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While the cross-sectional relationship between internet gaming disorder (IGD) and depression is well-established, whether IGD predicts future depression remains debated, and the underlying mechanisms are not fully understood. This large-scale, three-wave longitudinal study aimed to clarify the predictive role of IGD in depression and explore the mediating effects of resilience and sleep distress.
Methods
A cohort of 41,215 middle school students from Zigong City was assessed at three time points: November 2021 (T1), November 2022 (T2) and November 2023 (T3). IGD, depression, sleep distress and resilience were measured using standardized questionnaires. Multiple logistic regression was used to examine the associations between baseline IGD and both concurrent and subsequent depression. Mediation analyses were conducted with T1 IGD as the predictor, T2 sleep distress and resilience as serial mediators and T3 depression as the outcome. To test the robustness of the findings, a series of sensitivity analyses were performed. Additionally, sex differences in the mediation pathways were explored.
Results
(1) IGD was independently associated with depression at baseline (T1: adjusted odds ratio [AOR] = 4.76, 95% confidence interval [CI]: 3.79–5.98, p < 0.001), 1 year later (T2: AOR = 1.42, 95% CI: 1.16–1.74, p < 0.001) and 2 years later (T3: AOR = 1.24, 95% CI: 1.01–1.53, p = 0.042); (2) A serial multiple mediation effect of sleep distress and resilience was identified in the relationship between IGD and depression. The mediation ratio was 60.7% in the unadjusted model and 33.3% in the fully adjusted model, accounting for baseline depression, sleep distress, resilience and other covariates. The robustness of our findings was supported by various sensitivity analyses; and (3) Sex differences were observed in the mediating roles of sleep distress and resilience, with the mediation ratio being higher in boys compared to girls.
Conclusions
IGD is a significant predictor of depression in adolescents, with resilience and sleep distress serving as key mediators. Early identification and targeted interventions for IGD may help prevent depression. Intervention strategies should prioritize enhancing resilience and improving sleep quality, particularly among boys at risk.
Metastructures composed of a closely spaced plate array have been widely used in bespoke manipulation of waves in contexts of acoustics, electromagnetics, elasticity and water waves. This paper focuses on wave scattering by discrete plate array metastructures of arbitrary cross-sections, including isolated vertical metacylinders, periodic arrays and horizontal surface-piercing metacylinders. A suitable transform-based method has been applied to each problem to reduce the influence of barriers in a two-dimensional problem to a set of points in a one-dimensional wave equation wherein the solution is constructed using a corresponding Green's function. A key difference from the existing work is the use of an exact description of the plate array rather than an effective medium approximation, enabling the exploration of wave frequencies above resonance where homogenisation models fail but where the most intriguing physical findings are unravelled. The new findings are particularly notable for graded plate array metastructures that produce a dense spectrum of resonant frequencies, leading to broadband ‘rainbow reflection’ effects. This study provides new ideas for the design of structures for the bespoke control of waves with the potential for innovative solutions to coastal protection schemes or wave energy converters.
With the development of overall design methodologies for hypersonic vehicles and their propulsion systems, nozzles should expand airflow in a short length and provide sufficient thrust. Therefore, the large expansion ratio single expansion ramp nozzle (LSERN) is widely used. The form of the overexpanded flow field in the nozzle is complex, under the conditions of nozzle start-up, low speed and low nozzle pressure ratio (NPR), thereby negatively influencing the entire propulsion system. Thus, the nozzle flow separation pattern and the key factors affecting the flow separation pattern also deserve considerable attention. In this study, the design of SERN is completed using the cubic curve design method, and the model is numerically simulated for specific operating conditions to study the flow separation patterns and the transition processes of different patterns. Furthermore, the key factors affecting the various flow separation patterns in the nozzle are investigated in detail. Results show that the LSERN in different NPRs appeared in two types of restricted shock separation (RSS) pattern and free shock separation (FSS) pattern, as well as their corresponding flow separation pattern transition processes. The initial expansion angle and the nozzle length affect the range of NPRs maintained by the FSS pattern. The initial expansion angle affects the pattern of flow separation, whereas the nozzle length remarkably influences the critical NPR during transition.
