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Ramping a physical parameter is one of the most common experimental protocols in studying a quantum system, and ramping dynamics has been widely used in preparing a quantum state and probing physical properties. Here, we present a novel method of probing quantum many-body correlation by ramping dynamics. We ramp a Hamiltonian parameter to the same target value from different initial values and with different velocities, and we show that the first-order correction on the finite ramping velocity is universal and path-independent, revealing a novel quantum many-body correlation function of the equilibrium phases at the target values. We term this method as the non-adiabatic linear response since this is the leading order correction beyond the adiabatic limit. We demonstrate this method experimentally by studying the Bose-Hubbard model with ultracold atoms in three-dimensional optical lattices. Unlike the conventional linear response that reveals whether the quasi-particle dispersion of a quantum phase is gapped or gapless, this probe is more sensitive to whether the quasi-particle lifetime is long enough such that the quantum phase possesses a well-defined quasi-particle description. In the Bose-Hubbard model, this non-adiabatic linear response is significant in the quantum critical regime where well-defined quasi-particles are absent. And in contrast, this response is vanishingly small in both superfluid and Mott insulators which possess well-defined quasi-particles. Because our proposal uses the most common experimental protocol, we envision that our method can find broad applications in probing various quantum systems., Comment: 7 pages for main text. Science Bulletin (2022)

Tongue squamous cell carcinoma is highly malignant and has a poor prognosis. In this study, we aimed to combine whole-genome sequencing, whole-genome methylation, and whole-transcriptome analyses to understand the molecular mechanisms of tongue squamous cell carcinoma better. Oral tongue squamous cell carcinoma and adjacent normal tissues from five patients with tongue squamous cell carcinoma were included as five paired samples. After multi-omics sequencing, differentially methylated intervals, methylated loop sites, methylated promoters, and transcripts were screened for variation in all paired samples. Correlations were analyzed to determine biological processes in tongue squamous cell carcinoma. We found five mutated methylation promoters that were significantly associated with mRNA and lncRNA expression levels. Functional annotation of these transcripts revealed their involvement in triggering the mitogen-activated protein kinase cascade, which is associated with cancer progression and the development of drug resistance during treatment. The prognostic signature models constructed based on WDR81 and HNRNPH1 and combined clinical phenotype–gene prognostic signature models showed high predictive efficacy and can be applied to predict patient prognostic risk in clinical settings. We identified biological processes in tongue squamous cell carcinoma that are initiated by mutations in the methylation promoter and are associated with the expression levels of specific mRNAs and lncRNAs. Collectively, changes in transcript levels affect the prognosis of tongue squamous cell carcinoma patients.

Background Local environmental factors are associated with health and healthcare-seeking behaviors. However, there is a paucity in the literature documenting the link between air pollution and healthcare-seeking behaviors. This study aimed to address the gap in the literature through a cross-sectional study of domestic migrants in China. Methods Data were extracted from the 2017 China Migrants Dynamic Survey (n = 10,051) and linked to the official air pollution indicators measured by particulate matter (PM2.5 and PM10) and air quality index (AQI) in the residential municipalities (n = 310) of the study participants over the survey period. Probit regression models were established to determine the association between air pollution and refraining from visiting health facilities after adjustment for variations in the predisposing, enabling and needs factors. Thermal inversion intensity was adopted as an instrumental variable to overcome potential endogeneity. Results One unit (µg/m3) increase in monthly average PM2.5 was associated with 1.8% increase in the probability of refraining from visiting health facilities. The direction and significance of the link remained unchanged when PM2.5 was replaced by AQI or PM10. Higher probability of refraining from visiting health facilities was also associated with overwork (β = 0.066, p = 0.041) and good self-related health (β = 0.171, p = 0.006); whereas, lower probability of refraining from visiting health facilities was associated with short-distance (inter-county) migration (β=-0.085, p = 0.048), exposure to health education (β=-0.142, p p = 0.018), and having hypertension/diabetes (β=-0.169, p = 0.005). Conclusion Air pollution is a significant predictor of refraining from visiting health facilities in domestic migrants in China.

Dysregulated iron homeostasis plays an important role in the hepatic manifestation of metabolic-associated fatty liver disease (MAFLD). We investigated the causal effects of five iron metabolism markers, regular iron supplementation and MAFLD risk.Genetic summary statistics were obtained from open genome-wide association study databases. Two-sample bidirectional Mendelian randomization analysis was performed to estimate the causal effect between iron status and MAFLD, including Mendelian randomization inverse-variance weighted, weighted median methods and Mendelian randomization-Egger regression. The Mendelian randomization-PRESSO outlier test, Cochran's Q test and Mendelian randomization-Egger regression were used to assess outliers, heterogeneity and pleiotropy respectively.Mendelian randomization inverse-variance weighted results showed that the genetically predicted per standard deviation increase in liver iron (Data set 2: odds ratio 1.193, 95% confidence interval [CI] 1.074-1.326, p = .001) was associated with an increased MAFLD risk, consistent with the weighted median estimates and Mendelian randomization-Egger regression, although Data set 1 was not significant. Mendelian randomization inverse-variance weighted analysis showed that genetically predicted MAFLD was significantly associated with increased serum ferritin levels in both datasets (Dataset 1: β = .038, 95% CI = .014 to .062, p = .002; Dataset 2: β = .081, 95% CI = .025 to .136, p = .004), and a similar result was observed with the weighted median methods for Dataset 2 instead of Mendelian randomization-Egger regression.This study uncovered genetically predicted causal associations between iron metabolism status and MAFLD. These findings underscore the need for improved guidelines for managing MAFLD risk by emphasizing hepatic iron levels as a risk factor and ferritin levels as a prognostic factor.

