Coping Strategies, Anxiety and Transition Readiness: A Test of Mediation in Adolescents with Chronic Conditions

Transition readiness is defined as the subjective or objective readiness for health care transition (i.e., transfer from pediatric to adult health care) in adolescents with chronic conditions. Anxiety has been linked to poor transition readiness, and adaptive coping strategies have been shown to effectively reduce anxiety in adolescents with chronic conditions. However, no study to date has explored the relationship between the three variables. The present study investigated the relationship between coping strategies, anxiety, and transition readiness in a sample of 185 adolescents (age 13.03 ± 2.02 years, 48.3% male) with various chronic conditions and their parents recruited from 2018 Victory Junction Camp. Campers and parents completed the child and parent versions of Kidcope, PROMIS anxiety subscale, and STARx through Qualtrics survey, respectively. Results showed that use of coping strategies was significantly correlated with transition readiness. Anxiety partially mediated the relationship between use of maladaptive coping strategies and self-reported transition readiness, but not the relationship between use of adaptive coping strategies and transition readiness. The use of coping strategies may be a direct influential factor for transition readiness, and anxiety may be more relevant to the relationship between use of maladaptive coping strategies and transition readiness. Implications for clinical rehabilitation and mental health counseling research and practice are discussed.Master of Scienc

Antibacterial Activity and Physical Properties of Fish Gelatin-Chitosan Edible Films Supplemented with D-Limonene

Fish gelatin-chitosan edible films with D-limonene were successfully prepared, which exhibited exceptional mechanical properties and antimicrobial activity. It has been demonstrated that water-soluble chitosan, fish gelatin, and D-limonene could be a candidate precursor to prepare low cost and high-performance edible food packaging material. The results showed that D-limonene in the films could effectively resist the penetration of light and water because of its hydrophobicity. Moreover, the elongation at break (EAB) increased with the addition of D-limonene, which indicated that D-limonene served as a strong plasticizer for the film. Microscopic characterization showed that D-limonene was uniformly distributed in the as-prepared film. And we found that the film exhibited strong antibacterial activity against Escherichia coli (E. coli). All the results indicate that the as-prepared film could be a promising food packaging

Activation of Interleukin-1β Release by the Classical Swine Fever Virus Is Dependent on the NLRP3 Inflammasome, Which Affects Virus Growth in Monocytes

Classical swine fever virus (CSFV) is a classic Flavivirus that causes the acute, febrile, and highly contagious disease known as classical swine fever (CSF). Inflammasomes are molecular platforms that trigger the maturation of proinflammatory cytokines to engage innate immune defenses that are induced upon cellular infection or stress. However, the relationship between the inflammasome and CSFV infection has not been thoroughly characterized. To understand the function of the inflammasome response to CSFV infection, we infected porcine peripheral blood monocytes (PBMCs) with CSFV. Our results indicated that CSFV infection induced both the generation of pro-interleukin-1β (pro-IL-1β) and its processing in monocytes, leading to the maturation and secretion of IL-1β through the activation of caspase 1. Moreover, CSFV infection in PBMCs induced the production and cleavage of gasdermin D (GSDMD), which is an inducer of pyroptosis. Additional studies showed that CSFV-induced IL-1β secretion was mediated by NLRP3 and that CSFV infection could sufficiently activate the assembly of the NLRP3 inflammasome in monocytes. These results revealed that CSFV infection inhibited the expression of NLRP3, and knockdown of NLRP3 enhanced the replication of CSFV. In conclusion, these findings demonstrate that the NLRP3 inflammasome plays an important role in the innate immune response to CSFV infection

Refining the ERA5-based global model for vertical adjustment of zenith tropospheric delay

Abstract Tropospheric delay is an important factor affecting high precision Global Navigation Satellite System (GNSS) positioning and also the basic data for GNSS atmospheric research. However, the existing tropospheric delay models have some problems, such as only a single function used for the entire atmosphere. In this paper, an ERA5-based (the fifth generation of European Centre for Medium-Range Weather Forecasts Reanalysis) global model for vertical adjustment of Zenith Tropospheric Delay (ZTD) using a piecewise function is developed. The ZTD data at 611 radiosonde stations and the MERRA-2 (second Modern-Era Retrospective analysis for Research and Applications) atmospheric reanalysis data were used to validate the model reliability. The Global Zenith Tropospheric Delay Piecewise (GZTD-P) model has excellent performance compared with the Global Pressure and Temperature (GPT3) model. Validated at radiosonde stations, the performance of the GZTD-P model was improved by 0.96 cm (23%) relative to the GPT3 model. Validated with MERRA-2 data, the quality of the GZTD-P model is improved by 1.8 cm (50%) compared to the GPT3 model, showing better accuracy and stability. The ZTD vertical adjustment model with different resolutions was established to enrich the model's applicability and speed up the process of tropospheric delay calculation. By providing model parameters with different resolutions, users can choose the appropriate model according to their applications

Does the leading pharmaceutical reform in China really solve the issue of overly expensive healthcare services? Evidence from an empirical study.

