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The COVID-19 outbreak required the significantly increased working time and intensity for health professionals in China, which may cause stress signs.
From March 2–13 of 2020, 4,618 health professionals in China were included in an anonymous, self-rated online survey regarding their concerns on exposure to the COVID-19 outbreak. The questionnaires consisted of five parts: basic demographic information and epidemiological exposure; occupational and psychological impact; concerns during the episode; coping strategies; and the Huaxi Emotional-Distress Index (HEI).
About 24.2% of respondents experienced high levels of anxiety or/and depressive symptoms since the COVID-19 outbreak. Respondents who worried about their physical health and those who had COVID-19 infected friends or close relatives were more likely to have high HEI levels, than those without these characteristics. Further, family relationship was found to have an independent protective effect against high HEI levels. Their main concerns were that their families would not be cared for and that they would not be able to work properly. Compared to respondents with clear emotional problems, those with somewhat hidden emotional issues adopted more positive coping measures.
About a quarter of medical staff experienced psychological problems during the pandemic of COVID-19. The psychological impact of stressful events was related to worrying about their physical health, having close COVID-19 infected acquaintances and family relationship issues. Therefore, the psychological supprot for medical staff fighting in the COVID-19 pandemic may be needed.
Epidemiological data for Toxoplasma gondii regarding malignancy have gained increasing attention; however, the information about T. gondii infection among children with malignant lymphoma (ML) in China is unclear. Therefore, 314 children with lymphoma and 314 healthy children, age- and gender-matched, were recruited to estimate the seroprevalence of T. gondii in the participants and identify the risk factors of infection. Blood samples from all participants were collected and examined for T. gondii IgG and IgM antibodies using ELISA. The results showed that the overall seroprevalence of T. gondii antibodies (including IgG and/or IgM) in ML patients and healthy controls was 19.8% and 9.9%, respectively. Contact with the cats, consumption of oysters and history of chemotherapy were estimated to be the risk factors for T. gondii infection in children with lymphoma by multivariable logistic regression analysis, whereas in healthy children, contact with cats and consumption of oysters were the risk factors. Moreover, among various histological types of lymphoma, individuals with NK/T-cell lymphoma, B-small lymphocytic lymphoma, marginal zone B-lymphoma and Hodgkin's lymphoma had a higher seroprevalence than healthy controls (P < 0.05). These findings indicated the high prevalence of T. gondii infection in children with lymphoma, and hence, efforts should be performed to evaluate the effect of the infection further in lymphoma patients.
The influence of the nozzle aspect ratio (
, 2 and 4), stroke length (
, 3.7 and 5.55) and Reynolds number (
, 158, 316 and 632) on the behaviour of elliptic synthetic jets is studied experimentally. Laser-induced fluorescence and two-dimensional and stereoscopic particle image velocimetry are used to analyse the vortex dynamics and evolution mechanism. It is found that the fluid elements around the major axis of an elliptic vortex ring move downstream faster and tend to approach the centreline, while the fluid elements around the minor axis move downstream at a slower speed and away from the centreline, thereby resulting in the occurrence of the well-known axis-switching phenomenon for elliptic synthetic jets. During this process, a pair of arc-like vortices forms ahead of the primary vortex ring, and they are constituted by streamwise vortices in the leg part and spanwise vortices in the head part; two pairs of streamwise vortices form from the inside of the primary vortex ring and develop in the tails. The streamwise vortices are pushed away progressively from the centreline by the synthetic jet vortex rings that are formed during the subsequent periods. These additional vortical structures for non-circular synthetic jets show regular and periodic characteristics, which are quite different from the previous findings for non-circular jets. Their mutual interaction with the vortex ring causes significant changes in the topology of elliptic synthetic jets, which further results in the variation of the statistical characteristics. Increasing the aspect ratio, stroke length and Reynolds number will make the evolution of the synthetic jet become more unstable and complex. In addition, the entrainment rate of an elliptical synthetic jet is larger than that of a circular synthetic jet and it increases with the nozzle aspect ratio (
) and Reynolds number. It is indicated that the formation of streamwise vortices could enhance the entrainment rate. This finding provides substantial evidence for the potential application of elliptic synthetic jets for effective flow control.
