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This study investigated the factors influencing the mental health of rural doctors in Hebei Province, to provide a basis for improving the mental health of rural doctors and enhancing the level of primary health care.
Background:
The aim of this study was to understand the mental health of rural doctors in Hebei Province, identify the factors that influence it, and propose ways to improve their psychological status and the level of medical service of rural doctors.
Methods:
Rural doctors from 11 cities in Hebei Province were randomly selected, and their basic characteristics and mental health status were surveyed via a structured questionnaire and the Symptom Checklist-90 (SCL-90). The differences between the SCL-90 scores of rural doctors in Hebei Province and the Chinese population norm, as well as the proportion of doctors with mental health problems, were compared. Logistic regression was used to analyse the factors that affect the mental health of rural doctors.
Results:
A total of 2593 valid questionnaires were received. The results of the study revealed several findings: the younger the rural doctors, the greater the incidence of mental health problems (OR = 0.792); female rural doctors were more likely to experience mental health issues than their male counterparts (OR = 0.789); rural doctors with disabilities and chronic diseases faced a significantly greater risk of mental health problems compared to healthy rural doctors (OR = 2.268); rural doctors with longer working hours have a greater incidence of mental health problems; and rural doctors with higher education backgrounds have a higher prevalence of somatization (OR = 1.203).
Conclusion:
Rural doctors who are younger, male, have been in medical service longer, have a chronic illness or disability, and have a high degree of education are at greater risk of developing mental health problems. Attention should be given to the mental health of the rural doctor population to improve primary health care services.
Mamyshev oscillators (MOs) demonstrate extraordinarily superior performance compared with fiber laser counterparts. However, the realization of a fully fiberized, monolithic laser system without pulse degradation remains a key challenge. Here we present a high-energy MO using large mode area Yb-doped fiber and fiber-integrable interferometric super-Gaussian spectral filters that directly generates a nearly diffraction-limited beam with approximately 9.84 W average power and 533 nJ pulse energy. By implementing pre-chirp management with anti-resonant hollow-core fiber (AR-HCF), the adverse effects of super-Gaussian filtering on pulse quality are effectively mitigated, enabling pulse compression to 1.23 times the transform limit. Furthermore, AR-HCF is employed to provide negative dispersion to compensate for the positive chirp of output pulses, resulting in approximately 37 fs de-chirped pulses with approximately 10 MW peak power. This approach represents a significant step toward the development of monolithic fiber lasers capable of generating and flexible delivery of sub-50-fs pulses with tens of megawatts peak power.
Patients with chronic insomnia are characterized by alterations in default mode network and alpha oscillations, for which the medial parietal cortex (MPC) is a key node and thus a potential target for interventions.
Methods
Fifty-six adults with chronic insomnia were randomly assigned to 2 mA, alpha-frequency (10 Hz), 30 min active or sham transcranial alternating current stimulation (tACS) applied over the MPC for 10 sessions completed within two weeks, followed by 4- and 6-week visits. The connectivity of the dorsal and ventral posterior cingulate cortex (vPCC) was calculated based on resting functional MRI.
Results
For the primary outcome, the active group showed a higher response rate (≥ 50% reduction in Pittsburgh Sleep Quality Index (PSQI)) at week 6 than that of the sham group (71.4% versus 3.6%) (risk ratio 20.0, 95% confidence interval 2.9 to 139.0, p = 0.0025). For the secondary outcomes, the active therapy induced greater and sustained improvements (versus sham) in the PSQI, depression (17-item Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale), and cognitive deficits (Perceived Deficits Questionnaire-Depression) scores. The response rates in the active group decreased at weeks 8–14 (42.9%–57.1%). Improvement in sleep was associated with connectivity between the vPCC and the superior frontal gyrus and the inferior parietal lobe, whereas vPCC-to-middle frontal gyrus connectivity was associated with cognitive benefits and vPCC-to-ventromedial prefrontal cortex connectivity was associated with alleviation in rumination.
Conclusions
Targeting the MPC with alpha-tACS appears to be an effective treatment for chronic insomnia, and vPCC connectivity represents a prognostic marker of treatment outcome.
