The severe state of health of patients with coronavirus disease 2019 (COVID-19) has increased the risk of arduous and hazardous work conditions for nurses. The aim of this study is to identify the conditions of nurses' work during the care of patients with COVID-19 during the state of epidemic threat.

The COVID-19 pandemic has significantly impacted the healthcare system, especially that of frontline nurses. This study aimed to assess the work conditions and psychological stress experienced by nurses during the pandemic. This study included 116 nurses who provided care to patients with COVID-19 in hospital wards. A random sampling method was employed to select participants from among those working in the shift system. A diagnostic survey method was used to collect data, with a focus on work conditions, stress exposure, and the provision of personal protective equipment (PPE). Data analysis was performed using SPSS v.29 (Statistical Package for the Social Sciences, Version 29), and chi-squared and Fisher's exact tests were applied.

Of the total nurses, 69.0% reported that they were 'sometimes' provided with personal protective equipment. According to 60.3% of participants, nurse staffing was provided in accordance with regulations 'sometimes.' A total of 64.7% of the participants experienced stress: concern about infection with SARS-CoV-2, severe health status of patients, patient death, and shortage of equipment. The main complaints related to stress were difficulty concentrating, sleep problems, and headaches; 69.8% of the participants were exposed to hazardous factors at work, and 69.0% experienced arduous factors. Shortages of medical equipment were reported, mainly because of the lack of respirators, cardiac monitors, and inhalators.

Nurses employed in hospital wards during the care of patients with COVID-19 worked under difficult conditions. Sometimes, they were provided with personal protective equipment, and sometimes, nurse staffing was provided in accordance with regulations. There was significant exposure to stress, hazardous and arduous factors, and shortages of medical equipment.

Chronic obstructive pulmonary disease (COPD) is a highly prevalent and progressive disease, hence greater understanding of its humanistic, economic, and environmental impact is essential for guiding effective management strategies. A systematic literature review (SLR; 2021-2023), complemented with a targeted literature review (TLR; 2013-2023) identified 2039 publications on the economic and humanistic burden of severe COPD. Additionally, an SLR and complementary TLR to evaluate the impact of environmental and sociodemographic factors on COPD (2013-2023), identified 1018 records. All searches were conducted on November 17, 2023. After applying prespecified selection criteria, 50 studies reporting on the humanistic and economic impact of COPD, and six studies on the environmental and sociodemographic impact, were selected. Severe COPD significantly impairs health-related quality of life, exerting effects on physical and psychological well-being, with a progressive decline as COPD worsens from mild to very severe. Evidence indicates that there is a significant burden of disease due to exacerbations of COPD, with their frequency and severity increasing with disease progression, and an increased mortality risk associated with very severe versus severe COPD. The studies reported a high frequency of healthcare resource utilization, including primary care visits, emergency department visits, and hospitalizations among patients with severe COPD, all of which contribute to a significant economic burden, particularly in patients with advanced disease. Environmental factors demonstrated diverse impacts on outcomes for individuals with severe COPD, varying by type of pollutant, disease severity, and patient characteristics. Studies examining the sociodemographic impact of underserved populations on the burden of severe COPD were not identified. Severe COPD is a multifaceted disease that imposes considerable humanistic and economic impact on both patients and healthcare systems. Further work is needed to understand the impact of environmental and sociodemographic factors on the burden of COPD, with such insights ultimately optimizing patient care.

The COVID-19 pandemic, which emerged in late December 2019, has significantly altered the dietary and oral health-related habits and lifestyles of nearly every age group within the global population.

The purpose of this research is to explore the impact of the COVID-19 pandemic on dietary behaviors, daily oral hygiene practices and caries risk among children, adolescents, and young adults from diverse regions within Saudi Arabia.

A cross-sectional analytical study spanning multiple regions of Saudi Arabia was carried out to assess the effects of COVID-19 on dietary habits, oral hygiene practices, and caries risk across various age groups within the Saudi population. A total of 655 participants were included in the study after providing informed consent. Data collection was performed using a questionnaire divided into four sections: personal and demographic information, socioeconomic information, oral hygiene practices, and dietary habits, both prior to and during the COVID-19 lockdown.

