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A significant proportion of people attending Primary Care (PC) have anxiety-depressive symptoms and work-related burnout and there is a lack of resources to attend them. The COVID-19 pandemic has worsened this problem, particularly affecting healthcare workers, and digital tools have been proposed as a workaround.
Objectives
We present the development, feasibility and effectiveness studies of chatbot (Vickybot) aimed at screening, monitoring, and reducing anxiety-depressive symptoms and work-related burnout in PC patients and healthcare workers.
Methods
User-centered development strategies were adopted. Main functions included self-assessments, psychological modules, and emergency alerts. (1) Simulation: HCs used Vickybot for 2 weeks to simulate different possible clinical situations and evaluated their experience. (3) Feasibility and effectiveness study: People consulting PC or healthcare workers with mental health problems were offered to use Vickybot for one month. Self-assessments for anxiety (GAD-7) and depression (PHQ-9) symptoms, and work-related burnout (based on the Maslach Burnout Inventory) were administered at baseline and every two weeks. Feasibility was determined based on the combination of both subjective and objective user-engagement Indicators (UEIs). Effectiveness was measured using paired t-tests as the change in self-assessment scores.
Results
(1) Simulation: 17 HCs (73% female; mean age=36.5±9.7) simulated different clinical situations. 98.8% of the expected modules were recommended according to each simulation. Suicidal alerts were correctly activated and received by the research team. (2) Feasibility and effectiveness study: 34 patients (15 from PC and 19 healthcare workers; 77% female; mean age=35.3±10.1) completed the first self-assessments, with 34 (100%) presenting anxiety symptoms, 32 (94%) depressive symptoms, and 22 (64.7%) work-related burnout. Nine (26.5%) patients completed the second self-assessments after 2-weeks of use. No significant differences were found for anxiety [t(8) = 1.000, p = 0.347] or depressive [t(8) = 0.400, p = 0.700] symptoms, but work-related burnout was significantly reduced [t(8) = 2.874, p = 0.021] between the means of the first and second self-assessments. Vickybot showed high subjective-UEIs, but low objective-UEIs (completion, adherence, compliance, and engagement).
Conclusions
The chatbot proved to be useful in screening the presence and severity of anxiety and depressive symptoms, in reducing work-related burnout, and in detecting suicidal risk. Subjective perceptions of use contrasted with low objective-use metrics. Our results are promising, but suggest the need to adapt and enhance the smartphone-based solution in order to improve engagement. Consensus on how to report UEIs and validate digital solutions, especially for chatbots, are required.
Limited studies provide direct evidence of Clonorchis sinensis adults in the early stage of gallbladder stone formation. Our current research systematically studied 33 gallbladder stones resembling adult worms and shed light on the definite connection of C. sinensis infection with concomitant cholelithiasis. A total of 33 gallbladder stones resembling adult C. sinensis worms were systematically analysed. Fourier transform infrared spectroscopy, scanning electron microscopy and X-ray energy spectrometry were used to analyse the composition and microstructure. Meanwhile, a histopathological examination of the stone was carried out. The 33 gallbladder stones resembling adult C. sinensis worms included nine calcium carbonate (CaCO3) stones, 12 bilirubinate stones and 12 mixed stones. Clonorchis sinensis eggs were found in 30 cases, including all CaCO3 and mixed stones. Parasite tissues were detected in 12 cases, which were mainly CaCO3 stones or bilirubinate–CaCO3 mixed stones. The outer layer of stones was wrapped with 12.88% calcium salt, as revealed by X-ray energy spectrometry, while surprisingly, many C. sinensis eggs were found in the inner part of these stones. Based on our current findings, we concluded that calcification and packaging occurred after C. sinensis adult entrance into the gallbladder, subsequently leading to the early formation of CaCO3 or bilirubinate–CaCO3 mixed gallbladder stones. This discovery highlights definite evidence for C. sinensis infection causing gallbladder stones.
Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations.
Methods
We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0–18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity.
Results
We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04–1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98–1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10–1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54–0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05–1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77–1.08).
Conclusions
The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.