Background: Irritable bowel syndrome (IBS) reduces patients’ quality of life and causes great burdens due to its unclear pathogenesis and criteria for diagnosis. This study aimed to explore the differences in prevalence and the influencing factors for IBS and its subtypes.Methods: The UK Biobank surveyed 174,771 adult participants who completed the Digestive Health Questionnaire (DHQ) through emails and websites. DHQ included the Rome III criteria, IBS symptom severity score, and Patient Health Questionnaire 12 Somatic Symptom score. The UK Biobank also asked regarding previous IBS diagnosis, diagnosis for post-infectious IBS (PI-IBS), and environmental exposures and associated conditions (including anxiety or depression, based on treatment sought or offered). Pearson’s Chi-squared test or Wilcoxon’s rank-sum test was used for potential associations. Binary logic regression based on sex stratification was used to examine associations between selected factors and IBS and its subtypes.Results: This study included 31,918 participants who met the Rome III criteria for IBS. The pooled prevalence of IBS in the UK Biobank was 18.3%, with mixed IBS as the predominant subtype (59.0%), followed by diarrhea-predominant IBS (25.1%), constipation-predominant IBS (14.7%), and untyped IBS (1.1%). IBS was significantly associated with somatization (male: OR = 5.326, 95% CI = 4.863–5.832; female: OR = 4.738, 95% CI = 4.498–4.992) and coeliac disease (male: OR = 4.107, 95% CI = 3.132–5.385; female: OR = 3.783, 95% CI = 3.310–4.323). Differences in antibiotics and mental status were presented among subtypes and sex. Furthermore, 1,787 individuals were diagnosed with PI-IBS in the group of patients with IBS. The prevalence of PI-IBS in IBS was 16.6% in the UK Biobank, and it was characterized by diarrhea, fever, bloody diarrhea, and vomiting.Conclusion: Somatization and coeliac disease are primary risk factors for IBS. Distinguishing differential risk factors is critical for the precise diagnosis and treatment of IBS subtypes, particularly sex-specific differences in mental health status. General practitioners should focus on the treatment according to IBS subtypes.

Tongue squamous cell carcinoma is highly malignant with a poor prognosis. This study aimed to combine whole-genome sequencing, whole-genome methylation, and whole transcriptome analyses to better understand the molecular mechanisms of this cancer. Cancerous and paraneoplastic tissues from five patients with tongue squamous cell carcinoma were included as five paired samples. After multi-omics sequencing, differentially methylated intervals, methyl loop sites, methylated promoters, and transcripts were screened for variation in all paired samples. Correlations between them were analyzed to determine biological processes in tongue squamous cell carcinoma. We found five mutated methylation promoters that were significantly associated with the expression levels of mRNAs and lncRNAs. Functional annotation of these transcripts revealed their involvement in triggering the mitogen-activated protein kinase cascade, which is associated with cancer progression and the development of drug resistance during treatment. The prognostic signature models constructed based on the WDR81 and HNRNPH1 genes and combined clinical phenotype-gene prognostic signature models have shown high predictive efficacy and can be applied to predict patient prognostic risk in clinical settings. We identified biological processes in tongue squamous cell carcinoma that are initiated by mutations in the methylation promoter and are associated with the expression levels of specific mRNAs and lncRNAs. Ultimately, changes in the transcript levels affect the prognosis of tongue squamous cell carcinoma patients.

Manipulation of ultracold atoms in optical lattices is one of the optimal ways to observe phase transitions of the Hubbard model which is useful in a variety of condensed-matter systems. Bosonic atoms in this model experience a phase transition from superfluids to Mott insulators by tuning systematic parameters. However, in conventional setups, phase transitions take place over a large range of parameters instead of one critical point due to the background inhomogeneity caused by the Gaussian shape of optical-lattice lasers. To probe the phase transition point more precisely in our lattice system, we apply a blue-detuned laser to compensate for this local Gaussian geometry. By inspecting the change of visibility, we find a sudden jump point at one particular trap depth of optical lattices, corresponding to the first appearance of Mott insulators in inhomogeneous systems. This provides a simple method to detect the phase transition point in such inhomogeneous systems. We believe it will be a useful tool for most cold atom experiments.

