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Pregnancy is a complex biological process. The establishment and maintenance of foetal–maternal interface are pivotal events. Decidual immune cells and inflammatory cytokines play indispensable roles in the foetal–maternal interface. The disfunction of decidual immune cells leads to adverse pregnancy outcome. Tumour necrosis factor (TNF)-α, a common inflammatory cytokine, has critical roles in different stages of normal pregnancy process. However, the relationship between the disorder of TNF-α and adverse pregnancy outcomes, including preeclampsia (PE), intrauterine growth restriction (IUGR), spontaneous abortion (SA), preterm birth and so on, is still indefinite. In this review, we thoroughly reviewed the effect of TNF-α disorder on pathological conditions. Moreover, we summarized the reports about the adverse pregnancy outcomes (PE, IUGR, SA and preterm birth) of using anti-TNF-α drugs (infliximab, etanercept and adalimumab, certolizumab and golimumab) currently in the clinical studies. Overall, IUGR, SA and preterm birth are the most common adverse pregnancy outcomes of anti-TNF-α drugs. Our review may provide insight for the immunological treatment of pregnancy-related complication, and help practitioners make informed decisions based on the current evidences.
In this report, we focus on the significant upward trend of occupational accidental traffic injuries in commercial couriers during the COVID-19 pandemic. This review comments on the characteristics of occupational accidental injuries of commercial couriers in China, and then discusses the reasons of the high incidence rate and associated risk factors. Various potential protective measures were also explored to prevent and control the occupational injuries in this vulnerable worker group.
Accumulating evidence suggests that supplementation of omega-3 polyunsaturated fatty acids (ω−3 PUFAs) was associated with reduction in risk of major cardiovascular events. This meta-analysis was to systematically evaluate whether daily supplementation and accumulated intake of ω−3 PUFAs is associated with improved left ventricular (LV) remodeling in patients with chronic heart failure (CHF). Articles were obtained from Pubmed, Clinical key and Web of Science from inception to January 1 in 2021, and a total of 12 trials involving 2162 participants were eligible for inclusion. The sources of study heterogeneity were explained by I2 statistic and subgroup analysis. Compared with placebo groups, ω−3 PUFAs supplementation improved LV ejection fraction (LVEF) (11 trials, 2112 participants, WMD=2.52, 95%CI 1.25 to 3.80, I2=87.8%) and decreased LV end-systolic volume (LVESV) (5 studies, 905 participants, WMD=−3.22, 95%CI −3.67 to −2.77, I2=0.0%) by using the continuous variables analysis. Notably, the high accumulated ω−3 PUFAs dosage groups (≥600g) presented a prominent improvement in LVEF, while the low and middle accumulated dosage (≤300g and 300-600g) showed no effects on LVEF. In addition, ω−3 PUFAs supplementation decreased the levels of pro-inflammatory mediators including tumor necrosis factor−α (TNF-α), interleukin-6 (IL-6) and hypersensitive-c-reactive protein (Hs-CRP). Therefore, the present meta-analysis demonstrated that ω−3 PUFAs consumption was associated with a substantial improvement of LV function and remodeling in patients subjected to CHF. The accumulated dosage of ω-3 PUFAs intake is vital for its cardiac protective role.
Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.
Aims
This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.
Method
Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.
Results
Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).
Conclusions
COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
The sudden outbreak of the COVID-19 pandemic has caused tremendous challenges to the medical system. The government and hospitals have taken robust measures to curb the spread of the deadly virus. Its impact on routine medical services is gradually being taken seriously.
Objective:
To identify the impact of the novel Coronavirus pandemic on emergency department (ED) patient flow and the performance of the routine ED service.
Methods:
This retrospective cohort study was undertaken in a tertiary public teaching hospital ED in Chengdu, China. ED data of patients were routinely collected to compare demographic, clinical characteristics and outcomes during an 8-week period from January 1, 2019 to February 25, 2020. Data were analyzed with the chi-square statistical test.
Results:
Over the study periods, there were 31855 and 25244 patients presented to the ED in 2019 and 2020 respectively. During the pandemic period in 2020, the daily number of average ED visits was lower than that in 2019 (430 ± 134.9 versus 572 ± 38.6, P = 0.00), with fewer triage 1&2 cases (145 ± 33.3 versus 178 ± 15.0, P = 0.00). Nevertheless, the mortality increased remarkably during the pandemic period in 2020 (0.2% versus 0.1%, P = 0.009), with higher APACHE II scores (28 versus 19, P = 0.022) and shorter ED elapsed time (0.2 versus 1.4 days, P = 0.016) among these death cases.
