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This study aimed to investigate the organization, workload, and psychological impact of COVID-19 on healthcare workers from the domestic Medical Aid Teams (MATs) sent to Wuhan in China.
Methods:
Leaders and members of MATs involved in the care for COVID-19 patients were invited to participate in a study by completing 2 separate self-report questionnaires from April 1 to 24, 2020.
Results:
A total of 9 MAT leaders were involved and 464 valid questionnaires were collected from 140 doctors and 324 nurses. Mean age of the doctors and nurses were 39.34 ± 6.70 (26∼58 years old) and 31.88 ± 5.29 (21∼52 years old), with 72 (15.5%) being males. Nurses were identified as an independent risk factor (HR 1.898; P = 0.001) for a day working time in the multivariate analysis. The proportions of psychological consulting received among nurses were higher than those among doctors (49.7 vs 30.0%, P < 0.001). More than 50% of the anesthetists and emergency doctors who have received psychological consulting thought that it was effective according to self-evaluation.
Conclusions:
This study focused on healthcare workers’ situation during the early period of the pandemic. Nurses worked longer than doctors. The effectiveness of psychological consulting depends on the physicians’ specialties and the working conditions of the nurses and psychological consulting targeting different specialties need to be improved.
T long-term effects of cognitive therapy and behavior therapy (CTBT) for menopausal symptoms are unknown, and whether the effects are different between natural menopause and treatment-induced menopause are currently unclear. Therefore, we sought to conduct an accurate estimate of the efficacy of CTBT for menopausal symptoms.
Methods
We conducted searches of Cochrane Library, EMBASE, PsycINFO, PubMed, and Web of Science databases for studies from 1 January 1977 to 1 November 2021. Randomized controlled trials (RCTs) comparing intervention groups to control groups for menopausal symptoms were included. Hedge's g was used as the standardized between-group effect size with a random-effects model.
Results
We included 14 RCTs comprising 1618 patients with a mean sample size of 116. CTBT significantly outperformed control groups in terms of reducing hot flushes [g = 0.39, 95% confidence interval (CI) 0.23–0.55, I2 = 45], night sweats, depression (g = 0.50, 95% CI 0.34–0.66, I2 = 51), anxiety (g = 0.38, 95% CI 0.23–0.54, I2 = 49), fatigue, and quality of life. Egger's test indicated no publication bias.
Conclusions
CTBT is an effective psychological treatment for menopausal symptoms, with predominantly small to moderate effects. The efficacy is sustained long-term, although it declines somewhat over time. The efficacy was stronger for natural menopause symptoms, such as vasomotor symptoms, than for treatment-induced menopause symptoms. These findings provide support for treatment guidelines recommending CTBT as a treatment option for menopausal symptoms.
Laser–plasma accelerators (LPAs) have great potential to realize a compact X-ray free-electron laser (FEL), which is limited by the beam properties currently. Two-color high-intensity X-ray FEL provides a powerful tool for probing ultrafast dynamic systems. In this paper, we present a simple and feasible method to generate a two-color X-ray FEL pulse based on an LPA beam. In this scheme, time-dependent mismatch along the bunch is generated and manipulated by the designed lattice system, enabling FEL lasing at different wavelength within two undulator sections. The time separation between the two pulses can be precisely adjusted by varying the time-delay chicane. Numerical simulations show that two-color soft X-ray FELs with gigawatt-level peak power and femtosecond duration can be generated, which confirm the validity and feasibility of the scheme.
To estimate the risks of depressive symptoms for developing frailty, accounting for baseline robust or pre-frailty status.
Design:
An incident cohort study design.
Setting:
Community dwellers aged 55 years and above from urban and rural areas in seven regions in Taiwan.
Participants:
A total of 2,717 participants from the Healthy Aging Longitudinal Study in Taiwan (HALST) were included. Subjects with frailty at baseline were excluded. The average follow-up period was 5.9 years.
Measurements:
Depressive symptoms were measured by the 20-item Center for Epidemiological Studies Depression (CES-D) Scale. Frailty was assessed using the Fried frailty measurement. Participants were stratified by baseline robust or pre-frailty status to reduce the confounding effects of the shared criteria between depressive symptoms and frailty. Overall and stratified survival analyses were conducted to assess risks of developing frailty as a result of baseline depressive symptoms.
