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Omar Alqudah,1 Hamzeh Feras Alshahwan,2,&ast; Jehad Feras Alsamhouri,2,&ast; Saif Yamin,2,&ast; Ahmad Kaffaf,2,&ast; Mohannad Alassaf,2,&ast; Zaid Alwarawrah3 1Department of Medicine, Division of Hepatology and Gastroenterology, Jordan University Hospital and School of Medicine, The University of Jordan, Amman, Jordan; 2School of Medicine, The University of Jordan, Amman, Jordan; 3School of Medicine, University of Mu’tah, Al-Karak, Jordan&ast;These authors contributed equally to this workCorrespondence: Hamzeh Feras Alshahwan, Email alshahwanhamzeh@gmail.comPurpose: The most prevalent chronic liver disease in both developed and developing nations is Metabolic dysfunction-associated Steatotic Liver Disease (MASLD). The condition increases the risk of comorbidities and liver-related morbidity and mortality. The public’s awareness and medical personnel’s understanding are essential in creating countermeasures to stop the disease’s spread; a positive attitude is essential for early screening. This study aimed to explore the knowledge and attitudes of Jordanians living in Amman toward MASLD to determine the public’s awareness and medical personnel’s understanding of the disease.Materials and Methods: A cross-sectional study was conducted using an online self-administered questionnaire that included 5 items for knowledge and 8 for attitude. Demographic questions were also included to further examine how demographic factors affected knowledge and attitude.Results: Among 906 responders, (63.4%) were females, and (36.6%) were males. The majority age group was 18– 30 (56.2%). Only 49.5% had previous knowledge of MASLD, (44.6%) believed they were at risk of developing it. There is a statistical significance between age, gender, educational level, and having a good knowledge of MASLD and a positive attitude towards it (p< 0.05).Conclusion: Generally, Jordan’s population has a fair knowledge of MASLD and a positive attitude towards it.

Makiko Komasawa,1,2 Kiyoko Saito,1 Miho Sato,3 Robert Tamale Ssekitoleko,4 Christopher Nsereko,5 Mitsuo Isono,6 Jesca Nantume,4 Myo Nyein Aung2 1Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, Tokyo, Japan; 2Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 3School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan; 4College of Health Sciences, Makerere University, Kampala, Uganda; 5Department of Internal Medicine, Entebbe Regional Referral Hospital, Entebbe, Uganda; 6Department of Human Development, Japan International Cooperation Agency, Tokyo, JapanCorrespondence: Makiko Komasawa, Ogata Sadako Research Institute for Peace and Development, Japan International Cooperation Agency, 10-5, Ichigaya Honmura-cho, Shinjuku-ku, Tokyo, 162-8433, Japan, Tel +81-3-3269-2911, Fax +81-3-3269-2054, Email mkomasa@juntendo.ac.jpBackground: Coronavirus disease 2019 caused significant negative damage to the health status of populations and health systems globally. In Uganda, our previous study revealed that the strict Public Health and Social measures (PHSMs) and the closure of Entebbe Regional Referral Hospital (ERRH) led to missed healthcare access among the citizens in the Entebbe municipality. Limited studies, however, exist on the impact of the response measures on the local health systems. This study aims to explore the impacts of these measures on the local health service provision from the views of health facilities in Entebbe.Methods: We used a thematic framework method, grounded by the health systems resilience framework consisting of five components: (1) health service delivery; (2) medical products and technology; (3) health workforce; (4) public health functions; and (5) governance and financing. Key informant interviews with eight representatives from four private hospitals and four health centers were conducted from September to October 2022

João Marcelo Barreto Silva,1,2 Paulo Henrique De Souza Bermejo,3 Marina Figueiredo Moreira,3 David Nadler Prata,1 Daniela Mascarenhas de Queiroz Trevisan,1 Otávio Augusto dos Santos2 1Program in Governance and Digital Transformation, Federal University of Tocantins, Palmas, TO, Brazil; 2Department of Assistance Regulation and Control, Ministry of Health, Brasília, DF, Brazil; 3Administration Department, Faculty of Economics, Administration, Accounting and Public Policy Management of University of Brasília, Brasília, DF, BrazilCorrespondence: João Marcelo Barreto Silva, Department of Assistance Regulation and Control, Ministry of Health, St. de Adm. Federal Sul Q1-G, Sala 147B, Brasília, DF, 70058-900, Brasil, Email joao.marcelo@saude.gov.brBackground: Analyzing patients’ nonattendance at medical appointments helps address an issue impacting the management and sustainability of health systems globally, providing valuable insights for healthcare managers. This study aims to identify factors at both patient and health system levels that contribute to understanding missed appointments.Methods: The analysis was conducted using data from secondary care consultations within the Brazilian Unified Health System between April 2018 and March 2020. Primary care includes general medical consultations, while secondary care involves specialized services provided by doctors with advanced expertise. We examined demographic factors (age, sex, race/color, socioeconomic level) and health system practices (waiting time, hospitalization, distance to service, medical specialty, and severity of clinical condition) to assess their impact on patient attendance. A weighted analysis and receiver operating characteristic (ROC) analysis were applied to determine the relative risk of nonattendance.Findings: Of 5,003,159 consultations, 435,523 (8.7%) were missed. Nonattendance was highest among patients facing long distances to the service (13.3%, [RRR] 1.227), younger age (16– 30 years

Chenxiao Hu,&ast; Mingwei Sheng,&ast; Ke Wang,&ast; Zi Yang, Shiping Che Solicitation Office, The First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Shiping Che, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou, Gansu, 730000, People’s Republic of China, Email ldyycheshiping@163.comObjective: Identify the collaborations between authors, countries, and institutions, respectively, and explore the hot issues and prospects for research on hospital medication management.Materials and Methods: Publications on hospital medication management were retrieved from the Web of Science Core Collection. Bibliometric analyses were performed using CiteSpace 6.1.R3, HistCite 2.1, and VOSviewer 1.6.16. The network maps were created between authors, countries institutions, and keywords.Results: A total of 18,723 articles related to hospital medication management studies were identified. Rapid growth in the number of publications since 2017. The high papers were published in AM J HEALTH-SYST PH, while JAMA-J AM MED ASSOC was the most co-cited journal. Manias E and WHO ranked first in the author and cited author. There were active collaborations among the top authors. Bates DW was the key author in this field. The authors have active collaborations in adverse drug events, acute coronary syndrome, in-hospital major bleeding, and so on. The US was the leading contributor in this field. The UK, Australia, and China are also very active. Active cooperation between countries and between institutions was observed. The main hot topics included matters related to outcome indicators, hospital pharmacy service behaviors, and medication use in pain management. More recent keywords focus on chronic disease medication management and clinical medication management.Conclusion: Hospital medication management studies have significantly increased after 2017. There

Norah A Alhwoaimel,1 Bader A Alqahtani,1 Ahmed S Alhowimel,1 Mohammed M Alshehri,2 Afrah K Alhelal,1 Lujain G Al-assaf,1 Aqeel M Alenazi1 1Department of Health and Rehabilitation Sciences, Prince Sattam Bin Abdulaziz University, Al-kharj, 11942, Saudi Arabia; 2Department of Physical Therapy, Jazan University, Jazan, 45142, Saudi ArabiaCorrespondence: Mohammed M Alshehri, Department of Physical Therapy, Jazan University, Jazan, 45142, Saudi Arabia, Email moalshehehri@jazanu.edu.saBackground: Clinical guidelines emphasize the use of standardized outcome measures (SOMs) in post-stroke rehabilitation. However, the extent of SOM utilization among physiotherapists in this context in Saudi Arabia remains unclear.Aim: 1) assess the current use of SOMs by physiotherapists involved in stroke rehabilitation in Saudi Arabia and 2) identify facilitators and barriers influencing the use of SOMs.Methods: An online survey was administered using a three-section questionnaire designed for this study. The first section collected demographic data, the second evaluated the use of SOMs recommended by the American Physical Therapy Association, and the third explored factors facilitating or hindering SOM use in clinical practice. Only highly recommended outcome measures capturing the three levels of the International Classification of Functioning, and Disability (ICF) model were considered: body structure and function, activities, and participation. Poisson regression analysis was used to investigate the association between SOMs utilization and educational level, work experience, type of work facility, and the number of patients treated per week.Results: A total of 138 physiotherapists responded. Most participants (98.5%) used at least one outcome measure in clinical practice. Regression analysis showed that number of strokes treated per week and facility type were associated with the likelihood of using higher number of SOMs. Physiotherapists managing more than 10 stroke patients per week

Xiao-Yan He,1 Wen-Yan Tan,2 Li-Li Guo,1 Ying-Ying Ji,1 Fu-Jun Jia,2 Shi-Bin Wang2,3 1The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, Jiangsu Province, People’s Republic of China; 2Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China; 3School of Health, Zhuhai College of Science and Technology, Zhuhai, Guangdong Province, People’s Republic of ChinaCorrespondence: Ying-Ying Ji, 5/F. The Affiliated Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Jiangsu Province, People’s Republic of China, Tel +86-510-83290034, Fax +86-510-83012698, Email yingying@jiangnan.edu.cn Shi-Bin Wang, 3/F, Guangdong Mental Health Center, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, People’s Republic of China, Tel +86-20-81888553, Fax +86-20-8188-2664, Email spiriorwang@126.comPurpose: The study aims to understanding the mental health literacy level of urban and rural residents in Guangdong Province, the first major province in China, and its influencing factors is crucial.Methods: A multi-stage stratified equal-volume random sampling method was adopted in October-December 2022 to select permanent residents aged 18 years and above in Guangdong Province for the questionnaire survey, which consisted of a general demographic information questionnaire and a national mental health literacy questionnaire. Rao-Scott χ²-test with correction based on sampling design, independent samples t-test and binary multivariate logistic regression analysis were performed.Results: A total of 51744 individuals completed the questionnaire, including 31822 urban residents and 19200 rural residents. The rate of achievement of mental health literacy was 13.6% among urban reside

