Background Grassroots medical and health personnel are an important component of China's public health system, and guaranteeing their physical and mental health will have a profound impact on the development of China's health service. Objective To identify potential influencing factors of occupational stress, anxiety, depression, and insomnia as well as their interactions. Methods In August 2021, a cross-sectional survey was conducted among all the staff (2675 medical and health personnel) at 7 secondary public hospitals and 8 health institutions in Xiong’an New Area of Hebei Province by cluster sampling. Occupational stress, anxiety, depression, and insomnia were evaluated by the Effort-Reward Imbalance Questionnaire (ERI), the Generalized Anxiety Disorder-7 (GAD-7), the Patient Health Questionnaire-9 (PHQ-9), and the Athens Insomnia Scale (AIS). The bnlearn and gmodels packages of R4.2.1 software were used to construct Bayesian networks on work and personal factors-occupational stress- health effects. The Bayesian network model was visualized by Netica32.0. Results Among the 3018 questionnaires distributed, a total of 2675 valid questionnaires were recovered, with an effective recovery rate of 88.63%. The positive rates of occupational stress, anxiety, depression, and insomnia were 51.48%, 62.13%, 62.50%, and 56.37%, respectively in the grassroots medical and health personnel. The positive rate of occupational stress among the medical and health workers varied by age, educational level, and organization type (P<0.05); the positive rate of anxiety varied by age, marital status, and daily working hours (P<0.05); and the positive rates of depression and insomnia varied by gender, educational level, and overcommitment (P<0.05). The final Bayesian network contained 14 nodes and 18 directed edges, and its prediction accuracy was 85.4%. .Job title, daily working hours, overcommitment and exercise directly associated with occupational stress, and other work and personal factors associated with occupational stress indirectly. Occupational stress associated with insomnia directly or indirectly via anxiety. Anxiety and insomnia associated with reporting depression. Conclusion Grassroots medical and health personnel of Xiong'an New Area, Hebei Province report high levels of occupational stress, anxiety, depression, and insomnia. Occupational stress directly or indirectly associates with anxiety, depression, and insomnia. Work and personal factors associate with occupational stress, and associate with anxiety, depression, and insomnia via occupational stress. Occupational stress may be an early warning factor of general work and personal factors affecting anxiety, depression, insomnia, and other mental health problems. Attention should be paid to the assessment and intervention of occupational stress in medical and health personnel to prevent mental health problems.

Objective To observe the changes of plasma gastrointestinal hormones in motion sickness sensitive and insensitive individuals before and after vertical oscillation stimulation,and to construct a susceptibility prediction model for motion sickness.Methods A total of 60 healthy male volunteers were enrolled to receive sinusoidal vertical oscillation stimulation for 45 min.The motion sickness susceptibility questionnaire(MSSQ)was filled out before the experiment.Immediately after motion,the severity of motion sickness was evaluated by Graybiel scale.The motion sickness sensitive(Graybiel score≥8 and MSSQ susceptibility index＞21,n=15)and insensitive(Graybiel score≤2 and MSSQ susceptibility index＜5,n=15)participants were screened.Plasma levels of glucagon-like peptide-1(GLP-1),cholecystokinin(CCK),leptin,ghrelin,neuropeptide Y(NPY)and orexin A(OXA)were detected by enzyme-linked immunosorbent assay before and after vertical oscillation stimulation.Logistic regression model was used to analyze the predictive effect of plasma gastrointestinal hormone levels on susceptibility to motion sickness,and a combined predictive model was established.Receiver operating characteristic(ROC)curve was used to analyze predictive value of the model.Results Ghrelin and CCK levels were significantly increased in the sensitive group after stimulation compared with those before stimulation(both P＜0.01),while NPY and leptin levels were significantly decreased(both P＜0.01).Similar results were also observed when compared with the insensitive group after stimulation.Multivariate logistic regression analysis showed that plasma ghrelin,CCK and NPY were independent predictors of susceptibility to motion sickness.The established susceptibility prediction model for motion sickness was logit(P)=-0.051 ×ghrelin+0.060× NPY-0.169 ×CCK+33.397.ROC curve analysis showed that area under curve(AUC)value of the prediction model was 0.988,the sensitivity and specificity were 100.0％and 93.3％,respectively,and the prediction effect was better than ghrelin,CCK and NPY alone(AUC=0.792,0.880,0.838).Conclusion The changes of peripheral gastrointestinal appetite regulating hormone levels may be related to the susceptibility to motion sickness.The combined use of these indicators can predict the susceptibility to motion sickness.

