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Multimorbidity, especially physical–mental multimorbidity, is an emerging global health challenge. However, the characteristics and patterns of physical–mental multimorbidity based on the diagnosis of mental disorders in Chinese adults remain unclear.
Methods
A cross-sectional study was conducted from November 2004 to April 2005 among 13,358 adults (ages 18–65years) residing in Liaoning Province, China, to evaluate the occurrence of physical–mental multimorbidity. Mental disorders were assessed using the Composite International Diagnostic Interview (version 1.0) with reference to the Diagnostic and Statistical Manual of Mental Disorders (3rd Edition Revised), while physical diseases were self-reported. Physical–mental multimorbidity was assessed based on a list of 16 physical and mental morbidities with prevalence ≥1% and was defined as the presence of one mental disorder and one physical disease. The chi-square test was used to calculate differences in the prevalence and comorbidity of different diseases between the sexes. A matrix heat map was generated of the absolute number of comorbidities for each disease. To identify complex associations and potential disease clustering patterns, a network analysis was performed, constructing a network to explore the relationships within and between various mental disorders and physical diseases.
Results
Physical–mental multimorbidity was confirmed in 3.7% (498) of the participants, with a higher prevalence among women (4.2%, 282) than men (3.3%, 216). The top three diseases with the highest comorbidity rate and average number of comorbidities were dysphoric mood (86.3%; 2.86), social anxiety disorder (77.8%; 2.78) and major depressive disorder (77.1%; 2.53). A physical–mental multimorbidity network was visually divided into mental and physical domains. Additionally, four distinct multimorbidity patterns were identified: ‘Affective-addiction’, ‘Anxiety’, ‘Cardiometabolic’ and ‘Gastro-musculoskeletal-respiratory’, with the digestive-respiratory-musculoskeletal pattern being the most common among the total sample. The affective-addiction pattern was more prevalent in men and rural populations. The cardiometabolic pattern was more common in urban populations.
Conclusions
The physical–mental multimorbidity network structure and the four patterns identified in this study align with previous research, though we observed notable differences in the proportion of these patterns. These variations highlight the importance of tailored interventions that address specific multimorbidity patterns while maintaining broader applicability to diverse populations.
In this paper, a capsule endoscopy system with a sensing function is proposed for medical devices. A single-arm spiral antenna is designed for data transmission and is combined with the voltage controlled oscillator to achieve sensing capabilities. The designed antenna operates at a 900 MHz industrial scientific medical band. By establishing a three-layer cylindrical model of the stomach, it was concluded that the antenna in the stomach has a high peak gain of −1.1 dBi. Additionally, the antenna achieved a −10 dB impedance bandwidth of 5%. The capsule endoscopy was experimentally measured in both actual stomach and simulated environments. The maximum working distance of the capsule endoscope was measured to be 6.8 m. Additionally, the proposed capsule endoscope was tested for its sensing function using solutions with different dielectric constants. Finally, it was confirmed through link analysis that it has good communication capabilities. The results and analysis confirm that the proposed capsule endoscope can be used for examining gastric diseases.
Depression is one of the major mental disorders, which seriously endangers human health, brings a serious burden to patients’ families. In this study, we intended to further explore the antidepressant-like effect and possible molecular mechanisms of Salidroside (SAL). We built corticosterone (CORT)-induced depressive mice model and used behavioural tests to evaluate depression behaviour. To explore the molecular mechanisms of SAL, we employed a variety of methods such as immunofluorescence, western blot, pharmacological interference, etc. The results demonstrated that SAL both at 25 mg/kg and 50 mg/kg can reduce immobility time in the tail suspension test (TST). At the same time, SAL treatment could restore the reduced sugar water intake preference in the sucrose preference test (SPT) in CORT-induced depressive mice and reduce the immobility time in TST and forced swimming experiments (FST). In addition, SAL treatment reversed the reduction in the number of Ki-67, BrdU, and NeuN in the hippocampus due to CORT treatment. SAL treatment also restored the expression of SIRT1, PGC-1α, brain-derived neurotrophic factor (BDNF) and other proteins in the hippocampus. In addition, after blocking SIRT1 signalling with EX527, we found that the treatment with SAL failed to reduce the immobility time in TST and FST, the level of SIRT1 and PGC-1α activity were correspondingly downregulated, and the expression of DCX and Ki-67 in the hippocampus failed to be activated. These findings suggested that SAL exerts antidepressant-like effects by promoting hippocampal neurogenesis through the SIRT1/PGC-1α signalling pathway.
