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Few empirical studies have examined the collective impact of and interplay between individual factors on collaborative outcomes during major infectious disease outbreaks and the direct and interactive effects of these factors and their underlying mechanisms. Therefore, this study investigates the effects and underlying mechanisms of emergency preparedness, support and assurance, task difficulty, organizational command, medical treatment, and epidemic prevention and protection on collaborative outcomes during major infectious disease outbreaks.
Methods
A structured questionnaire was distributed to medical personnel with experience in responding to major infectious disease outbreaks. SPSS software was used to perform the statistical analysis. Structural equation modeling was conducted using AMOS 24.0 to analyze the complex relationships among the study variables.
Results
Organizational command, medical treatment, and epidemic prevention and protection had significant and positive impacts on collaborative outcomes. Emergency preparedness and supportive measures positively impacted collaborative outcomes during health crises and were mediated through organizational command, medical treatment, and epidemic prevention and protection.
Conclusions
The results underscore the critical roles of organizational command, medical treatment, and epidemic prevention and protection in achieving positive collaborative outcomes during health crises, with emergency preparedness and supportive measures enhancing these outcomes through the same key factors.
Bronze mou vessels appear in Shu tombs in south-west China during the Eastern Zhou period (c. 771–256 BC). Examination of these vessels reveals major changes in the supply of metal and alloying technology in the Shu State, throwing new light on the social impact of the Qin conquest and later unification of China.
Developing a model to describe the shock-accelerated cylindrical fluid layer with arbitrary Atwood numbers is essential for uncovering the effect of Atwood numbers on the perturbation growth. The recent model (J. Fluid Mech., vol. 969, 2023, p. A6) reveals several contributions to the instability evolution of a shock-accelerated cylindrical fluid layer but its applicability is limited to cases with an absolute value of Atwood numbers close to $1$, due to the employment of the thin-shell correction and interface coupling effect of the fluid layer in vacuum. By employing the linear stability analysis on a cylindrical fluid layer in which two interfaces separate three arbitrary-density fluids, the present work generalizes the thin-shell correction and interface coupling effect, and thus, extends the recent model to cases with arbitrary Atwood numbers. The accuracy of this extended model in describing the instability evolution of the shock-accelerated fluid layer before reshock is confirmed via direct numerical simulations. In the verification simulations, three fluid-layer configurations are considered, where the outer and intermediate fluids remain fixed and the density of the inner fluid is reduced. Moreover, the mechanisms underlying the effect of the Atwood number at the inner interface on the perturbation growth are mainly elucidated by employing the model to analyse each contribution. As the Atwood number decreases, the dominant contribution of the Richtmyer–Meshkov instability is enhanced due to the stronger waves reverberated inside the layer, leading to weakened perturbation growth at initial in-phase interfaces and enhanced perturbation growth at initial anti-phase interfaces.
A novel theoretical model for bubble dynamics is established that simultaneously accounts for the liquid compressibility, phase transition, oscillation, migration, ambient flow field, etc. The bubble dynamics equations are presented in a unified and concise mathematical form, with clear physical meanings and extensibility. The bubble oscillation equation can be simplified to the Keller–Miksis equation by neglecting the effects of phase transition and bubble migration. The present theoretical model effectively captures the experimental results for bubbles generated in free fields, near free surfaces, adjacent to rigid walls, and in the vicinity of other bubbles. Based on the present theory, we explore the effect of the bubble content by changing the vapour proportion inside the cavitation bubble for an initial high-pressure bubble. It is found that the energy loss of the bubble shows a consistent increase with increasing Mach number and initial vapour proportion. However, the radiated pressure peak by the bubble at the collapse stage increases with decreasing Mach number and increasing vapour proportion. The energy analyses of the bubble reveal that the presence of vapour inside the bubble not only directly contributes to the energy loss of the bubble through phase transition but also intensifies the bubble collapse, which leads to greater radiation of energy into the surrounding flow field due to the fluid compressibility.