Background Growing prevalence of multidrug-resistant/Rifampicin-resistant tuberculosis (MDR/RR-TB; resistance to Isoniazid and Rifampicin/Isolated resistance to Rifampicin) is putting in jeopardy the WHO End TB strategy. This study aimed to identify factors contributing to the high prevalence of MDR/RR-TB in Khabarovsk krai region of Russia. Methods A cross-sectional retrospective study was conducted, analyzing clinical, demographic, and drug susceptibility testing data on 1440 patients. As a source of raw data, the national electronic TB surveillance system was used. Anonymous data was collected on every patient diagnosed with TB in all healthcare facilities of the region from January 2018 to December 2019. Only patients with proven excretion of m. tuberculosis were included in the study. Factors associated with MDR/RR-TB were identified through logistic regression analysis, in conjunction with in-depth interviews with eight patients, five healthcare managers and five doctors. Findings 2661 patients were identified with TB, 1440 were incorporated in the study based on inclusion criteria. Of these, 618 (42.9%) were identified with MDR/RR-TB. Patients with a history of imprisonment were 16.53 times (95% CI 5.37 to 50.88,) more likely to have MDR/RR-TB, whereas re-treatment patients were 2.82 times (95% CI 2.16 to 3.66) more likely to have MDR/RR-TB. Other influencing factors included presence of disability (AOR is 2.32, 95% CI 1.38 to 3.89), cavitary disease (AOR is 1.76, 95% CI 1.37 to 2.25), and retirement status (AOR 0.65, 95% CI 0.43 to 0.98, p = 0.042). Poor patient knowledge and understanding of the disease, progressive weariness of prolonged TB treatment, and inability hospitalize infectious patients without their consent were perceived by the interviewees as major influencing factors. Conclusions Incarceration and treatment history, regardless of outcome, were identified as major factors influencing MDR/RR-TB prevalence. It is essential for the TB care system to eliminate legal loopholes, which deprive doctors of means to enforce quarantine procedures and epidemiological surveillance on infected patients, former and current inmates. Increasing people’s awareness of TB, early detection and appropriate treatment of patients with TB are needed for successfully combating MDR/RR-TB.

Since the outbreak of novel Coronavirus Pneumonia 2019 (COVID-19), the role of Almonds (Xingren) in the protection and treatment of COVID-19 is not clear. Network pharmacology and molecular docking were used to explore the potential mechanism and potential key targets of Xingren on COVID-19. A total of nine common targets between them were obtained, and these targets were involved in multiple related processes of GO and KEGG pathway enrichment analysis. Molecular docking showed that licochalcone B has the best binding energy (-9.33 kJ·mol

In this study, cetyltrimethylammonium bromide (CTAB) additive was introduced to adjust the tunnel etching behavior of aluminum foil. The distribution and growth of etched tunnels in solutions with and without CTAB additive of various concentrations were thoroughly investigated. Compared to the etched tunnels obtained in solutions without CTAB, those obtained in solutions with 1 wt% CTAB had obviously improved distribution and increased length, resulting in an enhancement of the specific surface area. These effects can be attributed to the improvement of wettability between aluminum surface and solution, which is helpful to increase the contact area and facilitate the mass transfer within tunnels. This work exhibits a facile way to improve the tunnel etching behavior of aluminum foil, showing a potential engineering value in industrial production.

Numerous efforts have been devoted to capability improvement and cycling stability in the past decades, and these performances have been significantly enhanced. Low initial coulombic efficiency is still a problem in the metal sulfide-based anode materials. This study developed a strategy to achieve high initial coulombic efficiency and superior capacity retention by interpenetrating binary metal sulfides of SnS and MoS2 in a conductive carbon matrix. The synergy ascension of electrochemical performances for the metal sulfides is attributed to their mutual impeding effects on coarsening of metal grains and the capsule-shaped coating structure embedded in the carbon sheet architecture. The SnS/MoS2/C composite was prepared by a simple NaCl template-assisted ball milling method, and showed excellent electrochemical performances in terms of a high initial coulombic efficiency up to 90.2% and highly stable reversibility with a specific capacity of 515.4 mA h g−1 after 300 cycles at 1.0 A g−1. All of these characteristics suggest that the proposed materials are superior among the previously reported metal sulfide-based anode materials for lithium-ion batteries.

The effect of azelaic acid on microstructure evolution and electrical properties of anodic aluminum foil for electrolytic capacitor is studied quantitatively. The azelaic acid is selected as formation solution in the multi-step anodization process, and boric acid is applied for comparison. The field-emission scanning electron microscopy and X-ray diffractometer technologies are used for observation of microstructure and detection of crystallinity, respectively. The electrical properties are tested by LCR meter and T–V tester. The microstructure observation shows that the ‘corn-flake’ structures are taken place by ‘cotton-ball’ ones gradually along with the preparation process, and such phenomenon is more obvious when azelaic acid is used. The pores area of anodic aluminum foil formed in azelaic acid is larger because of the stronger acidity. The formation with azelaic acid induces smaller thickness of oxide film, promotes the formation of crystalline oxide, therefore, a barrier film with higher crystallinity and larger grain size is obtained. The barrier film formed in azelaic acid shows larger specific capacitance, lower withstand voltage and larger leakage current, which needs the multi-step anodization for performance improvement.

