关键词： Braking   Wheel slip   Beta basis function   Neural network   Coronavirus optimization   PREDICTIVE CONTROL   NEURAL-NETWORKS   WHEEL SLIP   ALGORITHM  

摘要： Controlling wheel slip during braking in vehicle tires is a challenging task due to the complex behavior and highly nonlinear dynamics involved. Uncertainties arising from parameter variations and un-modeled dynamics further complicate the control process, along with actuator saturation. This article introduces a novel approach for controlling vehicle antilock braking systems (VABSs) using a robust adaptive (RA) beta basis function (BBF) neural network (NN) framework. The BBF-NN is capable of approximating complex functions and is employed as both an online approximator for unknown nonlinear functions and an actuator saturation compensator. This framework addresses the challenges posed by undefined models, nonlinearity, and uncertainties associated with VABS. The BBF-NN is trained online and its stability is verified using the Lyapunov theory. The performance of the BBF-NN is greatly influenced by its parameter tuning. To address this, the Coronavirus disease optimization algorithm (COVIDOA) is employed to determine the constant parameters of the RA-BBF-NN. The optimization results demonstrate that COVIDOA outperforms other optimization algorithms. The hybrid RA-BBF-NN framework, optimized by COVIDOA, exhibits superior performance compared to alternative methods, as confirmed by the results.

关键词： COVID-19 pandemic   hypertensive disorders of pregnancy   maternal morbidity   telemedicine  

摘要： Objective Hypertensive disorders of pregnancy (HDP) are common complications associated with severe maternal and neonatal morbidity. One goal of prenatal care, especially at term, is to screen for HDP. As treatment of HDP centers on delivery when appropriate, timely diagnosis is crucial. We postulated that reduced in-person visits during the coronavirus disease 2019 (COVID-19) pandemic may have resulted in delayed diagnosis of HDP with concomitant higher rates of maternal morbidity. We sought to investigate the prevalence of HDP during the COVID-19 pandemic, as well as median gestational age at time of delivery as compared with the prepandemic median. Study DesignThis was a retrospective cohort analysis comparing singleton deliveries at four large-volume hospitals during the COVID-19 pandemic (April-July 2020 during a statewide "stay-at-home" order) to those in a pre-COVID era (April-July 2019). Deliveries complicated by HDP were identified by International Classification of Disease, Tenth Revision codes. Rates of HDP and markers of severe disease were the primary outcomes compared between the groups; multivariate regression was used to calculate the odds ratio of severe disease among women with any diagnosis of HDP. ResultsThe cohort included 9,974 deliveries: 5,011 in 2020 and 4,963 in 2019. Patient characteristics (age, body mass index, race, ethnicity, and insurance type) did not differ significantly between the groups. There was an increase in HDP during the COVID era (9.0 vs. 6.9%; p < 0.01), which was significant even when controlling for patient parity (odds ratio 1.41, 95% CI 1.20-1.66). Among women with HDP, gestational age at delivery did not differ between the cohorts, nor did the proportion of patients with severe disease. ConclusionWe found a statistically significant increase in the rate of HDP during the COVID-19 pandemic. However, there was no change in the proportion of severe disease, suggesting that this increase did not significantly impact clin

关键词： E-learning   Medical education   COVID-19   Syria   EDUCATION   BARRIERS   IMPACT  

摘要： BackgroundThe COVID-19 pandemic has had a significant impact on the education sector, leading to the closure of colleges and schools and disrupting the learning process for an uncertain duration. In response, electronic learning has emerged as a suitable method for continuing the educational process during the lockdown. This study aimed to assess the attitudes, practices, and barriers to e-learning among medical students at Syrian Private University. MethodsA cross-sectional survey study was conducted at the Faculty of Medicine of the Syrian Private University (SPU) in Damascus, Syria. The study used a convenience sampling approach and was carried out from June 2021 to January 2022. Data were collected using a self-administered questionnaire structured into two sections. The first section included 12 sociodemographic questions. The second section assessed students' attitudes, practices, and barriers related to e-learning, and consisted of 14 questions on attitudes, 11 questions on practices, and 9 questions on barriers. ResultsOf the 519 participating students, over half (55.1%) exhibited a negative attitude towards e-learning. However, more than 60% reported engaging in e-learning activities such as downloading educational content and participating in virtual study groups. The main barriers identified were unstable internet connections (92.7%) and challenges in communication with educators (82.7%). Bionomical logistic regression revealed that negative attitudes were predicted by housing status, academic year, health status, lack of engagement with colleagues in e-learning practices, and the reported barriers of difficulty adjusting learning style, lack of technical skills, poor communication with educators, limited access to devices, and limited space conducive for studying (P < 0.05). ConclusionWhile medical students at SPU were actively engaged in e-learning, over half held negative attitudes. These negative attitudes were associated with the various barriers tha

摘要： This cross-sectional study examines variation in masking policies at National Cancer Institute (NCI)-designated cancer centers during the winter 2023-2024 COVID-19 surge.