The Argentine ant (Linepithema humile) and the little fire ant (Wasmannia auropunctata) are among the top 100 invasive alien species globally, causing significant ecological and economic harm. Therefore, it is crucial to study their potential geographic distribution worldwide. This study aimed to predict their global distribution under current and future climate conditions. We used distribution data from various sources, including CABI, GBIF, and PIAKey, and key climate variables selected from 19 environmental factors to model their potential geographic distribution using MaxEnt. The AUC values were 0.925 and 0.937 for L. humile and W. auropunctata, respectively, indicating good predictive performance. Suitable areas for L. humile were mainly in southern North America, northern South America, Europe, central Asia, southern Oceania, and parts of Africa, while W. auropunctata suitable areas were mostly in southern North America, most of South America, a small part of Europe, southern Asia, central Africa, and some parts of Oceania. Under climate change scenario, suitable areas for L. humile increased, while highly suitable areas for W. auropunctata decreased. The top four countries with the largest areas of overlapping suitable habitat under current climate were Brazil, China, Australia, and Argentina, while under future SSP585 climate scenario, the top four countries were Brazil, China, Indonesia, and Argentina. Some countries, such as Estonia and Finland, will see an overlapping adaptation area under climate change. In conclusion, this study provides insight into controlling the spread and harm of L. humile and W. auropunctata.
This article considers the individual equilibrium behavior and socially optimal strategy in a fluid queue with two types of parallel customers and incomplete fault. Assume that the working state and the incomplete fault state appear alternately in the buffer. Different from the linear revenue and expenditure structure, an exponential utility function can be constructed to obtain the equilibrium balking thresholds in the fully observable case. Besides, the steady-state probability distribution and the corresponding expected social benefit are derived based on the renewal process and the standard theory of linear ordinary differential equations. Furthermore, a reasonable entrance fee strategy is discussed under the condition that the fluid accepts the globally optimal strategies. Finally, the effects of the diverse system parameters on the entrance fee and the expected social benefit are explicitly illustrated by numerical comparisons.
Instability evolutions of shock-accelerated thin cylindrical SF$_6$ layers surrounded by air with initial perturbations imposed only at the outer interface (i.e. the ‘Outer’ case) or at the inner interface (i.e. the ‘Inner’ case) are numerically and theoretically investigated. It is found that the instability evolution of a thin cylindrical heavy fluid layer not only involves the effects of Richtmyer–Meshkov instability, Rayleigh–Taylor stability/instability and compressibility coupled with the Bell–Plesset effect, which determine the instability evolution of the single cylindrical interface, but also strongly depends on the waves reverberated inside the layer, thin-shell correction and interface coupling effect. Specifically, the rarefaction wave inside the thin fluid layer accelerates the outer interface inward and induces the decompression effect for both the Outer and Inner cases, and the compression wave inside the fluid layer accelerates the inner interface inward and causes the decompression effect for the Outer case and compression effect for the Inner case. It is noted that the compressible Bell model excluding the compression/decompression effect of waves, thin-shell correction and interface coupling effect deviates significantly from the perturbation growth. To this end, an improved compressible Bell model is proposed, including three new terms to quantify the compression/decompression effect of waves, thin-shell correction and interface coupling effect, respectively. This improved model is verified by numerical results and successfully characterizes various effects that contribute to the perturbation growth of a shock-accelerated thin heavy fluid layer.
A 2 × 2 dual band MIMO flexible antenna with a low profile and CPW feeding is designed for Internet of Things (IoT) domains, operating in 5G (3.3–3.6/4.8–5.0 GHz), WiMAX (5.25–5.85 GHz) and WLAN (5.15–5.35/5.725–5.825 GHz) bands. Two resonant frequencies are generated by L-shaped branches and a rectangular monopole. The mentioned MIMO antenna comprises four elements arranged vertically. With the addition of an orthogonal branch, significant isolation is attained, which exceeds 21 dB in the entire bands. The four-element MIMO antenna is fabricated and experimented to analyze the performance. According to the measurement, the antenna can operate bandwidth covering 3.156–3.84 GHz (19.55%) and 4.638–6.348 GHz (31.13%). Furthermore, the provided four-element MIMO antenna possesses a number of advantageous properties, such as ECC, DG, and TARC, indicating its suitability for 5G/WiMAX/WLAN applications. In accordance with the results of bending measurement and human body influence, it is evident that the presented liquid crystal polymer antenna could be an ideal candidate for integrating into wearable 5G/WiMAX/WLAN devices.
