Since the outbreak of the coronavirus disease 2019(COVID-19),various measures have been taken to protect against the infection.As droplet and contact transmission are the main routes of COVID-19 infection,endoscopy ce...Since the outbreak of the coronavirus disease 2019(COVID-19),various measures have been taken to protect against the infection.As droplet and contact transmission are the main routes of COVID-19 infection,endoscopy centers are considered to be high-risk areas for exposure to COVID-19.We have undertaken several countermeasures in our endoscopic center during the pandemic,and have gained significant experience in terms of prevention and control of COVID-19.We here present our experience and strategies adopted for preventing hospital infection in our endoscopy center during the COVID-19 pandemic.We describe our management of the environment,endoscope,patients,and medical staff,and our self-made masks.展开更多
Objective:Correctly understanding and evaluating the level of public risk perception toward public health emergencies not only helps experts and decision-makers understand the public’s preventative health behaviors t...Objective:Correctly understanding and evaluating the level of public risk perception toward public health emergencies not only helps experts and decision-makers understand the public’s preventative health behaviors to these emergencies but also enhances their risk information communication with the public.The aim of this study was to develop a risk perception scale for public health emergencies and test its validity and reliability during the coronavirus disease 2019(COVID-19)pandemic.Methods:Guided by the theoretical model of risk perception,an initial scale was generated through literature review,group meetings,resident interviews,and expert consultation.A pretest and item screening were then conducted to develop a formal risk perception scale for public health emergencies.Finally,the reliability and validity of the scale were validated through a questionnaire survey of 504 Chinese adults.Results:The final scale had 9 items.The content validity index of the scale was 0.968,and the content validity index of individual items ranged from 0.83 to 1.00.Three common factors,dread risk perception,severe risk perception,and unknown risk perception,were extracted for exploratory factor analysis,and together they explained 66.26%of the variance in the score.Confirmatory factor analysis showed that the model had a satisfactory fit,whereχ^(2)/df=1.384,the goodness-of-fit index(GFI)=0.989,root mean square error of approximation(RMSEA)=0.028,root mean square residual(RMR)=0.018,comparative fit index(CFI)=0.995,normed fit index(NFI)=0.982,and non-normed fit index(NNFI)=0.990.The correlations between dimensions ranged from 0.306 to 0.483(P<0.01).Cronbach’s a was 0.793 for the total scale and ranged between 0.687 and 0.801 for the individual dimensions.The split-half coefficient was 0.861 for the total scale and ranged from 0.727 to 0.856 for induvial dimensions.The test-retest coefficient was 0.846 for the total scale and ranged from 0.843 to 0.868 for induvial dimensions.Conclusion:The developed scale for the risk perception of public health emergencies showed acceptable levels of reliability and validity,suggesting that it is suitable for evaluating residents’risk perception of public health emergencies.展开更多
Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effecti...Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effective psychological intervention.Methods:Applied questionnaire survey and used the“questionnaire star”platform to investigate the mental health status of medical staff assisting Ili by the General information,the PHQ-9,the GAD-7 and the SCL-90.And the relevant influencing factors were analyzed by univariate analysis and multiple linear regression analysis.Results:Factors such as whether they will support again,whether they need to provide psychological staff,and whether they have a sense of guilt for their families have a significant impact on the PHQ-9 of medical staff(p<0.05);Whether they will support again,whether they need psychological staff,and whether they feel bored and lonely during the closed loop management have a significant impact on the GAD-7 of medical staff(p<0.05);The SCL-90 was compared with the norm,and the scores of somatization,interpersonal sensitivity and terror factors of medical personnel were statistically significant(p<0.05),scores in other aspects(diet sleep)are obvious(1.63±0.72).Conclusion:During the period of COVID-19,the medical staff in Karamay City who assisted Ili had anxiety and depression,and their mental health was not optimistic,more attention and the necessary intervention should be given.展开更多
