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Somatic cell nuclear transfer (SCNT) holds vast potential in agriculture. However, its applications are still limited by its low efficiency. Histone 3 lysine 9 trimethylation (H3K9me3) was identified as an epigenetic barrier for this. Histone demethylase KDM4D could regulate the level of H3K9me3. However, its effects on buffalo SCNT embryos are still unclear. Thus, we performed this study to explore the effects and underlying mechanism of KDM4D on buffalo SCNT embryos. The results revealed that compared with the IVF embryos, the expression level of KDM4D in SCNT embryos was significantly lower at 8- and 16-cell stage, while the level of H3K9me3 in SCNT embryos was significantly higher at 2-cell, 8-cell, and blastocyst stage. Microinjection of KDM4D mRNA could promote the developmental ability of buffalo SCNT embryos. Furthermore, the expression level of ZGA-related genes such as ZSCAN5B, SNAI1, eIF-3a, and TRC at the 8-cell stage was significantly increased. Meanwhile, the pluripotency-related genes like POU5F1, SOX2, and NANOG were also significantly promoted at the blastocyst stage. The results were reversed after KDM4D was inhibited. Altogether, these results revealed that KDM4D could correct the H3K9me3 level, increase the expression level of ZGA and pluripotency-related genes, and finally, promote the developmental competence of buffalo SCNT embryos.
High fiber intake is associated with reduced mortality risk in both general and chronic kidney disease populations. However, in dialysis patients such data is limited. Therefore, the association between dietary fiber intake (DFI) and the risk of all-cause and cardiovascular disease (CVD) mortality was examined in this study. A total of 1044 maintenance hemodialysis (MHD) patients from eight outpatient dialysis centers in China were included in this study. Data on DFI was collected using 24-h dietary recalls for three days in a week and was normalized to actual dry weight. The study outcomes included all-cause and CVD mortality. Over a median of 46 months of follow-up, 354 deaths were recorded, of which 210 (59%) were due to CVD. On assessing DFI as tertiles, the CVD mortality risk was significantly lower in patients in tertile 2-3 (≥0.13g/kg/d; hazard ratio [HR]: 0.71; 95% confidence interval [CI]: 0.51-0.97) compared to those in tertile 1 (<0.13g/kg/d). A similar, but non-significant trend was found for the association between DFI (tertile 2-3 vs. tertile 1; HR: 0.83; 95%CI: 0.64-1.07) and all-cause mortality. In summary, higher DFI was associated with lower CVD mortality risk among Chinese patients of MHD. This study emphasized the significance of dietary fiber intake in MHD patients, and provided information that is critical for the improvement of dietary guidelines for dialysis patients.
In glaciology, snow–firn temperature at 10 m is considered a representation of the mean annual air temperature at the surface (MAAT) of the studied site. Although MAAT is an important parameter in ice-sheet investigations, it has not been widely measured in Antarctica. To measure the 10 m snow–firn temperature in Antarctica, a shallow hot-point drill system is designed. In this simple and lightweight system, a hot-point drill can melt boreholes with a diameter of 34 mm in the snow–firn to a depth of 30 m and a temperature sensors string can measure the borehole temperature precisely. In the 2018/19 field season, 16 boreholes along the Zhongshan–Dome A traverse were drilled, and the borehole temperature was measured. Although certain problems existed pertaining to the hot-point drill, a total depth of ~244 m was successfully drilled at an average penetration rate of ~10 m h−1. After borehole drilling, ~12–15 h were generally required for the borehole to achieve thermal equilibrium with the surroundings. Preliminary results demonstrated that the 10 m snow–firn temperature along the traverse route was affected by the increasing altitude and latitude, and it decreased gradually with an increase in the distance from Zhongshan station.
Examine mother-son, mother-daughter, father-son, and father-daughter resemblance in weight status, and potential modifying effects of socio-demographic and childcare characteristics.
1,973 school-age children and their parents from five mega-cities across China in 2017.
