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Hand, foot, and mouth disease (HFMD) shows spatiotemporal heterogeneity in China. A spatiotemporal filtering model was constructed and applied to HFMD data to explore the underlying spatiotemporal structure of the disease and determine the impact of different spatiotemporal weight matrices on the results. HFMD cases and covariate data in East China were collected between 2009 and 2015. The different spatiotemporal weight matrices formed by Rook, K-nearest neighbour (KNN; K = 1), distance, and second-order spatial weight matrices (SO-SWM) with first-order temporal weight matrices in contemporaneous and lagged forms were decomposed, and spatiotemporal filtering model was constructed by selecting eigenvectors according to MC and the AIC. We used MI, standard deviation of the regression coefficients, and five indices (AIC, BIC, DIC, R2, and MSE) to compare the spatiotemporal filtering model with a Bayesian spatiotemporal model. The eigenvectors effectively removed spatial correlation in the model residuals (Moran’s I < 0.2, p > 0.05). The Bayesian spatiotemporal model’s Rook weight matrix outperformed others. The spatiotemporal filtering model with SO-SWM was superior, as shown by lower AIC (92,029.60), BIC (92,681.20), and MSE (418,022.7) values, and higher R2 (0.56) value. All spatiotemporal contemporaneous structures outperformed the lagged structures. Additionally, eigenvector maps from the Rook and SO-SWM closely resembled incidence patterns of HFMD.
The emotion regulation network (ERN) in the brain provides a framework for understanding the neuropathology of affective disorders. Although previous neuroimaging studies have investigated the neurobiological correlates of the ERN in major depressive disorder (MDD), whether patients with MDD exhibit abnormal functional connectivity (FC) patterns in the ERN and whether the abnormal FC in the ERN can serve as a therapeutic response signature remain unclear.
Methods
A large functional magnetic resonance imaging dataset comprising 709 patients with MDD and 725 healthy controls (HCs) recruited across five sites was analyzed. Using a seed-based FC approach, we first investigated the group differences in whole-brain resting-state FC of the 14 ERN seeds between participants with and without MDD. Furthermore, an independent sample (45 MDD patients) was used to evaluate the relationship between the aforementioned abnormal FC in the ERN and symptom improvement after 8 weeks of antidepressant monotherapy.
Results
Compared to the HCs, patients with MDD exhibited aberrant FC between 7 ERN seeds and several cortical and subcortical areas, including the bilateral middle temporal gyrus, bilateral occipital gyrus, right thalamus, calcarine cortex, middle frontal gyrus, and the bilateral superior temporal gyrus. In an independent sample, these aberrant FCs in the ERN were negatively correlated with the reduction rate of the HAMD17 score among MDD patients.
Conclusions
These results might extend our understanding of the neurobiological underpinnings underlying unadaptable or inflexible emotional processing in MDD patients and help to elucidate the mechanisms of therapeutic response.
The stability of Taylor–Couette flow modulated by oscillatory wall suction/blowing is investigated using Floquet linear stability analysis. The growth rate and stability mode are obtained by numerical calculation and asymptotic expansion. By calculating the effect of wall suction/blowing on the critical mode of steady Taylor–Couette flow, it is found that for most suction/blowing parameters, the maximum disturbance growth rate of the critical mode decreases and the flow becomes more stable. Only in a very small parameter region, wall suction/blowing increases the maximum disturbance growth rate of the critical mode, resulting in flow instability when the gap between the cylinders is large. The asymptotic results for small suction/blowing amplitudes indicate that the change of flow instability is mainly due to the steady correction of the basic flow induced by the modulation. A parametric study of the critical inner Reynolds number and the associated critical wavenumber is performed. It is found that the flow is stabilized by the modulation for most of the parameter ranges considered. For a wide gap between the cylinders, it is possible for the system to be mildly destabilized by weak suction/blowing.
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.
Care of the dying is an essential part of holistic cancer nursing. Improving nurses’ attitudes and behaviors regarding care of the dying is one of the critical factors in increasing the quality of nursing service. This study aims to examine the impact of an educational program based on the CARES tool on nurses’ attitudes and behaviors toward care of the dying.