We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15 704 Chinese adults (38·86 % men) with a median age of 51·00 (interquartile range: 41·00–60·00) at baseline (2007–2008) and followed up during 2013–2014. Obesity was defined by waist circumference (WC: ≥ 90 cm for men and ≥ 80 cm for women) or waist-to-height ratio (WHtR: ≥ 0·5). The hazard ratio (HR) and 95 % CI for the risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6·01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) at baseline was 12·12 %, 2·80 %, 41·93 % and 43·15 %, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity and education, the risk of all-cause mortality was higher with both MUNO (HR = 1·20, 95 % CI 1·14, 1·26) and MUO (HR = 1·20, 95 % CI 1·13, 1·27) v. MHNO, but the risk was not statistically significant with MHO (HR = 0·99, 95 % CI 0·89, 1·10). This result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small.
The highly nonlinear evolution of the single-mode stratified compressible Rayleigh–Taylor instability (RTI) is investigated via direct numerical simulation over a range of Atwood numbers ($A_T=0.1$–$0.9$) and Mach numbers ($Ma=0.1$–$0.7$) for characterising the isothermal background stratification. After the potential stage, it is found that the bubble is accelerated to a velocity which is well above the saturation value predicted in the potential flow model. Unlike the bubble re-acceleration behaviour in quasi-incompressible RTI with uniform background density, the characteristics in the stratified compressible RTI are driven by not only vorticity accumulation inside the bubble but also flow compressibility resulting from the stratification. Specifically, in the case of strong stratification and high $A_T$, the flow compressibility dominates the bubble re-acceleration characters. To model the effect of flow compressibility, we propose a novel model to reliably describe the bubble re-acceleration behaviours in the stratified compressible RTI, via introducing the dilatation into the classical model that takes into account only vorticity accumulation.
Mechanistic studies have suggested that antioxidants have beneficial effects on age-related macular degeneration (AMD). This study aimed to investigate the association between the types and sources of dietary vitamin and carotenoid intakes and AMD risk in China. A matched case–control study of 260 AMD cases and 260 matched controls was performed. The participants were interviewed for dietary information and potential confounders, and comprehensive ophthalmic examinations were performed. Conditional logistic models were used to estimate the odds ratio (OR) and 95 % confidence interval (CI) of specific vitamins and carotenoids and their main sources. When comparing the extreme quartiles, the ORs (95 % CI) were 0·30 (0·10, 0·88) for lutein and 0·28 (0·11, 0·74) for β-cryptoxanthin. The associations for other dietary vitamin and carotenoid intakes were generally weaker and non-significant. Higher intakes of spinach and egg, which are important sources of lutein, were associated with a reduced odds of AMD. ORs (95% CIs) comparing extreme categories were 0·42 (0·20, 0·88) for spinach and 0·52 (95% CI: 0·27, 0·98) for egg. Participants who were in the highest category of both egg intake and spinach intake had a much greater reduced odds of having AMD (OR: 0·23; 95% CI: 0·08, 0·71) than those in the lowest category of egg intake and spinach intake. In conclusion, a higher intake of lutein and lutein-rich foods was associated with a significantly decreased odds of AMD. These findings provide further evidence of the benefits of lutein and lutein-rich foods in the prevention of AMD.
