bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender-and age-specific associations of sleep duration and quality with cognitive impairment in community-dwelling older adults in Anhui Province, China
Authors: Liu Xuechun , Xu Peiru , Wei Rong , Cheng Beijing , Sun Liang , Yang Linsheng , Chen Guihai 
Published: January 2024

ObjectiveTo examine associations of sleep duration and quality with cognitive impairment in older adults and the moderating role of gender and age in these associations.MethodsThis community-based cross-sectional study included 4,837 participants aged 60 years and above. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE), and the participants were grouped based on the presence of cognitive impairment. The duration and quality of sleep were assessed using the Pittsburgh Sleep Quality Index (PSQI). Multivariate logistic regression models were used to analyze associations of sleep duration and quality with cognitive impairment. The role of age and gender in these associations have also been explored.ResultsThe age (mean ± SD) of the participants was 71.13 ± 5.50 years. Of all older adults, 1,811 (37.44%) were detected as cognitive impairment, and 1755 (36.8%) had poor sleep quality. Among those with cognitive impairment, 51.09% were female. The proportion of the participants with cognitive impairment is significantly higher in those with symptoms of depression (49.73%, 273/549) (χ2 = 41.275, p &lt; 0.001) than in those without depressive symptoms. After adjustment for multiple confounding factors and the crucial covariate (depressive symptoms), the odds ratios (OR) (95% confidence interval [CI]) of cognitive impairment (with 7–7.9 h regarded as the reference group) for individuals with a sleep duration of &lt;6, 6–6.9, 8–8.9, and ≥ 9 h were 1.280 (1.053–1.557), 1.425 (1.175–1.728), 1.294 (1.068–1.566), and 1.360 (1.109–1.668), respectively. Subgroup analysis showed a V-shaped association between night sleep duration and cognitive impairment in males (p ≤ 0.05), and the association was stronger for individuals aged 60–80 years. With regard to sleep quality, the fully adjusted OR (95%CI) of cognitive impairment were 1.263 (1.108–1.440). According to scores of subscales in the PSQI, daytime dysfunction was associated with an increased risk of cognitive impairment (OR: 1.128, 95%CI: 1.055–1.207). Subgroup analysis also revealed a statistically significant correlation between poor sleep quality (including daytime dysfunction) and cognitive impairment in different gender and age groups, with the association being stronger in females (OR: 1.287, 95%CI: 1.080–1.534) and those aged 81–97 years (OR: 2.128, 95%CI: 1.152–3.934). For cognitive impairment, the group aged 81–97 years with daytime dysfunction was associated with a higher odds ratio than other age groups.ConclusionThe present study showed that inadequate or excessive sleep was associated with cognitive impairment, especially in males, who exhibited a V-shaped association. Cognitive impairment was also associated with poor sleep quality as well as daytime dysfunction, with females and individuals aged 81–97 years exhibiting the strongest association.
Latent profile and network analysis of risk perception among a sample of Chinese university students during the COVID-19 pandemic: a cross-sectional and longitudinal study
Authors: Niu Zhimin , Liu Ligang , Mei Songli , Li Li 
Published: January 2024

BackgroundThe risk perception of contracting COVID-19 is an important topic for assessing and predicting COVID-19 infection and health education during the pandemic. However, studies that use latent profiles and network analysis together to measure the risk perception of COVID-19 are rare. Therefore, this study combined latent profile analysis and network analysis to measure risk perception toward COVID-19 among Chinese university students through a cross-sectional and longitudinal study.MethodsA sample of 1,837 Chinese university students (735 males, 40%) completed the cross-sectional study with an eight-item risk perception questionnaire in January 2020, while 334 Chinese university students (111 males, 33.2%) completed the longitudinal study at three time points.ResultsA two-class model including a low risk perception class (n = 1,005, 54.7%) and a high risk perception class (n = 832, 45.3%) was selected for the cross-sectional study. Nodes rp6 (“Average people have chances of contracting COVID-19'') and rp7 (“Average people worry about catching COVID-19”) had the strongest edge intensity (r = 0.491), while node rp5 (“The COVID-19 outbreak affects the whole country”) had the highest strength centrality in the cross-sectional study. The risk perception of contracting COVID-19 decreased continuously at the three time points. Moreover, the network structures and global strengths had no significant differences in the longitudinal study.ConclusionsThe risk perception of contracting COVID-19 decreased continually during the COVID-19 pandemic, which indicated the importance of cultural influence and effective government management in China. In addition, university students displayed strong trust and confidence in the government's ability to fight COVID-19. The results indicate that the government should take strong measures to prevent and intervene in various risks and reinforce the public's trust through positive media communications.
Hand hygiene during the spread of COVID-19: a cross-sectional study of awareness and practices among academic institutions in Lebanon
Authors: Alwan Nisreen , Safwan Jihan , Kerek Racha , Ghach Wissam 
Published: January 2024

