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Background: Lockdown measures for controlling the COVID-19 epidemic were enforced in China between January and May 2020. Previous studies showed a decrease in HIV highrisk behaviors (HRBs) and updated testing during the lockdown, but little is known about these behaviors during the post-lockdown period. Objective: We conducted quantitative and qualitative assessments of HIV-related behaviors among MSM during the lockdown and post-lockdown periods in Changsha, south-central China. Methods: Face-to-face structured interviews with open-ended questions were conducted using the TimeLine Follow Back (TLFB) method for collecting retrospective data on frequencies of HRBs and testing. McNemar’s Chi-square test and Wilcoxon signed-rank test were used to comparing frequencies of behaviors between lockdown (January-May 2020) and post-lockdown periods (June- October 2020). Content analysis was used to analyze qualitative data on the reasons for rebounding HRBs and testing. Results: Of 159 MSM participants, 64% had at least one HRB during the post-lockdown period. Men had increased condomless sex (from 24% to 35%), multiple partners (23% to 35%), and substance abuse (16% to 27%) between the two study periods due to the negative emotions and increased use of social networks during the lockdown. HIV testing frequency also increased from 37% to 66% due to resuming routine testing services in the community-based organizations and increased HRBs among MSM during post-lockdown. Conclusions: After lifting the lockdown measures, MSM had rebounding HRBs and uptake of testing. Effective preventive measures and healthcare services should be available to MSM after the lockdown measures are lifted.

Although it is known that caffeic acid phenethyl ester (CAPE) and its derivatives could ameliorate acute myocardial injury, their effects on chronic myocardial ischemia (CMI) were not reported. This study aimed to investigate the potential effect of caffeic acid p-nitro phenethyl ester (CAPE-pNO2, a derivative of CAPE) on CMI and underlying mechanisms. SD rats were subjected to high-fat-cholesterol-diet (HFCD) and vitamin D3, and the H9c2 cells were treated with LPS to establish CMI model, followed by the respective treatment with saline, CAPE, or CAPE-pNO2. In vivo, CAPE-pNO2 could reduce serum lipid levels and improve impaired cardiac function and morphological changes. Data of related assays indicated that CAPE-pNO2 downregulated the expression of transforming growth factor-β1 (TGF-β1) and galectin-3 (Gal-3). Besides, CAPE-pNO2 decreased collagen deposition, the number of apoptotic cardiomyocytes, and some related downstream proteins of Gal-3 in the CMI rats. Interestingly, the effects of CAPE-pNO2 on TGF-β1, Gal-3, and other proteins expressed in the lung were consistent with that in the heart. In vitro, CAPE-pNO2 could attenuate the fibrosis, apoptosis, and inflammation by activating TGF-β1/Gal-3 pathway in LPS-induced H9c2 cell. However, CAPE-pNO2-mediated cardioprotection can be eliminated when treated with modified citrus pectin (MCP, an inhibitor of Gal-3). And in comparison, CAPE-pNO2 presented stronger effects than CAPE. This study indicates that CAPE-pNO2 may ameliorate CMI by suppressing fibrosis, inflammation, and apoptosis via the TGF-β1/Gal-3 pathway in vivo and in vitro.

Objectives: To describe the professional quality of life and explore its associated factors among nurses coming from other areas of China to assist with the anti-epidemic fight in Wuhan and especially examine whether the hospital ethical climate was independently associated with nurses’ professional quality of life. Methods: A cross-sectional online survey was conducted from March 2020 to April 2020. The nurses working in Wuhan from the other parts of China were the target population. The Professional Quality of Life Scale version 5, the Hospital Ethical Climate Survey, and a basic information sheet were used to collect data. Descriptive statistics, t-test, ANOVA, Pearson correlation, and multiple linear regression analysis were used to analyze the data. Results: In total, 236 nurses participated in this study, and 219 valid questionnaires were analyzed. The average age of the participants was 31.2 ± 5.0 years. Most nurses were female (176/219; 80.4%) and married (145/219; 66.2%). In term of professional quality of life, nurses reported moderate (129/219; 58.9%) to high (90/219; 41.1%) levels of compassion satisfaction, low (119/219; 54.3%) to moderate (100/219; 45.7%) levels of burnout, and low (67/219; 36.0%) to high (10/219; 4.6%) levels of secondary traumatic stress. Regarding hospital ethical climate, nurses reported moderately high hospital ethical climates with an average score of 4.46. After controlling for socio-demographic characteristics, the multiple linear regression models showed that the hospital ethical climate subscale of “relationship with physicians” was independently associated with the compassion satisfaction (β = 0.533, P