Depression has been linked to disruptions in resting-state networks (RSNs). However, inconsistent findings on RSN disruptions, with variations in reported connectivity within and between RSNs, complicate the understanding of the neurobiological mechanisms underlying depression.
Methods
A systematic literature search of PubMed and Web of Science identified studies that employed resting-state functional magnetic resonance imaging (fMRI) to explore RSN changes in depression. Studies using seed-based functional connectivity analysis or independent component analysis were included, and coordinate-based meta-analyses were performed to evaluate alterations in RSN connectivity both within and between networks.
Results
A total of 58 studies were included, comprising 2321 patients with depression and 2197 healthy controls. The meta-analysis revealed significant alterations in RSN connectivity, both within and between networks, in patients with depression compared with healthy controls. Specifically, within-network changes included both increased and decreased connectivity in the default mode network (DMN) and increased connectivity in the frontoparietal network (FPN). Between-network findings showed increased DMN–FPN and limbic network (LN)–DMN connectivity, decreased DMN–somatomotor network and LN–FPN connectivity, and varied ventral attention network (VAN)–dorsal attentional network (DAN) connectivity. Additionally, a positive correlation was found between illness duration and increased connectivity between the VAN and DAN.
Conclusions
These findings not only provide a comprehensive characterization of RSN disruptions in depression but also enhance our understanding of the neurobiological mechanisms underlying depression.
This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
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.
The AIMTB rapid test assay is an emerging test, which adopted a fluorescence immunochromatographic assay to measure interferon-γ (IFN-γ) production following stimulation of effector memory T cells in whole blood by mycobacterial proteins. The aim of this article was to explore the ability of AIMTB rapid test assay in detecting Mycobacterium tuberculosis (MTB) infection compared with the widely applied QuantiFERON-TB Gold Plus (QFT-Plus) test among rural doctors in China. In total, 511 participants were included in the survey. The concordance between the QFT-Plus test and the AIMTB rapid test assay was 94.47% with a Cohen’s kappa coefficient (κ) of 0.84 (95% CI, 0.79–0.90). Improved concordance between the two tests was observed in males and in participants with 26 or more years of service as rural doctors. The quantitative values of the QFT-Plus test was higher in individuals with a result of QFT-Plus-/AIMTB+ as compared to those with a result of QFT-Plus-/AIMTB- (p < 0.001). Overall, our study found that there was an excellent consistency between the AIMTB rapid test assay and the QFT-Plus test in a Chinese population. As the AIMTB rapid test assay is fast and easy to operate, it has the potential to improve latent tuberculosis infection testing and treatment at the community level in resource-limited settings.
Recent developments have indicated a potential association between tinnitus and COVID-19. The study aimed to understand tinnitus following COVID-19 by examining its severity, recovery prospects, and connection to other lasting COVID-19 effects. Involving 1331 former COVID-19 patients, the online survey assessed tinnitus severity, cognitive issues, and medical background. Of the participants, 27.9% reported tinnitus after infection. Findings showed that as tinnitus severity increased, the chances of natural recovery fell, with more individuals experiencing ongoing symptoms (p < 0.001). Those with the Grade II mild tinnitus (OR = 3.68; CI = 1.89–7.32; p = 0.002), Grade III tinnitus (OR = 3.70; CI = 1.94–7.22; p < 0.001), Grade IV (OR = 6.83; CI = 3.73–12.91; p < 0.001), and a history of tinnitus (OR = 1.96; CI = 1.08–3.64; p = 0.03) had poorer recovery outcomes. Grade IV cases were most common (33.2%), and severe tinnitus was strongly associated with the risk of developing long-term hearing loss, anxiety, and emotional disorders (p < 0.001). The study concludes that severe post-COVID tinnitus correlates with a worse prognosis and potential hearing loss, suggesting the need for attentive treatment and management of severe cases.