Objective To explore the improving effects of motion sickness acclimatization training methods,namely sinusoidal vertical oscillation stimulation and sinusoidal vertical oscillation stimulation combined with visual virtual reality(VR)swell stimulation,on cognitive performance of individuals with extremely severe motion sickness.Methods A total of 90 individuals with extremely severe motion sickness screened by the Graybiel score during 6 h navigation were randomly divided into vertical group,vertical+VR group,and control group(n=30).The abilities of vigilance,memory,rapid calculation,information processing and visual manipulation were evaluated before and after the acclimatization training using a self-developed cognitive performance evaluation software.Results On the 1st day of training,the numbers of missed targets of the vertical group and vertical+VR group were increased in the vigilance test;the reaction time was prolonged in the short-term memory,rapid calculation,information processing and visual manipulation tasks;and the efficiency of rapid calculation was reduced.After acclimatization training,the numbers of missed targets were reduced to the baseline level in the vertical and vertical+VR groups,and the reaction time in the short-term memory,rapid calculation,information processing and visual manipulation tasks and the efficiency of rapid calculation were improved.Conclusion Motion sickness caused by vertical oscillation stimulation or vertical oscillation combined with visual VR swell stimulation can decrease vigilance,short-term memory,rapid calculation,information processing and visual manipulation abilities.Motion sickness acclimatization training can significantly improve the above cognitive abilities.

Objective To study the acclimatization time and effects for preventing motion sickness under sinusoidal vertical oscillation stimulation,visual virtual reality(VR)swell stimulation,and their combined stimulation.Methods Totally 120 individuals with extremely severe motion sickness during 6 h navigation were randomly divided into 4 groups(n=30):vertical group,VR group,vertical+VR group,and control group.The severity of symptoms during the training period was assessed daily by Graybiel scale,and the number of drops from flexible treadmill in the VR group was recorded.The Graybiel score of 0 for 3 d and/or the number of drops for 0 were considered as complete acclimatization.The training effect was validated by navigation under more severe sea conditions.Results The Graybiel scores of the vertical group and vertical+VR group,as well as the number of drops of the VR group were decreased with the increase of training days,and reached the acclimatization level on the 3rd,5th,and 2nd training day,respectively.The longest acclimatization time in the vertical,vertical+VR,and VR groups was 8,8,and 5 d,with an average acclimatization time of 3.6,3.9,and 2.7 d,respectively;the acclimatization rates within 5 d were 93.33％(28/30),76.67％(23/30),and 100.00％(30/30),respectively;the proportions of individuals with effective acclimatization training in the verification voyage were 86.67％(26/30),96.67％(29/30),and 66.67％(20/30),respectively;and the training efficiency was 85.19％,96.30％,and 62.97％,respectively.Conclusion Three training methods all have effects on motion sickness acclimatization,and the acclimatization period is 5-8 d.The acclimatization effects of the vertical oscillation and vertical oscillation+VR training are better than the VR training.

Objective To observe the effect of the supine-posture ripple wood training in preventing motion sickness caused by linear acceleration.Methods Totally 61 motion sickness sensitive males were screened by a vertical oscillation simulator and divided into mildly sensitive group(Graybiel score 1-15,n=28)and severely sensitive group(Graybiel score 16,n=33).The participants in the 2 groups received 5-d ripple wood training,30 min/d.The movement frequency of the ripper wood was maintained at 0.25-0.35 Hz,with an acceleration of 0.15-0.25 g.Graybiel score during the training period was recorded.The static balance function test was conducted before and after training on the 1st and 5th day.Results During the training period,the Graybiel scores and motion sickness incidence in the severely sensitive group were decreased with the increase of training days,and all participants achieved complete acclimatization on the 4th day.The Graybiel scores of the mildly sensitive group were low during the whole period,and the complete acclimatization period was 2 d.There was no significant difference in the sway area of the severely sensitive group in static balance function test before and after training(P＞0.05).The mean velocity of the severely sensitive group in static balance function test was significantly increased after training versus before training on the 1st day(P＜0.01),and there was no significant difference before and after training on the 5th day(P＞0.05).There were no significant differences in the sway area or mean velocity of the mildly sensitive group during the whole training period(all P＞0.05).The validation experiment showed that the motion sickness incidence and the symptom severity were significantly decreased in both groups;the motion sickness incidence of the mildly sensitive group decreased from 100.00％(28/28)to 35.71％(10/28);the incidence of severe symptoms in the severely sensitive group decreased from 100.00％(33/33)to 6.06％(2/33)and the vomiting incidence decreased from 96.97％(32/33)to 6.06％(2/33).Conclusion The supine-posture ripple wood training has great effect in preventing motion sickness,with widespread use and simple operation.