Alaa M Albishi, Hanan M Al-Ageel, Sami S AlAbdulwahab Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi ArabiaCorrespondence: Alaa M Albishi; Hanan M Al-Ageel, King Saud University, P.O. Box 10219, Riyadh, 11433, Saudi Arabia, Email aalbeshi@ksu.edu.sa; hanan4pt@gmail.comBackground: Bell’s Palsy (BP) is an acute lower motor nerve impairment of the facial nerve, causing sudden paralysis on one side of the face and significantly affecting the patient’s quality of life. Physiotherapy is critical for rehabilitation after BP, aiding functional recovery. Various physical therapy interventions, such as dry needling, taping, and nerve mobilization, have proven effective in treating BP. However, different rehabilitation approaches and knowledge levels among therapists can result in varying treatment outcomes. Therefore, understanding rehabilitation specialists’ knowledge and attitudes towards BP is essential for ensuring effective treatment. To date, no studies have examined the knowledge and attitudes of rehabilitation professionals in Saudi Arabia regarding BP.Objective: This study aims to evaluate the knowledge and attitudes of physical therapists in Saudi Arabia regarding the rehabilitation of BP.Methods: A cross-sectional observational study was conducted with 150 licensed physical therapists in Saudi Arabia, selected via convenience sampling. Participants completed an anonymous online survey covering demographics, knowledge of, and attitudes toward BP rehabilitation techniques. Descriptive and inferential statistics were used to analyze the data.Results: The participants had a mean age of 33.13 ± 6.85 years, with 68.7% being female. Most held Bachelor’s degrees (65.3%) and worked in general hospitals (72.7%). The average knowledge score was 8.99 ± 1.95, indicating moderate knowledge levels. Attitudes towards BP rehabilitation were positive, particularly regarding early intervention, emotiona

Lei Zhang,&ast; Peng Sun,&ast; Xin Liu, Ya Yang, Ruo-Nan Sun, Xu-Dong Wang Department of Emergency Medicine, Aerospace Center Hospital, Beijing, 100049, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xu-Dong Wang, Department of Emergency Medicine, Aerospace Center Hospital, 15 Yuquan Road, Haidian District, Beijing, 100049, People’s Republic of China, Tel +86 01059975120, Email wxundong@126.comObjective: We aimed to analyze the clinical characteristics and prognostic factors of patients with severe hyperkalemia in the emergency department.Methods: This retrospective cohort study included adult patients diagnosed with severe hyperkalemia who sought medical care at the emergency department of Aerospace Center Hospital between January 2018 and May 2022. Clinical data, including demographics, comorbidities, laboratory findings, and outcomes, were systematically collected. Patients were categorized into survival and deceased groups based on in-hospital mortality. Comparative analysis between these groups identified significant differences, highlighting key clinically covariates. Binary logistic regression was employed to determine the primary factors influencing patient outcomes.Results: Of 90 patients diagnosed with severe hyperkalemia, 64 were in the survival group, and 26 in the deceased group. Binary logistic regression identified several significant predictors of mortality, including higher APACHE II scores (odds ratio [OR] 1.41, P = 0.02), widened QRS wave on electrocardiogram (ECG) (OR 79.39, P = 0.04), and elevated serum potassium levels (OR 1.3, P = 0.04). In contrast, emergency blood purification was associated with a reduced mortality rate (OR 0.29, P = 0.03).Conclusion: Key risk factors for mortality in patients with severe hyperkalemia include widened QRS wave on ECG, elevated APACHE II score, and high serum potassium level. Timely correction of hyperkalemia through emergency blood purification si

Wenyu Li,1 Yanqiu Hou,1 Jiayu An,1 Linxuan Chen,1 Shan Lu1,2 1School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; 2Research Centre for Rural Health Service, Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Wuhan, People’s Republic of ChinaCorrespondence: Shan Lu, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Hang Kong Road 13, Wuhan, 430030, People’s Republic of China, Tel +86 15827079650, Email shanlu@hust.edu.cnPurpose: The objective of this study was to explore the connection between family doctor contract services and preventable hospitalizations. Additionally, we sought to examine the role of primary health care quality as a mediating factor in the link between family doctor contract services and preventable hospitalizations among patients with hypertension.Patients and Methods: This cross-sectional study was performed in Dangyang (Hubei Province, Central China) and Xishui (Guizhou Province, Western China) counties in July–August 2023. Participants comprised 625 patients selected via a multi-stage sampling method. Causal mediation analysis was conducted to explore the effect of family doctor contract services on preventable hospitalizations and the mediating effect of primary healthcare quality on this relationship.Results: Utilization rate of family doctor contract services of hypertensive patients was 58.6%, score of primary health service quality was 70.75 and incidence of preventable hospitalizations was 28.2%. Amongst hypertensive patients, utilization of family doctor contract services decreased the occurrence of preventable hospitalizations, with a total effect of − 0.22 (p < 0.001). Primary healthcare quality mediates the association, with a mediate effect of − 0.05 (p < 0.001), explaining 22.73% of the total effect.Concl

Xinyuan Zhou,1,2,&ast; Fuxiang Zhu3,&ast; 1Department of Nephrology, the First People’s Hospital of Pinghu, Jiaxing, Zhejiang, People’s Republic of China; 2Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 3Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Fuxiang Zhu, Department of Nephrology, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang, People’s Republic of China, Email zfxywh@163.comPurpose: Depression is a major concern in maintenance hemodialysis. However, given the elusive nature of its risk factors and the redundant nature of existing assessment forms for judging depression, further research is necessary. Therefore, this study was devoted to exploring the risk factors for depression in maintenance hemodialysis patients and to developing and validating a predictive model for assessing depression in maintenance hemodialysis patients.Patients and Methods: This cross-sectional study was conducted from May 2022 to December 2022, and we recruited maintenance hemodialysis patients from a multicentre hemodialysis centre. Risk factors were identified by Lasso regression analysis and a Nomogram model was developed to predict depressed patients on maintenance hemodialysis. The predictive accuracy of the model was assessed by ROC curves, area under the ROC (AUC), consistency index (C-index), and calibration curves, and its applicability in clinical practice was evaluated using decision curves (DCA).Results: A total of 175 maintenance hemodialysis patients were included in this study, and cases were randomised into a training set of 148 and a validation set of 27 (split ratio 8.5:1.5), with a depression prevalence of 29.1%. Based on age, employment, albumin, and blood uric acid, a predictive map of depressi

Hui Tang,1 Xiurong Xing,1 Yingna Han,1 Daiquan Gao,2 Piu Chan,3 Shengfang Zhang,4 Huixin Xue4 1Department of Emergency Internal Medicine, Xuanwu Hospital of China Capital Medical University, Beijing, People’s Republic of China; 2Department of Neurology, Xuanwu Hospital of China Capital Medical University, Beijing, People’s Republic of China; 3Department of Neurobiology, Xuanwu Hospital of China Capital Medical University, Beijing, People’s Republic of China; 4School of Medicine, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Hui Tang, Department of Emergency Internal Medicine, Xuanwu Hospital of China Capital Medical University, No. 45 of Changchun Street, Xicheng District, Beijing, 100053, People’s Republic of China, Tel +86-1083198280, Email tanghui_202186@21cn.comObjective: To investigate the clinical characteristics, risk factors and outcomes of brain-heart syndrome (BHS) in patients with acute cerebrovascular diseases (ACVDs).Methods: A retrospective analysis was conducted of 100 patients who were admitted to our hospital with ACVDs between January 2023 and December 2023. The demographic, clinical, laboratory and imaging data of the patients were collected, and the presence and severity of BHS were evaluated. The neurological and cardiac outcomes of the patients at discharge and at 12-month follow-up were also assessed.Results: Out of the 100 patients, 38% had BHS, classified as mild (18%), moderate (12%) and severe (8%). The most prevalent ACVDs were cerebral infarction (58%), cerebral haemorrhage (32%) and subarachnoid haemorrhage (10%). Cardiac complications included arrhythmia (26%), myocardial ischaemia (18%) and heart failure (10%). Patients with BHS had higher results for blood pressure, heart rate, white blood cell count, C-reactive protein, IL-6, D-dimer and troponin, more severe neurological deficits, higher mortality and poorer functional outcomes. Multivariable analysis identified age, hypertension, diabetes

Yanting Zhang,&ast; Wei Zhang,&ast; Jing Ma,&ast; Xinbo Ding&ast; Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Critical Care Medicine, Wuhan, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xinbo Ding, Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Hubei Clinical Research Center for Critical Care Medicine, Wuhan, 430071, People’s Republic of China, Email dingxinbo@znhospital.cnBackground: Patients in Intensive Care Units (ICUs) face high risks of physical, functional, cognitive, and mental impairments. Early rehabilitation activities are crucial for reducing mortality and complication rates. This survey investigates the characteristics, current implementation, and detailed status of early rehabilitation activities in ICUs across Central China.Methods: A cross-sectional survey was conducted involving 158 hospitals, with 131 responding. Data on institutional characteristics and early rehabilitation activities were collected through questionnaires. Descriptive statistical analysis described the current status, and a univariate regression model identified factors associated with the implementation of early rehabilitation measures.Results: A total of 131 ICUs completed the survey, with a response rate of 82.91% (131/158). Results indicated that 82.44% (108/131) of ICUs implemented early rehabilitation activities, but only 65 (49.62%) had explicit early rehabilitation exercise protocols or standards/procedures. Before implementing early rehabilitation activities, approximately 89.97% (110/131) of ICUs conducted assessments, and 46.56% (61/131) regularly held structured interdisciplinary rounds to discuss early activity measures and goals. More than half of the participating adult ICUs reported screening patients for swallowing function (64.89%; 85/131), and 55.73% (73/131) of adult ICUs reported having a nut