Litter size has a great impact on the profit of swine producers. Uterine development is an important determinant of reproduction efficiency and could hence affect litter size. Chinese Erhualian pig is one of the most prolific breeds in the world, even though large phenotypic variation in litter size was observed within Erhualian sows. To dissect the genetic basis of the phenotypic variation, we herein conducted genome-wide association studies for total number born and number born alive (NBA) of Erhualian sows. In total, one significant single nucleotide polymorphism (SNP) (P<1.78e−06) and 11 suggestive SNPs (P<3.57e−05) were identified on 10 chromosomes, confirming seven previously reported quantitative trait loci (QTL) and uncovering six QTL for litter size or uterus length. One locus on Sus scrofa chromosome (SSC) 13 (79.28 to 90.43 Mb) harbored a cluster of suggestive SNPs associated with multiparous NBA. The SNP (rs81447100) within this region was confirmed to be significantly (P<0.05) associated with litter size in Erhualian (n=313), Sutai (n=173) and Yorkshire (n=488) populations. Retinol binding protein 2 and retinol binding protein 1 functionally related to the development of uterus were located in a region of 2 Mb around rs81447100. Moreover, four genes related to embryo implantation and development were also detected around other significant SNPs. Taken together, our findings provide a potential marker (rs81447100) for the genetic improvement of litter size not only in Chinese Erhualian pigs but also in European commercial pig breeds like Yorkshire, and would facilitate the final identification of causative variant(s) underlying the effect of SSC13 QTL on litter size.
This paper reports the measurement of the energy loss of protons at the energy of 100 keV penetrating a partially ionized hydrogen plasma. The plasma of ne ≈ 1015–16 cm−3; Te ≈ 1–2 eV and lifetime of about 8 µs is created by the hydrogen gas discharge. The experimental results show an increase of a factor of 2.8 in the energy loss, which are in good agreement with the Bethe, Standard Stopping Model, Li–Petrasso and Vlasov models’ predictions within the error limit. The Bethe–Bloch Coulomb logarithm term is found to increase by a factor of 4.0 for free electrons as compared with the situation where bound electrons prevail. The potential application of protons energy loss for diagnosing the electron density in plasma is proposed too.
The discovery of the first electromagnetic counterpart to a gravitational wave signal has generated follow-up observations by over 50 facilities world-wide, ushering in the new era of multi-messenger astronomy. In this paper, we present follow-up observations of the gravitational wave event GW170817 and its electromagnetic counterpart SSS17a/DLT17ck (IAU label AT2017gfo) by 14 Australian telescopes and partner observatories as part of Australian-based and Australian-led research programs. We report early- to late-time multi-wavelength observations, including optical imaging and spectroscopy, mid-infrared imaging, radio imaging, and searches for fast radio bursts. Our optical spectra reveal that the transient source emission cooled from approximately 6 400 K to 2 100 K over a 7-d period and produced no significant optical emission lines. The spectral profiles, cooling rate, and photometric light curves are consistent with the expected outburst and subsequent processes of a binary neutron star merger. Star formation in the host galaxy probably ceased at least a Gyr ago, although there is evidence for a galaxy merger. Binary pulsars with short (100 Myr) decay times are therefore unlikely progenitors, but pulsars like PSR B1534+12 with its 2.7 Gyr coalescence time could produce such a merger. The displacement (~2.2 kpc) of the binary star system from the centre of the main galaxy is not unusual for stars in the host galaxy or stars originating in the merging galaxy, and therefore any constraints on the kick velocity imparted to the progenitor are poor.
Worldwide 350 million people suffer from major depression, with the majority of cases occurring in low- and middle-income countries. We examined the patterns, correlates and care-seeking behaviour of adults suffering from major depressive episode (MDE) in China.
Method
A nationwide study recruited 512 891 adults aged 30–79 years from 10 provinces across China during 2004–2008. The 12-month prevalence of MDE was assessed by the Modified Composite International Diagnostic Interview-short form. Logistic regression yielded adjusted odds ratios (ORs) of MDE associated with socio-economic, lifestyle and health-related factors and major stressful life events.
Results
Overall, 0.7% of participants had MDE and a further 2.4% had major depressive symptoms. Stressful life events were strongly associated with MDE [adjusted OR 14.7, 95% confidence interval (CI) 13.7–15.7], with a dose–response relationship with the number of such events experienced. Family conflict had the highest OR for MDE (18.9, 95% CI 16.8–21.2) among the 10 stressful life events. The risk of MDE was also positively associated with rural residency (OR 1.5, 95% CI 1.4–1.7), low income (OR 2.3, 95% CI 2.1–2.4), living alone (OR 2.6, 95% CI 2.3–3.0), smoking (OR 1.4, 95% CI 1.3–1.6) and certain other mental disorders (e.g. anxiety, phobia). Similar, albeit weaker, associations were observed with depressive symptoms. Among those with MDE, about 15% sought medical help or took psychiatric medication, 15% reported having suicidal ideation and 6% reported attempting suicide.
