AbstractOccupational stress among health care workers (HCWs) is increasing due to the development of health services and occupational sensitivity. The aim of this study was to identify a mental health promotion model to reduce occupational stress among HCWs. This was a qualitative study, and its findings were the result of semi-structured interviews and focus groups with HCWs working in primary health care centers and superiors. Data analysis was done using the approach of inductive and deductive thematic analysis. For this study, the Precede-Proceed model and the Job Demands-Resource (JD-R) model were used. It was found that the origin of workplace stress is environmental and individual in nature. Furthermore, predisposing, reinforcing and empowering factors are necessary to control occupational stress with individual, social and organizational approaches. Finally, to create change and stress interventions in the workplace, it is necessary to formulate policies to deal with occupational stress and develop stress coping techniques. This study introduces a comprehensive conceptual model for promoting mental health in the workplace with individual, social, organizational and educational approaches in stressful occupations. Therefore, it enables researchers and employers to further understand the different dimensions of occupational stress in HCWs, interventions do the purposeful.KEYWORDS: occupational stress, health care worker, mental health promotion model at work, qualitative study, Precede-Proceed model, Job Demands-Resource (JD-R) model

Abstract Introduction Telehealth and remote monitoring of patients of patients with mild COVID-19 infection have developed rapidly in response to the pandemic. Many healthcare systems have embraced telehealth for remote clinical monitoring and pulse oximetry for enhanced monitoring. Methods The experience of a large healthcare centre’s COVID Virtual Ward was reviewed retrospectively with a particular focus on evaluating the effectiveness, safety and utility of finger pulse oximetry within the home. Data from a 2 month period in early 2022 during a BA1 Omicron wave was retrospectively reviewed. 551 high risk patients were issued with pulse oximeters for monitoring oxygen saturations within their home. All patients received daily clinical review via telephone by a nurse or doctor. The group was highly vaccinated with only 6.4% of the cohort unvaccinated. Oximeters were promptly delivered via a courier service across a vast geographical area. Results Pulse oximetry was well utilised by most patients. Only 2.7% of the cohort demonstrated resting oxygen saturations of <94% during their Virtual Ward admission. Most patients reporting dyspnoea were able to be safely managed without escalation to an emergency department due to reassuring clinical and oximetry assessment. Home oxygen saturations correlated well with saturations recorded within the ED, with no patients found to have lower saturations compared with home saturations. Discussion Within a high risk population experiencing COVID-19 infection, pulse oximetry was a useful tool in clinical assessment and allowed a substantial reduction in COVID-19 related ED presentations.

Proportional-resonant current controllers are the stationary frame counterparts of current proportional-integral controllers that operate in the rotating reference frame. Recently, proportional-resonant current controllers have been extensively investigated to reduce the complexity produced by the coordinates transformation and to achieve zero steady error in the case of multi-frequency reference signals. This paper introduces an alternative discrete approach to the state-of-the-art continuous proportional-resonant current controller. In particular, the direct discrete design of a state-space current controller with additional dynamics with multi-frequency robust tracking capabilities is presented in this contribution. Moreover, this paper discusses the state-space formulation, the design, and the stability analysis of such a state-space controller and compares its performance with the state-of-the-art continuous proportional-resonant current controller with delay compensation. It was found that the maximum frequency that the proposed controller can target falls within the limit of switching frequency divided by five in contrast to the limit of switching frequency divided by seven of the continuous proportional-resonant controller. Furthermore, the effectiveness of the proposed state-space controller is demonstrated through hardware-in-loop (HiL) tests and experimental measurements carried out in a one kVA active power filter based on voltage detection.

Class integration testing is an essential issue in software integration testing, and different class integration test order significantly impact the cost of testing. The Class Integration Test Order (CITO) problem is to find an optimal order of class integration test order to reduce the cost of software testing. The existing approaches tend to fall into local optimality when applied to complex systems and fail to achieve a better test order. This paper proposes a CITO generation approach based on deep reinforcement learning Categorical Double DQN (CDDQN) to address this limitation. The process uses the continuous interaction of the agent with the environment generated by inter-class dependencies to learn valuable experience and eventually obtain the optimal class integration test order. Experiments are conducted in eight systems to compare with graph-based, search-based, and reinforcement learning-based approaches. The experimental results show that the approach proposed in this paper can find CITO with lower stubbing complexity for most systems.