The study was to analyze the application of PDCA cycle in the clinical teaching of respiratory department during the outbreak of COVID-19.The teaching content focused on the prevention,control,diagnosis and treatment ...The study was to analyze the application of PDCA cycle in the clinical teaching of respiratory department during the outbreak of COVID-19.The teaching content focused on the prevention,control,diagnosis and treatment of COVID-19.Methods:Thirty clinical interns who entered the Department of Respiratory Medicine in our hospital from June 2020 to December 2020 were selected as the research objects and were randomly divided into two groups.The control group adopted traditional teaching methods and the experimental group adopted PDCA cycle.The teaching effect of the two group was compared.Results:The experimental group that used the PDCA cycle method had significantly higher theoretical knowledge,treatment skills,and comprehensive quality evaluation of COVID-19 than the traditional teaching method of the control group.Conclusion:The application of the PDCA cycle method in clinical teaching activities can improve the teaching process during the outbreak of COVID-19 and help improve the overall quality of clinical interns.展开更多
BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking beh...BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.展开更多
BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the c...BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019(COVID-19).CASE SUMMARY A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair,as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis.The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19.Several weeks after her COVID-19 infection,she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension.A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.CONCLUSION In the era of COVID-19,patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease.Patients may benefit from prophylactic antiplatelet or anticoagulation therapy.Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty,and/or a thrombolytic agent.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpfu...BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using theχ2 test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.展开更多
The ongoing coronavirus disease 2019(COVID-19)pandemic has necessitated rapid advancements in therapeutic strategies,with dexamethasone emerging as a key treatment for severe cases.This editorial discusses the systema...The ongoing coronavirus disease 2019(COVID-19)pandemic has necessitated rapid advancements in therapeutic strategies,with dexamethasone emerging as a key treatment for severe cases.This editorial discusses the systematic review conducted by Sethi et al,published in the World Journal of Virology.The review critically examines the efficacy and safety of varying dosages of dexamethasone in severe COVID-19 patients,providing a comprehensive meta-analysis that underscores the current clinical recommendations favoring a low-dose regimen.Despite these findings,the review highlights the potential benefits of tailored dosages for specific patient subgroups,suggesting a need for personalized treatment approaches.This editorial expands on the implications of these findings,advocating for the integration of evolving clinical data into treatment protocols and calling for further research into patient-specific responses to therapy.It emphasizes the importance of adaptability and precision in pandemic response,urging the medical community to consider both the robustness of existing evidence and the potential for innovative approaches to enhance patient outcomes in the face of global health challenges.展开更多
Rhabdomyolysis is a severe condition characterized by the breakdown of muscle tissue leading to the release of intracellular components into the bloodstream.This condition,when associated with acute kidney injury(AKI)...Rhabdomyolysis is a severe condition characterized by the breakdown of muscle tissue leading to the release of intracellular components into the bloodstream.This condition,when associated with acute kidney injury(AKI),can result in significant morbidity and mortality,particularly in the context of coronavirus disease 2019(COVID-19).This editorial discusses a retrospective study on patients with COVID-19 who developed rhabdomyolysis-related AKI.The study highlights that patients with rhabdomyolysis exhibited higher inflammatory markers,such as Creactive protein,ferritin,and procalcitonin,and experienced worse clinical outcomes compared to those with other causes of AKI.The findings underscore the importance of early recognition and management of rhabdomyolysis in COVID-19 patients to improve prognosis and reduce mortality rates.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)pla...BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.展开更多
BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial st...BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial stewardship.The coronavirus disease 2019(COVID-19)pandemic has introduced additional complexities,potentially influencing these patterns.AIM To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023,with a specific focus on the impact of the COVID-19 pandemic on these trends.METHODS A retrospective analysis of microbiological data was conducted,covering the period from 2018 to 2023.The study included key bacterial pathogens such as Escherichia coli(E.coli),Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,among others.The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods.To contextualize the findings,the findings were compared with similar studies from other regions,including China,India,Romania,Saudi Arabia,the United Arab Emirates,Malaysia,and United States.RESULTS The study revealed