Influenza-like illness(ILI)is an acute respiratory infection caused by various pathogens.However,the epidemiologic characteristics of ILI pathogens in Jiangsu province are unclear.To better understand the ILI etiology...Influenza-like illness(ILI)is an acute respiratory infection caused by various pathogens.However,the epidemiologic characteristics of ILI pathogens in Jiangsu province are unclear.To better understand the ILI etiology,the characteristics of the pathogens from nasopharyngeal swab samples of patients with ILI collected from 2012 to 2016 in 6 hospitals in Jiangsu province were studied.The pathogens,including influenza virus,respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),herpes simplex virus(HSV),human coronavirus(hCoV),Streptococcus pneumoniae and Haemophilus influenzae,were detected by real-time PCR.At least one pathogen was identified in 1334 of the patients(40.23%).Among viruses,HRV,influenza A virus(Flu A),ADV and RSV were the most frequently detected.ADV was the only pathogen that was distributed evenly in different years and regions(P>0.05).The etiological distribution varied in different age groups.Streptococcus pneumoniae was the most common pathogen in co-infections with a co-detection rate of 64.57%(319/494).The spectrum of etiologies could help to estimate disease burden and provide guidance for vaccination.展开更多
Introduction:This study investigated the lagged correlation between Baidu Index for influenza-related keywords and influenza-like illness percentage(ILI%)across regions in China.The aim is to establish a scientific fo...Introduction:This study investigated the lagged correlation between Baidu Index for influenza-related keywords and influenza-like illness percentage(ILI%)across regions in China.The aim is to establish a scientific foundation for utilizing Baidu Index as an early warning tool for influenza-like illness epidemics.Methods:In this study,data on ILI%and Baidu Index were collected from 30 provincial-level administrative divisions(PLADs)spanning April 2014 to March 2019.The Baidu Index was categorized into Overall Index,Ordinary Index,Prevention Index,Symptom Index,and Treatment Index based on search query themes.The lagged correlation between the Baidu Index and ILI%was examined through the cross-correlation function(CCF)method.Results:Correlating the Baidu Overall Index of 30 PLADs with ILI%revealed CCF values ranging from 0.46 to 0.86,with a median lag of 0.5 days.Subcategory analysis indicated that the Prevention Index and Symptom Index exhibited quicker responses to ILI%,with median lags of−9 and−0.5 days,respectively,compared to 0 and 3 days for the Ordinary and Treatment Indexes.The median lag days between the Baidu Index and the ILI%were earlier in the northern PLADs compared to the southern PLADs.Discussion:The Prevention and Symptom Indexes show promising predictive capabilities for influenzalike illness epidemics.展开更多
Background Some research groups have hypothesized that human rhinoviruses (HRVs) delayed the circulation of the 2009 pandemic influenza A(H1N1) virus (A(H1N1)pdm09) at the beginning of Autumn 2009 in France.Th...Background Some research groups have hypothesized that human rhinoviruses (HRVs) delayed the circulation of the 2009 pandemic influenza A(H1N1) virus (A(H1N1)pdm09) at the beginning of Autumn 2009 in France.This study aimed to evaluate the relationship between HRV and A(H1N1)pdm09 in pediatric patients with influenza-like illness in Beijing,China.Methods A systematic analysis to detect A(H1N1)pdm09 and seasonal influenza A virus (FLU A) was performed on 4 349 clinical samples from pediatric patients with influenza-like illness during the period June 1,2009 to February 28,2010,while a one-step real-time RT-PCR (rRT-PCR) assay was used to detect HRV in 1 146 clinical specimens selected from those 4 349 specimens.Results During the survey period,only one wave of A(H1N1)pdm09 was observed.The percentage of positive cases for A(H1N1)pdm09 increased sharply in September with a peak in November 2009 and then declined in February 2010.Data on the monthly distribution of HRVs indicated that more HRV-positive samples were detected in September (2.2%) and October (3.3%),revealing that the peak of HRV infection in 2009 was similar to that of other years.Among the 1 146 specimens examined for HRVs,21 (1.8%) were HRV-positive,which was significantly lower than that reported previously in Beijing (15.4% to 19.2%) (P <0.01).Overall,6 samples were positive for both A(H1N1)pdm09 and HRV,which represented a positive relative frequency of 1.60% and 2.08% HRV,considering the A(H1N1)pdm09-positive and-negative specimens,respectively.The odds ratio was 0.87 (95% CI 0.32; 2.44,P=0.80).Conclusions HRVs and A (H1N1)pdm09 co-circulated in this Chinese population during September and October 2009,and the HRV epidemic in 2009 did not affect A(H1N1)pdm09 infection rates in Beijing,China as suggested by other studies.However,the presence of A(H1N1)pdm09 might explain the unexpected reduction in the percentage of HRV positive cases during the period studied.展开更多
BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from...BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.展开更多
Athletes are commonly advised not to compete or train during major symptoms of a viral acute respiratory illness(ARI),which most commonly is a common cold.It has been traditionally thought that heavy physical stress c...Athletes are commonly advised not to compete or train during major symptoms of a viral acute respiratory illness(ARI),which most commonly is a common cold.It has been traditionally thought that heavy physical stress could induce the worsening of symptoms of ARI and possibly cause potentially severe complications like myocarditis or sudden cardiac death(SCD).In addition,viral ARI may decrease athlete's performance.1 These concerns have been recently stressed during the coronavirus disease 2019(COVID-19)pandemic.2 However,it is anecdotally well-known that athletes commonly compete while experiencing common colds,most commonly due to picornaviral ARIs.In this perspective,we discuss what is known or not known regarding the risks of exercising during the viral ARI.展开更多
Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of preve...Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.展开更多
