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This systematic review aims to synthesise findings from randomised, controlled trials and assess the efficacy and safety of radiofrequency ablation in treating allergic rhinitis.
Methods
A thorough search was conducted across PubMed, the Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, WanFang, Chinese Scientific Journal, and Chinese Biomedical Literature databases from their inception until October 2023. The primary outcome measure was the total effective rate, with secondary outcomes including adverse events.
Results
This review included 15 randomised, controlled trials involving 1430 patients. The pooled analysis revealed a statistically significant effect on the total effective rate (odds ratio = 3.27, 95 per cent confidence interval = 2.37 to ~4.51). However, no statistical significance was observed in adverse events (odds ratio = 1.18, 95 per cent confidence interval = 0.67 to ~2.08).
Conclusions
Based on the analytical results, radiofrequency ablation emerges as an efficacious and safe treatment modality for allergic rhinitis. Given the constraints posed by a limited sample size, it is imperative that forthcoming clinical trials adhere rigorously to the gold standard of randomised, controlled trials for the purpose of corroborating these conclusions.
To explore the associations between nutrition literacy (NL) and possible sarcopenia in older Chinese adults. A cross-sectional study was conducted. NL was assessed using a twelve-item short-form NL scale. Possible sarcopenia was identified using SARC-CALF. Logistic regression was used to calculate OR and 95 % CI for NL and the incidence of possible sarcopenia. A total of 1338 older individuals, aged 71·41 (sd 6·84) years, were enrolled in this study. After confounders were adjusted for, older adults in the upper quartile of NL were found to be 52 % less likely to have possible sarcopenia than those in the lower quartile of NL (OR = 0·48, 95 % CI: 0·29, 0·77). The associations between NL and possible sarcopenia were present only in those who lived in rural areas (OR: 0·38, 95 % CI: 0·19, 0·77), had a primary school education or less (OR: 0·21, 95 % CI: 0·09, 0·48), had a monthly income < 3000 RMB (OR: 0·39, 95 % CI: 0·22, 0·70) and had chronic diseases (OR: 0·37, 95 % CI: 0·22, 0·63). Moreover, an interaction effect was observed between having a chronic disease and junior high school education and being in the upper quartile of NL. The prevalence of possible sarcopenia in older Chinese adults is substantial, with prevalence decreasing with increasing NL. Moreover, the association between NL and possible sarcopenia varies by residence type, education level, monthly income and chronic disease experience. Targeted NL interventions are required to prevent and manage sarcopenia in older adults, particularly those with low socio-economic status and chronic diseases.
Characterised by the extensive use of obsidian, a blade-based tool inventory and microblade technology, the late Upper Palaeolithic lithic assemblages of the Changbaishan Mountains are associated with the increasingly cold climatic conditions of Marine Isotope Stage 2, yet most remain poorly dated. Here, the authors present new radiocarbon dates associated with evolving blade and microblade toolkits at Helong Dadong, north-east China. At 27 300–24 100 BP, the lower cultural layers contain some of the earliest microblade technology in north-east Asia and highlight the importance of the Changbaishan Mountains in understanding changing hunter-gatherer lifeways in this region during MIS 2.