Jingyi Lu,1,&ast; Caiping Zhang,1,&ast; Suren Rao Sooranna,2,3 Zhiyan He,1 Guangzi Qi,1,4– 6 Yaqin Pang1,4– 6 1College of Public Health and Management, Youjiang Medical University for Nationalities, Baise, Guangxi, People’s Republic of China; 2Life Science and Clinical Research Center, Youjiang Medical University for Nationalities, Baise, Guangxi, People’s Republic of China; 3Department of Metabolism, Digestion and Reproduction, Imperial College London, Chelsea & Westminster Hospital, London, SW10 9NH, UK; 4Modern Industrial College of Biomedicine and Great Health, Youjiang Medical University for Nationalities, Baise, Guangxi, People’s Republic of China; 5Key Laboratory of Research on Environment and Population Health in Aluminium Mining Areas (Youjiang Medical University for Nationalities), Education Department of Guangxi Zhuang Autonomous Region, Baise, Guangxi, People’s Republic of China; 6Key Laboratory of Research on Environmental Pollution and health Risk Assessment, Youjiang Medical University for Nationalities, Baise, Guangxi, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Guangzi Qi; Yaqin Pang, College of Public Health and Management, Youjiang Medical University for Nationalities, No. 98, Chengxiang Road, Baise, Guangxi, People’s Republic of China, Tel +86-0776-2846550, Fax +86-0776-2846565, Email qiguangzi@ymun.edu.com; pangyaqin@126.comObjective: To understand the current situation for social support and HPV vaccination behavior of female sex workers (FSWs) in entertainment venues and to explore the association between the support and HPV vaccination behavior.Methods: 923 FSWs in entertainment venues in a region of Guangxi were selected as survey respondents by using intentional sampling and employing a self-developed basic information questionnaire. The social support rating and the HPV vaccination behavior scales were analyzed to determine the current status of support and HP

Yong Hwa Lee,1,&ast; Dasom An,1,&ast; Youngsuk Baek,1 Kyungsook Yoo,2 Sumi Hyun,1 Sun-Kyeong Park,3 Eui-Kyung Lee1 1School of Pharmacy, Sungkyunkwan University, Suwon, Gyeonggi-do, South Korea; 2School of Pharmacy, Kangwon National University, Chuncheon, Gangwon-do, South Korea; 3College of Pharmacy, The Catholic University of Korea, Bucheon, Gyeonggi-do, South Korea&ast;These authors contributed equally to this workCorrespondence: Sun-Kyeong Park, College of Pharmacy, The Catholic University of Korea, 43 Jibong-ro, Bucheon-si, Gyeonggi-do, 14662, South Korea, Tel +82221644094, Email sk.park@catholic.ac.kr Eui-Kyung Lee, School of Pharmacy, Sungkyunkwan University, 2066, Seobu-ro, Jangan-gu, Suwon-si, Gyeonggi-do, 16419, South Korea, Tel +82312907786, Email ekyung@skku.eduPurpose: Drug shortages directly affect the final stage in the pharmaceutical supply chain, prescription fulfillment in community pharmacies (CPs). This study investigated the current state of drug shortages, their resolution, and influencing factors within CPs.Methods: A cross-sectional online survey was conducted among pharmacists working at pharmacies in Seoul between 7 and 31 October 2022. The survey gathered data on pharmacies and pharmacists’ characteristics, drug distribution, information, communication, and administrative practices. Logistic regression was used to identify the factors influencing these rates. Regression results are presented as odds ratios (OR) and 95% confidence intervals (CIs).Results: Of the 1200 pharmacists approached, 713 participated, yielding a response rate of 59.4%. After excluding incomplete responses, data from 671 respondents were analyzed. Pharmacies with higher prescription drug sales demonstrated a lower OR for drug shortages (OR=0.66, 95% CI=0.60– 0.72) compared to those with lower sales volumes. Resolution rates were significantly higher when pharmacies were located near clinics (OR=3.30, 95% CI=2.3– 4.74) and general hospitals (OR=3.45, 9

Khalid M Alshamrani,1– 3 Dana A Alzahrani,1 Yara S Alghamdi,1 Lama M Aljohani,1 Ziyad F Al Nufaiei1– 3 1College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; 2King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; 3Ministry of the National Guard - Health Affairs, Jeddah, Saudi ArabiaCorrespondence: Khalid M Alshamrani, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, P. O. Box 9515, Internal Mail Code 6610, Jeddah, 21423, Saudi Arabia, Tel +966-12-2266666 Ext 46396, Email alshamranik@ksau-hs.edu.saBackground: Occupational hazards among healthcare workers (HCWs) present serious risks, from infectious diseases to physical and chemical dangers, along with psychological stress, all of which threaten their health and safety. This study aims to identify the unique challenges and hazards encountered by radiology technologists in in Saudi Arabia by assessing the key factors contributing to these risks.Methods: A descriptive questionnaire study was conducted in January-February 2023, targeting 75 radiology technologists at King Abdulaziz Medical City (KAMC), Jeddah, with participants recruited via non-probability convenience sampling and invited to complete a widely recognized questionnaire previously used among radiographers. Descriptive statistics were calculated, and the Kruskal–Wallis H-test was conducted to examine the relationships between demographic factors and different aspects of occupational hazards.Results: Of the 75 technologists contacted, 63 responded, resulting in an 84% participation rate. Workload, work shifts, and patient-related factors are major contributors to occupational hazards, surpassing technologist-specific and organizational elements. Additionally, 68.3% cited rigid leadership and unequal treatment as aggravating factors, while insufficient staffing, inadequate protective devices, and patient interaction were also si

Hind Alshehri,1 Adnan Alharbi,1 Noof Alqethami,2 Mohammed Alnuhait,1 Abdullah Alshammari,1 Abdulmalik S Alotaibi1 1Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia; 2Clinical Pharmacy Department, Taif Health Cluster, King Faisal Medical Complex, Taif, Saudi ArabiaCorrespondence: Abdulmalik S Alotaibi, Email assalotaibi@uqu.edu.saBackground: Pharmacovigilance (PV) is an essential part of the healthcare system’s framework. In Saudi Arabia, pharmacovigilance is still a relatively new concept though it is well established in many countries.Study Aim: In this study, we aim to evaluate knowledge, attitude, and practice regarding pharmacovigilance and barriers to reporting adverse drug reactions (ADRs) among the general public in Saudi Arabia.Methods: This is a cross-sectional study that used a self-administered online questionnaire to assess knowledge, attitude, and practice of PV and ADRs. The study included only the adult population in Saudi Arabia. A scoring system was generated with a scale from 0 to 100, where 80% was set as a cut-off point, as any higher score resembled adequate knowledge, a positive attitude, and good practice. We used the Statistical Package for Social Sciences (SPSS) version 26 for performing the statistical analysis, where para-normal tests were used to associate scores with the socio-demographic characteristics of participants.Results: The study collected 1098 complete responses. The mean age (±SD) of participants was 37.9± 11.2 years. Females comprised 68.9% of the participants. The average knowledge score among participants was 37.8± 18.5, where only 4.3% of respondents had adequate knowledge. The average attitude score was 90.1± 19.2, where 83.4% had a positive attitude. The average practice score was 70.4± 18, and 34.5% of participants had good practice.Conclusion: The study found that the majority of participants had inadequate knowledge, a positive attitude, and poor practice. I

Qingqing Zhang,1,2,&ast; Jing Zheng,1,&ast; Guoyu Wang,1,3 Suyun Jiang,1 Peng Gao,1 Si Sun,1 Xiangwei Ding,3 Yucheng Wu3 1Department of Pan-Vascular Management Center, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China; 2Department of Endocrinology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China; 3Department of Cardiology, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yucheng Wu; Xiangwei Ding, Email 2567181759@qq.com; dingxw1208@126.comObjective: To determine the prevalence of Cardiovascular-Kidney-Metabolic (CKM) Syndrome and identify risk factors, including occupational factors, lifestyle factors and clinical measurements, and female-specific risk enhancers among healthcare workers in China.Methods: A cross-sectional study was conducted among healthcare workers at Taizhou People’s Hospital between April and May 2024. We collected data through surveys and laboratory results. Univariate and multivariate logistic regression analyses were performed to identify predictors of CKM syndrome and female-specific risk enhancers.Results: A total of 1110 participants were recruited (197 male; 913 female; mean age 34.8± 7.9). Almost 90% of male healthcare workers and 60% of female healthcare workers met the criteria for CKM syndrome (stage 1 or higher). Additionally, most male CKM syndrome patients were in stages 2– 3 (53.81%), while most female CKM syndrome patients were in stage 1 (35.82%). Multivariate logistic regression analysis revealed that, compared to those with over 20 years of w

Letao Zhu,1 Yanfeng Li,1 Qingshi Zhao,1 Changyu Li,1 Zongbi Wu,2 Youli Jiang1 1Department of Neurology, People’s Hospital of Longhua, Shenzhen, 518109, People’s Republic of China; 2Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, 518033, People’s Republic of ChinaCorrespondence: Youli Jiang, Department of Neurology, People’s Hospital of Longhua, No. 38, Jinglong Jianshe Road, Longhua District, Shenzhen, Tel +8618545403739, Fax +86 27741585-8500, Email h2362120381@163.com Zongbi Wu, Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine, No. 1, Fuhua Road, Futian District, Shenzhen, People’s Republic of China, Tel +8615384435576, Fax +86 0755-88359899, Email wuzongbi2016@126.comBackground: Acute ischemic stroke (AIS) is increasingly affecting younger populations, necessitating prompt thrombolytic therapy within a narrow therapeutic window. Pre-hospital delays are prevalent, particularly in China, yet targeted research on the youth population remains scarce.Methods: In this retrospective cohort study, data from AIS patients aged 18– 50 admitted to Longhua District People’s Hospital, Shenzhen from December 2021 to December 2023 were analyzed using XGBoost and Random Forest machine learning algorithms, coupled with SHAP visualization, to identify factors contributing to pre-hospital delays.Results: Among 1954 AIS patients, 528 young patients were analyzed. The median time to hospital arrival was 8.34 hours, with 82.0% experiencing delays. Analysis of different age subgroups showed that young patients aged 36– 50 years old had a higher delay rate than patients under 36 years old. Machine learning algorithms identified stroke awareness, age, TOAST classification, ambulance arrival, dysarthria, mRS on admission, dizziness, wake-up stroke, etc. as i