In this paper, the influence of strain rate on the mechanical behavior of high-strength low-alloy (HC420LA) steel were studied. Quasi-static and dynamic tensile experiments were performed with strain rates ranging from 0.001 to 500 s−1 at room temperature. The digital image correlation technique was used to obtain the full-field strain. The experimental results showed that HC420LA steel exhibited positive strain rate sensitivity. Based on experimental results, the modified Johnson–Cook (J–C) model was used to model the constitutive behavior of HC420LA steel. Predictions of the standard and modified J–C models were compared using standard statistical parameters. The modified J–C model showed better agreement with the experimental data. Then, numerical simulation of the representative tensile test at a strain rate of 100 s−1 was performed using the finite element code LS-DYNA. Good correlation between the experimental and numerical simulation results was achieved.
Normal odd-chain SFA (OCSFA), particularly tridecanoic acid (n-13 : 0), pentadecanoic acid (n-15 : 0) and heptadecanoic acid (n-17 : 0), are normal components of dairy products, beef and seafood. The ratio of n-15 : 0:n-17 : 0 in ruminant foods (dairy products and beef) is 2:1, while in seafood and human tissues it is 1:2, and their appearance in plasma is often used as a marker for ruminant fat intake. Human elongases encoded by elongation of very long-chain fatty acid (ELOVL)1, ELOVL3, ELOVL6 and ELOVL7 catalyse biosynthesis of the dominant even-chain SFA; however, there are no reports of elongase function on OCSFA. ELOVL transfected MCF7 cells were treated with n-13 : 0, n-15 : 0 or n-17 : 0 (80 µm) and products analysed. ELOVL6 catalysed elongation of n-13 : 0→n-15 : 0 and n-15 : 0→n-17 : 0; and ELOVL7 had modest activity toward n-15 : 0 (n-15 : 0→n-17 : 0). No elongation activity was detected for n-17 : 0→n-19 : 0. Our data expand ELOVL specificity to OCSFA, providing the first molecular evidence demonstrating ELOVL6 as the major elongase acting on OCSFA n-13 : 0 and n-15 : 0 fatty acids. Studies of food intake relying on OCSFA as a biomarker should consider endogenous human metabolism when relying on OCSFA ratios to indicate specific food intake.
Multidimensional instabilities always develop with time during the process of radiation pressure acceleration, and are detrimental to the generation of monoenergetic proton beams. In this paper, a sharp-front laser is proposed to irradiate a triple-layer target (the proton layer is set between two carbon ion layers) and studied in theory and simulations. It is found that the thin proton layer can be accelerated once to hundreds of MeV with monoenergetic spectra only during the hole-boring (HB) stage. The carbon ions move behind the proton layer in the light-sail (LS) stage, which can shield any further interaction between the rear part of the laser and the proton layer. In this way, proton beam instabilities can be reduced to a certain extent during the entire acceleration process. It is hoped such a mechanism can provide a feasible way to improve the beam quality for proton therapy and other applications.
The utilization of medical resources in China is unbalanced and insufficient. In order to find a way to maximize their utilization to face challenges in the upcoming decade, this study aims to investigate the elderly's first choice of health institutions when they were ill in the Zhejiang and Qinghai provinces, and to explore the potential pathways related to their choices, respectively.
The data used in this study was from cross-sectional surveys in Zhejiang and Qinghai. According to the Anderson Health Service Utilization Model, we applied structural equation modeling to explore the complex pathways from socioeconomic status (SES), accessibility, and health status to the elderly's first choice of health institutions.
The proportion of the elderly who selected community health institutions (CHI) as their first choice of medical institutions in Qinghai was higher than in Zhejiang. The Zhejiang model revealed a significantly negative direct effect of SES and significantly positive direct effects of accessibility to CHI and health status on the choice of institutions, and a significantly positive indirect effect of SES on choice of institutions, through the mediating factor of health status. SES played an important role in the Zhejiang model in direct and indirect ways. In the Qinghai model, only SES and accessibility to CHI had significantly direct effects on the choice of institutions, with accessibility to CHI having the biggest effects. SES had a significant and positive indirect impact on choice of institutions, through the factor of accessibility to CHI.
