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This study aimed to assess the relationship between COVID-19 infection-related conditions and depressive symptoms among medical staff after easing the zero-COVID policy in China, and to further examine the mediating role of professional burnout.
Methods
A total of 1716 medical staff from all levels of health care institutions in 16 administrative districts of Beijing, China, were recruited to participate at the end of 2022 in this cross-sectional study. Several multiple linear regressions and mediating effects tests were performed to analyze the data.
Results
At the beginning of the end of the zero-COVID policy in China, 91.84% of respondents reported infection with COVID-19. After adjusting for potential confounding variables, the severity of infection symptoms was significantly positively associated with high levels of depressive symptoms (β = 0.06, P < 0.001), and this association was partially mediated by professional burnout. Specifically, emotional exhaustion (95% CI, 0.131, 0.251) and depersonalization (95% CI, 0.009, 0.043) significantly mediated the association between the severity of infection symptoms and depressive symptoms.
Conclusions
The mental health of medical staff with more severe symptoms of COVID-19 infection should be closely monitored. Also, interventions aimed at reducing emotional exhaustion and depersonalization may effectively reduce their risk of developing depressive symptoms.
Turbulent circular pipe flows subjected to axial system rotation are studied using direct numerical simulations (DNS) for a wide range of rotation numbers of $Ro_b = 0\unicode{x2013}20$ at a fixed Reynolds number. To ensure that energetic turbulent eddy motions are captured at high rotation numbers, long pipes up to $L_z = 180{\rm \pi} R$ are used in DNS. Two types of energy-containing flow structures have been observed. The first type is hairpin structures that are characteristic of the turbulent boundary layer developing over the pipe wall for both non-rotating and axially rotating flows. The second type is Taylor columns forming at moderate and high rotation numbers. Based on the study of two-point autocorrelation coefficients, it is observed that Taylor columns exhibit quasi-periods in both axial and azimuthal directions. According to the premultiplied spectra, Taylor columns feature one single characteristic axial length scale at the moderate rotation numbers but two at high rotation numbers. It is discovered that the axial system rotation suppresses the sweep events systematically and impedes the formation of hairpin structures. As the rotation number is increased, the turbulence kinetic energy held by Taylor columns enhances rapidly associated with significant increases in their axial length scales.
The proton–boron ${}^{11}{\text{B}}\left( {p,\alpha } \right)2\alpha $ reaction (p-11B) is an interesting alternative to the D-T reaction ${\text{D}}\left( {{\text{T}},{\text{n}}} \right)\alpha $ for fusion energy, since the primary reaction channel is aneutronic and all reaction partners are stable isotopes. We measured the α production yield using protons in the 120–260 keV energy range impinging onto a hydrogen–boron-mixed target, and for the first time present experimental evidence of an increase of α-particle yield relative to a pure boron target. The measured enhancement factor is approximately 30%. The experiment results indicate a higher reactivity, and that may lower the condition for p-11B fusion ignition.
Disordered eating (DE) is associated with elevated cardiometabolic risk (CMR) factors, yet little is known about this association in non-Western countries. We examined the association between DE characteristics and CMR and tested the potential mediating role of BMI. This cross-sectional study included 2005 Chinese women (aged 18–50 years) from the 2015 China Health and Nutrition Survey. Loss of control, restraint, shape concern and weight concern were assessed using selected questions from the SCOFF questionnaire and the Eating Disorder Examination-Questionnaire. Eight CMR were measured by trained staff. Generalised linear models examined associations between DE characteristics with CMR accounting for dependencies between individuals in the same household. We tested whether BMI potentially mediated significant associations using structural equation modelling. Shape concern was associated with systolic blood pressure (β (95 % CI) 0·06 (0·01, 0·10)), diastolic blood pressure (DBP) (0·07 (95 % CI 0·03, 0·11)) and high-density lipoprotein (HDL)-cholesterol (–0·08 (95 % CI –0·12, −0·04)). Weight concern was associated with DBP (0·06 (95 % CI 0·02, 0·10)), triglyceride (0·06 (95 % CI 0·02, 0·10)) and HDL-cholesterol (–0·10 (95 % CI –0·14, −0·07)). Higher scores on DE characteristics were associated with higher BMI, and higher BMI was further associated with lower HDL-cholesterol and higher other CMR. In summary, we observed significant associations between shape and weight concerns with some CMR in Chinese women, and these associations were potentially partially mediated by BMI. Our findings suggest that prevention and intervention strategies focusing on addressing DE could potentially help reduce the burden of CMR in China, possibly through controlling BMI.
