as acute gastroenteritis (AGE) and constipation, before the pandemic and at the peak and slack periods of the pandemic in Taiwan. This retrospective observational study was conducted at a referral medical center in northern Taiwan. We recorded the number of weekly ED visits for GI bleeding, AGE, and constipation from 2019 to 2021. We then compared the baseline period (calendar weeks 4–18 and 21–31, 2019) with two peak pandemic periods (period 1, calendar weeks 4–18, 2020; period 2, calendar weeks 21–31, 2021) and their corresponding slack periods. The decline in the number of ED visits during the two peak pandemic periods for GI bleeding (−18.4% and −30.2%) were not as substantial as for AGE (−64.1% and −76.7%) or for constipation (−44.4% and −63.6%), but GI bleeding cases were still significantly lower in number relative to the baseline. During the slack period, the number of ED visits for all three diagnoses rebounded but did not exceed the baseline. Our study revealed that there was a significant decline of GI complaint during the pandemic. This phenomenon was more prominent in nonemergency complaints (AGE and constipation) and less prominent in serious complaints (GI bleeding). Full article