A better understanding of the complex pathways from factors to elderly's choices of health institutions was essential, which may inform priorities for maximizing the utilization of CHI further and prepare to face challenges in the new decade. Through this research method, policymakers could explore the specific pathways based on their own economic and societal status.
China has made great achievements in health insurance coverage and healthcare financing. Nonetheless, the rate of catastrophic health expenditure (CHE) in China was 13 percent in 2008, which is higher than in some other countries. There are differences among the provinces in China in terms of the lifestyles, customs, prevalent medical conditions, and health consciousness of their populations. This study aimed to compare the proportion of households with CHE and the factors influencing this expenditure between the Zhejiang and Qinghai province in China.
Data were derived from household surveys conducted in Zhejiang and Qinghai. Sampling was based on a multi-stage, stratified random cluster method. Households with CHE were defined as those with an out-of-pocket payment for health care that was at least 40 percent of the household income. Univariate and multivariate logistic regression analyses were used to identify the factors associated with CHE.
A total of 1,598 households were included: 995 in Zhejiang and 603 in Qinghai. The average rates of CHE in Zhejiang and Qinghai were 10 percent and 31 percent, respectively. The economic status of a household influenced the likelihood of experiencing CHE; households headed by an employed person were less likely to experience CHE. In contrast, households that included outpatients or individuals with chronic diseases had a higher risk of experiencing CHE across the two provinces. Poorer or uninsured households in Zhejiang were more likely to experience CHE, as were households in Qinghai that included outpatients or were headed by a person from a minority nationality.
This study highlighted the importance of promoting economic development, expanding employment, and adjusting policies to better protect individuals with chronic diseases and outpatients from the risk of CHE. The Chinese government should pay more attention to actual conditions in different provinces to ensure that policy decisions incorporate local knowledge.
Combining density functional theory calculations and temperature programmed desorption (TPD) experiments, the adsorption behavior of various sulfur containing compounds, including C2H5SH, CH3SCH3, tetrahydrothiophene, thiophene, benzothiophene, dibenzothiophene, and their derivatives on the coordinately unsaturated sites of Mo27Sx model nanoparticles, are studied systematically. Sulfur molecules with aromaticity prefer flat adsorption than perpendicular adsorption. The adsorption of nonaromatic molecules is stronger than the perpendicular adsorption of aromatic molecules, but weaker than the flat adsorption of them. With gradual hydrogenation (HYD), the binding affinity in the perpendicular adsorption modes increases, while in flat adsorption modes it increases first, then decreases. Significant steric effects on the adsorption of dimethyldibenzothiophene were revealed in perpendicular adsorption modes. The steric effect, besides weakening adsorption, could also activate the S–C bonds through a compensation effect. Finally, by comparing the theoretical adsorption energies with the TPD results, we suggest that HYD and direct-desulfurization path may happen simultaneously, but on different active sites.
Coherent cuboidal B2 nanoprecipitation in body-centered cubic (BCC)-based high-entropy alloys (HEAs) is important for the improvement of mechanical strength. The present work primarily investigated the effect of Ti substitution for Al on the cuboidal B2 nanoprecipitates in BCC Al0.7NiCoFeCr2 HEAs. A series of (Al,Ti)0.7NiCoFeCr2 HEAs with different Al/Ti ratios were prepared by suction-cast processing, and their microstructures and mechanical properties were then characterized comprehensively. It was found that the substitution of Ti for Al can change the phase structures of ordered precipitation, from the B2-AlNi to a highly ordered L21-Ni2AlTi phase. Especially, a small amount addition of Ti (≤4.2 at.%, Al/Ti ratio ≥2/1) renders the HEAs with cuboidal L21 nanoparticles coherently precipitated into the BCC matrix, which is attributed to the moderate lattice misfit (ε = 0.5–0.6%) between BCC and L21 phases. HEAs with such coherent microstructures exhibit high compressive yield strength of about 1700–1800 MPa. When the Ti content reaches up to 6.25 at.%, the matrix of the alloy will be turned into the σ phase, rather than BCC, leading to a heavy brittleness.