关键词： COVID-19   SARS-CoV-2   Pneumothorax   Complications   Mortality   Prevalence   National inpatient sample   CRITICALLY-ILL PATIENTS   CLINICAL CHARACTERISTICS   RISK   MANAGEMENT   OUTCOMES  

摘要： Background Spontaneous pneumothorax (PTX) is more prevalent among COVID-19 patients than other critically ill patients, but studies on this are limited. This study compared clinical characteristics and in-hospital outcomes among COVID-19 patients with concomitant PTX to provide insight into how PTX affects health care utilization and complications, which informs clinical decisions and healthcare resource allocation. Methods The 2020 Nationwide Inpatient Sample was used analyze patient demographics and outcomes, including age, race, sex, insurance status, median income, length of hospital stay, mortality rate, hospitalization costs, comorbidities, mechanical ventilation, and vasopressor support. Propensity score matching was employed for additional analysis. Results Among 1,572,815 COVID-19 patients, 1.41% had PTX. These patients incurred significantly higher hospitalization costs ($435,508 vs. $96,668, p < 0.001) and longer stays (23.6 days vs. 8.6 days, p < 0.001). In-hospital mortality was substantially elevated for PTX patients (65.8% vs. 14.4%, p < 0.001), with an adjusted odds ratio of 14.3 (95% CI 12.7-16.2). Additionally, these patients were more likely to require vasopressors (16.6% vs. 3.3%), mechanical circulatory support (3.5% vs. 0.3%), hemodialysis (16.6% vs. 5.6%), invasive mechanical ventilation (76.9% vs. 15.1%), non-invasive mechanical ventilation (19.1% vs. 5.8%), tracheostomy (13.3% vs. 1.1%), and chest tube placement (59.8% vs. 0.8%). Conclusions Our findings highlight the severe impact of PTX on COVID-19 patients, characterized by higher mortality, more complications, and increased resource utilization. Also, being Hispanic, male, or obese increased the risk of developing concomitant PTX with COVID-19.

关键词： Socio-economic status   COVID-19 pandemic   Older adults   Mental health   Intergenerational influences   HEALTH   TRAJECTORIES   MORTALITY   SURVIVAL   DEMENTIA  

摘要： BackgroundOlder adults' psychosocial outcomes during the COVID-19 pandemic have been inequitable by socio-economic status (SES). However, studies have focused solely on own SES, ignoring emerging evidence of the relationship between adult child SES and late-life health. We evaluated whether adult child educational attainment - a core marker of SES - is associated with older parents' psychosocial outcomes during the *** used data from the Survey of Health, Aging, and Retirement in Europe (SHARE) 2004-2018 and the SHARE Corona Surveys (SCS) 2020 and 2021. We included 40,392 respondents >= 65 years who had pre-pandemic information on adult child educational attainment and self-reported psychosocial outcomes during the pandemic, including self-assessments of worsened psychosocial outcomes compared to the pre-pandemic period. We used generalized estimating equations with a Poisson distribution and a log link, adjusted for respondent and family-level characteristics, including respondents' own educational *** adults whose adult children averaged levels of educational attainment at or above (vs. below) their country-specific mean had a lower prevalence of feeling nervous (Prevalence Ratio [PR]: 0.94, 95% Confidence Interval [CI]: 0.90, 0.97), sad or depressed (PR: 0.94, 95% CI: 0.91, 0.98), and having sleep problems (PR: 0.94, 95% CI: 0.90, 0.97) during the pandemic. Additionally, higher adult child educational attainment was associated with a lower risk of perceiving worsened feelings of nervousness (PR: 0.95, 95% CI: 0.90, 1.01) and worsened sleep problems (PR: 0.91, 95% CI: 0.82, 1.01) as compared to the pre-pandemic. In stratified models, protective associations were observed only in countries experiencing "high" levels of COVID-19 intensity at the time of the survey. All of these results are derived from adjusted *** child SES may have "upward" spillover effects on the psychosocial wellbeing of older parents durin

关键词： wearable technology   biosignals   digital health   SARS-CoV-2   vaccine reactogenicity   menstrual cycle   vaccine   wearables   sex   development   implementation   medical device   medical device   breathing rate   breathing rate   heart rate   heart rate   biological mechanism   biological mechanism   immune response   immune response   vaccination   vaccination   vaccination   HEART-RATE   VACCINES   VACCINATION   SARS-COV-2   OUTCOMES   IMPACT   RISK   SEX  