Pearson correlation coefficients (r) for body mass index (BMI) of father-son, father-daughter, mother-son, and mother-daughter pairs were 0·16, 0·24, 0·26, and 0·24, respectively, while their weighted kappa coefficients (k) were 0·09, 0·14, 0·04, and 0·15, respectively. Children aged 6–9 years (r ranged from 0·30 to 0·35) had larger BMI correlation with their parents than their counterparts aged 10–14 years or 15–17 years (r ranged from 0·15 to 0·24). Children residing at home (r ranged from 0·17 to 0·27) had greater BMI correlations with their parents than children residing at school/other places. BMI correlation coefficients were significant if children were mainly cared for by their mothers (r ranged from 0·17 to 0·29) but non-significant if they were mainly cared for by others. Only children who ate the same meal as their parents “most times” (r ranged from 0·17 to 0·27) or had dinner with their parents “at most times” (r ranged from 0·21 to 0·27) had significant BMI correlation with their parents. Similarly, children who had dinner with their parents “most times” but not “sometimes,” had significant BMI correlation coefficients.
Parent-child resemblance in weight status was modest, and varied by child age, gender, primary caregiver, whether having similar food or dinner with parents in China.
This study was undertaken to evaluate the influence of rumen-protected folic acid (RPFA) on slaughter performance, visceral organ and gastrointestinal tract coefficients, and meat quality in lambs. Sixty-six lambs from 120 Hu ewes were selected based on body weight and maternal diets, and then assigned to six groups using a randomized block experimental design in a 3 × 2 factorial arrangement. The first factor was folic acid (FA) as RPFA in the maternal diet (0 mg/kg [M0F], 16 mg/kg [M16F] or 32 mg/kg [M32F] on dry matter basis). The second factor was FA in the lambs’ diet from weaning until slaughter (0 mg/kg [OC] or 4.0 mg/kg [OF]). The results indicated that the addition of 16 mg/kg FA to the maternal diet increased pre-slaughter weight (PSW), dressing and meat percentage, the reticulum and omasum coefficients, length of the jejunum and ileum, tail fat and perirenal fat coefficient and a* value of the meat color. The addition of RPFA to the lambs’ diet increased PSW, dressing and meat percentage, eye muscle area, abomasum weight, weight and length of the small intestine, but reduced the coefficients of tail fat. A M×O interaction was observed for the weights of heart, lungs, rumen and total stomach, weight and coefficient of omental fat and the GR value. Collectively, RPFA in the maternal and lambs’ diet improved slaughter performance and meat quality by stimulating the morphological development of the gastrointestinal tract and the distribution of fat in the body.
It is essential to investigate the experiences behind why adolescents start and continue to self-harm in order to develop targeted treatment and prevent future self-harming behaviours.
The aims of this study are to understand the motivations for initiating and repeating nonfatal self-harm, the different methods used between first-time and repeated self-harm and the reasons that adolescents do not seek help from health services.
Adolescents with repeated nonfatal self-harm experiences were recruited to participate in individual, semi-structured qualitative interviews. The interviews were analysed with interpretative phenomenological analysis.
We found that nonfatal self-harm among adolescents occurred comparatively early and was often triggered by specific reasons. However, the subsequent nonfatal self-harm could be causeless, with repeated self-harm becoming a maladaptive coping strategy to handle daily pressure and negative emotions. The choice of tools used was related to the ease of accessibility, the life-threatening risk and the size of the scars. Adolescents often concealed their scars on purpose, which made early identification insufficient. Peer influence, such as online chat groups encouraging self-harm by discussing and sharing self-harm pictures, could also lead to increased self-harm. The results also included participants’ opinions on how to stop nonfatal self-harm and their dissatisfaction with the current healthcare services.
The current study provides important implications both for early identification and interventions for adolescents who engage in repeated nonfatal self-harm, and for individualising treatment planning that benefits them. It is also worthwhile to further investigate how peer influence and social media may affect self-harm in adolescents.
Various foods are associated with or protect against type 2 diabetes mellitus (T2DM). This study was to examine the associations of foods and food patterns with the risk of T2DM in South China.
The dietary patterns were identified by a principal components factor analysis. Univariable and multivariable conditional logistic regression analyses were used to analyse the associations between food groups and dietary patterns and the risk of T2DM.
