Patterns of gender inequality perception and depressive symptoms among Chinese adults: The mediating role of marital life satisfaction.

OBJECTIVES: As one of the most severe public health issues, depressive symptoms have attracted wide attention around the world. This study aims to investigate the mediating role of marital life satisfaction in the relationship between gender inequality perception and depressive symptoms. METHODS: Data were obtained from the China Family Panel Studies (CFPS) conducted in 2020. This study incorporated a total of 13,409 married residents aged 20 and above. RESULTS: The residents with middle (B = 0.19, 95 % CI = 0.01, 0.40) or high perception of gender inequality (B = 0.55, 95 % CI = 0.34, 0.75) were more likely to develop depressive symptoms. Marital life satisfaction plays a mediating effect in the relationship between patterns of gender inequality perception and depressive symptoms, and the mediating effect accounted for 4.89 % or 1.37 % of the total impact in the residents with middle or high patterns of gender inequality perception. LIMITATIONS: Further studies need to understand the mechanisms of perceived patterns of gender inequality and depressive symptoms, because the cross-sectional design in this study cannot draw causal inferences. CONCLUSION: Patterns of gender inequality perception are significantly associated with depressive symptoms. Marital life satisfaction plays a mediating role in the relationship between patterns of gender inequality perception and depressive symptoms. It is plausible that nurturing healthy marital relationships could mitigate depressive symptoms in individuals who perceive high degrees of gender disparity.

Atomistic Construction of Silicon Nitride Ceramic Fiber Molecular Model and Investigation of Its Mechanical Properties Based on Molecular Dynamics Simulations.

Molecular simulations are currently receiving significant attention for their ability to offer a microscopic perspective that explains macroscopic phenomena. An essential aspect is the accurate characterization of molecular structural parameters and the development of realistic numerical models. This study investigates the surface morphology and elemental distribution of silicon nitride fibers through TEM and EDS, and SEM and EDS analyses. Utilizing a customized molecular dynamics approach, molecular models of amorphous and multi-interface silicon nitride fibers with complex structures were constructed. Tensile simulations were conducted to explore correlations between performance and molecular structural composition. The results demonstrate successful construction of molecular models with amorphous, amorphous-crystalline interface, and mixed crystalline structures. Mechanical property characterization reveal the following findings: (1) The nonuniform and irregular amorphous structure causes stress concentration and crack formation under applied stress. Increased density enhances material strength but leads to higher crack sensitivity. (2) Incorporating a crystalline reinforcement phase without interfacial crosslinking increases free volume and relative tensile strength, improving toughness and reducing crack susceptibility. (3) Crosslinked interfaces effectively enhance load transfer in transitional regions, strengthening the material's tensile strength, while increased density simultaneously reduces crack propagation.

The Performance of Primary Healthcare in China: The Need for a Systematic Design for Improvement Comment on "Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China".

In the paper "Quality and Performance Measurement in Primary Diabetes Care: A Qualitative Study in Urban China," Rasooly and colleagues provide an in-depth analysis of the ways in which Shanghai manages the quality and performance of the primary healthcare (PHC). The present commentary extends the analytical perspective offered in this paper from the city of Shanghai to the entire Chinese Mainland. In so doing, it points out certain systemic shortcomings in the capabilities of family doctors, the unreasonable competition between primary, secondary, and tertiary forms of healthcare, and the negative incentives in the salary system for PHC providers that must be overcome to improve performance. This commentary also proposes strategies and other recommendations for overcoming the bottlenecks identified in the paper as a means of systematically enhancing PHC performance across Mainland China.

Impact of Diagnosis-Related-Group (DRG) payment on variation in hospitalization expenditure: evidence from China.

BACKGROUND: Diagnosis-Related-Group (DRG) payment is considered a crucial means of addressing the rapid increases of medical cost and variation in cost. This paper analyzes the impact of DRG payment on variation in hospitalization expenditure in China. METHOD: Patients with chronic obstructive pulmonary disease (COPD), acute myocardial infarction (AMI) and cerebral infarction (CI) in a Chinese City Z were selected. Patients in the fee-for-service (FFS) payment group and the DRG payment group were used as the control group and intervention group, respectively, and propensity-score-matching (PSM) was conducted. Interquartile distance (IQR), standard deviation (SD) and concentration index were used to analyze variation and trends in terms of hospitalization expenditure across the different groups. RESULTS: After DRG payment reform, the SD of hospitalization expenditure in respect of the COPD, AMI and CI patients in City Z decreased by 11,094, 4,833 and 4,987 CNY, respectively. The concentration indices of hospitalization expenditures for three diseases are all below 0 (statistically significant), with the absolute value tending to increase year by year. CONCLUSION: DRG payment can be seen to guide medical service providers to provide effective treatment that can improve the consistency of medical care services, bringing the cost of medical care closer to its true clinical value.

The impact of integrated urban and rural resident basic medical insurance on health service equity: Evidence from China.

