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The coronavirus disease 2019 (COVID-19) pandemic has led to significant strain on front-line healthcare workers.
In this multicentre study, we compared the psychological outcomes during the COVID-19 pandemic in various countries in the Asia-Pacific region and identified factors associated with adverse psychological outcomes.
From 29 April to 4 June 2020, the study recruited healthcare workers from major healthcare institutions in five countries in the Asia-Pacific region. A self-administrated survey that collected information on prior medical conditions, presence of symptoms, and scores on the Depression Anxiety Stress Scales and the Impact of Events Scale-Revised were used. The prevalence of depression, anxiety, stress and post-traumatic stress disorder (PTSD) relating to COVID-19 was compared, and multivariable logistic regression identified independent factors associated with adverse psychological outcomes within each country.
A total of 1146 participants from India, Indonesia, Singapore, Malaysia and Vietnam were studied. Despite having the lowest volume of cases, Vietnam displayed the highest prevalence of PTSD. In contrast, Singapore reported the highest case volume, but had a lower prevalence of depression and anxiety. In the multivariable analysis, we found that non-medically trained personnel, the presence of physical symptoms and presence of prior medical conditions were independent predictors across the participating countries.
This study highlights that the varied prevalence of psychological adversity among healthcare workers is independent of the burden of COVID-19 cases within each country. Early psychological interventions may be beneficial for the vulnerable groups of healthcare workers with presence of physical symptoms, prior medical conditions and those who are not medically trained.
Not all plant-based and animal foods exert the same health effects due to their various nutrient compositions. We aimed to assess the quality of plant-based vs. animal foods in relation to mortality in a prospective cohort study. Using data collected from a nationally representative sample of 36,825 adults in the National Health and Nutrition Examination Survey 1999-2014, we developed a de novo Comprehensive Diet Quality Index (cDQI) that assesses the quality of 17 foods based on the healthfulness, and separately scored the quality of 11 plant-based foods in a plant-based Diet Quality Index (pDQI) and 6 animal foods in an animal-based Diet Quality index (aDQI). Mortality from all causes, heart disease, and cancer were obtained from linkage to the National Death Index through December 31, 2015. Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) after multivariable adjustments. During a median follow-up of 8.3 years, 4,669 all-cause deaths occurred, including 798 deaths due to heart disease and 1,021 due to cancer. Compared to individuals in the lowest quartile, those in the highest quartile of cDQI had a lower risk of all-cause mortality (HR=0.75, 95% CI: 0.65, 0.86; P-trend<0.001), which largely reflected the inverse relationship between quality of plant-based foods (pDQI) and all-cause mortality (HR=0.66; 95% CI: 0.58, 0.74, P-trend<0.001). No independent association was found for the quality of animal-foods (aDQI) and mortality. Our results suggest that consuming healthy plant-based foods is associated with lower all-cause mortality among US adults.
Fluorescent quantum dots (QDs) modified with polyethylene glycol (PEG) and albumin bovine serum (BSA) have profound application in the detection and treatment of hepatocellular carcinoma (HCC) cells. In the present study, the effects and mechanism of PEG and BSA modification on the cytotoxicity of QDs have been explored. It was found that the diameter of the as-prepared QDs, PEG@QDs, BSA@QDs is 3–5 nm, 4–5 nm, and 4–6 nm, respectively. With increase of the treatment time from 0 to 24 h, the HCC cell viability treated with QDs, PEG@QDs, and BSA@QDs obviously decreases, showing a certain time-dependent manner. When the concentration of several nanomaterials is increased from 10 to 90 nM, the cell viability decreases accordingly, exhibiting a certain concentration-dependent manner. Under the same concentration change conditions, the reactive oxygen species contents of cells treated by QDs, PEG@QDs, and BSA@QDs also rise from 7.9 × 103, 6.7 × 103, and 4.7 × 103 to 13.2 × 103, 14.3 × 103, and 12.3 × 103, respectively. In these processes, superoxide dismutase does not play a major role. This study provides strong foundation and useful guidance for QD applications in the diagnosis and treatment of HCC.