Background: Healthcare-associated central line associated bloodstream infection (HA-CLABSI) surveillance is important for monitoring healthcare-associated infections (HAIs) and evaluating effectiveness of infection prevention (IP) measures. However, implementing it is a laborious and time-consuming approach. Exclusive focus on central lines neglects HAI risk due to peripheral vascular catheters. This study aimed to assess whether HA-CLABSI incidence could be inferred from HA-bloodstream infection (BSI) trends and explore shift to HA-BSI surveillance. Methods: The study was performed in a Singaporean tertiary care hospital. Electronic medical records review was performed to determine whether positive blood cultures met Centers for Disease Control/National Health Safety Network (CDC/NHSN) definitions for HA-CLABSI and HA-BSI. Incident episodes of HA-BSI were included (excluding positive cultures repeated within 14 days). Incident organisms were explored to identify common causative pathogens (excluding same organisms isolated from cultures repeated within 14 days). CLABSI and BSI occurring ≥72hrs after admission were considered healthcare-associated. Patients under oncology or hematology service were considered immunocompromised. Incidence rates (IR) per 10,000 patient-days, patient characteristics and causative pathogens were compared between both indicators. Results: From January 2022 to October 2023, mean IR for HA-CLABSI was 0.63 (n=68) and for HA-BSI was 10.06 (n=1094). Median age of patients with HA-CLABSI was 66 years and HA-BSI was 68 years. HA-CLABSI and HA-BSI were more common in males (60.86% & 58.68%). Median duration between admission to HA-CLABSI was 20 days and to HA-BSI was 12 days. Median duration between central line insertion to HA-CLABSI was 16 days. Of 1094, 631 (57.7%) patients had vascular catheter(s) (i.e., IV cannula, port-a-cath, peripherally-inserted central catheter or central line) inserted at time of HA-BSI diagnosis, of whom 46 (7.3%) patients had CLABSI ±2days from positive blood culture. There was no significant correlation between monthly aggregate data from these indicators (Spearman’s correlation coefficient= 0.36, p-value=0.1). Predominant organisms causing HA-CLABSI and HA-BSI were gram negative bacteria (GNB, 40% & 57.21%), gram positive bacteria (24.71% & 22.23%), and fungi. Common GNB in CLABSI patients were Pseudomonas spp. and Stenotrophomonas maltophilia (8.24%), followed by Serratia marcescens and Klebsiella pneumoniae (5.88%). The frequent GNB in HA-BSI patients were Escherichia coli (15.4%), Klebsiella pneumonia (12.68%), and Pseudomonas spp. (6.69%). Common multi-drug resistant organisms were vancomycin-resistant Enterococcus faecium (10.59% & 3.69%) and methicillin-resistant Staphylococcus aureus (10.59% & 3.07%). Conclusion: HA-BSI did not correlate with HA-CLABSI. HA-BSI reflects heterogenous population outcomes. For utilization as surveillance indicator, further assessment on exclusion criteria is required to improve specificity.
Real-time reverse-transcriptase polymerase chain reaction (RT-PCR) has been the gold standard for diagnosing coronavirus disease 2019 (COVID-19) but has a lag time for the results. An effective prediction algorithm for infectious COVID-19, utilized at the emergency department (ED), may reduce the risk of healthcare-associated COVID-19.
Objective:
To develop a prototypic prediction model for infectious COVID-19 at the time of presentation to the ED.
Material and methods:
Retrospective cohort study of all adult patients admitted to Singapore General Hospital (SGH) through ED between March 15, 2020, and December 31, 2022, with admission of COVID-19 RT-PCR results. Two prediction models were developed and evaluated using area under the curve (AUC) of receiver operating characteristics (ROC) to identify infectious COVID-19 patients (cycle threshold (Ct) of <25).
Results:
Total of 78,687 patients were admitted to SGH through ED during study period. 6,132 of them tested severe acute respiratory coronavirus 2 positive on RT-PCR. Nearly 70% (4,226 of 6,132) of the patients had infectious COVID-19 (Ct<25). Model that included demographics, clinical history, symptom and laboratory variables had AUROC of 0.85 with sensitivity and specificity of 80.0% & 72.1% respectively. When antigen rapid test results at ED were available and added to the model for a subset of the study population, AUROC reached 0.97 with sensitivity and specificity of 95.0% and 92.8% respectively. Both models maintained respective sensitivity and specificity results when applied to validation data.
Conclusion:
Clinical predictive models based on available information at ED can be utilized for identification of infectious COVID-19 patients and may enhance infection prevention efforts.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
As an important component of prehistoric subsistence, an understanding of bone-working is essential for interpreting the evolution of early complex societies, yet worked bones are rarely systematically collected in China. Here, the authors apply multiple analytical methods to worked bones from the Longshan site of Pingliangtai, in central China, showing that Neolithic bone-working in this area, with cervid as the main raw material, was mature but localised, household-based and self-sufficient. The introduction of cattle in the Late Neolithic precipitated a shift in bone-working traditions but it was only later, in the Bronze Age, that cattle bones were utilised in a specialised fashion and dedicated bone-working industries emerged in urban centres.
