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Background: Despite an increasing adoption rate of the tracking technologies (e.g., radio-frequency identification (RFID) and barcode) for hospitals in the United States (U.S.), scarce empirical studies examined hospital size, location, and types of hospital affiliations that are associated with the uptake, leaving the understanding towards the trend unclear. Objective: This study aimed to identify the hospital characteristics, geographic location, and hospital affiliation type attributive to adopting tracking technologies with a longitudinal dataset, and to compare critical factors associated with tracking technologies adoption for clinical and supply chain uses. We assume that hospital characteristics and hospital location have more impact on tracking technologies for clinical use, and types of hospital affiliation would have more impact on tracking technologies for supply chain use. Methods: This study was conducted based on national census data obtained from the American Hospital Association (AHA) Annual Survey and an AHA Information Technology Supplement survey. In the analysis, 3623 hospitals across 50 states in the U.S. from 2012 to 2015 were included. The effects of the hospital characteristics, location, and types of hospital affiliations were captured and assessed using population logistic regression models with the adjustment of the innate development of tracking technology over time. Results: We find that the proportion of hospitals where tracking technologies were implemented for clinical use increased from 36.3% to 54.6%, whilst that for supply chain increased from 28.6% to 41.3%. We also find that time effect and hospital size positively impact the hospital implementation of tracking technologies for both clinical and supply chain use. The implementation rate of tracking technologies for clinical use increased for the hospitals affiliated to the health systems compared to those that are not but decreased in the hospitals located in the rural area in c

BACKGROUND: China and the United States play critical leading roles in the global effort to contain the COVID-19 virus. Therefore, their population's preferences for initial diagnosis were compared to provide policy and clinical insights. OBJECTIVE: We aim to quantify and compare the public's preferences for medical management of fever and the attributes of initial diagnosis in the case of presenting symptoms during the COVID-19 pandemic in China and the United States. METHODS: We conducted a cross-sectional study from January to March 2021 in China and the United States using an online discrete choice experiment (DCE) questionnaire distributed through Amazon Mechanical Turk (MTurk; in the United States) and recruited volunteers (in China). Propensity score matching (PSM) was used to match the 2 groups of respondents from China and the United States to minimize confounding effects. In addition, the respondents' preferences for different diagnosis options were evaluated using a mixed logit model (MXL) and latent class models (LCMs). Moreover, demographic data were collected and compared using the chi-square test, Fisher test, and Mann-Whitney U test. RESULTS: A total of 9112 respondents (5411, 59.4%, from China and 3701, 40.6%, from the United States) who completed our survey were included in our analysis. After PSM, 1240 (22.9%) respondents from China and 1240 (33.5%) from the United States were matched for sex, age, educational level, occupation, and annual salary levels. The segmented sizes of 3 classes of respondents from China were 870 (70.2%), 270 (21.8%), and 100 (8.0%), respectively. Meanwhile, the US respondents' segmented sizes were 269 (21.7%), 139 (11.2%), and 832 (67.1%), respectively. Respondents from China attached the greatest importance to the type of medical institution (weighted importance=40.0%), while those from the United States valued the waiting time (weighted importance=31.5%) the most. Respondents from China preferred the emergency departmen

Objective: India and Europe have large populations, a large number of Coronavirus disease 2019 (COVID-19) cases, and different healthcare systems. This study aims to investigate the differences between the hesitancy toward and preference for COVID-19 vaccines in India and four European countries, namely, the United Kingdom (UK), Germany, Italy, and Spain. Methodology: We conducted a cross-national survey for distribution in India, the UK, Germany, Italy, and Spain. More specifically, a discrete choice experiment (DCE) was conducted to evaluate vaccine preferences, and Likert scales were used to probe the underlying factors that contribute to vaccination acceptance. Propensity score matching (PSM) was performed to directly compare India and European countries. Results: A total of 2565 respondents (835 from India and 1730 from the specified countries in Europe) participated in the survey. After PSM, more than 82.5% of respondents from India positively accepted the COVID-19 vaccination, whereas 79.9% of respondents from Europe had a positive attitude; however, the proportion in Europe changed to 81.6% in cases in which the vaccine was recommended by friends, family, or employers. The DCE found that the COVID-19 vaccine efficacy was the most important factor for respondents in India and the four European nations (41.8% in India and 47.77% in Europe), followed by the vaccine cost (28.06% in India and 25.88% in Europe). Conclusion: Although most respondents in both regions showed high acceptance of COVID-19 vaccines, either due to general acceptance or acceptance as a result of social cues, the vaccination coverage rate shows apparent distinctions. Due to the differences in COVID-19 situations, public health systems, cultural backgrounds, and vaccine availability, the strategies for COVID-19 vaccine promotion should be nation-dependent. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