This study examined the influences of coated folic acid (CFA) and coated riboflavin (CRF) on bull performance, nutrients digestion and ruminal fermentation. Forty-eight Angus bulls based on a randomised block and 2 × 2 factorial design were assigned to four treatments. The CFA of 0 or 6 mg of folic acid/kg DM was supplemented in diets with CRF 0 or 60 mg riboflavin (RF)/kg DM. Supplementation of CRF in diets with CFA had greater increase in daily weight gain and feed efficiency than in diets without CFA. Supplementation with CFA or CRF enhanced digestibility of DM, organic matter, crude protein, neutral-detergent fibre and non-fibre carbohydrate. Ruminal pH and ammonia N content decreased and total volatile fatty acids concentration and acetate to propionate ratio elevated for CFA or CRF addition. Supplement of CFA or CRF increased the activities of fibrolytic enzymes and the numbers of total bacteria, protozoa, fungi, dominant fibrolytic bacteria and Prevotella ruminicola. The activities of α-amylase, protease and pectinase and the numbers of Butyrivibrio fibrisolvens and Ruminobacter amylophilus were increased by CFA but were unaffected by CRF. Blood concentration of folate elevated and homocysteine decreased for CFA addition. The CRF supplementation elevated blood concentrations of folate and RF. These findings suggested that CFA or CRF inclusion had facilitating effects on performance and ruminal fermentation, and combined addition of CFA and CRF had greater increase in performance than CFA or CRF addition alone in bulls.
Long-acting injectable (LAI) antipsychotics improve medication adherence in patients with schizophrenia and extend the duration of therapeutic drug levels but with administration of an increased dose. Real-world mortality data in patients prescribed LAIs are lacking. We conducted a population-based cohort study to estimate and compare the incidence rates of all-cause death and completed suicide in patients with schizophrenia/schizoaffective disorder exposed to LAIs and oral antipsychotics.
Methods
Patients with a diagnosis of schizophrenia/schizoaffective disorder between January 1, 2015 and November 30, 2019 were enrolled from the Taiwan National Health Insurance Research Database and linked to Death Registry records. Eligible patients were new antipsychotic users. Relative risks of death for each antipsychotic compared with oral paliperidone were evaluated using a Cox proportional hazard model adjusted for age, sex, Charlson Comorbidity Index, index year, bipolar or major depressive or other mood disorders, mental disorders due to drug use, and baseline hospitalization frequency.
Results
There were 228,791.08 person-years of follow-up (mean 2.48 years). The incidence rates of all-cause death in users of LAI paliperidone administered monthly (PP1M) and every 3 months (PP3M) were 7.40/1,000 person-years (95% confidence interval 5.94–9.11) and 9.93 (5.88–15.79), respectively. The incidences of completed suicide were 2.03/1,000 person-years (1.32–2.99) and 3.10 (1.14–6.88), respectively. No significant associations were observed between PP1M and PP3M compared to oral paliperidone in incidences of all-cause death or for completed suicide.
Discussion
No increased risk of all-cause death or completed suicide was observed in users of antipsychotic LAIs, including PP1M and PP3M.
The Brain Health Test-7 (BHT-7) is a revised tool from the original BHT, containing more tests about frontal lobe function. It was developed with theaim of identifying patients with mild cognitive impairment (MCI) and early dementia.
Research objective
Here we report the validity of the BHT-7 versus the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in differentpsychiatry or neurology clinics.
Methods
Patients with memory complaints were recruited in this study from the outpatient clinic of psychiatry or neurology in 3 different kinds of hospitals. Allpatients underwent the evaluation of the BHT-7, MMSE, MoCA, and clinical dementia rating (CDR). The clinical diagnosis (normal, MCI, dementia) was made by consensus meeting, taking into account all available data.
Demographic data and the scores of the MMSE, MoCA, and BHT-7 between groups were compared. Logistic regression was adopted for analysis of optimal cutoff values, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curve,and the area under the ROC curve (AUC).
Results
We enrolled a total of 1090 subjects (normal 402, MCI 317, dementia 371); of them, 705 (64.7%) were female. There was a statistically significant differencein age, years of education, and 3 cognitive test scores among the 3 groups.
