关键词： Coronavirus disease   Discrete wavelet transform   Min-max normalization   Honey badger optimization   Fire hawk optimization   Bi-directional long short-term memory   Capsule network   DEEP   DIAGNOSIS  

摘要： In recent years, coronavirus disease 2019 (COVID-19) has been identified as one of the most infectious diseases spread all over the world. These existing methods faced limitations like higher computational complexity, inappropriate feature learning, overfitting, etc., in COVID-19 disease diagnosis. Thus, the proposed study aims to design a novel hybrid deep learning network for classifying COVID-19 disease from the Chest X-ray images. Initially, the input samples are pre-processed to improve image contrast using Extended Contrast Limited Adaptive Histogram Equalization (ECLAHE) and min -max normalization for normalizing pixel values between 0 and 1. Then, to reduce the computational complexity issues, the most significant features are extracted by using an enhanced discrete wavelet transform method with Grey Level Run Length Matrix (GLRLM), and the feature dimensionality issue is solved by introducing a new chaotic circle map-based honey badger optimization as feature selection (FS) technique. The COVID-19 disease is effectively detected using the selected feature maps, as proposed by a unique attention-based hybrid Bi-LSTM capsule network model. In order to enhance the ability of the proposed model, the hyperparameters are optimally fine-tuned by using a fire hawk optimization algorithm. The simulation is carried out in Python, and the publicly accessible Kaggle dataset is used for experimentation. The simulation analysis shows that the proposed study achieved better detection performance than other existing methods in terms of accuracy (99.3%), precision (99.01%), recall (98.99%), and mean AUC (98.55%). Thus, the proposed hybrid model 's outcomes were efficient with ablation and K-fold analysis in Chest X-ray-based COVID19 detection.

关键词： LIMB-SALVAGE   AMPUTATION   SURVIVAL  

摘要： 1 Background: COVID-19 pandemic had a major impact on the healthcare system globally. This work aims to evaluate COVID-19 impact on local treatment in bone sarcoma treated in a single, high-throughput institution. 2 Methods: We have analyzed the local outcomes (i.e., possibility of limb sparing surgery) in all bone sarcoma patients treated between January 2016 and November 2022 in the main sarcoma reference center in Poland. Patients treated in the 2016-2019 period were regarded as "pre-pandemic" group, patients treated in 2020-2022- "pandemic". Mann-Whitney U and Chi-square tests were used in the statistical analysis. No correction for multiple testing was applied. Tests with p < 0.05 were deemed significant. 3 Results: There were 302 eligible patients identified. The group characteristics are presented in table 1. There were no differences in patient-related variables and histological subtypes of tumors between two groups. The tumor size did not differ (p = 0.053), when all tumor grades were considered, but high grade tumors were larger in the "pandemic" group (p = 0.034). This was reflected in the percentage of limb sparing surgeries which dropped from 83.3% to 68.2 % ("pre-pandemic" vs. "pandemic", p = 0.004). This difference was even more stark in case of high grade tumors- 78 % vs. 54 % respectively (p = 0.001). 4 Conclusion: To our knowledge, this is the first report of the long lasting impact of COVID-19 pandemic on oncologic treatment outcomes in patients with malignant bone tumors.

关键词： democracy   democratic dissatisfaction   public health   economy   COVID-19   survey experiment   SUPPORT   VOTE   ACCOUNTABILITY   IDENTIFICATION   INFORMATION  

摘要： Crises of the magnitude of the COVID-19 pandemic may plausibly affect deep-seated attitudes of a large fraction of citizens. In particular, outcome-oriented theories imply that leaders' performance in response to such adverse events shapes people's views about the government and about democracy. To assess these causal linkages empirically, we use a preregistered survey experiment covering 12 countries and 22,500 respondents during the pandemic. Our design enables us to leverage exogenous variation in evaluations of policies and leaders with an instrumental variables strategy. We find that people use information on both health and economic performance when evaluating the government. In turn, dissatisfaction with the government decreases satisfaction with how democracy works, but it does not increase support for nondemocratic alternatives. The results suggest that comparatively bad government performance mainly spurs internal critiques of democracy.