SCN5A encodes sodium-channel α-subunit Nav1.5. The mutations of SCN5A can lead to hereditary cardiac arrhythmias such as the long-QT syndrome type 3 and Brugada syndrome. Here we sought to identify novel mutations in a family with arrhythmia.
Genomic DNA was isolated from blood of the proband, who was diagnosed with atrial flutter. Illumina Hiseq 2000 whole-exome sequencing was performed and an arrhythmia-related gene-filtering strategy was used to analyse the pathogenic genes. Sanger sequencing was applied to verify the mutation co-segregated in the family.
Results and conclusions
A novel missense mutation in SCN5A (C335R) was identified, and this mutation co-segregated within the affected family members. This missense mutation was predicted to result in amplitude reduction in peak Na+ current, further leading to channel protein dysfunction. Our study expands the spectrum of SCN5A mutations and contributes to genetic counselling of families with arrhythmia.
Equity is the core of primary care. The issue of equity in health has become urgent and China has attached increasing attention to it. With rapid economic development and great change of the policy on medical insurance, the pattern of equity in health has changed a lot. Reform of healthcare in Zhejiang province is at the forefront of China; studies on Zhejiang are of great significance to the whole country. This paper aims to measure the equity in health from the perspectives of health needs and health seeking behavior, and provides suggestions for decision making.
A household survey was conducted in August 2016. A sample of 1000 households, 2807 individuals in Zhejiang was obtained with the multi-stage stratified cluster sampling method. Descriptive analysis and Chi-square test were adopted in the analysis. The value of concentration index was used to measure the equity.
This study finds that the poor have more urgent health needs and poorer health situation compared with the rich. The utilization of outpatient services was almost equal, whilst the utilization of hospitalization was pro-rich (the rich use more).Individuals with employer-based medical insurance use more outpatient services than those with rural and urban medical insurance. Compared to the rich, there were more people in the poorer income groups who didn't use inpatient services due to financial difficulties.
The issue of equity in health has attracted broad attention in the world, and China is no exception. We measured and analyzed the equity of health needs and absent rate of health services. We find that the poor have more urgent health needs and high absent rate of inpatient services compared with the rich. Income level and medical insurance may well explain the equity of outpatient and inequity of hospitalization. In view of the pro-rich inequity of hospitalization, more financial protection should be provided for the poor.
The discovery of the ancient city of Loulan in Xinjiang, China, at the beginning of the 20th century was of great significance for understanding the evolution of culture and civilization in Inner Asia. However, due to the lack of systematic chronological studies, the history of this ancient city remains unclear, particularly the date of its construction and abandonment. Here, we present the results of the first systematic radiocarbon (14C) dating carried out on artifacts from ancient Loulan. Our results show that human activity began as early as 350 cal BC, flourished during the interval from the 1st to 4th centuries AD, and completely disappeared around 600 AD. Most of the buildings in the city were constructed during the Eastern Han Dynasty rather than in Wei/Jin Dynasty, as previously indicated by excavated documents and letters (Hedin 1898; Xiao 2006). The development and flourishing of Loulan coincided with the interval of high ice accumulation and meltwater supply from surrounding mountains. The city began to decline and was finally abandoned following an abrupt decrease in ice accumulation and meltwater supply (Yao et al. 1996; Lauterbach et al. 2014), suggesting that natural climate change was the major factor responsible for the abandonment of Loulan.
In this paper, a novel second-order two-scale (SOTS) computational method is developed for nonlinear dynamic thermo-mechanical problems of composites with cylindrical periodicity. The non-linearities of these multi-scale problems were caused by the temperature-dependent properties of the composites. Firstly, the formal SOTS solutions for these problems are constructed by the multiscale asymptotic analysis. Then we theoretically explain the importance of the SOTS solutions by the error analysis in the pointwise sense. In addition, a SOTS numerical algorithm is proposed in detail to effectively solve these problems. Finally, some numerical examples verify the feasibility and effectiveness of the SOTS numerical algorithm we proposed.
