How physicians respond to negative emotions in high-risk preoperative conversations

This work was supported by the China Medical Board, CMB 14-200.Objective To investigate physicians’ responses to negative emotions in high-risk preoperative conversations; and to explore the influencing factors of these responses. Methods One hundred and sixty-two audio recordings were coded using the Chinese Verona Coding Definition of Emotional Sequences (VR-CoDES). Big Five Personality Inventory Brief Version and Emotional Intelligence Scale were administered to explore the influencing factors of physicians’ responses. SPSS 24.0 and R 3.6.3 LME4 Package were used for data analysis. Results Reduce Space (83%), referring to physicians’ responses reducing the opportunities of patients to disclose emotions, was physicians’ most frequent response to patients or families’ emotions. The main responses were Information-advice (ERIa) and Ignoring (NRIa). Younger age, female, Agreeableness and Openness were factors positively associated with Explicit Provide Space (EP); Neuroticism was negatively correlated with EP. Extroversion was negatively correlated with Explicit Reduce Space (ER); Conscientiousness was negatively correlated with both EP and ER responses. Emotional intelligence had no significant influence on physicians’ responses. Conclusion The majority of physicians were inclined to reduce space by providing information advice or ignoring. Physicians’ responses were correlated with their gender, age and personality traits. Practice Implications The trainees’ gender, age and personality should be considered when conducting doctor-patient communication skills training.Publisher PDFPeer reviewe

Influence of long-term fertilization on soil aggregates stability and organic carbon occurrence characteristics in karst yellow soil of Southwest China

Current research has long focused on soil organic carbon and soil aggregates stability. However, the effects of different long-term fertilization on the composition of yellow soil aggregates and the characteristics of the occurrence of organic carbon in the karst region of Southwest China are still unclear. Based on a 25-year long-term located experiment on yellow soil, soil samples from the 0–20 cm soil layer were collected and treated with different fertilizers (CK: unfertilized control; NPK: chemical fertilizer; 1/4 M + 3/4 NP: 25% chemical fertilizer replaced by 25% organic fertilizer; 1/2 M + 1/2 NP: 50% chemical fertilizer replaced by organic fertilizer; and M: organic fertilizer). In water-stable aggregates, soil aggregates stability, total organic carbon (TOC), easily oxidized organic carbon (EOC), carbon preservation capacity (CPC), and carbon pool management index (CPMI) were analyzed. The findings demonstrated that the order of the average weight diameter (MWD), geometric mean diameter (GWD), and macro-aggregate content (R0.25) of stable water aggregates was M > CK > 1/2M +1/2NP > 1/4M +3/4NP> NPK. The MWD, GWD, and R0.25 of NPK treatment significantly decreased by 32.6%, 43.2%, and 7.0 percentage points, respectively, compared to CK treatment. The order of TOC and EOC content in aggregates of different particle sizes was M > 1/2M +1/2NP > 1/4M +3/4NP> CK > NPK, and it increased as the rate of organic fertilizer increased. In macro-aggregates and bulk soil, the CPC of TOC (TOPC) and EOC (EOPC), as well as CPMI, were arranged as M > 1/2M +1/2NP > 1/4M +3/4NP> CK > NPK, but the opposite was true for micro-aggregates. In bulk soil treated with organic fertilizer, the TOPC, EOPC, and CPMI significantly increased by 27.4%–53.8%, 29.7%–78.1%, 29.7–82.2 percentage points, respectively, compared to NPK treatment. Redundancy analysis and stepwise regression analysis show that TOC was the main physical and chemical factor affecting the aggregates stability, and the TOPC in micro-aggregates has the most direct impact. In conclusion, the primary cause of the decrease in SOC caused by the long-term application of chemical fertilizer was the loss of organic carbon in macro-aggregates. An essential method to increase soil nutrient supply and improve yellow soil productivity was to apply an organic fertilizer to increase aggregates stability, storage and activity of SOC in macro-aggregates

The Impact of Whole Brain Global Functional Connectivity Density Following MECT in Major Depression: A Follow-Up Study

To explore the alteration of global functional connectivity density (gFCD) in depressive patients after modified electroconvulsive therapy (MECT) and analyze the relationship between gFCD and clinical outcome. Thirty-seven subjects were evaluated based on the diagnostic criteria of the International Classification of Diseases-10 (ICD-10), consisting of a depressive group (24 patients after follow-ups) and a healthy control group with 13 normal individuals. All participants received Hamilton Depression Scale (HAMD) scores and resting-state functional magnetic resonance imaging scans. The gFCD significantly increased in the posterior-middle insula, the supra-marginal gyrus and the dorsal medial prefrontal cortex (dmPFC) before MECT treatment compared to healthy controlled patients. The gFCD statistically expanded in the perigenual anterior cingulate cortex (pgACC), the orbitofrontal cortex bilaterally and the left-supra-marginal gyrus after MECT, and it decreased notably in the posterior insula. The gFCD in the pgACC and the right orbital frontal cortex of depressive group before MECT showed a positive correlation with HAMD scores with treatment. Conforming to the impact of gFCD in depressive patients after MECT, the aforementioned brain region may become an indicator of MECT effect

Childhood Sexual Abuse and the Development of Recurrent Major Depression in Chinese Women