Results:
One hundred individuals (3.7%) had depressive symptoms at baseline. Twenty-seven individuals (27.0%) with depressive symptoms developed frailty, whereas only 305 out of the 2,617 participants (11.7%) without depressive symptoms developed frailty during the follow-up period. After adjusting for covariates, depressive symptoms were associated with a 2.6-fold (95% CI 1.6, 4.2) increased hazard of incident frailty. The patterns of increased hazard were also observed when further stratified by baseline robust or pre-frailty status.
Conclusions:
Depressive symptoms increased the risk of developing frailty among the older Asian population. The impact of late-life depressive symptoms on physical health was notable. These findings also replicated results from Western populations. Future policies on geriatric public health need to focus more on treatment and intervention against geriatric depressive symptoms to prevent incident frailty among older population.
The relationship between exposure to famine in early life and the risk of ascending aorta dilatation (AAD) in adulthood is still unclear; therefore, we aimed to examine the association in the Chinese population. We investigated the data of 2598 adults who were born between 1952 and 1964 in Guangdong, China. All enrolled subjects were categorised into five groups: not exposed to famine, exposed during fetal period, and exposed during early, mid or late childhood. AAD was assessed by cardiac ultrasound. Multivariate logistic regression and interaction tests were performed to estimate the OR and CI on the association between famine exposure and AAD. There were 2598 (943 male, mean age 58·3 ± 3·68 years) participants were enrolled, and 270 (10·4 %) subjects with AAD. We found that famine exposure (OR = 2·266, 95 % CI 1·477, 3·477, P = 0·013) was associated with elevated AAD after adjusting for multiple confounders. In addition, compared with the non-exposed group, the adjusted OR for famine exposure during fetal period, early, mid or late childhood were 1·374 (95 % CI 0·794, 2·364, P = 0·251), 1·976 (95 % CI 1·243, 3·181, P = 0·004), 1·929 (95 % CI 1·237, 3·058, P = 0·004) and 2·227 (95 % CI 1·433, 3·524, P < 0·001), respectively. Subgroup analysis showed that the effect of famine exposure on the association with AAD was more pronounced in female, current smokers, people with BMI ≥ 24 kg/m2 and hypertensive patients. We observed that exposure to famine during early life was linked to AAD in adulthood.
Spoofing is a kind of deliberate interference that aims to manipulate global navigation satellite system (GNSS) receivers into counterfeit position solutions. Conventional anti-spoofing methods are implemented prior to the calculation of the position solution, depending on the specific spoofing attack mechanisms. The paper presents a spoofing detection and mitigation method implemented in the position domain. The proposed method projects the correlograms of the visible satellites to a position-clock bias domain to construct the position domain projected correlogram. P(Y) code signatures retrieved from a reference station receiver are used to identify the counterfeit position solution and remove it from the victim receiver. Compared with the conventional single-channel spoofing detection technique, the proposed anti-spoofing method is more robust against thermal noise by combining the energy from multiple satellites. Detailed mathematical derivation of the statistical characteristics of this method is presented. Its effectiveness is validated using a realistic dataset generated by a Spirent GNSS simulator and NordNav wideband front-end. Results show that the proposed algorithm is capable of not only detecting a spoofing attack but also removing the spoofing effect from the victim receiver.
The prognostic factor for in-hospital mortality in tuberculosis (TB) patients requiring intensive care unit (ICU) care remains unclear. Therefore, a retrospective study was conducted aiming to estimate the in-hospital mortality rate and the risk factors for mortality in a high-burden setting. All patients with culture-confirmed TB that were admitted to the ICU of the hospital between March 2012 and April 2019 were identified retrospectively. Data, such as demographic characteristics, comorbidities, laboratory measures and mortality, were obtained from medical records. The Cox proportional hazards regression model was used to identify prognostic factors that influence in-hospital mortality. A total of 82 ICU patients with confirmed TB were included in the analysis, and 22 deaths were observed during the hospital stay, 21 patients died in the ICU. In the multivariable model adjusted for sex and age, the levels of serum albumin and white blood cell (WBC) count were significantly associated with mortality in TB patients requiring ICU care (all P < 0.01), the hazard ratios were 0.8 (95% confidence interval (CI): 0.7–0.9) per 1 g/l and 1.1 (95% CI: 1.0–1.2) per 1 × 109/l, respectively. In conclusion, in-hospital mortality remains high in TB patients requiring ICU care. Low serum albumin level and high WBC count significantly impact the risk of mortality in these TB patients in China.