There was a notable increase in the caries experience rate, which escalated from 26.1% before the onset of the COVID-19 pandemic to 45.0% during the pandemic (P < 0.001). The findings suggest a significant shift in the dietary practices of children and adolescents when comparing the two timeframes. Specifically, there was a marked rise in meal frequency (P < 0.001), snacking patterns (P < 0.001), and the consumption of sugary products like candies, chocolates, milk, and coffee (P < 0.001) during the pandemic. Furthermore, the percentage of children and adolescents brushing their teeth three times a day plummeted from 47.8% before the pandemic to a mere 4.3% during it (P < 0.001). The proportion of individuals using fluoride toothpaste also experienced a decline, falling from 15.9% before the pandemic to 5.2% during this crisis (P < 0.001).

The study illustrates that the COVID-19 pandemic has substantially changed the dynamics of dental caries and oral health, resulting in an increased risk of caries and a worrying decline in daily oral hygiene practices. Additionally, there has been a significant drop in the application of topical fluoride via toothpaste. These findings point to the critical importance of personalized dental care during public health crises to alleviate negative effects and ensure the maintenance of oral health.

The COVID-19 pandemic limited in-person recruitment opportunities for many training programs at academic medical centers. This study aimed to determine the prevalence of social media use among Primary Care Sports Medicine (PCSM) fellowship programs and to investigate the impact of social media on recruitment. Additionally, potential barriers to social media interaction between programs and applicants were examined.

A cross-sectional study was conducted using publicly available online sources to identify PCSM fellowship programs and corresponding social media accounts. PCSM Fellowship directors were surveyed regarding their program's use of social media. Prospective PCSM Fellowship Applicants and current fellows were surveyed to determine their interaction with PCSM fellowship social media accounts and how social media influenced their perception of the programs.

A total of 211 PCSM fellowship programs were identified on the American Medical Society for Sports Medicine (AMSSM) website, of which 83% had a social media presence. The most commonly used platforms were Instagram (43%), Facebook (30%) and Twitter (24%). Fifty-eight individuals who were either current fellows, recently graduated fellows, or current fellowship applicants responded to our survey. Among the surveyed fellows and applicants, 95% reported using social media, with 35% reported following PCSM accounts. Of those who did not follow (N = 38, 65%), the most common reason was lack of awareness of these accounts. Twenty-two percent of respondents indicated that social media positively influenced their perception of a program and its rank list position, while the remainder reported a neutral effect. Forty-seven percent of the fellowship directors reported their program did not have official guidelines for appropriate social media use. Lack of time, resources, and oversight were identified as the most common barriers to social media use.

A majority of PCSM fellowship programs, fellows, and applicants are present on social media. Social media presence can positively impact an applicant's view of a program. However, applicants' lack of awareness of these accounts may serve as a barrier for interaction. The development of universal guidelines for appropriate social media use may help increase adoption and utilization of social media platforms for PCSM fellowship recruitment, particularly during times when in-person recruitment opportunities are limited.

This study aimed to assess the knowledge, attitudes, and practices (KAP) of patients with chronic obstructive pulmonary disease (COPD) regarding inhalation devices. A cross-sectional survey was conducted at Chongqing Hospital of Traditional Chinese Medicine from January to April 2024 among patients with COPD who had been using inhaled medications for at least one month, using a structured questionnaire. Inhaler adherence was evaluated with the Test of Adherence to Inhalers (TAI). A total of 518 COPD patients were enrolled. The average scores for knowledge, attitude, practice, and TAI were 22.82 ± 3.24, 51.79 ± 6.61, 33.08 ± 5.58, and 35.12 ± 11.01, respectively. Correlation analysis demonstrated significant positive relationships between knowledge and attitude (r = 0.490), knowledge and practice (r = 0.368), and knowledge and TAI scores (r = 0.118). Additionally, significant correlations were noted between attitude and practice (r = 0.602) and attitude and TAI scores (r = 0.310). The analysis showed that knowledge directly influenced both attitude and practice and indirectly affected practice through attitude. This study revealed that although COPD patients had adequate knowledge and positive attitude towards inhaler use, their adherence was poor. Tailored educational interventions are recommended to improve adherence to inhalation therapy.

Public crisis has a profound impact on mental health, particularly among young children, since that they are often encountered with disrupted routine, restricted movement, school closure, caregiver illness or distress, greater likelihood of aversive or neglecting parenting etc. However, the mental distress of young children aged below 12 years-old has been less attended. Based on the Risk Factor Model, this study aims to observe the levels and predictors of posttraumatic stress symptoms (PTSS) in children aged 3-12 years at the hardest-hit area of China during the early stage of the Coronavirus Disease 2019 (COVID-19) outbreak.