Numerical simulations are carried out on the vortex-induced rotations of a freely rotatable rigid square cylinder in a two-dimensional uniform cross-flow. A range of Reynolds numbers between 40 and 150 and density ratios between 0.1 and 10 are considered. Results show eight different characteristic regimes, expanding the classification of Ryu & Iaccarino (J. Fluid Mech., vol. 813, 2017, pp. 482–507). New regimes include the transition and wavy rotation regimes; in the ${\rm \pi}$-limited oscillation regime we observe multipeak subregimes. Moment-generating mechanisms of these regimes and subregimes are further elucidated. A phenomenon related to the influence of density ratio is the tooth-like shape of the ${\rm \pi} /2$-limit oscillation regime observed in the regime map, which is explained as a result of the imbalance relation between the main frequencies of rotation response and the vortex shedding frequency. In addition, existence of multiple regimes and multistable states are discussed, indicating multiple stable attractive structures in phase space.
Chinese nurses working with immense stress may have issues with burnout during COVID-19 regular prevention and control. There were a few studies investigating status of burnout and associated factors among Chinese nurses. However, the relationships remained unclear.
Objectives
To investigate status and associated factors of nurses’ burnout during COVID-19 regular prevention and control.
Methods
784 nurses completed questionnaires including demographics, Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, Insomnia Severity Index, Impact of Event Scale-revised, Perceived Social Support Scale, Connor–Davidson Resilience Scale, General Self-efficacy Scale and Maslach Burnout Inventory.
Results
310 (39.5%), 393 (50.1%) and 576 (73.5%) of respondents were at high risk of emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). The risk of EE, DP and reduced PA were moderate, high and high. Nurses with intermediate and senior professional rank and title and worked >40 h every week had lower scores in EE. Those worked in low-risk department reported lower scores in PA. Anxiety, post-traumatic stress disorder (PTSD), self-efficacy and social support were influencing factors of EE and DP, while social support and resilience were associated factors of PA.
Conclusion
Chinese nurses’ burnout during COVID-19 regular prevention and control was serious. Professional rank and title, working unit, weekly working hours, anxiety, PTSD, self-efficacy, social support and resilience were associated factors of burnout.
Extreme events are ubiquitous in nature and social society, including natural disasters, accident disasters, crises in public health (such as Ebola and the COVID-19 pandemic), and social security incidents (wars, conflicts, and social unrest). These extreme events will heavily impact financial markets and lead to the appearance of extreme fluctuations in financial time series. Such extreme events lack statistics and are thus hard to predict. Recurrence interval analysis provides a feasible solution for risk assessment and forecasting. This Element aims to provide a systemic description of the techniques and research framework of recurrence interval analysis of financial time series. The authors also provide perspectives on future topics in this direction.
The laboratory generation and diagnosis of uniform near-critical-density (NCD) plasmas play critical roles in various studies and applications, such as fusion science, high energy density physics, astrophysics as well as relativistic electron beam generation. Here we successfully generated the quasistatic NCD plasma sample by heating a low-density tri-cellulose acetate (TCA) foam with the high-power-laser-driven hohlraum radiation. The temperature of the hohlraum is determined to be 20 eV by analyzing the spectra obtained with the transmission grating spectrometer. The single-order diffraction grating was employed to eliminate the high-order disturbance. The temperature of the heated foam is determined to be T = 16.8 ± 1.1 eV by analyzing the high-resolution spectra obtained with a flat-field grating spectrometer. The electron density of the heated foam is about under the reasonable assumption of constant mass density.
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.
In this paper, the feasibility of a high laser damage threshold liquid crystal spatial light modulator based on gallium nitride (GaN) transparent conductive electrodes is proved. The laser-induced damage threshold (LIDT) is measured, and a high LIDT reflective optically addressed liquid crystal light valve (OALCLV) based on GaN is designed and fabricated. The proper work mode of the OALCLV is determined; the OALCLV obtained a maximum reflectivity of about 55% and an on–off ratio of 55:1, and an image response is demonstrated.