An accurate and efficient method of identifying noise sources can provide guidance for acoustic improvement and troubleshooting of diesel engines. Due to the complexity and impact of diesel engine acoustic and vibration signal, the current signal decomposition methods are not adaptive enough in dealing with diesel engine acoustic signal, and it is difficult to identify non-order noise sources. In order to solve the above problems, an adaptive variational mode extraction method (AVME) was proposed by constructing the mutual correlation coefficient between decomposition signals and source signals as a judgment index. The accuracy and robustness of AVME algorithm were verified by constructing analog signals. The noise signal from the top of diesel engine was decomposed by AVME, and the time-frequency characteristics of the intrinsic mode function (IMF) components were extracted and decomposed. The acoustic-vibration coherence analysis and acoustic array technique were combined to identify the diesel engine noise source. The results show that the algorithm can successfully identify the oil pan noise, combustion noise, piston knock noise and air compressor noise of diesel engine.

Recently, the role of the gut microbiota in the context of drug addiction has attracted the attention of researchers; however, the specific effects and underlying mechanisms require further exploration. To accomplish this, C57BL/6 mice were firstly treated with methamphetamine (MA). Conditioned place preference (CPP) behavior changes, gut permeability and function, microglial activation, and inflammatory cytokine expression were systematically analyzed in antibiotics-treated mice with microbiota depletion and in fecal microbiota transplantation mice with microbiota reconstitution. MA treatment altered microbiota composition and caused gut dysbiosis. Depletion of gut microbiota with antibiotics inhibited MA-induced CPP formation, and fecal microbiota transplantation reversed this inhibition. Mechanistic analyses indicated that antibiotic treatment decreased gut permeability and neuroinflammation, while fecal microbiota transplantation offset the impact of antibiotic treatment. Additionally, MA-induced microglial activation was suppressed by antibiotics but restored by microbiota transplantation, and this correlated well with the CPP score. Compared to antibiotic treatment, microbiota transplantation significantly increased 5-HT4 receptor expression in both the nucleus accumbens and the hippocampus. Furthermore, when fecal microbiota from healthy mice was transplanted into MA-treated mice, the CPP scores decreased. Our results provide a novel avenue for understanding MA addiction and suggest a potential future intervention strategy.

As a state-of-the-art computer technology, virtual reality (VR) is considered to play an important role in helping manufacturing companies stay competitive in the international market. However, despite the achievements made in the field of VR, it is still an emerging technology that lacks deeper exploration and development in industrial application scenarios, especially in the coming fourth industrial revolution (Industry 4.0). This paper aims to systematically investigate the applications of VR in industrial maintenance to discover evidence of its values, limitations, and future directions so that VR can be guided to better serve manufacturing enterprises in remaining competitive in the coming Industry 4.0. A systematic literature review (SLR) methodology is adopted to review primary studies on this topic, by which 86 studies are ultimately included. The results show that VR has proved its value in benefiting maintenance issues through the product lifecycle. However, VR is still not an indispensable element for the lifecycle management of products regarding maintenance-related issues. Several key findings are concluded based on the analysis of the 86 studies. This review is valuable for researchers who are interested in the application of VR technology in maintainability design, maintenance training or maintenance task assistance.

