Burnout and Well-Being Among Medical Professionals in China: A National Cross-Sectional Study

ObjectiveTo determine the profile of Chinese medical professionals with burnout symptoms at the national level and identify the association between capability well-being and burnout.Design and SettingA cross-sectional study in a nonrandom national sample of medical staff from 6 provinces across western, central and eastern China.ParticipantsPhysicians, medical laboratory scientists, nurses, and general practitioners aged 18 years or above who submitted a completed online questionnaire from June 2019 to January 2020 successfully (N = 25,120).Main Outcome MeasuresThe prevalence of burnout symptoms was assessed by the 22-item Maslach Burnout Inventory-Human Services Survey (MBI-HSS), which consists of three domains: emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). The overall high burnout was defined as EE score ≥27 or DP score ≥10. The capability well-being was measured by the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A) and the overall ICECAP-A score was calculated using the UK value set, ranging from a score of 0–1. Multivariable logistic regression analysis was used to identify the association between well-being and the overall high burnout.ResultsAmong the 25,120 participants, 60.8% of the participants reported at least one symptom of burnout, whereas 11.2% reported all three symptoms of burnout. In the adjusted model, ICECAP-A score was independently associated with high burnout (AOR = 0.018, 95% CI = 0.015–0.022). Medical staff who were males, with shorter working years, working in tertiary hospitals, and those with the specialties of psychiatry, intensive care, emergency medicine, internal medicine, oncology, and pediatrics were at higher risk of reporting burnout symptoms.ConclusionThe burnout symptoms were relatively common among Chinese medical staff and they were found to be independently associated with capability well-being in health professionals. Interventions should be enhanced on vulnerable groups to reduce burnout and promote well-being in future studies.

Research on the Growth Mechanism of PM2.5 in Central and Eastern China during Autumn and Winter from 2013–2020

Haze is a majorly disastrous type of weather in China, especially central and eastern of China. The development of haze is mainly caused by highly concentrated fine particles (PM2.5) on a regional scale. Here, we present the results from an autumn and winter study conducted from 2013 to 2020 in seven highly polluted areas (27 representative stations) in central and eastern China to analyze the growth mechanism of PM2.5. At the same time, taking Beijing Station as an example, the characteristics of aerosol composition and particle size in the growth phase are analyzed. Taking into account the regional and inter-annual differences of fine particles (PM2.5) distribution, the local average PM2.5 growth value of the year is used as the boundary value for dividing slow, rapid, and explosive growth (only focuses on the hourly growth rate greater than 0). The average value of PM2.5 in the autumn and winter of each regional representative station shows a decreasing trend as a whole, especially after 2017, whereby the decreasing trend was significant. The distribution value of +ΔPM2.5 (PM2.5 hourly growth rate) in the north of the Huai River is lower than that in the south of the Huai River, and both of the +ΔPM2.5 after 2017 showed a significant decreasing trend. The average PM2.5 threshold before the explosive growth is 70.8 µg m−3, and the threshold that is extremely prone to explosive growth is 156 µg m−3 to 277 µg m−3 in north of the Huai River. For the area south of the Huai River, the threshold for PM2.5 explosive growth is relatively low, as a more stringent threshold also puts forward stricter requirements on atmospheric environmental governance. For example, in Beijing, the peak diameters gradually shift to larger sizes when the growth rate increases. The number concentration increasing mainly distributed in Aitken mode (AIM) and Accumulation mode (ACM) during explosive growth. Among the various components of submicron particulate matter (PM1), organic aerosol (OA), especially primary OA (POA), have become one of the most critical components for the PM2.5 explosive growth in Beijing. During the growth period, the contribution of secondary particulate matter (SPM) to the accumulated pollutants is significantly higher than that of primary particulate matter (PPM). However, the proportion of SPM gradually decreases when the growth rate increases. The contribution of the PPM can reach 48% in explosive growth. Compared to slow and rapid growth, explosive growth mainly occurs in the stable atmosphere of higher humidity, lower pressure, lower temperature, small winds, and low mixed layers.

Changes in the Prevalence of Hyperuricemia in Clients of Health Examination in Eastern China, 2009 to 2019