The aim of this study was to analyze the profile of chest injuries, oxygen therapy for respiratory failure, and the outcomes of victims after the Jiangsu tornado, which occurred on June 23, 2016 in Yancheng City, Jiangsu Province, China.
The clinical records of 144 patients referred to Yancheng City No.1 People’s Hospital from June 23 through June 25 were retrospectively investigated. Of those patients, 68 (47.2%) sustained major chest injuries. The demographic details, trauma history, details of injuries and Abbreviated Injury Scores (AIS), therapy for respiratory failure, surgical procedures, length of intensive care unit (ICU) and hospital stay, and mortality were analyzed.
Of the 68 patients, 41 (60.3%) were female and 27 (39.7%) were male. The average age of the injured patients was 57.1 years. Forty-six patients (67.6%) suffered from polytrauma. The mean thoracic AIS of the victims was calculated as 2.85 (SD = 0.76). Rib fracture was the most common chest injury, noted in 56 patients (82.4%). Pulmonary contusion was the next most frequent injury, occurring in 12 patients (17.7%). Ten patients with severe chest trauma were admitted to ICU. The median ICU stay was 11.7 (SD = 8.5) days. Five patients required intubation and ventilation, one patient was treated with noninvasive positive pressure ventilation (NPPV), and four patients were treated with high-flow nasal cannula (HFNC). Three patients died during hospitalization. The hospital mortality was 4.41%.
Chest trauma was a common type of injury after tornado. The most frequent thoracic injuries were rib fractures and pulmonary contusion. Severe chest trauma is usually associated with a high incidence of respiratory support requirements and a long length of stay in the ICU. Early initiation of appropriate oxygen therapy was vital to restoring normal respiratory function and saving lives. Going forward, HFNC might be an effective and well-tolerated therapeutic addition to the management of acute respiratory failure in chest trauma.
Findings for the roles of dairy products, Ca and vitamin D on ovarian cancer risk remain controversial. We aimed to assess these associations by using an updated meta-analysis. Five electronic databases (e.g. PubMed and Embase) were searched from inception to 24 December 2019. Pooled relative risks (RR) with 95 % CI were calculated. A total of twenty-nine case–control or cohort studies were included. For comparisons of the highest v. lowest intakes, higher whole milk intake was associated with increased ovarian cancer risk (RR 1·35; 95 % CI 1·15, 1·59), whereas decreased risks were observed for higher intakes of low-fat milk (RR 0·84; 95 % CI 0·73, 0·96), dietary Ca (RR 0·71; 95 % CI 0·60, 0·84) and dietary vitamin D (RR 0·80; 95 % CI 0·67, 0·95). Additionally, for every 100 g/d increment, increased ovarian cancer risks were found for total dairy products (RR 1·03; 95 % CI 1·01, 1·04) and for whole milk (RR 1·07; 95 % CI 1·03, 1·11); however, decreased risks were found for 100 g/d increased intakes of low-fat milk (RR 0·95; 95 % CI 0·91, 0·99), cheese (RR 0·87; 95 % CI 0·76, 0·98), dietary Ca (RR 0·96; 95 % CI 0·95, 0·98), total Ca (RR 0·98; 95 % CI 0·97, 0·99), dietary vitamin D (RR 0·92; 95 % CI 0·87, 0·97) and increased levels of circulating vitamin D (RR 0·84; 95 % CI 0·72, 0·97). These results show that whole milk intake might contribute to a higher ovarian cancer risk, whereas low-fat milk, dietary Ca and dietary vitamin D might reduce the risk.
Globally, China is among the ‘saltiest’ nations. In order to support current nationwide salt reduction initiatives, we investigated Chinese consumers’ knowledge, beliefs and behaviours related to salt intake and salt reduction.
A cross-sectional face-to-face survey was carried out, focusing on salt knowledge, beliefs and behaviours related to salt intake and salt reduction, perceptions of salt reduction responsibility and support for different national strategies.
The survey was carried out in China mainland.
Consumers (n 2444) from six of seven major geographical regions in China participated in the survey. After data cleaning, a sample of 2430 was included in the final analysis.