To generate optical vortex with multiple topological charges, a simple scheme based on the phase mask shaping technique is proposed and applied in a seeded free electron laser. With a tailored phase mask, an extreme-ultraviolet (EUV) vortex with multiple topological charges can be produced. To prove the feasibility of this method, an eight-step phase mask is designed to shape the seed laser. The simulation results demonstrate that 100-MW, fully coherent EUV vortex pulses with topological charge 2 can be generated based on the proposed technique. We have also demonstrated the possibility of generating higher topological charges by using a phase mask with more steps.
The disease burden of infectious diarrhea cannot be underestimated. Its seasonal patterns indicate that weather patterns may play an important role and have an important effect on it. The objective of this study was to clarify the relationship between temperature and infectious diarrhea, and diarrhea-like illness.
Methods:
Distributed lag non-linear model, which was based on the definition of a cross-basis, was used to examine the effect.
Results:
Viral diarrhea usually had high incidence in autumn-winter and spring with a peak at -6°C; Norovirus circulated throughout the year with an insignificant peak at 8°C, while related bacteria usually tested positive in summer and peaked at 22°C. The lag-response curve of the proportion of diarrhea-like cases in outpatient and emergency cases revealed that at -6°C, with the lag days increasing, the proportion increased. Similar phenomena were observed at the beginning of the curves of virus and bacterial positive rate, showing that the risk increased as the lag days increased, peaking on days 16 and 9, respectively. The shape of lag-response curve of norovirus positive rate was different from others, presenting m-type, with 2 peaks on day 3 and day 18.
Conclusion:
Weather patterns should be taken into account when developing surveillance programs and formulating relevant public health intervention strategies.
Maternal supraphysiological estradiol (E2) environment during pregnancy leads to adverse perinatal outcomes. However, the influence of oocyte exposure to high E2 levels on perinatal outcomes remains unknown. Thus, a retrospective cohort study was conducted to explore the effect of high E2 level induced by controlled ovarian stimulation (COH) on further outcomes after frozen embryo transfer (FET). The study included all FET cycles (n = 10,581) between 2014 and 2017. All cycles were categorized into three groups according to the E2 level on the day of the human Chorionic Gonadotropin trigger. Odds ratios (ORs) and their confidence intervals (CIs) were calculated to evaluate the association between E2 level during COH and pregnancy outcomes and subsequent neonatal outcomes. From our findings, higher E2 level was associated with lower percentage of chemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth as well as increased frequency of early miscarriage. Preterm births were more common among singletons in women with higher E2 level during COH (aOR1 = 1.93, 95% CI: 1.22–3.06; aOR2 = 2.05, 95% CI: 1.33–3.06). Incidence of small for gestational age (SGA) was more common in both singletons (aOR1 = 2.01, 95% CI: 1.30–3.11; aOR2 = 2.51, 95% CI: 1.69–3.74) and multiples (aOR1 = 1.58, 95% CI: 1.03–2.45; aOR2 = 1.99, 95% CI: 1.05–3.84) among women with relatively higher E2 level. No association was found between high E2 level during COH and the percentage of macrosomia or large for gestational age. In summary, oocyte exposure to high E2 level during COH should be brought to our attention, since the pregnancy rate decreasing and the risk of preterm birth and SGA increasing following FET.
We report an experimental study of turbulent Rayleigh–Bénard (RB) convection in an annular cell of water (Prandtl number $Pr=4.3$) with a radius ratio $\unicode[STIX]{x1D702}\simeq 0.5$. Global quantities, such as the Nusselt number $Nu$ and the Reynolds number $Re$, and local temperatures were measured over the Rayleigh range $4.2\times 10^{9}\leqslant Ra\leqslant 4.5\times 10^{10}$. It is found that the scaling behaviours of $Nu(Ra)$, $Re(Ra)$ and the temperature fluctuations remain the same as those in the traditional cylindrical cells; both the global and local properties of turbulent RB convection are insensitive to the change of cell geometry. A visualization study, as well as local temperature measurements, shows that in spite of the lack of the cylindrical core, there also exists a large-scale circulation (LSC) in the annular system: thermal plumes organize themselves with the ascending hot plumes on one side and the descending cold plumes on the opposite side. Near the upper and lower plates, the mean flow moves along the two circular branches. Our results further reveal that the dynamics of the LSC in this annular geometry is different from that in the traditional cylindrical cell, i.e. the orientation of the LSC oscillates in a narrow azimuthal angle range, and no cessations, reversals or net rotation were detected.
