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To evaluate the associations between sleep duration and total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C).The present study included 60,283 adults aged ≥18 years from the Chronic Disease and Risk Factor Surveillance in Nanjing. Generalized additive model (GAM) with forward stepwise selection method was used to analyze the nonlinear relationships between sleep duration and abnormal serum lipids. The reported effective degree of freedom (EDF) values in GAM indicates the degree of smooth curvature. EDF = 1 is a sign of linear correlation between predictors and outcome. EDF1 is the sign of a more complex relationship between sleep duration and abnormal serum lipids.The evaluation of interaction of sex and sleep duration by using multivariable GAM revealed a U-shaped correlation between sleep duration and dyslipidemia (EDF = 4.60, P 0.001), high TC (EDF = 3.38, P 0.001), and high LDL-C (EDF = 3.67, P 0.001) in male, and a U-shaped correlation between sleep duration and dyslipidemia (EDF = 4.69, P 0.001), high TC (EDF = 3.33, P 0.001), and high LDL-C (EDF = 3.21, P 0.001) in female. There was a U-shaped correlation between sleep duration and high TG in male (EDF = 3.84, P 0.001) and semi-linear correlation in female (EDF = 1.82, P = 0.028). Moreover, there was a linear correlation between sleep duration and low HDL-C in men (EDF = 1.04, P = 0.002), but no significant correlation in women (EDF = 3.18, P = 0.080).Both shorter and longer sleep durations were associated with abnormal serum lipid profiles in men and women.

During liver surgery, hepatic blood flow needs to be blocked in order to reduce bleeding, which inevitably results in hepatic ischemia/reperfusion injury (HI/R). Paeoniflorin (PF) is the main active ingredient of the traditional Chinese herbal medicine peony, which has been shown to exert anti-oxidative and anti-apoptotic properties. In the present study, a mouse model of HI/R was generated by clamping the hepatoportal vein, hepatic artery, and hepatic duct of BALB/c mice with a vascular clamp for 30 min, followed by reperfusion for 6 h under anesthesia. Six mice in the three PF treatment groups (5, 10 and 20 mg/kg) were then injected with PF, via the tail vein. A sham group, consisting of six mice that did not undergo the procedure, and a vehicle group, consisting of 6 mice that underwent the procedure but subsequently received injections of physiological saline only, were used as controls. Liver injury was indicated by serum levels of the enzymes alanine transaminase (ALT) and aspartate transaminase (AST). The activities of oxidative stress biomarkers, including superoxide dismutase (SOD), glutathione (GSH), glutathione peroxidase (GSH-PX) and malondialdehyde (MDA), were also measured. Furthermore, the activity of caspase-3 was analyzed in hepatic tissue using a commercial kit. Treatment with PF significantly attenuated HI/R injury histologically, as compared with the vehicle group. In addition, significant reductions in the serum levels of ALT and AST were observed in the PF-treated ischemic mice. Furthermore, treatment with PF enhanced the activities of hepatic tissue SOD, GSH and GSH-PX, but decreased the MDA content. Treatment of ischemic mice with PF markedly reduced the expression levels of inflammatory mediators, including nuclear factor-κB, tumor necrosis factor-α, interleukin (IL)-6, and IL-1β, and decreased the HI/R injury-induced expression of caspase-3. The results of the present study suggest that PF attenuates the HI/R injury of mice via anti-oxidative, anti-inflammatory and anti-apoptotic activities.

Objective: Numerous systematic reviews and meta-analyses on the interventions to reduce burnout of physicians and nurses have been published nowadays. This study aimed to summarize the evidence and clarify a bundled strategy to reduce burnout of physicians and nurses. Methods: Researches have been conducted within Cochrane Library, PubMed, Ovid, Scopus, EBSCO, and CINAHL published from inception to 2019. In addition, a manual search for relevant articles was also conducted using Google Scholar and ancestral searches through the reference lists from articles included in the final review. Two reviewers independently selected and assessed, and any disagreements were resolved through a larger team discussion. A data extraction spreadsheet was developed and initially piloted in 3 randomly selected studies. Data from each study were extracted independently using a pre-standardized data abstraction form. The the Risk of Bias in Systematic reviews and assessment of multiple systematic reviews (AMSTAR) 2 tool were used to evaluate risk of bias and quality of included articles. Results: A total of 22 studies published from 2014 to 2019 were eligible for analysis. Previous studies have examined burnout among physicians (n = 9), nurses (n = 6) and healthcare providers (n = 7). The MBI was used by majority of studies to assess burnout. The included studies evaluated a wide range of interventions, individual-focused (emotion regulation, self-care workshop, yoga, massage, mindfulness, meditation, stress management skills and communication skills training), structural or organizational (workload or schedule-rotation, stress management training program, group face-to-face delivery, teamwork/transitions, Balint training, debriefing sessions and a focus group) and combine interventions (snoezelen, stress management and resiliency training, stress management workshop and improving interaction with colleagues through personal training). Based on the Risk of Bias in Systematic reviews and AMSTAR 2 criteria, the risk of bias and methodological quality included studies was from moderate to high. Conclusions: Burnout is a complicated problem and should be dealt with by using bundled strategy. The existing overview clarified evidence to reduce burnout of physicians and nurses, which provided a basis for health policy makers or clinical managers to design simple and feasible strategies to reduce the burnout of physicians and nurses, and to ensure clinical safety.

It is well noticed that imbalance between winter heat requirement and summer heat gain in soil has an effect on heat transfer characteristic of ground heat exchanger (GHE), which results into the decrease of operation efficiency of ground-coupled heat pump system year by year. Therefore, the research on heat transfer characteristic of GHE for different heat imbalance rate is firstly presented in the article, and then, based on numerical model of heating conduction and groundwater heat advection, the influence of groundwater flow rate is analyzed. Finally, several suggestions such as auxiliary cool and heat source, GHE adjustment strategy are put forward for better and efficient operation of system.Copyright © 2010 by ASME

The energy-Internet is a new energy supply method based on urban compact and densely populated community in a low-carbon city. The principle is to connect small energy generation stations and combined heat and power system (CHP) based on distributed energy technology and renewable energy into a network in the urban district. In this way, the cooling, heating and electricity could all back each other up. Each building of the community could collect the energy and then put that energy into the energy-internet to supply the heating and power to buildings. The power in the energy-internet could also be used for charging electric vehicles. So the energy use in the urban community would be basically self-sufficient. The energy generation stations in the energy-internet could be solar power, wind power, biomass cogeneration (including refuse power generation), household fuel cell, low-grade heat in rivers, lakes, urban sewage and soil. In this way, large-scale renewable energy and unused energy could be fully used and applied in a compact and dense community. If the energy-internet is suitable designed, the equipment capacity, energy consumption and CO2 emission of the community could be greatly reduced, energy efficiency could be optimized and improved and the heat island effect could also be alleviated. This article explores three major problems of the construction of energy internet and their solutions: namely, the location and layout of the energy station, the environmental economic dispatch model of the energy internet with power dispatching as an example, the optimal path design of hot water pipe network combined with graph theory and genetic algorithms.Copyright © 2010 by ASME