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An outbreak of clusters of viral pneumonia due to a novel coronavirus (2019-nCoV/SARS-CoV-2) happened in Wuhan, Hubei Province in China in December 2019. Since the outbreak, several groups reported estimated R 0 of Coronavirus Disease 2019 (COVID-19) and generated valuable prediction for the early phase of this outbreak. After implementation of strict prevention and control measures in China, new estimation is needed. An infectious disease dynamics SEIR (Susceptible, Exposed, Infectious, and Removed) model was applied to estimate the epidemic trend in Wuhan, China under two assumptions of R t . In the first assumption, R t was assumed to maintain over 1. The estimated number of infections would continue to increase throughout February without any indication of dropping with R t  = 1.9, 2.6, or 3.1. The number of infections would reach 11,044, 70,258, and 227,989, respectively, by 29 February 2020. In the second assumption, R t was assumed to gradually decrease at different phases from high level of transmission ( R t  = 3.1, 2.6, and 1.9) to below 1 ( R t  = 0.9 or 0.5) owing to increasingly implemented public health intervention. Several phases were divided by the dates when various levels of prevention and control measures were taken in effect in Wuhan. The estimated number of infections would reach the peak in late February, which is 58,077–84,520 or 55,869–81,393. Whether or not the peak of the number of infections would occur in February 2020 may be an important index for evaluating the sufficiency of the current measures taken in China. Regardless of the occurrence of the peak, the currently strict measures in Wuhan should be continuously implemented and necessary strict public health measures should be applied in other locations in China with high number of COVID-19 cases, in order to reduce R t to an ideal level and control the infection.

In recent decades, precast concrete buildings have undergone significant development, attracting considerable academic attention to their mechanical performances. Unlike cast-in-situ buildings, precast buildings are assembled on site by connecting precast components using mechanical devices or on-site casted joints, which makes the connections particularly important for overall structural performances. This study presents a comprehensive review of the mechanical performances of precast buildings, with a specific focus on various types of connections and their structural properties. This study reviews the mechanical performances of building connections using dry, wet, and/or hybrid methods between pre-manufactured components, e.g., beam–column joints, wall–panel connections, and column/wall–foundation connections. Both experimental and numerical investigations are reviewed. The paper provides a valuable reference regarding the mechanical performances of precast concrete buildings.

Patients with infectious diseases are often at increased risk of anxiety during treatment. The prevalence of anxiety and depression in infected people increased significantly during the COVID-19 pandemic, and the risk factors for these mental health problems need to be urgently investigated. In this study, a cross-sectional study was conducted in Shanghai in 2022, which included 1283 patients and systematically assessed their sociodemographic characteristics and mental health status. A random forest classifier combined with the Boruta algorithm was used to screen predictors, and a nomogram was constructed based on the screening results. The results of the study showed that entrapment (OR 1.07, 95% CI 1.05–1.09, P  < 0.001), defeat (OR 1.04, 95% CI 1.01–1.07, P  < 0.01) and stigma (OR 1.05, 95% CI 1.03–1.06, P  < 0.001) were positively associated with anxiety, whereas social support (OR 0.97, 95% CI 0.96–0.98, P  < 0.001) was negatively associated with anxiety. The C-index of the model was 0.858, the area under the ROC curve (AUC) was 0.861 (95% CI 0.834–0.888), and the P value of the Hosmer–Lemeshow test was 0.07, indicating that the model fit well. Based on the Random Forest machine learning method, this study successfully constructed a prediction model for anxiety risk in COVID-19 patients, screening out key risk factors such as feeling trapped, frustration, stigma and social support, providing a scientific basis for clinical practice and public health, and helping to promote personalized interventions for anxiety and the building of a mental health support system.

Background High prevalence and strong relationships among suicidal ideation, Internet gaming disorder (IGD), insomnia, and depression have been reported for adolescents worldwide, but the mechanism underlying these psychological problems remains unclear. This cross-sectional study explored the mediating effect of insomnia and depression on the association between IGD and suicidal ideation. Methods Participants were 1066 adolescents (median age = 13.0 years) with Internet games exposure in the previous 12 months from junior high schools in Shanghai, China. Questionnaire measures of suicidal ideation, IGD, insomnia, depressive symptoms, and background characteristics were obtained. Path analysis was conducted to test the multiple mediating roles of insomnia and depression. Results Suicidal ideation, IGD, insomnia, and depression prevalence was 27.2, 13.6, 9.2, and 17.0%, respectively. A serial multiple mediation model was generated. The mediation effect of insomnia and depression on the pathway from IGD to suicidal ideation was 45.5% (direct effect: standardized estimate [Std. estimate] = 0.186; total indirect effect: Std. estimate = 0.155). The association between IGD and depression was partially mediated by insomnia (direct effect: Std. estimate = 0.211; indirect effect: Std. estimate = 0.135). The proposed model fit the data well. Conclusions Insomnia and depression may serially mediate the association between IGD and suicidal ideation. IGD was positively associated with insomnia, then with depression, which in turn positively contributed to suicidal ideation. We suggest greater monitoring of Internet use and prevention of insomnia and depression to mitigate the risk of suicidal ideation among Chinese adolescents.

