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Noncompressible torso hemorrhage (NCTH) is a major challenge in prehospital bleeding control and is associated with high mortality. This study was performed to estimate medical knowledge and the perceived barriers to information acquisition among health-care workers (HCWs) regarding NCTH in China.
Methods:
A self-administered and validated questionnaire was distributed among 11 WeChat groups consisting of HCWs engaged in trauma, emergency, and disaster rescue.
Results:
A total of 575 HCWs participated in this study. In the knowledge section, the majority (87.1%) denied that successful hemostasis could be obtained by external compression. Regarding attitudes, the vast majority of HCWs exhibited positive attitudes toward the important role of NCTH in reducing prehospital preventable death (90.4%) and enthusiasm for continuous learning (99.7%). For practice, fewer than half of HCWs (45.7%) had heard of NCTH beforehand, only a minority (14.3%) confirmed they had attended relevant continuing education, and 16.3% HCWs had no access to updated medical information. The most predominant barrier to information acquisition was the lack of continuing training (79.8%).
Conclusions:
Knowledge and practice deficiencies do exist among HCWs. Obstacles to update medical information warrant further attention. Furthermore, education program redesign is also needed.
Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.
Aims
This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.
Method
Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.
Results
Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).
Conclusions
COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
Acceptance and willingness to pay for the COVID-19 vaccine are unknown.
Aims
We compared attitudes toward COVID-19 vaccination in people suffering from depression or anxiety disorder and people without mental disorders, and their willingness to pay for it.
Method
Adults with depression or anxiety disorder (n = 79) and healthy controls (n = 134) living in Chongqing, China, completed a cross-sectional study between 13 and 26 January 2021. We used a validated survey to assess eight aspects related to attitudes toward the COVID-19 vaccines. Psychiatric symptoms were assessed by the 21-item Depression, Anxiety and Stress Scale.
Results
Seventy-six people with depression or anxiety disorder (96.2%) and 134 healthy controls (100%) reported willingness to receive the COVID-19 vaccine. A significantly higher proportion of people with depression or anxiety disorder (64.5%) were more willing to pay for the COVID-19 vaccine than healthy controls (38.1%) (P ≤ 0.001). After multivariate adjustment, severity of depression and anxiety was significantly associated with willingness to pay for COVID-19 vaccination among psychiatric patients (P = 0.048). Non-healthcare workers (P = 0.039), health insurance (P = 0.003), living with children (P = 0.006) and internalised stigma (P = 0.002) were significant factors associated with willingness to pay for COVID-19 vaccine in healthy controls.
Conclusions
To conclude, psychiatric patients in Chongqing, China, showed high acceptance and willingness to pay for the COVID-19 vaccine. Factors associated with willingness to pay for the COVID-19 vaccine differed between psychiatric patients and healthy controls.
The Dayao Paleolithic site, located in Inner Mongolia on the eastern margin of China's vast northwestern drylands, was a lithic quarry-workshop utilized by Pleistocene human migrants through the region. Determining the age of this activity has previously yielded controversial results. Our magnetostratigraphic and OSL dating results suggest the two artifact-bearing paleosols are correlated with MIS 5 and 7, respectively. Correlating paleoclimatic data with marine δ18O records leads us to conclude that two sandy gravel layers containing many artifacts in the lower part of the Dayao sequence were formed during MIS 9 and 11, if not earlier. Our results reveal that the earliest human occupation at the Dayao site occurred before ca. 400 ka during a relatively warm and moist interglacial period, similar to several subsequent occupations, documenting the earliest and northernmost archaeological assemblage yet reported in China's arid northwest. We conclude that the northward and southward displacements of the East Asian summer monsoon rain belt during past interglacial-glacial cycles were responsible for the discontinuous human occupation detected at the Dayao site. The penetration of this precipitation regime into dryland ecologies via the Huanghe (Yellow River) Valley effectively created a corridor for hominin migration into China's arid northwest.
The dependence of fishbone cycle on energetic particle intensity has been investigated in EAST low-magnetic-shear plasmas. It is observed that the fishbone mode growth rate, saturation amplitude as well as fishbone cycle frequency clearly increase with increasing neutral beam injection (NBI) power. Moreover, enhanced electron density and temperature perturbations as well as energetic particle loss were observed with greater injected NBI power. Simulation results using M3D-K code show that as the NBI power increases, the resonant frequency and the energy of the resonant particles become higher, and the saturation amplitude of the mode also changes, due to the non-perturbative energetic particle contribution. The relationship between the calculated energetic particle pressure ratio and fishbone cycle frequency is obtained as ${f_{\textrm{FC}}} = 2.2{(1000{\beta _{\textrm{ep,calc}}} - 0.1)^{5.9 \pm 0.5}}$. Results consistent with the experimental observations have been achieved based on a predator–prey model.
