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Rates of self-harm among children and young people (CYP) have been on the rise, presenting major public health concerns in Australia and worldwide. However, there is a scarcity of evidence relating to self-harm among CYP from culturally and linguistically diverse (CALD) backgrounds.
Aims
To analyse the relationship between self-harm-related mental health presentations of CYP to emergency departments and CALD status in South Western Sydney (SWS), Australia.
Method
We analysed electronic medical records of mental health-related emergency department presentations by CYP aged between 10 and up to 18 years in six public hospitals in the SWS region from January 2016 to March 2022. A multilevel logistic regression model was used on these data to assess the association between self-harm-related presentations and CALD status while adjusting for covariates and individual-level clustering.
Results
Self-harm accounted for 2457 (31.5%) of the 7789 mental health-related emergency department presentations by CYP; CYP from a CALD background accounted for only 8% (n = 198) of the self-harm-related presentations. CYP from the lowest two most socioeconomic disadvantaged areas made 63% (n = 1544) of the total self-harm-related presentations. Findings of the regression models showed that CYP from a CALD background (compared with those from non-CALD backgrounds) had 19% lower odds of self-harm (adjusted odds ratio 0.81, 95% CI 0.66–0.99).
Conclusions
Findings of this study provide insights into the self-harm-related mental health presentations and other critical clinical features related to CYP from CALD backgrounds that could better inform health service planning and policy to manage self-harm presentations and mental health problems among CYP.
Characterised by the extensive use of obsidian, a blade-based tool inventory and microblade technology, the late Upper Palaeolithic lithic assemblages of the Changbaishan Mountains are associated with the increasingly cold climatic conditions of Marine Isotope Stage 2, yet most remain poorly dated. Here, the authors present new radiocarbon dates associated with evolving blade and microblade toolkits at Helong Dadong, north-east China. At 27 300–24 100 BP, the lower cultural layers contain some of the earliest microblade technology in north-east Asia and highlight the importance of the Changbaishan Mountains in understanding changing hunter-gatherer lifeways in this region during MIS 2.
In this paper, we consider a joint drift rate control and two-sided impulse control problem in which the system manager adjusts the drift rate as well as the instantaneous relocation for a Brownian motion, with the objective of minimizing the total average state-related cost and control cost. The system state can be negative. Assuming that instantaneous upward and downward relocations take a different cost structure, which consists of both a setup cost and a variable cost, we prove that the optimal control policy takes an $\left\{ {\!\left( {{s^{\ast}},{q^{\ast}},{Q^{\ast}},{S^{\ast}}} \right),\!\left\{ {{\mu ^{\ast}}(x)\,:\,x \in [ {{s^{\ast}},{S^{\ast}}}]} \right\}} \right\}$ form. Specifically, the optimal impulse control policy is characterized by a quadruple $\left( {{s^{\ast}},{q^{\ast}},{Q^{\ast}},{S^{\ast}}} \right)$, under which the system state will be immediately relocated upwardly to ${q^{\ast}}$ once it drops to ${s^{\ast}}$ and be immediately relocated downwardly to ${Q^{\ast}}$ once it rises to ${S^{\ast}}$; the optimal drift rate control policy will depend solely on the current system state, which is characterized by a function ${\mu ^{\ast}}\!\left( \cdot \right)$ for the system state staying in $[ {{s^{\ast}},{S^{\ast}}}]$. By analyzing an associated free boundary problem consisting of an ordinary differential equation and several free boundary conditions, we obtain these optimal policy parameters and show the optimality of the proposed policy using a lower-bound approach. Finally, we investigate the effect of the system parameters on the optimal policy parameters as well as the optimal system’s long-run average cost numerically.
This chapter surveys the culture, knowledge, practice, and experience of sex in Chang’an (modern Xi’an), capital of Tang dynasty China, during the eighth and ninth centuries. It discusses courtesans and candidates, medical and religious texts, sex in literature, and ideals and practices of marriage. The era coincided with the height of the examination culture, whereby all government officials were expected to demonstrate high literacy skills and knowledge of Confucian classics. As the Tang administration increasingly relied on the civil service examinations to recruit high-ranking officials, so Chang’an became the site where examination candidates and graduates mingled with courtesans and flaunted their sensual pleasures. The changing religious landscape throughout China also reshaped how sex was understood and experienced in Chang’an in the Tang era: while Daoist sexologists continued to produce writings about the art of the bedchamber, Tantric Buddhist ideals of sexuality as a source of spiritual energy took root. Meanwhile Tang medical texts discussed sex extensively, providing a theoretical basis for treating symptoms related to intercourse and pregnancy and prescribing aphrodisiacs. The very first wave of erotica in Chinese history appeared. Aspects of Chang’an sexuality exerted a strong influence on sexuality in China for centuries to come.