Se Young Kim,1 Young Ko,2 Bong Hee Sim,3 Yeon Ok Yoon,4 Chunseon Jang5 1Department of Nursing, Changwon National University, Changwon, Repulic of Korea; 2College of Nursing, Gachon University, Incheon, Republic of Korea; 3Department of Nursing, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea; 4Department of Nursing, Hanyang University Changwon Hanmaeum Hospital, Changwon, Republic of Korea; 5Department of Nursing, Sungkyunkwan University Changwon Hospital, Changwon, Republic of KoreaCorrespondence: Young Ko, College of Nursing, Gachon University, 191 hambakmoero, Yeonsu-Gu, Incheon, 21936, Republic of Korea, Tel +82 32 820 4205, Fax +82 32 820 4201, Email moodory@gmail.comPurpose: Understanding that the complexity and dynamic nature of the nursing care setting creates diverse conditions for teamwork is important when developing tools to measure nursing unit team effectiveness. The Team Effectiveness Scale for Nursing Units (TES-NU), based on the Integrated Team Effectiveness Model, was developed without confirmatory factor analysis and only tested on one nursing organization. It needs further research to prove its validity and reliability. This study aims to refine and validate the TES-NU in various nursing organizations.Methods: We designed this methodological study to refine the TES-NU by establishing its validity and reliability. The study included 330 clinical nurses from six general hospitals in South Korea, selected via convenience sampling. The TES-NU’s refinement process includes item analysis, exploratory factor analysis, confirmatory factor analysis, item analysis, and convergent validity.Results: The KMO of 22 preliminary items was 0.89, the cumulative variance of the five factors was 67.58%, and the commonality was > 0.40. Confirmatory factor analysis indicated the revised model fit well with better indices: CMIN/DF = 1.687, CFI = 0.936, TLI = 0.924, RMSEA = 0.059, and SRMR = 0.057. We simplified the refined scale to 2

Suad Abdikarim Isse,1 Ahmet Do&gbreve;an,2 Tigad Abdisad Ali,1 Jabir Abdullahi Wehlie,3 Abdirahim Ali Adam,4 Hüsna Öztürk5 1Department of Infect&inodot;on Prevent&inodot;on Control, Mogad&inodot;shu Somal&inodot; Turk&inodot;ye Recep Tayy&inodot;p Erdogan Tra&inodot;n&inodot;ng and Research Hosp&inodot;tal, Mogadishu, Somalia; 2Department of Infectious Diseases and Clinical Microbiology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkiye; 3Department of Dermatology, New Vision Hospital, Mogadishu, Somalia; 4Department of Infectious Diseases and Clinical Microbiology, Mogadishu-Somalia-Turkiye Recep Tayyip Erdo&gbreve;an Training and Research Hospital, Mogadishu, Somalia; 5Department of Infectious Control Nurse Istanbul Ko&scedil;uyolu Yüksek &Idot;htisas E&gbreve;itim ve Ara&scedil;t&inodot;rma Hastanesi, Istanbul, TurkiyeCorrespondence: Suad Abdikarim Isse; Tigad Abdisad Ali, Email suadabdikarim89@gmail.com; tigaadvip@gmail.comBackground: Hand hygiene is a critical preventive measure for controlling infections, particularly in underdeveloped nations.Materials and Methods: A cross-sectional study was conducted in a hospital in Mogadishu, Somalia, from January to March 2024. This study aimed to assess compliance with hand hygiene practices and related factors among healthcare professionals.Results: The study population comprised 52% men and 47.3% women. Most participants held bachelor’s degrees, with the majority being nurses or midwives. A significant proportion had over five years of work experience. Almost all participants were knowledgeable about hand hygiene. Most reported cleaning and drying their hands before, during, and after contact with bodily fluids during aseptic procedures. Age, gender, educational status, marriage, working experience, type of occupation, receiving hand hygiene training and knowledge, and having the availability of water, soap, alcohol, and gloves signif

Qing-Lin Li,1,2,&ast; Xue-Jiao Liu,1,2,&ast; Shu-E Zhang,3 Chao-Yi Chen,1,2 Liang Zhang,4 Xiang Zhang1,2 1Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China; 2The Key Research Institute of Humanities and Social Science of Hubei Province, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China; 3Department of Health Management, School of Health Management, Harbin Medical University, Harbin, 150081, People’s Republic of China; 4School of Political Science and Public Administration, Wuhan University, Wuhan, 430030, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiang Zhang, Department of Health Administration, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People’s Republic of China, Tel +86 18907145152, Email zhangchxiang@163.comPurpose: This study aimed to identify distinct trends among Chinese residents based on their health-related quality of life (HR-QoL) outcomes and to analyze the demographic characteristics that contribute to these trends.Materials and Methods: The study conducted latent class analysis using baseline data obtained from a survey of health service utilization behaviors (from July to December 2016) among residents of Hubei Province, China (N = 1517). Latent classes were used to implement the HR-QoL grouping of different trends among the respondents. Multinomial logistic regression analysis was used to identify demographic characteristic factors affecting HR-QoL in the trend groups.Results: A three-class model emerged as the most suitable grouping classification for HR-QoL among Chinese residents: the low HR-QoL class, exhibiting a downward trend (5.5%); the medium HR-QoL class, exhibiting an upward trend (12.1%); and the stable HR

Yuan Zhang,1 Lin Fu,2 Xingyu Guo,1 Mengkun Li1 1School of Management, Capital Normal University, Beijing, People’s Republic of China; 2School of Management, China Women’s University, Beijing, People’s Republic of ChinaCorrespondence: Yuan Zhang; Mengkun Li, Email zhangyuan@cnu.edu.cn; limengkun@cnu.edu.cnBackground and Purpose: In public health emergencies, rapid perception and analysis of public demands are essential prerequisites for effective crisis communication. Public demands serve as the most instinctive response to the current state of a public health crisis. Therefore, the government must promptly grasp and leverage public demands information to enhance the effectiveness and efficiency of health emergency management, that is planned to better deal with the outbreak and meet the medical demands of the public.Methods: This study employs dynamic topic mining and knowledge graph construction to analyze public demands, presenting a spatial-temporal evolution analysis method for emergencies based on EBU models. EBU models are three large language models, including ERNIE, BERTopic, and UIE.Results: The data analysis of Shanghai’s city closure and control during the COVID-19 epidemic has verified that this method can simplify the labeling and training process, and can use massive social media data to quickly, comprehensively, and accurately analyze public demands from both time and space dimensions. From the visual analysis, geographic information on public demands can be quickly obtained and areas with serious problems can be located. The classification of geographical information can help guide the formulation and implementation of government policies at different levels, and provide a basis for health emergency material dispatch.Conclusion: This study extends the scope and depth of research on health emergency management, enriching subject categories and research methods in the context of public health emergencies. The use of social media data underscore

Lifen Lu,1 Di Sheng,1 Xiaowei Xia,2 Guanghui Chen,3 Jiali Liang,4 Xiulan Shen,1 Gui Zheng1 1Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China; 2Ministry of Health, the Third Hospital of Ninghai County, Ningbo, Zhejiang, People’s Republic of China; 3Ministry of Health, the Liangzhu Street Community Health Service Center, Yuhang District, Hangzhou, Zhejiang, People’s Republic of China; 4Department of Nursing, the First People’s Hospital of Yuhang District, Hangzhou, Zhejiang, People’s Republic of ChinaCorrespondence: Xiulan Shen; Gui Zheng, Department of Nursing, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China, Email shenxl@zju.edu.cn; zhenggui1119@zju.edu.cnAim: To investigate the emotional response of hospital staff to the Depression Anxiety Stress Scale-21 (DASS-21) over the COVID-19 pandemic and after the relaxation of prevention and control measures in Zhejiang Province, China, and identify influencing factors.Design: Multicenter online cross-sectional design.Methods: From January 10, 2023, to January 20, 2023, 1054 hospital employees in Zhejiang, China, were recruited using WeChat. Data was gathered via online, self-administered surveys. T-tests and one-way analyses of variance, Pearson’s correlation analysis, and multiple linear stepwise regression analyses were used to examine the data.Results: More than 90% of hospital employees were infected with COVID-19. Through regression analysis, the following variables were found to be independent predictors of emotional response to DASS-21: resilience (− 13.346, P < 0.0001), sleep (14.689, P < 0.0001), friend support (− 4.278, P < 0.0001), education level (2.699, P = 0.007), and marriage (− 2.214, P = 0.027). The emotional responses were not as severe as predicted, but they were still well above the Chinese norm. A longitudinal co

Changqin Li, Li Zeng, Meiling Jiang Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of ChinaCorrespondence: Li Zeng, Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, People’s Republic of China, Tel +86-18980607090, Email zengli998@163.comBackground and Objective: Concealed penis (CP) is a condition involving a congenital abnormality of the external genitalia, wherein the penile shaft is partially or completely obscured by surrounding skin tissues, negatively affecting the psychological and physical health of children. The guardians, who are primarily responsible for the daily care of children, play a crucial role in the early detection of this condition. Therefore, this study aims to explore knowledge, attitude, and practices (KAP) toward CP among guardians of young boys; results would provide a theoretical basis for the development of health education programs.Methods: This web-based cross-sectional study was conducted among guardians of boys in the Department of Pediatric Surgery, local hospital between June 2023 and September 2023. A self-designed questionnaire was developed to collect demographic information of the guardians and to assess their knowledge, attitudes and practices toward CP.Results: A total of 394 questionnaires were collected. Among the guardians, 143 (36.29%) of them were male, 375 (95.18%) were the parents of the children, 279 (70.81%) had a junior college or bachelor’s degree, and 46 (11.68%) reported their children had CP. The knowledge, attitudes and practices scores were 4.00± 2.00 (possible range: 0– 7), 35.63± 3.40 (possible range: 9– 45), and 23.03± 6.97 (possible range: 9– 45), respectively. The structural equation model demonstrated that knowledge had direct effects on attitudes (β=0.63, p< 0.001), and practices (β=0.81, p< 0.001). Moreover, attitudes had direct effects on practices (β=0.43, p< 0.001).Conc