Many professional managers are driven to achieve the bottom line to secure income, honor, and standing in the workplace. Drawing on social information processing theory, we propose that supervisor bottom-line mentality in the workplace has a dysfunctional effect on organizations. Specifically, supervisor bottom-line mentality will hinder subordinates’ perception of the meaning of work, which eventuates high employee withdrawal (turnover intention and work withdrawal behavior). We also verified that amoral management weakens the negative relationship between supervisor bottom-line mentality and meaning of work in the first-stage moderated mediation model. Additionally, the strength of the indirect effects of supervisor bottom-line mentality on turnover intention and work withdrawal behavior is weaker (stronger) when supervisors’ amoral management is high (low). Our hypothesized moderated mediation model is supported by 301 data points generated by a three-stage full-time staff member. Furthermore, we put forward important theoretical and practical implications according to the research.
Tuberculosis (TB) infection prevention and control (IPC) in healthcare facilities is key to reducing transmission risk. A framework for systematically improving TB IPC through training and mentorship was implemented in 9 healthcare facilities in China from 2017 to 2019.
Methods:
Facilities conducted standardized TB IPC assessments at baseline and quarterly thereafter for 18 months. Facility-based performance was assessed using quantifiable indicators for IPC core components and administrative, environmental, and respiratory protection controls, and as a composite of all control types We calculated the percentage changes in scores over time and differences by IPC control type and facility characteristics.
Results:
Scores for IPC core components increased by 72% during follow-up when averaged across facilities. The percentage changes for administrative, environmental, and respiratory protection controls were 39%, 46%, and 30%, respectively. Composite scores were 45% higher after the intervention. Overall, scores increased most during the first 6 months. There was no association between IPC implementation and provincial economic development or volume of TB services.
Conclusions:
TB IPC policies and practices showed most improvement early during implementation and did not differ consistently by facility characteristics. The training component of the project helped increase the capacity of healthcare professionals to manage TB transmission risks. Lessons learned here will inform national TB IPC guidance.
As frontline workers, pharmacists often face significant work stress, especially in psychiatric settings. A multicenter cross-sectional design was conducted in 41 psychiatric hospitals. The Depression, Anxiety and Stress Scale–21 (DASS-21) was used to measure the mental health of 636 pharmacists. We also collected demographic data and work-related variables. The prevalence of depression, anxiety and stress was 20.60%, 22.96% and 8.96%, respectively. Multivariate logistic regression showed that several common factors were associated with depression, anxiety and stress, including professional identity (odds ratio [OR] = 0.132, 0.381 and 0.352) and verbal violence (OR = 2.068, 2.615 and 2.490). Those who were satisfied with their job were less likely to develop depression (OR = 0.234) or anxiety (OR = 0.328). We found specific factors associated with mental health. Older age (OR = 1.038) and perceived negative impact (OR = 2.398) of COVID-19 on medical work were associated with anxiety, and those with frontline experience with COVID-19 patients (OR = 2.306) were more likely to experience stress. More than one-fifth of pharmacists in psychiatric hospitals experienced symptoms of depression or anxiety during the pandemic, highlighting the need for policy change to improve workplace conditions and psychological well-being for this professional group.
As there exists a growing demand for chronological research and tracer applications using radiocarbon (14C) analyses of samples smaller than 100 μg C, a compact micro-specific hydrogen graphitization method has been developed at the Xi’an Accelerator Mass Spectrometry (AMS) Center. This article describes the performance of the system and the mass of carbon background produced during ultra-small sample preparation. Furthermore, we discuss the results of contamination corrections and perform 14C analyses on small samples with known age or reference values. The results reveal that our 14C analysis of ultra-small samples of 10–100 μg C can obtain accurate and reliable results, and the micro-scale 14C-AMS analysis technique meets our research objectives for dating and tracer applications.
