The Mediating Role of Fatigue Between Mental Health and Its Associated Factors: Evidence From Chinese Healthcare Workers During the COVID-19 Pandemic

The aim of this study was to explore the mediating role of fatigue between mental health and its associated factors, including workload, social support, and occupational protection, among healthcare workers during the COVID-19 pandemic in China. A national cross-sectional survey was performed to collect data from healthcare workers who have attended to patients with COVID-19. Structural equation modeling (SEM) was conducted to test the mediating effect of fatigue. The results indicated that fatigue was a significant mediator of mental health. The proportion of indirect effect with regards to the total effect of workload on mental health was 54.2%, significantly greater than other factors such as social support (19.7%) and occupational protection (23.4%). The findings confirmed that workload, social support, and occupational protection both had indirect and direct effects on mental health status through fatigue. To some extent, potential interventions designed to alleviate fatigue would reduce mental health problems among healthcare workers during the COVID-19 pandemic

A Systematic Molecular Pathology Study of a Laboratory Confirmed H5N1 Human Case

Autopsy studies have shown that human highly pathogenic avian influenza virus (H5N1) can infect multiple human organs other than just the lungs, and that possible causes of organ damage are either viral replication and/or dysregulation of cytokines and chemokines. Uncertainty still exists, partly because of the limited number of cases analysed. In this study, a full autopsy including 5 organ systems was conducted on a confirmed H5N1 human fatal case (male, 42 years old) within 18 hours of death. In addition to the respiratory system (lungs, bronchus and trachea), virus was isolated from cerebral cortex, cerebral medullary substance, cerebellum, brain stem, hippocampus ileum, colon, rectum, ureter, aortopulmonary vessel and lymph-node. Real time RT-PCR evidence showed that matrix and hemagglutinin genes were positive in liver and spleen in addition to positive tissues with virus isolation. Immunohistochemistry and in-situ hybridization stains showed accordant evidence of viral infection with real time RT-PCR except bronchus. Quantitative RT-PCR suggested that a high viral load was associated with increased host responses, though the viral load was significantly different in various organs. Cells of the immunologic system could also be a target for virus infection. Overall, the pathogenesis of HPAI H5N1 virus was associated both with virus replication and with immunopathologic lesions. In addition, immune cells cannot be excluded from playing a role in dissemination of the virus in vivo

Multi-skeleton model for top-down design of complex products

Generally, there are two alternative design approaches available to engineers: bottom-up and top-down. Considering the sharp increase in the complexity of most mechanical products, the top-down design approach is more widely adopted in the development of complex products. However, in traditional top-down design process, design parameters are communicated through single-skeleton models, and design units are strongly coupled due to the multi-dimensional complexity of products. Toward this end, a new top-down design approach based on multi-skeleton model is proposed in this article. First, in accordance with different kinds of design parameters, three major skeleton models are defined, including location skeleton model, published skeleton model, and design skeleton model. And the characteristics of multi-skeleton models are also described. Then, the top-down design process based on the multi-skeleton model is explored, especially in the multi-skeleton modeling phase. It is also illustrated in detail that how to realize design parameter transmission and design unit reuse. Subsequently, it elaborates the communicating way and structure optimization of design parameters to support parameters controlled publishing and design units reuse. Finally, a meteorological satellite and a crawler crane design cases are implemented to expound the feasibility and effectiveness of the proposed framework