AimThe present study aimed to investigate the construct structure behind the psychosocial response, behavioral response, prenatal depression, and post-traumatic stress disorder (PTSD) in pregnant women during the COVID-19 pandemic in China. MethodThe validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), PTSD CheckList (PCL)-6, and two newly established scales for COVID-19-related psychological and behavioral responses were used. Structural equation modeling (SEM) analysis was applied to evaluate the structural relationships of psychological and behavioral responses during the COVID-19 pandemic. ResultsOf the 1,908 mothers who completed the questionnaires, 1,099 met the criteria for perinatal depression, and 287 were positively screened for PTSD, where 264 women exceed the cut-off points for both. Pregnant women with full-time or part-time jobs tended to have the lowest scores of EPDS (10.07 +/- 5.11, P < 0.001) and stress levels (23.85 +/- 7.96, P = 0.004), yet they were more likely to change their behavior in accordance with the COVID-19 outbreak (13.35 +/- 3.42, P = 0.025). The structural model fit the data (chi(2) = 43.260, p < 0.001) and resulted in satisfactory fit indices (CFI = 0.984, TLI = 0.959, RMSEA = 0.072, and chi(2)/df = 10.815), all path loadings were significant (p < 0.05). The SEM indicates that the level of QoL was attributable to the occurrence of PND, leading to PTSD, and COVID-19 related behavioral and psychological responses. ConclusionThe inter-relationships between the COVID-19-related psychosocial and behavioral responses have been assessed, indicating that the pandemic increased the burden of perinatal depression. Psychoeducation, as well as other psychological interventions, may be needed to alleviate the COVID-19-based anxiety and increase their engagement in protective behaviors.

Background/Objectives: Observational studies link elevated homocysteine concentrations (Hcy) with female fertility, pregnancy loss, and low offspring birthweight. Maternal rs1801133, a functional variant in MTHFR strongly associated with lifelong elevated Hcy, is associated with recurrent pregnancy loss and offspring birthweight in Asian women. We investigated if genetically elevated Hcy is associated with fertility, pregnancy loss, and offspring birthweight in European women. Subjects/Methods: We performed a two-sample Mendelian randomization (MR) study using publicly available data. We obtained 18 genetic variants (five involved in Hcy metabolism) explaining up to 5.9% of the variance in Hcy from a genome-wide association meta-analysis of 44,147 European individuals (82% women). We investigated fertility (including age at menopause), pregnancy loss, and offspring birthweight in the UK Biobank (N = 194,174), EGG (N = 190,406), and ReproGen (N = 69,360–252,514) consortia using summary statistics. We calculated inverse-variance weighted, and several sensitivity MR regression statistics. Results: rs1801133 was associated with a 7.45 months (95% CI: 4.09, 10.80) increase in age at menopause and 29.69 (12.87, 46.51) g decrease in offspring birthweight per SD increase in Hcy in the UK biobank, and confirmed in EGG and ReproGen. MR for Hcy metabolism alone (five variants in MTHFR, MTR, CBS) showed similar results for offspring birthweight across consortia. However, using all 18 variants resulted in no association for any of the outcomes across consortia. Conclusion: Hcy and suggestively vitamin B variants are most likely the drug targets for folate supplementation in pregnant women on the offspring birthweight, while Hcy variants related to renal function or diabetes are not involved.