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BACKGROUND: Gender disparity in authorship broadly persists in medical literature, little is known about female authorship within pulmonary medicine. METHODS: A bibliometric analysis of publications from 2012 to 2021 in 12 journals with the highest impact in pulmonary medicine was conducted. Only original research and review articles were included. Names of the first and last authors were extracted and their genders were identified using the Gender-API web. Female authorship was described by overall distribution and distribution by country/region/continent and journal. We compared the article citations by gender combinations, evaluated the trend in female authorship, and forecasted when parity for first and last authorship would be reached. We also conducted a systematic review of female authorship in clinical medicine. RESULTS: 14,875 articles were included, and the overall percentage of female first authors was higher than last authors (37.0% vs 22.2%, p<0.001). Asia had the lowest percentage of female first (27.6%) and last (15.2%) authors. The percentages of female first and last authors increased slightly over time, except for a rapid increase in the COVID-19 pandemic periods. Parity was predicted in 2046 for the first authors and 2059 for the last authors. Articles with male authors were cited more than articles with female authors. However, male-male collaborations significantly decreased, whereas female-female collaborations significantly increased. CONCLUSIONS: Despite the slow improvement in female authorship over the past decade, there is still a substantial gender disparity in female first and last authorship in high-impact medical journals in pulmonary medicine.
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Suboptimal health has become a core public health challenge, especially during the pandemic. This study adopts an interdisciplinary perspective to examine the relationships between suboptimal health status, COVID-19 fear and stress, cultural values, and outbound travel. A theoretical model was evaluated using data from 800 Beijing residents, 439 of whom were in suboptimal health. Four dimensions of suboptimal health (fatigue, mental status, immune system, and cardiovascular system) significantly affected COVID-19 stress and fear. Post-pandemic travel intention was positively related to fatigue symptoms and leisure and life enjoyment but negatively associated with COVID-19 stress. Suggestions for highlighting travellers' health status and promoting holistic health through post-pandemic travel are provided. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
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In the midst of the COVID-19 pandemic, distant learning has become a norm. In this study, a situated learning game "Ticketing Expert” was designed, combining the real person-NPC mechanism to provide a highly realistic travel agency environment and atmosphere. In the game, the real person-NPCs play the customer, which allow the learners to be immersed in the travel agency's ticketing department and simulate the interaction between the ticketing staffs and customers for enhancing learners' ticketing and communication capabilities. The preliminary study investigated the learners' flow state and their acceptance of the game. The results showed that the game-based learning mechanism could effectively enhance the flow of the learners, enabling them to be highly concentrated. And the learners highly agreed with the idea of using the game to help them learn in the ticketing field. © ICCE 2022.All rights reserved.
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The assembly of modular containers using building information modelling (BIM) technologies was studied. The purpose of this study was to analyse the literature on prefabricated (prefab) houses and explore the concept of creating a digital prototype of a building based on Huoshenshan hospital using Autodesk Revit software. This hospital was constructed to treat Covid-19 patients in early 2020. The article describes the methodology of installing modular containers and assembly structures using BIM technologies for rapid construction. The results of this study showed that building object implementation depends directly on a proper model with a step-by-step mechanism for installation. Due to the supply of prefab structures at the construction site, both initial project cost and project time can be reduced. Prefab house technology demonstrated the high efficiency of using BIM technology in the assembly of Huoshenshan hospital, which was constructed in 10 days. The need for information modelling data exchange with modern technology and systems, which allows the team to become acquainted with the project before installation work starts at the construction site, is investigated.
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The paper analyzes the assembly process by the example of assembly-modular containers using building information modeling technologies. This paper simulates a 3D model of the Huoshenshan Hospital with a description of the assembly mechanism process based on information modeling of prefabricated buildings. The purpose of this paper is to analyze the sources on prefabricated houses and explore the concept of creating a digital prototype of a building based on Huoshenshan Hospital, using the Autodesk Revit software. The article describes the methodology of installing modular containers and assembly structures using building information modeling technologies to improve rapid construction technology. The study results showed that building object implementation directly depends on a proper model with a step-by-step mechanism for installation, which can reduce the initial project cost due to the supply of prefabricated structures on the construction site, as well as reduce the project time. The prefabricated house technology demonstrated the high efficiency of using information technology in the assembly of the Huoshenshan Hospital, with which the simulated facility was implemented in 10 days. The need for information modeling data exchange with modern gadgets and systems is investigated, which allows one to get acquainted with the object at the construction site before installation work start. © 2022 ICE Publishing: All rights reserved.