Conclusions:
The COVID-19 pandemic had an evident impact on the patient’s behavioral patterns and routine emergency services, which caused higher ED mortality.
The very high frequency data exchange system (VDES) is promising in promoting electronic navigation (E-navigation) and improving navigation safety. The multiple access control (MAC) protocol is crucial to the transmission performance of VDES. The self-organising time division multiple access (SOTDMA) protocol, as the only access mode given by current recommendations, leads to a high rate of transmission collisions in the traditional automatic identification system (AIS), especially with heavy traffic loads. This paper proposes a novel feedback based time division multiple access (FBTDMA) protocol to address the problems caused by SOTDMA, such that collision of transmissions can be avoided in information transmission among vessels. Simulation results demonstrate that the proposed FBTDMA outperforms the traditional SOTDMA in terms of channel utilisation and throughput, and significantly reduces the transmission collision rate. The study is expected to provide insights into VDES standardisation and E-navigation modernisation.
A multicenter study of sharps injuries (SIs) and other blood or body fluid (OBBF) exposures was conducted among 33,156 healthcare workers (HCWs) from 175 hospitals in Anhui, China. In total, 12,178 HCWs (36.7%) had experienced at least 1 SI in the previous 12 months and 8,116 HCWs (24.5%) had experienced at least 1 OBBF exposure during the previous 12 months.
With the rapid rise in the prevalence of non-tuberculous mycobacteria (NTM) diseases across the world, the microbiological diagnosis of NTM isolates is becoming increasingly important for the diagnosis and treatment of NTM disease. In this study, the clinical presentation, species distribution and drug susceptibility of patients with NTM disease visiting the Chongqing Public Health Medical Centre during March 2016–April 2019 were retrospectively analysed. Among the 146 patients with NTM disease, eight NTM species (complex) were identified. The predominant NTM species in these patients were identified to be Mycobacterium abscessus complex (53, 36.3%), M. intracellulare (38, 26%) and M. fortuitum (17, 11.7%). In addition, two or more species were isolated from 7.5% of the patients. Pulmonary NTM disease (142, 97.3%) showed the highest prevalence among the patients. It was observed that 40.1% of the patients with pulmonary NTM disease had chronic pulmonary obstructive disease and bronchiectasis, while 22.5% had prior tuberculosis. Male patients showed more association with the conditions of cough and haemoptysis than the female patients. In an in vitro antimicrobial susceptibility testing, most of the species showed susceptibility to linezolid, amikacin and clarithromycin, while M. fortuitum exhibited low susceptibility to tobramycin. In conclusion, the prevalence of NTM disease, especially that of the pulmonary NTM disease, is common in Southwest China. Species identification and drug susceptibility testing are thus extremely important to ensure appropriate treatment regimens for patient care and management.
The present study was conducted to test the hypothesis that dietary supplementation with a nano chitosan–zinc complex (CP–Zn, 100 mg/kg Zn) could alleviate weaning stress in piglets challenged with enterotoxigenic Escherichia coli K88 by improving growth performance and intestinal antioxidant capacity. The in vivo effects of CP–Zn on growth performance variables (including gastrointestinal digestion and absorption functions and the levels of key proteins related to muscle growth) and the antioxidant capacity of the small intestine (SI) were evaluated in seventy-two weaned piglets. The porcine jejunal epithelial cell line IPEC-J2 was used to further investigate the antioxidant mechanism of CP–Zn in vitro. The results showed that CP–Zn supplementation increased the jejunal villus height and decreased the diarrhoea rate in weaned piglets. CP–Zn supplementation also improved growth performance (average daily gain and average daily feed intake), increased the activity of carbohydrate digestion-related enzymes (amylase, maltase, sucrase and lactase) and the mRNA expression levels of nutrient transporters (Na+-dependent glucose transporter 1, glucose transporter type 2, peptide transporter 1 and excitatory amino acid carrier 1) in the jejunum and up-regulated the expression levels of mammalian target of rapamycin (mTOR) pathway-related proteins (insulin receptor substrate 1, phospho-mTOR and phospho-p70S6K) in muscle. In addition, CP–Zn supplementation increased glutathione content, enhanced total superoxide dismutase (T-SOD) and glutathione peroxidase (GSH-px) activity, and reduced malondialdehyde (MDA) content in the jejunum. Furthermore, CP–Zn decreased the content of MDA and reactive oxygen species, enhanced the activity of T-SOD and GSH-px and up-regulated the expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) pathway-related proteins (Nrf2, NAD(P)H:quinone oxidoreductase 1 and haeme oxygenase 1) in lipopolysaccharide-stimulated IPEC-J2 cells. Collectively, these findings indicate that CP–Zn supplementation can improve growth performance and the antioxidant capacity of the SI in piglets, thus alleviating weaning stress.