关键词： Telepsychology   Telepsychiatry   Child adolescent psychology   Anxiety disorders   Obsessive-compulsive disorder   OBSESSIVE-COMPULSIVE DISORDER   COGNITIVE-BEHAVIORAL THERAPY   FAMILY-BASED TREATMENT   EARLY-ONSET OCD   CHILDHOOD ANXIETY   PSYCHIATRIC-DISORDERS   LIFETIME PREVALENCE   PANIC DISORDER   SOCIAL-ANXIETY   CHILDREN  

摘要： Despite research supporting the efficacy of weekly outpatient videoconferencing-based cognitive behavioral therapy (VCBT), limited evidence exists about the benefits of leveraging VCBT for brief intensive formats. We examined the effectiveness of an intensive outpatient VCBT targeting pediatric anxiety and OCD. Quasi-experimental design was used to compare outcomes of intensive, in-person, group-based cognitive-behavioral therapy with medication management and caregiver guidance pre-pandemic, to a similar VCBT peri-pandemic (n = 130). Pretreatment and posttreatment assessments included patient- and caregiver-report of anxiety and functional impairment. Analyses of covariance were conducted, examining changes in anxiety and impairment between treatment groups, controlling for admission levels. No significant differences in posttreatment anxiety or impairment were observed between conditions. This study illustrates that intensive, group-based treatment for pediatric anxiety and OCD using VCBT is associated with comparable reductions in anxiety and impairment. It marks a crucial step toward providing broader access to quality care for youth in need.

关键词： Financial technology   technology COVID-19   Investment efficiency   Financing constraint  

摘要： We quantify the FinTech development level by textual analysis. The results show that the intensification of the COVID epidemic adversely affects corporate investment efficiency, but the development of FinTech mitigates such a negative effect by alleviating financing constraints.

关键词： Trust/therapeutic alliance   Qualitative Research   Primary health care   Health promotion   RECOMMENDATION   ADULTS  

摘要： Objective: To describe primary care providers' (PCPs) perspectives on discussing COVID-19 vaccination with their patients. Methods: All PCPs from 11 primary care clinics at 3 health systems were invited to participate. Focus groups were conducted between December 2021-January 2022, and were recorded and transcribed. Participants were asked about their experience communicating about the COVID-19 vaccine. Themes and subthemes were inductively identified using thematic analysis. Results: 40 PCPs participated. All PCPs viewed discussing COVID-19 vaccination as high priority. Strategies for promoting COVID-19 vaccination included influencing what people think and feel, building trust and leveraging their relationship with patients, and practical strategies such as on-site vaccination. Most strategies aimed at influencing what people think and feel and leveraging relationships were viewed as generally ineffective. On-site vaccine availability was identified as the most influential factor. PCPs expressed frustration by their interactions with vaccine hesitant patients, leading them to truncate their communication with these patients. Conclusions: Despite using a broad range of strategies, most PCPs were unable to change the strongly held beliefs among the most vaccine hesitant patients that were often informed by misinformation and mistrust. Practice implications: Promising strategies for promoting vaccination include social/relational (expressing empathy) and practical (on-site COVID-19 vaccine availability).

关键词： COVID-19 pandemic   online learning   photovoice method   students   Vietnam  

摘要： Globally, the COVID-19 epidemic had significantly influenced people's lives. In Vietnam, during the pandemic, we had implemented various safeguards to protect our lives. This article explores student's experiences in the COVID-19 epidemic in Binh Duong, Vietnam. Eight students were recruited, and they enrolled in the same social work class. By using photovoice as a participatory method, 13 images were collected and illustrated their lives during COVID-19. Research findings show that Vietnamese students faced many difficulties. These included Online learning experiences: Insufficient educational equipment; volunteer engagement for the community; memorable experiences when participants were in the "three on the spot"; increasing trauma in life; and returning to normal as a new life. This study sheds light on the multifaceted impacts of the COVID-19 pandemic on student life, emphasizing the importance of adaptive learning strategies, support systems, and the value of resilience and community engagement in overcoming challenges.