BackgroundDepression is one of the greatest public health problems worldwide. The potential benefit of social participation (SP) on mental health has been widely acknowledged. Nevertheless, a few studies have used propensity score matching (PSM) to reduce the influence of data bias and confounding variables. This study explored the effect of social participation on depression among middle-aged and older Chinese persons through a PSM method, considering the frequency, type, and quantity of SP. Effects were compared among different age groups, genders, and places of residence.MethodsThe datasets were obtained from the 2018 wave of the China Health and Retirement Longitudinal Study. A total of 9,404 respondents aged 45 and above were included in the study. PSM and ordinary least squares methods were used to estimate the effect of social participation on depression.ResultsPSM estimation results showed that SP had a significantly positive effect on decreasing depression scores (p < 0.001) by 0.875–0.898 compared with persons without SP. All types of SP had a significantly positive effect (p < 0.001), and participating in community activities had the largest effect (β = −1.549 to −1.788, p < 0.001). Higher frequency of participation and more types of SP promoted lower depression scores; subgroup analyses revealed that the promotion effect was significantly greater among women, those aged ≥75 years, and those living in urban areas.ConclusionPSM indicated that SP could alleviate the depression of middle-aged and older Chinese persons. Targeted measures should be adopted to promote SP and thereby improve mental health and promote healthy and active aging.

Catalytic graphitization opens a route to prepare graphitic carbon under fairly mild conditions. Biomass has been identified as a potentially attractive precursor for graphitic carbon materials. In this work, corn starch was used as carbon source to prepare hollow graphitic carbon microspheres by pyrolysis after mixing impregnation with nitrate salts, and the surface of these carbon microspheres is covered with controllable pores structure. Under optimal synthesis conditions, the prepared carbon microspheres show a uniform pore size distribution and high degree of graphitization. When tested as electrode materials for supercapacitor with organic electrolyte, the electrode exhibited a superior specific capacitance of 144.8 F g−1 at a current density of 0.1 A g−1, as well as large power density and a capacitance retention rate of 93.5% after 1,000 cycles in galvanostatic charge/discharge test at 1.0 A g−1. The synthesis extends use of the renewable nature resources and sheds light on developing new routes to design graphitic carbon microspheres.

Background Sleep affects a wide array of health outcomes and is associated with the quality of life. Among students, sleep quality is affected by school stage and grade; however, data regarding the different sleep-related problems students experience at different school stages are limited. In this study, we aimed to explore sleep quality among a student sample ranging from elementary school to university level. Methods Overall, data were examined for 9392 subjects aged 9-22 years. Information on sociodemographic characteristics and other variables were collected through self-administered questionnaires. Sleep quality on school nights was evaluated using the standard Pittsburgh Sleep Quality Index; global score >5 was classified as poor sleep quality. For the high school sample, logistic regression analysis was used to estimate associations between sleep quality and certain factors. Results Of the elementary school, middle school, vocational high school, senior high school, and university students, 7.5%, 19.2%, 28.6%, 41.9%, and 28.5%, respectively, showed poor sleep quality. The high school students reported the highest prevalence of shorter sleep duration (70.8%), day dysfunction (84.7%), and subjective poor sleep quality (17.2%). The elementary school students showed the highest prevalence of poor sleep efficiency (17.9%). The university students showed the highest prevalence of sleep medication use (6.4%). The vocational high school students reported the highest prevalence of sleep latency (6.3%) and sleep disturbance (7.4%). Logistic regression modeling indicated that sleep quality is positively associated with school stage, grade, family atmosphere, academic pressure, and number of friends. Conclusion Sleep quality and sleep features change greatly from elementary school to university. Interventions to improve sleep quality should consider targeting the specific issues students experience at each school stage. Alarmed by the high prevalence of poor sleep quality among high school students, it is recommended that high school students should be informed of their sleep matter and the consequences.

Background China’s fragmentation of social health insurance schemes has become a key obstacle that hampers equal access to health care and financial protection. This study aims to explores if the policy intervention Urban and Rural Residents Basic Medical Insurance (URRBMI) scheme, which integrates Urban Resident Basic Medical Insurance (URBMI) and New Rural Cooperative Medical Scheme (NCMS), can curb the persistent inequity of catastrophic health expenditure (CHE) and further analyses the determinants causing inequity. Methods Data were derived from the Fifth National Health Service Survey (NHSS). A total of 11,104 households covered by URRBMI and 20,590 households covered by URBMI or NCMS were selected to analyze CHE and the impoverishment rate from medical expenses. Moreover, the decomposition method based on a probit model was employed to analyse factors contributing CHE inequity. Results The overall incidence of CHE under integrated insurance scheme was 15.53%, about 1.10% higher than the non-integrated scheme; however, the intensity of CHE and impoverishment among the poorest was improved. Although CHE was still concentrated among the poor under URRBMI (CI = -0.53), it showed 28.38% lower in the degree of inequity. For URRBMI households, due to the promotion of integration reform to the utilization of rural residents’ better health services, the factor of residence (24.41%) turns out to be a major factor in increasing inequity, the factor of households with hospitalized members (− 84.53%) played a positive role in reducing inequity and factors related to social economic status also contributed significantly in increasing inequity. Conclusion The progress made in the integrated URRBMI on CHE equity deserves recognition, even though it did not reduce the overall CHE or the impoverishment rate effectively. Therefore, for enhanced equity, more targeted solutions should be considered, such as promoting more precise insurance intervention for the most vulnerable population and including costly diseases suitable for outpatient treatment into benefit packages. Additionally, comprehensive strategies such as favourable targeted benefit packages or job creation are required for the disadvantaged.