Elanda Fikri1,2 1Department of Environmental Health, Poltekkes Kemenkes Bandung, Bandung, Indonesia; 2Center of Excellence on Utilization of Local Material for Health Improvement, Bandung Health Polytechnic, Bandung, IndonesiaCorrespondence: Elanda Fikri, Department of Environmental Health, Poltekkes Kemenkes Bandung, Jl.Pajajaran 56, Bandung, Jawa Barat, Indonesia, Email elandafikri@staff.poltekkesbandung.ac.id

Myeongjeong Chae,1 Boyoung Kim2 1Department of Nursing, Gwangju Women’s University, Gwangju, South Korea; 2College of Nursing, Chonnam National University, Gwangju, 61469, South KoreaCorrespondence: Boyoung Kim, College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju, 61469, South Korea, Tel +82-62-530-4936, Fax +82-62-220-4544, Email bkimjhu@gmail.comPurpose: This study uses grounded theory to explore the process and conceptual framework of how nursing students’ attitudes toward others and different cultures change after receiving education on multicultural understanding.Methods: This study used the Corbin and Strauss grounded theory throughout data collection and analysis. We used purposive sampling to select participants and then gathered data through in-depth interviews with 18 students who completed a multicultural understanding education course.Results: Two researchers conducted a comparative semantic analysis of the transcribed data, applying open, axial, and selective coding techniques. With the collected data, the two researchers exchanged opinions to categorize and structure the data according to the research questions. Through the analysis, open coding yielded 11 categories and 26 subcategories from 135 concepts. In a model that recombined nine categories through axial coding, the central phenomenon was “distance”, while the core category was “perceive people from different cultures as others/accept with reduced distance”.Conclusion: Since nursing students are more likely to care for patients from diverse cultural backgrounds in their future clinical practice, they must have specialized cultural knowledge.Keywords: multicultural, education, cultural barrier, distance, nursing student

Dan M Wood,1,&ast; Brad Beauvais,2,&ast; Rodney X Sturdivant,3,&ast; Forest S Kim4,&ast; 1Graduate Program in Health and Business Administration, Army-Baylor University, San Antonio, TX, USA; 2School of Health Administration, Texas State University, San Marcos, TX, USA; 3Department of Statistical Science, Baylor University, Waco, TX, USA; 4Department of Economics, Baylor University, Waco, TX, USA&ast;These authors contributed equally to this workCorrespondence: Dan M Wood, Army-Baylor University MHA/MBA Program, 3630 Stanley Road, San Antonio, TX, 78234, USA, Email dan_wood@baylor.eduPurpose: This study explores the effects of CMS reimbursement financial penalties from the Hospital-Acquired Condition Reduction Program (HACRP) on hospital-acquired infections (HAI) in hospitals across the United States.Methods: Hospital-level data for 2896 hospitals in the United States were evaluated using multiple linear regression models with random effects analysis through a difference-in-differences study design to examine HAIs under the HACRP between hospitals that were financially penalized or not from calendar years 2013 to 2020.Results: This study showed significant differences from the pre-program Total HAC scores to the most recent reviewed year, validating the efficacy of the HACRP, and showing a reduction of overall HAIs over the years evaluated in the study. The multiple linear regression model with random effects analysis produced a significant (p < 0.001) interaction term between hospitals expected to be penalized in 2013 and each year evaluated in the study (− 0.412 estimate) confirming decreases in HAI scores, and overall decreases in HAIs across the years of the study. Notably, 98% of hospitals in the worst-performing, expected to be financially penalized quartile from 2013, were found to have decreased their HAIs in their facilities, while only 38.8% of hospital in the performing, non-penalized quartiles showed decreases in HAIs across thei

Tenggao Chen,1,&ast; Wanlin Lei,2,&ast; Maofeng Wang2 1Department of Colorectal Surgery, Affiliated Dongyang Hospital, Wenzhou Medical University, Dongyang, Zhejiang, 322100, People’s Republic of China; 2Department of Biomedical Sciences Laboratory, Affiliated Dongyang Hospital, Wenzhou Medical University, Dongyang, Zhejiang, 322100, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Maofeng Wang, Department of Biomedical Sciences Laboratory, No. 60 Wuning West Road, Affiliated Dongyang Hospital, Wenzhou Medical University, Dongyang, 322100, People’s Republic of China, Email wzmcwmf@wmu.edu.cnObjective: This study aimed to develop a predictive model for assessing internal bleeding risk in elderly aspirin users using machine learning.Methods: A total of 26,030 elderly aspirin users (aged over 65) were retrospective included in the study. Data on patient demographics, clinical features, underlying diseases, medical history, and laboratory examinations were collected from Affiliated Dongyang Hospital of Wenzhou Medical University. Patients were randomly divided into two groups, with a 7:3 ratio, for model development and internal validation, respectively. Least absolute shrinkage and selection operator (LASSO) regression, extreme gradient boosting (XGBoost), and multivariate logistic regression were employed to develop prediction models. Model performance was evaluated using area under the curve (AUC), calibration curves, decision curve analysis (DCA), clinical impact curve (CIC), and net reduction curve (NRC).Results: The XGBoost model exhibited the highest AUC among all models. It consisted of six clinical variables: HGB, PLT, previous bleeding, gastric ulcer, cerebral infarction, and tumor. A visual nomogram was developed based on these six variables. In the training dataset, the model achieved an AUC of 0.842 (95% CI: 0.829– 0.855), while in the test dataset, it achieved an AUC of 0.820 (95% CI: 0.800–

Huifang Cai,1,* Zongbi Wu,2,* Jieling Xu,1 Taifen Wang,2 Yanfeng Li,3 Youli Jiang,3 Mingming Xu2 1Guangzhou University of Chinese Medicine Fourth Clinical Medical College, Shenzhen, People’s Republic of China; 2Nursing Department, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, People’s Republic of China; 3Department of Neurology, People’s Hospital of Longhua, Shenzhen, People’s Republic of China*These authors contributed equally to this workCorrespondence: Youli Jiang; Mingming Xu, Email h2362120381@163.com; szszyyhlb@163.comObjective: This study investigates the prevalence and determinants of social isolation in peritoneal dialysis (PD) patients, focusing on the influence of environmental systems and individual behaviors on their social well-being.Methods: We conducted a cross-sectional study from December 2023 to February 2024 at Shenzhen Traditional Chinese Medicine Hospital. A total of 259 PD patients were enrolled using a consecutive sampling method. Data were collected via validated tools including the Pittsburgh Sleep Quality Index (PSQI), Lubben Social Network Scale-6 (LSNS-6), Family APGAR Questionnaire, and Social Anxiety Subscale of Self-Consciousness Scale (SASS-CS). Statistical analyses utilized Spearman correlation and multiple linear regression to identify factors associated with social isolation.Results: The average score for social isolation was 11 (range 7– 15). Significant predictors of social isolation included education level, physical inactivity, and normal hemoglobin concentrations. Social isolation was negatively correlated with family functionality and positively correlated with social anxiety. Regression analysis confirmed education, family functionality, and social anxiety as significant independent predictors of social isolation.Conclusion: Social isolation is common among PD patients, driven by factors such as education level, physical inactivity, and unexpectedly, normal hemog

Yang Li,1,&ast; Huihui Fan,2,&ast; Wei Wei,3 Hanyu Zhu,4 Haifeng Wang,4 Dayao Lyu,1 Zengrui Zhang,1 Ying Tan1 1Department of Neurology, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 2Department of Ultrasound, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 3Department of Key Laboratory of Basic Research and Clinical Translation, Huzhou Central Hospital, The Fifth School of Clinical Medicine of Zhejiang Chinese Medical University, Huzhou, People’s Republic of China; 4Department of Neurology, Medical School of Huzhou University, Huzhou, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ying Tan, Email zzftyzhy@126.comIntroduction: The primary clinical manifestation of venous thrombosis is discomfort in the lower extremities. Some early Parkinson’s disease (PD) patients feel discomfort in the lower limbs. Venous thrombosis can risk lives by causing pulmonary embolism. This study examines the incidence of DVT in early PD patients and its correlation with different clinical and lab features.Methods: A cross-sectional study was conducted on 117 patients with early-stage PD. Ultrasonography was employed to detect the presence of DVT. Factors such as age, gender, body mass index, lifestyle habits (smoking and drinking), medical history (hypertension, diabetes, atrial fibrillation, and tumor), and other lab tests linked to thrombosis were analyzed.Results: In 117 patients, 11 (9.4%) had DVT, while 106 (90.6%) did not. There were no significant differences in gender, BMI, habits, medical history, or other thrombosis-related tests between both groups. However, DVT patients were older with higher d-dimer levels. They also showed an increased right substantia nigra ultrasound echo area, higher HY grades, higher UPDRS 3 scores, less im

Jieun Hwang,1,2 Kyunghee Lee3 1Department of Health Administration, College of Health Science, Dankook University, Cheonan City, Chungcheongnam-do, South Korea; 2Institute of Convergence Healthcare, Dankook University, Cheonan City, Chungcheongnam-do, South Korea; 3Department of Healthcare Management, Eulji University of Korea, Seongnam City, Kyeonggi-do, South KoreaCorrespondence: Kyunghee Lee, Department of Healthcare Management, Eulji University of Korea, 553 Sanseongdaero, Sujeong-Gu, Seongnam City, Kyeonggi-do, 13135, South Korea, Tel +821072428346, Email rose1294@hanmail.netPurpose: The aim of this study was to analyze hospital-discharged acute myocardial infarction (AMI) patients in Korea (2006– 2020) to understand how pre-existing conditions affect mortality rates.Participants and Methods: This study utilized the 2006– 2020 Korean National Hospital Discharge In-depth Injury Survey data. A weighted frequency analysis estimated discharged AMI patients and calculated age-standardized discharge and mortality rates, Charlson Comorbidity Index (CCI) score distribution, and general patient characteristics. Weighted logistic regression analysis examined influencing mortality factors.Results: There were 486,464 AMI patients (143,751 female), with AMI-related mortality rates at 7.5% (36,312): 5.7% for males (19,190) and 11.8% for females (17,122). The highest mortality rate was among individuals aged 70– 79 years (25%). Factors influencing mortality included sex, insurance type, admission route, hospital bed count, region, operation status, and CCI score. Mortality risk at discharge was 1.151 times higher in females than males (95% CI: 1.002– 1.322), 0.787 times lower among those with national health insurance than Medicaid recipients (95% CI 0.64– 0.967), 2.182 times higher among those admitted via the emergency department than the outpatient department (95% CI 1.747– 2.725), and 3.402 times higher in patients with a CCI score of 3 points than those with