Clusteroluminescence (CL) has drawn much attention in recent years. However, the design of red emission clusteroluminogens (CLgens) with tunable CL is still in its infancy. Herein, we report a simple heating process to prepare red emission Poly(maleic anhydride-alt-vinyl acetate) (PMV) derivatives with tunable maximum emission wavelength between 620-675 nm. Firstly, heating above the glass transition temperature (Tg) would promote the movement of polymer chains and facilitate the formation of clusters in both solid and solution states. Then, heating beyond the decomposition temperature at which vinyl acetate converts to C=C is favorable to the formation of new clusters and large through-space conjugation among subgroups in polymer chains. Their synergistic effects realize the adjustable emission wavelength and higher quantum yield (QY) of polymers. Additionally, the obtained low-cost and eco-friendly derivatives of PMV also show application prospects among agricultural light conversion film.

Among the power inverters, modular multilevel converters (MMC) have gained popularity due to their advantages over conventional two-level inverters. Although the MMC utilizes more power switches than traditional inverters, the former exhibits notable benefits such as low total harmonic distortion, low switching losses with lower voltage stress, high power quality, reduced electromagnetic interface, and modularity with numerous degrees of freedom to synthesize output waveforms. Concerning the synthesized voltage quality, several low-frequency modulation techniques have been proposed to produce output voltage with low harmonic content. A particular case of study consisting of a three-phase even-level MMC inverter is taken as a benchmark to comparatively evaluate four methods for synthesizing high-quality output voltage. The employed techniques are ( i) selective harmonic elimination (SHE), ( ii) generalized SHE, ( iii) THD Voltage Minimization, and ( iv) Optimum Nearest Level Modulation, selected based on the phase and line-to-line output voltage THD. The model is formulated to compute the commutating angles to control the MMC submodules. Simulations show individual performance under the same operating conditions. A lab-scale prototype is built to corroborate the theoretical approach. The results allow the selection of the most convenient modulation technique based on the number of commutations and harmonic spectrum.

Hepatocellular carcinoma has been a serious threat to human life and health, and there is an urgent need for new treatments to prolong the overall survival time of patients. The liver plays an immunomodulatory function due to its unique physiological structural characteristics; therefore, following surgical resection and radiotherapy, immunotherapeutic options have shown great potential in the treatment of hepatocellular carcinoma in recent years, and adoptive cellular immunotherapy is developing rapidly in the treatment of hepatocellular carcinoma. In this review we summarize the latest research on adoptive cell therapy for hepatocellular carcinoma, focusing on chimeric antigen receptor (CAR) T cells and T cell receptor-engineered (TCR) T cells, and then briefly discuss tumor infiltrating lymphocytes (TILs), natural killer (NK) cells and cytokine-induced killer cells (CIKs). The aim is to provide readers with a comprehensive understanding of the current status of HCC adoptive cellular immunotherapy and new therapeutic strategies being developed, in the hope of providing new ideas for the clinical management of hepatocellular carcinoma.

Fear overgeneralization and perceived uncertainty about future outcomes have been suggested as risk factors for clinical anxiety. However, little is known regarding how they influence each other. In this study, we investigated whether different levels of threat uncertainty influence fear generalization. Three groups of healthy participants underwent a differential fear conditioning protocol followed by a generalization test. All groups learned to associate one female face (conditioned stimulus, CS+) with a female scream (unconditioned stimulus, US) while the other face (CS-) was not associated with the scream. In order to manipulate threat uncertainty, one group (low uncertainty, n = 26) received 80%, the second group (moderate uncertainty, n = 32) received 60%, and the third group (high uncertainty, n = 30) 40% CS-US contingency. In the generalization test, all groups saw CS+ and CS- again as well as four morphs that varied in similarity with the CS+ in steps of 20%. Subjective (expectancy, valence, and arousal ratings), psychophysiological (skin conductance response, SCR), and visuocortical (steady-state visual evoked potentials, ssVEPs) indices of fear were registered. Participants expected the US in accordance with their reinforcement schedules but displayed stronger skin conductance with more uncertainty. However, acquisition of conditioned fear was not evident in ssVEPs. During the generalization test, we found no effect of threat uncertainty in any of the measured variables, but the strength of generalization for threat expectancy ratings was positively correlated with dispositional intolerance of uncertainty. This study suggests that mere threat uncertainty does not modulate fear generalization.