Background A number of previous studies have explored international students’ adaptation process with regards to language, lifestyle, food, and environment. However, there have yet been no studies conducted to address the menstrual symptoms challenges faced by international female students during the acculturation period. Thus, this study aims to describe the prevalence of menstrual symptoms change and to explore the influencing factors among international female students studying in China during the acculturation period. Methods An online cross sectional study was conducted among international female students studying in China during the acculturation period (defined as the first six months of living in the host country) in Hunan Province of China from March 2019 to July 2019. Menstrual symptoms questionnaire, sociocultural adaptation scale, China higher education student satisfaction scale, perceived stress scale, and Pittsburgh sleep quality index were used for data collection. Descriptive analysis, ANOVA, paired t-test, Pearson correlation, and multivariate linear regressions were used to analyze the data using SPSS 21.0 software. Results Three hundred and forty-five (97.18%, 345/355) female students from 45 countries fully completed the questionnaire. The mean age of the participants was (26.59 ± 6.439) years. In total, 18.49% of participants had encountered menstrual symptoms change. There were significant differences in the menstrual symptoms score between before arrival and evaluation during the first six months of living in China (t = − 11.700, p = 0.000). The main menstrual symptoms change included cramps (17.68%), irritation (14.78%), abdominal pain (12.46%), fatigue (12.46%), and headaches (9.85%). Cultural adaptation level (β = 0.198, 95% CI: 0.934, 2.995), sleep quality (β = 0.166, 95% CI: 0.112, 0.496), perceived stress (β = 0.193, 95% CI: 0.123, 0.410), time spent in the host environment, (β = − 0.270, 95% CI: − 3.200, − 1.444) and experience of visiting foreign countries (β = 0.184, 95% CI: 1.134, 4.125) were significantly correlated with menstrual symptoms change. Conclusion The prevalence of menstrual symptoms change among international female students should not be overlooked when considering menstrual health in this population. Poorer cultural adaptation, poorer sleep quality, higher stress, and lack of overseas living experiences significantly influence the menstrual symptoms of international female students studying in China.

Sound quality (SQ) plays important role in automobile competitiveness, in which the high frequency characteristics of tones are prominent when internal combustion engines are replaced by fuel cells or batteries. Hence, it is of great significance to explore the influence of tones on the SQ of such electric vehicles. At the moment, the prominence of tones is concerned but the influence of tones in different frequency ranges is not comprehensively considered. Meanwhile, there are some researches on the masking effect of background noise, but they are insufficient. To address these issues, the SQs of four types of vehicles (van, SUV, pure electric car, fuel cell heavy truck) are studied. The prominence ratio (PR) is found to be effective in the evaluation of tones SQ. The influence of tones on subjective evaluation is explored from two dimensions of “audible” and “irritable”. The results show that whether tones can be “audible” and “irritable” are related to the masking effect of background noise and the frequency distribution. Meanwhile, the PR limits of tones are obtained in different frequencies under various working conditions and operating modes.

Background: To investigate current knowledge, attitudes, and practices for CPR quality control among emergency physicians in Chinese tertiary hospitals.Methods: Anonymous questionnaires were distributed to physicians in 75 tertiary hospitals in China between January and July 2018.Results: A total of 1405 respondents answered survey without obvious logical errors. Only 54.4% knew all criteria of high-quality CPR. The main problems during CPR were related to chest compression: low quality due to fatigue (67.3%), inappropriate depth (57.3%) and rate (54.1%). 91.0% respondents considered CPR quality monitoring should be used, 72.4% knew objective method for monitoring, and 63.2% always/often monitored CPR quality during actual resuscitation. The utilization rate of recommended monitoring methods was reported as follow, ETCO2 was 42.7%, audio-visual feedback devices was10.1%, coronary perfusion pressure was 17.9%, and invasive arterial pressure was 31.1%. 96.3% respondents considered it was necessary to participate in regular CPR retraining, but 21.4% did not receive any retraining. The ideal retraining interval was considered to be 3 to 6 months, but actual interval was 6 to 12 months. CPR feedback devices were always/often used in training was reported by 49.7% of respondents.Conclusion: Chinese emergency physicians were very concerned about CPR quality, but they did not fully understand the high-quality criteria and impact on prognosis. CPR quality monitoring was not routine procedure during actual resuscitation. The methods recommended in guidelines were rarely used in practice. Many physicians have not received retraining or have received retraining at long intervals. Feedback devices were not commonly used in training.

