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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.
For individual cultures, findings on regulating embryo density by changing the microdrop volume are contradictory. The aim of this study was to investigate the relationship between embryo density and the developmental outcome of day 3 embryos after adjusting covariates. In total, 1196 embryos from 206 couples who had undergone in vitro fertilization treatment were analyzed retrospectively. Three embryo densities were used routinely, i.e. one embryo in a drop (30 μl/embryo), two embryos in a drop (15 μl/embryo) and three embryos in a drop (10 μl/embryo). Embryo quality on day 3 was evaluated, both the cell number of day 3 embryos and the proportion of successful implantations served as endpoints. Maternal age, paternal age, antral follicles and level of anti-Müllerian hormone, type of infertility, controlled ovarian stimulation protocol, length of stimulation, number of retrieved oocytes, number of zygotes (two pronuclei) and insemination type were covariates and adjusted. After adjusting fully for all covariates, the cell number of day 3 embryos was significantly increased by 0.40 (95% CI 0.00, 0.79; P = 0.048) and 0.78 (95% CI 0.02, 1.54; P = 0.044) in the 15 μl/embryo and 10 μl/embryo group separately, compared with the 30 μl/embryo group. The proportions of implanted embryos were 42.1%, 48.7% and 0.0% in the 30 μl/embryo, 15 μl/embryo and 10 μl/embryo groups respectively. There was no statistical significance (P = 0.22) between the 30 μl/embryo group and the 15 μl/embryo group. After adjusting for confounders that were significant in univariate analysis, embryo density was still not associated with day 3 embryo implantation potential (P > 0.05). In a 30-μl microdrop, culturing embryos with an embryo density of both 15 and 10 μl/embryo increased the cell number of day 3 embryos, which did not benefit embryo implanting potential, compared with individual culture of 30 μl/embryo.
To explore the relationship between parameters of Na and K excretion using 24-h urine sample and mild cognitive impairment (MCI) in general population.
Design:
This is a cross-sectional study.
Setting:
Community-based general population in Emin China.
Participants:
Totally, 1147 subjects aged ≥18 years were selected to complete the study, with a multistage proportional random sampling method. Cognitive status was assessed with Mini Mental State Examination (MMSE) questionnaire and timed 24-h urine specimens were collected. Finally, 561 participants aged ≥35 years with complete urine sample and MMSE data were included for the current analysis and divided into groups by tertiles of 24-h urinary sodium to potassium ratio (24-h UNa/K) as lowest (T1), middle (T2) and highest (T3) groups.
Results:
The MMSE score was significantly lower in T3, compared with the T1 group (26·0 v. 25·0, P = 0·002), and the prevalent MCI was significantly higher in T3 than in T1 group (11·7 % v. 25·8 %, P < 0·001). In multiple linear regression, 24-UNa/K (β: −0·184, 95 % CI −0·319, −0·050, P = 0·007) was negatively associated with MMSE score. In multivariable logistic regression, compared with T1 group, 24-h UNa/K in the T2 and T3 groups showed 2·01 (95 % CI 1·03, 3·93, P = 0·041) and 3·38 (95 % CI 1·77, 6·44, P < 0·001) fold odds for presence of MCI, even after adjustment for confounders. More augmented results were demonstrated in sensitivity analysis by excluding individuals taking anti-hypertensive agents.
Conclusions:
Higher 24-h UNa/K is in an independent association with prevalent MCI.
GBF1 [Golgi brefeldin A (BFA) resistance factor 1] is a member of the guanine nucleotide exchange factors Arf family. GBF1 localizes at the cis-Golgi and endoplasmic reticulum (ER)-Golgi intermediate compartment where it participates in ER-Golgi traffic by assisting in the recruitment of the coat protein COPI. However, the roles of GBF1 in oocyte meiotic maturation are still unknown. In the present study, we investigated the regulatory functions of GBF1 in mouse oocyte organelle dynamics. In our results, GBF1 was stably expressed during oocyte maturation, and GBF1 localized at the spindle periphery during metaphase I. Inhibiting GBF1 activity led to aberrant accumulation of the Golgi apparatus around the spindle. This may be due to the effects of GBF1 on the localization of GM130, as GBF1 co-localized with GM130 and inhibiting GBF1 induced condensation of GM130. Moreover, the loss of GBF1 activity affected the ER distribution and induced ER stress, as shown by increased GRP78 expression. Mitochondrial localization and functions were affected, as the mitochondrial membrane potential was altered. Taken together, these results suggest that GBF1 has wide-ranging effects on the distribution and functions of Golgi apparatus, ER, and mitochondria as well as normal polar body formation in mouse oocytes.
