Burnout and study engagement among medical students at Sun Yat-sen University, China: A cross-sectional study.

This study aims to investigate burnout and study engagement among medical students at Sun Yat-sen University, China.A cross-sectional survey was conducted among undergraduate medical students of Sun Yat-sen University, China. A total of 453 undergraduate students completed a self-administered, structured questionnaire between January and February, 2016. Burnout and study engagement were measured using the Maslach Burnout Inventory-Student Survey (MBI-SS) and the UTRECHT Work Engagement Scale-Students (UWES-S), respectively. Subjects who scored high in emotional exhaustion subscale, high in cynicism subscale, and low in professional efficacy subscale simultaneously were graded as having high risk of burnout. Independent sample t tests and chi-square tests were used to compare the differences in burnout and work engagement between genders, majors, and grade levels.The means (standard deviations) of the MBI-SS subscales were 3.42 (1.45) for emotional exhaustion, 2.34 (1.64) for cynicism, and 3.04 (1.30) for professional efficacy. The means (standard deviations) of the UWES-S subscales were 3.13 (1.49) for vigor, 3.44 (1.47) for dedication and 3.00 (1.51) for absorption. Approximately 1 in 11 students experienced a high risk of burnout. There were no statistically significant gender differences in burnout and study engagement. There were also no statistically significant differences in burnout and study engagement subscales according to student major. Students in higher grades displayed increased burnout risk, higher mean burnout subscale score of cynicism, lower mean burnout subscale score of professional efficacy, and decreased mean study engagement subscale scores of dedication and absorption. There were strong correlations within study engagement subscales.Chinese medical students in this university experience a high level of burnout. Students at higher-grade level experience more burnout and decreased study engagement compared with students in lower level

Microtube's Tapers Affect its Subwavelength Focusing Effect

AbstractA tapered microtube fabricated from a glass capillary tube can achieve subwavelength focusing at optical frequencies. This focusing effect is influenced by many factures. The role of taper ratios is invested in this paper with theoretical analysis and numerical simulation. It revealed that when the taper ratio is larger, the focusing spot has higher intensity and smaller FWHM

Engineering ferroelectricity in monoclinic hafnia

Ferroelectricity in the complementary metal-oxide semiconductor (CMOS)-compatible hafnia (HfO$_2$) is crucial for the fabrication of high-integration nonvolatile memory devices. However, the capture of ferroelectricity in HfO$_2$ requires the stabilization of thermodynamically-metastable orthorhombic or rhombohedral phases, which entails the introduction of defects (e.g., dopants and vacancies) and pays the price of crystal imperfections, causing unpleasant wake-up and fatigue effects. Here, we report a theoretical strategy on the realization of robust ferroelectricity in HfO$_2$-based ferroelectrics by designing a series of epitaxial (HfO$_2$)$_1$/(CeO$_2$)$_1$ superlattices. The advantages of the designated ferroelectric superlattices are defects free, and most importantly, on the base of the thermodynamically stable monoclinic phase of HfO$_2$. Consequently, this allows the creation of superior ferroelectric properties with an electric polarization $>$25 $\mu$C/cm$^2$ and an ultralow polarization-switching energy barrier at $\sim$2.5 meV/atom. Our work may open an entirely new route towards the fabrication of high-performance HfO$_2$ based ferroelectric devices

Patterns and Determinants of Antibiotic Use Behaviors among Rural Community Residents in Eastern China

Inappropriate antibiotic use may lead to antibiotic resistance, which has become a serious global crisis. Addressing suboptimal antibiotic use in the general population can play a significant role in the fight against antimicrobial resistance. This study aims to describe antibiotic use and sources of acquisition, and to identify factors influencing antibiotic access among rural community residents in Eastern China. A cross-sectional survey was conducted from July to August 2020, and 1494 participants from two villages in Eastern China were enrolled. Information was obtained using face-to-face interviews with a structured electronic questionnaire. Chi-squared and multinominal logistic regression analysis were used to explore possible determinants. In total, 1379 participants were eligible for the analysis. In the past 12 months, nearly half the respondents had taken any antibiotic (48.4%), and this proportion varied across marital status and age group. Two thirds of them (59.9%) obtained antibiotics from medical facilities with a prescription when they last took antibiotics, while 17.7% and 22.4% chose retail pharmacies and other sources, respectively. Multinominal analysis found that a higher proportion obtained antibiotics outside medical facilities among those aged 15 to 44 years, unmarried, non-white collar workers, with more years of education, lower annual household income per capita and lower levels of antibiotic knowledge. The antibiotic use behavior of rural community residents in Eastern China remains suboptimal. Antibiotic use and access behaviors need to be further addressed. Effective antibiotic stewardship in non-medical facility sources and training programs targeted for rural Chinese is warranted in future