BACKGROUND Many countries and organizations recommended people living with HIV/AIDS (PLWHA) receive the COVID-19 vaccine. However, vaccine hesitancy still exists and becomes a barrier for promoting COVID-19 vaccination among PLWHA. OBJECTIVE This study aims to investigate factors that contributed to COVID-19 vaccine hesitancy among PLWHA. METHODS The study used a multicenter cross-sectional design and an online survey mode. We recruited PLWHA aged 18-65 years from 5 metropolitan cities in China between January 2021 and February 2021. Participants completed an online survey through Golden Data, a widely used encrypted web-based survey platform. Multiple linear regression models were used to assess the background characteristics in relation to COVID-19 vaccine hesitancy, and structural equation modeling was performed to assess the relationships among perceived benefits, perceived risks, self-efficacy, subjective norms, and COVID-19 vaccine hesitancy. RESULTS Among 1735 participants, 41.61% (722/1735) reported COVID-19 vaccine hesitancy. Older age, no other vaccinations in the past 3 years, and having chronic disease history were positively associated with COVID-19 vaccine hesitancy. Structural equation modeling revealed a direct relationship of perceived benefits, perceived risks, and subjective norms with self-efficacy and vaccine hesitancy and an indirect relationship of perceived benefits, perceived risks, and subjective norms with vaccine hesitancy. Moreover, self-efficacy toward COVID-19 vaccination was low. PLWHA had concerns of HIV disclosure during COVID-19 vaccination. Family member support could have an impact on COVID-19 vaccination decision-making. CONCLUSIONS COVID-19 vaccine hesitancy was high among PLWHA in China. To reduce COVID-19 vaccine hesitancy, programs and strategies should be adopted to eliminate the concerns for COVID-19 vaccination, disseminate accurate information on the safety and efficacy of the COVID-19 vaccine, encourage family member support for COVID-19 vaccination, and improve PLWHA’s trust of medical professionals.

Although it is known that caffeic acid phenethyl ester (CAPE) and its derivatives could ameliorate acute myocardial injury, their effects on chronic myocardial ischemia (CMI) were not reported. This study aimed to investigate the potential effect of caffeic acid p-nitro phenethyl ester (CAPE-pNO

In virtual maintenance, the most widely used accessibility evaluation method is to use virtual human reach envelope surface to judge and evaluate accessibility. However, this method can only give two kinds of evaluation results: reachable and unreachable. There is not enough data and theoretical support for the construction of envelope surface, and the precision and accuracy of evaluation need to be improved. In this paper, a parameterized accessibility evaluation method and a method of accessibility envelope surface construction are proposed. Firstly, to objectively describe the movement of human body, a 6-joint and 5-link D-H (Denavit-Hartenberg) link model is established from the waist to the fingertip of the human body, and the ranges of 10 degrees of freedom and angles related to accessibility are determined according to ergonomics. Then, comfort is introduced to refine the accessibility evaluation, and a multi-level accessibility evaluation system based on comfort is constructed according to RULA (the rapid upper limb assessment). In order to facilitate the application of this method in virtual environment, a method of accessibility envelope surface construction is proposed. Firstly, the reachable points are generated by Monte Carlo simulation based on the D-H model. Secondly, the accessibility envelope surface is composed of the outermost random reachable points. Finally, the comparison experiment with the reachable envelope provided by DELMIA in virtual environment shows that the proposed method is more accurate, meticulous and objective. Based on this method, an accessibility evaluation tool has been developed in CATIA and has been applied in some scientific research institutes.

To ensure the safety of the astronauts and the prolongation of the life of the space station, maintainability design and verification is an integral part of design process. As a crucial factor in maintainability design, visibility evaluation is the most important part of maintainability design and verification. However, completely different ergonomics parameters and lacking of relevant research are the two major problems limiting the development and application of the visibility design in the microgravity environment. This paper proposes a visibility automation analysis and evaluation model in microgravity environment based on virtual maintenance. Firstly, visibility evaluation indicators are determined by the literature research and the astronauts working condition investigations. Secondly, in responds to the indicators, this paper proposes an evaluation method combining ergonomics and maintainability criteria based on microgravity. Moreover, a comprehensive visual accessibility evaluation model in microgravity environment is developed. Finally, a case of ORU disassembly in space station is conducted and verifies the effectiveness of the proposed method.

ObjectiveChina has seen an increasing number of international students in recent years, mostly from Africa and Asia. However, little is known about these students’ HIV knowledge, sexual practices and potential HIV risk. This study aimed to describe HIV-related risk among international students.DesignAn online cross-sectional survey.Setting10 universities situated in one province of China.Participants617 international students filled out the questionnaire and 607 international students were included in this study.Primary and secondary outcome measuresSocio-demographic and programme-related characteristics, HIV-related knowledge, sexual practices and other HIV/sexually transmitted infection-related variables. Logistic regression analyses were performed to examine factors associated with inconsistent condom use among international students.ResultThe results showed that in total, only 51.6% (313/607) of international students had adequate HIV-related knowledge, and 64.9% (394/607) reported not receiving any HIV related education or training while studying in China. Moreover, 32.3% (196/607) reported having penetrative sex including oral, vaginal and anal sex during the period in which they studied in China and among them. The proportions of inconsistent condom use in vaginal and oral intercourse while studying in China were 52.6% (50/95) and 79.5% (35/44), respectively, with casual partners, and 60% (80/129) and 91.2% (52/57) with regular partners, respectively. Female gender, being married and having multiple sexual partners were associated with inconsistent condom use.ConclusionThe present study indicated that international students in one province of China have suboptimal HIV-related knowledge, significant unprotected sex, less HIV testing and less safe sex education, which highlights an urgent need to provide HIV education and related health services to international students in China.