Biological materials represent a major source of inspiration to engineer protein-based polymers that can replicate the properties of living systems. Combined with our ability to control the molecular structure of proteins at the single amino acid level, this results in a vast array of attractive possibilities for materials science, an interest that is undeniably related to simplified procedures in gene synthesis, cloning, and biotechnological production. In parallel, it has been increasingly appreciated that living organisms exploit liquid–liquid phase separation (LLPS) to fabricate extracellular structures. In this article, we discuss the central role of protein LLPS in the fabrication of selected biological structures, including biological adhesives and hard biomolecular composites, and how physicochemical lessons from these systems are being replicated in synthetic analogs. Recent translational applications of protein LLPS are highlighted, notably aqueous-resistant adhesives, stimuli-responsive therapeutics carriers, and matrix materials for green structural composites.
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.
The novel coronavirus disease 2019 (COVID-19) pandemic has spread to over 213 countries and territories. We sought to describe the clinical features of fatalities in patients with severe COVID-19.
Methods:
We conducted an Internet-based retrospective cohort study through retrieving the clinical information of 100 COVID-19 deaths from nonduplicating incidental reports in Chinese provincial and other governmental websites between January 23 and March 10, 2020.
Results:
Approximately 6 of 10 COVID-19 deaths were males (64.0%). The average age was 70.7 ± 13.5 y, and 84% of patients were elderly (over age 60 y). The mean duration from admission to diagnosis was 2.2 ± 3.8 d (median: 1 d). The mean duration from diagnosis to death was 9.9 ± 7.0 d (median: 9 d). Approximately 3 of 4 cases (76.0%) were complicated by 1 or more chronic diseases, including hypertension (41.0%), diabetes (29.0%) and coronary heart disease (27.0%), respiratory disorders (23.0%), and cerebrovascular disease (12.0%). Fever (46.0%), cough (33.0%), and shortness of breath (9.0%) were the most common first symptoms. Multiple organ failure (67.9%), circulatory failure (20.2%), and respiratory failure (11.9%) are the top 3 direct causes of death.
Conclusions:
COVID-19 deaths are mainly elderly and patients with chronic diseases especially cardiovascular disorders and diabetes. Multiple organ failure is the most common direct cause of death.
From 21 January 2020 to 9 February 2020, three family clusters involving 31 patients with coronavirus disease 2019 were identified in Wenzhou, China. The epidemiological and clinical characteristics of the family cluster patients were analysed and compared with those of 43 contemporaneous sporadic cases. The three index cases transmitted the infection to 28 family members 2–10 days before illness onset. Overall, 28 of the 41 sporadic cases and three of 31 patients in the family clusters came back from Wuhan (65.12 vs. 9.68%, P< 0.001). In terms of epidemiological characters and clinical symptoms, no significant differences were observed between the family cluster and sporadic cases. However, the lymphocyte counts of sporadic cases were significantly lower than those of family cluster cases ((1.32 ± 0.55) × 109/l vs. (1.63 ± 0.70) × 109/l, P = 0.037), and the proportion of hypoalbuminaemia was higher in sporadic cases (18/43, 41.86%) than in the family clusters (6/31, 19.35%) (P < 0.05). Within the family cluster, the second- and third-generation cases had milder clinical manifestations, without severe conditions, compared with the index and first-generation cases, indicating that the virulence gradually decreased following passage through generations within the family clusters. Close surveillance, timely recognition and isolation of the suspected or latent patient is crucial in preventing family cluster infection.
To investigate homocysteine (Hcy) and folate levels, prevalence of hyperhomocysteinaemia (HHcy) and folate deficiency, which are affected by lifestyles in urban, agricultural and stock-raising populations.
Design:
This is a cross-sectional study.
Setting:
Urban, agricultural and stock-raising regions in Emin, China.
Participants:
Totally 1926 subjects – 885 (45·9 %) from urban, 861 (44·7 %) from agricultural and 180 (9·4 %) from stock-raising regions – were obtained using multistage stratified random sampling. Inclusion criteria encompassed inhabitants aged ≥15 years who resided at the current address for ≥6 months and agreed to participate in the study. Surveys on health behaviour questionnaires and physical examinations were conducted and blood samples collected.
Results:
The folate level of subjects from the stock-raising region was the lowest, followed by those from the agricultural region, and the highest in those from the urban region (3·48 v. 6·50 v. 7·12 ng/ml, P < 0·001), whereas mean Hcy showed no significant difference across regions. The OR for HHcy in stock-raising regions was 1·90 (95 % CI 1·11, 3·27) compared with the urban region after adjusting for all possible covariates. The OR for folate deficiency in stock-raising and agriculture regions was 11·51 (95 % CI 7·09, 18·67) and 1·91 (95 % CI 1·30, 2·82), respectively, compared with the urban region after adjusting for all possible covariates.