关键词： COVID-19   Hand surgery   Survey   Hand trauma   Elective hand surgery   PLASTIC-SURGERY   IMPACT  

摘要： Hand surgery services were required to rapidly adapt to the coronavirus disease 2019 (COVID-19). Two years following the initial wave, hand surgery units continue to adapt and recover from the pandemic. The aim of the RSTN COVID-19 Hand Recovery survey was to evaluate what adaptions made to hand surgery services during COVID-19 have been maintained in the COVID recovery phase. A survey was distributed to hand surgery units, across the UK and Ireland. The survey was completed by consultant hand surgeons across 39 hospitals. Most practices returned to pre-pandemic standards. The main changes that endured were the increase in consultant-led triaging for referrals and utilisation of video conferencing platforms for teaching and meetings. Changes made during the pandemic, such as increased use of WALANT, out of theatre operating and use of telemedicine were not sustained during the recovery period. The COVID-19 pandemic allowed the opportunity for hand surgery services to adapt their services. Several changes that were implemented have since been proven to be more efficient and equally effective for patients. However, these changes have not been sustained and the barriers preventing permanent implementation should be scrutinised. We call on hand surgery units to evaluate their current practice to ensure that patients are provided a streamlined and sustainable service. Crown Copyright (c) 2024 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

关键词： health policy/politics/law/regulation   Medicaid   state health policies  

摘要： Objective: To investigate the impact of Medicaid expansion on state expenditures through the end of 2022. Data Sources: We used data from the National Association of State Budget Officers (NASBO)'s State Expenditure Report, Kaiser Family Foundation (KFF)'s Medicaid expansion tracker, US Bureau of Labor Statistics data (BLS), US Bureau of Economic Analysis data (BEA), and Pandemic Response Accountability Committee Oversight (PRAC). Study Design: We investigated spending per capita (by state population) across seven budget categories, including Medicaid spending, and four spending sources. We performed a difference-in-differences (DiD) analysis that compared within-state changes in spending over time in expansion and nonexpansion states to estimate the effect of Medicaid expansion on state budgets. We adjusted for annual state unemployment rate, annual state per capita personal income, and state spending of Coronavirus Relief Funds (CRF) from 2020 to 2022 and included state and year fixed effects. Data Collection/Extraction Methods: We linked annual state-level data on state-reported fiscal year expenditures from NASBO with state-level characteristics from BLS and BEA data and with CRF state spending from PRAC. Principal Findings: Medicaid expansion was associated with an average increase of 21% (95% confidence interval [CI]: 16%-25%) in per capita Medicaid spending after Medicaid expansion among states that expanded prior to 2020. After inclusion of an interaction term to separate between the coronavirus disease (COVID) era (2020-2022) and the prior period following expansion (2015-2019), we found that although Medicaid expansion led to an average increase of 33% (95% CI: 21%-45%) in federal funding of state expenditures in the post-COVID years, it was not significantly associated with increased state spending. Conclusions: There was no evidence of crowding out of other state expenditure categories or a substantial impact on total state spending, even in the COVID-19

关键词： Suicide   Suicidal ideation   Suicide attempts   COVID-19 pandemic   Treatment seeking   Treatment barriers   POSTTRAUMATIC-STRESS-DISORDER   PROFESSIONAL HELP-SEEKING   MENTAL-HEALTH   SEXUAL ORIENTATION   COMPLETED SUICIDE   UNITED-STATES   IDEATION   YOUTH   CARE   DEPRESSION  

摘要： Introduction: Researchers predict long-term increases in suicide deaths following the COVID-19 pandemic. Little is known about risk factors for suicidal ideation (SI) and suicidal attempts (SA) or treatment barriers and promoters during the pandemic. We examine these factors in a young adult sample. Methods: Analyses used a 2022 cross-sectional survey dataset (N = 1,956). Logistic regression identified factors associated with pandemic suicidality (i.e., SI, SA). Non-treatment seekers reported barriers to seeking treatment. Logistic regression identified promotive factors associated with treatment-seeking. Results: 28.6 % of our sample developed suicidality during the pandemic, of whom 49.6 % did not seek treatment. Asian race and sexual minority status were strongly associated with increased odds of pandemic suicidality. Among SI non-treatment-seekers, barriers were primarily attitudinal (e.g., "symptoms are not serious enough for treatment"); among non-treatment-seekers with SA, barriers were mostly structural (e.g., insufficient funds). Previous depression treatment was strongly associated with increased odds of treatment-seeking. Conclusion: Asian American individuals were at increased risk for pandemic suicidality, which may reflect interpersonal risks related to COVID-19-related anti-Asian racism. Our findings point to a "foot-in-the-door" effect: past treatment-seeking was positively associated with future treatment-seeking. To promote this effect and decrease barriers, we suggest integrated mental health screening and referrals in primary care.