RESUMEN
Background: Primary care physicians (PCPs) are doctors in primary health care institutions, namely village clinics, township health centers and community health service centers (stations) who are the main providers of primary health care services in primary health care settings. Improving the overall health status of the population requires the support of a large number of primary care physicians; however, the job satisfaction of this group has not been sufficiently emphasized and recognized. Objective: The purpose of this study was to examine the effects of primary care physicians' work-family conflict on their job satisfaction, as well as the mediating role of burnout and the moderating role of social support. Methods: This cross-sectional study was conducted from February 2023 to March 2023. Participants were 749 primary care physicians from four cities of Xuzhou, Linyi, Huaibei, and Shangqiu in the Huaihai Economic Zone of China. SPSS statistical analysis was used to evaluate the relationship between work-family conflict, social support, burnout and job satisfaction among medical workers. Results: Work-family conflict had a significant negative effect on job satisfaction (ß = -0.36, p< 0.001), after adding burnout in the model, work-family conflict also negatively predicted job satisfaction (ß = -0.32, p< 0.001). Social support had a moderating effect on the direct effect of burnout on job satisfaction (ß = 0.00, t = 2.66, p< 0.01, 95%CI [0.001, 0.007]), the predictive effect of burnout on job satisfaction at high level of social support (ß = -0.45, p< 0.001) was higher than a low level of social support (ß = -0.33, p< 0.001). Conclusions: This study demonstrated the negative impact of work-family conflict on primary care physicians' job satisfaction, as well as the mediating role of burnout and the moderating role of social support on burnout and job satisfaction, which are important for improving primary care physicians' job satisfaction and enhancing the quality of primary care in the future.
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Severe cases of COVID-19 are characterized by dysregulated immune responses, but specific mechanisms contributing to the most severe outcomes remain unclear. Neutrophils are the most abundant leukocyte population in human hosts and reach markedly high numbers during severe COVID-19. However, a detailed examination of their responses has been largely overlooked in the COVID-19 literature to date. Here, we report for the first time a dedicated study of neutrophil responses using single-cell RNA sequencing (scRNA-Seq) of fresh leukocytes from 11 hospitalized adult patients with mild and severe COVID-19 disease and 5 healthy controls. We observed that neutrophils display a pronounced inflammatory profile, with dramatic disruption of predicted cell-cell interactions as the severity of the disease increases. We also identified unique mature and immature neutrophil subpopulations based on transcriptomic profiling, including an antiviral phenotype, and changes in the proportion of each population linked to the severity of the disease. Finally, pathway analysis revealed increased markers of oxidative phosphorylation and ribosomal genes, along with downregulation of many antiviral and host defense pathway genes during severe disease compared to mild infections. Collectively, our findings indicate that neutrophils are capable of mounting effective antiviral defenses but adopt a form of immune dysregulation characterized by excess cellular stress, thereby contributing to the pathogenesis of severe COVID-19.
RESUMEN
The Yangtze River Delta is one of the most developed regions in China and the rapid development of urbanization have greatly influenced regional hydrology and water resources. Taking several typical urbanizing areas in the Yangtze River Delta as examples, this paper probes into the impacts of urbanization on hydrologic cycle and hydrological process with the support of RS, GIS and hydrological model. The research centers on the impacts of urbanization on precipitation, hydrological process, river networks, and water environment in some typical cities. The results show that: (1) Urban rain island effect is not evident when the process of urbanization is slow, while the differences of annual precipitation and flood season precipitation between urban and suburban areas increased to a certain extent in the booming stage of urbanization. (2) The annual runoff depth and the runoff coefficient increased with the development of urbanization, and the effect will be more notable when the urban areas expand to a certain size; (3) River network systems, especially low-grade rivers have been greatly destroyed in the process of urbanization, which increases the risk of flood and water degradation, so it is very important to protect natural river systems. Based on the results, some proposals of sustainable utilization and protection of water resources is also addressed.