This study aimed to evaluate the methodological quality of existing meta-analyses (MA) and the quality of evidence for outcome indicators to provide an updated overview of the evidence concerning the therapeutic efficacy of the Mediterranean diet (MD) for various types of CVD.
Design:
We conducted comprehensive searches of PubMed, Cochrane Library, and Embase databases. The quality of the MA was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, while the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence evaluation system was employed to evaluate the quality of evidence for significant outcomes.
Setting:
The CVD remains a significant contributor to global mortality. Multiple MA have consistently demonstrated the efficacy of medical interventions in managing CVD. However, due to variations in the scope, quality and outcomes of these reviews, definitive conclusions are yet to be established.
Participants:
This study included five randomized trials and twelve non-randomized studies, with a combined participant population of 716 318.
Results:
The AMSTAR 2 checklist revealed that 54·55 % of the studies demonstrated high quality, while 9·09 % exhibited low quality, and 36·36 % were deemed critically low quality. Additionally, there was moderate evidence supporting a positive correlation between MD and CHD/acute myocardial infarction, stroke, heart failure, cardiovascular events, coronary events and major adverse cardiovascular events.
Conclusions:
This study indicates that although recognizing the potential efficacy of MD in managing CVD, the quality of the methodology and the evidence for the outcome indicators remain unsatisfactory.
In this paper, the ordering properties of convex and increasing convex orders of the dependent random variables are studied. Some closure properties of the convex and increasing convex orders under independent random variables are extended to the dependent random variables under the Archimedean copula. Two applications are provided to illustrate our results.
Music and language are unique communication tools in human society, where stress plays a crucial role. Many studies have examined the recognition of lexical stress in Indo-European languages using beat/rhythm priming, but few studies have examined the cross-domain relationship between musical and linguistic stress in tonal languages. The current study investigates how musical stress and lexical stress influence lexical stress recognition in Mandarin. In the auditory priming experiment, disyllabic Mandarin words with initial or final stress were primed by disyllabic words or beats with either congruent or incongruent stress patterns. Results showed that the incongruent condition elicited larger P2 and the late positive component (LPC) amplitudes than the congruent condition. Moreover, the Strong-Weak primes elicited larger N400 amplitudes than the Weak-Strong primes, and the Weak-Strong primes yielded larger LPC amplitudes than the Strong-Weak primes. The findings reveal the neural correlates of the cross-domain influence between music and language during lexical stress recognition in Mandarin.
In preparation for an experiment with a laser-generated intense proton beam at the Laser Fusion Research Center at Mianyang to investigate the 11B(p,α)2α reaction, we performed a measurement at very low proton energy between 140 keV and 172 keV using the high-voltage platform at the Institute of Modern Physics, Lanzhou. The aim of the experiment was to test the ability to use CR-39 track detectors for cross-section measurements and to remeasure the cross-section of this reaction close to the first resonance using the thick target approach. We obtained the cross-section σ = 45.6 ± 12.5 mb near 156 keV. Our result confirms the feasibility of CR-39 type track detector for nuclear reaction measurement also in low-energy regions.
This study presents novel findings on stochastic electron heating via a random electron cyclotron wave (ECW) in a spherical tokamak. Hard x ray measurements demonstrate the time evolution of hard x ray counts at different energy bands, consistent with predictions from the stochastic heating model. The ECW heating rate shows a positive correlation with applied power, confirming the effectiveness of stochastic heating. Remarkably, the ECW-driven plasma current remains insensitive to ECW incidence angle, consistent with model predictions. The observed stochastic heating of electrons offers potential for exploring innovative non-inductive current drive modes in spherical tokamaks. This research contributes to the understanding of plasma behaviour and motivates the development of new models for non-inductive current drive in fusion devices.