Iron is a double-edged sword!Despite being essential for numerous physiological processes of the body,a dysregulated iron metabolism can result in tissue da-mage,exaggerated inflammatory response,and increased suscept...Iron is a double-edged sword!Despite being essential for numerous physiological processes of the body,a dysregulated iron metabolism can result in tissue da-mage,exaggerated inflammatory response,and increased susceptibility to infection with certain pathogens that thrive in iron-rich environment.During sepsis,there is an alteration of iron metabolism,leading to increased transport and uptake into cells.This increase in labile iron may cause oxidative damage and cellular injury(ferroptosis)which progresses as the disease worsens.Critically ill patients are often complicated with systemic inflammation which may contribute to multiple organ dysfunction syndrome or sepsis,a common cause of mortality in intensive care unit.Originally,ferritin was known to play an important role in the hematopoietic system for its iron storage capacity.Recently,its role has emerged as a predictor of poor prognosis in chronic inflammation and critical illnesses.Apart from predicting the disease outcome,serum ferritin can poten-tially reflect disease activity as well.展开更多
BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease.Although surgical treatments are effective,the outcomes of postoperative recovery(POR)are influenced by various fac...BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease.Although surgical treatments are effective,the outcomes of postoperative recovery(POR)are influenced by various factors,including individual differences among patients,the characteristics of the disease itself,and the psychological state of the patient.Understanding these factors can help healthcare providers develop more personalized and effective post-operative care plans for patients with perianal disease.AIM To investigate the effect of illness perception(IP)and negative emotions on POR outcomes in patients with perianal disease.METHODS A total of 146 patients with perianal disease admitted to the First People's Hospital of Changde City from March to December 2023 were recruited.We employed a general information questionnaire,the Brief Illness Perception Questionnaire(B-IPQ),and the Hospital Anxiety and Depression Scale(HADS).We used the 15-item Quality of Recovery Score(QoR-15)to measure patients’recovery effects.Finally,we conducted Pearson’s correlation analysis to examine the relationship between pre-operative IP and anxiety and depression levels with POR quality.RESULTS Fifty-three(36.3%)had poor knowledge of their disease.Thirty(20.5%)were suspected of having anxiety and 99(67.8%)exhibited symptoms.Forty(27.4%)were suspected of having depression and 102(69.9%)displayed symptoms.The B-IPQ,HADS-A,HADS-D,and QoR-15 scores were 46.82±9.97,12.99±3.60,12.58±3.36,and 96.77±9.85,respectively.There was a negative correlation between pre-operative IP,anxiety,and depression with POR quality.The influence of age and disease course on post-operative rehabilitation effect are both negative.The impact of B-IPQ,HADS-A,and HADS-D on POR was negative.Collectively,these variables accounted for 72.6%of the variance in POR.CONCLUSION The quality of POR in patients with perianal disease is medium and is related to age,disease course,IP,anxiety,and depression.展开更多
Bipolar disorder is a serious mental condition that may be caused by any kind of stress or emotional upset experienced by the patient.It affects a large percentage of people globally,who fluctuate between depression a...Bipolar disorder is a serious mental condition that may be caused by any kind of stress or emotional upset experienced by the patient.It affects a large percentage of people globally,who fluctuate between depression and mania,or vice versa.A pleasant or unpleasant mood is more than a reflection of a state of mind.Normally,it is a difficult task to analyze through physical examination due to a large patient-psychiatrist ratio,so automated procedures are the best options to diagnose and verify the severity of bipolar.In this research work,facial microexpressions have been used for bipolar detection using the proposed Convolutional Neural Network(CNN)-based model.Facial Action Coding System(FACS)is used to extract micro-expressions called Action Units(AUs)connected with sad,happy,and angry emotions.Experiments have been conducted on a dataset collected from Bahawal Victoria Hospital,Bahawalpur,Pakistan,Using the Patient Health Questionnaire-15(PHQ-15)to infer a patient’s mental state.The experimental results showed a validation accuracy of 98.99%for the proposed CNN modelwhile classification through extracted featuresUsing SupportVectorMachines(SVM),K-NearestNeighbour(KNN),and Decision Tree(DT)obtained 99.9%,98.7%,and 98.9%accuracy,respectively.Overall,the outcomes demonstrated the stated method’s superiority over the current best practices.展开更多
Objective:To conduct a scoping review of longitudinal studies related to disease perception in cancer patients and to provide a reference for the improvement of disease perception in cancer patients.Methods:Using the ...Objective:To conduct a scoping review of longitudinal studies related to disease perception in cancer patients and to provide a reference for the improvement of disease perception in cancer patients.Methods:Using the scoping method,PubMed,Web of Science,The Cochrane Library,Medline,CNKI,Wanfang Database,VIP Chinese Scientific and Technical Journals Database,and China Biomedical Literature Database were searched up to July 2023 for analysis and discussion of the included literature.Results:A total of 19 articles were included,distributed across 9 countries including China,the Netherlands,and the United Kingdom,with 8 articles published in China.The study subjects included patients with breast cancer,colorectal cancer,laryngeal cancer,lung cancer,esophageal cancer,and bladder cancer.The content covered dynamic changes in disease perception,the impact of disease perception,and the influencing factors of disease perception.Conclusion:The number of longitudinal studies on disease perception in cancer patients is gradually increasing and becoming more diverse.However,issues such as a small total number of studies,single research methods,and short observation periods persist.In the future,it is necessary to conduct in-depth longitudinal research on disease perception in cancer patients,expand the scope of research fields,and provide more comprehensive theories to guide clinical treatment and nursing practices,ultimately improving the treatment outcomes and quality of life for cancer patients.展开更多