The cyclic oxidation experiment of yttria-stabilized zirconia coatings deposited on NiCoCrAlYHf alloys by air plasma spraying was investigated at 1050 °C in air and in air containing water vapor. The results revealed that water vapor has a great influence on the oxidation resistance of the thermal barrier coatings (TBCs). Compared with the samples oxidized in air atmosphere, TBCs oxidized in air containing water vapor had a longer lifetime. It was also found that different atmospheres could lead to different HfO2 formation positions, which could decrease the rumpling in the oxide layer. In particular, after the coatings on Hf-doped NiCoCrAlY were first pretreated in air containing water vapor for 24 h at 1050 °C, the lifetime of the pretreated coating was doubled compared to the coating in laboratory air only. The water vapor pretreatment of the coatings could be an important method for optimizing the lifetime of TBCs.
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.
Study of the residues of organochlorine pesticides (OCPs) can assist with the assessment of the contamination level, distribution, sources, transportation and trends in these selected OCPs. We investigated the concentration levels of hexachlorocyclohexanes (HCHs), dichlorodiphenyltrichloroethane (DDT), chlordane, which is currently used, and the never-used aldrin and dieldrin in the Ningbo region – a heavily industrialised and urbanised area in East China. OCPs were found in all soil samples and were predominantly composed of HCHs, DDT and its metabolites. The concentration of DDTs in the soil ranged from 2.2 to 566.6ngg–1, with a mean value of 55.6±94.8ngg–1, while the concentration of HCHs ranged from 2.7 to 28.2ngg–1, with an average of 4.6±2.9ngg–1. Aldrin, dieldrin, endrin and heptachlor were detected at much lower concentrations. The wide distribution of these never-used OCPs indicates that they have been input via long-range atmospheric processes. The results from analysis suggest that HCHs and DDTs were mainly derived from use in historical times.
(1 − x)Ba(Mg1/3Ta2/3)O3–xBa(Co1/3Nb2/3)O3 (BMT–BCN, x = 0.0, 0.20, 0.25, 0.30, 0.40) ceramics were prepared using the traditional solid-state reaction method. X-ray diffraction patterns have shown that the intensities of (001) and (100) super-lattices decrease with the increase in the BCN content. Seven main Raman vibrational modes are observed, assigned, and illustrated, in particular. Raman shifts of Eg(O) modes and the FWHM values of F2g(O)/A1g(O) modes have close relationship with the dielectric properties. The calculated values by the four-parameter semiquantum model based on IR reflectivity match well with the measured data (@3.8 GHz), which means that most of dielectric contribution to the system may be ascribed to the absorption of structural phononic oscillations at the infrared region, and the contribution from the scattering of the defective phonons is small. The contributions of each vibrational mode on the dielectric responses were investigated in detail, indicating that the low-frequency modes (A2u(1) and Eu(1)) have a decisive role to the dielectric properties.
Sedative–hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan.
Methods:
A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders. Sedatives and hypnotics use was determined via both self-reporting and prescription records. Logistic regression modeling was used to evaluate associations between sedative–hypnotic use and demographic and health status.
Results:
Among the 3,978 participants aged 65 years and over, the rate of sedative–hypnotic use was 19.7% (n = 785). 4.5% (n = 35) of users reported sedative–hypnotic use without a doctor's prescription. Several sociodemographic characteristics were positively associated with sedative and hypnotic use, including older age, female gender, higher education level, married status, unemployment, and current alcohol consumption. Comorbid chronic and cardiovascular diseases, mental illness, depression, pain, and sleep problems also increased the likelihood of sedative–hypnotic use.
Conclusions:
This study is one of the largest pioneer studies to date to survey sedatives–hypnotics use among community-dwelling elderly. One in five community-dwelling older adults reported sedative–hypnotic drugs use in Taiwan, and about 5% of sedative and/or hypnotics usage was without a doctor's prescription. Findings could be helpful for drug-use safety interventions to identify target geriatric patients who are in general at higher risk of downstream harm associated with sedative–hypnotic use in geriatric patients.
This study was conducted to estimate prevalence rates and risk factors for late-life depression in a large nationwide representative sample from Taiwan.
Methods:
A total of 5,664, randomly sampled individuals aged ≥55 years were enrolled. Clinically, relevant depressive symptoms were classified using the Center for Epidemiological Studies Depression Scale (CES-D score ≥16), and major depression was confirmed using the Primary Care Evaluation of Mental Disorders. Individuals with clinically relevant depressive symptoms, who did not meet the strict diagnostic criteria for major depression, were considered to have minor depression. Multinomial logistic regression analyses were conducted to identify risk factors for major and minor depression, including socio-demographic characteristics, medical conditions, lifestyle behaviors, social support network, and life events.