The recent outbreak of coronavirus in Wuhan, China, has imposed challenges on the Chinese medical system. Not only the dramatically increasing number of infected cases and insufficient medical resources, but also the peoples’ panic throughout the whole country have made medical services extremely difficult. To respond to these challenges effectively, our hospital implemented an urgent response strategy, including human resources and medical resources preparation and re-allocation, immediate fever screening, strict patient-visiting flow management, and reasonable information communication. Our experience and response measures could provide a reference for other hospitals in the current situation.
Paediatric Mycoplasma pneumoniae pneumonia (MPP) is a major cause of community-acquired pneumonia in China. Data on epidemiology of paediatric MPP from China are little known. This study retrospectively collected data from June 2006 to June 2016 in Beijing Children's Hospital, Capital Medical University of North China and aims to explore the epidemiological features of paediatric MPP and severe MPP (SMPP) in North China during the past 10 years. A total of 27 498 paediatric patients with pneumonia were enrolled. Among them, 37.5% of paediatric patients had MPP. In this area, an epidemic took place every 2–3 years at the peak, and the positive rate of MPP increased during these peak years over time. The peak age of MPP was between the ages of 6 and 10 years, accounting for 75.2%, significantly more compared with other age groups (χ2 = 1384.1, P < 0.0001). The epidemics peaked in September, October and November (χ2 = 904.9, P < 0.0001). Additionally, 13.0% of MPP paediatric patients were SMPP, but over time, the rate of SMPP increased, reaching 42.6% in 2016. The mean age of paediatric patients with SMPP (6.7 ± 3.0 years old) was younger than that of patients with non-SMPP (7.4 ± 3.2 years old) (t = 3.60, P = 0.0001). The prevalence of MPP and SMPP is common in China, especially in children from 6 to 10 years old. Paediatric patients with SMPP tend to be younger than those with non-SMPP. MPP outbreaks occur every 2–3 years in North China. September, October and November are the peak months, unlike in South China. Understanding the epidemiological characteristics of paediatric MPP can contribute to timely treatment and diagnosis, and may improve the prognosis of children with SMPP.
Delay discounting refers to the reduction in the present value of a future reward as the delay to that reward increases, which is related to various problematic behaviors, such as substance abuse. In this study, we explored the neuroanatomical correlates of delay discounting by employing voxel-based morphometry and the individual difference approach. We found that participants’ delay discounting, measured by the Monetary Choice Questionnaire, was correlated with the gray matter volume (GMV) of two cortical regions. On the one hand, individuals with a larger GMV of the orbitofrontal cortex (OFC) were likely to discount future values less steeply and choose large but delayed rewards. On the other hand, individuals with a larger GMV of the anterior cingulate cortex (ACC) are likely to discount the future value more steeply and prefer small but immediate rewards. Our study revealed the neuroanatomical correlates of delay discounting across the whole brain, and may help to understand the delay discounting in the frame of the hot versus cool system, which demonstrates the dynamics of resisting present temptation for future rewards.