Routine coronavirus disease 2019 (COVID-19) screening found 1 asymptomatic COVID-19 patient. An emergency sampling team was organized consisting of 1200 health-care workers, and a total of 3.2228 million COVID-19 samples had been collected and detected. This study summarizes the on-site management experience in large-scale COVID-19 nucleic acid testing from various aspects: staff preparation, materials preparation, site layout, logistics support, and information system support. Suggestions are put forward for the deficiencies and parts needing improvement. Such deficiencies included some sampling sites were not properly chosen, different areas were unclearly marked off from each other, and some site moving lines were confounding; how to communicate with the street service workers who had little professional knowledge on the epidemic spread or the working principles of the workflow and site layout; and the way to resolve conflicts on site.
We investigated the drug resistance of Mycobacterium tuberculosis isolates from patients with tuberculosis (TB) and HIV, and those diagnosed with only TB in Sichuan, China. TB isolates were obtained from January 2018 to December 2020 and subjected to drug susceptibility testing (DST) to 11 anti-TB drugs and to GeneXpert MTB/RIF testing. The overall proportion of drug-resistant TB (DR-TB) isolates was 32.1% (n = 10 946). HIV testing was not universally available for outpatient TB cases, only 29.5% (3227/10 946) cases had HIV testing results. The observed proportion of multidrug-resistant TB (MDR-TB) isolates was almost double than that of the national level, with approximately 1.5% and 0.1% of the isolates being extensively drug resistant and universally drug resistant, respectively. The proportions of resistant isolates were generally higher in 2018 and 2019 than in 2020. Furthermore, the sensitivities of GeneXpert during 2018–2020 demonstrated a downward trend (80.9, 95% confidence intervals (CI) 76.8–85.0; 80.2, 95% CI 76.4–84.1 and 75.4, 95% CI 70.7–80.2, respectively). Approximately 69.0% (7557/10 946) of the TB cases with DST results were subjected to GeneXpert detection. Overall, the DR-TB status and the use of GeneXpert in Sichuan have improved, but DR-TB challenges remain. HIV testing for all TB cases is recommended.
In this paper, we propose an effective method to compensate for the performance degradation of optically addressed spatial light modulators (OASLMs). The thermal deposition problem usually leads to the on-off ratio reduction of amplitude OASLM, so it is difficult to achieve better results in high-power laser systems. Through the analysis of the laser-induced temperature rise model and the liquid crystal layer voltage model, it is found that reducing the driving voltage of the liquid crystal light valve and increasing the driving current of the optical writing module can compensate for the decrease of on–off ratio caused by temperature rise. This is the result of effectively utilizing the photoconductive effect of Bi12SiO20 (BSO) crystal. The experimental results verify the feasibility of the proposed method and increase the laser withstand power of amplitude-only OASLM by about a factor of 2.5.
Metabolically healthy obesity (MHO) might be an alternative valuable target in obesity treatment. We aimed to assess whether alternative Mediterranean (aMED) diet and Dietary Approaches to Stop Hypertension (DASH) diet were favourably associated with obesity and MHO phenotype in a Chinese multi-ethnic population. We conducted this cross-sectional analysis using the baseline data of the China Multi-Ethnic Cohort study that enrolled 99 556 participants from seven diverse ethnic groups. Participants with self-reported cardiometabolic diseases were excluded to eliminate possible reverse causality. Marginal structural logistic models were used to estimate the associations, with confounders determined by directed acyclic graph (DAG). Among 65 699 included participants, 11·2 % were with obesity. MHO phenotype was present in 5·7 % of total population and 52·7 % of population with obesity. Compared with the lowest quintile, the highest quintile of DASH diet score had 23 % decreased odds of obesity (OR = 0·77, 95 % CI 0·71, 0·83, Ptrend < 0·001) and 27 % increased odds of MHO (OR = 1·27, 95 % CI 1·10, 1·48, Ptrend = 0·001) in population with obesity. However, aMED diet showed no obvious favourable associations. Further adjusting for BMI did not change the associations between diet scores and MHO. Results were robust to various sensitivity analyses. In conclusion, DASH diet rather than aMED diet is associated with reduced risk of obesity and presents BMI-independent metabolic benefits in this large population-based study. Recommendation for adhering to DASH diet may benefit the prevention of obesity and related metabolic disorders in Chinese population.