The goal of this study is to explore the risk factors associated with self-contamination points during personal protective equipment (PPE) donning and doffing among health care workers (HCWs).
Methods:
In total, 116 HCWs were randomly sampled and trained to don and doff the whole PPE set. We smeared the whole PPE set with the fluorescent powder. After each participant finished PPE doffing, the whole body was irradiated with ultraviolet light in order to detect contamination points and record the position and quantity. Sociodemographic characteristics and previous infection prevention control (IPC) training experience, among others, were collected by using electronic questionnaires. Poisson regression was used in identifying risk factors that are associated with the number of contamination points, and the relative risk (RR) and its 95% confidence interval (CI) were calculated.
Results:
About 78.5% of participants were contaminated. Ever training experience (RR = 0.37; 0.26, 0.52), clinical departments (RR = 0.67; 0.49, 0.93), body mass index (BMI) (RR = 1.09; 1.01, 1.18), and shoulder width (RR = 1.07; 1.01, 1.13) were associated with the number of contamination points.
Conclusions:
Previous IPC training experience, department types, BMI, and shoulder width were associated with self-contamination points after the PPE was removed.
A target benefit plan (TBP) is a collective defined contribution (DC) plan that is growing in popularity in Canada. Similar to DC plans, TBPs have fixed contribution rates, but they also implement pooling of longevity and investment risk. In this paper, we formulate a multi-period model that incorporates two sources of risk – asset risk and labor income risk for active members. We present an optimal investment and retirement benefits schedule for TBP members with a fixed contribution rate. Using Australian data from 1965 to 2018, we evaluate the performance of the optimal TBP scheme and compare it to the optimal DC scheme. By adopting the benefit–investment strategy derived in this paper, we demonstrate the stability of benefit distribution over time for a TBP scheme in this stochastic formulation. To outperform the DC scheme’s benefit payment, careful consideration shall be given to the benefit target in the TBP scheme. A high target may not be achievable, while a low target can impede the accumulation momentum of the fund’s wealth in its early stages. Moreover, a TBP fund’s investment strategy is primarily influenced by the wealth target, with more aggressive investments in risky assets as the wealth target increases. This analysis may shed light on the possible improvements to retirement planning in Australia. Although the results are sensitive to the choice of model parameters, overall, the proposed TBP promotes system stability in various scenarios.
In 2016, an outbreak of paratyphoid fever occurred in 40 cases at Qingyang town, in China. A case-control study was carried out to determine the source of this outbreak. Case-control study was conducted to identify the risk factors of this outbreak. The cases were identified as patients with isolation of S. Paratyphi, controls were confirmed cases’ healthy classmates, colleagues or neighbors and matched by age (±5 y) and gender. Pulsed-field gel electrophoresis was performed to source tracking. Totally, 40 cases were reported: 24 cases were students, and 20 (20/24) of them were Qingyang High School students. For the case-control study, consuming Chinese egg pancakes was detected as a risk factor (OR1:1 = 5.000; 95% CI: 1.710-14.640), and hand-washing before meals was protective behavior compared with seldom hand-washing (OR1:1 = 23.256; 95% CI: 2.451-200.000). S. Paratyphi was cultured from a well water sample used for washing contents of the pancakes. Isolates from well water and paratyphoid cases showed the same PFGE patterns. Contaminated well water and Chinese egg pancakes were likely source and vehicle of this outbreak. Health education, especially handwashing, and food safety supervision should be promoted particularly in schools.