A total of 384 patients with T2DM and 768 controls.
After adjustment for total energy intake, the standard intake of grains (228·3 ± 71·9 v. 238·8 ± 73·1 g/d, P = 0·025) and fruits (109 ± 90 v. 145 ± 108 g/d, P < 0·001) were lower in T2DM than in controls. Four dietary patterns were identified: (1) high light-coloured vegetables and low grains, (2) high fruits, (3) high red meat and low grains and (4) high dark-coloured vegetable. After adjustment for covariables, multivariable conditional logistic regression analyses showed significant dose-dependent inverse associations between total fruit intake, whole grains intake and the score of the high-fruit dietary pattern (all Pfor trend < 0·001) and the risk of T2DM. The adjusted OR (95 % CI) for T2DM comparing the extreme quartiles were 0·46 (0·29, 0·76) for total fruits, 0·48(0·31, 0·77) for whole grains and 0·42 (0·26, 0·68) for the high-fruit dietary pattern, respectively. Similar associations were observed for all subgroups of fruits (dark-colour and light-colour).
In South China, a diet rich in fruit and whole grains is associated with lower risk of T2DM.
The association between dietary iron intake and diabetes risk remains inconsistent. We aimed to explore the association of dietary iron intake and type 2 diabetes mellitus (T2DM) risk in middle-aged and older adults in urban China. This study used data from the Guangzhou Nutrition and Health Study (GNHS), an on-going community-based prospective cohort study. Participants were recruited from 2008 to 2013 in Guangzhou community. 2,696 participants aged 40-75 years without T2DM at baseline were included in data analyses, with a median of 5.6 (IQR: 4.1-5.9) years of follow-up. T2DM was identified by self-reported diagnosis, fasting glucose ≥7.0 mmol/L, or glycosylated hemoglobin ≥6.5%. Cox proportional hazard models were used to estimate HRs and 95%CIs. We ascertained 205 incident T2DM cases during 13,476 person-years. The adjusted HR for T2DM risk in the fourth quartile of heme iron intake was 1.92 (95%CI: 1.07, 3.46; P-trend=0.010), compared with the first quartile intake. These significant associations were found in heme iron intake from total meat (HR:2.74; 95%CI: 1.22, 6.15; P-trend=0.011) and heme iron intake from red meat (HR:1.86; 95%CI: 1.01, 3.44; P-trend=0.034), but not heme iron intake from processed meat, poultry or fish/shellfish. The association between dietary intake of total iron or nonheme iron with T2DM risk had no significance. Our findings suggested that higher dietary intake of heme iron (especially from red meat), but not total iron or nonheme iron, was associated with greater T2DM risk in middle-aged and older adults.
To determine if specific dietary patterns are associated with breast cancer risk in Chinese women.
Latent class analysis (LCA) was performed to identify generic dietary patterns based on daily food-frequency data.
The Chinese Wuxi Exposure and Breast Cancer Study (2013-2014).
A population-based case-control study (695 cases, 804 controls).
Four dietary patterns were identified, Prudent, Chinese traditional, Western, and Picky, the proportion in the controls and cases were 0.30/0.32/0.16/0.23 and 0.29/0.26/0.11/0.33, respectively. Women in Picky class were characterized by higher extreme probabilities of non-consumption on specific foods, the highest probabilities of consumption of pickled foods, and the lowest probabilities of consumption of cereals, soy foods, and nuts. Compared with Prudent class, Picky class was associated with a higher risk (OR=1.42, 95%CI=1.06, 1.90), while the relevant association was only in post- (OR=1.44, 95%CI=1.01, 2.05) but not premenopausal women. The Western class characterized by high-protein, -fat, and -sugar foods, the Chinese traditional class characterized by typical consumption of soy foods and white meat over red meat, both of them showed no difference in BC risk compared with Prudent class did.
LCA capture the heterogeneity of individuals embedded in the population, could be a useful approach in the study of dietary pattern and disease. Our results indicated that the Picky class might have a positive association with the risk of breast cancer.