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Introduction: The COVID-19 pandemic led to temporary restrictions on in-person cardiac rehabilitation (CR) services to mitigate high-risk exposure. Hypothesis: In order to better understand the impact of COVID-19 restrictions on CR services, we evaluated changes in the frequency and characteristics of CR visits in 2020 compared with 2019 in a commercially-insured population. Methods: We queried the Michigan Value Collaborative statewide claims data registry for outpatient CR visits between 01/01/2019 and 12/31/2020 using CPT codes (93797, 93798) among patients with diagnoses of ischemic heart disease, heart failure, percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), or heart valve procedure. We described monthly trends in CR visits, and used bivariate analyses to compare changes in the demographics and medical diagnoses for CR visits in 2020 compared with 2019. Results: We identified a total of 45,553 CR visits in 2019 and 30,236 visits in 2020, representing a 33.6% relative decline. Monthly CR visits reached a nadir of 138 visits in April 2020 (96.5% reduction compared with April 2019), recovered to 3072 visits in September (-17.9%), and fell again to 2434 visits in December (-34.7%) (Figure). Relative changes in CR visits from 2019 to 2020 varied by diagnosis (p<0.001):-50.3% for heart failure (2931 to 1456,-37.5% for CABG (10121 to 6329),-35.3% for PCI (19669 to 12729),-28.9% for valve surgery (5621 to 3994), and-20.6% for ischemic heart disease (7211 to 5728). There were no significant differences in patient mean age (68.0 vs. 68.1 years, p=0.62) or gender (39.8% vs. 39.9% female, p=0.839) in 2019 compared with 2020. Conclusions: Total cardiac rehabilitation visits in 2020 were 33.6% lower compared with 2019, with heterogeneity in declines by underlying eligible diagnosis. Continued monitoring is needed to understand the public health impact of reduced CR use due to the COVID-19 pandemic.
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Purpose: As the world grapples with the pervasive effects of the coronavirus pandemic, a notable disconnect has emerged in the public's understanding of scientific and medical research. Particularly, the travel industry has become unquestionably vulnerable amid the COVID-19 outbreak;this pandemic has interrupted the industry's operations with devastating economic consequences. This paper aims to highlight the importance of deconstructing barriers between medical science and public awareness related to COVID-19, taking tourism as a case in point. It also discusses the role of interdisciplinary research in facilitating the tourism and hospitality industry's recovery and alleviating tourists' uncertainties in the wake of COVID-19. Design/methodology/approach: This paper offers a synthesis of news coverage from several media outlets, framed within the literature on knowledge transformation across disciplines. This framing focuses on the medical sciences (e.g. public health) and social sciences (e.g. tourism management) to identify gaps between medical scientific knowledge and public awareness in the context of COVID-19. The authors' experience in public health and tourism management further demonstrates a missing link between academic research and the information made available in public health and everyday settings. A potential research agenda is proposed accordingly. Findings: This paper summarizes how salient issues related to knowledge transfer can become intensified during a global pandemic, such as medical research not being communicated in plain language, which leads some citizens to feel apathetic about findings. Reporting on the prevalence and anticipated consequences of disease outbreaks can hence be difficult, especially early in the development of diseases such as COVID-19. Research limitations/implications: By assuming a cross-disciplinary perspective on medical/health and social science research, this paper encourages academic and practical collaboration to bring medical research to the masses. This paper also outlines several research directions to promote public health, safety and sustainability through tourism. Practical implications: This paper highlights that it is essential for medical knowledge to be disseminated in a manner that promotes public understanding. The tourism and hospitality industry can benefit from an essential understanding of medical findings, particularly during this pandemic. Without a firm grasp on COVID-19's origins and treatment, the tourism and hospitality industry will likely struggle to recover from this catastrophe. Social implications: Taking COVID-19 as a case in point, this study advocates leveraging the strengths of disparate domains to bring medical findings to a wider audience and showcase cutting-edge developments for the greater good. This study also emphasizes the importance of engaging the general public in reputable scientific research findings to increase public awareness in a professional and accurate manner. Originality/value: This paper presents a unique and critical discussion of the gap between medical science knowledge and public awareness, as well as its implications for tourism and hospitality recovery after COVID-19, with a focus on applying medical scientific knowledge to post-pandemic industry recovery. © 2021, Jun Wen, Haifeng Hou, Metin Kozak, Fang Meng, Chung-En Yu and Wei Wang.