The COVID-19 pandemic has had a globally devastating psychosocial impact. A detailed understanding of the mental health implications of this worldwide crisis is critical for successful mitigation of and preparation for future pandemics. Using a large international sample, we investigated in the present study the relationship between multiple COVID-19 parameters (both disease characteristics and government responses) and the incidence of the suicide crisis syndrome (SCS), an acute negative affect state associated with near-term suicidal behavior.
Methods:
Data were collected from 5528 adults across 10 different countries in an anonymous web-based survey between June 2020 and January 2021.
Results:
Individuals scoring above the SCS cut-off lived in countries with higher peak daily cases and deaths during the first wave of the pandemic. Additionally, the longer participants had been exposed to markers of pandemic severity (eg, lockdowns), the more likely they were to screen positive for the SCS. Findings reflected both country-to-country comparisons and individual variation within the pooled sample.
Conclusion:
Both the pandemic itself and the government interventions utilized to contain the spread appear to be associated with suicide risk. Public policy should include efforts to mitigate the mental health impact of current and future global disasters.
We first sequenced and characterised the complete mitochondrial genome of Toxocara apodeme, then studied the evolutionary relationship of the species within Toxocaridae. The complete mitochondrial genome was amplified using PCR with 14 specific primers. The mitogenome length was 14303 bp in size, including 12 PCGs (encoding 3,423 amino acids), 22 tRNAs, 2 rRNAs, and 2 NCRs, with 68.38% A+T contents. The mt genomes of T. apodemi had relatively compact structures with 11 intergenic spacers and 5 overlaps. Comparative analyses of the nucleotide sequences of complete mt genomes showed that T. apodemi had higher identities with T. canis than other congeners. A sliding window analysis of 12 PCGs among 5 Toxocara species indicated that nad4 had the highest sequence divergence, and cox1 was the least variable gene. Relative synonymous codon usage showed that UUG, ACU, CCU, CGU, and UCU most frequently occurred in the complete genomes of T. apodemi. The Ka/Ks ratio showed that all Toxocara mt genes were subject to purification selection. The largest genetic distance between T. apodemi and the other 4 congeneric species was found in nad2, and the smallest was found in cox2. Phylogenetic analyses based on the concatenated amino acid sequences of 12 PCGs demonstrated that T. apodemi formed a distinct branch and was always a sister taxon to other congeneric species. The present study determined the complete mt genome sequences of T. apodemi, which provide novel genetic markers for further studies of the taxonomy, population genetics, and systematics of the Toxocaridae nematodes.
The effect of treatment with praziquantel (PZQ) on the tegument of adult Schistosoma mansoni worms and on liver egg-granulomas has been examined in mice infected with PZQ-resistant and -susceptible parasite isolates. Two PZQ-resistant S. mansoni isolates, one selected by passage in the laboratory under drug pressure and one from Senegal established from eggs excreted by an uncured patient, were compared with PZQ-susceptible control isolates. Scanning electron microscopic observations on the tegument of Schistosoma adult worms treated in vivo with PZQ showed that more severe damage was inflicted by PZQ on susceptible worms than on drug-resistant worms. Observations on the pathology of Schistosoma egg-granulomas in the liver of infected mice after treatment with PZQ indicated that eggs from susceptible control isolates were more sensitive to PZQ than those from drug-resistant isolates.
In this paper, we study wave scattering and radiation by a surface-piercing vertical truncated metamaterial cylinder composed of a closely spaced array of thin vertical barriers, between which fluid can flow. A theoretical model is developed under full depth-dependent linearised water wave theory, where an effective medium equation and effective boundary conditions are employed, respectively, to describe the fluid motion inside the cylinder and match the flow between the fluid regions in and outside the metamaterial cylinder. A damping mechanism is introduced at the surface of the fluid occupied by the metamaterial cylinder to consider the wave power dissipation in narrow gaps between the thin vertical plates. The wave excitation forces acting on the cylinder and the hydrodynamic coefficients can be calculated straightforwardly in terms of the velocity potential inside the cylinder. An alternative way is by using the velocity potential outside the cylinder, the expression of which has the reduction of the integral and an infinite accumulation that are included in the straightforward expression. The results highlight the patterns of the radiated waves induced by the oscillation of the cylinder and the characteristics of the hydrodynamic coefficients. The metamaterial cylinder when fixed in place and with a damping mechanism included is found to capture more wave power than that of a traditional axisymmetric heaving wave energy converter over a wide range of wave frequencies.