Menyfah Q Alanazi,1– 3,&ast; Eyad K Alkhadhairi,3 Waleed H Alrumi,4 Sami A Alajlan3,&ast; 1Drug Policy and Economics Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3Logistics and Contracts Management, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia; 4Expenditure Efficiency and Projects Authority, Riyadh, Saudi Arabia&ast;These authors contributed equally to this workCorrespondence: Menyfah Q Alanazi, Drug Policy and Economics Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, 11426, Saudi Arabia, Tel +966118011111, Email menefah@gmail.comAim: To evaluate the prevalence and trend of inventory waste in a tertiary hospital over the last 7 years. This included the type and average monetary value (MV) of inventory waste, as well as the outcome of using the Always-Better-Control (ABC)-Vital-Essential-Non-essential (VEN) matrix as part of a Zero-Waste Strategy.Methods: This was a retrospective observational study conducted at King Abdulaziz Medical City (KAMC) over 7 years.Results: The prevalence of waste was 0.21%, which equates to (SAR) 15 million out of SAR 7 billion. The pharmaceutical inventory had significantly higher waste in terms of MV and the number of items (89.8%, and 80.3%, respectively) (P< 0.001). The expired pharmaceutical inventory had a significantly higher waste of MV than non-moving and obsolete inventory (79.8%, 14.3%, and 5.9%, respectively) (P< 0.001). The ABC-VEN matrix categorized the inventory into Category I, which has the highest MV waste at 82.3%, followed by Category II with 16.8%, and then Category III with 0.9%. However, category II had a significantly higher number of wasted items at (58.2%), followed by Category I (24%) and Category III (17.8%) (P< 0.

Xia Wang,1 Yu Song,2 Yicong Ji,3 Anming Chen,3 Shancheng Si3 1Department of Infection Management, Weihai Central Hospital Affiliated to Qingdao University, Weihai Central Hospital, Weihai, 264400, People’s Republic of China; 2Department of Ophthalmology, Weihai Central Hospital Affiliated to Qingdao University, Weihai Central Hospital, Weihai, 264400, People’s Republic of China; 3Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, 102218, People’s Republic of ChinaCorrespondence: Shancheng Si, Eye Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, People’s Republic of China, Tel +8618701580485, Email sishancheng@126.comPurpose: To investigate the clinical characteristics and systemic risk factors of K. pneumoniae related endogenous endophthalmitis (KPREE) in China and explore the possible pathophysiological mechanisms.Methods: This was a retrospective comparative study. All enrolled KPREE patients were followed up for at least 1 month to observe their clinical characteristics, unfavorable prognosis, and risk factors, and were compared with intraocular surgery-related postoperative endophthalmitis (ISRPE).Results: Finally, a total of 15 eyes (3 both eyes) from 12 patients were enrolled in KPREE group, and 11 eyes (none both eyes) from 11 patients were enrolled in ISRPE group. Compared to the ISRPE group, the KPREE group had a higher percentage of fever (100% vs 9.09%, P = 0.000), liver abscess (91.67% vs 0%, P = 0.000), lung involvement (50.00% vs 0%, P = 0.024), and lower plasma albumin levels (24.1 [17.8, 31.7] vs 44.0 [37.7, 48.4], P = 0.001). Furthermore, Pearson’s partial correlation analysis showed that fever (adjusted r = 0.592, adjusted P = 0.026) and plasma albumin (adjusted r = − 0.658, adjusted P = 0.011) were independent factors associated with KPREE. In the KPREE group, ten eyes received

Heaven Yohannes Habte,1 Merhawi Bahta,1 Natnael Russom,1 Fitsum Kibreab,2 Adiam Andemariam,3 Tomas Tewelde,4 Mulugeta Russom1,5,6 1National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea; 2Health Research and Resources Centre Division, Ministry of Health, Asmara, Eritrea; 3Zoba Maekel Pharmaceutical Service, Ministry of Health, Asmara, Eritrea; 4Orotta College of Medicine and Health Science, Department of Medical Science, Unit of Pharmacy, Asmara, Eritrea; 5Department of Medical Informatics, Erasmus Medical Center, Rotterdam, Netherlands; 6European Programme for Pharmacovigilance and Pharmacoepidemiology, University of Bordeaux, Bordeaux, FranceCorrespondence: Natnael Russom, National Medicines and Food Administration, Ministry of Health, Asmara, Eritrea, Tel +291-7602351, Email natiraesi@gmail.comIntroduction: Unused and/or expired pharmaceuticals stored in households are potential health and environment hazards that require safe disposal. In Eritrea, there has not been a proper household medicines disposal system and pharmaceutical wastes had been disposed of irrationally. The study was therefore conducted to assess community’s understanding and disposal practices of unused/expired medications and willingness to participate in a household medicines take-back system.Methods: A cross-sectional study was conducted from January to February 2023 in randomly selected households of Asmara. The study participants were selected using a multi-stage-cluster sampling. Data, collected through face-to-face interview using a structured questionnaire, were double entered using CSPro version 7.3 software package and analyzed using SPSS version 26.Results: A total of 327 participants were enrolled in the study with a predominance of female respondents (84%). The most commonly used disposal practices were throwing with household garbage (65.6%), followed by dumping under soil (38.7%) and flushing down the toilet/sink (15.2%). Around three-quarters (70.5%) o

Jiangtao Yu,1,&ast; Benfeng Zheng,2,&ast; Na Liu,2,3 Yiheng Zhu,4 Fen Hui,5 Jin Zhang,5 Lin Luan1,2 1Department of Epidemiology, School of Public Health, National Vaccine Innovation Platform, Nanjing Medical University, Nanjing, 210000, People’s Republic of China; 2Department of Immunization Program, Suzhou Center for Disease Control and Prevention, Suzhou, 215000, People’s Republic of China; 3Center for Immunization Planning, Chinese Center for Disease Control and Prevention, Beijing, 100050, People’s Republic of China; 4Suzhou Municipal Health Commission, Suzhou, 215000, People’s Republic of China; 5The Fifth People’s Hospital of Suzhou, Suzhou, 215000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Lin Luan, Email szluanlin@163.comObjective: To investigate the epidemiology, and hospitalization of tetanus in Suzhou, Jiangsu Province, China, focusing on the severity of the disease, treatment, outcomes and hospitalization costs, and to explore the risk factors for severe tetanus.Methods: This retrospective, multicenter observational study analyzed tetanus patients admitted to various medical institutions between 2013 and 2023. Patients were classified into two groups as severe or non-severe, using the Ablett classification. Differences between the two groups were compared using the Chi-squared test, Fisher’s exact test and Mann–Whitney U-test. Binary logistic regression analysis was used to evaluate potential risk factors for severe disease.Results: A total of 63 patients with tetanus were included in this study. The median age of the patients was 57.0 (48.0– 74.0) years, with a predominance of males (65.1%). There was an overall increasing trend in the rate of severe illness in tetanus patients from 2013– 2023 (P< 0.001). The proportion of patients admitted to the hospital was highest (39.7%) in summer (June–August) (P=0.001). The rate of severe tetanus was significantly higher in p

Oktay Yap&inodot;c&inodot;, Ye&scedil;im Ça&gbreve;lar Department of Infectious Disease and Clinical Microbiology, Bal&inodot;kesir University School of Medicine, Bal&inodot;kesir, TurkeyCorrespondence: Oktay Yap&inodot;c&inodot;, Department of Infectious Disease and Clinical Microbiology, Bal&inodot;kesir University School of Medicine, Bal&inodot;kesir, Turkey, Tel +90266 6121461, Email yapicio@hotmail.comObjective: The aim of this study is to assess the impact of educational interventions on knowledge and attitudes toward HIV/AIDS, with the goal of reducing stigma.Methods: A cross-sectional epidemiological study was conducted. This intervention study assessed knowledge and attitudes about HIV/AIDS using a 5-point Likert scale. Participants, selected by convenience sampling method, included patients, their relatives, and healthcare providers at a University Hospital, excluding those with HIV/AIDS. After completing a pre-test questionnaire, participants received written information from an infectious disease specialist on HIV/AIDS, covering prevalence, transmission, prevention, and treatment per WHO guidelines. A post-test was then administered to evaluate changes in knowledge and attitudes. The study used a validated Turkish attitude scale. Statistical analysis was performed using SPSS 23.0. Continuous variables were presented as mean ± standard deviation or median and range. Correlation analysis examined the relationship between HIV/AIDS knowledge and stigmatizing attitudes.Results: In the study conducted with 388 participants, the mean age was 34, with 48.7% male and 51.3% female. Education significantly increased HIV/AIDS knowledge and improved empathetic, accepting attitudes toward individuals living with HIV (p< 0.05).Conclusion: These results suggest that educational interventions should be implemented widely, especially in healthcare settings, to combat stigma. Future actions could include integrating similar prog