Background Our prior study in Han Chinese women has shown that women with a history of childhood sexual abuse (CSA) are at increased risk for developing major depression (MD). Would this relationship be found in our whole data set? Method Three levels of CSA (non-genital, genital, and intercourse) were assessed by self-report in two groups of Han Chinese women: 6017 clinically ascertained with recurrent MD and 5983 matched controls. Diagnostic and other risk factor information was assessed at personal interview. Odds ratios (ORs) were calculated by logistic regression. Results We confirmed earlier results by replicating prior analyses in 3,950 new recurrent MD cases. There were no significant differences between the two data sets. Any form of CSA was significantly associated with recurrent MD (OR 4.06, 95% confidence interval (CI) [3.19–5.24]). This association strengthened with increasing CSA severity: non-genital (OR 2.21, 95% CI 1.58–3.15), genital (OR 5.24, 95% CI 3.52–8.15) and intercourse (OR 10.65, 95% CI 5.56–23.71). Among the depressed women, those with CSA had an earlier age of onset, longer depressive episodes. Recurrent MD patients those with CSA had an increased risk for dysthymia (OR 1.60, 95%CI 1.11–2.27) and phobia (OR 1.41, 95%CI 1.09–1.80). Any form of CSA was significantly associated with suicidal ideation or attempt (OR 1.50, 95% CI 1.20–1.89) and feelings of worthlessness or guilt (OR 1.41, 95% CI 1.02–2.02). Intercourse (OR 3.47, 95%CI 1.66–8.22), use of force and threats (OR 1.95, 95%CI 1.05–3.82) and how strongly the victims were affected at the time (OR 1.39, 95%CI 1.20–1.64) were significantly associated with recurrent MD

Associations of Educational Attainment, Occupation, Social Class and Major Depressive Disorder among Han Chinese Women

Background The prevalence of major depressive disorder (MDD) is higher in those with low levels of educational attainment, the unemployed and those with low social status. However the extent to which these factors cause MDD is unclear. Most of the available data comes from studies in developed countries, and these findings may not extrapolate to developing countries. Examining the relationship between MDD and socio economic status in China is likely to add to the debate because of the radical economic and social changes occurring in China over the last 30 years. Principal findings We report results from 3,639 Chinese women with recurrent MDD and 3,800 controls. Highly significant odds ratios (ORs) were observed between MDD and full time employment (OR = 0.36, 95% CI = 0.25–0.46, logP = 78), social status (OR = 0.83, 95% CI = 0.77–0.87, logP = 13.3) and education attainment (OR = 0.90, 95% CI = 0.86–0.90, logP = 6.8). We found a monotonic relationship between increasing age and increasing levels of educational attainment. Those with only primary school education have significantly more episodes of MDD (mean 6.5, P-value = 0.009) and have a clinically more severe disorder, while those with higher educational attainment are likely to manifest more comorbid anxiety disorders. Conclusions In China lower socioeconomic position is associated with increased rates of MDD, as it is elsewhere in the world. Significantly more episodes of MDD occur among those with lower educational attainment (rather than longer episodes of disease), consistent with the hypothesis that the lower socioeconomic position increases the likelihood of developing MDD. The phenomenology of MDD varies according to the degree of educational attainment: higher educational attainment not only appears to protect against MDD but alters its presentation, to a more anxious phenotype

Bus transit subsidy under China’s transit metropolis initiative: The case of Shenzhen

Transit services are subsidized in various cities. Our article reviews bus transit subsidy in Shenzhen, one of China’s mega cities undertaking tremendous effort to strengthen transit service under the national transit metropolis initiative. The operational data of Shenzhen’s bus transit reveals that the past subsidy policy, which guaranteed 6% of profit, led to significant increase in operational cost per passenger kilometer. The recent switch toward a ridership-based subsidy helps to reverse this trend, but could risk service quality. Shenzhen’s experience has significant implications while China’s city governments implement transit-priority strategies. The gain of social benefit and the loss of operational efficiency have to be carefully balanced when designing subsidy programs

Distributed Economic Dispatch Control Method with Frequency Regulator for Smart Grid under Time-Varying Directed Topology

The paper studies a new distributed control method to solve the economic dispatch problem (EDP) under directed topology based on consensus protocol. Electrical equipment is closely related to frequency, and the frequency of each generator varies independently during operation. Therefore, it hinders the realization of economic dispatch. To solve the problem, we combine a frequency regulator with a consensus protocol, which eliminates the effect of frequency variation on the designed consensus algorithm. Meanwhile, considering the problem of excessive communication cost and low computational efficiency in large-scale power systems, an event-triggered mechanism is introduced into the designed algorithm. Furthermore, in order to overcome the unexpected loss of communication links, the time-varying topology mechanism is employed to develop the distributed economic dispatch (DED) algorithm to improve the robustness. Then, the stability of the above algorithm is proved by graph theory and convergence analysis. Finally, several simulations illustrate that our proposed methods are effective

Decentralized Primal-Dual Proximal Operator Algorithm for Constrained Nonsmooth Composite Optimization Problems over Networks

In this paper, we focus on the nonsmooth composite optimization problems over networks, which consist of a smooth term and a nonsmooth term. Both equality constraints and box constraints for the decision variables are also considered. Based on the multi-agent networks, the objective problems are split into a series of agents on which the problems can be solved in a decentralized manner. By establishing the Lagrange function of the problems, the first-order optimal condition is obtained in the primal-dual domain. Then, we propose a decentralized algorithm with the proximal operators. The proposed algorithm has uncoordinated stepsizes with respect to agents or edges, where no global parameters are involved. By constructing the compact form of the algorithm with operators, we complete the convergence analysis with the fixed-point theory. With the constrained quadratic programming problem, simulations verify the effectiveness of the proposed algorithm