Conclusions
Among Chinese adults, the patterns and correlates of MDE were generally consistent with those observed in the West. The low rates of seeking professional help and treatment highlight the great gap in mental health services in China.
The transmission of haemorrhagic fever with renal syndrome (HFRS) is deeply influenced by the reservoir and hantavirus prevalence rate. In this study, a surveillance on human HFRS cases, relative rodent abundance, and hantavirus infection prevalence was conducted in Shaanxi province, China, during 1984–2012. A generalized linear model with Poisson-distributed residuals and a log link was used to quantify the relationship between reservoir, virus and HFRS cases. The result indicated that there was a significant association of HFRS incidence with relative rodent density and the prevalence rate. This research provides evidence that the changes of infection prevalence in the reservoir could lead directly to the emergence of a new epidemic. It was concluded that the measurement of a number of these variables could be used in disease surveillance to give useful advance warning of potential disease epidemics.
We report plasmon lasers with strong cavity feedback and optical confinement to 1/20th wavelength. Strong feedback arises from total internal reflection of plasmons, while confinement enhances the spontaneous emission rate by up to 18 times.
Abnormalities in the connectivity of white-matter (WM) tracts in schizophrenia are supported by evidence from post-mortem investigations, functional and structural magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). The aims of this study were to explore the microstructural changes in first-episode schizophrenia in a Han Chinese population and to investigate whether a family history of psychiatric disorder is related to the severity of WM tract integrity abnormalities in these patients.
Method
T1-weighted MR and DT images were collected in 68 patients with first-episode schizophrenia [22 with a positive family history (PFH) and 46 with a negative family history (NFH)] and 100 healthy controls. Voxel-based analysis was performed and WM integrity was quantified by fractional anisotropy (FA). Cluster- and voxel-level analyses were performed by using two-sample t tests between patients and controls and/or using a full factorial model with one factor and three levels among the three sample groups (patients with PFH or NFH, and controls), as appropriate.
Results
FA deficits were observed in the patient group, especially in the left temporal lobe and right corpus callosum. This effect was more severe in the non-familial schizophrenia than in the familial schizophrenia subgroup.
Conclusions
Overall, these findings support the hypothesis that loss of WM integrity may be an important pathophysiological feature of schizophrenia, with particular implications for brain dysmaturation in non-familial and familial schizophrenia.
Field rodent surveys for Babesia infection were performed from 2002 to 2005 in the vicinities of human babesiosis occurrences in Taiwan and mainland China. Babesia microti was identified by microscopical examination and/or PCR in 1 Rattus coxinga and 1 Crocidura horsfieldii in central Taiwan and in 13 Niviventer confucianus and 1 Apodemus agrarius in Zhejiang and Fujian Provinces of southeastern China. Of 15 B. microti samples detected by PCR, all except 1 were shown to be the Kobe-type, the aetiological small subunit rRNA gene-type of the first Japanese patient; the exception was also a Kobe-related type. The Kobe-type had been found in rodents only in a few places including the human infection occurrence place in Japan. The internal transcribed spacer 1 to 2 sequences of the Taiwanese and Chinese Kobe-types were very similar to each other but considerably different (approx. 94% pairwise identities) from that of the Japanese Kobe-type. A Taiwanese Kobe-type strain was serologically differentiated from the Kobe strain originating from the Japanese first patient. The distribution of the Kobe-type in the vicinities of human babesiosis occurrences in Taiwan and China as well as in Japan is suggestive of involvement of the Kobe-type in Asian human babesiosis.
To date, there has been no large-scale survey of geriatric depression (GD) involving both rural and urban areas in China using standardized assessment tools and diagnostic criteria. This study aimed to determine the 12-month and lifetime prevalence rates of GD and sociodemographic correlates in urban and rural regions of Beijing, China.
Method
A total of 1601 elderly patients (aged ⩾60 years) were randomly selected and interviewed in Beijing using the Composite International Diagnostic Interview (CIDI 1.0). Basic sociodemographic and clinical data were also collected during the interviews.
Results
The overall 12-month prevalence of GD was 4.33%, and the 12-month prevalence rates for men and women were 2.65% and 5.83% respectively. The overall lifetime prevalence of GD was 7.83%, and lifetime prevalence rates for men and women were 4.65% and 10.66% respectively. Female sex, lower educational level, monthly income, rural abode, and the presence of one or more major medical conditions were associated with increased risk of GD. Of the GD subjects interviewed, 25.2% were receiving some type of treatment, with only 4.7% preferring to seek treatment from mental health professionals.