Background: Many countries and regions worldwide are improving their healthcare systems through the integration and unification of health insurance programs covering different groups of people. In China, the past 10 years has been the time when Chinese government promote the Urban and Rural Residents Basic Medical Insurance (URRBMI) by integrating the Urban Residents' Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NRCMS). Objectives: To evaluate the impact of the URRBMI on equity in relation to health services. Methods: The quantitative data used in this study were obtained from the CFPS 2014-2020 database, and all respondents with health insurance type UEBMI, URBMI, and NRCMS were included. UEBMI respondents were set as the control group and URBMI or NRCMS as the intervention group, and a DID method model was used to analyze the impact of integrating health insurance on health service utilization, costs and health status. Heterogeneity analysis was also conducted after stratifying the sample according to income level and chronic disease status. This was done to investigate whether there were differences in the effects of the integrated health insurance program across different social groups. Results: The implementation of URRBMI is found to be associated with a significant increase in inpatient service utilization (OR = 1.51, P < 0.01) among rural Chinese residents. Regression results by income stratum show that the utilization of inpatient services increased in rural areas for high-, middle- and low-income groups, with the fastest increase (OR = 1.78, P < 0.05) emerging for low-income groups. Analysis by chronic disease status shows that rural residents with chronic disease are associated with a higher increase in hospitalization rates (OR = 1.64, P < 0.01). Conclusion: The implementation of URRBMI is found to have improved health insurance's ability to withstand risks and effectively improve access to health services for rural residents. In this regard, it can be considered as playing a positive role in bridging the gap in health service utilization between rural and urban areas and in improving regional equity.

Nano Si-Doped Ruthenium Oxide Particles from Caged Precursors for High-Performance Acidic Oxygen Evolution.

RuO2 is well known as the benchmark acidic oxygen evolution reaction (OER) catalyst, but its practical application has been impeded by its limited durability. Herein, it is presented that the stability of ruthenium oxide can be significantly improved by pretrapping RuCl3 precursors within a cage compound possessing 72 aromatic rings, which leads to well carbon-coated RuOx particles (Si-RuOx @C) after calcination. The catalyst survives in 0.5 M H2 SO4 for an unprecedented period of 100 hours at 10 mA cm-2 with minimal overpotential change during OER. In contrast, RuOx prepared from similar non-tied compounds doesn't exhibit such catalytic activity, highlighting the importance of the preorganization of Ru precursors within the cage prior to calcination. In addition, the overpotential at 10 mA cm-2 in acid solution is only 220 mV, much less than that of commercial RuO2 . X-ray absorption fine structure (FT-EXAFS) reveals the Si doping through unusual Ru-Si bond, and density functional theory (DFT) calculation reveals the importance of the Ru-Si bond in enhancing both the activity and stability of the catalyst.

Gender difference in the relationship between personality traits and changes in depressive symptoms before and after the COVID-19 outbreak: A follow-up study among Chinese adults.

OBJECTIVES: Increasing depressive symptoms have become an urgent public health concern worldwide. This study aims to explore the correlation between personality traits and changes in depressive symptoms before and after the COVID-19 outbreak and to examine the gender difference in this association further. METHODS: Data were obtained from the China Family Panel Studies (CFPS, wave in 2018 and 2020). A total of 16,369 residents aged 18 and above were included in this study. Multinomial logistic regression analysis was used to examine whether personality traits were associated with changes in depressive symptoms. We also analyzed whether there was an interaction effect of gender and personality traits on depressive symptoms. RESULTS: Conscientiousness, extroversion, and agreeableness are negatively associated with depressive symptoms, while neuroticism and openness are positively related. Gender moderates the relationship between personality traits and depressive symptoms. Compared to men, women have demonstrated a stronger association between neuroticism (OR = 0.79; 95 % CI = 0.66, 0.94), conscientiousness (OR = 1.40; 95 % CI = 1.15, 1.69), and persistent depressive symptoms. LIMITATIONS: Given its longitudinal study design, it is insufficient to draw a causal inference between personality traits and depressive symptoms. CONCLUSION: Personality traits and their various dimensions are correlated with changes in depressive symptoms. Persistent depressive symptoms are positively related to neuroticism and negatively associated with conscientiousness. Women demonstrate a stronger association between personality traits and persistent depressive symptoms. Thus, in Chinese adults' mental health intervention and prevention programs, personality and gender-specific strategies should be considered, especially in the context of the COVID-19 pandemic.

Cage-modified hypocrellin against multidrug-resistant Candida spp. with unprecedented activity in light-triggered combinational photodynamic therapy.

