Educational degree differences in the association between work stress and depression among Chinese healthcare workers: Job satisfaction and sleep quality as the mediators

BackgroundDepressive status of medical personnel worldwide and especially in China is an important public health and social problem. There is a strong relationship between education and depression, but no studies have studied grouping healthcare workers (HCWs) with different educational degree to discuss whether there are differences in the factors that affect depression. This study aims to examine the role of job satisfaction and sleep quality in the relationship between work stress and depression among Chinese HCWs, and teste whether the mediation models are differed by the differences of educational degree.MethodsPatient Health Questionnaire-9 (PHQ-9) scale was used to test depression. Work stress was assessed using the Challenge-blocking stress scale (CBSS). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). HCWs’ satisfaction with their current work was assessed using the Job Satisfaction Index (JSI). The representative sample of HCWs was chosen using a multi-stage stratified cluster random sampling procedure and 844 HCWs were utilized to the statistical analysis of the study.ResultsIn the overall sample, sleep quality could mediate the relationship between work stress and depression in healthcare workers (p < 0.001, CMIN/DF = 3.816, GFI = 0.911, AGFI = 0.886, IFI = 0.943, TLI = 0.933, CFI = 0.942, RMSEA = 0.058, SRMR = 0.055, AIC = 1039.144), and the mediating effect accounted for 36.5%. After grouping educational qualifications, the model with sleep quality and job satisfaction as mediating variables reported a better fit in the group with low educational qualifications. The intermediary effect accounted for 50.6 and 4.43%, respectively. The highly educated group only has sleep quality as an intermediary variable in the structural model, and the mediating effect accounted for 75.4% (p < 0.001, CMIN/DF = 2.596, GFI = 0.887, AGFI = 0.857, IFI = 0.937, TLI = 0.926, CFI = 0.937, RMSEA = 0.044, SRMR = 0.056, AIC = 1481.322).ConclusionIn the overall sample, sleep quality could mediate the relationship between work stress and depression in HCWs. Among HCWs with technical secondary school education and below, job satisfaction can mediate the positive relationship between work stress and depression, while this mediating effect is not significant among HCWs with college degree and above

Broadband vibration energy harvesting from underground trains for self-powered condition monitoring

A broadband vibration energy harvester tailored for self-powered condition monitoring of underground trains is proposed and developed using mechanical non-linearity and integrated multi-mode vibration. A datadriven approach is adopted for harvester design using operational vibration data on a train bogie. The harvester is designed to be unobtrusive while exhibiting good performance in harvesting energy over a wide bandwidth. In this work, the on-site vibration data are first analysed with the design goals identified. Then, a broadband harvester is proposed, implemented and evaluated. The harvester consists of a pre-stretched hosting beam and a group of micro-beams with repulsive magnetic forces on their free ends. A multiple vibration-mode harvester with non-linear dynamics is obtained in such a design. This harvester exhibits good performance over a broad bandwidth in frequency sweep and pseudo-random tests, illustrating its capability in self-powered condition monitoring applications.</div

Time-resolved transcriptomic and proteomic profiling of Heyndrickxia coagulans during NaOH-buffered L-lactic acid production

The L-lactic acid (L-LA) fermentation process, based on sodium hydroxide neutralization, demonstrates environmental friendliness during product extraction. However, lactate fermentation is hindered by the pronounced stress effect of sodium lactate on the strain compared with calcium lactate. In this study, we performed time-resolved transcriptomic and proteomic analyses of Heyndrickxia coagulans DSM1 during NaOH-buffered L-LA production. The expression levels of the glycolytic genes demonstrated an initial increase followed by a subsequent decrease, whereas the tricarboxylic acid cycle genes exhibited an initial decrease followed by a subsequent increase throughout the fermentation process. Moreover, we identified clusters of genes consisting of transcription factors and ATP-binding cassette (ABC) transporters that demonstrate a progressive elevation of expression levels throughout the fermentation process, with significant upregulation observed at later stages. This investigation yields valuable insights into the response mechanisms of H. coagulans during NaOH-buffered L-LA fermentation and presents potential targets for metabolic engineering

Burnout and Associated Factors among Family Doctor Team Members in Different Types of Primary Healthcare Institutions：a Comparative Study