BackgroundThe Chinese health system has long been committed to eliminating inequalities in health services utilization. However, few studies have analyzed or measured these inequalities in economically underdeveloped regions in China.MethodsA total of 6,627 respondents from 3,000 households in Heilongjiang Province were extracted from the Sixth National Health Services Survey. We measured horizontal inequity in both 2-week outpatient rate and annual inpatient rate, and then identified the factors contributing to inequality.ResultsThe horizontal inequity indices of the 2-week outpatient and annual impatient rates in Heilongjiang Province were 0.0586 and 0.1276, respectively. Household income, health status, place of residence, basic medical insurance, and commercial health insurance were found to be the main factors affecting inequality in health services utilization. The contributions of household income to these two indices were 184.03 and 253.47%, respectively. Health status factors, including suffering from chronic disease, limitations in daily activities, and poor self-rated health, played positive roles in reducing inequality in these two indices. The contributions of place of residence to these two indices were 27.21 and −28.45%, respectively. Urban Employee Basic Medical Insurance made a pro-rich contribution to these two indices: 56.25 and 81.48%, respectively. Urban and Rural Resident Basic Medical Insurance, Urban Resident Basic Medical Insurance, New Rural Cooperative Medical Scheme, and other basic medical insurance made a pro-poor contribution to these two indices: −73.51 and −54.87%, respectively. Commercial health insurance made a pro-rich contribution to these two indices: 20.79 and 7.40%, respectively. Meanwhile, critical illness insurance made a slightly pro-poor contribution to these two indices: −4.60 and −0.90%, respectively.ConclusionsThe findings showed that the “equal treatment in equal need” principle was not met in the health services utilization context in Heilongjiang Province. To address this issue, the government could make policy changes to protect low-income populations from underused health services, and work to improve basic medical insurance, critical illness insurance, and social security systems.

ObjectivesPatient-centred communication improves patient experiences and patient care outcomes. This study aimed to assess the preference of medical professionals in China towards patient-centred communication under the context of the deteriorating doctor–patient relationship.MethodsA cross-sectional survey of medical professionals was conducted in January and February 2018 in H City of Heilongjiang province, the northeast of China. The Chinese-Revised Patient-Practitioner Orientation Scale (CR-PPOS) was adopted to measure the individual preference of respondents towards patient-centredness in clinical communication. Multivariate logistic regression models were established to identify the sociodemographic (gender, age, marital status and educational attainment) and work experience (years of working, seniority, satisfaction with income, daily workload and perceived doctor–patient relationship) predictors of the preference towards patient-centredness.Patient and public involvementNot applicable.ResultsA total of 618 valid questionnaires were returned. The CR-PPOS demonstrated acceptable reliability and validity. Overall, a low level of preference towards patient-centredness in clinical communication was found. Relatively higher scores on ‘caring for patients’ (20.42±4.42) was found compared with those on ‘information/responsibility sharing’ (15.26±4.21). Younger age, higher educational attainment, lower daily workload and a perception of harmonious doctor–patient relationship were associated with a higher preference towards patient-centredness in clinical communication.ConclusionsA low level of preference towards patient-centredness in clinical communication was found in medical professionals in the northeast of China, which may further jeopardise the efforts to improve doctor–patient relationship.

In the present study, it is proposed to achieve the synthesis of bowknot-like CoP microstructures via a facile hydrothermal method combined with a subsequent phosphorylation step. With improved lithium-ion diffusing channels and enhanced conductivity, the novel CoP microstructure is effective in promoting charge transport and maintaining structural integrity during the repeated charge/discharge process. The resulting bowknot-like CoP anode produces a better electrochemical performance, with a specific capacity of 421 mAh·g−1 over 800 cycles at 500 mA·g−1, and a specific capacity of 334 mAh·g−1 at 1000 mA·g−1 with coulombic efficiency of 98.8% after 1000 cycles.

The aim of our study was to identify factors associated with coronavirus disease 2019 (COVID-19)vaccine willingness in China to aid future public health actions to improve vaccination.This study was conducted in August 2020 using a mixed-method approach, including a cross-sectional self-administered anonymous questionnaire survey and in-depth interviews with community residents in China.Of the participants, 30.9% showedCOVID-19 vaccine hesitancy. Being female(Nearly one-thirdof people showed hesitancy to accept COVID-19 vaccination in China. Our findings highlight that health communication and publicity should be performed for the targeted population, and immunization programs should be designed to remove underlying barriers to vaccine uptake.

Objectives The doctor–patient relationship is usually measured in line with patient needs and demands. This study aimed to develop a scale measuring such a relationship from the perspective of doctors. Methods A draft scale was developed and adapted to the hospital context of China based on several existing scales, with an intention to measure how medical doctors view and manage their relationship with patients beyond episodic clinical encounters. Two rounds of Delphi consultations involving 14 experts were conducted to seek their consensus on the inclusion and descriptions of items. This resulted in a 19-item scale measuring four domains of the relationship. The scale was validated through a survey of 1,712 medical doctors selected from 27 public hospitals in Heilongjiang province of China. The internal consistency of the scale was assessed using Cronbach’s α coefficients of the four domains. Confirmatory factor analyses were performed to test the construct validity of the scale. Linear regression analyses were performed to assess the known-group validity of the scale. Results The scale measures four domains. The Cronbach’s α of the scale reached an acceptable level, ranging from 0.61 to 0.78 for its four domains. Good fitness of data into the four-domain structure of the scale was confirmed by the confirmatory factor analysis. Known-group differences were demonstrated in the regression analyses. Conclusion The doctor–patient relationship scale developed in this study is a psychometrically valid tool assessing how medical doctors view and manage their relationship with patients in the hospital setting in China.