Healthcare system reform of Sanming city has become a leading healthcare reform model in China. It has developed a rigorous pharmaceutical reform consisted of the Zero Mark-up Drug Policy and the Centralized Procurement of Medicine Policy to bring down drug expenses and total health expenditures. However, despite the credit and much attention have been given to Sanming's pharmaceutical reform, its impact still remains unclear. Therefore, the purpose of this study was to explore the impact of the pharmaceutical reform of Sanming on both drug and total health expenditures.Interrupted time series analysis with three segments divided by two intervention points was employed to evaluate the impact of the pharmaceutical reform. Segment 1 was the pre-reform period which captured the baseline information. Segment 2 occurred after the first intervention point when the Zero Mark-up Drug Policy was implemented, whereas Segment 3 was after the implementation of the Centralized Procurement of Medicine Policy. Primary outcomes are outpatient drug expenditure, outpatient total health expenditure, inpatient drug expenditure, and inpatient total health expenditure. Data spanning from May 2012 to May 2014 are included.Both drug and total health expenditures exhibited rising trends before any policy was carried out. The launch of Zero Mark-up Drug Policy led to significant instant reductions in levels of outpatient drug expenditure (coefficient = -6,602.99, p<0.01), outpatient total health expenditure (coefficient = -9,958.58, p<0.05), inpatient drug expenditure (coefficient = -7,520.90, p<0.01), and inpatient total health expenditure (coefficient = -16,737, p<0.01). Moreover, the previous upward trends were changed into downward trends for inpatient drug expenditure (coefficient = -2,747.02, p = 0.00) and total health expenditure (coefficient = -3,069.29, p = 0.12). However, after the implementation of Centralized Procurement of Medicine Policy, we observed no significant instant level changes and also, the inpatient drug expenditure (coefficient = 372.95, p = 0.01) and total health expenditure (coefficient = 788.76, p = 0.06) resumed upward trends again.Although the pharmaceutical reform could control or reduced drug expenditure and total health expenditure in short term, expenditures gradually resumed growing again and reached or even exceeded their baseline levels of pre-reform period, indicating the effect became weakened or even faded out in long term. In all, the pharmaceutical reform as a whole failed to meet its goal of combating sharp growth of drug and total health expenditure

Development of a ZTD Vertical Profile Model Considering the Spatiotemporal Variation of Height Scale Factor with Different Reanalysis Products in China

Tropospheric delay is one of the key factors that may affect high-precision satellite navigation and positioning and water vapor retrieval performance. Its variation in the vertical direction is much greater than that in the horizontal direction. Therefore, the vertical profile model of zenith total delay (ZTD) is important for the spatial interpolation of high-precision ZTD products and the development of ZTD models. However, in China, low spatial and temporal resolutions remain persistent in ZTD vertical profile models and limit their application. In this study, ZTD vertical profile grid models (CZTD-H model: CZTD-HM and CZTD-HE models) were developed by considering the time-varying height scale factor for China and employing ZTD layered profile information with high temporal-spatial resolution calculated using MERRA-2 data and ERA5 data based on the integration method during 2012&ndash;2016. The CZTD-H model accuracy was verified using the global navigation satellite system (GNSS) data acquired from the Crustal Movement Observation Network of China (CMONOC) and radiosonde data as reference and was compared with the canonical GPT3 model accuracy. The applicability of CZTD-HM and CZTD-HE models was discussed. The results showed that: (1) CZTD-HM and CZTD-HE models exhibited excellent performance for ZTD layered vertical interpolation in northwestern and southeastern China, respectively. Among ZTD layered profiles from 84 radiosonde stations, the RMSE of ZTD data interpolated using CZTD-HM and CZTD-HE models improved by 12.9/16.23% and 13.8/17.16% compared with GPT3-1 and GPT3-5 models, respectively. (2) The CZTD-H model maintained high performance for the spatial interpolation of GGOS grid ZTD data. Validation with ZTD data from 249 GNSS stations showed that the RMSEs of both CZTD-HM and CZTD-HE models improved by 2.8 mm (19.7%) and 2.6 mm (18.6%) compared with those of the GPT3-1 and GPT3-5 models, respectively. The CZTD-HE model showed excellent performance in summer among all the models. Only the location and day of the year were required for the application of the CZTD-H model, which showed excellent ZTD vertical correction performance in China. With the different performances of the CZTD-HE and CZTD-HM models in China, the ERA5 model can be recommended for practical applications. Therefore, these results can provide a reference for the data source selection of ZTD vertical profile model construction on the basis of high-precision reanalysis data, GNSS real-time high-precision positioning, and GNSS meteorology in China