Infections caused by multidrug-resistant fungi pose a devastating threat to human health worldwide, making new antifungal strategies urgently desired. Antimicrobial photodynamic therapy (aPDT) has gained increasing attention due to its potential in fighting against fungal infection. However, the preparation of highly efficient and water-soluble photosensitizers (PSs) for this purpose remains a challenge. Herein, we present a new strategy to prepare powerful PSs for efficient aPDT by introducing a porous cage compound, which could facilitate the transportation of O2 and reactive oxygen species (ROS). Specifically, the natural PS hypocrellin A (HA) was attached to a novel organic cage compound (covalent organic polyhedra 1 tied, COP1T) with polyethylene glycol (PEG) chains to improve its water solubility. It was found that the resulting COP1T-HA exhibited in vitro antifungal efficiency several folds higher compared to the free HA in fighting against four types of multidrug-resistant fungal planktonic cells and biofilms, including the "super fungus" Candida auris. Interestingly, the red-shift of COP1T-HA adsorption led to the realization of phototheranostic aPDT for cage-modified HA or derivatives. Additionally, COP1T-HA exhibited good biocompatibility, excellent disinfection capacity and wound healing efficiency without obvious toxic effects in vivo of rat model. With further development and optimization, COP1T-HA has great potential to become a new class of antifungal agent to fight against drug-resistant pathogens.

Influence of social distancing on physical activity among the middle-aged to older population: Evidence from the nationally representative survey in China.

Background: Group-based physical activity is an important positive factor assisting the middle-aged to older population to be regularly physically active, especially inside a society with a large population and highly sociable environment. However, when group-based physical activity is restricted during a public health crisis such as the infectious disease pandemic, the influence of social distancing on physical activity among this vulnerable group needs to be recognized. Objectives: This study aimed to investigate the influence of social distancing on physical activity among the middle-aged to older Chinese population at the national level. Methods: Data from a nationally representative social follow-up survey (China Family Panel Studies, CFPS) for 2018 and 2020 were used. Physical activity level in year 2018 was set as the baseline to be compared with that for each individual in 2020, when China implemented social distancing during the COVID-19. Chinese population with an age greater than 45 years were included, and three levels of physical activity were established. Logistic models were developed to identify sociodemographic characteristic that may be associated with a higher probability of worse PA behaviors during the social distancing. Results: Over 46% respondents could be described as being Physically Inactivity during 2018 and this proportion increased to 67.2% in 2020. Respondents who live in the Northeast or rural regions, having a spouse, being employed, having a low level of education, and being of low-income level showed a higher decrease in physical activity compared to other groups. However, individuals living with chronic diseases emerge as being more likely to maintain positive habits with respect to physical activity in this context. Conclusion: Social distancing during the COVID-19 pandemic has significantly influenced the extent of physical activity among middle-aged to older Chinese residents. This is especially true in respect to middle-aged and elderly people who are at increased risk of chronic diseases. Given this, there is a clear need to consider effective modalities for physical activity in the context of social distancing based on home quarantine and city lockdown. Furthermore, specific health-related strategies need to be considered in relation to different regions and populations.

Carbon Material With Ordered Sub-Nanometer Hole Defects.

A holey carbon material with ordered sub-nanometer hole defects was synthesized from oxidative cyclodehydrogenation of a polyhexaphenylbenzene precursor. Band gap of around 2.2 eV is formed due to the narrow connection between the hexabenzocoronene subunits. It has weak interlayer interaction energy compared with graphene and shows easy dispersion in a wide range of solvents, surprisingly including water. Density functional theory calculations confirmd the excellent dispersion of this material in water. This new carbon material was then proved as effective support for various inorganic nanoparticles of small sizes. The supported iron nanoparticles showed enzyme-like catalysis behavior in nitrophenyl reduction reaction by NaBH4, exemplifying the great potential of this new material in catalysis.

Biomimetic caged platinum catalyst for hydrosilylation reaction with high site selectivity.

Natural enzymes exhibit unparalleled selectivity due to the microenvironment around the active sites, but how to design artificial catalysts to achieve similar performance is a formidable challenge for the catalysis community. Herein, we report that a less selective platinum catalyst becomes highly active and selective for industrially relevant hydrosilylation of a broad range of substrates when a porous cage ligand is used for confinement around the catalytic active site. The catalyst is more than ten times more active than Karstedt's catalyst while being recyclable. Properties such as size-selective catalysis and Michaelis-Menten kinetics support the proposed enzyme-like model. This biomimetic catalyst exhibits remarkable site-selectivity through the cage's confining effect, which amplifies small steric differences into dramatic reactivity changes for similar functional groups within a molecule.

Polysiloxane-Modified Tetraphenylethene: Synthesis, AIE Properties, and Sensor for Detecting Explosives.

Polysiloxane-modified tetraphenylethene (PTPESi) is successfully synthesized by attaching tetraphenylethene (TPE) units onto methylvinyldiethoxylsiloxane and subsequent polycondensation. Introducing polysiloxane into TPE has minimal effect on the photophysical properties and aggregation-induced emission behavior of TPE. The highest occupied and lowest unoccupied molecular orbital (HOMO and LUMO) energy levels of PTPESi are located mainly on the tetraphenylethene moieties. The fluorescence intensity and the half width of the emission peak of PTPESi before and after annealing at 120 °C for 12 h are nearly the same, indicating high thermal stability and morphological stability. In addition, use of PTPESi film as a sensor toward the vapor-phase detection of explosives is also studied and it displays quite high fluorescence quenching efficiency and good reversibility.