Quantum critical behavior of many-body phase transitions is one of the most fascinating yet challenging questions in quantum physics. Here, we improved the band-mapping method to investigate the quantum phase transition from superfluid to Mott insulators, and we observed the critical behaviors of quantum phase transitions in both dynamical steady-state-relaxation region and phase-oscillation region. Based on various observables, two different values for the same quantum critical parameter are observed. This result is beyond a universal-scaling-law description of quantum phase transitions known as the Kibble-Zurek mechanism, and suggests that multiple quantum critical mechanisms are competing in many-body quantum phase transition experiments in inhomogeneous systems., 6 pages, 4 figures for main text

BackgroundPoor quality of care would significantly increase adverse patient outcomes. Improving the quality of care is an urgent priority. The relationship between work-related fatigue and quality of care has not been systematically explored. This paper explores the occurrence of work-related fatigue, job satisfaction, and its relationship with quality of care.MethodsSelf-report questionnaires assessing work-related fatigue and job satisfaction were distributed among 1,299 nurses from 20 hospitals in North-Eastern China. Regression analysis was performed to assess the associations between work-related fatigue, job satisfaction, and quality of care. Mediate effect analysis was used to explore the mediating role of job satisfaction.ResultsApproximately 55% of nurses got moderate or severe work-related fatigue. The results from the t-test indicated that nurses with a high level of work-related fatigue were more prone to nursing errors. The mediation analysis showed that work-related fatigue indirectly affected the quality of care through job satisfaction (indirect effect: β 0.047, 95%Cl 0.040-0-054), while the direct effect was β 0.059, 95%Cl 0.050-0.068.ConclusionsThe present study concluded that more than half of the nurses surveyed were moderate to severe work-related fatigue. Nurses with a high level of work-related fatigue were likely to provide significantly more nursing errors. We confirmed that job satisfaction was a mediator for the relationship between work-related fatigue and quality of care. Therefore, hospitals managers and relevant management departments should consider work-related fatigue and job satisfaction among nurses to improve health services in the future.

ObjectivesThe sudden outbreak of the novel coronavirus disease (COVID-19) plunged healthcare workers (HCWs) into warfare. This study aimed to determine the prevalence of burnout and the factors associated with it among frontline HCWs fighting COVID-19.MethodsA cross-sectional survey was conducted among frontline HCWs fighting against the COVID-19 in Wuhan, Harbin, and Shenzhen during the period from February 18 to March 4. Finally, HCWs were recruited using cluster sampling, 1,163 HCWs were included in the final analysis. Burnout was measured using a 22-item Maslach Burnout Inventory scale (MBI scale).ResultsOf the participants, 48.6% suffered from burnout, and 21.8% showed a high degree of burnout. Doctors (b = 3.954, P = 0.011) and nurses (b = 3.067, P = 0.042) showed higher emotional exhaustion (EE) than administrators. Participants who worked continuously for more than 8 h a day (b = 3.392, P = 0.000), those who were unable to eat three regular daily meals (b = 2.225, P = 0.008), whose daily water intake was no more than 800 ml (b = 3.007, P = 0.000), who slept for no more than 6 h (b = 1.609, P = 0.036), and who were infected or had colleagues who were infected with COVID-19 (b = 4.182, P = 0.000) experienced much higher levels of EE, while those who could adhere to infection control procedures (b = −5.992, P = 0.000), who were satisfied with their hospital’s infection control measures(b = −3.709, P = 0.001), and who could receive sufficient psychological crisis intervention (b = −1.588, P = 0.039) reported lower levels of EE.ConclusionThe study reveals that burnout is prevalent among frontline HCWs and that the known factors associated with burnout, such as workload, and the factors directly associated with COVID-19, such as having insufficient protection, can affect burnout symptoms in frontline HCWs. Synergized and comprehensive interventions should be targeted at reducing its occurrence among frontline HCWs fighting COVID-19.

Objective China has made remarkable achievements in poverty alleviation. However, with the change in economic development and age structure, the population stricken by poverty due to medical expenses and disability accounted for 42.3 and 14.4% of the total poverty-stricken population, respectively. Accordingly, it is crucial to accurately pinpoint the characteristics of people who are about to become poor due to illness. In this study, we analyzed the incidence of impoverishment by medical expense at the provincial, family, and different medical insurance scheme levels to identify the precise groups that are vulnerable to medical-related poverty. Method Data were extracted from the Fifth National Health Service Survey in China in 2013 through a multi-stage, stratified, and random sampling method, leaving 93,570 households (273,626 people) for the final sample. The method recommended by World Health Organization (WHO) was adopted to calculate impoverishment by medical expense, and logistic regression was adopted to evaluate its determinants. Results The poverty and impoverishment rate in China were 16.2 and 6.3% respectively. The poverty rate in western region was much higher than that of central and eastern regions. The rate of impoverishment by medical expense (IME) was higher in the western region (7.2%) than that in the central (6.5%) and eastern (5.1%) regions. The New Cooperative Medical Scheme (NCMS) was associated with the highest rate (9.1%) of IME cases. The top three diseases associated with IME were malignant tumor, congenital heart disease, and mental disease. Households with non-communicable disease members or hospitalized members had a higher risk on IME. NCMS-enrolled, poorer households were more likely to suffer from IME. Conclusion The joint roles of economic development, health service utilization, and welfare policies result in medical impoverishment for different regions. Poverty and health service utilization are indicative of households with high incidence of medical impoverishment. Chronic diseases lead to medical impoverishment. The inequity existing in different medical insurance schemes leads to different degrees of risk of IME. A combined strategy to precise target multiple vulnerabilities of poor population would be more effective.