fluctuating trends in the prevalence of bacterial isolates,with notable changes during the COVID-19 pandemic.For example,a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years,while the prevalence of E.coli showed a more variable pattern.Antibiotic resistance rates varied among the different pathogens,with a concerning rise in resistance to commonly used antibiotics,particularly among Klebsiella pneumoniae and E.coli.Additionally,the study identified an alarming increase in the prevalence of multidrug-resistant(MDR)strains,especially within Klebsiella pneumoniae and E.coli isolates.The impact of the COVID-19 pandemic on these trends was evident,with shifts in the frequency,resistance patterns,and the emergence of MDR bacteria among several key pathogens.CONCLUSION This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex,particularly in the context of the COVID-19 pandemic.The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance.Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.展开更多
This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National ...This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.展开更多
Background: SARS-CoV-2 has circulated worldwide with dramatic consequences. In Chad, we have no data reported of variants. The aim of this study was to identify the SARS-CoV-2 variants that circulated during the epide...Background: SARS-CoV-2 has circulated worldwide with dramatic consequences. In Chad, we have no data reported of variants. The aim of this study was to identify the SARS-CoV-2 variants that circulated during the epidemic from 2020 to 2021. Methods: This is a cross-sectional, descriptive study carried out between 2020 and 2021. Samples from patients with suspected COVID-19 were tested in five laboratories in N’Djamena. One hundred quality samples of the positives were sequenced in Kinshasa using Oxford nanopore technologies minion and the Protocol Midnight SARS-CoV2. Data were processed using Excel version 16 software. Results: Of the 100 samples sequenced, 77 (77%) produced sequences, 23 (23%) did not. The genomic profiles were wild-type Wuhan and minor mutations (19A, 19B (A), 20A (B.1, B.2), 20B (AV.1), 20D (B.1.1.1 /C.36), 20C), variant of concern Alpha (20I), variant of concern Delta (21A/J), variant of interest Eta (21D), variant of concern Omicron (21K) and unclassified variant under surveillance (B.1.640). Of these variants, the maximums were detected in patients aged 26 - 35 with 30.26% and 25.26% in 36 - 45. However, 24.67% were in travelers and 75.32% in residents, 35.06% in those vaccinated against COVID-19 and 62.33% in non-vaccinates. The estimated case-fatality rate was 2.44% (107/4374). Conclusion: This work has provided preliminary data on COVID-19 and SARS-CoV-2 variants circulating during the 2020-2021 epidemics in Chad.展开更多
Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the ...Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as relative risk factors, and science course, measles/ rubella (MR) vaccination, and COVID-19 vaccination remained as relative protective factors in adjusted OR analyses. Club/group activities with member gathering and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may be equivalent to or replace COVID-19 vaccines.展开更多
This study used Topological Weighted Centroid (TWC) to analyze the Coronavirus outbreak in Brazil. This analysis only uses latitude and longitude in formation of the capitals with the confirmed cases on May 24, 2020 t...This study used Topological Weighted Centroid (TWC) to analyze the Coronavirus outbreak in Brazil. This analysis only uses latitude and longitude in formation of the capitals with the confirmed cases on May 24, 2020 to illustrate the usefulness of TWC though any date could have been used. There are three types of TWC analyses, each type having five associated algorithms that produce fifteen maps, TWC-Original, TWC-Frequency and TWC-Windowing. We focus on TWC-Original to illustrate our approach. The TWC method without using the transportation information predicts the network for COVID-19 outbreak that matches very well with the main radial transportation routes network in Brazil.展开更多
目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSvie...目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSviewer软件生成知识图谱。结果:共鉴定出768篇文章,发文涉及美国、意大利和中国为首的319个国家/地区和4 366个机构,领先的研究机构是梅奥诊所和哈佛医学院。New England Journal of Medicine是该领域最常被引用的期刊。在6 687位作者中,Arbelo Elena撰写的研究最多,Guo T被共同引用的次数最多,心房纤颤是最常见的关键词。结论:随着COVID-19的暴发,对COVID-19所致新发/进行性心律失常事件的研究蓬勃发展,未来的研究者可能会对COVID-19感染后新发或遗留的快速性心律失常/缓慢性心律失常的发生机制进行进一步的探索。展开更多
文摘Since the outbreak of the coronavirus disease 2019(COVID-19),various measures have been taken to protect against the infection.As droplet and contact transmission are the main routes of COVID-19 infection,endoscopy centers are considered to be high-risk areas for exposure to COVID-19.We have undertaken several countermeasures in our endoscopic center during the pandemic,and have gained significant experience in terms of prevention and control of COVID-19.We here present our experience and strategies adopted for preventing hospital infection in our endoscopy center during the COVID-19 pandemic.We describe our management of the environment,endoscope,patients,and medical staff,and our self-made masks.