In the Western Scheldt estuary, like in many estuaries, safe navigation, flood protection, and ecological targets require a balanced and sustainable sediment management. A thorough understanding of the morphodynamic functioning of the estuary and its response to changes in hydrodynamics (natural sediment transport) and large-scale interventions is imperative. This paper presents a detailed overview of over 65 years of morphological changes and a comprehensive sediment budget of the Western Scheldt estuary that is based on analysis of a unique series of frequent bathymetric surveys and historical data on human–sediment interactions of dredging, dredge disposal and sand mining. Solving the sediment budget reveals an annual sediment import of 2.2 million m3. The highest sediment imports occurred between 1980–1994 and 2005–2020 (2.9 and 3.7 million m3/year). A 1.3 million m3/year net export prevailed between 1994 and 2005. Natural variations in the hydrodynamics (e.g., tidal asymmetry and amplification) and sediment transports cannot explain the derived temporal variations in sediment import rates. Anthropogenic activities play a dominant role. Capital dredging of the main navigation channel has led to channel deepening and significantly increased dredge and disposal volumes. Disposal on tidal flats and in the secondary channel leads to a long-term storage of sand and, consequently, a local increase in bed level and a sand deficit in the remainder of the system that results in increased sediment imports. Large-scale disposal in the western part of the estuary can (temporarily) reverse the sediment exchange between the estuary and its mouth area, as observed between 1994 and 2005. Apparently, large-scale anthropogenic reallocation of sediment by dredging and/or disposal as part of navigation channel improvement, sand mining or nourishment essentially influences the morphological development of the Western Scheldt estuary. This reveals responsibilities as well as opportunities of sediment management for the Western Scheldt and similar estuaries worldwide.
An online pattern recognition method of lower limb movements is proposed based on the personalized surface electromyography (sEMG) signals, and the corresponding experimental researches are performed in the rehabilitation training. Further, a wireless wearable acquisition instrument is used. Based on this instrument, a host computer for the personal online recognition and real-time control of rehabilitation training is developed. Three time-domain features and two features in the nonlinear dynamics are selected as the joint set of the characteristic values for the sEMG signals. Then a particle swarm optimization (PSO) algorithm is used to optimize the feature channels, and a k-nearest neighbor (KNN) algorithm and the extreme learning machine (ELM) algorithm are combined to classify and recognize individual sample data. Based on the multi-pose lower limb rehabilitation robot, the real-time motion recognition and the corresponding rehabilitation training are carried out by using the online personalized classifier. The experimental results of eight subjects indicate that it takes only 6 min to build an online personalized classifier for the four types of the lower limb movements. The recognition between switches of different rehabilitation training movements is timely and accurate, with an average recognition accuracy of more than 95%. These results demonstrate that this system has a strong practicability.
Environment-induced epigenetics are involved in diapause regulation, but the molecular mechanism that epigenetically couples nutrient metabolism to diapause regulation remains unclear. In this study, we paid special attention to the significant differences in the level of N6-adenosine methylation (m6A) of dihydroxyacetone phosphate acyltransferase (DHAPAT) and phosphatidate phosphatase (PAP) genes in the lipid metabolism pathway of the bivoltine silkworm (Bombyx mori) strain Qiufeng developed from eggs incubated at a normal temperature (QFHT, diapause egg producer) compared to those from eggs incubated at a low temperature (QFLT, non-diapause egg producer). We knocked down DHAPAT in the pupal stage of the QFLT group, resulting in the non-diapause destined eggs becoming diapausing eggs. In the PAP knockdown group, the colour of the non-diapause destined eggs changed from light yellow to pink 3 days after oviposition, but they hatched as normal. Moreover, we validated that YTHDF3 binds to m6A-modified DHAPAT and PAP mRNAs to promote their stability and translation. These results suggest that RNA m6A methylation participates in the diapause regulation of silkworm by changing the expression levels of DHAPAT and PAP and reveal that m6A epigenetic modification can be combined with a lipid metabolism signal pathway to participate in the regulation of insect diapause traits, which provides a clearer image for exploring the physiological basis of insect diapause.