The impact of diet on the metabolic syndrome (MetS) and CVD has been investigated widely, but few studies have investigated the association between dietary patterns (DP) and the predicted CVD, derived from reduced rank regression (RRR). The objectives of this study were to derive DP using RRR and principal component analysis (PCA) and investigate their associations with the MetS and estimated 10-year atherosclerotic CVD (ASCVD). We used the baseline dataset from the Xinjiang multi-ethnic cohort study in China, collected from June 2018 to May 2019. A total of 14 982 subjects aged 35–74 years from Urumqi, Huo Cheng and Mo Yu were included in the analysis. The 10-year ASCVD risk was estimated using the Chinese ASCVD risk equations. The associations of DP with the MetS and 10-year ASCVD were determined using multivariable logistic regression models. In Urumqi and Mo Yu, the increased RRR DP score was associated with a higher OR of having the MetS and with a higher OR of elevated 10-year ASCVD risk. However, only the first DP determined by PCA in Urumqi was inversely associated with the MetS and elevated 10-year ASCVD risk. The prevalence of the MetS and elevated ASCVD risk in urban population is higher than that in rural areas. Our results may help nutritionists develop more targeted dietary strategies to prevent the MetS and ASCVD in different regions in China.
In this paper, the generation of relativistic electron mirrors (REMs) and the reflection of an ultra-short laser off this mirrors are discussed, applying two-dimensional particle-in-cell (2D-PIC) simulations. REMs with ultra-high acceleration and expanding velocity can be produced from a solid nanofoil illuminated normally by an ultra-intense femtosecond laser pulse with a sharp rising edge. Chirped attosecond pulse can be produced through the reflection of a counter-propagating probe laser off the accelerating REM. In the electron moving frame, the plasma frequency of the REM keeps decreasing due to its rapidly expanding. The laser frequency, on the contrary, keeps increasing due to the acceleration of REM and the relativistic Doppler shift from the lab frame to the electron moving frame. Within an ultra-short time interval, the two frequencies will be equal in the electron moving frame, which leads the resonance between laser and REM. The reflected radiation near this interval and the corresponding spectra will be amplified due to the resonance. Through adjusting the arriving time of the probe laser, certain part of the reflected field could be selectively amplified or depressed, leading to the selectively adjusting of the corresponding spectra.
Lead-free BaTiO3 (BT)-based multilayer ceramic capacitors (MLCCs) with the thickness of dielectric layers ~9 μm were successfully fabricated by tape-casting and screen-printing techniques. A single phase of the pseudo-cubic structure was revealed by X-ray diffraction. Backscattered images and energy-dispersive X-ray elemental mapping indicated the high quality of MLCCs without observation of interaction, wrapping, or delamination. The relaxor state was confirmed by transmission electron microscopy and temperature-dependent permittivity. Impedance spectroscopy at various temperatures revealed the electrical heterogeneous response for MLCCs with high-resistive electrical components. Improved energy storage performance was obtained by multilayering, comparing with the bulk ceramics. Enhanced recoverable energy density ~6.88 J/cm3 with high efficiency ~90% were realized under an electric field of 820 kV/cm, which is mainly attributed to the intrinsic high-resistivity and relaxor behavior. Furthermore, good temperature (20–85 °C) and frequency stabilities (0.5–50 Hz) were observed in the MLCCs, which are attractive for pulsed power applications.
Some studies have suggested that the Toll-like receptor 9 polymorphism (TLR9 rs352140) is closely related to the risk of bacterial meningitis (BM), but this is subject to controversy. This study set out to estimate whether the TLR9 rs352140 polymorphism confers an increased risk of BM. Relevant literature databases were searched including PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure (CNKI) up to August 2020. Seven case-control studies from four publications were enrolled in the present meta-analysis. Odds ratios (OR) and confidence intervals (95% CI) were calculated to estimate associations between BM risk and the target polymorphism. Significant associations identified were allele contrast (A vs. G: OR 0.66, 95% CI 0.59–0.75, P = 0.000), homozygote comparison (AA vs. AG/GG: OR 0.62, 95% CI 0.49–0.78, P = 0.000), heterozygote comparison (A vs. G: OR 0.74, 95% CI 0.61–0.91, P = 0.005), recessive genetic model (AA vs. AG/GG: OR 0.78, 95% CI 0.65–0.93, P = 0.006) and dominant genetic model (AA vs. AG/GG: OR 0.70, 95% CI 0.57–0.85, P = 0.000). The findings indicate that, in contrast to some studies, the TLR9 rs352140 polymorphism is associated with a decreased risk for BM.