文摘Objective:Correctly understanding and evaluating the level of public risk perception toward public health emergencies not only helps experts and decision-makers understand the public’s preventative health behaviors to these emergencies but also enhances their risk information communication with the public.The aim of this study was to develop a risk perception scale for public health emergencies and test its validity and reliability during the coronavirus disease 2019(COVID-19)pandemic.Methods:Guided by the theoretical model of risk perception,an initial scale was generated through literature review,group meetings,resident interviews,and expert consultation.A pretest and item screening were then conducted to develop a formal risk perception scale for public health emergencies.Finally,the reliability and validity of the scale were validated through a questionnaire survey of 504 Chinese adults.Results:The final scale had 9 items.The content validity index of the scale was 0.968,and the content validity index of individual items ranged from 0.83 to 1.00.Three common factors,dread risk perception,severe risk perception,and unknown risk perception,were extracted for exploratory factor analysis,and together they explained 66.26%of the variance in the score.Confirmatory factor analysis showed that the model had a satisfactory fit,whereχ^(2)/df=1.384,the goodness-of-fit index(GFI)=0.989,root mean square error of approximation(RMSEA)=0.028,root mean square residual(RMR)=0.018,comparative fit index(CFI)=0.995,normed fit index(NFI)=0.982,and non-normed fit index(NNFI)=0.990.The correlations between dimensions ranged from 0.306 to 0.483(P<0.01).Cronbach’s a was 0.793 for the total scale and ranged between 0.687 and 0.801 for the individual dimensions.The split-half coefficient was 0.861 for the total scale and ranged from 0.727 to 0.856 for induvial dimensions.The test-retest coefficient was 0.846 for the total scale and ranged from 0.843 to 0.868 for induvial dimensions.Conclusion:The developed scale for the risk perception of public health emergencies showed acceptable levels of reliability and validity,suggesting that it is suitable for evaluating residents’risk perception of public health emergencies.
文摘Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effective psychological intervention.Methods:Applied questionnaire survey and used the“questionnaire star”platform to investigate the mental health status of medical staff assisting Ili by the General information,the PHQ-9,the GAD-7 and the SCL-90.And the relevant influencing factors were analyzed by univariate analysis and multiple linear regression analysis.Results:Factors such as whether they will support again,whether they need to provide psychological staff,and whether they have a sense of guilt for their families have a significant impact on the PHQ-9 of medical staff(p<0.05);Whether they will support again,whether they need psychological staff,and whether they feel bored and lonely during the closed loop management have a significant impact on the GAD-7 of medical staff(p<0.05);The SCL-90 was compared with the norm,and the scores of somatization,interpersonal sensitivity and terror factors of medical personnel were statistically significant(p<0.05),scores in other aspects(diet sleep)are obvious(1.63±0.72).Conclusion:During the period of COVID-19,the medical staff in Karamay City who assisted Ili had anxiety and depression,and their mental health was not optimistic,more attention and the necessary intervention should be given.
基金Jiangsu Medical Vocational College Educational Reform Project(L201910)。
文摘The study was to analyze the application of PDCA cycle in the clinical teaching of respiratory department during the outbreak of COVID-19.The teaching content focused on the prevention,control,diagnosis and treatment of COVID-19.Methods:Thirty clinical interns who entered the Department of Respiratory Medicine in our hospital from June 2020 to December 2020 were selected as the research objects and were randomly divided into two groups.The control group adopted traditional teaching methods and the experimental group adopted PDCA cycle.The teaching effect of the two group was compared.Results:The experimental group that used the PDCA cycle method had significantly higher theoretical knowledge,treatment skills,and comprehensive quality evaluation of COVID-19 than the traditional teaching method of the control group.Conclusion:The application of the PDCA cycle method in clinical teaching activities can improve the teaching process during the outbreak of COVID-19 and help improve the overall quality of clinical interns.