In traditional antenna design, metal components are not placed in the central part of the antenna as they change the characteristics of near field radiation. However, we show that placing a metal ring in the centre of the strip lines, which connect the ends of folded high-frequency dipoles, does not damage the performance of the feed. Instead it significantly improves the voltage standing wave ratio of the feed whilst other performance indicators are not compromised. Thus, our findings show an excellent way of improving the wide band feed. Based on this foundation, a new circularly polarised feed for operation between 0.4 to 2 GHz is introduced for the Chinese Spectral Radioheliograph in this paper. The issue of a feed impedance matching network is investigated. By optimising the impedance matching, the performance of the feed is enhanced with respect to the previous realisations of the Eleven feed. The simulation and experimental results show that the gain of the feed is about 10 dBi, and the VSWR is less than 2:1. In addition, the feed has a low axial ratio, fixed phase centre location, and constant beam width in the range of 0.4 to 2 GHz.
We present experimental studies of higher-order modes of the flow in turbulent thermal convection in cells of aspect ratio (
) 1 and 0.5. The working fluid is water with the Prandtl number (
) kept at around 5.0. The Rayleigh number (
) ranges from
. We found that in
cells, the first mode, which corresponds to the large-scale circulation (LSC), dominates the flow. The second mode (quadrupole mode), the third mode (sextupole mode) and the fourth mode (octupole mode) are very weak, on average these higher-order modes each contains less than 4 % of the total flow energy. In
cells, the first mode is still the strongest but less dominant, the second mode becomes stronger which contains 13.7 % of the total flow energy and the third and the fourth modes are also stronger (containing 6.5 % and 1.1 % of the total flow energy respectively). It is found that during a reversal/cessation, the amplitude of the second mode and the remaining modes experiences a rapid increase followed by a decrease, which is opposite to the behaviour of the amplitude of the first mode – it decreases to almost zero then rebounds. In addition, it is found that during the cessation (reversal) of the LSC, the second mode dominates, containing 51.3 % (50.1 %) of the total flow energy, which reveals that the commonly called cessation event is not the cessation of the entire flow but only the cessation of the first mode (LSC). The experiment reveals that the second mode and the remaining higher-order modes play important roles in the dynamical process of the reversal/cessation of the LSC. We also show direct evidence that the first mode is more efficient for heat transfer. Furthermore, our study reveals that, during the cessation/reversal of the LSC,
drops to its local minimum and the minimum of
is ahead of the minimum of the amplitude of the LSC; and reversals can be distinguished from cessations in terms of global heat transport. A direct velocity measurement reveals the flow structure of the first- and higher-order modes.
In this work, the selective removal of ions from multicomponent mixtures using functionalized magnetic nanoparticles (FMNPs) was demonstrated. As, Sb, and Se ions were efficiently removed from complex mixtures, such as Rhodiola rosea extracts and influent water from the sewage treatment unit of a beer brewery. As, Sb, and Se ions could be selectively adsorbed by FMNP, as demonstrated by the inductively coupled plasma mass spectrometer analyses. We also demonstrated that Pb ions are weakly adsorbed, whereas Cu, Cd, and Zn ions cannot be adsorbed by FMNP. The complexity of the mixture did not affect the selective removal of As, Sb, and Se ions. FMNP could be recycled and used repeatedly. Magnetic separation could then be applied for the selective separation of complex mixtures, such as plant extracts, industrial wastewater, and tap water.
The objective of this study was to build a database to collect infectious disease information at the scene of a disaster through the use of 128 epidemiological questionnaires and 47 types of options, with rapid acquisition of information regarding infectious disease and rapid questionnaire customization at the scene of disaster relief by use of a personal digital assistant (PDA).
SQL Server 2005 (Microsoft Corp, Redmond, WA) was used to create the option database for the infectious disease investigation, to develop a client application for the PDA, and to deploy the application on the server side. The users accessed the server for data collection and questionnaire customization with the PDA.
A database with a set of comprehensive options was created and an application system was developed for the Android operating system (Google Inc, Mountain View, CA). On this basis, an infectious disease information collection system was built for use at the scene of disaster relief. The creation of an infectious disease information collection system and rapid questionnaire customization through the use of a PDA was achieved.
This system integrated computer technology and mobile communication technology to develop an infectious disease information collection system and to allow for rapid questionnaire customization at the scene of disaster relief. (Disaster Med Public Health Preparedness. 2017;11:668–673)