From 24 January 2020 to 18 May 2020, Chaoshan took measures to limit the spread of coronavirus disease 2019 (COVID-19), such as restricting public gatherings, wearing masks and suspending classes. We explored the effects of these measures on the pathogen spectrum of paediatric respiratory tract infections in Chaoshan. Pharyngeal swab samples were collected from 4075 children hospitalised for respiratory tract infection before (May–December 2019) and after (January–August 2020) the COVID-19 outbreak. We used liquid chip technology to analyse 14 respiratory pathogens. The data were used to explore between-group differences, age-related differences and seasonal variations in respiratory pathogens. The number of cases in the outbreak group (1222) was 42.8% of that in the pre-outbreak group (2853). Virus-detection rates were similar in the outbreak (48.3%, 590/1222) and pre-outbreak groups (51.5%, 1468/2853; χ2 = 3.446, P = 0.065), while the bacteria-detection rate was significantly lower in the outbreak group (26.2%, 320/1222) than in the pre-outbreak group (44.1%, 1258/2853; χ2 = 115.621, P < 0.05). With increasing age, the proportions of respiratory syncytial virus (RSV) and cytomegalovirus (CMV) infections decreased, while those of Mycoplasma pneumoniae and adenovirus infections increased. Streptococcus pneumoniae, CMV and rhinovirus infections peaked in autumn and winter, while RSV infections peaked in summer and winter. We found that the proportion of virus-only detection decreased with age, while the proportion of bacteria-only detection increased with age (Table 2). Anti-COVID-19 measures significantly reduced the number of paediatric hospitalisations for respiratory tract infections, significantly altered the pathogen spectrum of such infections and decreased the overall detection rates of 14 common respiratory pathogens. The proportion of bacterial, but not viral, infections decreased.
In this paper, we study inertial and gravity wave transmissions near radiative–convective boundaries on the f-plane. Two configurations have been considered: waves propagate from the convective layer to the radiative stratified stable layer, or the other way around. It has been found that waves prefer to survive at low latitudes when the stable layer is strongly stratified ($N^2/(2\varOmega )^2>1$). When the stable layer is weakly stratified ($N^2/(2\varOmega )^2 < 1$), however, waves can survive at any latitude if the meridional wavenumber is large. Then we have discussed transmission ratios for two buoyancy frequency structures: the uniform stratification and the continuously varying stratification. For the uniform stratification, we have found that the transmission is efficient when the rotation is rapid, or when the wave is near the critical colatitude. For the continuously varying stratification, we have discussed the transmission ratio when the square of buoyancy frequency is an algebraic function $N^2\propto z^{\nu } (\nu >0)$. We have found that the transmission can be efficient when the rotation is rapid, or when the wave is near the critical colatitude, or when the thickness of the stratification layer is far greater than the horizontal wavelength. The transmission ratio does not depend on the configurations (radiative layer sits above convective layer, or vice versa; wave propagates outward or inward), but only on characteristics of the wave (frequency and wavenumber) and the fluid (degree of stratification).
In this paper, we study wave transmission in a rotating fluid with multiple alternating convectively stable and unstable layers. We have discussed wave transmissions in two different circumstances: cases where the wave is propagative in each layer and cases where wave tunnelling occurs. We find that efficient wave transmission can be achieved by ‘resonant propagation’ or ‘resonant tunnelling’, even when stable layers are strongly stratified, and we call this phenomenon ‘enhanced wave transmission’. Enhanced wave transmission only occurs when the total number of layers is odd (embedding stable layers are alternatingly embedded within clamping convective layers, or vice versa). For wave propagation, the occurrence of enhanced wave transmission requires that the clamping layers have similar properties, the thickness of each clamping layer is close to a multiple of the half-wavelength of the corresponding propagative wave and the total thickness of the embedded layers is close to a multiple of the half-wavelength of the corresponding propagating wave (resonant propagation). For wave tunnelling, we have considered two cases: tunnelling of gravity waves and tunnelling of inertial waves. In both cases, efficient tunnelling requires that the clamping layers have similar properties, the thickness of each embedded layer is much smaller than the corresponding e-folding decay distance and the thickness of each clamping layer is close to a multiple-and-a-half of the half-wavelength (resonant tunnelling).