Objective: To analyze the accuracy of serum prealbumin levels in predicting the prognosis of patients with critical respiratory illness. Methods: Fifty patients with critical respiratory illness admitted to our hospit...Objective: To analyze the accuracy of serum prealbumin levels in predicting the prognosis of patients with critical respiratory illness. Methods: Fifty patients with critical respiratory illness admitted to our hospital from October 2022 to September 2023 were selected and divided into an observation group and a control group after condition assessment, with 25 cases in each group. The results of cholinesterase (ChE), prealbumin (PALB), albumin (ALB), aspartate aminotransferase (AST), total protein (TP), and forced expiratory volume (FEV1)/Predicted (Pred) of the two groups were measured. Results: The ChE levels of the observation group were lower than those of the control group, while the PALB and ALB levels of the observation group were higher than those of the control group (P < 0.05). The AST, TP, and FEV1 /Pred levels of the observation group were higher than those in the control group (P < 0.05). Conclusion: Serum PALB levels can be used as the main indicator for prognosis in critically ill respiratory patients.展开更多
This viral outbreak of the novel SARS-CoV-2 has profoundly disrupted lives globally and has placed unparalleled burdens on individual physical and psychological health.It is imperative to comprehend the psychological ...This viral outbreak of the novel SARS-CoV-2 has profoundly disrupted lives globally and has placed unparalleled burdens on individual physical and psychological health.It is imperative to comprehend the psychological journey of COVID-19 patients to provide them with effective care.This study aimed to explore the psychological illness experience of severe COVID-19 survivors from the first symptoms,to hospitalization,recovery,and post-discharge adjustment.Semi-structured interviews were conducted from November 2022 to April 2023,with 30 Romanian former COVID-19 patients.Thematic analysis of transcribed interviews identified four major themes:(1)a distant threat;(2)the tipping point;(3)the turning point;and(4)readjustment and growth.Some participants faced denial or uncertainty early on,misattributing symptoms and delaying seeking care.Hospitalization as a last resort brought anxiety,isolation,and closer confrontations with mortality perception.As symptoms improved,and participants received supportive care from both healthcare professionals and family members,hope and optimism appeared.Despite health improvements and feelings of safety,lingering anxiety persisted.Post-discharge adjustment involved managing lasting effects and selectively resuming activities.For some of the participants,reflection afterward prompted greater self-understanding,empathy and connection,and motivation for self-care.The results have implications for healthcare practitioners,policymakers,and researchers.展开更多
Objective: To investigate Chinese medicine (CM) patterns and epidemiological characters of patients with influenza-like illness (ILI) syndromes in clinics in China. Methods: A prospective multi-center observatio...Objective: To investigate Chinese medicine (CM) patterns and epidemiological characters of patients with influenza-like illness (ILI) syndromes in clinics in China. Methods: A prospective multi-center observational epidemiology survey on the clinical CM patterns of ILI and its prevalence was conducted from September 2009 to April 2010. A unified survey questionnaire was developed for data collection of ILI symptoms and CM pattems. Totally 45 hospitals from 22 provinces, municipality cities and autonomous regions of China participated this study. The collected data were input by EPI-data v3.1 and analyzed by SPSS 18.0, which included descriptive analysis and Chi-square test for group comparison. Results: A total of 5,967 ILI patients were included in the study. The proportion of the 18-34 aged group (56.2%) was the largest; students (41.0%) were more than other occupations. Majority of the patients had the wind-heat invading Lung (Fei) syndrome (76%), while in Southwest China mainly wind-heat invading Lung syndrome and wind-cold tightening the exterior syndrome occurred. The typical symptoms of ILI were ranked as fatigue (80.9%), cough (72.2%), sore throat (67.2%), muscular soreness (67.1%), headache (65.4%), aversion to cold (60.1%), thirst (55.1%) and nasal obstruction (48.1%). Conclusions: The ILl patients in clinics were mainly teenagers and young adults. In regard to CM syndrome, wind-heat invading Lung syndrome prevailed in all regions except the Southwest China. The characteristics of CM syndrome of ILl patients may be relevant to age and region distribution.展开更多
Jishou Municipal Center for Disease Control and Prevention(Jishou CDC)received a phone call at 7:30 a.m.on April 24,2020 from Xiangxi Tujia and Miao Autonomous Prefectural CDC(Xiangxi CDC)that avian influenza A/H9N2 v...Jishou Municipal Center for Disease Control and Prevention(Jishou CDC)received a phone call at 7:30 a.m.on April 24,2020 from Xiangxi Tujia and Miao Autonomous Prefectural CDC(Xiangxi CDC)that avian influenza A/H9N2 virus was detected by quantitative reverse transcription-polymerase chain reaction(RT-PCR)from the throat swab sample of an influenza-like illness in an outpatient in the Xiangxi Traditional Chinese Medicine Hospital.展开更多
Objective To analyze the status of acute upper respiratory infection and influenza-like illness(ILI)among community residents in Jinan in 2015,and to make an understanding of the patients’medical treatment behavior a...Objective To analyze the status of acute upper respiratory infection and influenza-like illness(ILI)among community residents in Jinan in 2015,and to make an understanding of the patients’medical treatment behavior and influenza vaccination coverage status in 2014.Methods Balloting method and convenient展开更多
Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Slee...Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment.This review will outline the predisposing and precipitating factors for sleep disturbance,categorised into patient,environmental and treatment-related factors.The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed.While polysomnography remains the gold-standard,its use in the critical care setting still presents many barriers.Other methodologies are needed to better understand the pathophysiology,epidemiology and treatment of sleep disturbance in this population.Subjective outcome measures,including the Richards-Campbell Sleep Questionnaire,are still required for trials involving a greater number of patients and provide valuable insight into patients’experiences of disturbed sleep.Finally,sleep optimisation strategies are reviewed,including intervention bundles,ambient noise and light reduction,quiet time,and the use of ear plugs and eye masks.While drugs to improve sleep are frequently prescribed to patients in the ICU,evidence supporting their effectiveness is lacking.展开更多
Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their...Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.展开更多
Background Influenza is an acute respiratory infectious disease with a significant global disease burden.Additionally,the coronavirus disease 2019 pandemic and its related non-pharmaceutical interventions(NPIs)have in...Background Influenza is an acute respiratory infectious disease with a significant global disease burden.Additionally,the coronavirus disease 2019 pandemic and its related non-pharmaceutical interventions(NPIs)have introduced uncertainty to the spread of influenza.However,comparative studies on the performance of innovative models and approaches used for influenza prediction are limited.Therefore,this study aimed to predict the trend of influenza-like illness(ILI)in settings with diverse climate characteristics in China based on sentinel surveillance data using three approaches and evaluate and compare their predictive performance.Methods The generalized additive model(GAM),deep learning hybrid model based on Gate Recurrent Unit(GRU),and autoregressive moving average-generalized autoregressive conditional heteroscedasticity(ARMA—GARCH)model were established to predict the trends of ILI 1-,2-,3-,and 4-week-ahead in Beijing,Tianjin,Shanxi,Hubei,Chongqing,Guangdong,Hainan,and the Hong Kong Special Administrative Region in China,based on sentinel surveillance data from 2011 to 2019.Three relevant metrics,namely,Mean Absolute Percentage Error(MAPE),Root Mean Squared Error(RMSE),and R squared,were calculated to evaluate and compare the goodness of fit and robustness of the three models.Results Considering the MAPE,RMSE,and R squared values,the ARMA—GARCH model performed best,while the GRU-based deep learning hybrid model exhibited moderate performance and GAM made predictions with the least accuracy in the eight settings in China.Additionally,the models’predictive performance declined as the weeks ahead increased.Furthermore,blocked cross-validation indicated that all models were robust to changes in data and had low risks of overfitting.Conclusions Our study suggested that the ARMA—GARCH model exhibited the best accuracy in predicting ILI trends in China compared to the GAM and GRU-based deep learning hybrid model.Therefore,in the future,the ARMA—GARCH model may be used to predict ILI trends in public health practice across diverse climatic zones,thereby contributing to influenza control and prevention efforts.展开更多
As basic facts of life,illness and healing occur frequently and in a variety of patterns in Chinese non-medical literature,starting from the earliest sources inscribed on oracle bones and continuing throughout literar...As basic facts of life,illness and healing occur frequently and in a variety of patterns in Chinese non-medical literature,starting from the earliest sources inscribed on oracle bones and continuing throughout literary history up to the present day.This article looks at illness narratives in early medieval anecdotal literature(3rd to 6th century CE)to understand how the experience of being sick or of attending to the sick was reflected in these socio-literary environments and what rhetorical and ideological roles these narratives played in their larger narrative contexts.By focusing on the experiences of the sick and those around them,this article aims at“Honoring the Stories of Illness,”in Rita Charon’s words,that are hiding in plain sight in much of Chinese non-medical literature.展开更多
This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of d...This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual,their family,and their community.It is also highly preventable.Current recommendations for intervention and management of PPI are limited and vary considerably from country to country.Furthermore,there are several significant challenges associated with implementation of these recommendations.These challenges are magnified in number and consequence among women of color and/or minority populations,who experience persistent and negative health disparities during pregnancy and the postpartum period.This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges.An equityinformed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health.Uniquely,this model emphasizes the importance of managing and eliminating known barriers to traditional health care models.Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.展开更多
基金supported by the Jiangsu Provincial Major Science & Technology Demonstration Project (No.BE2017749)the Jiangsu Province Science & Technology Demonstration Project for Emerging Infectious Diseases Control and Prevention (No.BE2015714)
文摘Influenza-like illness(ILI)is an acute respiratory infection caused by various pathogens.However,the epidemiologic characteristics of ILI pathogens in Jiangsu province are unclear.To better understand the ILI etiology,the characteristics of the pathogens from nasopharyngeal swab samples of patients with ILI collected from 2012 to 2016 in 6 hospitals in Jiangsu province were studied.The pathogens,including influenza virus,respiratory syncytial virus(RSV),rhinovirus(HRV),adenovirus(ADV),herpes simplex virus(HSV),human coronavirus(hCoV),Streptococcus pneumoniae and Haemophilus influenzae,were detected by real-time PCR.At least one pathogen was identified in 1334 of the patients(40.23%).Among viruses,HRV,influenza A virus(Flu A),ADV and RSV were the most frequently detected.ADV was the only pathogen that was distributed evenly in different years and regions(P>0.05).The etiological distribution varied in different age groups.Streptococcus pneumoniae was the most common pathogen in co-infections with a co-detection rate of 64.57%(319/494).The spectrum of etiologies could help to estimate disease burden and provide guidance for vaccination.