Background Hostility can result in negative outcomes in people living with HIV/AIDS (PLWHA); however, previous research on this topic is far from adequate. To contribute to existing knowledge on this aspect of PLWHA, the current study examined the prevalence of hostility and its potential influencing factors among PLWHA. Methods A cross-sectional questionnaire survey was undertaken on 218 HIV patients in Heilongjiang Province of China between March and August in 2013. A multiple logistic regression analysis was performed to identify factors associated with hostility. Results The prevalence of hostility was 17.0% among the participants. The three most alarming types of hostility included desiring to kill the person who infected them, blaming the infection on the society, and abandoning themselves to despair. A multiple logistic regression model identified that depression (OR = 3.845, 95% CI = 1.309–9.229), perceived stigma (OR = 3.281, 95% CI = 1.109–7.711), and fear of dying (OR = 2.710, 95% CI = 1.068–6.881) were the risk factors for hostility, while higher levels of trust-in-doctor (OR = 0.176, 95% CI = 0.060–0.517) and per capita household income (OR = 0.344, 95% CI = 0.119–0.991) were protective factors. Conclusions Our findings highlight the prominent influence of psychological, healthcare, and social factors on hostility among PLWHA. Interventions specifically targeted to reduce hostility should be provided, including incorporating psychological service into HIV management guidelines, enhancing PLWHA’s trust-in-doctor, establishing comprehensive services for PLWHA, reducing the social stigma against PLWHA, and paying more attention to PLWHA with financial problems. These interventions may improve the management and control of HIV/AIDS.

The purpose of our research was to (a) identify sleep quality complications experienced by patients living with HIV infection and treated with antiretroviral therapy (ART), and (b) explore factors associated with sleep quality complications. From March to August in 2013, a cross-sectional study was conducted at HIV-designated hospitals in Harbin of Heilongjiang Province, China. Participants completed a questionnaire using the Spiegel scale to assess sleep quality; 32.1% of patients were negatively affected by sleep disturbances. Nighttime dreams and waking up were the most serious complications. We found that anxiety was the most prominent factor contributing to poor sleep quality, followed by ART medication types and family and social support. Patients with HIV infection and receiving ART experienced many different types of sleep complications. More attention should be given to the development of treatment guidelines for proper management of sleep disturbances experienced by patients with HIV.

Numerous efforts have been devoted to capability improvement and cycling stability in the past decades, and these performances have been significantly enhanced. Low initial coulombic efficiency is still a problem in the metal sulfide-based anode materials. This study developed a strategy to achieve high initial coulombic efficiency and superior capacity retention by interpenetrating binary metal sulfides of SnS and MoS

BackgroundIndividual protective behaviors play an important role in the control of the spread of infectious diseases. This study aimed to investigate the adoption of protective behaviors by Chinese citizens amid the COVID-19 outbreak and its associated factors.MethodsAn online cross-sectional survey was conducted from 22 January to 14 February 2020 through Wenjuanxing platform, measuring their knowledge, risk perception, negative emotion, response to official communication, and protective behaviors in relation to COVID-19. A total of 3008 people completed the questionnaire, of which 2845 were valid questionnaires.ResultsOn average, 71% of respondents embraced protective behaviors. Those who made no error in the knowledge test (AOR = 1.77,p p p = 0.005), reported good health (AOR = 1.94,p p p ConclusionThe majority of Chinese citizens embraced protective behaviors. Higher levels of protective behaviors are associated with higher knowledge, perceived severity, negative emotion, and attention to and trust in the official governmental media. Official governmental communication is the largest single predictor of protective behaviors.