文摘BACKGROUND Revisiting the epidemiology of posttraumatic stress symptoms(PTSSs)among university students during the coronavirus disease 2019(COVID-19)pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics.AIM To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students.METHODS A total of 2507 Chinese university students were recruited via snowball sampling.The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China.Sociodemo-graphic characteristics,pandemic-related characteristics,and mental health help-seeking behaviors of students with PTSSs were also collected.RESULTS The prevalence of PTSSs among the participants was 28.0%.Seven significant correlates of PTSSs were identified(odds ratio=1.23-3.65,P≤0.024):Female sex,being 19 years old or older,living with others or alone,a low level of family economic status,fair or poor interpersonal relationships,severe or very severe local pandemic,and having family members diagnosed with COVID-19.However,only 3.28%of the students with PTSSs reported seeking help from mental health specialists.Among the 23 students who sought help from mental health specialists,13 opted for online or telephone-based psychological consultation.CONCLUSION Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic.The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.
文摘BACKGROUND Alagille syndrome is a multisystem disease that results in various vascular anomalies,commonly involving the cardiac and pulmonary systems.To the best of our knowledge,there is no literature regarding the cardiovascular outcomes of these patients in association with coronavirus disease 2019(COVID-19).CASE SUMMARY A 34-year-old woman with a history of Alagille syndrome who underwent successful atrial septal defect with partial anomalous pulmonary veins and patent ductus arteriosus repair,as well as left pulmonary artery catheterization and stenting in childhood due to pulmonary stenosis.The patient was without any respiratory symptoms and was a dancer prior to contracting COVID-19.Several weeks after her COVID-19 infection,she developed left pulmonary artery stent thrombosis and subsequent symptomatic pulmonary hypertension.A treatment strategy of anticoagulation alongside pharmacological agents for pulmonary hypertension for 3 months followed by balloon pulmonary artery angioplasty to reopen the stenosis was unsuccessful.CONCLUSION In the era of COVID-19,patients with pulmonary vascular malformations and endovascular stents are at an increased risk for chronic thromboembolic disease.Patients may benefit from prophylactic antiplatelet or anticoagulation therapy.Stent thrombosis is a devastating phenomenon and should be treated urgently and aggressively with balloon pulmonary angioplasty,and/or a thrombolytic agent.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
文摘BACKGROUND Understanding a patient's clinical status and setting priorities for their care are two aspects of the constantly changing process of clinical decision-making.One analytical technique that can be helpful in uncertain situations is clinical judgment.Clinicians must deal with contradictory information,lack of time to make decisions,and long-term factors when emergencies occur.AIM To examine the ethical issues healthcare professionals faced during the coronavirus disease 2019(COVID-19)pandemic and the factors affecting clinical decision-making.METHODS This pilot study,which means it was a preliminary investigation to gather information and test the feasibility of a larger investigation was conducted over 6 months and we invited responses from clinicians worldwide who managed patients with COVID-19.The survey focused on topics related to their professional roles and personal relationships.We examined five core areas influencing critical care decision-making:Patients'personal factors,family-related factors,informed consent,communication and media,and hospital administrative policies on clinical decision-making.The collected data were analyzed using theχ2 test for categorical variables.RESULTS A total of 102 clinicians from 23 specialties and 17 countries responded to the survey.Age was a significant factor in treatment planning(n=88)and ventilator access(n=78).Sex had no bearing on how decisions were made.Most doctors reported maintaining patient confidentiality regarding privacy and informed consent.Approximately 50%of clinicians reported a moderate influence of clinical work,with many citing it as one of the most important factors affecting their health and relationships.Clinicians from developing countries had a significantly higher score for considering a patient's financial status when creating a treatment plan than their counterparts from developed countries.Regarding personal experiences,some respondents noted that treatment plans and preferences changed from wave to wave,and that there was a rapid turnover of studies and evidence.Hospital and government policies also played a role in critical decision-making.Rather than assessing the appropriateness of treatment,some doctors observed that hospital policies regarding medications were driven by patient demand.CONCLUSION Factors other than medical considerations frequently affect management choices.The disparity in treatment choices,became more apparent during the pandemic.We highlight the difficulties and contradictions between moral standards and the realities physicians encountered during this medical emergency.False information,large patient populations,and limited resources caused problems for clinicians.These factors impacted decision-making,which,in turn,affected patient care and healthcare staff well-being.