A steady granular flow experiment was performed in a confined annular shear cell to examine how the wall friction coefficient $\mu _w$ degrades from the intrinsic sliding friction coefficient $f$ between the grains and the container wall. Two existing models are invoked to examine the decay trend of $\mu _w/f$ in view of the ratio of shear velocity to the square root of granular temperature $\chi$ (Artoni & Richard, Phys. Rev. Lett., vol. 115, 2015, 158001) and the ratio of grain angular and slip velocities $\varOmega$ (Yang & Huang, Granul. Matt., vol. 18, issue 4, 2016, p. 77), respectively. As both models correlate $\mu _w/f$ to different flow properties, a hidden relation is speculated between $\chi$ and $\varOmega$, or equivalently, between the granular temperature and the grain rotation speed. We used experiment data to confirm and reveal this hidden relation. From there, a unified $\mu _w/f-\chi$ model is proposed with physical meanings for the model coefficients and to show general agreement with the measured trend. Hence we may conclude that both the fluctuations in grain translations and their mean rotation are the crucial yet equivalent mechanisms to degrade $\mu _w/f$.
SARS-CoV-2 rapidly spreads among humans via social networks, with social mixing and network characteristics potentially facilitating transmission. However, limited data on topological structural features has hindered in-depth studies. Existing research is based on snapshot analyses, preventing temporal investigations of network changes. Comparing network characteristics over time offers additional insights into transmission dynamics. We examined confirmed COVID-19 patients from an eastern Chinese province, analyzing social mixing and network characteristics using transmission network topology before and after widespread interventions. Between the two time periods, the percentage of singleton networks increased from 38.9$ \% $ to 62.8$ \% $$ (p<0.001) $; the average shortest path length decreased from 1.53 to 1.14 $ (p<0.001) $; the average betweenness reduced from 0.65 to 0.11$ (p<0.001) $; the average cluster size dropped from 4.05 to 2.72 $ (p=0.004) $; and the out-degree had a slight but nonsignificant decline from 0.75 to 0.63 $ (p=0.099). $ Results show that nonpharmaceutical interventions effectively disrupted transmission networks, preventing further disease spread. Additionally, we found that the networks’ dynamic structure provided more information than solely examining infection curves after applying descriptive and agent-based modeling approaches. In summary, we investigated social mixing and network characteristics of COVID-19 patients during different pandemic stages, revealing transmission network heterogeneities.
Polymers maintain colloidal stability by adsorbing onto the surface of sepiolite particles, and changes in temperature and salinity can affect this process. We chose three typical polymers to investigate their interactions with sepiolite under high-salinity (15 wt.% NaCl) conditions at >180°C. Sepiolite samples were characterized using infrared testing, X-ray diffraction testing, contact angle testing, thermogravimetric testing, filtration loss testing and rheological testing. The experimental results showed that the desorption of the polymers under high-temperature and high-salinity conditions reduces the stability and filtration control of the suspension significantly. Adding polymers to sepiolite suspensions can maintain good stability even after thermal ageing at 240°C. In terms of drilling fluid regulation, sepiolite can play a role in regulating rheological properties, and the interactions between various polymers and sepiolite can be utilized to maintain the stable colloidal state of the drilling fluid. Studying the adsorption behaviour of various types of polymers on the surface of sepiolite under high-temperature and high-salinity conditions has important implications for the design and selection of sepiolite drilling fluid treatment agents.
An 8-week experiment was performed to investigate the influence on growth performance, plasma biochemistry, glucose metabolism and the insulin pathway of supplementation of dietary taurine to a high-carbohydrate diet for grass carp. In this study, fish were fed diets at one of two carbohydrate levels, 31·49 % (positive control) or 38·61 % (T00). The high-carbohydrate basal diet (T00), without taurine, was supplemented with 0·05 % (T05), 0·10 % (T10), 0·15 % (T15) or 0·20 % (T20) taurine, resulting in six isonitrogenous (30·37 %) and isolipidic (2·37 %) experimental diets. The experimental results showed that optimal taurine level improved significantly weight gain, specific growth rate (SGR), feed utilisation, reduced plasma total cholesterol levels, TAG and promoted insulin-like growth factor level. Glucokinase, pyruvate kinase and phosphoenolpyruvate carboxykinase activities showed a quadratic function model with increasing dietary taurine level, while hexokinase, fatty acid synthetase activities exhibited a positive linear trend. Optimal taurine supplementation in high-carbohydrate diet upregulated insulin receptor (Ir), insulin receptor substrate (Irs1), phosphatidylinositol 3-kinase (pi3k), protein kinase B (akt1), glycogen synthase kinase 3 β (gs3kβ) mRNA level and downregulated insulin-like growth factor (igf-1), insulin-like growth factor 1 receptor (igf-1R) and Fork head transcription factor 1 (foxo1) mRNA level. The above results suggested that optimal taurine level could improve growth performance, hepatic capacity for glycolipid metabolism and insulin sensitivity, thus enhancing the utilisation of carbohydrates in grass carp. Based on SGR, dietary optimal tributyrin taurine supplementation in grass carp was estimated to be 0·08 %.