Methods
A quasi-experimental study with pre- and post-intervention measures was conducted. A total of 222 oncology nurses from 14 hospitals in Beijing, China, were enrolled using a convenient sampling method. This online educational course developed based on the CARES framework comprised 7 modules and 10 sessions. Each session was carried out twice a week over 30–60 min. Data were collected using a sociodemographic characteristics questionnaire, the Frommelt Attitude Towards Care of the Dying Scale (FATCOD) and the Nurses’ Practice Behavior Toward Care of the Dying Questionnaire (NPBTCOD). Reassessment of attitudes and behaviors was conducted when completed the learning and 6 months after the learning, respectively. The sociodemographic characteristics of the nurses were analyzed using descriptive statistics, and differences in attitudes and behaviors were reported and compared by the paired t-test.
Results
All the 222 oncology nurses completed educational courses, and 218 nurses (98.20%) completed the pre- and post-attitudes evaluation and 213 (95.9%) nurses completed the pre- and post-behaviors evaluation. The mean (SD) FATCOD score before and after the educational program was 108.83 (12.07) versus 115.09 (14.91), respectively (t = −8.546, p ≥ 0.001). The mean (SD) NPBTCOD score before and after the educational program was 69.14 (17.56) versus 73.40 (18.96), respectively (t = −3.231, p = 0.001).
Significance of results
This educational intervention was found to be an effective method for improving oncology nurses’ attitudes and behaviors toward caring for dying patients.
We define a knot to be half ribbon if it is the cross-section of a ribbon 2-knot, and observe that ribbon implies half ribbon implies slice. We introduce the half ribbon genus of a knot K, the minimum genus of a ribbon knotted surface of which K is a cross-section. We compute this genus for all prime knots up to 12 crossings, and many 13-crossing knots. The same approach yields new computations of the double slice genus. We also introduce the half fusion number of a knot K, that measures the complexity of ribbon 2-knots of which K is a cross-section. We show that it is bounded below by the Levine–Tristram signatures, and differs from the standard fusion number by an arbitrarily large amount.
This study investigates neuropsychological and psychosocial outcomes in patients with traumatic brain injury (TBI) and post-traumatic epilepsy (PTE) compared to a healthy control group.
Method:
Utilizing a quasi-experimental cross-sectional design, the research involved patients with TBI and PTE referred from a Taiwanese medical center. An age- and education-matched control group of healthy adults without traumatic injuries was also recruited. The study involved analyzing retrospective medical records and applying a comprehensive suite of neuropsychological tests and psychosocial questionnaires.
Results:
Executive function measures revealed significantly reduced performance in both the TBI and PTE groups compared to controls. Specifically, the MoCA scores were lowest in the PTE group, followed by the TBI group, and highest in the controls. Measures of subjective symptomatology showed comparably elevated levels in both the TBI and PTE groups relative to controls.
Conclusion:
The research suggests that PTE may intensify the difficulties faced by individuals with TBI, but its impact on overall recovery might not be significant, considering the trajectory of the brain injury itself. Notably, the MoCA results indicate that cognitive deficits are more pronounced in PTE patients compared to those with TBI, underscoring the necessity for targeted neuropsychological assessments. Further investigation is essential to explore PTE’s broader neuropsychological and psychosocial impacts. These findings advocate for tailored care strategies that address both neuropsychological and psychosocial needs, ensuring comprehensive management of TBI and PTE.
As a required sample preparation method for 14C graphite, the Zn-Fe reduction method has been widely used in various laboratories. However, there is still insufficient research to improve the efficiency of graphite synthesis, reduce modern carbon contamination, and test other condition methodologies at Guangxi Normal University (GXNU). In this work, the experimental parameters, such as the reduction temperature, reaction time, reagent dose, Fe powder pretreatment, and other factors, in the Zn-Fe flame sealing reduction method for 14C graphite samples were explored and determined. The background induced by the sample preparation process was (2.06 ± 0.55) × 10–15, while the 12C– beam current were better than 40μA. The results provide essential instructions for preparing 14C graphite of ∼1 mg at the GXNU lab and technical support for the development of 14C dating and tracing, contributing to biology and environmental science.