IntroductionDuring the pandemic, the World Health Organization has recommended hand hygiene as one of the effective preventive measures to limit the global spread of COVID-19. However, the awareness gap of hand hygiene protocols could increase the spread of COVID-19 and consequently increase the absenteeism rate among academic institutions. This study aims to assess hand hygiene awareness and practices levels among various university communities in Lebanon.MethodsA cross-sectional study was conducted between December 2021 and June 2022 among 1,291 participants from academic settings in Lebanese universities. An online survey (score-based questionnaire) of hand hygiene was conducted to evaluate the awareness and practices among university communities (faculty, staff, and students). Mann-Whitney and Kruskal-Wallis tests were used to determine whether significant differences exist in the levels of awareness with regard to gender, age, provinces, educational level, and university status. Pearson’s chi-squared test was applied to assess differences among the sample characteristics and participants’ practice of hand hygiene.ResultsIt was found that most of the participants showed a moderate level of awareness (76.4%) with a mean score of 7.59 out of 12 (SD = 1.68). The Mann-Whitney test indicated that females recorded higher levels of awareness than males with a significant difference of 102, 104: p &lt; 0.05. Another notable variable was the educational level of the participants with university degrees holders recording higher scores of awareness than the ones with high school degrees as per the Kruskal-Wallis test (p &lt; 0.05). Significant differences were also shown in awareness scores among the age groups and the university status (p &lt; 0.05). The Pearson’s chi-squared test results showed that females used alcohol-based hand rubs or soap and water more frequently than males (p &lt; 0.05). However, males significantly preferred the frequent use of water alone compared to females (p &lt; 0.05).ConclusionThe study findings highlighted the necessity of awareness campaigns and health educational programs addressing the technical skills of hand hygiene among both genders (especially males) of the academic communities in Lebanon.
Cases of Monkeypox show highly-overlapping co-infection with HIV and syphilis
Authors: Jia Lin , Yan Benyong , Fang Yuan , Yang Xiaodong , Jia Han , Zhang Mei , Li Shuang , Zhang Yang , Wang Wen , Guo Caiping , Zhang Tong , Huang Xiaojie , Jiang Taiyi 
Published: January 2024