Basira Bek,1 Yahya Fayaz,2 Rahila Bek,1 Shahab Uddin Ahmadi2 1Department of Medicine, Kateb University, Kabul, Afghanistan; 2Department of Stomatology, Khatam AL Nabieen University, Kabul, AfghanistanCorrespondence: Yahya Fayaz, Department of Stomatology, Khatam AL Nabieen University, Kabul, Afghanistan, Tel +93 (0) 706281798, Email dr.yahyafayaz@gmail.comAbstract: The global spread of the Mpox virus represents a significant public health challenge, particularly for regions with fragile healthcare systems. Afghanistan, already grappling with severe healthcare deficits, faces the added threat of Mpox, a zoonotic disease caused by the monkeypox virus. The recent emergence of Clade Ib, a new strain associated with rising outbreak cases, exacerbates concerns as Afghanistan’s healthcare infrastructure continues to deteriorate due to reduced international aid, healthcare worker shortages, and an ongoing socio-political crisis. This commentary underscores the urgent need for international intervention to avert a potential public health crisis that could devastate Afghanistan’s already weakened healthcare system. It calls for immediate support to enhance disease surveillance, improve healthcare infrastructure, and address the pressing challenges of malnutrition and access to medical services.Keywords: monkeypox virus, outbreak, Afghanistan

Qizhi Diao,1 Yongpei Long,2 Fangyu Yang,3 Cuihui Nong,1 Huamiao Tang,1 Xiangmin Zhou,1 Guoqiang Zhu,4 Qiang Ding5 1Hainan Branch, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Sanya, People’s Republic of China; 2Department of Laboratory Medicine, The People’s Hospital of Jianyang City, Sichuan, People’s Republic of China; 3Department of Clinical Laboratory Medicine, University-Town Hospital of Chongqing Medical University, Chongqing, People’s Republic of China; 4Chong Qing King Med Center for Clinical Laboratory Co., Ltd, Chongqing, People’s Republic of China; 5The Sixth People’s Hospital of Chongqing, Chongqing, People’s Republic of ChinaCorrespondence: Guoqiang Zhu; Qiang Ding, Email Guoqiangzhu01@163.com; yung10167086@126.comBackground and Objective: Inadequate risk assessment and a lack of risk monitoring are common deficiencies in clinical laboratory, and are also the main causes of biosafety incidents. Therefore, we summarized the experience of implementing adequate risk assessment and maintaining risk monitoring, and established a procedure for continuously improving biosafety management.Methods: Learning from our laboratory’s experience in implementing risk assessment, risk response, and risk monitoring before and during the COVID-19 epidemic, we summarized the procedures for fully identifying risks, accurately evaluating risks, maintaining risk monitoring, establishing and regular reviewing safety indicators. On this basis, we established a system for continuously improving biosafety management through risk monitoring and reviewing safety indicator.Results: We identified a total of 30 unacceptable risks prior to the COVID-19 pandemic, and developed and implemented appropriate risk control measures. After risk control, residual risks were acceptable, and no biosafety incidents have occurred. During the COVID-19 pandemic, after multiple risk monitoring, we identified ten new risks, three ineffective r

Jiali Teng,1 Qian Li,1 Guihang Song,2 Youli Han1 1School of Public Health, Capital Medical University, Beijing, People’s Republic of China; 2Department of Medical Services Management, Gansu Healthcare Security Administration, Lanzhou, Gansu, People’s Republic of ChinaCorrespondence: Youli Han, School of Public Health, Capital Medical University, 10 Xi Toutiao Road, Youanmenwai District, Beijing, People’s Republic of China, 100069, Email hanyouli@ccmu.edu.cn Guihang Song, Department of Medical Services Management, Gansu Healthcare Security Administration, 101 Guangchangnan Road, Chengguan District, Lanzhou, Gansu, People’s Republic of China, 730030, Email 285601604@qq.comPurpose: To control medical costs and regulate the behavior of providers, China has formed an original widely piloted case-based payment under the regional global budget, called the Diagnosis-Intervention Packet (DIP). This study aimed to evaluated the impact of the DIP payment reform on medical costs, quality of care, and medical service capacity in a less-developed pilot city in Northwest China.Patients and Methods: We used the de-identified case-level discharge data of hospitalized patients from January 2021 to June 2022 in pilot and control cities located in the same province. We performed difference-in-differences (DID) analysis to examine the differential impact of the DIP reform for the entire sample and between secondary and tertiary hospitals.Results: The DIP payment reform resulted in a significant decrease of total expenditure per case in the entire sample (5.5%, P < 0.01) and tertiary hospitals (9.3%, P < 0.01). In-hospital mortality rate decreased significantly in tertiary hospitals (negligible in size, P < 0.05), as did all-cause readmission rate within 30 days in the entire sample (1.1 percentage points, P < 0.01) and secondary hospitals (1.4 percentage points, P < 0.01). Proportion of severe patients increased significantly in the entire sample (1.2 percentage p

Liqun Luo,1 Xiulin Wen,1 Jingrong Wang,2 Qian Xiao,3 Liuju Su,3 Min Zhou3 1Department of Nursing, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China; 2Department of Surgical, The Second Affiliated Hospital of the Air Force Military Medical University, Xi’an, People’s Republic of China; 3School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, People’s Republic of ChinaCorrespondence: Xiulin Wen, Email 332919997@qq.com

Yueming Ding,1 Huiying Zhang,1 Zhiqing Hu,1 Yanjun Sun,1 Yiping Wang,2 Baolong Ding,3 Guofeng Yue,4 Yuan He1,5 1Institute of Medical Humanities, School of Marxism, Nanjing Medical University, Nanjing, People’s Republic of China; 2School of Nursing, Nanjing Medical University, Nanjing, People’s Republic of China; 3School of Pharmacy, Nanjing Medical University, Nanjing, People’s Republic of China; 4School of Health Policy and Management, Nanjing Medical University, Nanjing, People’s Republic of China; 5Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, People’s Republic of ChinaCorrespondence: Yuan He, Institute of Medical Humanities, School of Marxism, School of Nursing, Research Center for Social Risk Management of Major Public Health Events (Key Research Base of Philosophy and Social Sciences of Universities in Jiangsu), Nanjing Medical University, Nanjing, 211166, People’s Republic of China, Email heyuan@njmu.edu.cn Guofeng Yue, School of Health Policy and Management, Nanjing Medical University, Nanjing, 211166, People’s Republic of China, Email gfyue@njmu.edu.cnBackground: Improving health-related quality of life (HRQoL) among hypertensive individuals has emerged as a significant public health issue. However, current research has ignored the individual heterogeneity of perceived social support (PSS) among hypertensive patients. The potential mechanism of delay discounting (DD), living alone, and PSS on HRQoL remains unclear, and further exploration is required.Aim: This study aimed to ascertain PSS profiles among hypertensive patients and examine the hypotheses that DD mediates the relationship between PSS and HRQoL and that this mediating process is moderated by living alone in hypertensive patients.Methods: A cross-sectional study was carried out in Jiangsu, China. In total, 1815 hypertensive patients comple

E&scedil;e Ba&scedil;bulut,1 Melek Bilgin,1 Hacer I&scedil;ler,1 Ahmet &Scedil;en,2 Süleyman S&inodot;rr&inodot; K&inodot;l&inodot;ç,3 Mahcube Çubukçu4 1Department of Medical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey; 2Department of Anesthesia and Reanimation, Trabzon Faculty of Medicine, Trabzon, Turkey; 3Department of Infectious Disease and Clinical Microbiology, Samsun Training and Research Hospital, Samsun, Turkey; 4Department of Family Medicine, Samsun University Faculty of Medicine, Samsun, TurkeyCorrespondence: Mahcube Çubukçu, Tel +905052332232, Fax +903623111522, Email mahcube.cubukcu@samsun.edu.trBackground: The objective of this study is to compare the measles immunoglobulin G (IgG) and rubella IgG levels in patient groups with mild and severe COVID-19 disease and reveal the possible relationship.Methods: This study was conducted among COVID-19-confirmed patients over 18, under 65 years of age. This study involved 75 participants- divided into two groups. The first group usually comprised asymptomatic patients who did not require hospitalization (n=43), and the second group consisted of patients who had diffuse pneumonia on thoracic CT and required hospitalization (n=32).Results: Anti-measles and anti-rubella IgG titers were detected to be higher in the group with severe disease compared to the group with mild disease (p=0.001 and p=0.001, respectively). The analyses were repeated by taking n=27 in Group 1 and n=27 in Group 2, which were similar in terms of age, gender and number. In the analysis performed without any age difference between the groups, no significant difference was found between the two groups in terms of Anti Measles IgG antibody titers (p=0.068). However, Anti Rubella antibody titers were found to be higher in the group with severe COVID-19 disease than in those with mild disease (p=0.03). Regardless of the severity of the disease, there was a positive correlation between A

Lizhen Huang,1,&ast; Yanjun Jin,2,&ast; Ching-Wen Chien,3 Qinyi Xu,3 Yen-Ching Chuang,4– 6 Tao-Hsin Tung6,7 1School of Economics and Management, Fuzhou University, Fuzhou, Fujian, 350108, People’s Republic of China; 2Department of Urology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000 People’s Republic of China; 3Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, Shenzhen, People’s Republic of China; 4Business College, Taizhou University, Taizhou, Zhejiang, 318000, People’s Republic of China; 5Institute of Public Health & Emergency Management, Taizhou University, Taizhou, Zhejiang, 318000, People’s Republic of China; 6Key Laboratory of Evidence-Based Radiology of Taizhou, Linhai, Zhejiang, 317000, People’s Republic of China; 7Evidence-based Medicine Center, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai, Zhejiang, 317000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yen-Ching Chuang; Tao-Hsin Tung, Email yenching.chuang@gmail.com; ch2876@gmail.comBackground: Improving overall and individual health literacy is a major focus of national initiatives in China and similar initiatives globally. However, few studies have examined the identification and improvement of individual health literacy levels, especially among patients.Purpose: To develop an interpretable method with decision rules to assess the health literacy levels of male patients and identify key factors influencing health literacy levels.Methods: Using a convenience sampling method, we conducted on-site surveys with 212 male patients of a hospital in China from July 2020 to September 2020. The questionnaire was developed by the Ministry of Health of the People’s Republic of China. A total of 206 of the completed surveys were ultimately included for analyses in this study. The rough set theory was used to iden