The upsurge in the number of people affected by the COVID-19 is likely to lead to increased rates of emotional trauma and mental illnesses. This article systematically reviewed the available data on the benefits of interventions to reduce adverse mental health sequelae of infectious disease outbreaks, and to offer guidance for mental health service responses to infectious disease pandemic. PubMed, Web of Science, Embase, PsycINFO, WHO Global Research Database on infectious disease, and the preprint server medRxiv were searched. Of 4278 reports identified, 32 were included in this review. Most articles of psychological interventions were implemented to address the impact of COVID-19 pandemic, followed by Ebola, SARS, and MERS for multiple vulnerable populations. Increasing mental health literacy of the public is vital to prevent the mental health crisis under the COVID-19 pandemic. Group-based cognitive behavioral therapy, psychological first aid, community-based psychosocial arts program, and other culturally adapted interventions were reported as being effective against the mental health impacts of COVID-19, Ebola, and SARS. Culturally-adapted, cost-effective, and accessible strategies integrated into the public health emergency response and established medical systems at the local and national levels are likely to be an effective option to enhance mental health response capacity for the current and for future infectious disease outbreaks. Tele-mental healthcare services were key central components of stepped care for both infectious disease outbreak management and routine support; however, the usefulness and limitations of remote health delivery should also be recognized.
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.
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).
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.
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.
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.
To reveal the thermal shock resistance of double-layer thermal barrier coatings (TBCs), two types of TBCs were prepared via atmospheric plasma spraying, i.e., Gd2Zr2O7/yttria-stabilized zirconia (GZ/YSZ) TBCs and La2Zr2O7 (LZ)/YSZ TBCs, respectively. Subsequently, thermal cycling tests of the two TBCs were conducted at 1100 °C and their thermal shock resistance and failure mechanism were comparatively investigated through experiments and the finite element method. The results showed that the thermal shock failure of the two TBCs occurred inside the top ceramic coating. However, the GZ/YSZ TBCs had longer thermal cycling life. It was the mechanical properties of the top ceramic coating, and the thermal stresses arising from the thermal mismatch between the top ceramic coating and the substrate that determined the thermal cycling life of the two TBCs together. Compared with the LZ layer in the LZ/YSZ TBCs, the GZ layer in the GZ/YSZ TBCs had smaller elastic modulus, larger fracture toughness, and smaller thermal stresses, which led to the higher crack propagation resistance and less spallation tendency of the GZ/YSZ TBCs. Therefore, the GZ/YSZ TBCs exhibited superior thermal shock resistance to the LZ/YSZ TBCs.
The outbreak of COVID-19 generated severe emotional reactions, and restricted mobility was a crucial measure to reduce the spread of the virus. This study describes the changes in public emotional reactions and mobility patterns in the Chinese population during the COVID-19 outbreak.
We collected data on public emotional reactions in response to the outbreak through Weibo, the Chinese Twitter, between 1st January and 31st March 2020. Using anonymized location-tracking information, we analyzed the daily mobility patterns of approximately 90% of Sichuan residents.
There were three distinct phases of the emotional and behavioral reactions to the COVID-19 outbreak. The alarm phase (19th–26th January) was a restriction-free period, characterized by few new daily cases, but a large amount public negative emotions [the number of negative comments per Weibo post increased by 246.9 per day, 95% confidence interval (CI) 122.5–371.3], and a substantial increase in self-limiting mobility (from 45.6% to 54.5%, changing by 1.5% per day, 95% CI 0.7%–2.3%). The epidemic phase (27th January–15th February) exhibited rapidly increasing numbers of new daily cases, decreasing expression of negative emotions (a decrease of 27.3 negative comments per post per day, 95% CI −40.4 to −14.2), and a stabilized level of self-limiting mobility. The relief phase (16th February–31st March) had a steady decline in new daily cases and decreasing levels of negative emotion and self-limiting mobility.