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Objective: To retrospectively analyze the clinical characteristics and drug resistance among COVID-19 patients with bacterial and fungal infections. Methods: Clinical data of COVID-19 patients whose blood, urine, sputum and alveolar lavage fluid samples were positive for bacteria and fungi were collected in Tongji Hospital from February 10 to March 31, 2020. WHONET5.6 software was used to analyze drug susceptibility test results. Results: A total of 95 COVID-19 patients positive for pathogenic bacteria were enrolled and among them, 23 were non-critical patients and 72 were critical patients. The main symptoms in these patients included fever, cough with sputum, fatigue and dyspnea. Male and female critical patients accounted for 63.89% and 36.11%, respectively. Most of the patients with bacterial and fungal infections were critical type, accounting for 23.61%. The mortality rates of non-critical and critical patients were 13.04% and 61.11%, respectively. A total of 179 strains of pathogenic bacteria were isolated. The positive rate of Escherichia coli in non-critical patients was 37.50%, which was higher than that in critical patients. However, the positive rates of Acinetobacter baumannii and Klebsiella pneumoniae in critical patients were both 29.87%, higher than those in non-critical patients. There was no significant difference in the positive rate of gram-positive bacteria or fungi between non-critical and critical patients. It was noteworthy that the positive rate of Candida parapsilosis in blood samples of critical patients was relatively high, reaching 36.40%. Drug susceptibility test results showed that no carbapenem-resistant Escherichia coli stains were detected and 60.87% of Klebsiella pneumoniae strains were resistant to carbapenems. Acinetobacter baumannii strains were 100% resistant to three antimicrobial drugs. Methicillin-resistant Staphylococcus aureus strains accounted for 71.43%, but no vancomycin-resistant gram-positive cocci were found. Conclusions: Critical COVID-19 patients were mostly male and prone to multiple bacterial and fungal infections. The mortality of critical patients was higher than that of non-critical patients. Critical COVID-19 was often complicated by hospital acquired infections caused by bacteria including Acinetobacter baumannii and Klebsiella pneumoniae with high drug resistance. © 2021 Chinese Medical Association
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Objective: To investigate the value of peripheral blood lymphocytes and lymphocyte subsets in the diagnosis of illness severity and prognosis of coronavirus disease 2019 (COVID-19). Methods: A retrospective analysis was performed on 179 COVID-19 patients admitted to the optical valley and Sino-French new branch district of Tongji Hospital in Wuhan, from February 8th, 2020 to February 18th, 2020. The included patients were divided into a mild group (n=84), a severe group (n=58) and a critical group (n=37). The median age of recruited patients was 65, including 107 males and 72 females. ROC analysis was performed to determine the best threshold value of the lymphocyte subsets in distinguishing critical patients from severe or mild patients. GraphPad Prism6 and SPSS19.0 statistical software were used for data analysis. Differences among groups were analyzed using the Mann-Whitney U test. Results: On admission, the white blood cell (WBC) of the critical patients were significantly higher than that of the mild and severe patients (P<0.001), and the lymphocytes of the mild patients were significantly higher than that of the critical and severe patients (P<0.001). The counts of T+B+NK, CD3, CD4, CD8, and NK cells were significantly decreased with the increase of illness severity (P<0.001) while the CD4/CD8 ratio in the critical group was significantly higher than that of the mild and severe groups (mild vs. critical, P=0.002;severe vs. critical, P=0.030). Furthermore, the receiver operating characteristic (ROC) analysis revealed that T+B+NK and CD3 showed the highest area under ROC for the identification of critical cases. Then the mild and severe cases were combined into one group and compared with the critical group. Neutrophil-to-lymphocyte ratio (NLR), neutrophil-to-CD3, neutrophil-to-CD4 and neutrophil-to-CD8 were used to assess illness severity, and our data showed that NLR was the best marker. The lymphocytes of the mild and severe patients were increased ten days after admission with improvement of the disease. However, the lymphocytes of the critical patients were progressively decreased with the deterioration of diseases. Conclusions: The decrease of T+B+NK and CD3 cells, the increase of CD4/CD8 ratio and NLR serve as significant factors for identification of severe COVID-19 cases. The dynamic monitoring of total lymphocytes and subsets has potential clinical value in predicting the prognosis of COVID-19.
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Effective laboratory markers for the estimation of disease severity and predicting the clinical progression of coronavirus disease-2019 (COVID-19) is urgently needed. Laboratory tests, including blood routine, cytokine profiles and infection markers, were collected from 389 confirmed COVID-19 patients. The included patients were classified into mild (n = 168), severe (n = 169) and critical groups (n = 52). The leukocytes, neutrophils, infection biomarkers [such as C-reactive protein (CRP), procalcitonin (PCT) and ferritin] and the concentrations of cytokines [interleukin (IL)-2R, IL-6, IL-8, IL-10 and tumor necrosis factor (TNF)-α] were significantly increased, while lymphocytes were significantly decreased with increased severity of illness. The amount of IL-2R was positively correlated with the other cytokines and negatively correlated with lymphocyte number. The ratio of IL-2R to lymphocytes was found to be remarkably increased in severe and critical patients. IL-2R/lymphocytes were superior compared with other markers for the identification of COVID-19 with critical illness, not only from mild but also from severe illness. Moreover, the cytokine profiles and IL-2R/lymphocytes were significantly decreased in recovered patients, but further increased in disease-deteriorated patients, which might be correlated with the outcome of COVID-19. Lymphopenia and increased levels of cytokines were closely associated with disease severity. The IL-2R/lymphocyte was a prominent biomarker for early identification of severe COVID-19 and predicting the clinical progression of the disease.