A majority of Chinese consumers believed that salt added during home cooking was the biggest contributor to their salt intake. Knowledge gaps existed in the awareness of salt hidden in certain foods and flavouring products. Chinese consumers in general were interested in lowering their salt intake. They were aware of salt reduction tools, but the adoption level was low. Consumers expressed strong support for promotion of salt-restriction spoons and public education, but not fiscal policies (e.g. salt-related tax or subsidies). In terms of individual differences, education status demonstrated a substantial impact on salt reduction knowledge and behaviour.
There is still big room to ‘shake’ Chinese consumers’ salt habit. The present study provides important evidence and consumer insights to support China’s efforts to meet its salt reduction targets.
Silver/titanium dioxide (Ag/TiO2) membranes were successfully deposited on poly(sulfone amide) substrates by direct current magnetron sputtering and radio frequency magnetron sputtering techniques with pure silver (Ag) and TiO2 targets. The prepared membranes were systematically characterized by scanning electron microscopy X-ray diffraction, insulation tests, and Fourier transform infrared spectrometry. The dependence of the main sputtering parameters on optical and thermal properties of the film was investigated by an orthogonal analysis method. Optimal parameters of fabricate Ag/TiO2 membranes with better comprehensive performances could be obtained ultimately. The infrared reflection rate and temperature difference of the Ag/TiO2 film deposited with the optimized parameters were 81.6% and 90 °C, respectively. The high infrared reflection and excellent thermal conductivity properties of the Ag/TiO2 composite membrane make it a promising candidate for thermal insulating coatings on fabrics, and can be used for the development of high-performance protective garments in the future.
The jungles of Linyun and Longlin Autonomous Prefecture, located in the heart of the southwestern Guangxi Zhuang Autonomous Region of China, are home to the oldest tea trees (Camellia sinensis) in the world. In the absence of regular annual rings, radiocarbon (14C) dating is one of the most powerful tools that can assist in the determination of the ages and growth rates of these plants. In this work, cores were extracted from large ancient tea trees in a central Longlin rain forest; extraction of carbon was performed with an automated sample preparation system. The 14C levels in the tree cores were measured using accelerator mass spectrometry (AMS) at the University of Tsukuba. These measurements indicated that contrary to conventional views, the ages of trees in these forests range up to ~700 years, and the growth rate of this species is notably slow, exhibiting a long-term radial growth rate of 0.039±0.006 cm/yr. It was demonstrated that 14C analyses provide accurate determination of ages and growth rates for subtropical wild tea trees.
Androgenetic embryonic stem (AgES) cells offer a possible tool for patient-specific pluripotent stem cells that will benefit genomic imprinting studies and clinic applications. However, the difficulty in producing androgenetic embryos and the unbalanced expression of imprinted genes make the therapeutic applicability of AgES cells uncertain. In this study, we produced androgenetic embryos by injecting two sperm into an enucleated metaphase II (MII) oocyte. By this method, 88.48% of oocytes survived after injection, and 20.24% of these developed to the blastocyst stage. We successfully generated AgES cell lines from the androgenetic embryos and assayed the expression of imprinted genes in the cell lines. We found that the morphological characteristics of AgES cells were similar to that of fertilized embryonic stem cells (fES), such as expression of key pluripotent markers, and generation of cell derivatives representing all three germ layers following in vivo and in vitro differentiation. Furthermore, activation of paternal imprinted genes was detected, H19, ASC12 and Tss3 in AgES cell activation levels were lower while other examined genes showed no significant difference to that of fES cells. Interestingly, among examined maternal imprinted genes, only Mest and Igf2 were significantly increased, while levels of other detected genes were no different to that of fES cells. These results demonstrated that activation of some paternal imprinted genes, as well as recovery of maternal imprinted genes, was present in AgES cells. We differentiated AgES cells into a beating embryoid body in vitro, and discovered that the AgES cells did not show significant higher efficiency in myocardial differentiation potential.