基金Supported by CAMS Innovation Fund for Medical Sciences(2021-I2M-1-044)National Key Research and Development Program of China(2023YFC2308701).
文摘Introduction:This study investigated the lagged correlation between Baidu Index for influenza-related keywords and influenza-like illness percentage(ILI%)across regions in China.The aim is to establish a scientific foundation for utilizing Baidu Index as an early warning tool for influenza-like illness epidemics.Methods:In this study,data on ILI%and Baidu Index were collected from 30 provincial-level administrative divisions(PLADs)spanning April 2014 to March 2019.The Baidu Index was categorized into Overall Index,Ordinary Index,Prevention Index,Symptom Index,and Treatment Index based on search query themes.The lagged correlation between the Baidu Index and ILI%was examined through the cross-correlation function(CCF)method.Results:Correlating the Baidu Overall Index of 30 PLADs with ILI%revealed CCF values ranging from 0.46 to 0.86,with a median lag of 0.5 days.Subcategory analysis indicated that the Prevention Index and Symptom Index exhibited quicker responses to ILI%,with median lags of−9 and−0.5 days,respectively,compared to 0 and 3 days for the Ordinary and Treatment Indexes.The median lag days between the Baidu Index and the ILI%were earlier in the northern PLADs compared to the southern PLADs.Discussion:The Prevention and Symptom Indexes show promising predictive capabilities for influenzalike illness epidemics.
基金This study was supported by the grants from the National Natural Science Foundation of China (No. 30872153) and the Beijing Outstanding Personnel Training Grant from the Beijing Municipal Committee for Science and Technology (No. 2006A63).Acknowledgements: We would like to thank all the doctors and nurses in the Department of Emergency and the Outpatient Department at the Affiliated Children's Hospital of the Capital Institute of Pediatrics for collecting specimens from patients and information from their parents.
文摘Background Some research groups have hypothesized that human rhinoviruses (HRVs) delayed the circulation of the 2009 pandemic influenza A(H1N1) virus (A(H1N1)pdm09) at the beginning of Autumn 2009 in France.This study aimed to evaluate the relationship between HRV and A(H1N1)pdm09 in pediatric patients with influenza-like illness in Beijing,China.Methods A systematic analysis to detect A(H1N1)pdm09 and seasonal influenza A virus (FLU A) was performed on 4 349 clinical samples from pediatric patients with influenza-like illness during the period June 1,2009 to February 28,2010,while a one-step real-time RT-PCR (rRT-PCR) assay was used to detect HRV in 1 146 clinical specimens selected from those 4 349 specimens.Results During the survey period,only one wave of A(H1N1)pdm09 was observed.The percentage of positive cases for A(H1N1)pdm09 increased sharply in September with a peak in November 2009 and then declined in February 2010.Data on the monthly distribution of HRVs indicated that more HRV-positive samples were detected in September (2.2%) and October (3.3%),revealing that the peak of HRV infection in 2009 was similar to that of other years.Among the 1 146 specimens examined for HRVs,21 (1.8%) were HRV-positive,which was significantly lower than that reported previously in Beijing (15.4% to 19.2%) (P <0.01).Overall,6 samples were positive for both A(H1N1)pdm09 and HRV,which represented a positive relative frequency of 1.60% and 2.08% HRV,considering the A(H1N1)pdm09-positive and-negative specimens,respectively.The odds ratio was 0.87 (95% CI 0.32; 2.44,P=0.80).Conclusions HRVs and A (H1N1)pdm09 co-circulated in this Chinese population during September and October 2009,and the HRV epidemic in 2009 did not affect A(H1N1)pdm09 infection rates in Beijing,China as suggested by other studies.However,the presence of A(H1N1)pdm09 might explain the unexpected reduction in the percentage of HRV positive cases during the period studied.
基金the Researchers Supporting Project number,King Saud University,Riyadh,Saudi Arabia,No.RSPD2024R919.