BackgroundBurnout has become a prominent issue as the increase of workload in family doctor team members in primary healthcare institutions during the promotion of contracted family doctor services. There is still a lack of research comparing the differences in burnout among family doctor team members in different types of primary healthcare institutions.ObjectiveTo compare burnout prevalence and associated factors between family doctors in community/township health centers, and those in community health stations/village clinics, providing a basis for improving the mental health status and team stability of family doctors, as well as the quality of services provided by them.MethodsFrom August 1 to 21, 2020, a multistage cluster random sampling method was used to select 760 family doctor team members〔201 (26.4%) working at community/township health centers, and 559 (73.6%) working at community health stations/village clinics〕 as the participants from primary healthcare institutions in 6 counties/county-level cities /districts of Taian City, Shandong Province. They were invited to attend a survey to complete Demographic Questionnaire and the Chinese version of Maslach Burnout Inventory-General Survey (MBI-GS) .ResultsOverall, the prevalence of burnout among the participants was 68.9% (524/760) . Overall, the prevalence of burnout among the participants was 68.9% (524/760) , and the prevalence of burnoutof family doctor team members in community/township health centers and community health stations/village clinics was 63.7% (128/201) and 70.8% (396/559) , respectively. The levels of burnout of family doctor team members in community health stations/village clinics was higher than that of those in community/township health centers, with a statistically significant difference (P&lt;0.05) . Family doctor team members in community health stations/village clinics had higher total score of MBI-GS and higher subscale score of reduction of professional efficacy than did those in community /township health centers, with a statistically significant difference (P&lt;0.05) . Multivariate Logistic regression analysis showed that: for family doctor team members in community/township health centers, the risk of burnout of those aged 41-50 years is higher than that aged≤30 years〔OR (95%CI) =7.119 (1.770, 28.638) 〕, the risk of burnout of those with monthly income &gt;4 000 yuan is lower than that with monthly income &lt;2 000 yuan〔OR (95%CI) =0.194 (0.040, 0.941) 〕, the risk of burnout of those with high/very high self-rated work pressure is higher than that of those without/little self-rated work pressure〔OR (95%CI) =3.629 (1.475, 8.929) 〕, the risk of job burnout of those who evaluated the incentive mechanism as ordinary and relative effective/very effective was lower than that evaluated the incentive mechanism as very ineffective/less effective〔OR (95%CI) were 0.196 (0.052, 0.739) and 0.235 (0.066, 0.834) 〕. For the family doctor team members in community health stations/village clinics, the risk of burnout in women is lower than that in men〔OR (95%CI) =0.603 (0.396, 0.920) 〕, the risk of job burnout of those with general and relatively high/very high self-assessment residents&apos; recognition is lower than that with very low/relatively low self-assessment residents&apos; recognition〔OR (95%CI) were 0.258 (0.113, 0.590) and 0.428 (0.199, 0.918) 〕, the risk of burnout of those with high/very high self-rated job stress is higher than that without/little self-rated job stress〔OR (95%CI) =2.320 (1.368, 3.935) 〕.ConclusionFamily doctor team members in community health stations/village clinics demonstrated higher burnout prevalence, and lower professional efficacy. To reduce the burnout prevalence and improve professional efficacy in family doctor team members, it is suggested to strengthen trainings, increase salary and further improve incentive mechanism for those in community/township health centers, and to increase the number of officially budgeted posts, and promotion opportunities as well as the propaganda of contracted family doctor services for those in community health stations/village clinics. Moreover, the workflow of contracting family doctor services should be simplified in all these institutions

Methylprednisolone as Adjunct to Endovascular Thrombectomy for Large-Vessel Occlusion Stroke

Importance It is uncertain whether intravenous methylprednisolone improves outcomes for patients with acute ischemic stroke due to large-vessel occlusion (LVO) undergoing endovascular thrombectomy. Objective To assess the efficacy and adverse events of adjunctive intravenous low-dose methylprednisolone to endovascular thrombectomy for acute ischemic stroke secondary to LVO. Design, Setting, and Participants This investigator-initiated, randomized, double-blind, placebo-controlled trial was implemented at 82 hospitals in China, enrolling 1680 patients with stroke and proximal intracranial LVO presenting within 24 hours of time last known to be well. Recruitment took place between February 9, 2022, and June 30, 2023, with a final follow-up on September 30, 2023.InterventionsEligible patients were randomly assigned to intravenous methylprednisolone (n = 839) at 2 mg/kg/d or placebo (n = 841) for 3 days adjunctive to endovascular thrombectomy. Main Outcomes and Measures The primary efficacy outcome was disability level at 90 days as measured by the overall distribution of the modified Rankin Scale scores (range, 0 [no symptoms] to 6 [death]). The primary safety outcomes included mortality at 90 days and the incidence of symptomatic intracranial hemorrhage within 48 hours. Results Among 1680 patients randomized (median age, 69 years; 727 female [43.3%]), 1673 (99.6%) completed the trial. The median 90-day modified Rankin Scale score was 3 (IQR, 1-5) in the methylprednisolone group vs 3 (IQR, 1-6) in the placebo group (adjusted generalized odds ratio for a lower level of disability, 1.10 [95% CI, 0.96-1.25]; P = .17). In the methylprednisolone group, there was a lower mortality rate (23.2% vs 28.5%; adjusted risk ratio, 0.84 [95% CI, 0.71-0.98]; P = .03) and a lower rate of symptomatic intracranial hemorrhage (8.6% vs 11.7%; adjusted risk ratio, 0.74 [95% CI, 0.55-0.99]; P = .04) compared with placebo. Conclusions and Relevance Among patients with acute ischemic stroke due to LVO undergoing endovascular thrombectomy, adjunctive methylprednisolone added to endovascular thrombectomy did not significantly improve the degree of overall disability.Trial RegistrationChiCTR.org.cn Identifier: ChiCTR210005172