In this paper, a sandwiched type frequency selective surface (FSS) is designed and analyzed. The design procedure and operating principle is given based on the equivalent circuit model. The proposed FSS includes two identical layers of periodic metallic arrays, which are separated by a foam layer. In each layer of the periodic array, the unit cell is composed of a gridded-triple square loop structure. The FSS provides three pass-bands, in which a flat band response is presented. Three bands are separated by one or two transmission zeros, which leads to a sharp rejection on both sides of each pass-band. The central frequencies of the three pass-bands are 7.0, 10.9 and 14.0 GHz. To verify the simulated results, a prototype of the FSS is fabricated and measured. The simulated results agree well with the measured ones. This work can be used in area of a radar stealth or satellite communication system.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
Compared with commercial polyolefin membranes, polyacrylonitrile (PAN) membrane prepared by electrostatic spinning has higher porosity, electrolyte uptake, thermal stability, and lithium-ion conductivity, etc. However, poor mechanical performance has largely limited the application of electrospun PAN separators. In this study, PAN/polyimide (PI) composite membrane is prepared by electrostatic spinning to improve the mechanical and electrochemical performances. Scanning electron microscopy, thermal analysis method, and electrochemical methods were used for evaluation of the electrospun composite membrane. The results show that the composite membrane possesses good thermal stability and exhibits better mechanical performance than pristine PAN membrane (increasing by 1.1 times in tension strength). The addition of PI can increase porosity and fluid absorption rate obviously. In addition, the composite membrane has high ionic conductivity (18.77 × 10−4 S/cm), wide electrochemical window (about 4.0 V), and excellent cycling performance. It can retain a discharge specific capacity of 153 mA h/g even after 50 cycles at 0.5 C. The electrospun PAN/PI membrane may be a promising candidate for lithium-ion battery separators.
The objective of this study was to investigate the effects of dietary pyrroloquinoline quinone disodium (PQQ·Na2) supplementation on the reproductive performance and intestinal barrier functions of gestating and lactating female Sprague–Dawley (SD) rats and their offspring. Dietary supplementation with PQQ·Na2 increased the number of implanted embryos per litter during gestation and lactation at GD 20 and increased the number of viable fetuses per litter, and the weight of uterine horns with fetuses increased at 1 d of newborn. The mRNA expression levels of catalase (CAT), glutathione peroxidase (GPx2), superoxide dismutase (SOD1), solute carrier family 2 member 1 (Slc2a1) and solute carrier family 2 member 3 (Slc2a3) in the placenta were increased with dietary PQQ·Na2 supplementation. Dietary supplementation with PQQ·Na2 in gestating and lactating rats increased the CAT, SOD and GPx activities of the jejunal mucosa of weaned rats on PD 21. Dietary supplementation with PQQ·Na2 in female rats affected the expression of tight junction proteins (claudin, zonula occludens-1 (ZO-1) and occludin) in the jejunal mucosa of their offspring by increasing the expression of ZO-1 mRNA in the expression of ZO-1 and claudin mRNA in the jejunal mucosa of weaned rats on PD 21. In conclusion, dietary supplementation with PQQ·Na2 in gestating and lactating female rats had positive effects on their reproductive performance and on the intestinal barrier of weaned rats.
In inertial confinement fusion experiments that involve short-laser pulses such as fast ignition (FI), diagnosis of neutrons is usually very challenging because high-intensity γ rays generated by short-laser pulses would mask the much weaker neutron signal. In this paper, fast-response scintillators with low afterglow and gated microchannel plate photomultiplier tubes are combined to build neutron time-of-flight (nTOF) spectrometers for such experiments. Direct-drive implosion experiments of deuterium-gas-filled capsules were performed at the Shenguang-II Upgrade (SG-II-UP) laser facility to study the compressed fuel areal density (〈ρR〉) and evaluate the performance of such nTOF diagnostics. Two newly developed quenched liquid scintillator detectors and a gated ultrafast plastic scintillator detector were used to measure the secondary DT neutrons and primary DD neutrons, respectively. The secondary neutron signals were clearly discriminated from the γ rays from (n, γ) reactions, and the compressed fuel areal density obtained with the yield-ratio method agrees well with the simulations. Additionally, a small scintillator decay tail and a clear DD neutron signal were observed in an integrated FI experiment as a result of the low afterglow of the oxygen-quenched liquid scintillator.
