关键词： Healthcare Financings   Informal care   Patient Preferences   COVID-19   Machine learning   CONTINGENT VALUATION   HEALTH-CARE   PREFERENCES   COST   CAREGIVERS  

摘要： BackgroundInformal care plays an essential role in managing the COVID-19 pandemic. Expanding health insurance packages that reimburse caregivers' services through cost-sharing policies could increase financial resources. Predicting payers' willingness to contribute financially accurately is essential for implementing such a policy. This study aimed to identify the key variables related to WTP/WTA of COVID-19 patients for informal care in Sanandaj city, *** cross-sectional study involved 425 COVID-19 patients in Sanandaj city, Iran, and 23 potential risk factors. We compared the performance of three classifiers based on total accuracy, specificity, sensitivity, negative likelihood ratio, and positive likelihood *** showed that the average total accuracy of all models was over 70%. Random trees had the most incredible total accuracy for both patient WTA and patient WTP(0.95 and 0.92). Also, the most significant specificity (0.93 and 0.94), sensitivity (0.91 and 0.87), and the lowest negative likelihood ratio (0.193 and 0.19) belonged to this model. According to the random tree model, the most critical factor in patient WTA were patient difficulty in personal activities, dependency on the caregiver, number of caregivers, patient employment, and education, caregiver employment and patient hospitalization history. Also, for WTP were history of COVID-19 death of patient's relatives, and patient employment *** of a more flexible work schedule, encouraging employer to support employee to provide informal care, implementing educational programs to increase patients' efficacy, and providing accurate information could lead to increased patients' willingness to contribute and finally promote health outcomes in the population.

关键词： digital media use   negative emotions   family members-strangers trust gap   family members-acquaintances trust gap   mediation effect   COVID-19   SOCIAL MEDIA   RISK PERCEPTION   NEWS   KNOWLEDGE   HEALTH   GRATIFICATIONS   EXPOSURE   STUDENTS   ROLES  

摘要： Background: Retrospecting the trust gaps and their dynamics during the pandemic is crucial for understanding the root causes of postpandemic challenges and offers valuable insights into preparing for future public health emergencies. The COVID-19 pandemic eroded people's trust in strangers and acquaintances, while their trust in family members remained relatively stable. This resulted in 2 trust gaps, namely, the family members-strangers trust gap and the family members-acquaintances trust gap. Widening trust gaps impede social integration and undermine the effective management of public health crises. However, little is known about how digital media use shaped trust gaps during a pandemic. Objective: This study aims to investigate the relationships between digital media use, negative emotions, the family members-strangers trust gap, and the family members-acquaintances trust gap during the COVID-19 pandemic in China. We test the mediating role of negative emotions between digital media use and 2 trust gaps and compare the indirect effect of digital media use on 2 trust gaps through negative emotions. Methods: A cross-sectional web-based survey was conducted in China between January 31, 2020, and February 9, 2020. A total of 1568 adults participated in the survey. Questions related to digital media use, negative emotions, trust in family members, trust in acquaintances, and trust in strangers during the pandemic were asked. Regression analyses were performed to test the associations between the examined variables. We used a 95% bootstrap CI approach to estimate the mediation effects. Results: Digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), which in turn were positively associated with the family members-strangers trust gap (B=0.15, SE 0.03; P<.001). Likewise, digital media use was positively associated with negative emotions (B=0.17, SE 0.03; P<.001), while negative emotions were positively associated with the family mem

关键词： ventilation/perfusion mismatch   mechanical ventilation   obesity   acute respiratory failure   COVID-19   dual-energy computed tomography   DUAL-ENERGY CT   INTRAOPERATIVE ARTERIAL OXYGENATION   REGIONAL-DISTRIBUTION   COMPUTED-TOMOGRAPHY   EXTREMELY OBESE   LUNG   VENTILATION   ANESTHESIA   PERFUSION   VOLUME  