Nightclubs are entertainment and hospitality venues historically vulnerable to terrorist attacks. This study identified and characterized terrorist attacks targeting nightclubs and discotheques documented in the Global Terrorism Database (GTD) over a 50-y period.
Methods:
A search of the Global Terrorism Database (GTD) was conducted from 1970 to 2019. Precoded variables for target type “business” and target subtype “entertainment/cultural/stadium/casino” were used to identify attacks potentially involving nightclubs. Nightclub venues were specifically identified using the search terms “club,” “nightclub,” and “discotheque.” Two authors manually reviewed each entry to confirm the appropriateness for inclusion. Descriptive statistics were performed using R (3.6.1).
Results:
A total of 114 terrorist attacks targeting nightclub venues were identified from January 1, 1970, through December 31, 2019. Seventy-four (64.9%) attacks involved nightclubs, while forty (35.1%) attacks involved discotheques. A bombing or explosion was involved in 84 (73.7%) attacks, followed by armed assault in 14 (12.3%) attacks. The highest number of attacks occurred in Western Europe and Sub-Saharan Africa. In total, 284 persons died, and 1175 persons were wounded in attacks against nightclub venues.
Conclusions:
While terrorist attacks against nightclub venues are infrequent, the risk for mass casualties and injuries can be significant, mainly when explosives and armed assaults are used.
To describe educational interventions that have been implemented in healthcare settings to increase the compliance of healthcare personnel (HCP) with cleaning and disinfection of noncritical portable medical equipment (PME) requiring low-level disinfection (LLD).
Design:
Systematic review.
Methods:
Studies evaluating interventions for improving LLD practices in settings with HCP, including healthcare students and trainees, were eligible for inclusion.
Results:
In total, 1,493 abstracts were identified and 1,416 were excluded, resulting in 77 studies that underwent full text review. Among these, 68 were further excluded due to study design, setting, or intervention. Finally, 9 full-text studies were extracted; 1 study was excluded during the critical appraisal process, leaving 8 studies. Various forms of interventions were implemented in the studies, including luminescence, surveillance of contamination with feedback, visual signage, enhanced training, and improved accessibility of LLD supplies. Of the 8 included studies, 4 studies reported successes in improving LLD practices among HCP.
Conclusions:
The available literature was limited, indicating the need for additional research on pedagogical methods to improve LLD practices. Use of visual indicators of contamination and multifaceted interventions improved LLD practice by HCP.
We used a strand-specific RT-qPCR to evaluate viral replication as a surrogate for infectiousness among 242 asymptomatic inpatients with a positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) admission test. Only 21 patients (9%) had detectable SARS-CoV-2 minus-strand RNA. Because most patients were found to be noninfectious, our findings support the suspension of asymptomatic admission testing.
Headache as a presenting symptom is commonly encountered by the emergency department (ED) physician. The differential diagnosis of headaches is extensive and the etiologies can range from benign to life-threatening. These patients can pose a diagnostic and therapeutic challenge to the treating clinician. This chapter encapsulates the clinical approach, appropriate evaluation, and treatment options in patients presenting with the complaint of headache.
In China, government at all levels relies on the specially selected graduates (SSG) scheme to recruit elite university students as future political leaders. This article examines the mechanism of the SSG scheme and the relationship between elite university education and political selection in China. We show that elite education is increasingly stratified, such that graduates from top elite universities have significant selection advantages in the SSG competition and are more likely to be offered incentives and preferences. We argue that taking elite university education as a hard eligibility criterion reinforces the homophily effects in selection of future political elites and strengthens the political influence of top elite universities on China's politics. Further, because poor and lower-class students have little chance of entering elite universities, the SSG does not provide an effective route of upward mobility for non-elite classes. Merit-based political recruitment as a channel of upward mobility for non-elite classes is largely an illusion.