Understanding the patterns of treatment response is critical for the treatment of patients with schizophrenia; one way to achieve this is through using a longitudinal dynamic process study design.
Aims
This study aims to explore the response trajectory of antipsychotics and compare the treatment responses of seven different antipsychotics over 6 weeks in patients with schizoprenia (trial registration: Chinese Clinical Trials Registry Identifier: ChiCTR-TRC-10000934).
Method
Data were collected from a multicentre, randomised open-label clinical trial. Patients were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and follow-up at weeks 2, 4 and 6. Trajectory groups were classified by the method of k-means cluster modelling for longitudinal data. Trajectory analyses were also employed for the seven antipsychotic groups.
Results
The early treatment response trajectories were classified into a high-trajectory group of better responders and a low-trajectory group of worse responders. The results of trajectory analysis showed differences compared with the classification method characterised by a 50% reduction in PANSS scores at week 6. A total of 349 patients were inconsistently grouped by the two methods, with a significant difference in the composition ratio of treatment response groups using these two methods (χ2 = 43.37, P < 0.001). There was no differential contribution of high- and low trajectories to different drugs (χ2 = 12.52, P = 0.051); olanzapine and risperidone, which had a larger proportion in the >50% reduction at week 6, performed better than aripiprazole, quetiapine, ziprasidone and perphenazine.
Conclusions
The trajectory analysis of treatment response to schizophrenia revealed two distinct trajectories. Comparing the treatment responses to different antipsychotics through longitudinal analysis may offer a new perspective for evaluating antipsychotics.
This study aimed to identify clinical features for prognosing mortality risk using machine-learning methods in patients with coronavirus disease 2019 (COVID-19). A retrospective study of the inpatients with COVID-19 admitted from 15 January to 15 March 2020 in Wuhan is reported. The data of symptoms, comorbidity, demographic, vital sign, CT scans results and laboratory test results on admission were collected. Machine-learning methods (Random Forest and XGboost) were used to rank clinical features for mortality risk. Multivariate logistic regression models were applied to identify clinical features with statistical significance. The predictors of mortality were lactate dehydrogenase (LDH), C-reactive protein (CRP) and age based on 500 bootstrapped samples. A multivariate logistic regression model was formed to predict mortality 292 in-sample patients with area under the receiver operating characteristics (AUROC) of 0.9521, which was better than CURB-65 (AUROC of 0.8501) and the machine-learning-based model (AUROC of 0.4530). An out-sample data set of 13 patients was further tested to show our model (AUROC of 0.6061) was also better than CURB-65 (AUROC of 0.4608) and the machine-learning-based model (AUROC of 0.2292). LDH, CRP and age can be used to identify severe patients with COVID-19 on hospital admission.
This paper presents a soft robot which can imitate the crawling locomotion of an earthworm. Locomotion of the robot can be achieved by expanding and contracting the body that is made of flexible material. A link of the earthworm-like robot is combined with three modules, and a multi-cavity earthworm-like soft robot is combined with multiple links. The multiple links of the earthworm-like soft robot are fabricated by silicone in the three-dimensional printed customized molds. Experiments on a single module, two-links, and three-links show that the soft robot can move and bend on condition of modules extension and contraction in a specified gait. The development of the earthworm-like soft robot shows a great prospect in many complicated environments such as pipeline detection.
Infant colic is a condition of unknown cause which can result in carer distress and attachment difficulties. Recent studies have implicated the gut microbiota in infant colic, and certain probiotics have demonstrated possible efficacy. We aim to investigate whether the intestinal microbiota composition in infants with colic is associated with cry/fuss time at baseline, persistence of cry/fuss at 4-week follow-up, or child behavior at 2 years of age. Fecal samples from infants with colic (n = 118, 53% male) were analyzed using 16S rRNA sequencing. After examining the alpha and beta diversity of the clinical samples, we performed a differential abundance analysis of the 16S data to look for taxa that associate with baseline and future behavior, while adjusting for potential confounding variables. In addition, we used random forest classifiers to evaluate how well baseline gut microbiota can predict future crying time. Alpha diversity of the fecal microbiota was strongly influenced by birth mode, feed type, and child gender, but did not significantly associate with crying or behavioral outcomes. Several taxa within the microbiota (including Bifidobacterium, Clostridium, Lactobacillus, and Klebsiella) associate with colic severity, and the baseline microbiota composition can predict further crying at 4 weeks with up to 65% accuracy. The combination of machine learning findings with associative relationships demonstrates the potential prognostic utility of the infant fecal microbiota in predicting subsequent infant crying problems.