Background: With the continuous improvement of people's living standards, the incidence of hyperuricemia (HUA) is increasing globally. The prevalence of HUA ranged in terms of region, race, and age. This study aims to investigate the changes in the prevalence of HUA in clients of health examination in Eastern China between 2009 and 2019. Methods: Chinese men and women aged 20-79 years (n = 4847 in the 2009 cohort and n = 12188 in 2019) who had received health examinations were enrolled. Serum uric acid (UA) levels and biochemical parameters, including fasting blood-glucose (FBG), triglyceride (TG), total cholesterol (CHOL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), creatinine (Cr) and blood urea nitrogen (BUN) were evaluated. The prevalence of HUA in different age groups were measured, and the correlation of biochemical parameters with the onset of HUA were analyzed. Results: The prevalence of HUA was 18.7% in the 2019 cohort, which was significantly higher than that in 2009 (13.3%). In females, the prevalence of HUA was significantly higher in 2019 than 2009 for age groups of 20-29 and 30-39 years. In male population, 2019 cohort had significantly higher age-specific prevalence for all age groups than 2009 cohort. Young men aged 20-29 years became the main population of HUA in the 2019 male cohort, whereas middle-aged men aged 40-49 years had the highest prevalence of HUA in the 2009 male cohort. The prevalence rates of HUA in all BMI groups in 2019 cohort were significantly higher than those in 2009 cohort. Spearmen’s correlation analysis and Logistic regression analysis indicated that BMI was positively correlated with the onset of HUA. The receiver-operating characteristic curve (ROC) analysis showed BMI＞24.48kg/m2 and BMI＞23.84 kg/m2 displayed good capacities to discriminate the population with HUA from those without HUA in 2009 and 2019 cohort, respectively. Conclusions: In recent 10 years, the prevalence of HUA was increased rapidly in Chinese adults, especially in males. Young men aged 20-29 years in the 2019 cohort replaced the middle-aged males (40-49 years old) in the 2009 cohort, and became the main population of male HUA in the 2019 cohort. BMI was positively correlated with HUA, and might be a potential risk factors to predict the onset of HUA.

A Comparison of Convective and Stratiform Precipitation Microphysics of the Record-Breaking Typhoon In-Fa (2021)

In July 2021, Typhoon In-Fa attacked eastern China and broke many records for extreme precipitation over the last century. Such an unrivaled impact results from In-Fa’s slow moving speed and long residence time due to atmospheric circulations. With the supports of 66 networked surface disdrometers over eastern China and collaborative observations from the advanced GPM satellite, we are able to reveal the unique precipitation microphysical properties of the record-breaking Typhoon In-Fa (2021). After separating the typhoon precipitation into convective and stratiform types and comparing the drop size distribution (DSD) properties of Typhoon In-Fa with other typhoons from different climate regimes, it is found that typhoon precipitation shows significant internal differences as well as regional differences in terms of DSD-related parameters, such as mass-weighted mean diameter (Dm), normalized intercept parameter (Nw), radar reflectivity (Z), rain rate (R), and intercept, shape, and slope parameters (N0, µ, Λ). Comparing different rain types inside Typhoon In-Fa, convective rain (Nw ranging from 3.80 to 3.96 mm−1 m−3) shows higher raindrop concentration than stratiform rain (Nw ranging from 3.40 to 3.50 mm−1 m−3) due to more graupels melting into liquid water while falling. Large raindrops occupy most of the region below the melting layer in convective rain due to a dominant coalescence process of small raindrops (featured by larger ZKu, Dm, and smaller N0, µ, Λ), while small raindrops account for a considerable proportion in stratiform rain, reflecting a significant collisional breakup process of large raindrops (featured by smaller ZKu, Dm, and larger N0, µ, Λ). Compared with other typhoons in Hainan and Taiwan, the convective precipitation of Typhoon In-Fa shows a larger (smaller) raindrop concentration than that of Taiwan (Hainan), while smaller raindrop diameter than both Hainan and Taiwan. Moreover, the typhoon convective precipitation measured in In-Fa is more maritime-like than precipitation in Taiwan. Based on a great number of surface disdrometer observational data, the GPM precipitation products were further validated for both rain types, and a series of native quantitative precipitation estimation relations, such as Z–R and R–Dm relations were derived to improve the typhoon rainfall retrieval for both ground-based radar and spaceborne radar.

The sensitivity of simulated aerosol climatic impact to domain size using regional model (WRF-Chem v3.6)

Domain size can have significant impact on regional modeling results, but few studies examined the sensitivities of simulated aerosol impact to regional domain size. This study investigates the regional modeling sensitivities of aerosol impact on the East Asian summer monsoon (EASM) to domain size. The simulations with two different domain sizes demonstrate consistently that aerosols induce the cooling of the lower troposphere that leads to the anticyclone circulation anomalies and thus the weakening of EASM moisture transport. The aerosol-induced adjustment of monsoonal circulation results in an alternate increase and decrease pattern of precipitation over China. Domain size has a great influence on the simulated meteorological fields. For example, the simulation with larger domain size produces weaker EASM circulation, which also affects aerosol distributions significantly. This leads to the difference of simulated strength and area extent of aerosol-induced changes of lower-tropospheric temperature and pressure, which further results in different distributions of circulation and precipitation anomalies over China. For example, over southeastern China, aerosols induce the increase (decrease) of precipitation from the smaller-domain (larger-domain) simulation. Different domain sizes consistently simulate an aerosol-induced increase in precipitation around 30∘ N over eastern China. This study highlights the important influence of domain size on regional modeling results of aerosol impact on circulation and precipitation, which may not be limited to East Asia. More generally, this study also implies that proper modeling of meteorological fields with appropriate domain size is one of the keys to simulating robust aerosol climatic impact.