This article investigates the optimal hedging problem of the European contingent claims written on non-tradable assets. We assume that the risky assets satisfy jump diffusion models with a common jump process which reflects the correlated jump risk. The non-tradable asset and jump risk lead to an incomplete financial market. Hence, the cross-hedging method will be used to reduce the potential risk of the contingent claims seller. First, we obtain an explicit closed-form solution for the locally risk-minimizing hedging strategies of the European contingent claims by using the Föllmer–Schweizer decomposition. Then, we consider the hedging for a European call option as a special case. The value of the European call option under the minimal martingale measure is derived by the Fourier transform method. Next, some semi-closed solution formulae of the locally risk-minimizing hedging strategies for the European call option are obtained. Finally, some numerical examples are provided to illustrate the sensitivities of the optimal hedging strategies. By comparing the optimal hedging strategies when the underlying asset is a non-tradable asset or a tradable asset, we find that the liquidity risk has a significant impact on the optimal hedging strategies.
Early identification of patients with novel corona virus disease 2019 (COVID-19) who may be at high mortality risk is of great importance.
Methods:
In this retrospective study, we included all patients with COVID-19 at Huanggang Central Hospital from January 23 to March 5, 2020. Data on clinical characteristics and outcomes were compared between survivors and nonsurvivors. Univariable and multivariable logistic regression were used to explore risk factors associated with in-hospital death. A nomogram was established based on the risk factors selected by multivariable analysis.
Results:
A total of 150 patients were enrolled, including 31 nonsurvivors and 119 survivors. The multivariable logistic analysis indicated that increasing the odds of in-hospital death associated with higher Sequential Organ Failure Assessment score (odds ratio [OR], 3.077; 95% confidence interval [CI]: 1.848-5.122; P < 0.001), diabetes (OR, 10.474; 95% CI: 1.554-70.617; P = 0.016), and lactate dehydrogenase greater than 245 U/L (OR, 13.169; 95% CI: 2.934-59.105; P = 0.001) on admission. A nomogram was established based on the results of the multivariable analysis. The AUC of the nomogram was 0.970 (95% CI: 0.947-0.992), showing good accuracy in predicting the risk of in-hospital death.
Conclusions:
This finding would facilitate the early identification of patients with COVID-19 who have a high-risk for fatal outcome.
In this paper, a multiantenna wireless transmitter communicates with an information receiver while radiating RF energy to surrounding energy harvesters. The channel between the transceivers is known to the transmitter, but the channels between the transmitter and the energy harvesters are unknown to the transmitter. By designing its transmit covariance matrix, the transmitter fully charges the energy buffers of all energy harvesters in the shortest amount of time while maintaining the target information rate toward the receiver. At the beginning of each time slot, the transmitter determines the particular beam pattern to transmit with. Throughout the whole charging process, the transmitter does not estimate the energy harvesting channel vectors. Due to the high complexity of the system, we propose a novel deep Q-network algorithm to determine the optimal transmission strategy for complex systems. Simulation results show that deep Q-network is superior to the existing algorithms in terms of the time consumption to fulfill the wireless charging process.
Renal fibrosis is common especially in the elderly population. Recently, we found that vitamin D deficiency caused prostatic hyperplasia. This study aimed to investigate whether vitamin D deficiency promotes renal fibrosis and functional impairment. All mice except controls were fed with vitamin D-deficient (VDD) diets, beginning from their early life. The absolute and relative kidney weights on postnatal week 20 were decreased in VDD diet-fed male pups but not in female pups. A mild pathological damage was observed in VDD diet-fed male pups but not in females. Further analysis showed that VDD-induced pathological damage was aggravated, accompanied by renal dysfunction in 40-week-old male pups. An obvious collagen deposition was observed in VDD diet-fed 40-week-old male pups. Moreover, renal α-smooth muscle actin (α-SMA), a marker of epithelial–mesenchymal transition (EMT), and Tgf-β mRNA were up-regulated. The in vitro experiment showed that 1,25-dihydroxyvitamin D3 alleviated transforming growth factor-β1 (TGF-β1)-mediated down-regulation of E-cadherin and inhibited TGF-β1-evoked up-regulation of N-cadherin, vimentin and α-SMA in renal epithelial HK-2 cells. Moreover, 1,25-dihydroxyvitamin D3 suppressed TGF-β1-evoked Smad2/3 phosphorylation in HK-2 cells. These results provide experimental evidence that long-term vitamin D deficiency promotes renal fibrosis and functional impairment, at least partially, through aggravating TGF-β/Smad2/3-mediated EMT in middle-aged male mice.