Conclusions:
HHcy and folate deficiency are highly prevalent in stock-raisers, which is of important reference for HHcy control in Xinjiang, with a possibility of extension to others with approximate lifestyles.
Hypertension is a common comorbidity in COVID-19 patients. However, the association of hypertension with the severity and fatality of COVID-19 remain unclear. In the present meta-analysis, relevant studies reported the impacts of hypertension on SARS-CoV-2 infection were identified by searching PubMed, Elsevier Science Direct, Web of Science, Wiley Online Library, Embase and CNKI up to 20 March 2020. As the results shown, 12 publications with 2389 COVID-19 patients (674 severe cases) were included for the analysis of disease severity. The severity rate of COVID-19 in hypertensive patients was much higher than in non-hypertensive cases (37.58% vs 19.73%, pooled OR: 2.27, 95% CI: 1.80–2.86). Moreover, the pooled ORs of COVID-19 severity for hypertension vs. non-hypertension was 2.21 (95% CI: 1.58–3.10) and 2.32 (95% CI: 1.70–3.17) in age <50 years and ⩾50 years patients, respectively. Additionally, six studies with 151 deaths of 2116 COVID-19 cases were included for the analysis of disease fatality. The results showed that hypertensive patients carried a nearly 3.48-fold higher risk of dying from COVID-19 (95% CI: 1.72–7.08). Meanwhile, the pooled ORs of COVID-19 fatality for hypertension vs. non-hypertension was 6.43 (95% CI: 3.40–12.17) and 2.66 (95% CI: 1.27–5.57) in age <50 years and ⩾50 years patients, respectively. Neither considerable heterogeneity nor publication bias was observed in the present analysis. Therefore, our present results provided further evidence that hypertension could significantly increase the risks of severity and fatality of SARS-CoV-2 infection.
The nitrogen-decorated CeO2/reduced graphene oxide nanocomposite (CeO2/N-rGO) was one-step synthesized by a facile hydrothermal technique and applied as counter electrode materials for dye-sensitized solar cells (DSSCs). For comparison, CeO2/rGO and rGO were also synthesized by adjusting corresponding reactants. It was found that the as-synthesized CeO2/N-rGO shows better electrocatalytic activity for triiodide/iodide reduction than that of pure rGO and CeO2/rGO, and a synergistic effect of nitrogen and CeO2 on the rGO sheets was observed. The photoelectric conversion efficiency of DSSCs based on CeO2/N-rGO counter electrode was 3.20%, which is higher than that of CeO2/rGO (2.45%) and rGO counter electrode (1.37%). Furthermore, the synergistic effect of nitrogen and CeO2 on the rGO sheets was also discussed in detail with different CeO2 amount levels. It is believed that this one-step synthetic method is a potential way to synthesize low-cost and efficient rGO-based multiple composited counter electrode materials to replace more expensive Pt.
To gain more comprehensive understanding of metabolic syndrome (Mets) among in general Chinese population.
Design:
Cross-sectional study. Mets was defined by three widely accepted definitions including modified Adults Treatment Panel (ATP) III criteria, International Diabetes Federation (IDF) criteria and harmonized definition. Risk factors were evaluated by using multivariate logistic regression.
Setting:
Nineteen rural villages in northeast China.
Participants:
The survey was conducted in September 2017 and May 2018 on 10 926 individuals.
Results:
According to modified ATP III criteria, IDF criteria and harmonised definition, the overall prevalence of Mets was 41·3 % (95 % CI 40·3, 42·2), 34·2 % (95 % CI 33·2, 35·1) and 44·1 % (95 % CI 43·1, 45·1), respectively. Females had a higher prevalence, and elevated blood pressure was the most frequent. Age, female sex, non-peasant worker, higher BMI and lower-annual income were independent risk factors of Mets in all three definitions (all ps < 0·05). Based on modified ATP III criteria and harmonised definition, heavy drinking was positively correlated with Mets. In contrast, former drinking was inversely associated with Mets.
Conclusions:
Mets is highly prevalent in rural areas of northeast China. Its independent risk factors include higher age, female sex, non-peasantry worker, higher BMI and lower-annual income. Modified ATP III criteria and harmonised definition may be superior definitions of Mets.