Results:
The prevalence rates of minor and major depression were 3.7% and 1.5%, respectively. Major depression was associated with personal vulnerability factors, such as poor social support, cognitive impairment, comorbid pain conditions, and sleep disturbance. However, minor depression was more likely to be related to adverse life events, including increased burden on families, changes in health status, or relationship problem. Approximately, 20.0% of individuals with major depression received antidepressant treatment.
Conclusions:
Late-life depression was less prevalent among community-dwelling older adults in Taiwan than among populations in other countries. Our findings may aid the early detection and treatment of late-life depression and provide a basis for future investigations.
Several previous cross-sectional studies have shown that vegetarians have a better metabolic profile than non-vegetarians, suggesting that a vegetarian dietary pattern may help prevent chronic degenerative diseases. However, longitudinal studies on the impact of vegetarian diets on metabolic traits are scarce. We studied how several sub-types of vegetarian diets affect metabolic traits, including waist circumference, BMI, systolic blood pressure (SBP), diastolic blood pressure, fasting blood glucose, total cholesterol (TC), HDL, LDL, TAG and TC:HDL ratio, through both cross-sectional and longitudinal study designs. The study used the MJ Health Screening database, with data collected from 1994 to 2008 in Taiwan, which included 4415 lacto-ovo-vegetarians, 1855 lacto-vegetarians and 1913 vegans; each vegetarian was matched with five non-vegetarians based on age, sex and study site. In the longitudinal follow-up, each additional year of vegan diet lowered the risk of obesity by 7 % (95 % CI 0·88, 0·99), whereas each additional year of lacto-vegetarian diet lowered the risk of elevated SBP by 8 % (95 % CI 0·85, 0·99) and elevated glucose by 7 % (95 % CI 0·87, 0·99), and each additional year of ovo-lacto-vegetarian diet increased abnormal HDL by 7 % (95 % CI 1·03, 1·12), compared with non-vegetarians. In the cross-sectional comparisons, all sub-types of vegetarians had lower likelihoods of abnormalities compared with non-vegetarians on all metabolic traits (P<0·001 for all comparisons), except for HDL and TAG. The better metabolic profile in vegetarians is partially attributable to lower BMI. With proper management of TAG and HDL, along with caution about the intake of refined carbohydrates and fructose, a plant-based diet may benefit all aspects of the metabolic profile.
We report on the radiative transfer process and optical properties of sea ice in the thermal infrared (TIR) band, presenting two new linear kernel driver models (Relative Emissivity Distribution Function, REDF) that describe TIR emission characteristics of smooth and rough ice. In order to test the models and determine the necessary coefficients, in situ measurements from the Bohai Sea were carried out during the 2011/12 and 2012/13 boreal winters. The results show that the relative emissivity of smooth sea ice decreases along with increasing viewing zenith angle, and the shape of the relative emissivity curve is similar to that of an ideal plane. Affected by parameters such as roughness and surface temperature distribution, the anisotropy of relative emissivity of sea ice with a high degree of roughness is stronger relative to the cosine emitter. The model coefficients were also obtained using a robust regression method based on the measured data. The presented models are more practical than the numerical radiative transfer model and can be used for multi-angular TIR remote sensing.
The dynamical processes of a low-energy carbon ion collision with the graphene sheet supported by diamond at three impact positions are studied by using empirical potential molecular dynamics simulations. The energy transformation and the structural evolution have been studied. Five types of processes are observed: adsorption, hybridization, defects formation in diamond, atom emission and transmission. We find that the irradiation damage is closely related to the incident energy and impact position. In our simulations, as the projectile collides at a graphene atom, it transfers most of its energy to the primary knock-on atom, and defects are created in graphene. When the projectile moves perpendicular towards the center of a C-C bond in the graphene sheet, the energy transferred from the projectile to the atoms associated with the bond increases firstly and then decreases with the increasing incident energy, and the graphene sheet remains two-dimensional crystal structure after collision when the incident energy is larger than 360 eV. While the impact location is the center of a hexagonal ring on the graphene sheet, the energy transferred from the projectile to the atoms of the target ring is very small regardless of how large is the incident energy, and the graphene sheet is able to keep perfect crystal structure when the incident energy is larger than 34 eV.