摘要： Background: Rapid development and implementation of vaccines constituted a crucial step in containing the COVID-19pandemic. A comprehensive understanding of physiological responses to these vaccines is important to build trust in medicine. Objective: This study aims to investigate temporal dynamics before and after COVID-19 vaccination in 4 physiological parameters as well as the duration of menstrual cycle phases. Methods: In a prospective trial, 17,825 adults in the Netherlands wore a medical device on their wrist for up to 9 months. The device recorded their physiological signals and synchronized with a complementary smartphone app. By means of multilevel quadratic regression, we examined changes in wearable-recorded breathing rate, wrist skin temperature, heart rate, heart rate variability, and objectively assessed the duration of menstrual cycle phases in menstruating participants to assess the effects of COVID-19 vaccination. Results: The recorded physiological signals demonstrated short-term increases in breathing rate and heart rate after COVID-19vaccination followed by a prompt rebound to baseline levels likely reflecting biological mechanisms accompanying the immune response to vaccination. No sex differences were evident in the measured physiological responses. In menstruating participants, we found a 0.8% decrease in the duration of the menstrual phase following vaccination. Conclusions: The observed short-term changes suggest that COVID-19 vaccines are not associated with long-term biophysicalissues. Taken together, our work provides valuable insights into continuous fluctuations of physiological responses to vaccinationand highlights the importance of digital solutions in health care.

关键词： Self-medication   Pharmacist   COVID-19   Older adults   Theory of planned behavior   Public health   COMPLEMENTARY MEDICINE   UNIVERSITY-STUDENTS   DIETARY-SUPPLEMENTS   GENERAL-POPULATION   PLANNED BEHAVIOR   PRESCRIPTION   PREVALENCE   ATTITUDE   ANTIBIOTICS   PREVENTION  

摘要： IntroductionSelf-medication was remarkably popular during the COVID-19 pandemic. In older populations, the risk of self-medication is higher. Pharmacists are well positioned to provide public health education and disease prevention. This study aims to explore the self-medication patterns and intention to seek pharmacist guidance among older adults in *** face-to-face cross-sectional survey was subsequently performed in March-April 2023 among older adults in Macao. The questionnaire was designed based on the Theory of Planned Behavior (TPB) framework. Multiple logistic regression was used to analyze predictors of self-medication behavior and multiple linear regression analysis to determine whether the TPB construct was the predictor of older adults' intention to seek guidance from *** total of 412 participants completed the questionnaire. The self-medication rate among older adults in Macao was 64.2%. The most commonly used types of medications were over-the-counter and traditional Chinese medicine, mainly from government anti-pandemic packages. The majority of individuals engaged in self-medication to treat COVID-19 symptoms or prevent COVID-19 infection. The prevalent reasons for self-medication were the perceived non-seriousness of the illness. 85 years old or older and university degree were significantly associated with self-medication behavior. Older adults had moderate intention to seek pharmacist guidance on medication use. The average scores (standard deviation) were 3.43 (1.10) for Attitude, 2.69 (0.99) for Subjective Norm, 3.56 (1.04) for Perceived Behavioral Control, and 3.07 (1.43) for Intention. Attitude, Subjective Norm, and Perceived Behavioral Control were all strong predictors of intention, which explained 53% of the variance in intention. In demographic factors, age was identified as a significant predictor of ***-medication was widely practiced in Macao during the COVID-19 pandemic. To better cont

关键词： COVID-19 pandemic   exercise adherence   positive mental character   subjective well-being   indirect effect   POSITIVE PSYCHOLOGY   MENTAL-HEALTH   BUILD THEORY   PERSONALITY   ANXIETY  

摘要： Introduction This study aims to investigate whether exercise adherence and positive mental character significantly affect subjective well-being among Chinese college students during the COVID-19 pandemic and whether positive mental character plays a mediating *** The study employed questionnaires, including the Exercise Adherence Scale, the Positive Mental Character Scale, and the Subjective Well-Being Scale, which were administered to students across seven universities in Henan Province, China. A total of 1,001 participants were analyzed in the final sample. Data were analyzed using SPSS 21.0 for descriptive statistics, independent samples T-test, correlation, and regression analyses. Furthermore, structural equation model with AMOS was conducted to examine the potential mediating effect of positive mental characteristics on the relationship between exercise adherence and subjective *** The results indicated significant differences in exercise adherence, positive mental character, and subjective well-being between male and female participants, with males scoring higher in all three domains. Among Chinese university students during the COVID-19 pandemic, there was a significant correlation among exercise adherence, positive mental character, and subjective well-being. Exercise adherence was found to have a significant and positive impact on both positive mental character and subjective well-being. Additionally, it was found that positive mental character had a significant positive association with subjective well-being. The mediating role of positive mental character in the relationship between exercise adherence and subjective well-being was partially *** Exercise adherence among Chinese college students had a significant positive association on both positive mental character and subjective well-being throughout the COVID-19 pandemic. The exercise adherence can directly or indirectly enhance subjective well-being through its