Compared with the MMSE and MoCA, the BHT-7 performed slightly betterthan MMSE and MoCA in differentiating MCI or dementia from the normalcontrols (Table 1). For BHT- 7, the cutoff point was 17 between normal andMCI, and 14 between normal and dementia. These cutoff points for BHT-7were consistent through 3 different clinical settings, but inconsistent for MMSE and MoCA. The testing time for the BHT-7 was about 5-7 minutes, shorter than that of the MMSE and MoCA.
Conclusion
Compared with MMSE and MoCA, the BHT-7 showed slightly better performance in differentiating normal from MCI or dementia subjects. The testing time for the BHT-7 was shorter, and its cutoff points were consistent through different outpatient clinic settings. The results support that BHT-7 is auseful cognitive screening tool for MCI or early dementia in various hospital settings.
Table 1
Comparisons of the performance of BHT-7, MMSE, MoCA
Chronic inflammation exerts pleiotropic effects in the aetiology and progression of chronic obstructive pulmonary disease (COPD). Glucosamine is widely used in many countries and may have anti-inflammatory properties. We aimed to prospectively evaluate the association of regular glucosamine use with incident COPD risk and explore whether such association could be modified by smoking in the UK Biobank cohort, which recruited more than half a million participants aged 40–69 years from across the UK between 2006 and 2010. Cox proportional hazards models with adjustment for potential confounding factors were used to calculate hazard ratios (HR) as well as 95 % CI for the risk of incident COPD. During a median follow-up of 8·96 years (interquartile range 8·29–9·53 years), 9016 new-onset events of COPD were documented. We found that the regular use of glucosamine was associated with a significantly lower risk of incident COPD with multivariable adjusted HR of 0·80 (95 % CI, 0·75, 0·85; P < 0·001). When subgroup analyses were performed by smoking status, the adjusted HR for the association of regular glucosamine use with incident COPD were 0·84 (0·73, 0·96), 0·84 (0·77, 0·92) and 0·71 (0·62, 0·80) among never smokers, former smokers and current smokers, respectively. No significant interaction was observed between glucosamine use and smoking status (Pfor interaction = 0·078). Incident COPD could be reduced by 14 % to 84 % through a combination of regular glucosamine use and smoking cessation.
The present study evaluated effects of dietary supplementation with tryptophan (Trp) on muscle growth, protein synthesis and antioxidant capacity in hybrid catfish Pelteobagrus vachelli♀ × Leiocassis longirostris♂. Fish were fed six different diets containing 2·6 (control), 3·1, 3·7, 4·2, 4·7 and 5·6 g Trp/kg diet for 56 d, respectively. Results showed that dietary Trp significantly (1) improved muscle protein content, fibre density and frequency of fibre diameter; (2) up-regulated the mRNA levels of PCNA, myf5, MyoD1, MyoG, MRF4, IGF-I, IGF-II, IGF-IR, PIK3Ca, TOR, 4EBP1 and S6K1; (3) increased phosphorylation levels of AKT, TOR and S6K1; (4) decreased contents of MDA and PC, and increased activities of CAT, GST, GR, ASA and AHR; (5) up-regulated mRNA levels of CuZnSOD, CAT, GST, GPx, GCLC and Nrf2, and decreased Keap1 mRNA level; (6) increased nuclear Nrf2 protein level and the intranuclear antioxidant response element-binding ability, and reduced Keap1 protein level. These results indicated that dietary Trp improved muscle growth, protein synthesis as well as antioxidant capacity, which might be partly related to myogenic regulatory factors, IGF/PIK3Ca/AKT/TOR and Keap1/Nrf2 signalling pathways. Finally, based on the quadratic regression analysis of muscle protein and MDA contents, the optimal Trp requirements of hybrid catfish (21·82–39·64 g) were estimated to be 3·94 and 3·93 g Trp/kg diet (9·57 and 9·54 g/kg of dietary protein), respectively.