A slip asymmetry can break the fore–aft symmetry of the local hydrodynamic force distribution on the surface of an otherwise no-slip or uniform-slip particle. Here, we use the Lorentz reciprocal theorem to demonstrate that such asymmetry, even in a fractional amount, can qualitatively alter the swimming characteristics of a self-propelled spherical squirmer, markedly different from those of no-slip or uniform-slip squirmers. Unlike the usual tangential squirming by the thrust-providing B1 mode and the type-determining B2 mode, we discover two unique features for a stick-slip squirmer. First, the squirmer can acquire a swimming velocity U without the B1 mode but simply by a symmetric extensile/contractile squirming from the B2 mode, which is able to reverse the swimming direction of the squirmer. Second, a stresslet $\boldsymbol{\mathsf{S}}$ can also be induced by a unidirectional squirming from the B1 mode, capable of inverting the squirmer's stresslet from extensile type to contractile type or vice versa to change the squirmer from puller to pusher or in a reverse manner. We further show that the two squirming modes can reinforce or compete with each other to enhance or diminish U and $\boldsymbol{\mathsf{S}}$ due to interplays between the asymmetric squirming forces on the stick and the slip faces. A phase diagram is also established to categorize a variety of newly emerging swimming states, such as an enhanced/degraded puller/pusher and a backward puller/pusher, depending on the relative strength of the squirming modes β = B2/B1, the direction of the stick-slip polarity and the degree of the slip disparity. As a result of such cooperative and competitive natures, a stick-slip squirmer can swim more or less efficiently than no-slip and uniform-slip ones. These distinctive features arising from stick-slip disparity can not only be made geometrically tuneable for steering the motion of a squirmer, but also provide new means for making efficient artificial microswimmers using amphiphilic Janus particles.
At present, among college students, their psychological state has problems of varying degrees. Serious psychological problems will make students suffer from anxiety and depression and other mental diseases, which will damage their cognitive function, and then seriously affect their learning and life. Therefore, colleges and universities should pay close attention to students’ psychological state and improve the professional quality of teachers and students to help students improve their cognitive function of depression.
Subjects and Methods
93 patients with depression from 3 colleges and universities were selected as the research objects to participate in the experiment of improving the cognitive function of depression by the combination of professional quality and psychosocial intervention in colleges and universities. In the experiment, 93 college students were divided into three groups, 31 in each group, which were the psychosocial intervention group, the intervention group for improving professional quality, and the combination intervention group. Self-Rating Depression Scale (SDS) and State Trait Anxiety Inventory (ATAI) were used to analyze the anxiety symptoms of college students before and after the experiment.
Results
The SDS scores and ATAI scores of the three groups of patients before and after the experiment are shown in Table 1. Before the experiment, there was no significant difference in the scores of the three groups. After the experiment, the scores of each group decreased to varying degrees, and the effect of the combination intervention group was the most obvious.Table 1.
Comparison results of two groups of patients
Experimental grouping
SDS
ATAI
Before experiment
After experiment
Before experiment
After experiment
Psychosocial intervention group
64.24±3.51
52.16±2.55
67.12±2.48
41.25±2.74
Intervention group for improving professional quality
63.35±3.19
50.15±2.16
68.04±3.17
40.98±1.95
Combination intervention group
64.39±3.27
42.11±3.41
37.59±3.07
31.28±1.36
Conclusions
In the research on the improvement of college students’ cognitive function of depression, the experiment successfully helped college students improve their mental status by combining the methods of improving college students’ professional quality with the methods of psychosocial intervention. Therefore, this method can significantly improve students’ cognitive function of depression.