Neurovascular coupling (NVC) interaction with dynamic cerebral autoregulation (dCA) remains unclear. Sixteen healthy participants (31.6 ± 11.6 years) performed verbal fluency (naming words (NW)) and serial subtraction (SS) paradigms, of varying complexity, at durations of 05, 30 and 60s. Bilateral middle cerebral artery blood velocity (MCAv, transcranial Doppler), blood pressure (BP, Finapres) and end-tidal CO2 (EtCO2, capnography), were recorded continuously. The autoregulation index (ARI), was estimated from the MCAv step response, calculated by transfer function analysis (TFA), for each paradigm during unstimulated (2min) and neuroactivated (1min) segments. Intraclass correlation (ICC) determined reproducibility for two visits. ARI was averaged across visits, and objective criteria were applied to classify responders (R) and non-responders (NoR) to task-induced MCAv increase. MCAv, BP and heart rate increased during all cognitive tasks (p<0.001). ICC values demonstrated fair reproducibility in all tasks. ARI decreased in right (RH) and left (LH) hemispheres during all cognitive activations, irrespective of paradigm complexity and duration (p<0.0001). Bilateral ARI estimates were significantly decreased during NW for the R group only (5.9 vs 4.3 for RH and 5.8 vs 4.2 for LH, p<0.0001) but were reduced in both R (5.9 vs 4.5 for RH and 5.8 vs 4.2 for LH, p<0.0001) and NoR (5.9 vs 4.6 for RH and 5.8 vs 5.0 for LH, p=0.03) groups for SS tasks compared with baseline. The reproducible attenuation of dCA efficiency due to paradigm-induced NVC response, its interaction, and different behaviour in R and NoR subjects, warrant further research in different physiological and clinical conditions.

Social comparison is an important way for individuals to define their social characteristics, and online games with a large number of social information provide a convenient platform for social comparison between players. At the same time, the spontaneous self-classification brought by social information makes the social comparison process among players potentially affected by group identity. This study explored the neural mechanism of intergroup and intragroup social comparison among players through fMRI and point estimation paradigm. 26 subjects participated in our experiment, and 25 of their head movement amplitudes were less than 2.5mm and were included in the statistics. We found that the downward comparison led to significantly different brain activation compared with the upward comparison. The fusiform gyrus, putamen, lentiform nucleus, precuneus and precentral gyrus were significantly activated when the group identity of the comparison object was the same as that of the player. When the two have different identities, downward comparison significantly activated the angular gyrus, middle frontal gyrus and superior frontal gyrus. Our research has proved that group identity has a moderating effect on social comparison cognitive process among players. When the object of downward comparison is an out-of-group member, the player will receive the reward information and positive emotional valence, which can positively predict their continuous game behavior in theory. This study provides a new possibility for the cause of game addiction at the perspective of neural mechanism.

The pretreatment of pumpkin seeds with proteolytic, cellulolytic and pectolytic enzymes and their effect on cell structure and oil yield was studied. Pumkin seed samples were treated with pepsin, papain, Viscozyme L, cellulase or pectinase. The evaluation of cell integrity by immediate hexane extraction (shaking method) showed that all samples treated with different enzymes had a higher oil yield, ranging from 33.2 to 34.1 % of seed weight, than the control samples (32.1 %). The number of disrupted cells was also higher than the control (64.4%), ranging from 67.6 to 69.5 %. The highest percentage of disrupted cells, 71.0 and 71.1 %, was found in samples treated with pepsin+Viscozyme L+pectinase and pepsin+cellulase+pectinase mixtures, respectively. To study the effect of enzymatic pretreatment on the microstructure of pumkin seeds, ultramicrotome slices of pumpkin seeds were treated with individual enzymes and enzyme mixtures. The highest percentage of cell destruction was observed in samples treated with Viscozyme L and the mixture of pepsin+Viscozyme L+pectinase. The yield of pressed oil from pumpkin seeds pretreated with the pepsin+Viscozyme L+pectinase mixture was 7.0 % higher than that of control samples. The quality parameters, chemical composition and antioxidant activity of pressed oils were investigated and the enzymatic pretreatment did not significantly affect the free fatty acid content, peroxide value, fatty acid composition, or phytosterol profiles. The antioxidant activity expressed as DPPH° radical scavenging effect of the enzymatically pretreated pressed oil was 2.7 % higher than that of the sample not pretreated with enzymes.