This study analyzed and assessed publication trends in articles on “disaster medicine,” using scientometric analysis. Data were obtained from the Web of Science Core Collection (WoSCC) of Thomson Reuters on March 27, 2017. A total of 564 publications on disaster medicine were identified. There was a mild increase in the number of articles on disaster medicine from 2008 (n=55) to 2016 (n=83). Disaster Medicine and Public Health Preparedness published the most articles, the majority of articles were published in the United States, and the leading institute was Tohoku University. F. Della Corte, M. D. Christian, and P. L. Ingrassia were the top authors on the topic, and the field of public health generated the most publications. Terms analysis indicated that emergency medicine, public health, disaster preparedness, natural disasters, medicine, and management were the research hotspots, whereas Hurricane Katrina, mechanical ventilation, occupational medicine, intensive care, and European journals represented the frontiers of disaster medicine research. Overall, our analysis revealed that disaster medicine studies are closely related to other medical fields and provides researchers and policy-makers in this area with new insight into the hotspots and dynamic directions. (Disaster Med Public Health Preparedness. 2019;13:165–172)
Barium-rich silicates were recently found in the lower Cambrian black shale sequence of Anhui Province, South China. The Ba silicates can be divided into Ba-poor K-feldspar, Ba-rich K-feldspar and cymrite, on the basis of occurrence and composition. The Ba-poor K-feldspar have low BaO contents (<1.00 wt.%) and occur as sporadic grains in mudstone. In contrast, the Ba-rich K-feldspar have higher BaO contents (1.36–20.51 wt.%) and occur mainly as rims around grains of Ba-poor K-feldspar in mudstone, as void fillings in dolostone, and as grains dispersed in chert. The cymrite is observed only in chert and occurs as dispersed euhedral tabular crystals. Analyses of the Ba-poor K-feldspar and Ba-rich K-feldspar provide compositions that total <100 wt.% and show non-stoichiometry characterized by (Na + K + Ba + Ca)apfu less than 1.00 and (Al + Si)apfu slightly higher than 4.00. Raman and infrared (IR) spectroscopy has revealed the presence of ${\rm NH}_{\rm 4}^{\rm +} $ and H2O in the Ba-rich K-feldspar, which accounts for the unusual composition of these feldspars. We suggest that the formation processes of the Ba-poor K-feldspar, Ba-rich K-feldspar and cymrite were closely associated with multi-stage hydrothermal fluids enriched in Ba and NH4, consistent with an extensional tectonic setting during the early Cambrian. The Ba-poor K-feldspars might have formed through interactions between pre-existing K-feldspars and hydrothermal fluids. The Ba-rich K-feldspars in mudstone and dolostone formed mainly by precipitation from hydrothermal fluids that infiltrated the sediments, and we suggest the Ba-rich K-feldspars and cymrite in the chert are of exhalative hydrothermal origin.
We study a nonpreemptive scheduling on two parallel identical machines with a dedicated loading server and a dedicated unloading server. Each job has to be loaded by the loading server before being processed on one of the machines and unloaded immediately by the unloading server after its processing. The loading and unloading times are both equal to one unit of time. The goal is to minimize the makespan. Since the problem is NP-hard, we apply the classical list scheduling and largest processing time heuristics, and show that they have worst-case ratios, $8/5$ and $6/5$, respectively.
The high-energy oscillating electric current pulse (ECP) technology was introduced to relieve the residual stresses in the small AISI 1045 steel specimens treated by the pulsed-laser surface irradiation. The high-energy oscillating ECP stress relief experiments were conducted to study the effectiveness of the high-energy oscillating ECP technology. In addition, the electroplasticity framework was developed based on the thermal activation theory to reveal the mechanism of the high-energy oscillating ECP stress relief. The results show that the high-energy oscillating ECP stress relief has good effects on eliminating the residual stress. Furthermore, the residual stress relieving mechanism of the high-energy oscillating ECP stress relief can be attributed to the electric softening effect and the dynamic stress effect. The findings confirm that the significant effects of high-energy oscillating ECP on metal plasticity and provide a basis to understand the underlying mechanism of the high-energy oscillating ECP stress relief.
The high-frequency vibration technology was introduced to relieve the quenched residual stress in the Cr12MoV steel based on the high-frequency vibration system that mainly consisted of an electromagnetic vibrator and an amplitude boost unit. The high-frequency vibratory stress relief (VSR) experiments were conducted to study the effectiveness of the high-frequency vibration technology. In addition, the high-frequency vibration plasticity model was developed based on the thermal activation theory to reveal the mechanism of the high-frequency VSR. The results show that the high-frequency VSR has good effects on eliminating residual stress, while the surface hardness for the Cr12MoV steel remains almost the same. Moreover, there are no changes in the grain size of the Cr12MoV steel during the high-frequency VSR, while the dislocation density for the Cr12MoV steel during the high-frequency VSR decreases by 27.21%. The decrease of dislocation density in the Cr12MoV steel is the essence of residual stress relaxation. The findings confirm the significant effects of high-frequency vibration on metal plasticity and provide a basis to understand the underlying mechanism of the high-frequency VSR.