摘要： Background: The effects of obesity on pulmonary gas and blood distribution in patients with acute respiratory failure remain unknown. Dual-energy computed tomography (DECT) is a X-ray-based method used to study regional distribution of gas and blood within the lung. We hypothesized that 1) regional gas/blood mismatch can be quantified by DECT; 2) obesity influences the global and regional distribution of pulmonary gas and blood; 3) regardless of ventilation modality (invasive vs. non-invasive ventilation), patients' body mass index (BMI) has an impact on pulmonary gas/blood mismatch. Methods: This single-centre prospective observational study enrolled 118 hypoxic COVID-19 patients (92 male) in need of respiratory support and intensive care who underwent DECT. The cohort was divided into three groups according to BMI: 1. BMI<25 kg/m(2) (non-obese), 2. BMI = 25-40 kg/m(2) (overweight to obese), and 3. BMI>40 kg/m(2) (morbidly obese). Gravitational analysis of Hounsfield unit distribution of gas and blood was derived from DECT and used to calculate regional gas/blood mismatch. A sensitivity analysis was performed to investigate the influence of the chosen ventilatory modality and BMI on gas/blood mismatch and adjust for other possible confounders (i.e., age and sex). Results: 1) Regional pulmonary distribution of gas and blood and their mismatch were quantified using DECT imaging. 2) The BMI>40 kg/m(2) group had less hyperinflation in the non-dependent regions and more lung collapse in the dependent regions compared to the other BMI groups. In morbidly obese patients, gas and blood were more evenly distributed; therefore, the mismatch was lower than in other patients (30% vs. 36%, p < 0.05). 3) An increase in BMI of 5 kg/m(2) was associated with a decrease in mismatch of 3.3% (CI: 3.67% to -2.93%, p < 0.05). Neither the ventilatory modality nor age and sex affected the gas/blood mismatch (p > 0.05). Conclusion: 1) In a hypoxic COVID-19 population needing intensive care

关键词： RESPIRATORY-FAILURE   NASAL CANNULA  

摘要： Optimal timing for intubating patients with coronavirus disease 2019 (COVID-19) has been debated throughout the pandemic. Early use of high-flow nasal cannula (HFNC) can help reduce the need for intubation, but delay can result in poorer outcomes. This study examines trends in laboratory parameters and serum severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA levels of patients with COVID-19 in relation to HFNC failure. Patients requiring HFNC within three days of hospitalization between July 1 and September 30, 2021 were enrolled. The primary outcome was HFNC failure (early failure <= Day 3; late failure >= Day 4), defined as transfer to intensive care just before/after intubation or in-hospital death. We examined changes in laboratory markers and SARS-CoV2-RNAemia on Days 1, 4, and 7, together with demographic data, oxygenation status, and therapeutic agents. We conducted a univariate logistic regression with the explanatory variables defined as 10% change rate in each laboratory marker from Day 1 to 4. We utilized the log-rank test to assess the differences in HFNC failure rates, stratified based on the presence of SARS-CoV2 RNAemia. Among 122 patients, 17 (13.9%) experienced HFNC failure (early: n = 6, late: n = 11). Seventy-five patients (61.5%) showed an initial SpO(2)/FiO(2) ratio <= 243, equivalent to PaO2/FiO(2) ratio <= 200, and the initial SpO(2)/FiO(2) ratio was significantly lower in the failure group (184 vs. 218, p = 0.018). Among the laboratory markers, a 10% increase from Day 1 to 4 of lactate dehydrogenase (LDH) and interleukin (IL)-6 was associated with late failure (Odds ratio [OR]: 1.42, 95% confidence interval [CI]: 1.09-1.89 and OR: 1.04, 95%CI: 1.00-1.19, respectively). Furthermore, in patients with persistent RNAemia on Day 4 or 7, the risk of late HFNC failure was significantly higher (Log-rank test, p<0.01). In conclusion, upward trends in LDH and IL-6 levels and the persistent RNAemia even after treatment were associated with

关键词： Audit evidence quality   COVID-19   Big and non-Big Four   Academics   Professionals   MENA region   NON-BIG 4   EMPIRICAL-EVIDENCE   PERCEPTIONS   GOVERNANCE   PRESSURE  