To assist communities who suffered from hurricane-inflicted damages, emergency responders may monitor social media messages. We present a case-study using the event of Hurricane Matthew to analyze the results of an imputation method for the location of Twitter users who follow school and school districts in Georgia, USA.
Methods:
Tweets related to Hurricane Matthew were analyzed by content analysis with latent Dirichlet allocation models and sentiment analysis to identify needs and sentiment changes over time. A hurdle regression model was applied to study the association between retweet frequency and content analysis topics.
Results:
Users residing in counties affected by Hurricane Matthew posted tweets related to preparedness (n = 171; 16%), awareness (n = 407; 38%), call-for-action or help (n = 206; 19%), and evacuations (n = 93; 9%), with mostly a negative sentiment during the preparedness and response phase. Tweets posted in the hurricane path during the preparedness and response phase were less likely to be retweeted than those outside the path (adjusted odds ratio: 0.95; 95% confidence interval: 0.75, 1.19).
Conclusions:
Social media data can be used to detect and evaluate damages of communities affected by natural disasters and identify users’ needs in at-risk areas before the event takes place to aid during the preparedness phases.
Studies on humans that exploit contemporary data-intensive, high-throughput ‘omic’ assay technologies, such as genomics, transcriptomics, proteomics and metabolomics, have unequivocally revealed that humans differ greatly at the molecular level. These differences, which are compounded by each individual’s distinct behavioral and environmental exposures, impact individual responses to health interventions such as diet and drugs. Questions about the best way to tailor health interventions to individuals based on their nuanced genomic, physiologic, behavioral, etc. profiles have motivated the current emphasis on ‘precision’ medicine. This review’s purpose is to describe how the design and execution of N-of-1 (or personalized) multivariate clinical trials can advance the field. Such trials focus on individual responses to health interventions from a whole-person perspective, leverage emerging health monitoring technologies, and can be used to address the most relevant questions in the precision medicine era. This includes how to validate biomarkers that may indicate appropriate activity of an intervention as well as how to identify likely beneficial interventions for an individual. We also argue that multivariate N-of-1 and aggregated N-of-1 trials are ideal vehicles for advancing biomedical and translational science in the precision medicine era since the insights gained from them can not only shed light on how to treat or prevent diseases generally, but also provide insight into how to provide real-time care to the very individuals who are seeking attention for their health concerns in the first place.
In view of the cooperative guidance problem with time delay, this paper proposes a two-stage time-delay prescribed-time cooperative guidance law in the three-dimensional (3D) space. In the first stage, by introducing a time scaling function and time-delay consensus, the proposed cooperative guidance law can overcome the negative influence of time delay to guaranteed the desired convergence performance. Derived from the Lyapunov convergence analysis, the time-delay stability of the first stage can be ensured and the convergence time can be described as the relationship between delayed time and mission-assigned convergence time. Then, taking the prescribed-time-related convergence time as the switching point, the second stage begins with suitable initial conditions and all interceptors are governed by proportional navigation guidance. Finally, comparative simulations are performed to demonstrate the effectiveness and superiority of the proposed time-delay guidance law.
We report the experimental results of the commissioning phase in the 10 PW laser beamline of the Shanghai Superintense Ultrafast Laser Facility (SULF). The peak power reaches 2.4 PW on target without the last amplifying during the experiment. The laser energy of 72 ± 9 J is directed to a focal spot of approximately 6 μm diameter (full width at half maximum) in 30 fs pulse duration, yielding a focused peak intensity around 2.0 × 1021 W/cm2. The first laser-proton acceleration experiment is performed using plain copper and plastic targets. High-energy proton beams with maximum cut-off energy up to 62.5 MeV are achieved using copper foils at the optimum target thickness of 4 μm via target normal sheath acceleration. For plastic targets of tens of nanometers thick, the proton cut-off energy is approximately 20 MeV, showing ring-like or filamented density distributions. These experimental results reflect the capabilities of the SULF-10 PW beamline, for example, both ultrahigh intensity and relatively good beam contrast. Further optimization for these key parameters is underway, where peak laser intensities of 1022–1023 W/cm2 are anticipated to support various experiments on extreme field physics.
