Impact of early phase COVID-19 precautionary behaviors on seasonal influenza in Hong Kong: A time-series modeling approach.

Background: Before major non-pharmaceutical interventions were implemented, seasonal incidence of influenza in Hong Kong showed a rapid and unexpected reduction immediately following the early spread of COVID-19 in mainland China in January 2020. This decline was presumably associated with precautionary behavioral changes (e.g., wearing face masks and avoiding crowded places). Knowing their effectiveness on the transmissibility of seasonal influenza can inform future influenza prevention strategies. Methods: We estimated the effective reproduction number (R t ) of seasonal influenza in 2019/20 winter using a time-series susceptible-infectious-recovered (TS-SIR) model with a Bayesian inference by integrated nested Laplace approximation (INLA). After taking account of changes in underreporting and herd immunity, the individual effects of the behavioral changes were quantified. Findings: The model-estimated mean R t reduced from 1.29 (95%CI, 1.27-1.32) to 0.73 (95%CI, 0.73-0.74) after the COVID-19 community spread began. Wearing face masks protected 17.4% of people (95%CI, 16.3-18.3%) from infections, having about half of the effect as avoiding crowded places (44.1%, 95%CI, 43.5-44.7%). Within the current model, if more than 85% of people had adopted both behaviors, the initial R t could have been less than 1. Conclusion: Our model results indicate that wearing face masks and avoiding crowded places could have potentially significant suppressive impacts on influenza.

Career Preferences among Nursing Students: A Cross-Sessional Study.

Introduction: It is estimated that mores nurses are needed in the future, nursing students' career preferences are important to contribute the shortage of nursing manpower in Macao. Little is known regarding the preferences for nursing students' career preferences and related factors among nursing students. Objective: To explore and investigate the career preferences and related factors among nursing students in Macao. Methods: A descriptive, cross-sectional survey study design was adopted to assess career preferences and related factors among nursing students in Macao. Results: In total, 217 nursing students completed surveys. The most favorite career preferences among nursing students were community health nursing, paediatric nursing, medical surgical nursing, and obstetric & gynecological nursing; while the least career preferences among nursing students were oncology and hospice nursing, mental health nursing, and ER nursing. Factors were related to "gender", "education", and "nursing is my first study preference" among Macao nursing students for career preferences. Conclusion: The senior nursing students prefer working in community health nursing and the junior and female nursing students prefer working in pediatric nursing and obstetric and gynecological nursing. The more understandings of nursing students' career preferences, the better nursing curriculum design and implication to promote nursing students' intention for working in the least career preferences work.

Prognostics for lithium-ion batteries using a two-phase gamma degradation process model.

To address the degradation of rechargeable batteries, this paper presents a two-phase gamma process model with a fixed change-point for modeling the voltage-discharge curves of battery cycle aging under a constant current. The model can be applied to estimate the state of charge (SOC) and the remaining useful discharge time (RUT) in a cycle with consideration of the effect of cycle aging, and can also be applied to estimate the state of life (SOL) and the remaining useful life (RUL) across cycles. The applications of the proposed model are demonstrated using the experimental cycle aging data of a lithium iron phosphate battery. A comparison shows that the proposed model generates a more accurate prediction than the conventional two-term exponential model with capacity data under a particle filter framework, and this reveals the superiority of modeling with voltage over modeling with capacity. The analytical expression of mean useful discharge time in a cycle (or mean time to failure) is developed with approximation by a Taylor expansion and the Birnbaum-Saunders distribution, and the result is shown to be in good agreement with the true mean of a gamma process.

Relationship Between Gerontological Nursing Education and Attitude Toward Older People.

BACKGROUND: Nursing students' attitudes toward older people affect the quality of care provided to the aging population. Although gerontological nursing has been delivered as a stand-alone course in Macao since 2008, Macao nursing students' attitudes toward older people have not been investigated. OBJECTIVE: The purposes of this study were 1) to explore nursing students' background information and attitudes toward older people and 2) to examine the presence of relationships between these factors and gerontological nursing education in Macao, a special administrative region of China. METHODS: A cross-sectional survey design was adopted. Nursing students in Macao were invited to complete a questionnaire to record their demographic characteristics and gerontological nursing education and measure their attitudes toward older people using Kogan's Attitudes Toward Older People (KAOP) scale. RESULTS: Data from 377 (83.04%) nursing students who returned the questionnaire were analyzed. The students were found to have positive attitudes toward older people, with a mean KAOP score of 168.44 ±â€¯18.38 (mean ±â€¯standard deviation). In particular, the item with the lowest mean score was "older adults have excessive demands for love" (2.5 ±â€¯1.2), while the item with the highest mean score was "older adults need no more love than others" (6.0 ±â€¯1.0). The results also revealed that Macao nursing students' positive attitudes toward older people were associated with having "religion," "good experience in gerontological nursing taught course," and "good experience in clinical practice with older people," which were thus considered to be the predictors of their positive attitudes toward older people. CONCLUSION: Religion and gerontological nursing education are associated with Macao nursing students' attitudes toward older people. A longitudinal study is needed to evaluate the gradual changes in nursing students' attitudes. Nursing students' future career choices and perceptions of gerontological nursing education should be explored in a future study.

A gamma process modeling approach for the comparison of dissolution profiles.

In this paper, we propose a stochastic gamma process model for assessing the similarity of two dissolution profiles. Based on the proposed stochastic model, we utilize the difference factor and similarity factor to test the similarity of two dissolution profiles based on bootstrap confidence intervals. The performances of the proposed methods are compared with a multivariate test procedure via Monte Carlo simulation studies. The proposed testing methods are shown to be powerful and effectively controlling the error rate. The proposed model provides a simple yet useful alternative parametric statistical model for assessing the similarity of two dissolution profiles. All the methods are illustrated with a numerical example.

Confidence intervals for a difference between proportions based on paired data.

We construct several explicit asymptotic two-sided confidence intervals (CIs) for the difference between two correlated proportions using the method of variance of estimates recovery (MOVER). The basic idea is to recover variance estimates required for the proportion difference from the confidence limits for single proportions. The CI estimators for a single proportion, which are incorporated with the MOVER, include the Agresti-Coull, the Wilson, and the Jeffreys CIs. Our simulation results show that the MOVER-type CIs based on the continuity corrected Phi coefficient and the Tango score CI perform satisfactory in small sample designs and spare data structures. We illustrate the proposed CIs with several real examples.

Exact and approximate unconditional confidence intervals for proportion difference in the presence of incomplete data.

Confidence interval (CI) construction with respect to proportion/rate difference for paired binary data has become a standard procedure in many clinical trials and medical studies. When the sample size is small and incomplete data are present, asymptotic CIs may be dubious and exact CIs are not yet available. In this article, we propose exact and approximate unconditional test-based methods for constructing CI for proportion/rate difference in the presence of incomplete paired binary data. Approaches based on one- and two-sided Wald's tests will be considered. Unlike asymptotic CI estimators, exact unconditional CI estimators always guarantee their coverage probabilities at or above the pre-specified confidence level. Our empirical studies further show that (i) approximate unconditional CI estimators usually yield shorter expected confidence width (ECW) with their coverage probabilities being well controlled around the pre-specified confidence level; and (ii) the ECWs of the unconditional two-sided-test-based CI estimators are generally narrower than those of the unconditional one-sided-test-based CI estimators. Moreover, ECWs of asymptotic CIs may not necessarily be narrower than those of two-sided-based exact unconditional CIs. Two real examples will be used to illustrate our methodologies.