PurposeOngoing Monkeypox (MPX) outbreaks in countries outside Africa have unique characteristics. However, data on cohorts of confirmed cases in China is limited. The study provides important epidemiological, diagnostic, and clinical information about this disease in China.MethodsWe report a series of Chinese individuals with confirmed MPX infections identified at Beijing Youan Hospital (China) from June 10 to July 15, 2023. Samples were taken from the skin, anus, throat, and blood. An epidemiological questionnaire was used to collect demographic and clinical data. Further, we compared the MPX viral (MPXV) loads across different anatomical sites.Results66 samples were collected from 20 patients, all of whom were cisgender men. Median patient age was 29 years. Notably, 19 (95%) patients reported unprotected sexual encounters with men in the preceding month, and 13 (65%) were human immunodeficiency virus (HIV)-positive. Among those with HIV, 12 (92%) were receiving antiretroviral therapy, and 11 (85%) had well-controlled infections (HIV viral load &lt;40/mL). The median CD4+ T cell count was 667 cells/mm3. In the HIV-negative group, three (43%) patients were taking preexposure prophylaxis. Fifteen patients (75%) had concurrent sexually transmitted infections (50% had syphilis and 65% had HIV) and eight (40%) had HIV and syphilis co-infection. MPXV loads were significantly higher in samples from the skin (cycle threshold value [Ct value]: 19·0) and anus (Ct value: 23.0) compared to samples from the throat (Ct value: 31.0) or blood (Ct value: 34.5). All patients had skin lesions (85% of whom presented with anogenital lesions). Common systemic symptoms included fever (85%) and lymphadenopathy (55%). The median incubation period was 8 d [interquartile range (IQR): 6–16 d]. The median time from the onset of skin lesions to scab removal was 14 d (IQR: 10–16 d). No deaths or severe cases were reported.ConclusionMPXV primarily affects young homosexual men. The high MPXV viral loads in skin and anal lesions indicate that transmission most likely occurs through direct and close body contact. This study also reports high rates of HIV and syphilis co-infection. Therefore, preventive efforts should focus on homosexual men.
Advances in objective assessment of ergonomics in endoscopic surgery: a review
Authors: Liu Shuang , Li Yuan-you , Li Dan , Wang Feng-Yi , Fan Ling-Jie , Zhou Liang-xue 
Published: January 2024

BackgroundMinimally invasive surgery, in particular endoscopic surgery, has revolutionized the benefits for patients, but poses greater challenges for surgeons in terms of ergonomics. Integrating ergonomic assessments and interventions into the multi-stage endoscopic procedure contributes to the surgeon’s musculoskeletal health and the patient’s intraoperative safety and postoperative recovery.ObjectiveThe purpose of this study was to overview the objective assessment techniques, tools and assessment settings involved in endoscopic procedures over the past decade and to identify the potential factors that induce differences in high workloads in endoscopic procedures and ultimately to design a framework for ergonomic assessment in endoscopic surgery.MethodsLiterature searches were systematically conducted in the OVID, pubmed and web of science database before October 2022, and studies evaluating ergonomics during the process of endoscopic procedures or simulated procedures were both recognized.ResultsOur systematic review of 56 studies underscores ergonomic variations in endoscopic surgery. While endoscopic procedures, predominantly laparoscopy, typically incur less physical load than open surgery, extended surgical durations notably elevate ergonomic risks. Surgeon characteristics, such as experience level and gender, significantly influence these risks, with less experienced and female surgeons facing greater challenges. Key assessment tools employed include electromyography for muscle fatigue and motion analysis for postural evaluation.ConclusionThis review aims to provide a comprehensive analysis and framework of objective ergonomic assessments in endoscopic surgery, and suggesting avenues for future research and intervention strategies. By improving the ergonomic conditions for surgeons, we can enhance their overall health, mitigate the risk of WMSDs, and ultimately improve patient outcomes.
Supervised machine learning algorithms to predict the duration and risk of long-term hospitalization in HIV-infected individuals: a retrospective study
Authors: Li Jialu , Hao Yiwei , Liu Ying , Wu Liang , Liang Hongyuan , Ni Liang , Wang Fang , Wang Sa , Duan Yujiao , Xu Qiuhua , Xiao Jinjing , Yang Di , Gao Guiju , Ding Yi , Gao Chengyu , Xiao Jiang , Zhao Hongxin 
Published: January 2024

ObjectiveThe study aimed to use supervised machine learning models to predict the length and risk of prolonged hospitalization in PLWHs to help physicians timely clinical intervention and avoid waste of health resources.MethodsRegression models were established based on RF, KNN, SVM, and XGB to predict the length of hospital stay using RMSE, MAE, MAPE, and R2, while classification models were established based on RF, KNN, SVM, NN, and XGB to predict risk of prolonged hospital stay using accuracy, PPV, NPV, specificity, sensitivity, and kappa, and visualization evaluation based on AUROC, AUPRC, calibration curves and decision curves of all models were used for internally validation.ResultsIn regression models, XGB model performed best in the internal validation (RMSE = 16.81, MAE = 10.39, MAPE = 0.98, R2 = 0.47) to predict the length of hospital stay, while in classification models, NN model presented good fitting and stable features and performed best in testing sets, with excellent accuracy (0.7623), PPV (0.7853), NPV (0.7092), sensitivity (0.8754), specificity (0.5882), and kappa (0.4672), and further visualization evaluation indicated that the largest AUROC (0.9779), AUPRC (0.773) and well-performed calibration curve and decision curve in the internal validation.ConclusionThis study showed that XGB model was effective in predicting the length of hospital stay, while NN model was effective in predicting the risk of prolonged hospitalization in PLWH. Based on predictive models, an intelligent medical prediction system may be developed to effectively predict the length of stay and risk of HIV patients according to their medical records, which helped reduce the waste of healthcare resources.
Differences in mental indicators and state-hope related to the level of engagement in social unrest: Israel 2023
Authors: Hamama-Raz Yaira , Leshem Elazar , Ben-Ezra Menachem 
Published: January 2024