To investigate the influences of cobalt (Co) and folic acid (FA) on growth performance and rumen fermentation, Holstein male calves (n 40) were randomly assigned to four groups according to their body weights. Cobalt sulphate at 0 or 0·11 mg Co/kg DM and FA at 0 or 7·2 mg/kg DM were used in a 2 × 2 factorial design. Average daily gain was elevated with FA or Co supplementation, but the elevation was greater for supplementing Co in diets without FA than with FA. Supplementing FA or Co increased DM intake and total-tract nutrient digestibility. Rumen pH was unaltered with FA but reduced with Co supplementation. Concentration of rumen total volatile fatty acids was elevated with FA or Co inclusion. Acetate percentage and acetate to propionate ratio were elevated with FA inclusion. Supplementing Co decreased acetate percentage and increased propionate percentage. Activities of xylanase and α-amylase and populations of total bacteria, fungi, protozoa, Ruminococcus albus, Fibrobacter succinogenes and Prevotella ruminicola increased with FA or Co inclusion. Activities of carboxymethyl-cellulase and pectinase increased with FA inclusion and population of methanogens decreased with Co addition. Blood folates increased and homocysteine decreased with FA inclusion. Blood glucose and vitamin B12 increased with Co addition. The data suggested that supplementing 0·11 mg Co/kg DM in diets containing 0·09 mg Co/kg DM increased growth performance and nutrient digestibility but had no improvement on the effects of FA addition in calves.
Intestinal stem cells, which are capable of both self-renewal and differentiation to mature cell types, are responsible for maintaining intestinal epithelial homeostasis. Recent evidence indicates that these processes are mediated, in part, through nutritional status in response to diet. Diverse dietary patterns including caloric restriction, fasting, high-fat diets, ketogenic diets and high-carbohydrate diets as well as other nutrients control intestinal stem cell self-renewal and differentiation through nutrient-sensing pathways such as mammalian target of rapamycin and AMP-activated kinase. Herein, we summarise the current understanding of how intestinal stem cells contribute to intestinal epithelial homeostasis and diseases. We also discuss the effects of diet and nutrient-sensing pathways on intestinal stem cell self-renewal and differentiation, as well as their potential application in the prevention and treatment of intestinal diseases.
The impact of baseline hypertension status on the BMI–mortality association is still unclear. We aimed to examine the moderation effect of hypertension on the BMI–mortality association using a rural Chinese cohort.
Design:
In this cohort study, we investigated the incident of mortality according to different BMI categories by hypertension status.
Setting:
Longitudinal population-based cohort.
Participants:
17 262 adults ≥18 years were recruited from July to August of 2013 and July to August of 2014 from a rural area in China.
Results:
During a median 6-year follow-up, we recorded 1109 deaths (610 with and 499 without hypertension). In adjusted models, as compared with BMI 22–24 kg/m2, with BMI ≤ 18, 18–20, 20–22, 24–26, 26–28, 28–30 and >30 kg/m2, the hazard ratios for mortality in normotensive participants were 1·92 (95% CI 1·23, 3·00), 1·44 (95% CI 1·01, 2·05), 1·14 (95% CI 0·82, 1·58), 0·96 (95% CI 0·70, 1·31), 0·96 (95% CI 0·65, 1·43), 1·32 (95% CI 0·81, 2·14) and 1·32 (95% CI 0·74, 2·35), respectively, and in hypertensive participants were 1·85 (95% CI 1·08, 3·17), 1·67 (95% CI 1·17, 2·39), 1·29 (95% CI 0·95, 1·75), 1·20 (95% CI 0·91, 1·58), 1·10 (95% CI 0·83, 1·46), 1·10 (95% CI 0·80, 1·52) and 0·61 (95% CI 0·40, 0·94), respectively. The risk of mortality was lower in individuals with hypertension with overweight or obesity v. normal weight, especially in older hypertensives (≥60 years old). Sensitivity analyses gave consistent results for both normotensive and hypertensive participants.
Conclusions:
Low BMI was significantly associated with increased risk of all-cause mortality regardless of hypertension status in rural Chinese adults, but high BMI decreased the mortality risk among individuals with hypertension, especially in older hypertensives.