The polymerization of 3,4-ethylenedioxythiophene (EDOT) onto nanosilica (SiO2) was synthesized in this study by using supercritical carbon dioxide (SCCO2). With the addition of dopants of p-toluenesulfonic acid (p-TSA) or decylbenzene sulfonic acid (DBSA), the PEDOT/SiO2 composite became conductive. The product was characterized by FTIR spectroscopy and the core-shell structure was confirmed through the TEM images. The electrical properties were analyzed by UV-vis absorbance and four-point probe measurement. DBSA is shown as the better dopants with the molar ratio (DBSA/EDOT) of 0.2 at the reaction time of 48 hours. The maximum coating percentage is 63 wt% under the optimal operation conditions at 40oC and 280 bar. The conductivity is tuned up to 6.6×10-2 S/cm after the coating process.
We aimed to investigate the association between plasma retinol and incident cancer among Chinese hypertensive adults. We conducted a nested case–control study, including 231 patients with incident cancer and 231 matched controls during a median 4·5-year follow-up of the China Stroke Primary Prevention Trial. There was a significant, inverse association between retinol levels and digestive system cancer (per 10 μg/dl increases: OR 0·79; 95 % CI 0·69, 0·91). When compared with participants in the first quartile of retinol (< 52·3 μg/dl), a significantly lower cancer risk was found in participants in quartile 2–4 ( ≥ 52·3 μg/dl: OR 0·31; 95 % CI 0·13, 0·71). However, there was a U-shaped association between retinol levels and non-digestive system cancers where the risk of cancers decreased (although not significantly) with each increment of plasma retinol (per 10 μg/dl increases: OR 0·89; 95 % CI 0·60, 1·31) in participants with retinol < 68·2 μg/dl, and then increased significantly with retinol (per 10 μg/dl increase: OR 1·65; 95 % CI 1·12, 2·44) in participants with retinol ≥ 68·2 μg/dl. In conclusion, there was a significant inverse dose–response association between plasma retinol and the risk of digestive system cancers. However, a U-shaped association was observed between plasma retinol and the risk of non-digestive cancers (with a turning point approximately 68·2 μg/dl).
To revise an abbreviated version of the Silhouettes subtest of the Visual Object and Space Perception (VOSP) battery in order to recognize mild cognitive impairment (MCI) and determine the optimal cutoffs to differentiate among cognitively normal controls (NC), MCI, and Alzheimer’s Disease (AD) in the Chinese elderly.
Design:
A cross-sectional validation study.
Setting:
Huashan Hospital, Shanghai, China.
Subjects:
A total of 591 participants: Individuals with MCI (n = 211), AD (n = 139) and NC (n = 241) were recruited from the Memory Clinic, Huashan Hospital, Shanghai, China.
Methods:
Baseline neuropsychological battery (including VOSP) scores were collected from firsthand data. An abbreviated version of silhouettes test (Silhouettes-A) was revised from the original English version more suitable for the elderly, including eight silhouettes of animals and seven silhouettes of inanimate objects, with a score ranging from 0 to 15.
Results:
Silhouettes-A was an effective test to screen MCI in the Chinese elderly with good sensitivity and specificity, similar to the Montreal cognitive assessment and superior to other single tests reflecting language, spatial, or executive function. However, it had no advantage in distinguishing MCI from AD. The corresponding optimal cutoff scores of Silhouettes-A were 10 for screening MCI and 8 for AD.
Conclusion:
Silhouettes-A is a quick, simple, sensitive, and dependable cognitive test to distinguish among NC, MCI, and AD patients.
Given the global water challenges, solar-driven steam generation has become a renewed topic recently as an energy-efficient way for clean water production. Here, a hybrid plasmonic structure consisting of a top layer of TiN nanoparticles (NPs) and a bottom layer of mesoporous anodized alumina membrane (AAM) was rationally designed and fabricated. The top TiN NPs with broadband light absorption acted as a plasmonic heating layer, which converted the absorbed light to heat efficiently for interfacial water heating. The AAM acted as the mechanical support layer, guaranteeing the heat isolation and continuous water replenishment. With optimized thickness of the TiN top layer, a solar steam generation efficiency of 87.7% was achieved in this study. This efficiency is comparable or even higher than prior studies. The current work proves the capability of the TiN NPs as an alternative photothermal material.