Relationship between hearing loss and depression symptoms among older adults in China: The mediating role of social isolation and loneliness.

OBJECTIVES: To evaluate whether social isolation and loneliness mediates the relationship between hearing loss and depression symptoms in older adults in China. METHODS: A cross-sectional analysis was conducted of 3769 participants (aged≥60 years) in Shandong province of China. Hearing loss was assessed using Pure-Tone Audiometry test, depression symptoms using 15-item Geriatric Depression Scale, loneliness through UCLA Loneliness Scale and social isolation using Lubben Social Network Scale. Regression and bootstrap analyses were performed to test both direct associations of hearing loss and depression symptoms, and whether the mediating role of social isolation and loneliness. RESULTS: Overall, 44% of older adults had hearing loss, which was generally mild (30%) rather than moderate (10%), severe (3%) or profound (0.6%). Increasing levels of hearing loss was associated with increasing levels of social isolation and depressions. Hearing loss was also associated with loneliness, but here a threshold effect was apparent and no trend for increasing loneliness with increasing hearing loss. Models that included social isolation and loneliness showed an amelioration in the association of hearing loss and depression, although it remained significant at all levels of hearing loss. Overall, 8% of the total effect of hearing loss on depression symptoms was explained by the mediated effect through social isolation and 42% by loneliness. CONCLUSIONS: Psychosocial factors such as social isolation and loneliness might explain the association between hearing loss and depression. Interventions that address older adults' social isolation and loneliness may ameliorate depression in older adults with hearing loss

Prognostic value of inflammatory markers NLR, PLR, and LMR in gastric cancer patients treated with immune checkpoint inhibitors: a meta-analysis and systematic review

BackgroundImmune checkpoint inhibitors (ICIs) represent a groundbreaking approach to cancer therapy. Inflammatory markers such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) have emerged as potential indicators strongly associated with tumor prognosis, albeit their prognostic significance remains contentious. The predictive value of NLR, PLR, LMR in patients with gastric cancer (GC) treated with ICIs has not been fully explored; therefore, we conducted a meta-analysis to examine the potential of inflammatory markers NLR, PLR, and LMR as survival predictors in this population.MethodsA comprehensive search was conducted across PubMed, Embase, Web of Science, and Cochrane databases, with the search cut-off date set as March 2024. Hazard ratios (HR) and their corresponding 95% confidence intervals (CI) were calculated to assess the prognostic significance of NLR, PLR, and LMR for both progression-free survival (PFS) and overall survival (OS).ResultsFifteen cohort studies involving 1336 gastric cancer patients were finally included in this meta-analysis. The results of the meta-analysis showed that high levels of NLR were associated with poorer OS and PFS in GC patients receiving ICIs, with combined HRs of OS [HR=2.01, 95%CI (1.72,2.34), P&lt;0.01], and PFS PFS[HR=1.59, 95%CI (1.37,1.86), P&lt;0.01], respectively; high levels of PLR were associated with poorer OS and PFS, and the combined HR was OS [HR=1.57, 95%CI (1.25,1.96), P&lt;0.01], PFS [HR=1.52,95%CI (1.20, 1.94), P&lt;0.01], respectively; and there was an association between elevated LMR and prolonged OS and PFS, and the combined HR was OS [HR=0.62, 95%CI (0.47,0.81), P&lt;0.01], and PFS [HR=0.69, 95%CI (0.50,0.95), P&lt;0.01].ConclusionIn gastric cancer (GC) patients treated with immune checkpoint inhibitors (ICIs), elevated neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with poorer overall survival (OS) and progression-free survival (PFS), while high lymphocyte-to-monocyte ratio (LMR) was linked to improved OS and PFS. Subgroup analyses suggested that NLR might be particularly pertinent to the prognosis of GC patients. In conclusion, the inflammatory markers NLR, PLR, and LMR serve as effective biomarkers for prognostic assessment in GC patients, offering valuable insights for therapeutic decision-making in the realm of GC immunotherapy. Prospective studies of high quality are eagerly awaited to validate these findings in the future.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier CRD42024524321