The micro-nano rough structure promotes the formation of superhydrophobic surfaces, while the formation of superoleophobic surfaces requires the support of re-entrant structures. Electrochemical etching and boiling water treatment methods were used to process the superoleophobic surface in the Al–Mg alloy substrate. The differences between the potential of the aluminum and the magnesium promoted the formation of the surface microstructure under the current stimulation, and the surface was formed into dense nanoscale needle-like coating after boiling water treatment. Scanning electron microscopy, energy dispersive spectroscopy, and contact angle measurement were performed to characterize the morphological features, chemical composition, and surface wettability, respectively. The so-prepared superoleophobic surfaces showed high contact angles and small sliding angles for water, ethylene glycol, and hexadecane. In addition, surface topography, reaction mechanism, and experimental parameters were also studied.
The pathophysiology of cognitive impairment in patients with the major depressive disorder (MDD) may involve neuroinflammation mediated by cytokines.
The aim of this study was to examine the serum interleukin-6 (IL-6) levels, sustained attention, and their association in patients with MDD.
Thirty patients with MDD and 30 healthy controls were enrolled in this case-control study. Sustained attention was measured using the Rapid Visual Information Processing (RVP) task in the Cambridge Neuropsychological Tests Automated Battery. The serum IL-6 levels of all subjects were assessed by sandwich enzyme-linked immunosorbent assays.
There were significant differences in the log10RVP total hits, log10RVP total misses, and log10RVP mean latency between patients with MDD and healthy controls (F = 6.04, p = 0.017; F = 19.77, p < 0.0001; F = 14.42, p < 0.0001, respectively). The serum levels of Log10IL-6 were significantly higher in patients with MDD than in healthy controls (F = 192.27, p < 0.0001). The log10IL-6 levels were also positively correlated with the log10RVP mean latency in patients with MDD (r = 0.45, p = 0.013). A further stepwise multivariate regression analysis indicated that the log10IL-6 levels were significantly associated with the log10RVP mean latency in patients with MDD (β = 0.31, t = 2.41, p = 0.025).
Our data suggested that increased IL-6 levels were associated with the psychopathology of MDD, and that abnormal IL-6 levels were implicated in the impairment of sustained attention in patients with MDD.
To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.
A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.
One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.
Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.
Isolation of multidrug-resistant gram-negative bacteria (MDR-GNB) from patients in the community has been increasingly observed. A prediction model for MDR-GNB colonization and infection risk stratification on hospital admission is needed to improve patient care.
A 2-stage, prospective study was performed with 995 and 998 emergency department patients enrolled, respectively. MDR-GNB colonization was defined as isolates resistant to 3 or more classes of antibiotics, identified in either the surveillance or early (≤48 hours) clinical cultures.
A score-assigned MDR-GNB colonization prediction model was developed and validated using clinical and microbiological data from 995 patients enrolled in the first stage of the study; 122 of these patients (12.3%) were MDR-GNB colonized. We identified 5 independent predictors: age>70 years (odds ratio [OR], 1.84 [95% confidence interval (CI), 1.06–3.17]; 1 point), assigned point value in the model), residence in a long-term-care facility (OR, 3.64 [95% CI, 1.57–8.43); 3 points), history of cerebrovascular accidents (OR, 2.23 [95% CI, 1.24–4.01]; 2 points), hospitalization within 1 month (OR, 2.63 [95% CI, 1.39–4.96]; 2 points), and recent antibiotic exposure (OR, 2.18 [95% CI, 1.16–4.11]; 2 points). The model displayed good discrimination in the derivation and validation sets (area under ROC curve, 0.75 and 0.80, respectively) with the best cutoffs of<4 and ≥4 points for low- and high-risk MDR-GNB colonization, respectively. When applied to 998 patients in the second stage of the study, the model successfully stratified the risk of MDR-GNB infection during hospitalization between low- and high-risk groups (probability, 0.02 vs 0.12, respectively; log-rank test, P<.001).
A model was developed to optimize both the decision to initiate antimicrobial therapy and the infection control interventions to mitigate threats from MDR-GNB.