The carbonate-hosted Pb–Zn deposits in the Sichuan–Yunnan–Guizhou (SYG) triangle region are important Indosinian deposits in South China. The Tianbaoshan deposit is a typical large Pb–Zn deposit in the SYG area and occurs as pipe-like type, hosted by Sinian dolostone. It contains ∼26 Mt Zn–Pb ore (7.76–10.09 % Zn, 1.28–1.50 % Pb and 93.6 g t−1 Ag) and >0.1 Mt Cu ore (2.55 % Cu). In this study, the detailed mineral textures, mineral chemical and sulphur isotopic compositions of the various sulphides have been analysed to constrain the abnormal enrichment mechanism and mineralization relationship. Four mineralization stages have been recognized: Stage 1, minor early pyrite (Py1) with relics and infill of intergranular dolomite or quartz grains; Stage 2, Cu mineralization with coarse-grained, elliptical crystal chalcopyrite (Cp1); (3) Stage 3, Zn mineralization with dark fine-grained sphalerite (Sph1) and light coarse-grained sphalerite (Sph2); and (4) Stage 4, as represented by a quartz–calcite assemblage with galena, minor pyrite (Py2) and chalcopyrite (Cp2). The petrography of the sulphide minerals (Py1, Cp1, Sph1 and Sph2) demonstrates a mutual inclusion relationship. The nature of this relationship from core to rim and their similar sulphur isotope values (5.5–8.3 ‰) indicates a single sulphur source, suggesting that the different mineralization types are the result of different stages of a continuous hydrothermal system. Sphalerite geothermometer study suggests that sphalerite in the Tianbaoshan deposit formed in a low-temperature (<200 °C) hydrothermal system. The low concentrations of Mn and In, low In/Ge ratios and high Fe/Cd ratios in the sphalerite are consistent with those of Mississippi Valley-type (MVT) deposits, but different from those of magmatism-related deposits (e.g. epithermal, skarn and VMS deposits). The positive δ34S values for Py1 (5.1–7.9 ‰), Cp1 (5.1–7.2 ‰), Sph1 (4.7–7.4 ‰), Sph2 (3.9–8.7 ‰), Py2 (4.4–9.3 ‰) and Cp2 (5.0–6.8 ‰) indicate a sulphur source from thermochemical reduction of coeval seawater sulphate. Widely developed dissolved textures (caverns and breccias) with massive sulphide infillings and deformed host rock remnants suggest that replacement of host dolostones by ore fluids was volumetrically significant and the ore formed nearly simultaneously with the cavities. The Tianbaoshan deposit is a typical MVT deposit, which resulted from mixing of a H2S-rich fluid and a metal-rich fluid, with thermochemical sulphate reduction occurring before ore precipitation rather than during ore precipitation.
Based on a close reading of 118 Tang epitaphs for those who died young, this paper explores how Tang parents remembered and recounted their children's lives as well as factors that contributed to the rise of intense expression of mourning. It finds that while descriptions in epitaphs for adults largely followed Confucian ideals of life course and gender roles, the epitaphs for the young are much less formulaic, allowing space and latitude for parents and families to impart anecdotes and emotions. More importantly, it argues that the rise of epitaphs for children (especially for daughters in the ninth century) reflected a strong influence of Buddhist perception of death and Buddhist mourning rituals. As a result, Tang parents ignored the restrictions and decorum stipulated in The Book of Rites and mourned their children with outward grief, regardless their age and gender.
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.
We investigated the feasibility and effectiveness of virtual team-based learning (TBL) in teaching neurolocalisation (NL) in a sample of 18 student volunteers. Student satisfaction and knowledge outcomes were evaluated using the modified TBL Student Assessment Instrument and Extended Matching Questionnaire (EMQ), respectively. Mean student satisfaction rating was good at 3.9 out of 5.0 (SD 0.3). Participants achieved high mean EMQ scores of 84.2% (SD 2.9) with moderate correlation between individual assessment scores and EMQ scores (ρ = 0.587, p = 0.01). Virtual TBL is feasible for teaching NL with good student satisfaction and knowledge outcomes.
This study uses a sample of technological mergers and acquisitions (M&As) of A-share listed companies in the five major high-tech industries from 2012 to 2016, and conducts factor analysis to measure the heterogeneity of these enterprises in terms of financial slack resources, equity resources, and governance structure. On this basis, multivariate regression analysis is utilized to explore the influence of the acquiring firms' heterogeneity on their innovation performance, and the adjustment action of absorptive capacity between heterogeneity and innovation performance. The research results show that the slack financial resources and highly centralized equity structure of enterprises are not conducive to enterprises improving their innovation performance following a technological M&A, while the impact of governance structure on innovation performance following an M&A is similarly not significant. The empirical evidence provided offer insights and a decision reference for technological M&As of high-tech enterprises.
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.