Conclusions
Although still relatively low by international standards, there is an increasing trend in the prevalence of GD in China. The low percentage of subjects treated for GD is a major public health concern that should be addressed urgently.
We report structural, electrical, and thermopower properties of epitaxial and topotaxial NaxCoO2 thin films on (0001) sapphire substrate. Topotaxial NaxCoO2 films were prepared by converting an epitaxial Co3O4 film to NaxCoO2 by annealing in Na vapor and epitaxial NaxCoO2 films were obtained by pulsed laser deposition. All the films are c-axis oriented. For topotaxial films, annealing in different Na vapor pressures resulted in films with different Na concentrations, which showed distinct transport properties. For directly deposited epitaxial films by pulsed laser deposition, deposition parameters are found to control the Na concentration and hence the film properties. The largest thermoelectric power of the samples made by different methods is found to be similar in the range of 70-100 μV/K at room temperature
Raman and infrared measurements of the LiB3O5 (LBO) crystals were completed. The experimental results shown here are more and stronger Raman lines and infrared absorption peaks, which implies that the external vibrations of the trigonal (BO3)3− and tetrahedral (BO4)5− ions, especially the former, in the six-membered boron–oxygen rings at the low wave number are strong and the internal vibrations of the (BO4)5− ions above 200 cm−1 are stronger than those of the (BO3)3− ions if compared with the Raman spectra of BaB2O4 crystals. These are caused due to the slope and distortions of the B3O7 rings and their BO3 and BO4 units in LBO, which change the structural rigidity of the crystals, intensify the long-range electrostatic force and short-range molecular force, and shorten the ultraviolet absorption edge.
Ion-beam assisted deposition was used to fabricate biaxially aligned cubic zirconia on flexible metal substrates. These films were used as templates for heteroepitaxially deposited YBa2Cu3O7-δ (YBCO) films. The quality of the crystalline texture of the template films has a direct influence on the superconducting properties of the final YBCO films. We describe our efforts to fabricate high-quality cubic zirconia templates on short-length substrates processed in stationary mode and meter-long substrates processed in continuous mode. Our best phi scan FWHM values for the films on the meter-long tapes were 12.6 degrees for the template and 6.1 degrees for the overcoated YBCO. This meter-long tape had a self-field, 75 K, superconducting critical current of 122 amps.
We studied the feasibility of creating new tissue engineered tendons, using bovine tendon fibroblasts (tenocytes) attached to synthetic biodegradable polymer scaffolds in athymic mice. Calffore- and hind-limbs were obtained from a local slaughterhouse within 6 hours of sacrifice. Tenocytes were isolated from the calf tendons. Cells were seeded onto an array of fibers composed of polymer (PGA) configured either as a random mesh of fibers, or as an array of parallel fibers. Fifty cell-polymer constructs were implanted subcutaneously in athymic mice and harvested at 3, 6, 8, 10 and 12 weeks. Grossly, all excised specimens resembled the tendons from which the cells had been isolated. Histologic sections stained with hematoxylin and eosin (H&E) and Masson's trichrome showed cells arranged longitudinally within parallel collagen fibers in the periphery. Centrally, collagen fibers were more randomly arranged, although they seemed to attain a parallel arrangement of cells and fibers over time. By 10 weeks, specimens showed very similar histologic characteristics to normal tendon. Histologically, 12-week samples were virtually identical to normal tendon. When longitudinal polymer fibers seeded with cell had been implanted, the collagen fibers seen in the neo-tendons became organized at an earlier interval of time. Biomechanical tests demonstrated linear increase in tensile strength of the neo-tendons over time. Eight-week specimens showed 30% the tensile strength of normal tendon samples of similar size. By 12 weeks, tensile strength was already 57% that of normal bovine tendon.
The materials and electronic properties of the new cuprate superconductors are critically dependent upon both the oxygen stoichiometry and annealing history of the material. Improving Jc, Tc, and determining the underlying mechanism of superconductivity depend on a better understanding of these effects. In the study of Bi2Sr2CaCu2O8-δ we have combined standard material characterization techniques with high resolution angle resolved photoemission spectroscopy and resonant photoemission spectroscopy to illuminate these issues. Specifically, we make high quality single crystals of BSCCO and then anneal in different atmospheres and pressures. We correlate this with c-axis resistivity, a, b-plane resistivity, and resonant photoemission spectroscopy. In this way we can explain the macroscopic transport properties in terms of the electronic properties of the material determined from photoemission. We find that we can change the c-axis resistivity from non-metallic to metallic by adding oxygen and that this correlates with increased oscillator strength in the c-axis direction at the Fermi level.