The absorption and distribution of radiocarbon-labeled urea at the ultratrace level were investigated with a 14C-AMS biotracer method. The radiopharmaceutical concentrations in the plasma, heart, liver, spleen, lung, kidney, stomach, brain, bladder, muscle, testis, and fat of rats after oral administration of 14C urea at ultratrace doses were determined by AMS, and the concentration-time curves in plasma and tissues and pharmacokinetic distribution data were obtained. This study provides an analytical method for the pharmacokinetic parameters and tissue distribution of exogenous urea in rats at ultratrace doses and explores the feasibility of evaluation and long-term tracking of ultratrace doses of drugs with AMS.
We created a web-based design guide to transfer our previous research findings to better support design education in the digital health design area for improving patient experience. To seek insights to iteratively improve the design guide, we conducted a workshop with 19 MSc students who specialized in design for healthcare. The guide was perceived as having the potential to improve their understanding of digital PEx improvements, but the content clarity and information presentation need to be improved.
Determine the impact of limited implementation of a rapid blood culture identification (BCID) panel.
Design:
Retrospective cohort study.
Methods:
From February to April 2022, positive blood cultures identified via e-Plex BCID (Roche, Carlsbad, CA) were compared to those identified using standard microbial identification techniques. The primary outcomes assessed were time to optimal therapy, time to de-escalation of anti-MRSA (methicillin-resistant Staphylococcus aureus) agents, and time to de-escalation of anti-pseudomonal agents. Additional analysis investigated the impact of the availability of antimicrobial stewardship program support. This study was conducted at Grady Health System, a large metropolitan safety-net hospital in the southeastern United States.
Results:
A total of 253 blood cultures were included in this study (153 BCID and 100 standard). Blood culture identification use was associated with a reduction in median time to optimal antimicrobial therapy (43.4 vs 72.1 h, P < .001) and median time to de-escalation of anti-MRSA agents (27.7 vs 46.7 h, P = .006), and a trend towards reduction of median time to de-escalation of anti-pseudomonal agents (38.8 vs 54.8 h, P = .07). These reductions persisted when controlling for patient age, sex, intensive care unit status, Charlson Comorbidity Index, and antimicrobial stewardship program availability.
Conclusions:
Despite restricted use and lack of 24/7 antimicrobial stewardship program availability, BCID panel utilization was associated with earlier initiation of optimal therapy and pathogen identification with subsequent de-escalation of broad-spectrum antimicrobials, as compared to standard antimicrobial techniques. This suggests the potential for benefit from adopting novel diagnostic technologies outside of idealized fully-resourced settings.
The assessment of seed quality and physiological potential is essential in seed production and crop breeding. In the process of rapid detection of seed viability using tetrazolium (TZ) staining, it is necessary to spend a lot of labour and material resources to explore the pretreatment and staining methods of hard and solid seeds with physical barriers. This study explores the TZ staining methods of six hard seeds (Tilia miqueliana, Tilia henryana, Sassafras tzumu, Prunus subhirtella, Prunus sibirica, and Juglans mandshurica) and summarizes the TZ staining conditions required for hard seeds by combining the difference in fat content between seeds and the kinship between species, thus providing a rapid viability test method for the protection of germplasm resources of endangered plants and the optimization of seed bank construction. The TZ staining of six species of hard seeds requires a staining temperature above 35 °C and a TZ solution concentration higher than 1%. Endospermic seeds require shorter staining times than exalbuminous seeds. The higher the fat content of the seeds, the lower the required incubation temperature and TZ concentration for staining, and the longer the staining time. And the closer the relationship between the two species, the more similar their staining conditions become. The TZ staining method of similar species can be predicted according to the genetic distance between the phylogenetic trees, and the viability of new species can be detected quickly.
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.