Emerging evidence has been revealed that high fat diet (HFD) correlate with insulin resistance (IR) which could be induced by endoplasmic reticulum stress (ERS). Recently, obesity or HFD induced nonalcoholic fatty liver disease (NAFLD) could promote alteration of iron metabolism. Disorder of iron metabolism have been linked to unnormal metabolism of glucose and lipid. Herein, we investigated the effect of impaired iron homeostasis on hepatic IR, focusing on ferritinophagy. Male C57/6J mice were administered with HFD (60% energy from fat) or LFD (10% energy from fat) for 10 weeks (n = 10), and Palmitic acid (PA)-insulin treated HepG2 cells were also established. Hepatic IR as evidenced by increased hepatic steatosis and decreased of p-AKT (48%, p < 0.0005), p-GSK-3β (34%, p < 0.05) in the liver of HFD mice. In addition, decreased iron level and expression NCOA4, as well as increased up-regulation of IRE1α and EIF2α were observed in HFD liver. By using desferrioxamine (DFO) and ferric ammonium citrate (FAC), we examined iron level on IRE1α and EIF2α. And glucose uptake assay shown that FAC supplementation, and ERS inhibitors of 4-PBA and STF could improve the glucose uptake of HepG2 cells in the presence of PA. Furthermore, we evaluated the glucose uptake of HepG2 cells incubated with adenovirus which mediated overexpression of NCOA4, FAC, 4-PBA (ERS inhibitor) or STF (IRE1 inhibitor). Taken together, deficiency of iron induced by impaired ferritinophagy induced hepatic IR, partly by aggravating hepatic ERS, especially IRE1 signal pathway in vivo and vitro. These findings provide evidence and new insight for therapeutic strategy of iron deficiency in NAFLD.
Pseudo-line tensions are used in a continuum approach to simulate contact angle hysteresis. A pair of pseudo-line tensions in the receding and advancing states, respectively, are utilized to represent contact line interactions with a substrate because of the nanoscale topological and/or chemical heterogeneity on the substrate. A water droplet sitting on a horizontal or inclined substrate, whose volume is 4–30 µL, has been studied experimentally and numerically. Our simulation model predicts consistent hysteresis at four different droplet sizes compared with experiments. Meanwhile, the critical roll-off angles captured in simulations match well with experiments.
Existing data on folate status and hepatocellular carcinoma (HCC) prognosis are scarce. We prospectively examined whether serum folate concentrations at diagnosis were associated with liver cancer-specific survival (LCSS) and overall survival (OS) among 982 patients with newly diagnosed, previously untreated HCC, who were enrolled in the Guangdong Liver Cancer Cohort (GLCC) study between September 2013 and February 2017. Serum folate concentrations were measured using chemiluminescent microparticle immunoassay. Cox proportional hazards models were performed to estimate hazard ratios (HR) and 95 % CI by sex-specific quartile of serum folate. Compared with patients in the third quartile of serum folate, patients in the lowest quartile had significantly inferior LCSS (HR = 1·48; 95 % CI 1·05, 2·09) and OS (HR = 1·43; 95 % CI 1·03, 1·99) after adjustment for non-clinical and clinical prognostic factors. The associations were not significantly modified by sex, age at diagnosis, alcohol drinking status and Barcelona Clinic Liver Cancer (BCLC) stage. However, there were statistically significant interactions on both multiplicative and additive scale between serum folate and C-reactive protein (CRP) levels or smoking status and the associations of lower serum folate with worse LCSS and OS were only evident among patients with CRP > 3·0 mg/l or current smokers. An inverse association with LCSS were also observed among patients with liver damage score ≥3. These results suggest that lower serum folate concentrations at diagnosis are independently associated with worse HCC survival, most prominently among patients with systemic inflammation and current smokers. A future trial of folate supplementation seems to be promising in HCC patients with lower folate status.
Modeling static and dynamic contact angles is a great challenge in studying wetting and de-wetting. We propose a new slip boundary model based on the Navier–Stokes equations, and establish a realistic continuum approach to simulate the contact line dynamics in 3-D. To validate our model, a water droplet interacting with micrometer-sized patterns of a hybrid hydro-phobic/-philic surface is studied numerically and compared with experimental measurements. Good agreement has been observed with four pillar spacings in the static, receding, and advancing modes. Moreover, details of the droplet–surface interaction are revealed, i.e., penetrations, sagging, local, and global contact angles.
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.
Two ice cores (118.4 and 214.7 m in length) were collected in 2000 from the Puruogangri ice cap in the center of the Tibetan Plateau (TP) in a joint US-Chinese collaborative project. These cores yield paleoclimatic and environmental records extending through the Middle Holocene, and complement previous ice-core histories from the Dunde and Guliya ice caps in northeast and northwest Tibet, respectively, and Dasuopu glacier in the Himalaya. The high-resolution Puruogangri climate record since AD 1600 details regional temperature and moisture variability. The post-1920 period is characterized by above-average annual net balance, contemporaneous with the greatest 18O enrichment of the last 400 years, consistent with the isotopically inferred warming observed in other TP ice-core records. On longer timescales the aerosol history reveals large and abrupt events, one of which is dated ∼4.7 kyr BP and occurs close to the time of a drought that extended throughout the tropics and may have been associated with centuries-long weakening of the Asian/Indian/African monsoon system. The Puruogangri climate history, combined with the other TP ice-core records, has the potential to provide valuable information on variations in the strength of the monsoon across the TP during the Holocene.