Background: The COVID-19 pandemic has resulted in significant global social and economic disruptions, as well as changes in personal attitude and behavior. The purpose of this research is to assess the sleep quality and stress levels of medical students.Method: Data was collected from medical students over the course of a month in 2021. A total of 4,677 students at the University of Medicine Pham Ngoc Thach were invited to complete an anonymous web-based survey, which included the Pittsburgh Sleep Quality Questionnaire Index (PSQI) for measuring sleep quality and the COVID-19 Student Stress Questionnaire (CSSQ) for evaluating stress.Results: A total of 1,502 students participated in our survey. More than half of the participants exhibited poor quality of sleep as indicated by their PSQI score. Many students reported going to bed after midnight and spending time on their smartphones. Among the students surveyed, 21.84% experienced low levels of stress (CSSQ ≤6), 63.38% had mild stress (7 ≤ CSSQ score ≤ 14), 14.78% reported high levels of stress (CSSQ >14).Conclusion: This study showed a high prevalence of poor sleep quality in the surveyed students, which could be attributed to changes in their behavior following the COVID-19 outbreak. Mild stress was also frequently observed, and it may be related to sleep disorders in this population. These important findings provide valuable insights for making recommendations, including lifestyle modifications to improve sleep quality.

Lack of sleep is common in adolescence, and represents an important threat to adolescents' well‐being, academic commitment, and general health. It also has significant behavioral consequences through an increased likelihood of interpersonal violence. Previous studies have demonstrated an association between aggressive behavior and lack of sleep, but the psychological mediators remain completely unexplored. Grounded in the General Aggression Model, we investigated the affective pathway as one of the potential mechanisms linking lack of sleep and aggression. We hypothesized and showed that psychological distress is an intermediary phenomenon linking lack of sleep and physical aggression. Based on a school sample of 11,912 participants (median age: 14.5), we observed that 23.7% of the young people admitted having been involved in physical fighting on one or more occasions, and that 25.81% were in sleep debt when referred for medical assessment. We analyzed the relationship between sleep duration and physical fighting and the mediating link of psychological distress by performing multiple regressions in the components' paths. The results showed that the adolescents' amount of sleep appeared to be a significant predictor of physical fighting, and that this relationship was partially mediated by psychological distress. These results are consistent with the General Aggression Model, and represent the first empirical confirmation that psychological distress symptoms partially mediate the connection between lack of sleep and physical aggression.

Background. Sleep problems have been reported in children with autism spectrum disorder (ASD). One of the methods proposed to improve sleep characteristics is based on physical activity (PA). Objective. To assess characteristics of sleep and the effect of PA level on sleep quality in children with ASD compared to controls. Methods. Fifty boys with ASD (ASD; 10.8 ± 2.6 years) and 18 controls (CONT, 10.1 ± 2.2 years) wore an accelerometer device for five consecutive days to obtain measures of activity and sleep characteristics. Results. Some significant differences were reported between ASD and CONT groups. Wake-up time resistance was significantly higher (p < 0.05) in ASD. Total time for PA, and daily steps number were significantly lower in the ASD group (p < 0.05). Time for sedentary behavior was significantly higher (p < 0.01) in the ASD group. Using a principal component analysis and an agglomerative hierarchical analysis, we observed three clusters. Two showed the same poor-quality indices of sleep but two opposing profiles of PA, either an insufficient PA volume (cluster 1, Total time PA = 75.1 min; Daily steps: 7704) or an important PA volume (cluster 3, Total time PA = 222.1 min; Daily steps: 17,164). Cluster 2 was characterized by moderate participation in PA and children with the best sleep indices (Total time PA = 166.8 min; Daily steps: 12,718). Conclusion. The dose–response effect of exercise on sleep may indicate large individual differences but the present findings are important to prevent sedentary behaviors or to correct over-activity that could be detrimental to the sleep quality in children with ASD.

Introduction The fourth outbreak of COVID-19 with the delta variant in Vietnam was very fierce due to the limited availability of vaccines and the lack of healthcare resources. During that period, the high mortality of patients with severe and critical COVID-19 caused many concerns for the health system, especially the intensive care units. This study aimed to analyze the predictive factors of death and survival in patients with severe and critical COVID-19. Methods We conducted a cross-sectional and descriptive study on 151 patients with severe and critical COVID-19 hospitalized in the Intensive Care Unit of Binh Duong General Hospital. Results Common clinical symptoms of severe and critical COVID-19 included shortness of breath (97.4%), fatigue (89.4%), cough (76.8%), chest pain (47.7%), loss of smell (48.3%), loss of taste (39.1%), and headache (21.2%). The abnormal biochemical features were leukopenia (2.1%), anemia, thrombocytopenia (18%), hypoxia with low PaO₂ (34.6%), hypocapnia with reduced PaCO₂ (29.6%), and blood acidosis (18.4%). Common complications during hospitalization were septic shock (15.2%), cardiogenic shock (5.3%), and embolism (2.6%). The predictive factors of death were being female, age > 65 years, cardiovascular comorbidity, thrombocytopenia (< 137.10⁹/l), and hypoxia at inclusion or after the first week or blood acidosis (pH < 7.28). The use of a high dose of corticosteroids reduced the mortality during the first 3 weeks of hospitalization but significantly increased risk of death after 3 and 4 weeks. Conclusions Common clinical symptoms, laboratory features, and death-related complications of critical and severe COVID-19 patients were found in Vietnamese patients during the fourth wave of the COVID-19 pandemic. The results of this study provide new insight into the predictive factors of mortality for patients with severe and critical COVID-19.

Background/Objectives: Physical inactivity needs to be strategically addressed throughout adolescence because it is often accompanied by an alteration in the quality of life. Fatigue is one of the most common symptoms encountered in medical practice. However, little is known about the causal relationship between lifestyle and fatigue. The purpose of this study was to describe the prevalence of fatigue among children and adolescents and to investigate whether various sport types and training volume/week are related to increased fatigue over time while considering gender and age. Methods: A total of 1617 participants (mean age = 13.3 ± 1.9 years, 8.2 to 16.1) completed a questionnaire assessing their perception of fatigue and including questions regarding weekly physical practices and attitudes toward sports and health. The participants were secondary school students, whether or not they practiced sports, leisure activities, or music. Analyses of variance and Newman–Keul post-hoc tests were applied to assess differences between groups. A mediation model was used to determine the relationship between physical activity and fatigue score with the relevant role of mediating factors (physical activity level or physical activity type). Results: Older adolescents had significantly higher scores of fatigue than younger ones (28.9 ± 17.5 vs. 25.6 ± 16.6; p < 0.01). Girls had significantly higher scores of fatigue than boys (30.7 ± 17.5 vs. 23.8 ± 15.8; p < 0.001). Additionally, 10.7% of participants were sedentary and presented significantly higher scores of fatigue than participants in the Leisure (35.1 ± 18.2 vs. 29.4 ± 17.3; p < 0.001) and Sport groups (35.1 ± 18.2 vs. 25.3 ± 16.2; p < 0.0001). In the sedentary group, low physical activity was associated with a high score of fatigue; but in the Sport group, high physical activity was associated with a low score of fatigue. Conclusions: Fatigue is closely related to health, physical activity volume, gender, and age. Fatigue symptoms obtained through a questionnaire assessment can serve as an important index for health evaluation.