The fall armyworm (FAW) Spodoptera frugiperda (J.E. Smith) is a highly damaging invasive omnivorous pest that has developed varying degrees of resistance to commonly used insecticides. To investigate the molecular mechanisms of tolerance to tetraniliprole, spinetoram, and emamectin benzoate, the enzyme activity, synergistic effect, and RNA interference were implemented in S. frugiperda. The functions of cytochrome P450 monooxygenase (P450) in the tolerance to tetraniliprole, spinetoram, and emamectin benzoate in S. frugiperda was determined by analysing changes in detoxification metabolic enzyme activity and the effects of enzyme inhibitors on susceptibility to the three insecticides. 102 P450 genes were screened via transcriptome and genome, of which 67 P450 genes were differentially expressed in response to tetraniliprole, spinetoram, and emamectin benzoate and validated by quantitative real-time PCR. The expression patterns of CYP9A75, CYP340AA4, CYP340AX8v2, CYP340L16, CYP341B15v2, and CYP341B17v2 were analysed in different tissues and at different developmental stages in S. frugiperda. Silencing CYP340L16 significantly increased the susceptibility of S. frugiperda to tetraniliprole, spinetoram, and emamectin benzoate. Furthermore, knockdown of CYP340AX8v2, CYP9A75, and CYP341B17v2 significantly increased the sensitivity of S. frugiperda to tetraniliprole. Knockdown of CYP340AX8v2 and CYP340AA4 significantly increased mortality of S. frugiperda to spinetoram. Knockdown of CYP9A75 and CYP341B15v2 significantly increased the susceptibility of S. frugiperda to emamectin benzoate. These results may help to elucidate the mechanisms of tolerance to tetraniliprole, spinetoram and emamectin benzoate in S. frugiperda.
Anorexia nervosa (AN) is a serious psychiatric illness that remains difficult to treat. Elucidating the neural mechanisms of AN is necessary to identify novel treatment targets and improve outcomes. A growing body of literature points to a role for dorsal fronto-striatal circuitry in the pathophysiology of AN, with increasing evidence of abnormal task-based fMRI activation within this network among patients with AN. Whether these abnormalities are present at rest and reflect fundamental differences in brain organization is unclear.
Methods
The current study combined resting-state fMRI data from patients with AN (n = 89) and healthy controls (HC; n = 92) across four studies, removing site effects using ComBat harmonization. First, the a priori hypothesis that dorsal fronto-striatal connectivity strength – specifically between the anterior caudate and dlPFC – differed between patients and HC was tested using seed-based functional connectivity analysis with small-volume correction. To assess specificity of effects, exploratory analyses examined anterior caudate whole-brain connectivity, amplitude of low-frequency fluctuations (ALFF), and node centrality.
Results
Compared to HC, patients showed significantly reduced right, but not left, anterior caudate-dlPFC connectivity (p = 0.002) in small-volume corrected analyses. Whole-brain analyses also identified reduced connectivity between the right anterior caudate and left superior frontal and middle frontal gyri (p = 0.028) and increased connectivity between the right anterior caudate and right occipital cortex (p = 0.038). No group differences were found in analyses of anterior caudate ALFF and node centrality.
Conclusions
Decreased coupling of dorsal fronto-striatal regions indicates that circuit-based abnormalities persist at rest and suggests this network may be a potential treatment target.
Let $f: M\rightarrow M$ be a $C^{1+\alpha }$ diffeomorphism on an $m_0$-dimensional compact smooth Riemannian manifold M and $\mu $ a hyperbolic ergodic f-invariant probability measure. This paper obtains an upper bound for the stable (unstable) pointwise dimension of $\mu $, which is given by the unique solution of an equation involving the sub-additive measure-theoretic pressure. If $\mu $ is a Sinai–Ruelle–Bowen (SRB) measure, then the Kaplan–Yorke conjecture is true under some additional conditions and the Lyapunov dimension of $\mu $ can be approximated gradually by the Hausdorff dimension of a sequence of hyperbolic sets $\{\Lambda _n\}_{n\geq 1}$. The limit behaviour of the Carathéodory singular dimension of $\Lambda _n$ on the unstable manifold with respect to the super-additive singular valued potential is also studied.