This project aimed to quantify and compare Massachusetts and Georgia public school districts’ 2017–2018 winter-storm-related Twitter unplanned school closure announcements (USCA).
Methods:
Public school district Twitter handles and National Center for Education Statistics data were obtained for Georgia and Massachusetts. Tweets were retrieved using Twitter application programming interface. Descriptive statistics and regression analyses were conducted to compare the rates of winter-storm-related USCA.
Results:
Massachusetts had more winter storms than Georgia during the 2017–2018 winter season, but Massachusetts school districts posted winter-storm-related USCA at a 60% lower rate per affected day (adjusted rate ratio, aRR = 0.40, 95% confidence intervals, CI: 0.30, 0.52) than Georgia school districts after controlling for the student enrollments and Twitter followers count per Twitter account. A 10-fold increase in followers count was correlated with a 118% increase in USCA rate per affected day (aRR = 2.18; 95% CI: 1.74, 2.75). Georgia school districts had a higher average USCA tweet rate per winter-storm-affected day than Massachusetts school districts. A higher number of Twitter followers was associated with a higher number of USCA tweets per winter-storm-affected day.
Conclusion:
Twitter accounts of school districts in Massachusetts had a lower tweet rate for USCA per winter-storm-affected days than those in Georgia.
We report on experimental observation of non-laminar proton acceleration modulated by a strong magnetic field in laser irradiating micrometer aluminum targets. The results illustrate the coexistence of ring-like and filamentation structures. We implement the knife edge method into the radiochromic film detector to map the accelerated beams, measuring a source size of 30–110 μm for protons of more than 5 MeV. The diagnosis reveals that the ring-like profile originates from low-energy protons far off the axis whereas the filamentation is from the near-axis high-energy protons, exhibiting non-laminar features. Particle-in-cell simulations reproduced the experimental results, showing that the short-term magnetic turbulence via Weibel instability and the long-term quasi-static annular magnetic field by the streaming electric current account for the measured beam profile. Our work provides direct mapping of laser-driven proton sources in the space-energy domain and reveals the non-laminar beam evolution at featured time scales.
The location of the vertical segment of the facial nerve varies greatly among patients undergoing otological surgery. Its position relative to the incus determines facial recess width, which has implications for ease of cochlear implantation.
Objective
To investigate the variation in facial nerve depth, relative to the incus, on pre-operative computed tomography in patients undergoing cochlear implantation.
Methods
A retrospective cohort study was conducted of paediatric patients undergoing cochlear implantation at a tertiary referral centre. Distance between the incus short process and facial nerve, in the transverse (medial-lateral) dimension, was measured at six imaging slices, ranging from 1.25 to 7.25 mm below the tip of the incus short process.
Results
Facial nerve depth relative to the incus short process demonstrated significant variability. Among all subjects and at all measurements taken inferior to the incus, the mean dimension between the facial nerve and the incus short process was 1.71 mm.
Conclusion
This paper presents a rapid, repeatable technique to assess the depth of the facial nerve vertical segment on pre-operative computed tomography, as measured relative to the tip of the incus short process. This allows the surgeon to anticipate facial recess width and round window access during cochlear implantation.
Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), that is, an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. The SVR was measured by bioelectrical impedance in a cohort of 613 (M/F = 443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression and subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e. non-alcoholic steatohepatitis (NASH) or NASH with the presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score ≥5, with a minimum score of 1 for each of its categories. The presence of fibrosis was classified as having a histological stage ≥1. The SVR was inversely associated with NASH in men (adjusted OR 0·62; 95 % CI 0·42, 0·92, P = 0·017 for NASH, adjusted OR 0·65; 95 % CI 0·43, 0·99, P = 0·043 for NASH with the presence of fibrosis), but not in women (1·47 (95 % CI 0·76, 2·83), P = 0·25 for NASH, and 1·45 (95 % CI 0·74, 2·83), P = 0·28 for NASH with the presence of fibrosis). There was a significant interaction for sex and SVR (Pinteraction = 0·017 for NASH and Pinteraction = 0·033 for NASH with the presence of fibrosis). Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.