Objective To observe the distribution characteristics of motion sickness susceptibility and compare the efficacy of modified motion sickness susceptibility questionnaire(MSSQ),motion sickness history questionnaire and Graybiel scale in evaluating motion sickness.Methods The susceptibility to motion sickness and historical symptoms were investigated using MSSQ and motion sickness history questionnaire among 1 661 males in navy units A,B,and C.A total of 389 people from the unit C were selected for simulating vertical oscillation stimulation,and the severity of motion sickness was evaluated by Graybiel scale during the stimulation process.The evaluation efficacy of MSSQ,motion sickness history questionnaire and Graybiel scale for motion sickness was analyzed by receiver operating characteristic(ROC)curves.Results The overall distribution of motion sickness susceptibility assessed by MSSQ and motion sickness history questionnaire in this population was right skewed.The distribution characteristics in the units A,B,and C were consistent with the overall distribution,and there was no significant difference among the 3 units.A positive correlation was observed between the MSSQ and the motion sickness history questionnaire in the units A,B,and C(rs=0.565,0.565,0.554),and both of them were comparable in assessing the incidence of motion sickness and severe motion sickness.However,the incidence of motion sickness assessed by Graybiel scale was significantly lower than that assessed by MSSQ and motion sickness history questionnaire(both P＜0.05),and the incidence of severe motion sickness was significantly higher than that assessed by MSSQ and motion sickness history questionnaire(both P＜0.05).ROC curve analysis showed that MSSQ had good predictive value for motion sickness susceptibility and severe motion sickness(area under curve[AUC]=0.736,0.750),while the Graybiel scale had poor predictive ability(AUC=0.559,0.557).Conclusion The right skewed distribution of susceptibility to motion sickness is preliminarily determined.During the acclimatization training for motion sickness,the susceptible individuals can be screened by MSSQ and then subjected to vertical oscillation stimulation to improve the training efficiency.

Background Grassroots center for disease control and prevention (CDC) staff undertake intensive work of disease prevention and control, and may be susceptible to occupational stress, anxiety, depression, and other health problems. Objective To understand the current situation of occupational stress, anxiety, and depression among grassroots CDC staff, and to identify potential risk factor configurations for occupational stress, anxiety, and depression using fuzzy set qualitative comparative analysis (fsQCA), so as to provide a basis for effective intervention. Methods The staff working in county/district-level CDCs in Hebei Province were the target population of the current study. Stratified random cluster sampling method was used to select 1860 staff members of the target population. A questionnaire of general situation, Job Content Scale, 7-item Generalized Anxiety Disorder Scale, and Patient Health Questionnaire-9 were used. Risk factor configurations associated with health outcomes of interest were identified by fsQCA3.0 software. Results The positive rates of occupational stress, anxiety, and depression were 42.69%, 44.25%, and 47.96%, respectively. Marital status was a necessary condition for occupational stress, anxiety, and depression in the grassroots CDC staff (the necessity values were 0.911, 0.939, and 0.933, respectively). There were two types of risk factor configurations for occupational stress: "self-improvement" and "disease burden"; the risk factor configurations for anxiety were "disease burden" and "economic-disease burden"; while the risk factor configurations for depression were "disease burden", "economic-disease burden", and "self-improvement". The overall consistency scores of occupational stress, anxiety, and depression were 0.941, 0.820, and 0.774, respectively. Regarding outstanding components, "self-improvement" included pressure of job requirements and promotion, "disease burden" included impact of chronic illness on psychological state, and "economic-disease burden" included not only impact of chronic illness but also financial support for CDC staff. Conclusion All positive rates of occupational stress, anxiety, and depression are high among grassroots CDC staff in Hebei Province. Occupational stress, anxiety, and depression of grassroots CDC staff are the results of multiple influencing factors, so targeted intervention measures should be formulated.