摘要： PurposeThis study assesses the perception of academics and practitioners of ramifications that may have impacted audit evidence quality during COVID-19 in ***/methodology/approachA questionnaire was collected and designed regarding the factors affecting the quality of audit evidence during the COVID-19 pandemic using a five-point Likert scale, and detailed descriptive statistics and regression analyses were *** study finds that there is no significant association between social distancing (SD), changing in the economic environment (CEE), time constraint (TC) and stress on audit personnel (SAP) as repercussions of the COVID-19 pandemic with the quality of audit evidence (QAE). The disruption in operational results (DOR), changes in the internal control (CIC) and the stress on client personnel (SCP) significantly affect the quality of audit evidence. Moreover, there is a significant difference between Big and non-Big Four audit firms in terms of changes in economic conditions, internal controls, disruption of operational results and time-constraint variables. The latter has significantly affected the audit evidence quality for both academics and *** implicationsDue to the implementation of SD and work-from-home policies, audit firms are highly recommended to invest more in digital programs and to be more adaptable to work-from-home, which policy and enhances the effectiveness and flexibility of communication between auditors and their ***/valueThis paper is one of the foremost papers that provides empirical evidence for the antecedents or variables that may affect audit quality evidence due to the COVID-19 pandemic.

关键词： COVID-19 vaccination   solid organ transplant recipient   vaccine immunogenicity   lung transplant recipients   liver transplant recipients   humoral response   cell mediated response  

摘要： This study assessed humoral and T cell-mediated immune responses to the BNT162b2 vaccine in orthotopic liver transplant (OLT) and lung transplant (LUT) recipients who received three doses of the vaccine from March 2021 at our institution. Serum samples were collected 60 days post-second and third dose to quantify antibodies against the spike region of SARS-CoV-2 while whole blood samples were collected to analyze the SARS-CoV-2-specific T-cell response using an IFN-gamma ELISpot assay. We enrolled 244 OLT and 120 LUT recipients. The third dose increased antibody titres in OLT recipients (from a median value of 131 after the second dose to 5523 IU/mL, p < 0.001) and LUT recipients (from 14.8 to 1729 IU/mL, p < 0.001). T-cell response also increased in OLT recipients (from 8.5 to 23 IFN-gamma SFU per 250,000 PBMC, p < 0.001) and LUT recipients (from 8 to 15 IFN-gamma SFU per 250,000 PBMC, p < 0.001). A total of 128 breakthrough infections were observed: two (0.8%) OLT recipients were hospitalized due to COVID-19 and one died (0.4%); among LUT recipients, seven were hospitalized (5.8%) and two patients died (1.7%). In conclusion, the three-dose schedule of the BNT162b2 vaccine elicited both humoral and T cell-mediated responses in solid organ transplant recipients. The risk of severe COVID-19 post-vaccination was low in this population.

关键词： NOX EMISSIONS   AIR-QUALITY   FORMALDEHYDE RETRIEVALS   ANTHROPOGENIC EMISSIONS   S5P TROPOMI   GEOS-CHEM   OZONE   CHEMISTRY   SENSITIVITY   PRECURSOR  

摘要： Due to the lockdown during the COVID-19 pandemic in China from late January to early April in 2020, a significant reduction in primary air pollutants, as compared to the same time period in 2019, has been identified by satellite and ground observations. However, this reduction is in contrast with the increase of surface ozone (O-3) concentration in many parts of China during the same period from 2019 to 2020. The reasons for this contrast are studied here from two perspectives: emission changes and inter-annual meteorological variations. Based on top-down constraints of nitrogen oxide (NOx) emissions from TROPOMI measurements and GEOS-Chem model simulations, our analysis reveals that NOx and volatile organic compound (VOC) emission reductions as well as meteorological variations lead to 8 %, -3 % and 1 % changes in O-3 over North China, respectively. In South China, however, we find that meteorological variations cause similar to 30 % increases in O-3, which is much larger than -1 % and 2 % changes due to VOC and NOx emission reductions, respectively, and the overall O-3 increase in the simulations is consistent with the surface observations. The higher temperature associated with the increase in solar radiation and the decreased relative humidity are the main reasons that led to the surface O-3 increase in South China. Collectively, inter-annual meteorological variations had a larger impact than emission reductions on the aggravated surface O-3 pollution in China during the lockdown period of the COVID-19 pandemic.