BackgroundThis study examined the interplay between engagement in social unrest, mental indicators, state-hope and demographic variables. In addition, mental indicators and state-hope were compared in line with levels of engagement in social unrest.MethodsIn a cross-sectional study, conducted from March 23 to April 10, 2023, 2031 Israelis were recruited via a survey company. Participants completed self-report questionnaires to assess engagement in social unrest, anxiety, social unrest related distress, state-hope and demographic variables.ResultsParticipants with higher engagement in social unrest, who opposed the law reform, were prone to higher levels of social unrest related distress, anxiety, and lower levels of state-hope compared to those not engaged in social unrest activities or those who supported the law reform.ConclusionsConcerns regarding unmet mental health needs, during and following social unrest, regardless of the engagement level, should be actively addressed by mental health professionals and health policy makers.
Exploring human resource management in the top five global hospitals: a comparative study
Authors: Wang Xingyou , Wang Richard Szewei , Qin Xiaoping , Huang Yu-Ni , Chiu Herng-Chia , Wang Bing-Long 
Published: January 2024

BackgroundThe pivotal role of Human Resource Management (HRM) in hospital administration has been acknowledged in research, yet the examination of HRM practices in the world’s premier hospitals has been scant.ObjectiveThis study explored how the world’s leading hospitals attain operational efficiency by optimizing human resource allocation and melding development strategies into their HRM frameworks. A comparative analysis of the HRM frameworks in the top five global hospitals was undertaken to offer a reference model for other hospitals.MethodsThis research offers a comparative exploration of the HRM frameworks utilized by the top five hospitals globally, underscoring both shared and distinct elements. Using a multi-case study methodology, the research scrutinized each hospital’s HRM framework across six modules, drawing literature from publicly accessible sources, including websites, annual reports, and pertinent English-language scholarly literature from platforms such as Google Scholar, PubMed, Medline, and Web of Science.ResultsThe analyzed hospitals exhibited inconsistent HRM frameworks, yet all manifested potent organizational cultural attributes and maintained robust employee training and welfare policies. The design of the HR systems was strategically aligned with the hospitals’ objectives, and the study established that maintaining a sustainable talent system is pivotal to achieving hospital excellence.ConclusionThe HRM frameworks of the five analyzed hospitals align with their developmental strategies and exhibit unique organizational cultural attributes. All five hospitals heavily prioritize aligning employee development with overall hospital growth and place a spotlight on fostering a healthy working environment and nurturing employees’ sense of achievement. While compensation is a notable performance influencer, it is not rigorously tied to workload in these hospitals, with employees receiving mid-to-upper industry-range compensation. Performance assessment criteria focus on job quality and aligning employee actions with organizational values. Comprehensive welfare and protection are afforded to employees across all five hospitals.
Smartphone sensors for evaluating COVID-19 fear in patients with cancer: a prospective study
Authors: Kasputytė Gabrielė , Jenciūtė Gabrielė , Šakinis Nerijus , Bunevičienė Inesa , Korobeinikova Erika , Vaitiekus Domas , Inčiūra Arturas , Jaruševičius Laimonas , Bunevičius Romas , Krikštolaitis Ričardas , Krilavičius Tomas , Juozaitytė Elona , Bunevičius Adomas 
Published: January 2024