Background The prevalence of osteoporosis (OP) is rapidly increasing. Healthy behaviors are crucial for the management of OP. Application of the information–motivation–behavioral skills (IMB) model has been verified in various chronic diseases, but this model has not been investigated for behavioral interventions among people with OP. This study aimed to examine factors influencing OP self-management behavior and their interaction paths based on the IMB model. Methods We conducted a cross-sectional study using a convenience sampling method in 20 community health service centers in Shanghai, China. Predictive relationships between IMB model variables and self-management behaviors were evaluated using an anonymous questionnaire. Structural equation modeling was used to test the IMB model. Results In total, 571 participants completed the questionnaire, of which 461 (80.7%) were female. Participants’ mean age was 68.8 ± 10.1 years. Only 101 (17.7%) participants were classified as having better OP self-management behaviors. The model demonstrated the data had an acceptable fit. Paths from information to self-efficacy (β = 0.156, P  < 0.001) and self-management behaviors (β = 0.236, P  < 0.001), from health beliefs to self-efficacy (β = 0.266, P  < 0.001), from medical system support to self-efficacy (β = 0.326, P  < 0.001) and self-management behaviors (β = 0.230, P  < 0.001), and from self-efficacy to self-management behaviors (β = 0.376, P  < 0.001) were all significant and in the predicted direction. Conclusion This study validated the utility of the IMB model for OP self-management behaviors in this population. Middle-aged and older adult patients with OP have poor self-management behaviors. Enhanced knowledge about OP and is important for improving self-management behaviors.

Background The competence of public health workers is crucial for grassroots public health service capabilities. This study aimed to establish a competency model for public health workers and to test the reliability and validity of the model. Methods An evaluation indicators scale of competency of public health workers in Shanghai community health service centers (CHSCs) was constructed through a literature review, expert consultation, behavioral event interviews and questionnaire surveys. A questionnaire survey was carried out with 3809 public health workers from 249 Shanghai CHSCs to test the reliability and validity of the constructed scale. Results Exploratory factor analysis identified 5 common factors: comprehensive ability, professional spirit, professional knowledge, professional skills, research and development ability. The cumulative variance contribution rate was 62.241%. The factor load for each item ranged from 0.495 to 0.868. The overall Cronbach's alpha coefficient for the questionnaire was 0.985, for the five dimensions ranged from 0.916 to 0.969. The overall split-half reliability of the questionnaire was 0.842, and that of the five dimensions ranged from 0.913 to 0.952, with the Guttman split-half reliability coefficient ranging from 0.912 to 0.949. The correlation coefficients for all scale items with the total score ranged from 0.591 to 0.854 ( p  < 0.01). The correlation coefficients between each item and each dimension ranged from 0.434 to 0.925. Confirmatory factor analysis showed that the model had a good fitting effect ( χ 2 / df  = 2.288, TLI = 0.943, CFI = 0.957, IFI = 0.958, NFI = 0.928, RMSEA = 0.081). Using self-efficacy, self-esteem, work pressure, work motivation, and job satisfaction as benchmarks, all dimensions of the scale demonstrated significant positive correlations with the total scores of various benchmark questionnaires. Conclusions The constructed scale of competency of public health workers in Shanghai CHSCs has good reliability and validity and can be used as a tool to evaluate the competency level of public health workers.

Background The Information-Motivation-Behavioral Skills (IMB) model has received consistent empirical support in the context of HIV prevention among various key populations, but not yet among transgender women (TGW). None effective interventions has been carried out among TGW so far to control their high prevalence of unprotected anal intercourse. The intent of the current study is to examine the application of the IMB model to clarifying the association between condom use correlates and condom use frequency among TGW in China. Methods Using snowball sampling, we recruited 198 self-identified TGW in Shenyang, China from April 2017 to July 2017. Participants were required to complete a questionnaire assessing their background characteristics and IMB model constructs. Structural equation modeling (SEM) was conducted to demonstrate the utility of the IMB model. Results The consistent condom use (CCU) rate was 47.0%. Results of SEM indicated that HIV-preventive motivation (comprising condom use attitude and subjective norms; β = 0.823, P  <  0.001) and behavioral skills (including condom use skills and self-efficacy; β = 0.979, P  = 0.004) were related to more frequent condom use, whereas HIV knowledge was unrelated to condom use (β = 0.052, P  = 0.540). Conclusions The low CCU rate suggested that TGW in China were at high risk of HIV infection and transmission and a key intervention population. HIV-preventive interventions for this population should focus on enhancing motivation and strengthening behavioral skills to increase condom use frequency and reduce HIV infection.