In recent years, there have been a significant influenza activity and emerging influenza strains in China, resulting in an increasing number of influenza virus infections and leading to public health concerns. The aims of this study were to identify the epidemiological and aetiological characteristics of influenza and establish seasonal autoregressive integrated moving average (SARIMA) models for forecasting the percentage of visits for influenza-like illness (ILI%) in urban and rural areas of Shenyang. Influenza surveillance data were obtained for ILI cases and influenza virus positivity from 18 sentinel hospitals. The SARIMA models were constructed to predict ILI% for January–December 2019. During 2010–2018, the influenza activity was higher in urban than in rural areas. The age distribution of ILI cases showed the highest rate in young children aged 0–4 years. Seasonal A/H3N2, influenza B virus and pandemic A/H1N1 continuously co-circulated in winter and spring seasons. In addition, the SARIMA (0, 1, 0) (0, 1, 2)12 model for the urban area and the SARIMA (1, 1, 1) (1, 1, 0)12 model for the rural area were appropriate for predicting influenza incidence. Our findings suggested that there were regional and seasonal distinctions of ILI activity in Shenyang. A co-epidemic pattern of influenza strains was evident in terms of seasonal influenza activity. Young children were more susceptible to influenza virus infection than adults. These results provide a reference for future influenza prevention and control strategies in the study area.
Wireless power transfer (WPT) has attracted attention from academia and industry in recent years. WPT has natural electrical isolation between primary and secondary side, which ensures safe charging in an underwater environment. This breakthrough technology greatly facilitates the deep-sea power transmission. However, at the current stage the transferred power and energy efficiency level are not up to that of the WPT system in the air. The major concerns include the attenuation is seawater, extreme temperature and pressure conditions, disturbance of ocean currents, and bio-security. Three questions are answered in this paper: first, the expressions of eddy current loss and attenuation of electromagnetic wave in seawater are unified, and the influence of seawater as transmission medium on the WPT system is discussed. Second, the evolution of electromagnetic coupling structure suitable for underwater applications is studied. Third, the loss and heating effects of an underwater WPT system and the corresponding bio-fouling phenomenon are investigated. The questions above were addressed through analysis of electrical properties, coupler structures, and bio-fouling effects of the underwater WPT system. This paper will facilitate the study and research on underwater WPT applications.
Long-term sickness absence is a significant human and economic cost in many countries, including Sweden making research on factors which impact on return to work (RTW) relevant. This study has two aims: (1) provide an overview of factors that impact RTW expectations in a national sample of Swedish workers on long-term sickness absence; and (2) gain an understanding of the interrelationships among these factors using a socioecological framework and decision tree analysis.
Method:
A survey, designed to capture information about demographic variables, health and work ability, workplace contact, supervisor support and expectations of return to work, was mailed to 1,112 randomly selected sick-listed people in Sweden and completed by 534, representing a response rate of 48%.
Results:
The most important factors affecting RTW expectations were work ability and burnout. Employees reporting high levels of work ability were more likely to expect to RTW compared to those reporting low levels, and this was dependent on their relative burnout score. Those with a high burnout score were less likely to expect to RTW, while for those with a low burnout score RTW expectations were dependent on age, country of birth, and supervisor support. For young employees reporting low work ability and low burnout score, RTW expectations were lower.
Conclusions:
Our results suggest a more nuanced approach to delivery of RTW services is required, whereby practitioners need to understand the socioecology of the range of factors that impact RTW expectations. The use of decision tree analysis facilitates this understanding by describing the interrelationships between these factors.
The vortex sound interaction in acoustic resonance induced by vortex shedding from a cylinder in a flow duct is numerically studied based on a nonlinear physical model, which consists of three meshless sub-models describing the vortex shedding, sound generation and propagation within the duct. In addition, the acoustic particle velocity near the separation point of the shear layer is solved and added onto the Kutta condition of the vortex shedding, which takes the acoustic feedback effect into consideration and makes the vortex sound interaction bi-directional. The predicted results of resonant frequency and amplitude are found to be in conformity with previous experiment data, especially, a continuous description of the onset–sustain–cease of lock-in phenomenon is well captured. The lock-in phenomenon is depicted as a vigorous competition between the vortex shedding frequency $(f_{s})$ and the inherent frequency of the acoustic $\unicode[STIX]{x1D6FD}$-mode $(f_{a})$. The mutual capturing behaviour of these two frequencies is dominated by $f_{a}$. Moreover, $f_{s}$ cannot always be locked onto $f_{a}$ within the whole lock-in region, which is in marked contrast to the previous understanding. In this aspect, two lock-in regions, the synchronous region and the $\unicode[STIX]{x1D6FD}$-mode dominant region, are defined according to the relevance of $f_{s}$ and $f_{a}$. The maximum resonant sound appears at the end of the synchronous region. The present model not only predicts the proper characteristics of frequency lock-in as observed in experiments, but also helps to provide a more detailed understanding of the underlying lock-in mechanism.