Teenage childbearing is a common incident in developed countries. However, teenage births are much more likely in the USA than in any other industrialized country. Most of these births are delivered by female teenagers from low-income families. The hypothesis put forward here is that the welfare state (a set of redistributive institutions) has a significant influence on teenage childbearing behavior. We develop an economic theory of parental investments and the risky sexual behavior of teenagers. The model is estimated to fit stylized facts about income inequality, intergenerational mobility, and the sexual behavior of teenagers in the USA. The welfare state institutions are introduced via tax and public education expenditure functions derived from US data. In a quantitative experiment, we impose Norwegian taxes and education spending in the economic environment. The Norwegian welfare state institutions go a long way in explaining the differences in teenage birth rates between the USA and Norway.
Calorie restriction plays a role in reducing food intake and weight gain, and improving health and lifespan. We hypothesized that calorie restriction would affect body weight (BW), serum indices, gut microbiota, metabolites and short-chain fatty acids of finishing pigs. Castrated male (Landrace × Yorkshire) pigs (86.13 ± 3.50 kg) were randomly assigned into two groups indicated as control (Con) and calorie restriction (CR) (eight pigs/group), respectively. Pigs in the Con group consumed feed ad libitum, whereas pigs in the CR group were fed 70% of the amount of feed in the Con group. The trial lasted for 38 days. Blood and colonic contents were collected for serum parameters, and microbiota and metabolome analysis, respectively. Main effects were tested by Student’s t-test. We found that for finishing pigs, calorie restriction reduced the cumulative food intake, BW gain, serum total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, alanine aminotransferase and aspartate aminotransferase levels. Calorie restriction did not change the α and β diversity of intestinal microbiota. However, calorie restriction significantly increased the abundance of Romboutsia and unclassified_c_Bacilli, and significantly reduced the abundance of Lachnospiraceae_XPB1014_group, Candidatus_Saccharimonas, Escherichia-–Shigella and Gastranaerophilales. Calorie restriction also simultaneously changed the structure of intestinal metabolites and increased the concentration of isobutyric acid, isovaleric acid and valeric acid. In conclusion, calorie restriction may affect metabolism, reduce obesity and improve intestinal microbiota, which may be a healthy diet treatment that can reduce obesity and improve metabolism.
The unsteady mechanism of unstart flow for an inlet with rectangular-to-elliptical shape transition (REST) under the off-design condition at a Mach of 4 is investigated using the delay detached eddy simulation method. With the help of numerical simulations, the unsteady dynamics, especially the low-frequency characteristics of the REST inlet unstart flow, as well as the self-sustaining mechanism, is investigated. The instantaneous flow illustrates the unsteady phenomena of the REST unstart flow, including the interaction between the cowl-closure leading edge (CLE) shock and the shear layer, breathing of the separation bubble, flapping of the separation shock, instability of the shear layer and vortex shedding along the shear layer. The spectral analysis reveals that the lower frequency dynamics is associated with the breathing of the separation bubble and the flapping motion of the separation shock wave, while the higher frequency is related to the instability of the shear layer affected by cowl-closure leading edge shock and the formation of shedding vortices. Further, coherence analysis shows that the contribution of these flow structures dominating the low-frequency dynamics couple with each other. Based on the dynamic mode decomposition results, the characteristics that contribute to the unsteady behaviour of unstart flow are summarized. The streamwise vortices downstream of the separation and the shedding vortices are believed to be the main driving force of the global low-frequency unsteadiness of the REST inlet unstart flow under the off-design condition. Moreover, the CLE shock plays an important role in the process during the dominant flow structure conversion from the backflow within the separation bubble into elongated streamwise structures.
The acoustic response of a five-bladed rotor to an axisymmetric turbulent boundary layer at the tail end of a body of revolution (BOR) is investigated numerically to elucidate the physical sources of acoustics, particularly the role of coherent structures in sound generation. The BOR is at a length-based Reynolds number of $1.9 \times 10^6$ and free-stream Mach number of 0.059. Two rotor advance ratios, $1.44$ and $1.13$, are considered. The turbulent boundary layer on the nose and midsection of the BOR is computed using wall-modelled large-eddy simulation, whereas that in the acoustically important tail-cone section is wall-resolved. The radiated acoustic field is calculated using the Ffowcs Williams–Hawkings equation. The computed flow statistics and sound pressure spectra agree well with the experimental measurements at Virginia Tech. In addition to broadband turbulence-ingestion noise, spectral humps near multiples of the blade-passing frequency and accompanying valleys are captured. They are shown to be caused by correlated blade unsteady-loading dipole sources and their constructive and destructive interference as a result of successive blades cutting through the same coherent structures. The latter undergo rapid growth in the decelerating tail-cone boundary layer before their interaction with the rotor. The acoustic radiation is dominated by the outer region of the blade owing to a combination of larger blade chord-length, inflow turbulence intensity and blade speed. The numerical results also correctly predict the effect of the rotor advance ratio on the acoustic field. A mixed free-stream/convection Mach-number scaling successfully collapses the sound pressure spectra at the two advance ratios.