Objective:To understand the overall development and dynamic change trend of scientific research input-output efficiency of a tertiary hospital in Xinjiang from 2016 to 2021, so as to provide reference and basis for optimizing hospital scientific research configuration and improving scientific research efficiency.Methods:The BCC model of Data Envelopment Analysis (DEA) method is combined with Malmquist index method for analysis and evaluation.Results:Within 6 years, the average value of comprehensive technical efficiency of nursing units has not reached 1.The total factor productivity of nursing units was unstable, showing an alternating rise and fall trend, with a fluctuation range of 0.749~1.140.Conclusions:The overall efficiency of scientific research in clinical departments of hospitals is not high. Hospitals should implement multi-level scientific research evaluation, form a dynamic evaluation system for scientific research, reasonably optimize and supervise the investment and utilization of scientific research resources, improve the scientific research management system, enhance the scientific research awareness of researchers, promote technological progress of researchers, and thereby improve scientific research efficiency.

Background and Objectives: Mesenchymal stem cells (MSCs) have immunomodulatory function and participate in the pathogenesis of many immunoregulation-related diseases, including psoriasis. Previously, we found that MSCs from psoriatic lesions overexpress the proinflammatory microRNA, miR-155 and exhibit a decreased immunosuppressive capacity. But the origin of these aberrant characteristics is still not clear. To investigate whether inflammatory cytokines in serum and peripheral blood mononuclear cells (PBMCs) from psoriatic patients can regulate the expression patterns of immunoregulation-related cytokines and the immunoregulation function of MSCs. Methods: and Results: Normal dermal mesenchymal stem cells (nDMSCs) were treated with serum or PBMCs derived from patients with psoriasis or healthy donors. Expression of miR-155 and immunoregulation-related genes in each MSCs were measured using real-time PCR or western-blot. Meanwhile, the immunosuppressive capacity of DMSCs was evaluated by its inhibitory ability on proliferation of activated PBMCs. Compared to control serum, psoriatic serum significantly increased the expression levels of miR-155 (27.19±2.40 vs. 3.51±1.19, p<0.001), while decreased TAB2 expression (0.28±0.04 vs. 0.72±0.20, p<0.01) in DMSCs. Expression levels of immunoregulation-related genes such as PGE2, IL-10, and TLR4 were also markedly down-regulated following the psoriatic serum treatment. Those DMSCs treated with healthy serum could inhibit PBMC proliferation, while those psoriatic serum-treated DMSCs could not inhibit PBMC proliferation effectively. Conclusions Psoriatic serum up-regulate the expression of miR-155, down-regulate the expression of immunoregulation- related genes (PGE2, IL-10, and TLR4) in DMSCs, and along with the inhibition of the immunosuppressive function of MSCs.

Background Since the outbreak of the COVID-19 epidemic, staff of the centers for disease control and prevention (CDC) have been burdened with heavy epidemic prevention control, and excessive occupational stress can cause depression and other psychological problems. Objective To explore the status of occupational stress, resilience, and depression of CDC staff and potential relationships between them. Methods From December 2020 to April 2021, a survey was conducted at provincial and municipal levels, and the stratified cluster sampling method was used at county (district) level to select a total of 3514 samples. Their occupational stress, resilience, and depression status were evaluated using the Chinese Effort-Reward Imbalance Scale (ERI), the Chinese Connor-Davidson Resilience Scale (CD-RISC), and the Patient Health Questionnaire (PHQ-9). Independent sample t test, analysis of variance, χ² test, Pearson correlation analysis, and mediation test (structural equation model) were conducted. Results The positive rate of occupational stress was 34.29% in the CDC staff, the resilience score was 66.28±15.32, and the positive rate of depression was 48.58%. Significant differences were found in the positive rates of occupational stress among different groups of gender, age, education background, marital status, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the resilience scores among different groups of gender, age, administrative duty, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05); in the positive rates of depression among different groups of gender, age, educational background, personal monthly income, weekly exercise frequency, chronic disease prevalence, and participation in epidemic control (P<0.05). Occupational stress was negatively correlated with resilience (r=−0.165, P<0.01). Resilience was negatively correlated with depression (r=−0.383, P<0.01). Occupational stress was positively correlated with depression (r=0.343, P<0.01). The structural equation embracing a partial mediating effect of resilience on the relationship occupational stress and depression was established, and the partial mediating effect was 0.039, accounting for 10.46% of the total effect. Conclusion High positive rates of occupational stress, reduced resilience, and depression are shown among CDC staff in the context of the COVID-19 epidemic, and resilience partially mediates the effect of occupational stress on depression. The study findings suggest that improving resilience may reduce occupational stress and depression in CDC staff.