Chinese children who aged 3-12 years at Hubei province (the hardest-hit area, n = 1444) and other areas (n = 262) were surveyed through an online questionnaire from February 24 to March 21, 2020, with hyper-arousal and avoidance sub-scales of Posttraumatic Stress Disorder Check list-Civilian Version. For children who could not read Chinese or could not fully understand the questions (mainly third grade in primary school or lower grade), parents were encouraged to assist to fill in the answers based on their observations, explanation and inquiry.

The rate of avoidance and hyper-arousal symptoms among the surveyed children was 5.51% and 6.10% respectively. Chi-square tests showed that children from the hardest-hit area and other areas reported equivalent levels of avoidance (5.75% V.S. 4.20%, 858.98 V.S. 823.27, p > 0.05) and hyper-arousal symptoms (5.89% V.S. 7.25%, 847.41 V.S. 887.06, p > 0.05). Children reported less avoidance and hyper-arousal symptoms, in sub-population who aged 3-6 years-old, not experiencing negative life-events, not perceiving negative emotions, with unchanged caring from parents, while centralized isolation group reported the highest scores on the hyper-arousal symptom. Hierarchical linear regression analysis revealed that older age, having been quarantined at home, having perceived negative emotions, and having experienced negative life-events, were predictors of both avoidance and hyper-arousal symptoms, while death of family member due to infection, and unchanged or more help from parents were negative predictors of avoidance symptom, and unchanged help and gentleness, more gentleness and respecting from parents were protective predictors of hyper-arousal symptom. Notably, having heard horrible news about the pandemic was the strongest prediction for both symptoms.

The results are among the first to reveal the levels of PTSS in young children aged 3-12 years under crisis. The rate of avoidant and hyper-arousal symptoms in children is 5.51% and 6.10% respectively, which is equivalent in children at hardest-hit and other area, and lower than that of pre-COVID disasters such as earthquakes (13.1%), but higher than those reported in college students during COVID-19 (2.7%). Due to omission of intrusion-symptom observation, the findings may indicate partial symptoms and result in lower PTSS rate. Risk and protective predictors of PTSS help to recognize high-risk sub-populations and prevent PTSS in young children under crisis.

Studies have shown that autophagy was closely involved in host defense against mycobacteria, and genetic variations in autophagy genes were related to susceptibility to multiple diseases. We conducted this observational study to analyze the role of autophagy related genes polymorphisms and promoter methylation in the pathogenesis of pulmonary tuberculosis (PTB).

Ten single nucleotide polymorphisms (SNPs) in four autophagy related genes (ATG16L1, ATG5, IRGM, ULK1) were genotyped in 496 PTB patients and 498 controls using SNPscan technique, and the methylation levels of these genes were detected by MethylTarget technique in 98 PTB patients and 97 controls.

We found that ATG16L1 gene rs2241880 GG genotype frequency was significantly increased in PTB patients than that in controls. While, no significant association was found between PTB risk and ATG16L1 rs6754677, ATG5 rs2245214, rs510432, IRGM rs1000113, rs10065172, rs12658239, ULK1 rs7138581, rs9481, rs12297124. Haplotype analysis showed that ATG16L1 GA haplotype was associated with the increased risk to PTB, and ATG5 CC haplotype was related to the decreased risk to PTB. Stratification analysis demonstrated that ATG16L1 rs6754677, IRGM rs1000113, rs10065172 polymorphism were associated with pulmonary infection, and ULK1 rs7138581 polymorphism was related to fever, drug-induced liver injury in PTB patients. Compared with controls, ATG16L1 methylation level was significantly decreased in PTB, while ATG5, IRGM methylation levels were not significantly changed. Rs1000113, rs10065172, rs12658239 variants in IRGM had a major impact on IRGM methylation level in PTB patients.

ATG16L1, ATG5 genes variation and ATG16L1 gene methylation level were associated with the genetic background of PTB, while IRGM, ULK1 genes variations showed no significant association with PTB.