文摘BACKGROUND Psychological assessment after intensive care unit(ICU)discharge is increasingly used to assess patients'cognitive and psychological well-being.However,few studies have examined those who recovered from coronavirus disease 2019(COVID-19).There is a paucity of data from the Middle East assessing the post-ICU discharge mental health status of patients who had COVID-19.AIM To evaluate anxiety and depression among patients who had severe COVID-19.METHODS This is a prospective single-center follow-up questionnaire-based study of adults who were admitted to the ICU or under ICU consultation for>24 h for COVID-19.Eligible patients were contacted via telephone.The patient’s anxiety and depression six months after ICU discharge were assessed using the Hospital Anxiety and Depression Scale(HADS).The primary outcome was the mean HADS score.The secondary outcomes were risk factors of anxiety and/or depression.RESULTS Patients who were admitted to the ICU because of COVID-19 were screened(n=518).Of these,48 completed the questionnaires.The mean age was 56.3±17.2 years.Thirty patients(62.5%)were male.The main comorbidities were endocrine(n=24,50%)and cardiovascular(n=21,43.8%)diseases.The mean overall HADS score for anxiety and depression at 6 months post-ICU discharge was 11.4(SD±8.5).A HADS score of>7 for anxiety and depression was detected in 15 patients(30%)and 18 patients(36%),respectively.Results from the multivariable ordered logistic regression demonstrated that vasopressor use was associated with the development of anxiety and depression[odds ratio(OR)39.06,95% confidence interval:1.309-1165.8;P<0.05].CONCLUSION Six months after ICU discharge,30% of patients who had COVID-19 demonstrated a HADS score that confirmed anxiety and depression.To compare the psychological status of patients following an ICU admission(with vs without COVID-19),further studies are warranted.
基金funded by the Jenny and Antti Wihuri Foundation(OR)。
文摘Athletes are commonly advised not to compete or train during major symptoms of a viral acute respiratory illness(ARI),which most commonly is a common cold.It has been traditionally thought that heavy physical stress could induce the worsening of symptoms of ARI and possibly cause potentially severe complications like myocarditis or sudden cardiac death(SCD).In addition,viral ARI may decrease athlete's performance.1 These concerns have been recently stressed during the coronavirus disease 2019(COVID-19)pandemic.2 However,it is anecdotally well-known that athletes commonly compete while experiencing common colds,most commonly due to picornaviral ARIs.In this perspective,we discuss what is known or not known regarding the risks of exercising during the viral ARI.
文摘Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.
文摘Iron is a double-edged sword!Despite being essential for numerous physiological processes of the body,a dysregulated iron metabolism can result in tissue da-mage,exaggerated inflammatory response,and increased susceptibility to infection with certain pathogens that thrive in iron-rich environment.During sepsis,there is an alteration of iron metabolism,leading to increased transport and uptake into cells.This increase in labile iron may cause oxidative damage and cellular injury(ferroptosis)which progresses as the disease worsens.Critically ill patients are often complicated with systemic inflammation which may contribute to multiple organ dysfunction syndrome or sepsis,a common cause of mortality in intensive care unit.Originally,ferritin was known to play an important role in the hematopoietic system for its iron storage capacity.Recently,its role has emerged as a predictor of poor prognosis in chronic inflammation and critical illnesses.Apart from predicting the disease outcome,serum ferritin can poten-tially reflect disease activity as well.
文摘BACKGROUND Improvements in the standard of living have led to increased attention to perianal disease.Although surgical treatments are effective,the outcomes of postoperative recovery(POR)are influenced by various factors,including individual differences among patients,the characteristics of the disease itself,and the psychological state of the patient.Understanding these factors can help healthcare providers develop more personalized and effective post-operative care plans for patients with perianal disease.AIM To investigate the effect of illness perception(IP)and negative emotions on POR outcomes in patients with perianal disease.METHODS A total of 146 patients with perianal disease admitted to the First People's Hospital of Changde City from March to December 2023 were recruited.We employed a general information questionnaire,the Brief Illness Perception Questionnaire(B-IPQ),and the Hospital Anxiety and Depression Scale(HADS).We used the 15-item Quality of Recovery Score(QoR-15)to measure patients’recovery effects.Finally,we conducted Pearson’s correlation analysis to examine the relationship between pre-operative IP and anxiety and depression levels with POR quality.RESULTS Fifty-three(36.3%)had poor knowledge of their disease.Thirty(20.5%)were suspected of having anxiety and 99(67.8%)exhibited symptoms.Forty(27.4%)were suspected of having depression and 102(69.9%)displayed symptoms.The B-IPQ,HADS-A,HADS-D,and QoR-15 scores were 46.82±9.97,12.99±3.60,12.58±3.36,and 96.77±9.85,respectively.There was a negative correlation between pre-operative IP,anxiety,and depression with POR quality.The influence of age and disease course on post-operative rehabilitation effect are both negative.The impact of B-IPQ,HADS-A,and HADS-D on POR was negative.Collectively,these variables accounted for 72.6%of the variance in POR.CONCLUSION The quality of POR in patients with perianal disease is medium and is related to age,disease course,IP,anxiety,and depression.
文摘Bipolar disorder is a serious mental condition that may be caused by any kind of stress or emotional upset experienced by the patient.It affects a large percentage of people globally,who fluctuate between depression and mania,or vice versa.A pleasant or unpleasant mood is more than a reflection of a state of mind.Normally,it is a difficult task to analyze through physical examination due to a large patient-psychiatrist ratio,so automated procedures are the best options to diagnose and verify the severity of bipolar.In this research work,facial microexpressions have been used for bipolar detection using the proposed Convolutional Neural Network(CNN)-based model.Facial Action Coding System(FACS)is used to extract micro-expressions called Action Units(AUs)connected with sad,happy,and angry emotions.Experiments have been conducted on a dataset collected from Bahawal Victoria Hospital,Bahawalpur,Pakistan,Using the Patient Health Questionnaire-15(PHQ-15)to infer a patient’s mental state.The experimental results showed a validation accuracy of 98.99%for the proposed CNN modelwhile classification through extracted featuresUsing SupportVectorMachines(SVM),K-NearestNeighbour(KNN),and Decision Tree(DT)obtained 99.9%,98.7%,and 98.9%accuracy,respectively.Overall,the outcomes demonstrated the stated method’s superiority over the current best practices.