Hanxiang Gong,1,2,&ast; Tao Zhang,1,&ast; Xi Wang,1 Baoxin Chen,3 Baoling Wu,1 Shufang Zhao1 1Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macao, 999078, People’s Republic of China; 2The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China; 3Pingshan Hospital, Southern Medical University, Shenzhen, Guangdong, 518118, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xi Wang, Faculty of Humanities and Social Sciences, Macao Polytechnic University, Macao, 999078, People’s Republic of China, Tel +86-18029928803, Fax +86-853-28718003, Email xwang@mpu.edu.moPurpose: This study explores regional differences, dynamic evolution, and influencing factors of medical service levels in Guangzhou under the Health China Strategy to provide a basis for improving service quality and reducing disparities.Patients and Methods: An evaluation system was constructed using the entropy weight TOPSIS method. The Dagum Gini coefficient analyzed regional differences, Kernel density estimation assessed service levels’ distribution, and Tobit regression explored influencing factors. Data were collected from the “Guangzhou Statistical Yearbook”, Guangzhou Health Commission reports, and government work reports from 2017 to 2022.Results: The study shows that from 2017 to 2022, there were significant differences in medical service levels among different regions of Guangzhou, with higher service quality in central urban areas compared to remote and peripheral areas. The application of the entropy weight method revealed the importance of indicators such as medical business costs and the number of registered nurses per thousand population in evaluating service quality. According to the Dagum Gini coefficient decomposition method, regional differences in medical services in Guangzhou are the main factor causing uneven overall development quality.

Man Teng Iong Faculty of Law, University of Macau, Macao, People’s Republic of ChinaCorrespondence: Man Teng Iong, Faculty of Law (FLL), University of Macau, E32, Avenida da Universidade, Taipa, Macau, People’s Republic of China, Email mantengiong@um.edu.moAbstract: Governments worldwide have made significant efforts to combat the COVID-19 pandemic. Nonetheless, measures against the COVID-19 outbreak have raised concerns relating to the measures that can affect health and endanger the lives of patients not related to COVID-19 but needing emergency treatments. For instance, ambulances were sometimes unable to access restricted zones for patients in urgent situations, and emergency departments were closed or refused urgent cases due to healthcare policies during the pandemic. To prevent such issues in future public health emergencies, changes to existing pandemic prevention measures are necessary. This article, through narrative review, intends to find a better healthcare policy during pandemic to protect proportionally public health and simultaneously guarantee the health and lives of non-COVID-19 patients needing emergency care. For this purpose, it provides three suggestions: ensuring ambulance access to confined areas, strengthening emergency department capabilities, and finding a balance between pandemic control and respect for patient rights. These suggestions are paramount to safeguard public health while securing the health and living for those needing urgent medical care.Keywords: healthcare policy, pandemic, COVID-19, individual rights, public health

Junhua Zhu, Yue Zhuang, Wenjing Li School of Safety Science and Emergency Management, Wuhan University of Technology, Wuhan, People’s Republic of ChinaCorrespondence: Yue Zhuang, Email zhuangyue@whut.edu.cnPurpose: The use of multi-source precursor data to predict the epidemic risk level would aid in the early and timely identification of the epidemic risk of infectious diseases. To achieve this, a new comprehensive big data fusion assessment method must be developed.Methods: With the help of the Functional Resonance Analysis Method (FRAM) model, this paper proposes a risk portrait for the whole process of a pandemic spreading. Using medical, human behaviour, internet and geo-meteorological data, a hierarchical multi-source dataset was developed with three function module tags, ie, Basic Risk Factors (BRF), the Spread of Epidemic Threats (SET) and Risk Influencing Factors (RIF).Results: Using the dynamic functional network diagram of the risk assessment functional module, the FRAM portrait was applied to pandemic case analysis in Wuhan in 2020. This new-format FRAM portrait model offers a potential early and rapid risk assessment method that could be applied in future acute public health events.Keywords: epidemic risk, FRAM, model, big data portrait

Fei-Yi Zhao,1,2,&ast; Gerard A Kennedy,3– 5,&ast; Julia Gilbert,3,&ast; Russell Conduit,4,&ast; Peijie Xu,6 Li-Ping Yue,1 Wen-Jing Zhang,2 Yan-Mei Wang,2 Yuen-Shan Ho,7 Qiang-Qiang Fu,8 Zhen Zheng4 1Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, 201209, People’s Republic of China; 2Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, People’s Republic of China; 3Institute of Health and Wellbeing, Federation University, Mount Helen, VIC, 3353, Australia; 4School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia; 5Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, 3084, Australia; 6School of Computing Technologies, RMIT University, Melbourne, VIC, 3000, Australia; 7School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, People’s Republic of China; 8Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yuen-Shan Ho, School of Nursing, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, People’s Republic of China, Tel +852 2766-6410, Fax +852 2364-9663, Email janice.ys.ho@polyu.edu.hk Qiang-Qiang Fu, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, People’s Republic of China, Tel + 86 021-6569 0520, Fax + 86 021-6569 6249, Email qiangqiang.fu@tongji.edu.cnBackground: Growing demand exists for high-quality Traditional Chinese Medicine (TCM) care, particularly through Nurse-led TCM clinics (TCM-NLCs). Nurses with extensive experience in TCM departments represent a potential workforce for this healthcare model. This qualitative study aims to investigate the willingness of these candidates to engage in TCM-NLCs, with a specific fo

Xiaoling Zhou,1,2 Jing Wu,3 Ying Liu,3 Yuzhong Yan,2 Geyao Zhou,1 Ming Li1,4 1School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, People’s Republic of China; 2Research Department, Shanghai University of Medicine&Health Sciences Affiliated Zhoupu Hospital, Shanghai, People’s Republic of China; 3School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China; 4Party Committee office, Tongji University Affiliated Shanghai East Hospital, Shanghai, People’s Republic of ChinaCorrespondence: Ming Li; Geyao Zhou, Email liming1070202306@163.com; zhougeyao@163.comBackground: The health status of the occupational population is critical to the development of countries and regions as it is the main force of social and economic development. However, there is a dearth of comprehensive and systematic indicators to evaluate the health of occupational groups. This study aimed to construct a multi-dimensional evaluation index system for the general population.Methods: This study combined a literature review and initially established a multidimensional health system framework for the occupational population based on health ecology theory and then used two rounds of Delphi expert consultation to construct the final multidimensional health index system for the occupational population. Fifteen experts from related fields were selected for two rounds of Delphi expert consultation.Results: The recovery rates of the two rounds of expert questionnaires were 100.00% and 93.33% respectively, the expert authority coefficient were 0.90, and the Kendall’s coordination coefficients of the first and second level indexes were 0.32 and 0.42 (P ≥ 0. 001). The final index system includes four primary indicators (individual characteristics, health knowledge, health behavior, and health skills), 13 second-level indicators, and 41

Ting Yang,1,2 Yanan Du,1 Mingzhen Sun,1 Jingjing Meng,1 Yiyi Li1 1School of Health Services Management, Anhui Medical University, Hefei, Anhui, 230032, People’s Republic of China; 2Intelligent Interconnected Systems Laboratory of Anhui Province (Hefei University of Technology), Hefei, Anhui, 230009, People’s Republic of ChinaCorrespondence: Ting Yang, Email yangting@ahmu.edu.cnAbstract: Over the past decade, the global outbreaks of SARS, influenza A (H1N1), COVID-19, and other major infectious diseases have exposed the insufficient capacity for emergency disposal of medical waste in numerous countries and regions. Particularly during epidemics of major infectious diseases, medical waste exhibits new characteristics such as accelerated growth rate, heightened risk level, and more stringent disposal requirements. Consequently, there is an urgent need for advanced theoretical approaches that can perceive, predict, evaluate, and control risks associated with safe disposal throughout the entire process in a timely, accurate, efficient, and comprehensive manner. This article provides a systematic review of relevant research on collection, storage, transportation, and disposal of medical waste throughout its entirety to illustrate the current state of safe disposal practices. Building upon this foundation and leveraging emerging information technologies like Internet of Things (IoT), cloud computing, big data analytics, and artificial intelligence (AI), we deeply contemplate future research directions with an aim to minimize risks across all stages of medical waste disposal while offering valuable references and decision support to further advance safe disposal practices.Keywords: medical waste, safe disposal, major infectious diseases, progress and challenges

Marta Mellides González,1 Marta Elena Losa Iglesias,2 Inmaculada Corral-Liria,2 Ricardo Becerro-de-Bengoa-Vallejo,3 Eva Maria Martinez-Jimenez,3 Sandra Fares-Medina,2 Sara González-Martín,2 Marta San-Antolín,4 Raquel Jiménez-Fernández2 1Hospital Universitario 12 de Octubre, Usera, Madrid, 28041, Spain; 2Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922, Spain; 3Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid, Madrid, 28040, Spain; 4Department of Psychology, Universidad de Valladolid, Valladolid, 47002, SpainCorrespondence: Inmaculada Corral-Liria, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcon, 28922, Spain, Email inmaculada.corral.liria@urjc.esObjective: To evaluate the moral distress (MD)in health professionals of pediatric and adult units to show how the complexity of care in the pediatric field causes the professionals who carry out their activity in these units to present a higher level of moral distress and a worse climate ethical.Design: Observational study with health professionals who currently work in Spanish Hospitals.Methods: A 58-item questionnaire was electronically distributed which included sociodemographic and employment characteristics, the Spanish version of the Measure of Moral Unrest for Healthcare Professionals (MMD-HP-SPA) and the Hospital Ethical Climate Survey (HECS).Results: A total of 169 health professionals completed the questionnaire. The moral distress was significantly higher among nurses than among physicians and nursing assistant care technicians. Focusing on the type of unit, moral distress it was only significantly higher for those physicians treating adult patients compared to those treating pediatric patients. Regarding the total score of the HECS survey, the medical group shows higher scores compared to the nursing group.Conclusion: Statistically significant differences have been found only in the medical group that treats adult patients, pres