A 198.8 m deep borehole was drilled through ice to subglacial bedrock in the northwestern marginal part of Princess Elizabeth Land, ~12 km south of Zhongshan Station, in January–February 2019. Three years later, in February 2022, the borehole temperature profile was measured, and the geothermal heat flow (GHF) was estimated using a 1-D time-dependent energy-balance equation. For a depth corresponding to the base of the ice sheet, the GHF was calculated as 72.6 ± 2.3 mW m−2 and temperature −4.53 ± 0.27°C. The regional averages estimated for this area based, generally, on tectonic setting vary from 55 to 66 mW m−2. A higher GHF is interpreted to originate mostly from the occurrence of metamorphic complexes intruded by heat-producing elements in the subglacial bedrock below the drill site.
Due to the curvature of the droplet surface, the propagation of transmitted waves is complex inside a droplet impacted by an incident shock wave. The wave converging phenomena inside a two-dimensional water column impacted by different curved shock waves are explored in this paper by means of theoretical ray analysis and high-resolution numerical simulations. An analytical method describing the wave structure evolution characteristics inside the shocked water column is established. Hence, the morphological pattern and focus locations of these waves are theoretically obtained. The analysis shows that both the first and the second reflected waves focus inside the water column regardless of the convergent, planar or divergent nature of the incident shock wave shape. The dimensionless distances from focusing points to the column centre are derived as ${\kappa }/{( 3\kappa -{{M}_{0}}{{f}_{s}} )}$ for the former and ${\kappa }/{( 5\kappa -{{M}_{0}}{{f}_{s}})}$ for the latter, respectively. Here, $\kappa$, $M_0$ and $f_s$ represent the sound-speed ratio of the two phases, the incident shock wave strength and a function characterising the shock wave shape effect, respectively. Moreover, highly negative pressures due to the first reflected wave focusing and significant pressure oscillations due to the second reflected wave focusing are numerically tracked for three shapes of the incident shock. The effects of the incident shock wave intensity on the pressure variations at focus points are further studied. As the incident shock wave intensity increases, stronger negative pressure and higher pressure oscillation are induced. The converged incident shock wave can enhance the above phenomena, but the diverged one can weaken them.
Imbalance and gait disturbances are common in patients with vestibular schwannoma (VS) and can result in significant morbidity. Current methods for quantitative gait analysis are cumbersome and difficult to implement. Here, we use custom-engineered instrumented insoles to evaluate the gait of patients diagnosed with VS.
Methods
Twenty patients with VS were recruited from otology, neurosurgery, and radiation oncology clinics at a tertiary referral center. Functional gait assessment (FGA), 2-minute walk test (2MWT), and uneven surface walk test (USWT) were performed. Custom-engineered instrumented insoles, equipped with an 8-cell force sensitive resistor (FSR) and a 9-degree-of-freedom inertial measurement unit (IMU), were used to collect stride-by-stride spatiotemporal gait parameters, from which mean values and coefficients of variation (CV) were determined for each patient.
Results
FGA scores were significantly correlated with gait metrics obtained from the 2MWT and USWT, including stride length, stride velocity, normalized stride length, normalized stride velocity, stride length CV, and stride velocity CV. Tumor diameter was negatively associated with stride time and swing time on the 2MWT; no such association existed between tumor diameter and FGA or DHI.
Conclusions
Instrumented insoles may unveil associations between VS tumor size and gait dysfunction that cannot be captured by standardized clinical assessments and self-reported questionnaires.