Males and females often differ in ecology and behaviour, and these differences are expected to lead to sex differences in parasite susceptibility. However, sex differences in parasite prevalence have not yet been established across a broad range of taxa, and the ecological and evolutionary drivers of such differences have remained contested. Here we meta-analyse 942 sex-specific effect sizes in blood and gastrointestinal parasites of 179 wild bird species, representing 17 avian orders. Females exhibit higher infections in both Haemoproteus and Protozoan parasites than males and females also have higher prevalence in both Leucocytozoon and Haemoproteus blood parasites during the breeding season. Importantly, sex differences in parasite prevalence are not associated with sexual selection nor parental care, although male-biased prevalence in Leucocytozoon parasites were predicted by male-biased size dimorphism. Taken together, breeding systems and sexual selection have modest influence on sex difference in parasite prevalence across the avian tree of life.

Ascaridia galli is the largest gut-dwelling helminth of chickens which confers adverse effects on meat and egg production and thus, on the animal protein supply and the economy. Both adult and immature parasites affect the gut health, but larval stages play the major role in pathology. The larvae cause excessive mucus production, damage to the intestinal gland, hemorrhage, anemia, diarrhea, and malnutrition. The adult worms can cause death by intestinal obstruction and intussusception. Although both cellular and humoral immunity are involved in fighting against ascaridiasis, the role of naturally acquired immunity is poorly defined. In cellular immunity, Th-2 cytokines (IL-4, IL-5, IL-9 and IL-13), goblet cells (mucin), GALTs (gut -associated lymphoid tissues), CD8α+ intraepithelial cells, TCRγδ+T cells, and TGF-β4 form a protective band. Type 2 immunity provides protection by forming a network of eDAMP (endogenous damage-associated molecular pattern), chitin, and parasitic antigens. Among antibodies, IgY is the most prominent in chickens and provides temporary humoral protection. During parasitic infection, infiltration of various immune cells is evident, especially in the intestinal epithelium, lamina propria, and crypts of the duodenum and jejunum. In chickens older than 3 months, gradual reduction of worm burden is more successful. Female chickens exert a short-lived but higher level of protection by passing IgY to chicks in the form of egg yolk antibodies (EAB). In laying condition, immunity differs greatly between breeds. This review provides a good overview of the silent but inevitable pathological changes induced by A. galli; and the interaction of host immunity with the parasite.

Intestinal helminth infection promotes a Type 2 inflammatory response in resistant C57BL/6 mice that is essential for worm clearance. The study of inbred mouse strains has revealed factors that are critical for parasite resistance and delineated the role of Type 1 versus Type 2 immune responses in worm clearance. In C57BL/6 mice, basophils are key innate immune cells that promote Type 2 inflammation and are programmed via the Notch signaling pathway during infection with the helminth Trichuris muris. However, how the host genetic background influences basophil responses and basophil expression of Notch receptors remains unclear. Here we use genetically susceptible inbred AKR/J mice that have a Type 1-skewed immune response during T. muris infection to investigate basophil responses in a susceptible host. Basophil population expansion occurred in AKR/J mice even in the absence of fulminant Type 2 inflammation during T. muris infection. However, basophils in AKR/J mice did not robustly upregulate expression of the Notch2 receptor in response to infection as in C57BL/6 mice. Blockade of the Type 1 cytokine IFN-γ in infected AKR/J mice was not sufficient to elicit infection-induced basophil expression of the Notch2 receptor. These data suggest that the host genetic background, outside of the Type 1 skew, is important in regulating basophil responses during T. muris infection in susceptible AKR/J mice.

Until the isolation of IMNV from penaeid shrimps, the first Totiviridae member to be isolated from an arthopod, no Totiviridae member had been isolated from an arthopod, and more toti-like virus was discovered from arthopod. In this paper, we effectively isolated a novel totivirus-like particle from Culex tritaeniorhynchus designated NODE2. Sequence and phylogenetic analysis shows that the NODE2 has the similar genome organization just as some other members of Totiviridae family, and it may represent an entirely novel genus within the Totiviridae family.

