关键词： COVID-19  

摘要： This article presents skewed multifractal cross-correlations between price and volumes on the carbon emissions trading markets in China and Europe. The BEAST algorithm is first used to detect change points in financial time series and to divide series into two adjacent intervals. The study performs a skewed multifractal detrended cross-correlations analysis and further investigates the impact of the COVID-19 pandemic on multifractality and risk between price and volumes on both markets, from 30 April 2014 to 25 July 2023. The results demonstrate that the multifractality of cross-correlations in both markets underwent significant changes before and after the change points, indicating skewed multifractality. In both markets, the price-volume nexus exhibited increased anti-persistence, higher multifractal risks, and reduced market efficiency after the outbreak of the pandemic. This may be attributed to the pandemic-induced shifts in carbon emissions trading market trends and heightened volatility. In conclusion, the outbreak of the pandemic had increased the instability of the carbon markets and the Hubei market exhibited higher levels of multifractality and multifractal risk. © 2024 Elsevier Ltd

关键词： Long COVID   Primary care   PASC   Long COVID treatment   FATIGUE-SYNDROME   SYMPTOMS   SEQUELAE   HEALTH   REHABILITATION   PREVALENCE   COGSMART   THERAPY  

摘要： Long COVID is a complex, multisystem illness with a poorly understood pathophysiology, absence of specific diagnostic tests or criteria, or evidence-based treatments. With over 200 identified symptoms and approximately 10% of COVID-19 cases resulting in Long COVID, it is a challenge to provide comprehensive treatment at a scale commensurate with the illness burden. The diverse manifestations of Long COVID, encompassing numerous medical specialties, typically place primary care providers (PCPs) at the forefront of management, navigating an evolving landscape of research and lack of evidence-based guidelines. This paper presents a pragmatic, structured framework for Long COVID management in primary care, integrating current knowledge and best practices. The approach is individualized, addressing Long COVID's broad symptomatology through a four-step framework. The first step focuses on energy management strategies, emphasizing the prevention of postexertional malaise, a cardinal feature of Long COVID. The second step, intentional rehabilitation, employs carefully titrated multidisciplinary modalities to address physical, cognitive, and emotional domains. The third step utilizes symptomatic management through both pharmacological and non-pharmacological interventions, targeting debilitating symptoms like fatigue, insomnia, and chronic pain. The fourth step outlines an approach to trialing experimental, targeted therapies that may impact Long COVID's underlying pathophysiology. These treatments, while experimental and lacking quality evidence in Long COVID, may be available off-label on an individual basis following a thorough risk-benefit discussion. This stepwise framework can equip PCPs to effectively address the most common and disabling symptoms of Long COVID, individualize care, and remain attuned to the evolving scientific understanding of the condition.

关键词： Hypertension   COVID-19   Self-measured blood pressure monitoring  

摘要： Background The Coronavirus Disease 2019 (COVID-19) pandemic disrupted health care, with particularly profound effects on persons with chronic conditions like hypertension. Objectives In this study, we examined changes in the prevalence of blood pressure (BP) measurements by a healthcare professional among adults aged ≥ 18 years with hypertension before and during the COVID-19 pandemic in the United States (US). Methods This study utilized the National Health Interview Survey data from April to December of the 2019 and 2021 modules of the survey. A total of 15,855 participants were included in the analytic sample. The prevalence of BP measurements taken by a health professional was calculated and the association between survey year and BP measurements was evaluated using adjusted and unadjusted logistic regression models. Results Overall, the prevalence of BP measurements by a health professional among US adults with hypertension decreased from 95.9 % in the pre-pandemic period to 94.7 % in the pandemic period. Adults with hypertension were less likely (OR: 0.76, 95 % CI: 0.63–0.91) to report having had a BP measurement taken by a health professional during the pandemic compared to before the pandemic. Conclusion Self-measured BP monitoring with clinical support could ensure continuous and improved care of individuals with hypertension, especially when circumstances could interrupt healthcare access.