College Students' associations are the main positions of college young students' activities. The party and League branches of College Students' associations are an important guarantee for college young students' activities. The backbone of the party and League branches of college associations is the vanguard force of college young students' activities and even this group. The establishment and efficient operation of its training mechanism occupies an important position in the work of the Communist Youth League in Colleges and universities. This paper intends to combine the actual work of the community with the work practice of the party and League branches of the community, better design the training of the party and League branches of the community in Colleges and universities, implement the education and management of the party members and League members in the community, maintain and enhance the Progressiveness of the party members and League members, and give full play to the role of the party and League branches of the community, so as to further strengthen the management of the community and improve the development level of the community.

Aims: To investigate current practices and problems of neurological prognostication in comatose cardiac arrest (CA) patients. Methods: An anonymous questionnaire was distributed to 1600 emergency physicians in 75 hospitals which were selected randomly from China between January and July 2018. Results: 92.1% respondents fulfilled the survey. The details of the neurological prognosis were not well understood. The predictive value of brain stem reflex, motor response and myoclonus was confirmed by 63.5%, 44.6% and 31.7% respondents respectively. Only 30.7% knew that GWR value

Background Puffer fish poisoning is one of the main causes of death from food poisoning in China. Currently, there is still no effective treatment method. The establishment of artificial airway and early implementation of mechanical ventilation are crucial to the prognosis of patients, but the optimal time is still not clear. Case Presentation A 62-year-old male patient complained of ‘numbness around the mouth for 3 hours after eating puffer fish’ was admitted to the emergency department, he was performed gastric lavage in time, but did not be performed protective endotracheal intubation.His condition worsen rapidly and respiratory and cardiac arrest was quickly occurred.He received aggressive treatment in the ICU, but still did not regain spontaneous breathing. Conclusion The establishment of artificial airway and early implementation of mechanical ventilation are crucial for the prognosis of patients,and we provide possible principles for performing endotracheal intubation.

The outbreak of coronavirus disease 2019 (COVID-19) was declared a global public health emergency on 31 January 2020. Emergency medicine procedures in Emergency Department should be optimized to cope with the current COVID-19 pandemic by providing subspecialty services, reducing the spread of nosocomial infections, and promoting its capabilities to handle emerging diseases. Thus, the Chinese Society of Emergency Medicine and Wuhan Society of Emergency Medicine drafted this consensus together to address concerns of medical staffs who work in Emergency Department. Based on in-depth review of COVID-19 diagnosis and treatment plans, literatures, as well as management approval, this consensus proposes recommendations for improving the rationalization and efficiency of emergency processes, reducing the risk of nosocomial infections, preventing hospital viral transmission, and ensuring patient safety.

Modern society has a high demand for manufactured products in almost all fields. To achieve high availability and reduce costs, products require good maintainability, which is an intrinsic property that is decided mostly in the design and manufacturing stages. Design evaluation plays an important role in improving the maintainability of products. At present, though designers can verify maintainability by conducting virtual maintenance simulations on digital mockups (DMUs) to test design and manufacturing effects, this approach requires substantial time and specialist knowledge. In this paper, a hybrid maintainability evaluation method based on virtual reality (VR) and fuzzy comprehensive evaluation (FCE) is proposed to solve the problem. First, an evaluation index system is established to launch the design requirements. A VR-based method is proposed to help conduct the immersive maintenance simulation in a virtual environment. A maintenance simulation monitoring platform is developed to help designers evaluate maintainability and make decisions. Finally, FCE is leveraged to give a comprehensive evaluation result for maintainability status. A case of comparative experiments was conducted to verify the effectiveness of the proposed method. The participants of two groups were encouraged to evaluate the maintainability of a fluid physical experiment rack for a space station based on a traditional method and the proposed method. After the physical verification and result analysis, the proposed method was demonstrated to have better abilities to help predict design flaw and make design decision.