A 55-year old postmenopausal lady presented with a painless lump in the left groin which had progressed to its current size over last one and half months. Clinically the lump measured 9x9 cm and was hard, immobile, nontender, non-reducible, with regular margins and there were no other positive findings on physical examination (Figure 1). Fine needle aspiration cytology from the lump revealed carcinoma with areas of necrosis and immunohistochemistry was CK7+ (focal), p53+ (diffuse and strong), CK20− which suggested “primary ovarian carcinoma”. A PET-CT was done which showed increased FDG uptake in a normal sized left ovary, multiple avid para-aortic and pelvic nodes largest measuring 4x2.8 cm and 7.8X7.9X9.9 cm avid mass in left inguinal area. In view of unresectable disease in the groin she was planned for neoadjuvant chemotherapy follow by interval cytoreductive surgery.This was an unusual presentation of carcinoma ovary where PET-CT and immunohistochemistry helped in making a diagnosis. Published literature suggests that this presentation in lymph nodes without any clinical disease in the parent organ and peritoneal disease is not a usual finding (1). Diagnosis and management requires a multidisciplinary approach. These cases have been traditionally classified as stage IV but a recent retrospective study suggested that ovarian cancer patients with stage IV solely due to inguinal nodal metastases have similar survival as those with pelvic/para-aortic nodal involvement and improved survival compared to those harboring distant metastases (2).References:Metwally IH, Zuhdy M, Hassan A, Alghandour R, Megahed N. Ovarian cancer with metastatic inguinal lymphadenopathy: A case series and literature review. J Egypt Natl Canc Inst. 2017 Jun;29(2):109-114.Nasioudis D, Chapman-Davis E, Frey MK, Caputo TA, Witkin SS, Holcomb K. Should epithelial ovarian carcinoma metastatic to the inguinal lymph nodes be assigned stage IVB? Gynecol Oncol. 2017 Oct;147(1):81-84.

A document by Ke-Wei Zhu. Click on the document to view its contents.

Pitch-based carbon materials (PBCMs) are regarded as one of the most promising anodes used for alkali metal-ion (Li/Na/K) batteries due to the advantages of their low cost, high carbon yield, abundant resource, and environmental friendliness. However, PBCMs tend to be soft carbon with small layer spacing at high temperatures, resulting in undesirable reversible capacity and poor cycling stability during repeated charging and discharging, which limit their future development and application in energy storage systems. Up to now, many efforts are focused on the modification of the PBCMs to achieve excellent alkali metal-ion storage performance. In this review, the operation mechanisms and corresponding microstructural characteristics of PBCMs used for alkali metal-ion batteries are discussed. Moreover, the design and optimization strategies of PBCMs are summarized and discussed in detail, including structural adjustment strategy, heteroatom doping strategy, compound modification strategy, pre-oxidation strategy, and coating strategy, respectively. Furthermore, the research status and development prospects of PBCMs are presented, as well as a perspective on future research directions.

Epoxies have a weak fracture toughness; hence it is essential to enhance this property. This study revealed that interleaving 110-micron thickness of chopped carbon fibers and Poly-amide 66 nano-mats in Glass Fiber Reinforced Plastic laminates increased mode-I fracture toughness by 35% and 112%, respectively. Acoustic emission data illustrated that damage mechanisms initiate at further load-point displacement in modified samples. By classifying different failure types using a hierarchical clustering model, it was observed that the dominant damage mechanisms in reference, chopped carbon and nanomodified samples are matrix cracking, fiber breakage, and matrix cracking in order. Moreover, nanomodified samples’ cumulative released energy was 83% less than the reference and chopped carbon. Different damage mechanisms were validated by scanning electron microscope observations.

A 16-year-old male with past medical history of congenital atrial septal defect surgical repair presented with recurrent pericarditis secondary to post-cardiotomy injury syndrome (PCIS). After failing medical therapy, he ultimately underwent pericardiectomy for symptom resolution. PCIS is underdiagnosed in children and should be considered in patients with recurrent chest pain.