The specific role of lysophospholipids (LysoPLs) in the pathogenesis of chronic obstructive pulmonary disease (COPD) is not yet fully understood. We determined serum LysoPLs in 20 patients with stable COPD and 20 healthy smokers using liquid chromatography-mass spectrometry (LC-MS) and matching with the lipidIMMS library, and integrated these data with spirometry, systemic inflammation markers, and quantitative chest CT generated by an automated 3D-U-Net artificial intelligence algorithm model. Our findings identified three differential LysoPLs, lysophosphatidylcholine (LPC) (18:0), LPC (18:1), and LPC (18:2), which were significantly lower in the COPD group than in healthy smokers. Significant negative correlations were observed between these LPCs and the inflammatory markers C-reactive protein and Interleukin-6. LPC (18:0) and (18:2) correlated with higher post-bronchodilator FEV1, and the latter also correlated with FEV1% predicted, forced vital capacity (FVC), and FEV1/FVC ratio. Additionally, these three LPCs were negatively correlated with the volume and percentage of low attenuation areas (LAA), high-attenuation areas (HAA), honeycombing, reticular patterns, ground-glass opacities (GGO), and consolidation on CT imaging. In the patients with COPD, the three LPCs were most significantly associated with HAA and GGO. In conclusion, patients with stable COPD exhibited a unique LysoPL metabolism profile, with LPC (18:0), LPC (18:1), and LPC (18:2) being the most significantly altered lipid molecules. The reduction in these three LPCs was associated with impaired pulmonary function and were also linked to a greater extent of emphysema and interstitial lung abnormalities.

This study aims to analyze the correlation between post-traumatic stress levels and positive/negative emotion among the public during public health emergency, and examine the mediating effect of sleep quality. Our survey relies on an online research platform using the Post-traumatic stress disorder Checklist for DSM-5 (PCL-C), Positive and Negative emotion Schedule (PANAS), and Pittsburgh Sleep Quality Index (PSQI), which was conducted among individuals in Guangdong and other regions to assess post-traumatic stress levels, emotional status, and sleep conditions. A total of 729 participants were included in the study. The detection rates for Post-traumatic stress disorder (PTSD) and sleep disorders were 6.84% and 8.78%, respectively. There are significant differences in positive and negative emotion scores across different age groups and residential areas (P < 0.05). Mediation analysis indicated that sleep quality partially mediates the effects of post-traumatic stress on both positive and negative emotions, with a greater impact on positive emotion than on negative emotion. Relevant departments can enhance positive emotion, reduce negative emotion, and decrease the incidence of PTSD by improving sleep quality.

Autoimmune encephalitis (AE) has been described as a severe neurological complication of coronavirus disease 2019 (COVID-19). Following the adjustment of COVID-19 prevention strategies on December 7, 2022, the virus spread rapidly and extensively across China. This study aimed to explore the changing characteristics of AE pre- and post- COVID-19 epidemic in Guangxi, China. A total of 169 patients who were first diagnosed with AE and admitted to the First Affiliated Hospital of Guangxi Medical University from November 1, 2021 to December 31, 2023 were enrolled in this case-control study. Patients with the onset of AE before or after December 7, 2022, were respectively classified into the pre- and post- COVID-19 epidemic groups. There were 78 AE patients in the pre-COVID-19 epidemic group and 91 patients in the post-COVID-19 epidemic group. Compared to the AE patients pre-COVID-19 epidemic group, AE patients in the post-COVID-19 group had higher rates of abnormal movements (p = 0.013), autonomic dysfunction (p = 0.003), higher CASE scores (p = 0.041), and higher probabilities of complications such as pneumonia (p = 0.025) and other autoimmune diseases (p = 0.014). A higher proportion of AE patients in the post-COVID-19 pandemic period received rituximab treatment compared to those in the pre-COVID-19 (16.48% vs. 6.41%, p = 0.043). Among the AE patients infected with COVID-19, those who has a relapse of AE also had a higher risk of complications with tumors, autoimmune diseases, cranial magnetic resonance imaging (MRI) abnormalities, and higher baseline modified Rankin Scale (mRS) (median [IQR]:4[4,5] vs. 3[2.75,4.25], p = 0.029). AE patients in the post-COVID-19 epidemic group suffer from more severe clinical symptoms and higher rates of other immune diseases. Rituximab is commonly used in the post-COVID-19 epidemic period. Relapsed AE patients with COVID-19 had a higher risk of complications with tumors, autoimmune diseases, abnormal MRIs, and higher baseline mRS.