Here, we report the generation of MeV alpha-particles from H-11B fusion initiated by laser-accelerated boron ions. Boron ions with maximum energy of 6 MeV and fluence of 109/MeV/sr@5 MeV were generated from 60 nm-thick self-supporting boron nanofoils irradiated by 1 J femtosecond pulses at an intensity of 1019 W/cm2. By bombarding secondary hydrogenous targets with the boron ions, 3 × 105/sr alpha-particles from H-11B fusion were registered, which is consistent with the theoretical yield calculated from the measured boron energy spectra. Our results demonstrated an alternative way toward ultrashort MeV alpha-particle sources employing compact femtosecond lasers. The ion acceleration and product measurement scheme are referential for the studies on the ion stopping power and cross section of the H-11B reaction in solid or plasma.
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.
There are currently at least 50 million dementia patients worldwide, and this number is expected to reach 152 million by 2050, of which about 60-70% will be Alzheimer’s patients. The companion robot based on deep learning is a product of the development of artificial intelligence technology, which is of great significance to the physical and mental health of the elderly, so it is used in the research on the treatment of Alzheimer’s patients.
Subjects and Methods
100 patients with Alzheimer’s disease in a hospital were selected for the study, and 50 patients were randomly divided into experimental group and control group. In the experiment, 50 patients with Alzheimer in the experimental group used a companion robot based on deep learning for auxiliary treatment while carrying out daily treatment. The control group of 50 patients did not receive any adjuvant therapy in addition to daily treatment. After three months of treatment, the study used the 3D-CAM and the mini–mental state examination (MMSE) to collect the treatment status of all patients, and used the SPSS23.0 statistical software to statistically analyze the collected data.
Results
After statistical analysis, the results of the two groups were obtained. The scores of 3D-CAM and MMSE in the experimental group were significantly higher than those in the control group and the difference was statistically significant.
Conclusions
Companion robots based on deep learning are helpful in the treatment of Alzheimer’s patients. They can improve the therapeutic effect and have certain social value.
Acknowledgement
The Fundamental Research Funds in Heilongjiang Provincial Universities (No.135309356); Qiqihar University Young Teachers’ Scientific Research Initiation Support Program (No.2012k-M17).
A highly compressive effect would suppress the mixing of the shear layer in a convex wall jet. The spanwise distributed protrusions at the nozzle lip are employed to achieve mixing enhancement in this study. The mixing characteristics and enhancement mechanisms are numerically investigated by the delayed detached-eddy simulation method based on the two-equation shear-stress transport model. A widely applicable flow spatiotemporal analysis method, called proper orthogonal decomposition (POD), is used to gain further insight into the dynamical behaviours of the flow instability mode. The results reveal that the centrifugal effect maintains and amplifies the initial perturbations induced by the spanwise distributed heterogeneities, resulting in forced streamwise vortices. The instabilities induced by the streamwise vortices significantly increase the growth rate of the jet half-width and the shear layer vorticity thickness. The spanwise wavelength of the streamwise vortices is consistent with the spanwise distributed forced excitation. In addition, the spanwise meandering motion of the streamwise vortices is observed, which is usually associated with the streamwise travelling wave. This is further confirmed by the POD analysis of the spanwise velocity fluctuation in both stream-radial and stream-span sections. Also, the spatial distributions of the POD modes with the highest energy provide information on the secondary instability modes. Both sinuous and varicose types of disturbances are observed in the unforced jet, whereas the forced jet seems to be dominated by the sinuous type instability, which is more easily excited than the varicose type instability. Moreover, the turbulence intensity in the forced jet is also significantly enhanced as expected due to the earlier and stronger streamwise vortices and associated instabilities. The enhanced turbulent characteristics of the highly compressible condition tend to be isotropic, whereas in the unforced jet, it is anisotropic due to the strong compressibility suppressing the spanwise turbulent fluctuations.