Aim:This study aims to investigate the effects of maternal asthma on fetal cardiac functions. Methods:The study was planned with 30 pregnant women who presented to a tertiary health center and were diagnosed with asthma and 60 healthy controls with similar gestational ages. The fetal echocardiographic assessment was assessed between 33 and 35 weeks of gestation with pulsed-wave Doppler (PW), M-mode, and tissue Doppler imaging (TDI). Fetal cardiac functions were compared between maternal asthma and control group. Cardiac functions were assessed according to the duration of maternal asthma diagnosis, as well. Results:Early diastolic function parameters, tricuspid E wave (p=0.001), and tricuspid E/A ratio (P=0.005) were significantly lower in the group with maternal asthma. TAPSE and MAPSE values were statistically lower in the study group than in the control group; p=0.010 and p=0.012, respectively. Parameters assessed with TDI (E’, A’, S’, E/E’, and MPI’ of tricuspid valves) and global cardiac function parameters assessed with pulsed-wave Doppler like myocardial performance index (MPI) and left cardiac output (LCO) were similar between groups (p> 0.05). Although, MPI did not change between groups, and the isovolumetric relaxation time (IVRT) value was prolonged in maternal asthma cases (p=0.025). Conclusion:We found that maternal asthma disease causes alteration in fetal diastolic and early systolic cardiac functions, but the global fetal cardiac function does not change. Diastolic heart function values also varied with the duration of maternal asthma. Prospective studies are needed to compare fetal cardiac functions with additional patient groups according to disease severity and type of medical treatment.

In this paper, CIGS heterojunction solar cells have been proposed and analyzed by SCAPS “Solar Cell Capacitance Simulator” the effect of temperature and thickness on cell characteristics such as (η, FF, J sc and V oc). The effects of various layer parameters like thickness, carrier concentration, defect density, mobility, and conduction band offset. The photovoltaic cell has been studied further through capacitance-voltage simulations to obtain the net built-in potential and the apparent doping profile. The impedance plot (IS) analytical theory to the characterization of Cu (In, Ga) Se 2 (CIGS)-based solar cells was investigated. The equivalent circuit of the CIGS solar cell consisting of series and parallel resistances and a “capacitance-like element” labeled as constant phase element (CPE) around the CdS/CIGS interface was developed. The CPE reflects the depletion layer thickness and the p-n interface uniformity and quality. In particular, the CPE-p-value, which is an index of the impedance of CPE, affects the quality around the CdS/CIGS and CIGS-Si interface in terms of defect existence and inhomogeneity of the heterojunction. These results show a possible candidate for the practical application of IS as a simple method for characterizing the heterogeneity of a p-n interface.

Inter-specific adoption is an intriguing topic in behavioural and evolutionary ecology. Being a rare phenomenon is rarely documented in the literature and thus reports of inter-specific adoption based on solid data are particularly valuable. Here, owing to a long-term and extensive monitoring of a local population of the European blackbird (Turdus merula, hereafter blackbird), we describe observations of alloparental behaviour exhibited by blackbirds towards fieldfare (Turdus pilaris) nestlings (single nest, first record ever) and fledglings (twelve cases in total). We discuss the observations in respect to available literature.

Objective: Device lead-induced tricuspid regurgitation (LITR) mechanisms are well-defined by 3D transthoracic echocardiography (3D-TTE). There is a lack of data on the Latin-American population. The objective of this study was to describe the prevalence of several mechanisms and insights in patients with permanent right ventricular (RV) implanted devices by 3D-TTE examination. Methods: We performed a cross-sectional analysis of 101 patients with permanent cardiac devices such as pacemakers or defibrillators. 3D-TTE was obtained on all patients in RV-focused apical views to perform a complete tricuspid valve (TV) evaluation: leaflets, subvalvular apparatus, precise lead location, and functional assessment to evaluate possible mechanisms of tricuspid regurgitation (TR). Results: In a total of 101 patients, the leads did not interfere with TV function in 53 p. (59%), while LITR was observed in 38 (41%) patients. Adherent, impinging, entangled, and mixed lead-induced mechanisms were observed. Time in years since device implantation was significantly higher in patients with LITR. Conclusions: LITR was present in a high proportion of our population. LITR is the result of damage to the TV as well as its subvalvular apparatus due to the fibrotic and inflammatory response over time when leads are situated in unfavorable locations.