文摘The ongoing coronavirus disease 2019(COVID-19)pandemic has necessitated rapid advancements in therapeutic strategies,with dexamethasone emerging as a key treatment for severe cases.This editorial discusses the systematic review conducted by Sethi et al,published in the World Journal of Virology.The review critically examines the efficacy and safety of varying dosages of dexamethasone in severe COVID-19 patients,providing a comprehensive meta-analysis that underscores the current clinical recommendations favoring a low-dose regimen.Despite these findings,the review highlights the potential benefits of tailored dosages for specific patient subgroups,suggesting a need for personalized treatment approaches.This editorial expands on the implications of these findings,advocating for the integration of evolving clinical data into treatment protocols and calling for further research into patient-specific responses to therapy.It emphasizes the importance of adaptability and precision in pandemic response,urging the medical community to consider both the robustness of existing evidence and the potential for innovative approaches to enhance patient outcomes in the face of global health challenges.
文摘Rhabdomyolysis is a severe condition characterized by the breakdown of muscle tissue leading to the release of intracellular components into the bloodstream.This condition,when associated with acute kidney injury(AKI),can result in significant morbidity and mortality,particularly in the context of coronavirus disease 2019(COVID-19).This editorial discusses a retrospective study on patients with COVID-19 who developed rhabdomyolysis-related AKI.The study highlights that patients with rhabdomyolysis exhibited higher inflammatory markers,such as Creactive protein,ferritin,and procalcitonin,and experienced worse clinical outcomes compared to those with other causes of AKI.The findings underscore the importance of early recognition and management of rhabdomyolysis in COVID-19 patients to improve prognosis and reduce mortality rates.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)pneumonia with severe septic shock and acute respiratory distress syndrome(ARDS)are critical illnesses for patients following transplant.Intravenous immunoglobulin(IVIG)plays a role in both immune support and inflammation control,especially in immunocompromised patients.This case report describes the first successful experience using IVIG and pulse steroids to manage this critical condition following lung transplantation.CASE SUMMARY A 65-year-old male patient reported a history of chronic obstructive pulmonary disease and poor lung function and received bilateral sequential lung transplantations.Postoperatively,he developed COVID-19 pneumonia,severe septic shock,and ARDS.He recovered from this critical condition after empirical antibiotics administration and veno-venous extracorporeal membrane oxygenation,in addition to IVIG and pulse steroids.CONCLUSION IVIG is a valuable adjunct in managing severe sepsis in lung transplant recipients after COVID-19 infection.We aim,for the first time,to report the success of such a management approach for COVID-19 ARDS and sepsis in the post-lung transplant setting.With further investigations,this is a starting point for wider analysis of such an approach in this setting and consequently helps guide clinical practice for such a challenging patient population moving forward.
文摘BACKGROUND Antibiotic resistance is a growing global health threat,and understanding local trends in bacterial isolates and their susceptibility patterns is crucial for effective infection control and antimicrobial stewardship.The coronavirus disease 2019(COVID-19)pandemic has introduced additional complexities,potentially influencing these patterns.AIM To analyze trends in bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex from 2018 to 2023,with a specific focus on the impact of the COVID-19 pandemic on these trends.METHODS A retrospective analysis of microbiological data was conducted,covering the period from 2018 to 2023.The study included key bacterial pathogens such as Escherichia coli(E.coli),Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus,among others.The antibiotic susceptibility profiles of these isolates were assessed using standard laboratory methods.To contextualize the findings,the findings were compared with similar studies from other regions,including China,India,Romania,Saudi Arabia,the United Arab Emirates,Malaysia,and United States.RESULTS The study revealed fluctuating trends in the prevalence of bacterial isolates,with notable changes during the COVID-19 pandemic.For example,a significant increase in the prevalence of Staphylococcus aureus was observed during the pandemic years,while the prevalence of E.coli showed a more variable pattern.Antibiotic resistance rates varied among the different pathogens,with a concerning rise in resistance to commonly used antibiotics,particularly among Klebsiella pneumoniae and E.coli.Additionally,the study identified an alarming increase in the prevalence of multidrug-resistant(MDR)strains,especially within Klebsiella pneumoniae and E.coli isolates.The impact of the COVID-19 pandemic on these trends was evident,with shifts in the frequency,resistance patterns,and the emergence of MDR bacteria among several key pathogens.CONCLUSION This study highlights the dynamic nature of bacterial isolates and their antibiotic susceptibility patterns at Salmaniya Medical Complex,particularly in the context of the COVID-19 pandemic.The findings underscore the need for continuous monitoring and effective anti-microbial stewardship programs to combat the evolving threat of antibiotic resistance.Further research and policy initiatives are required to address the identified challenges and improve patient outcomes in the face of these ongoing challenges.