On 18 March 2014, outraged students, university faculty, and workers from nongovernmental organisations (NGOs) marched on the Legislative Yuan – Taiwan’s unicameral parliament – to protest the Cross-Strait Service Trade Agreement, a free trade pact with China that protesters believed would harm the economy and leave Taiwan vulnerable to political pressure from Beijing. Some 300 activists occupied the legislative chamber, while hundreds more gathered outside. This unprecedented occupation lasted for 24 days and there was also a demonstration on 30 March when about 500,000 people surrounded parliament. The media dubbed the action the ‘Sunflower Movement’ when a florist sent bunches of sunflowers to the protesters at the parliament building, but this name was not accepted by many of the activists. All of my research participants for this chapter prefer to call it the ‘3/18 Parliament Occupation Movement’, or the 3/18 Movement for short. This term is used throughout the chapter.
The movement opposing the free trade pact was one of a string of protests against President Ying-Jeou Ma’s embrace of China since taking office in 2008. For example, there was an anti– Media Monopoly Campaign in 2012, fuelled by widespread worry that China intended to use the mass media to spread its political propaganda and control Taiwan. Since 2008, citizens of Taiwan have formed many NGOs, including Taiwan Democracy Watch and the Democratic Front Against the Cross-Strait Service Trade Agreement, to put pressure on Taiwan’s government to sustain democracy and national sovereignty.
The 3/18 Movement’s parliamentary occupation was planned secretly by a small group of activists – students and professionals – in an informal network based on their cooperation in a series of social movements and protests in previous years (Hsu et al, 2019). According to my research participants, no one had expected that the occupation would last for more than three weeks. After several unsuccessful forced eviction attempts by the police, the activists occupied several areas: the Main Chamber of the parliament, the yard of the parliament (separated from the Main Chamber and the yard by some police officers) and the streets surrounding the parliament building.
Youth suicide rates have increased markedly in some countries. This study aimed to estimate the population-attributable risk of psychiatric disorders associated with suicide among Taiwanese youth aged 10–24 years.
Methods
Data were obtained from the National Death Registry and National Health Insurance (NHI) claims database between 2007 and 2019. Youth who died by suicide were included, and comparisons, 1:10 matched by age and sex, were randomly selected from the Registry for NHI beneficiaries. We used multivariable logistic regression to estimate suicide odds ratios for psychiatric disorders. The population-attributable fractions (PAF) were calculated for each psychiatric disorder.
Results
A total of 2345 youth suicide and 23 450 comparisons were included. Overall, 44.8% of suicides had a psychiatric disorder, while only 7.9% of the comparisons had a psychiatric disorder. The combined PAF for all psychiatric disorders was 55.9%. The top three psychiatric conditions of the largest PAFs were major depressive disorder, dysthymia, and sleep disorder. In the analysis stratified by sex, the combined PAF was 45.5% for males and 69.2% for females. The PAF among young adults aged 20–24 years (57.0%) was higher than among adolescents aged 10–19 years (48.0%).
Conclusions
Our findings of high PAF from major depressive disorder, dysthymia, and sleep disorder to youth suicides suggest that youth suicide prevention that focuses on detecting and treating mental illness may usefully target these disorders.
Coronavirus disease 2019 (COVID-19) asymptomatic cases are hard to identify, impeding transmissibility estimation. The value of COVID-19 transmissibility is worth further elucidation for key assumptions in further modelling studies. Through a population-based surveillance network, we collected data on 1342 confirmed cases with a 90-days follow-up for all asymptomatic cases. An age-stratified compartmental model containing contact information was built to estimate the transmissibility of symptomatic and asymptomatic COVID-19 cases. The difference in transmissibility of a symptomatic and asymptomatic case depended on age and was most distinct for the middle-age groups. The asymptomatic cases had a 66.7% lower transmissibility rate than symptomatic cases, and 74.1% (95% CI 65.9–80.7) of all asymptomatic cases were missed in detection. The average proportion of asymptomatic cases was 28.2% (95% CI 23.0–34.6). Simulation demonstrated that the burden of asymptomatic transmission increased as the epidemic continued and could potentially dominate total transmission. The transmissibility of asymptomatic COVID-19 cases is high and asymptomatic COVID-19 cases play a significant role in outbreaks.