文摘Objective:To conduct a scoping review of longitudinal studies related to disease perception in cancer patients and to provide a reference for the improvement of disease perception in cancer patients.Methods:Using the scoping method,PubMed,Web of Science,The Cochrane Library,Medline,CNKI,Wanfang Database,VIP Chinese Scientific and Technical Journals Database,and China Biomedical Literature Database were searched up to July 2023 for analysis and discussion of the included literature.Results:A total of 19 articles were included,distributed across 9 countries including China,the Netherlands,and the United Kingdom,with 8 articles published in China.The study subjects included patients with breast cancer,colorectal cancer,laryngeal cancer,lung cancer,esophageal cancer,and bladder cancer.The content covered dynamic changes in disease perception,the impact of disease perception,and the influencing factors of disease perception.Conclusion:The number of longitudinal studies on disease perception in cancer patients is gradually increasing and becoming more diverse.However,issues such as a small total number of studies,single research methods,and short observation periods persist.In the future,it is necessary to conduct in-depth longitudinal research on disease perception in cancer patients,expand the scope of research fields,and provide more comprehensive theories to guide clinical treatment and nursing practices,ultimately improving the treatment outcomes and quality of life for cancer patients.
文摘Objective: To analyze the accuracy of serum prealbumin levels in predicting the prognosis of patients with critical respiratory illness. Methods: Fifty patients with critical respiratory illness admitted to our hospital from October 2022 to September 2023 were selected and divided into an observation group and a control group after condition assessment, with 25 cases in each group. The results of cholinesterase (ChE), prealbumin (PALB), albumin (ALB), aspartate aminotransferase (AST), total protein (TP), and forced expiratory volume (FEV1)/Predicted (Pred) of the two groups were measured. Results: The ChE levels of the observation group were lower than those of the control group, while the PALB and ALB levels of the observation group were higher than those of the control group (P < 0.05). The AST, TP, and FEV1 /Pred levels of the observation group were higher than those in the control group (P < 0.05). Conclusion: Serum PALB levels can be used as the main indicator for prognosis in critically ill respiratory patients.
基金funded by Alliance on International Science Organizations(ANSO),grant number ANSO-CR-PP-2021-10Institutional Review Board Statement:The study was conducted in accordance with the 1964 Helsinki declaration and its later amendment and approved by The Ethical Committee of the Institute for Population and Human Studies Bulgarian Academy of Science(PD-2-140/15.08.22).
文摘This viral outbreak of the novel SARS-CoV-2 has profoundly disrupted lives globally and has placed unparalleled burdens on individual physical and psychological health.It is imperative to comprehend the psychological journey of COVID-19 patients to provide them with effective care.This study aimed to explore the psychological illness experience of severe COVID-19 survivors from the first symptoms,to hospitalization,recovery,and post-discharge adjustment.Semi-structured interviews were conducted from November 2022 to April 2023,with 30 Romanian former COVID-19 patients.Thematic analysis of transcribed interviews identified four major themes:(1)a distant threat;(2)the tipping point;(3)the turning point;and(4)readjustment and growth.Some participants faced denial or uncertainty early on,misattributing symptoms and delaying seeking care.Hospitalization as a last resort brought anxiety,isolation,and closer confrontations with mortality perception.As symptoms improved,and participants received supportive care from both healthcare professionals and family members,hope and optimism appeared.Despite health improvements and feelings of safety,lingering anxiety persisted.Post-discharge adjustment involved managing lasting effects and selectively resuming activities.For some of the participants,reflection afterward prompted greater self-understanding,empathy and connection,and motivation for self-care.The results have implications for healthcare practitioners,policymakers,and researchers.
基金Supported by the H1N1 Influenza of the Clinical Study of Traditional Chinese Medicine Management Project by State Administration of Traditional Chinese Medicine,China(No.200907001-2B)
文摘Objective: To investigate Chinese medicine (CM) patterns and epidemiological characters of patients with influenza-like illness (ILI) syndromes in clinics in China. Methods: A prospective multi-center observational epidemiology survey on the clinical CM patterns of ILI and its prevalence was conducted from September 2009 to April 2010. A unified survey questionnaire was developed for data collection of ILI symptoms and CM pattems. Totally 45 hospitals from 22 provinces, municipality cities and autonomous regions of China participated this study. The collected data were input by EPI-data v3.1 and analyzed by SPSS 18.0, which included descriptive analysis and Chi-square test for group comparison. Results: A total of 5,967 ILI patients were included in the study. The proportion of the 18-34 aged group (56.2%) was the largest; students (41.0%) were more than other occupations. Majority of the patients had the wind-heat invading Lung (Fei) syndrome (76%), while in Southwest China mainly wind-heat invading Lung syndrome and wind-cold tightening the exterior syndrome occurred. The typical symptoms of ILI were ranked as fatigue (80.9%), cough (72.2%), sore throat (67.2%), muscular soreness (67.1%), headache (65.4%), aversion to cold (60.1%), thirst (55.1%) and nasal obstruction (48.1%). Conclusions: The ILl patients in clinics were mainly teenagers and young adults. In regard to CM syndrome, wind-heat invading Lung syndrome prevailed in all regions except the Southwest China. The characteristics of CM syndrome of ILl patients may be relevant to age and region distribution.