ObjectiveThis study aimed to analyze the association between the behavior of cancer patients, measured using passively and continuously generated data streams from smartphone sensors (as in digital phenotyping), and perceived fear of COVID-19 and COVID-19 vaccination status.MethodsA total of 202 patients with different cancer types and undergoing various treatments completed the COVID-19 Fears Questionnaire for Chronic Medical Conditions, and their vaccination status was evaluated. Patients’ behaviors were monitored using a smartphone application that passively and continuously captures high-resolution data from personal smartphone sensors. In all, 107 patients were monitored for at least 2 weeks. The study was conducted between August 2022 and August 2023. Distributions of clinical and demographical parameters between fully vaccinated, partially vaccinated, and unvaccinated patients were compared using the Chi-squared test. The fear of COVID-19 among the groups was compared using the Mann–Whitney and the Kruskal–Wallis criteria. Trajectories of passively generated data were compared as a function of fear of COVID-19 and COVID-19 vaccination status using local polynomial regression.ResultsIn total, 202 patients were included in the study. Most patients were fully (71%) or partially (13%) vaccinated and 16% of the patients were unvaccinated for COVID-19. Fully vaccinated or unvaccinated patients reported greater fear of COVID-19 than partially vaccinated patients. Fear of COVID-19 was higher in patients being treated with biological therapy. Patients who reported a higher fear of COVID-19 spent more time at home, visited places at shorter distances from home, and visited fewer places of interest (POI). Fully or partially vaccinated patients visited more POI than unvaccinated patients. Local polynomial regression using passively generated smartphone sensor data showed that, although at the beginning of the study, all patients had a similar number of POI, after 1 week, partially vaccinated patients had an increased number of POI, which later remained, on average, around four POI per day. Meanwhile, fully vaccinated or unvaccinated patients had a similar trend of POI and it did not exceed three visits per day during the entire treatment period.ConclusionThe COVID-19 pandemic continues to have an impact on the behavior of cancer patients even after the termination of the global pandemic. A higher perceived fear of COVID-19 was associated with less movement, more time spent at home, less time spent outside of home, and a lower number of visited places. Unvaccinated patients visited fewer places and were moving less overall during a 14-week follow-up as compared to vaccinated patients.
Clinical features of omicron SARS-CoV-2 variants infection associated with co-infection and ICU-acquired infection in ICU patients
Authors: Li Dong-Jie , Zhou Can-Can , Huang Fang , Shen Fu-Ming , Li Ying-Chuan 
Published: January 2024

BackgroundAlthough the decreasing rate of hospital admission in the omicron wave has led countries to loosen control, still the patients requires ICU admission. It is common for viral respiratory infections to be co-infected with bacteria. However, the difference between co-infection and ICU-acquired infection on their clinical characteristics and outcomes during the Omicron wave was little reported.MethodsClinical and microbiological data were collected from ICU patients with omicron infection between April 1st, 2022, and May 31th, 2022 and a comprehensive comparative study of the clinical characteristics and endpoint were conducted.ResultsThe Omicron SARS-CoV-2 variants-infected patients requiring intensive care had high rates of co-infection (42.55%). Additionally, the ICU COVID-19 patients with co-infection showed more severe clinical features compared to those with ICU-acquired infection. Furthermore, Multivariate Cox analysis demonstrated that co-infection (hazard ratio: 4.670, p = 0.018) was a significant risk factor for poor outcomes in ICU patients with COVID-19. Besides, Kaplan–Meier survival curve analysis revealed that COVID-19 patients with co-infection had a significantly shorter 28-Day survival time compared to those with ICU-acquired infection (p &lt; 0.001). Finally, our investigation identified a significant association between the presence of Candida app. in the broncho-alveolar lavage and an elevated risk of mortality (OR: 13.80, p = 0.002) and invasive ventilation (OR: 5.63, p = 0.01).ConclusionCo-infection is prevalent among patients requiring intensive care and is linked to unfavorable outcomes in the Omicron wave. Consequently, more attention may be needed for the empirical antibacterial treatment in ICU patients within the COVID-19 Omicron variant, especially anti-fungi.