文摘This editorial comments on the article by Desai et al,which investigates the impact of coronavirus disease 2019(COVID-19)on in-hospital mortality among patients with recurrent stroke using data from the 2020 National Inpatient Sample.The findings reveal significantly higher mortality rates in COVID-19-positive patients compared to non-COVID-19 patients,particularly among middle-aged individuals,males,and ethnic minorities.This editorial explores the underlying mechanisms contributing to these outcomes and discusses the clinical implications for targeted management strategies in high-risk groups.The results emphasize the need for comprehensive approaches to mitigate the heightened risks faced by recurrent stroke patients during the COVID-19 pandemic.
文摘Background: SARS-CoV-2 has circulated worldwide with dramatic consequences. In Chad, we have no data reported of variants. The aim of this study was to identify the SARS-CoV-2 variants that circulated during the epidemic from 2020 to 2021. Methods: This is a cross-sectional, descriptive study carried out between 2020 and 2021. Samples from patients with suspected COVID-19 were tested in five laboratories in N’Djamena. One hundred quality samples of the positives were sequenced in Kinshasa using Oxford nanopore technologies minion and the Protocol Midnight SARS-CoV2. Data were processed using Excel version 16 software. Results: Of the 100 samples sequenced, 77 (77%) produced sequences, 23 (23%) did not. The genomic profiles were wild-type Wuhan and minor mutations (19A, 19B (A), 20A (B.1, B.2), 20B (AV.1), 20D (B.1.1.1 /C.36), 20C), variant of concern Alpha (20I), variant of concern Delta (21A/J), variant of interest Eta (21D), variant of concern Omicron (21K) and unclassified variant under surveillance (B.1.640). Of these variants, the maximums were detected in patients aged 26 - 35 with 30.26% and 25.26% in 36 - 45. However, 24.67% were in travelers and 75.32% in residents, 35.06% in those vaccinated against COVID-19 and 62.33% in non-vaccinates. The estimated case-fatality rate was 2.44% (107/4374). Conclusion: This work has provided preliminary data on COVID-19 and SARS-CoV-2 variants circulating during the 2020-2021 epidemics in Chad.
文摘Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as relative risk factors, and science course, measles/ rubella (MR) vaccination, and COVID-19 vaccination remained as relative protective factors in adjusted OR analyses. Club/group activities with member gathering and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may be equivalent to or replace COVID-19 vaccines.
文摘This study used Topological Weighted Centroid (TWC) to analyze the Coronavirus outbreak in Brazil. This analysis only uses latitude and longitude in formation of the capitals with the confirmed cases on May 24, 2020 to illustrate the usefulness of TWC though any date could have been used. There are three types of TWC analyses, each type having five associated algorithms that produce fifteen maps, TWC-Original, TWC-Frequency and TWC-Windowing. We focus on TWC-Original to illustrate our approach. The TWC method without using the transportation information predicts the network for COVID-19 outbreak that matches very well with the main radial transportation routes network in Brazil.
文摘目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSviewer软件生成知识图谱。结果:共鉴定出768篇文章,发文涉及美国、意大利和中国为首的319个国家/地区和4 366个机构,领先的研究机构是梅奥诊所和哈佛医学院。New England Journal of Medicine是该领域最常被引用的期刊。在6 687位作者中,Arbelo Elena撰写的研究最多,Guo T被共同引用的次数最多,心房纤颤是最常见的关键词。结论:随着COVID-19的暴发,对COVID-19所致新发/进行性心律失常事件的研究蓬勃发展,未来的研究者可能会对COVID-19感染后新发或遗留的快速性心律失常/缓慢性心律失常的发生机制进行进一步的探索。