基金We thank the colleagues from the Chinese National Influenza Center,who isolated and sequenced the full genome of A/Hunan/11173/2020(H9N2).
文摘Jishou Municipal Center for Disease Control and Prevention(Jishou CDC)received a phone call at 7:30 a.m.on April 24,2020 from Xiangxi Tujia and Miao Autonomous Prefectural CDC(Xiangxi CDC)that avian influenza A/H9N2 virus was detected by quantitative reverse transcription-polymerase chain reaction(RT-PCR)from the throat swab sample of an influenza-like illness in an outpatient in the Xiangxi Traditional Chinese Medicine Hospital.
文摘Objective To analyze the status of acute upper respiratory infection and influenza-like illness(ILI)among community residents in Jinan in 2015,and to make an understanding of the patients’medical treatment behavior and influenza vaccination coverage status in 2014.Methods Balloting method and convenient
基金supported through an Australian Government Research Training Program Scholarship
文摘Sleep is a complex process influenced by biological and environmental factors.Disturbances of sleep quantity and quality occur frequently in the critically ill and remain prevalent in survivors for at least 12 mo.Sleep disturbances are associated with adverse outcomes across multiple organ systems but are most strongly linked to delirium and cognitive impairment.This review will outline the predisposing and precipitating factors for sleep disturbance,categorised into patient,environmental and treatment-related factors.The objective and subjective methodologies used to quantify sleep during critical illness will be reviewed.While polysomnography remains the gold-standard,its use in the critical care setting still presents many barriers.Other methodologies are needed to better understand the pathophysiology,epidemiology and treatment of sleep disturbance in this population.Subjective outcome measures,including the Richards-Campbell Sleep Questionnaire,are still required for trials involving a greater number of patients and provide valuable insight into patients’experiences of disturbed sleep.Finally,sleep optimisation strategies are reviewed,including intervention bundles,ambient noise and light reduction,quiet time,and the use of ear plugs and eye masks.While drugs to improve sleep are frequently prescribed to patients in the ICU,evidence supporting their effectiveness is lacking.
文摘Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.
基金The Special Fund for Health Development Research of Beijing(2021-1G-3013)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(2021-I2M-1-044)the Bill&Melinda Gates Foundation(INV-024911).
文摘Background Influenza is an acute respiratory infectious disease with a significant global disease burden.Additionally,the coronavirus disease 2019 pandemic and its related non-pharmaceutical interventions(NPIs)have introduced uncertainty to the spread of influenza.However,comparative studies on the performance of innovative models and approaches used for influenza prediction are limited.Therefore,this study aimed to predict the trend of influenza-like illness(ILI)in settings with diverse climate characteristics in China based on sentinel surveillance data using three approaches and evaluate and compare their predictive performance.Methods The generalized additive model(GAM),deep learning hybrid model based on Gate Recurrent Unit(GRU),and autoregressive moving average-generalized autoregressive conditional heteroscedasticity(ARMA—GARCH)model were established to predict the trends of ILI 1-,2-,3-,and 4-week-ahead in Beijing,Tianjin,Shanxi,Hubei,Chongqing,Guangdong,Hainan,and the Hong Kong Special Administrative Region in China,based on sentinel surveillance data from 2011 to 2019.Three relevant metrics,namely,Mean Absolute Percentage Error(MAPE),Root Mean Squared Error(RMSE),and R squared,were calculated to evaluate and compare the goodness of fit and robustness of the three models.Results Considering the MAPE,RMSE,and R squared values,the ARMA—GARCH model performed best,while the GRU-based deep learning hybrid model exhibited moderate performance and GAM made predictions with the least accuracy in the eight settings in China.Additionally,the models’predictive performance declined as the weeks ahead increased.Furthermore,blocked cross-validation indicated that all models were robust to changes in data and had low risks of overfitting.Conclusions Our study suggested that the ARMA—GARCH model exhibited the best accuracy in predicting ILI trends in China compared to the GAM and GRU-based deep learning hybrid model.Therefore,in the future,the ARMA—GARCH model may be used to predict ILI trends in public health practice across diverse climatic zones,thereby contributing to influenza control and prevention efforts.
文摘As basic facts of life,illness and healing occur frequently and in a variety of patterns in Chinese non-medical literature,starting from the earliest sources inscribed on oracle bones and continuing throughout literary history up to the present day.This article looks at illness narratives in early medieval anecdotal literature(3rd to 6th century CE)to understand how the experience of being sick or of attending to the sick was reflected in these socio-literary environments and what rhetorical and ideological roles these narratives played in their larger narrative contexts.By focusing on the experiences of the sick and those around them,this article aims at“Honoring the Stories of Illness,”in Rita Charon’s words,that are hiding in plain sight in much of Chinese non-medical literature.
文摘This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual,their family,and their community.It is also highly preventable.Current recommendations for intervention and management of PPI are limited and vary considerably from country to country.Furthermore,there are several significant challenges associated with implementation of these recommendations.These challenges are magnified in number and consequence among women of color and/or minority populations,who experience persistent and negative health disparities during pregnancy and the postpartum period.This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges.An equityinformed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health.Uniquely,this model emphasizes the importance of managing and eliminating known barriers to traditional health care models.Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.