Robust H∞ control for a class of nonlinear discrete time-delay stochastic systems with missing measurements

This is the post print version of the article. The official published version can be obtained from the link - Copyright 2009 Elsevier LtdThis paper is concerned with the problem of robust H∞ output feedback control for a class of uncertain discrete-time delayed nonlinear stochastic systems with missing measurements. The parameter uncertainties enter into all the system matrices, the time-varying delay is unknown with given low and upper bounds, the nonlinearities satisfy the sector conditions, and the missing measurements are described by a binary switching sequence that obeys a conditional probability distribution. The problem addressed is the design of an output feedback controller such that, for all admissible uncertainties, the resulting closed-loop system is exponentially stable in the mean square for the zero disturbance input and also achieves a prescribed H∞ performance level. By using the Lyapunov method and stochastic analysis techniques, sufficient conditions are first derived to guarantee the existence of the desired controllers, and then the controller parameters are characterized in terms of linear matrix inequalities (LMIs). A numerical example is exploited to show the usefulness of the results obtained.This paper was not presented at any IFAC meeting. This paper was recommended for publication in revised form by Associate Editor Dragan Nešic under the direction of Editor Hassan K. Khalil. This work was supported in part by the Engineering and Physical Sciences Research Council (EPSRC) of the U.K. under Grant GR/S27658/01, the City University of Hong Kong under Grant 7001992, the Royal Society of the U.K. under an International Joint Project, the Natural Science Foundation of Jiangsu Province of China under Grant BK2007075, the National Natural Science Foundation of China under Grant 60774073, and the Alexander von Humboldt Foundation of Germany

Simultaneous separation and purification of chlorogenic acid, epicatechin, hyperoside and phlorizin from thinned young Qinguan apples by successive use of polyethylene and polyamide resins

The method for separating and purifying chlorogenic acid (CA), epicatechin (EC), hyperoside (HY) and phlorizin (PH) simutaneously from young Qinguan apples by successive use of X-5 and polyamide resins has been developed in this study. The order of adsorption capacities of X-5 for the four phenolics was PH\ua0>\ua0HY\ua0>\ua0EC\ua0>\ua0CA, and the adsorption equilibriums of the four phenolics onto X-5 resin conformed to Langmuir isotherms preferentially. The adsorption kinetics of EC and CA onto X-5 conformed to the pseudo-first-order model, while that of HY and PH accorded with the pseudo-second-order model. Interestingly, the values of equilibrium adsorption capacities (Q) calculated in the preferential kinetics models were closer to that of theoretical maximum adsorption capacities (Q) calculated by Langmuir isotherms. Through dynamic adsorption and desorption using X-5 and polyamide resins with ethanol solution as strippant, CA, EC, HY and PH were obtained with purities of 96.21%, 95.34%, 95.36% and 97.36%, respectively

Fecal Metabolomics and Potential Biomarkers for Systemic Lupus Erythematosus

The role of metabolomics in autoimmune diseases has been a rapidly expanding area in researches over the last decade, while its pathophysiologic impact on systemic lupus erythematosus (SLE) remains poorly elucidated. In this study, we analyzed the metabolic profiling of fecal samples from SLE patients and healthy controls based on ultra-high-performance liquid chromatography equipped with mass spectrometry for exploring the potential biomarkers of SLE. The results showed that 23 differential metabolites and 5 perturbed pathways were identified between the two groups, including aminoacyl-tRNA biosynthesis, thiamine metabolism, nitrogen metabolism, tryptophan metabolism, and cyanoamino acid metabolism. In addition, logistic regression and ROC analysis were used to establish a diagnostic model for distinguishing SLE patients from healthy controls. The combined model of fecal PG 27:2 and proline achieved an area under the ROC curve of 0.846, and had a good diagnostic efficacy. In the present study, we analyzed the correlations between fecal metabolic perturbations and SLE pathogenesis. In summary, we firstly illustrate the comprehensive metabolic profiles of feces in SLE patients, suggesting that the fecal metabolites could be used as the potential non-invasive biomarkers for SLE