Deep Unsupervised Hashing with Latent Semantic Components

Deep unsupervised hashing has been appreciated in the regime of image retrieval. However, most prior arts failed to detect the semantic components and their relationships behind the images, which makes them lack discriminative power. To make up the defect, we propose a novel Deep Semantic Components Hashing (DSCH), which involves a common sense that an image normally contains a bunch of semantic components with homology and co-occurrence relationships. Based on this prior, DSCH regards the semantic components as latent variables under the Expectation-Maximization framework and designs a two-step iterative algorithm with the objective of maximum likelihood of training data. Firstly, DSCH constructs a semantic component structure by uncovering the fine-grained semantics components of images with a Gaussian Mixture Modal~(GMM), where an image is represented as a mixture of multiple components, and the semantics co-occurrence are exploited. Besides, coarse-grained semantics components, are discovered by considering the homology relationships between fine-grained components, and the hierarchy organization is then constructed. Secondly, DSCH makes the images close to their semantic component centers at both fine-grained and coarse-grained levels, and also makes the images share similar semantic components close to each other. Extensive experiments on three benchmark datasets demonstrate that the proposed hierarchical semantic components indeed facilitate the hashing model to achieve superior performance.Comment: 9 pages, 15 figure

Effect of Particle Size on the Aerobic and Anaerobic Digestion Characteristics of Whole Rice Straw

The effect of reducing particle size on physical properties, the methane yield and energy flow were investigated through the biochemical methane potential (BMP) experiment of aerobic-anaerobic digestion (AAD) of rice straw (RS). The whole straw was crushed through four sieves of different aperture sizes (1, 3, 5, and 7 mm) to obtain the actual and non-uniform particle size distribution (PSD). The results indicated that the actual particle sizes were normally or logarithmic normally distributed. Reducing particle size could significantly promote the aerobic hydrolysis and acidification process, increase the content of volatile fatty acids (VFAs) from 4408.78 to 6225.15 mg/L and the degradation of volatile solids (VS) from 40.56% to 50.49%. The results of path analysis suggested that particle size reduction played an important role in improving lignocellulosic degradability, which was the main factor affecting methane production with the comprehensive decision of 0.4616. The maximum methane production obtained at 1 mm sieve size was 176.47 mLCH4g−1 VS. The phyla of Firmicutes (61.5%), Proteobacteria (9.3%), Chloroflexi (8.3%), Bacteroidetes (4.1%), Cyanobacteria/Chloroplast (4.6%) were mainly responsible for VFAs production and lignocellulose degradation. However, the net negative energy balance was observed at the 1 mm sieve size due to the increased energy input. Therefore, the optimum sieve size for AAD was 3 mm

Assessing variability of optimum air temperature for photosynthesis across site-years, sites and biomes and their effects on photosynthesis estimation

Gross primary productivity (GPP) of vegetation is affected by air temperature. Biogeochemical models use the optimum air temperature (Topt) parameter, which comes from biome-specific look-up tables (Topt−b−LT). Many studies have shown that plants have the capacity to adapt to changes in environmental conditions over time, which suggests that the static Topt−b−LT parameters in the biogeochemical models may poorly represent actual Topt and induce uncertainty in GPP estimates. Here, we estimated biome-specific, site-year-specific, and site-specific optimum air temperature using GPP data from eddy covariance (EC) flux tower sites (GPPEC) (Topt−b−EC, Topt−sy−EC, Topt−s−EC), the Enhanced Vegetation Index (EVI) from MODIS images (Topt−b−EVI, Topt−sy−EVI, Topt−s−EVI), and mean daytime air temperature (TDT). We evaluated the consistency among the four Topt parameters (Topt−b, Topt−sy, Topt−s and Topt−b−LT), and assessed how they affect satellite-based GPP estimates. We find that Topt parameters from MODIS EVI agree well with those from GPPEC, which indicates that EVI can be used as a variable to estimate Topt at individual pixels over large spatial domains. Topt−b, Topt−sy, and Topt−s differed significantly from Topt−b−LT. GPP estimates using Topt−b and Topt−sy were more consistent with GPPEC than when using Topt−b−LT for all the land cover types. Our use of Topt−sy substantially improved 8-day and annual GPP estimates across biomess (from 1% to 34%), especially for cropland, grassland, and open shrubland. Our simple calculation shows that global GPP estimates differ by up to 10 Pg C/yr when using our suggested Topt−sy−EVI instead of using the static Topt−b−LT. Our new approach on estimating Topt has the potential to improve estimates of GPP from satellite-based models, which could lead to better understanding of carbon-climate interactions