Objectives This study explores whether feelings of defeat (i.e., a sense of failed struggle and losing rank; referred to as defeat for simplicity) mediated the effect of work stress on depression/anxiety, the effect of interpersonal needs on depression/anxiety for Chinese industrial workers, and the possible moderating role of social support. Method A cross-sectional study was conducted in Shenzhen, China in 2019, in total, 2023 industrial workers (of 2700 invited; response rate = 75%) completed a self-administered survey consisted of Job Stress Scale, Interpersonal Needs Questionnaire, Defeat Scale, Centre for Epidemiological Studies Depression Scale, Generalized Anxiety Disorder Scale, two face-valid questions for social support, as well as sociodemographic information. Moderated mediation model was tested and loop plots were applied to probe into the conditional effects of work and interpersonal stress on depression and anxiety symptoms. Result Both the direct and indirect effect of work stress on depression and anxiety through defeat were significant (Work stress→ Depression: B  = 0.035, p  < .001, Work stress→ Defeat→ Depression: B  = 0.034, p  < .001; Work stress→ Anxiety: B  = 0.038, p  < .001, Work stress→ Defeat→ Anxiety: B  = 0.045, p  < .001). Meanwhile, defeat mediated the relationship of interpersonal needs with depression partially and the relationship of interpersonal needs with anxiety totally (Interpersonal needs→ Anxiety: B = 0.133, p < .001, Interpersonal needs→ Defeat→ Anxiety: B  = 0.010, p  = .537). Social support moderated the indirect path between interpersonal needs and depression/anxiety and buffered the effect. Conclusion The mediating role of defeat and the moderator role of social support in the relationship between stress and depression/anxiety were confirmed in industrial workers. Workers who reported more work and interpersonal stress would report more defeat feelings, and then exhibited more depression and anxiety symptoms; this mediation effect was stronger for those who had lower social support, respectively.

Objective To evaluate the association between the segmental bronchi radiation dose and radiation pneumonitis (RP) in patients with lung cancer who underwent radiotherapy. Methods A total of 135 patients with lung cancer who were treated with radiation therapy between December 2014 and December 2015 were enrolled in the study. RP was defined and graded according to the criteria of the Radiation Therapy Oncology Group. The radiation dose to the segmental bronchi, along with clinical, and other dosimetric factors were recorded. Logistic regression analysis was used to evaluate the association between the related factors and RP. Results Among the 135 enrolled patients, 24 (17.8%) developed grade 3 radiation pneumonitis or higher. Study found that RP was associated with the following factors: patient age, complications with chronic obstructive pulmonary disease, concurrent chemotherapy, percentage of lung volume receiving more than 30 Gy (V30), whole lung volume, and the segmental bronchi maximum and mean dose. Logistic regression analysis showed that the maximum dose of the segmental bronchi, whole lung volume, and V30 were independent risk factors for RP. According to the receiver operating characteristic curve, the maximum dose constraint of the segmental bronchi during radiotherapy is estimated at 23.85 Gy. Conclusion The segmental bronchi radiation dose should be considered as a normal tissue constraint, in addition to whole lung volume and V30 in radiotherapy for patients with lung cancer to decrease the incidence of RP.

Transgender women (TGW) worldwide report disproportionate violence victimization, depression and condomless anal intercourse (CAI), but the mechanism of the coexistence remains unclear. Using snowball sampling, we recruited 198 self-identified TGW in Shenyang, China between April 2017 and July 2017, and conducted confidential questionnaire survey among them. Positive HIV status was reported by 49 (24.7%) participants. 117 (59.1%) reported at least one type of lifetime violence victimization, with transactional sexual partners being the main violence perpetrators. 108 (54.5%) reported mild to severe depression. 105 (53.0%) reported having CAI with their sexual partners during the last 6 months. Path analysis showed that the association between participants’ violence victimization and CAI was fully mediated by their depression (indirect effect: 0.083, p = 0.014; direct effect: 0.137, p = 0.121). We suggest to incorporate violence screening and prevention and mental health services into intervention strategies to prevent CAI among Chinese TGW.