During the COVID-19 outbreak in China, the public's emotional reaction was strongest before the actual peak of the outbreak and declined thereafter. The change in human mobility patterns occurred before the implementation of restriction orders, suggesting a possible link between emotion and behavior.
Disorder of hepatic glucose metabolism is the characteristic of late-pregnant sows. The purpose of our study was to look into the mechanism of garcinol on the improvement of hepatic gluconeogenic enzyme in late-pregnant sows. Thirty second- and third-parity sows (Duroc × Yorkshire × Landrace, n 10/diet) were fed a basal diet (control) or that diet supplemented with 100 mg/kg (Low Gar) or 500 mg/kg (High Gar) garcinol from day 90 of gestation to the end of farrowing. The livers were processed to measure enzymatic activity. Hepatocytes from pregnant sows were transfected with P300/CBP-associating factor (PCAF) small interfering RNA (siRNA) or treated with garcinol. Dietary garcinol had no effect on average daily feed intake, body weight (BW), backfat and BW gain of late-pregnant sows. Garcinol promoted plasma glucose levels in pregnant sows and newborn piglets. Garcinol up-regulated hepatic gluconeogenic enzyme expression and decreased PCAF activity. Garcinol had no effect on the expression of PPAR-γ co-activator 1α (PGC-1α) and Forkhead box O1 (FOXO1) but significantly increased their activity and decreased their acetylation in late-pregnant sows. Transfection of PCAF siRNA to hepatocytes of pregnant sows increased PGC-1α and FOXO1 activities. Furthermore, in hepatocytes of pregnant sows, garcinol treatment also up-regulated the activities of PGC-1α and FOXO1 and inhibited the acetylation of PGC-1α and FOXO1. Garcinol improves hepatic gluconeogenic enzyme expression in late-pregnant sows, and this may be due to the mechanism of down-regulating the acetylation of PGC-1α and FOXO1 induced by PCAF in isolated hepatocytes.
We investigate stochastic comparisons of parallel systems (corresponding to the largest-order statistics) with respect to the reversed hazard rate and likelihood ratio orders for the proportional reversed hazard rate (PRHR) model. As applications of the main results, we obtain the equivalent characterizations of stochastic comparisons with respect to the reversed hazard rate and likelihood rate orders for the exponentiated generalized gamma and exponentiated Pareto distributions. Our results recover and strengthen some recent results in the literature.
No studies have reported on how to relieve distress or relax in medical health workers while wearing medical protective equipment in coronavirus disease 2019 (COVID-19) pandemic. The study aimed to establish which relaxation technique, among six, is the most feasible in first-line medical health workers wearing medical protective equipment.
This was a two-step study collecting data with online surveys. Step 1: 15 first-line medical health workers were trained to use six different relaxation techniques and reported the two most feasible techniques while wearing medical protective equipment. Step 2: the most two feasible relaxation techniques revealed by step 1 were quantitatively tested in a sample of 65 medical health workers in terms of efficacy, no space limitation, no time limitation, no body position requirement, no environment limitation to be done, easiness to learn, simplicity, convenience, practicality, and acceptance.
Kegel exercise and autogenic relaxation were the most feasible techniques according to step 1. In step 2, Kegel exercise outperformed autogenic relaxation on all the 10 dimensions among the 65 participants while wearing medical protective equipment (efficacy: 24 v. 15, no space limitation: 30 v. 4, no time limitation: 31 v. 4, no body position requirement: 26 v. 4, no environment limitation: 30 v. 11, easiness to learn: 28 v. 5, simplicity: 29 v. 7, convenience: 29 v. 4, practicality: 30 v. 14, acceptance: 32 v. 6).
Kegel exercise seems a promising self-relaxation technique for first-line medical health workers while wearing medical protective equipment among COVID-19 pandemic.