Employing self-determination theory, in this study, we explore how workplace ostracism (being ignored and excluded by others) affects newcomer’s voice behavior. Through an empirical study with 353 matched supervisor–subordinate pairs from a large high-technology company, we find that workplace ostracism has negative influence on newcomer’s both promotive and prohibitive voice through the mediating effect of psychological needs satisfaction. In addition, narcissism moderates the effects of ostracism on psychological needs satisfaction. Theoretical and practical implications of these findings are discussed.
Orthogonal frequency division multiplex (OFDM) system is a special cognitive radio system that is widely used in military and civilian applications. As a crucial aspect of spectrum monitoring and electronic countermeasures reconnaissance, it is important to identify the OFDM signal. An identification method based on fractal box dimension and pseudo-inverse spectrum (PIS) has been proposed in this paper for the recognition problem of OFDM signal under multipath channel. Firstly, by theoretically analyzing the fractal box dimension of OFDM signal and single carrier (SC) signal, it can be concluded that the fractal box dimension of OFDM signal and SC signal has obvious differences. Thus, the fractal box dimension of the two types of signal is used to discriminate OFDM signal and SC signal. Then, the PIS of an OFDM signal is constructed according to the characteristics of the OFDM signal. Through theoretical analysis and the experimental simulation, it illustrates that the classification feature could be extracted by detecting the periodical peak of the PIS of OFDM signal and used for identifying OFDM signal in the Gaussian noise. Simulation results demonstrate that the proposed algorithm has better performance than the conventional algorithm based on autocorrelation.
Transition metal dichalcogenides (TMDC), such as MoS2, WS2 have attracted attention due to their mechanical and electronic properties in their two dimensional (2D) structures. Here, we report a facile growth of monolayer TMDC using oxide source materials with the assistant of NaCl. The addition of NaCl can enhance the lateral growth and widen the growth window of TMDC. Through carefully controlling the growth parameters, large area growth of TMDC can be achieved. Two steps E-beam lithography was utilized to fabricate electrodes of TMDC. The phototransistors made from the CVD grown TMDC show strong persistent photoconductivity (PPC). It was finally shown that TMDC device capping with h-BN could have suppressed PPC effects.
The thermal properties of organic membranes attract much attention due to the fact that heat dissipation in electronic devices limits their functionality and reliability. Here, we enhance the thermal conductivity of polyvinyl alcohol (PVA) membrane using nano-fibers fabricated by electrospinning. Measured by the 3-Omega method, the results show that the effective thermal conductivity of the electrospinning membranes (with/without Cu nanoparticles) are as high as 0.7 W/m-K at room temperature which is as twice as the value of thermal conductivity of amorphous spin-coated PVA membrane (0.35 W/m-K). The mechanism of enhancement are that, compared with amorphous membrane, the phonon scattering is attenuated and the crystallinity is improved in the electrospinning process. Our studies bring new insights in designing new kind of membrane with high thermal conductivity.
In the foreland area of western Taiwan, some of the pre-orogenic basement-involved normal faults were reactivated during the subsequent compressional tectonics. The main purpose of this paper is to investigate the role played by the pre-existing normal faults in the recent tectonics of western Taiwan. In NW Taiwan, reactivated normal faults with a strike-slip component have developed by linkage of reactivated single pre-existing normal faults in the foreland basin and acted as transverse structures for low-angle thrusts in the outer fold-and-thrust belt. In the later stage of their development, the transverse structures were thrusted and appear underneath the low-angle thrusts or became tear faults in the inner fold-and-thrust belt. In SW Taiwan, where the foreland basin is lacking normal fault reactivation, the pre-existing normal faults passively acted as ramp for the low-angle thrusts in the inner fold-and-thrust belt. Some of the active faults in western Taiwan may also be related to reactivated normal faults with right-lateral slip component. Some main earthquake shocks related to either strike-slip or thrust fault plane solution occurred on reactivated normal faults, implying a relationship between the pre-existing normal fault and the triggering of the recent major earthquakes. Along-strike contrast in structural style of normal fault reactivation gives rise to different characteristics of the deformation front for different parts of the foreland area in western Taiwan. Variations in the degree of normal fault reactivation also provide some insights into the way the crust embedding the pre-existing normal faults deformed in response to orogenic contraction.