The effects of monolaurin (ML) on the health of piglets infected with porcine epidemic diarrhoea virus (PEDV) have not been fully understood. This study aimed to investigate its role in blood biochemical profile, intestinal barrier function, antioxidant function and the expression of antiviral genes in piglets infected with PEDV. Thirty-two piglets were randomly divided into four groups: control group, ML group, PEDV group and ML + PEDV group. Piglets were orally administrated with ML at a dose of 100 mg/kg·BW for 7 d before PEDV infection. Results showed that PEDV infection significantly decreased D-xylose content and increased intestinal fatty acid-binding protein content, indicating that PEDV infection destroyed intestinal barrier and absorption function. While it could be repaired by ML administration. Moreover, ML administration significantly decreased plasma blood urea nitrogen and total protein content upon PEDV infection. These results suggested ML may increase protein utilisation efficiency. ML administration significantly decreased the number of large unstained cells and Hb and increased the number of leucocytes and eosinophils in the blood of PEDV-infected piglets, indicating ML could improve the immune defense function of the body. In the presence of PEDV infection, ML administration significantly increased superoxide dismutase and catalase activities in blood and colon, respectively, indicating ML could improve antioxidant capacity. Besides, ML administration reversed the expression of ISG15, IFIT3 and IL-29 throughout the small intestine and Mx1 in jejunum and ileum, indicating the body was in recovery from PEDV infection. This study suggests that ML could be used as a kind of feed additive to promote swine health upon PEDV infection.
We present the third data release from the Parkes Pulsar Timing Array (PPTA) project. The release contains observations of 32 pulsars obtained using the 64-m Parkes ‘Murriyang’ radio telescope. The data span is up to 18 yr with a typical cadence of 3 weeks. This data release is formed by combining an updated version of our second data release with $\sim$3 yr of more recent data primarily obtained using an ultra-wide-bandwidth receiver system that operates between 704 and 4032 MHz. We provide calibrated pulse profiles, flux density dynamic spectra, pulse times of arrival, and initial pulsar timing models. We describe methods for processing such wide-bandwidth observations and compare this data release with our previous release.
The relationships between childhood weight self-misperception and obesity-related factors particularly health markers have not been extensively discussed. This study aims to examine the associations between weight self-misperception and obesity-related knowledge, attitudes, lifestyles and cardio-metabolic markers among Chinese paediatric population.
Design:
Cross-sectional study.
Setting:
Data sourced from a national survey in Chinese seven provinces in 2013.
Participants:
Children and adolescents aged 5–19 years.
Results:
Of the total 14 079 participants, there were 14·5 % and 2·2 % participants over-estimated and under-perceived their weight, respectively. Multi-variable logistic regression was applied to calculate OR and 95 % CI (95 % Cl) of obesity-related behaviours and cardio-metabolic markers by actual and perceived weight status. Individuals who perceived themselves as overweight/obese were more likely to have prolonged screen time, insufficient dairy intake and over sugar-sweetened beverages consumption (all P < 0·05), regardless of their weight. Furthermore, actual overweight/obese individuals had higher odds of abnormal cardio-metabolic markers, but a smaller magnitude of association was found among weight under-estimators. Among non-overweight/obese individuals, weight over-estimation was positively associated with abdominal obesity (OR: 10·49, 95 % CI: 7·45, 14·76), elevated blood pressure (OR: 1·30, 95 % CI: 1·12, 1·51) and dyslipidemia (OR: 1·43, 95 % CI: 1·29, 1·58).
Conclusions:
Weight over-perception was more prevalent than under-estimation, particularly in girls. Weight over-estimators tended to master better knowledge but behave more unhealthily; both weight over-perception and actual overweight/obesity status were associated with poorer cardio-metabolic markers. Future obesity intervention programmes should additionally pay attention to the population with inaccurate estimation of weight who were easily overlooked.