This study aims to gain insight into each attribute as presented in the value of implantable medical devices, quantify attributes’ strength and their relative importance, and identify the determinants of stakeholders’ preferences.
Methods
A mixed-methods design was used to identify attributes and levels reflecting stakeholders’ preference toward the value of implantable medical devices. This design combined literature reviewing, expert’s consultation, one-on-one interactions with stakeholders, and a pilot testing. Based on the design, six attributes and their levels were settled. Among 144 hypothetical profiles, 30 optimal choice sets were developed, and healthcare professionals (decision-makers, health technology assessment experts, hospital administrators, medical doctors) and patients as stakeholders in China were surveyed. A total of 134 respondents participated in the survey. Results were analyzed by mixed logit model and conditional logit model.
Results
The results of the mixed logit model showed that all the six attributes had a significant impact on respondents’ choices on implantable medical devices. Respondents were willing to pay the highest for medical devices that provided improvements in clinical safety, followed by increased clinical effectiveness, technology for treating severe diseases, improved implement capacity, and innovative technology (without substitutes).
Conclusions
The findings of DCE will improve the current evaluation on the value of implantable medical devices in China and provide decision-makers with the relative importance of the criteria in pricing and reimbursement decision-making of implantable medical devices.
The Tuluanshan Formation of the eastern Coastal Range of Taiwan overlies an andesitic core complex presumed to be the source of hydrothermal fluids responsible for the Si- and Mg-rich mineralization of sepiolite and palygorskite (attapulgite) which are found in veins within fissures and in fracture zones of the volcanic rocks of the region. This study was undertaken in order to understand these relationships better by characterizing sepiolite and palygorskite in this Formation and by examining their occurrence and distribution in the Tungho (TH) and Chunjih (CJ) areas. Samples were analyzed using X-ray diffraction (XRD), thermal analysis, Fourier-transform infrared (FTIR) spectroscopy, and petrographic, scanning (SEM), and transmission (TEM) electron microscopic methods. Sepiolite and palygorskite are blocky and earthy-type materials that display fibrous characteristics when viewed using TEM and SEM and occurred alone or with chalcedony in veins. The fibers of blocky sepiolite are commonly intercalated with smectite but the earthy type of sepiolite and palygorskite observed in this study displayed precipitation from fluid enriched in Si, Al, Mg, and minor Fe and depleted in other ions at an earlier stage of offset of the andesitic veins. Continuation of reverse faulting and high shearing stress caused the precipitation of a significant quantity of interlaminated sepiolite. Sepiolite and palygorskite were formed at an earlier stage of fluid interaction relative to smectite in the Tuluanshan Formation.
Mineral-microbe interactions are widespread in a number of environmental processes such as mineral weathering, decomposition, and transformation. Both clay minerals and silicate-weathering bacteria are widely distributed in nature, and the latter contribute to weathering, diagenesis, and mineralization of major rock-forming minerals. The purpose of this study was to observe changes in the chemical composition and structure, especially the phase transformation, of smectite after processing by a silicate-weathering bacterium. The interaction between Bacillus mucilaginosus and bentonite was studied using custom culture media. Results from Inductively Coupled Plasma-Atomic Emission Spectrometry revealed that the bacterium promoted release of Si and Al from solid bentonite to solution. Concomitantly, the Ka nd Fe contents of the mineral increased as shown by X-ray photoelectron spectroscopy results. After interaction with the bacterium, the montmorillonite underwent a possible structure transformation to smectite, as indicated by the emergence of a new weak peak (d = 9.08 Å) shown by X-ray diffraction patterns. The mineralogical changes were also demonstrated by the decrease in the specific surface area of the mineral from 33.0 to 24.0 m2/g (these lower values for SSA of bentonite are related to the particle size of the smectite examined (120-160 mesh) and the weakened absorption bands in Al-O-H and Si-O-Si vibrations by Micro Fourier-transform infrared spectroscopy. The morphology changes in the bacteria observed by environmental scanning electron microscopy and atomic force microscopy revealed an obvious growth of the flagella in the presence of bentonite.