Analyzing Dynamic Changes of Laboratory Indexes in Patients with Acute Heart Failure Based on Retrospective Study

Background. Changes of N-terminal probrain natriuretic peptide (NT-proBNP) have been studied whether in the long term or the short term in patients of acute heart failure (AHF); however, changes of NT-proBNP in the first five days and their association with other factors have not been investigated. Aims. To describe the dynamic changes of relevant laboratory indexes in the first five days between different outcomes of AHF patients and their associations. Methods and Results. 284 AHF with dynamic values recorded were analyzed. Changes of NT-proBNP, troponin T, and C-reactive protein were different between patients with different outcomes, with higher values in adverse group than in control group at the same time points ( < 0.05). Then, prognostic use and risk stratification of NT-proBNP were assessed by receiver-operating characteristic curve and logistic regression. NT-proBNP levels at day 3 showed the best prognostic power (area under the curve = 0.730, 95% confidence interval (CI): 0.657 to 0.794) and was an independent risk factor for adverse outcome (odds ratio, OR: 2.185, 95% CI: 1.584-3.015). Classified changes of NT-proBNP may be predictive for adverse outcomes in AHF patients. Conclusions. Sequential monitoring of laboratory indexes within the first 5 days may be helpful for management of AHF patients

Progress and perspectives of perioperative immunotherapy in non-small cell lung cancer

Lung cancer is one of the leading causes of cancer-related death. Lung cancer mortality has decreased over the past decade, which is partly attributed to improved treatments. Curative surgery for patients with early-stage lung cancer is the standard of care, but not all surgical treatments have a good prognosis. Adjuvant and neoadjuvant chemotherapy are used to improve the prognosis of patients with resectable lung cancer. Immunotherapy, an epoch-defining treatment, has improved curative effects, prognosis, and tolerability compared with traditional and ordinary cytotoxic chemotherapy, providing new hope for patients with non-small cell lung cancer (NSCLC). Immunotherapy-related clinical trials have reported encouraging clinical outcomes in their exploration of different types of perioperative immunotherapy, from neoadjuvant immune checkpoint inhibitor (ICI) monotherapy, neoadjuvant immune-combination therapy (chemoimmunotherapy, immunotherapy plus antiangiogenic therapy, immunotherapy plus radiotherapy, or concurrent chemoradiotherapy), adjuvant immunotherapy, and neoadjuvant combined adjuvant immunotherapy. Phase 3 studies such as IMpower 010 and CheckMate 816 reported survival benefits of perioperative immunotherapy for operable patients. This review summarizes up-to-date clinical studies and analyzes the efficiency and feasibility of different neoadjuvant therapies and biomarkers to identify optimal types of perioperative immunotherapy for NSCLC

CFD investigation of gas-solids flow in a new fluidized catalyst cooler

In our previous work, a new concept of annular catalyst cooler (ACC) was proposed and validated experimentally, which showed that an internal circulation of solids could be formed by using two gas distributors and both hydrodynamics and heat transfer could be largely improved. The current work simulated detailed hydrodynamics of gas-solids flow to advance our understanding of the ACC by using the two-fluid model. The influences of effective particle diameter dp⁎ and specularity coefficient φ were examined and compared with experimental data. Optimum values of dp⁎ = 170 μm and φ = 0.3 were determined and used in the simulations. Detailed hydrodynamics of gas-solids flow were then obtained, and the influential parameters were examined. The results showed that the proper selection of the ratio of gas velocities and the position of the heat transfer tube were needed to form a stable internal solids circulation in the ACC. The ACC had a combined hydrodynamic feature of up-flow and down-flow catalyst coolers with bigger solids volume fraction and smaller particle resident time, which are beneficial for improving the heat transfer between solids and wall