Chemical defoliants are widely used in cotton (Gossypium L.) to accelerate leaf abscission and boll maturation, as well as, to facilitate mechanical harvesting. The current study was conducted to determine the interactive effect of cotton cultivars and spraying time of defoliant on defoliation, boll opening, fibre yield and quality. An experiment was performed with four cultivars and three defoliant spraying time during 2019 and 2020 in split plot design with three replications. At harvest, the defoliation and boll opening rate of all treatments after spraying defoliant was 94.6 and 85.4%, while the blank control (water) was 73.9 and 79.1%, respectively. After spraying defoliant, the effects of defoliation rate, boll opening rate, fibre yield and quality were different among cultivars, indicating that different cultivars had different responses to defoliant. Among them, L7619 was the most sensitive to defoliant, with the average defoliation rate of 95.6% and a seed cotton yield reduction of 882.9 kg/ha. Among the different time of applications, late spraying (17 September, B3) of defoliant recorded the highest defoliation rate (97.3%), boll opening rate (89.8%), seed cotton yield (3991 kg/ha) and steadily increased the fibre strength by 0.59 cN/tex compared with the control. Late spraying of defoliant had little or even no adverse effect on the remaining fibre quality traits (length, uniformity, micronaire and elongation). In general, these results suggested that the appropriate time for spraying defoliant can be determined based on the sensitivity of the cotton cultivar, the weather conditions at the field and the harvest time.
Dietary transitions in China have undergone rapid changes in over the last three decades. The purpose of this study is to describe trends in the macronutrient consumption, the sources of those nutrients and the diet quality among Chinese adults.
Design:
Longitudinal China Health and Nutrition Survey (CHNS) cohort analysis. Main outcomes are dietary energy intake from total carbohydrate, protein and fat and their subtypes, as well as food sources of carbohydrates, protein, and fat, and the China Dietary Guidelines Index 2018 (CDGI-2018).
Setting:
CHNS (1991, 2000, 2009 and 2015).
Participants:
Data from the longitudinal 1991, 2000, 2009 and 2015 CHNS of adults aged 18 years or older who had complete demographic information.
Results:
The estimated mean energy intake from total carbohydrate decreased from 62·6 % to 50·6 % between 1991 and 2015, while the mean energy intake from total protein increased from 12·6 % to just 13·1 % and the mean energy intake from total fat significantly increased from 24·0 % to 35·8 % (P < 0·001 for trend). Decreases were observed in evaluated mean energy from low-quality carbohydrates (from 53·6 % to 41·7 %) and incomplete protein (from 9·3 % to 7·5 %), while increases were seen in estimated mean energy from high-quality protein (from 3·3 % to 5·5 %), high-quality fat (from 9·1 % to 16·7 %) and low-quality fat (from 14·9 % to 19·0 %). Low-quality carbohydrates, primarily those derived from refined grains, decreased from 52·2 % to 36·2 %. The diet quality as measured by CDGI-2018 improved, with the estimated mean increasing from 41·7 to 52·4 (P < 0·01 for trend).
Conclusion:
For Chinese adults, there was a significant change in the macronutrient composition over the previous few decades. The percentage of energy consumed from carbohydrates significantly decreased; however, the percentage of energy consumed from total fat significantly increased. Additionally, the diet quality remains suboptimal.
Rheumatoid arthritis (RA) is a heterogeneous autoimmune disorder that leads to severe joint deformities, negatively affecting the patient's quality of life. Extracellular vesicles (EVs), which include exosomes and ectosomes, act as intercellular communication mediators in several physiological and pathological processes in various diseases including RA. In contrast, EVs secreted by mesenchymal stem cells perform an immunomodulatory function and stimulate cartilage repair, showing promising therapeutic results in animal models of RA. EVs from other sources, including dendritic cells, neutrophils and myeloid-derived suppressor cells, also influence the biological function of immune and joint cells. This review describes the role of EVs in the pathogenesis of RA and presents evidence supporting future studies on the therapeutic potential of EVs from different sources. This information will contribute to a better understanding of RA development, as well as a starting point for exploring cell-free-based therapies for RA.