Baohua Liu,1,2,* Fei Gao,3,* Jianfeng Zhang,3,* Hongguo Zhou,1 Ning Sun,1 Laiyou Li,1 Libo Liang,2 Ning Ning,2 Qunhong Wu,2 Miaomiao Zhao4 1School of Health Services and Management, Ningbo College of Health Sciences, Ningbo 315100, Zhejiang, People’s Republic of China; 2Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin 150081, Heilongjiang, People’s Republic of China; 3Institute of Food Safety and School Health, Heilongjiang Center for Disease Control and Prevention, Harbin 150030, Heilongjiang, People’s Republic of China; 4Department of Health Management, School of Public Health, Nantong University, Nantong 226019, Jiangsu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qunhong Wu; Miaomiao Zhao Tel +8618686825192; +8618860979901Email wuqunhong@163.com; zhaomiaomiao0201@163.comBackground: Sleep affects a wide array of health outcomes and is associated with the quality of life. Among students, sleep quality is affected by school stage and grade; however, data regarding the different sleep-related problems students experience at different school stages are limited. In this study, we aimed to explore sleep quality among a student sample ranging from elementary school to university level.Methods: Overall, data were examined for 9392 subjects aged 9– 22 years. Information on sociodemographic characteristics and other variables were collected through self-administered questionnaires. Sleep quality on school nights was evaluated using the standard Pittsburgh Sleep Quality Index; global score > 5 was classified as poor sleep quality. For the high school sample, logistic regression analysis was used to estimate associations between sleep quality and certain factors.Results: Of the elementary school, middle school, vocational high school, senior high school, and university students, 7.5%, 19.2%, 28.6%, 41.9%, and 28.5%, respectively, showed poor sleep quality. The high school students reported the highest prevalence of shorter sleep duration (70.8%), day dysfunction (84.7%), and subjective poor sleep quality (17.2%). The elementary school students showed the highest prevalence of poor sleep efficiency (17.9%). The university students showed the highest prevalence of sleep medication use (6.4%). The vocational high school students reported the highest prevalence of sleep latency (6.3%) and sleep disturbance (7.4%). Logistic regression modeling indicated that sleep quality is positively associated with school stage, grade, family atmosphere, academic pressure, and number of friends.Conclusion: Sleep quality and sleep features change greatly from elementary school to university. Interventions to improve sleep quality should consider targeting the specific issues students experience at each school stage. Alarmed by the high prevalence of poor sleep quality among high school students, it is recommended that high school students should be informed of their sleep matter and the consequences.Keywords: different school stages, sleep quality, students, PSQI

Objective: China has made remarkable achievements in poverty alleviation. However, with the change in economic development and age structure, the population stricken by poverty due to medical expenses and disability accounted for 42.3% and 14.4% of the total poverty-stricken population, respectively. The efforts to reduce the catastrophic health expenditure among Chinese residents are not optimistic. Poverty alleviation efforts might only focus on the people who are currently poor but ignores the increase in poverty that may occur. Accordingly, it is crucial to accurately pinpoint the characteristics of people who are about to become poor due to illness. Therefore, we prospectively analyzed the incidence of impoverishment by medical expense at the provincial, family, and different medical insurance scheme levels to identify the precise groups that are vulnerable to medical-related poverty.Method: This study obtained the data from the Chinese government’s Fifth National Health Service Survey for 2013. This survey is conducted every five years and has the most nationally representative sample obtained through a multi-stage, stratified, and random sampling method. To clean the data, we excluded incomplete records and those with logic errors, leaving 93,570 households (273,626 people) for the final sample. The method recommended by World Health Organization (WHO) was adopted to calculate impoverishment by medical expense, and logistic regression was adopted to evaluate its determinants.Results: The poverty rates in western region had much higher poverty rates than the other two regions, and the eastern region had the lowest. The rate of medical impoverishment (MI) was higher in the western region (7.2%) than that in the central (6.5%) and eastern (5.1%) regions. Compared with people enrolled in other medical insurance schemes, those enrolled in the Medical Insurance for Urban Employees Scheme (UE-BMI) and a mixture of schemes had better capacity to deal with the burden brought by diseases. The New Cooperative Medical Scheme (NCMS)was associated with the highest rate (9.1%) of MI cases. A comparison of the MI groups revealed that the top three diseases associated with MI were malignant tumor, congenital heart disease, and mental disease. Households with members suffering from NCDs, and with members who were inpatients were all more likely to suffer from MI. NCMS-enrolled households had greater exposure to the risk of MI, at 1.84 times that of UE-BM-enrolled households. Poorer households were 15.8 times more likely to suffer from MI than richer households.Conclusion: The joint roles of economic development, health service utilization, and welfare policies result in medical impoverishment for different regions. Poverty and health service utilization are indicative of households with high incidence of medical impoverishment. Chronic diseases lead to medical impoverishment. The inequity existing in different medical insurance schemes leads to different degrees of risk of MI. A combined strategy to precise target multiple vulnerabilities of poor population should be more effective.

Objective ： We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. Methods: A national representative sample from the 2015 China Health and Pension Tracking Survey (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. Results ： The rate of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The rate of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the rate of IME. Conclusion ： The original poverty -promoting policies has not reached the maximum point of convergence with China’s current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance. Keywords: medical insurance, poverty alleviation, healthy poverty, catastrophic health expenditure, impoverishment by medical expenses.

Additional file 2:Figure S1. Distribution of proportion of inpatient service utilization among households across consumption expenditure quintiles under URRBMI and URBMI/NCMS.

Additional file 1. Description of the URRBMI and URBMI/NCMS household involved in the study.

Additional file 2: Table S1. Constructs and items measured in the PLS SEM. Table S2. Psychometric Table of Measurements. Fig. S1. Results of SEM. Table S3. Path coefficients tested in the SEM

Additional file 3: Table S4. Results of linear regression models

When the maximum ratio of torque to current strategy is used for IPMSM flux weakening speed regulation, it is needed to solve nonlinear High-Order equations determining the direct and quadrature axis current given value. Facing this problem, the paper used the curve fitting and obtained the given current, improved the control accuracy of the system. At the same time, in the weak magnetic high speed zone, proposed a new over-modulation control algorithm, which through the optimization of voltage vector and phase, achieved a natural transition of different modulation region, increased the output voltage of the inverter, and enhanced the stator voltage and output torque when motor runs at a certain speed given value, expanded steady weak magnetic region of IPMSM when the load torque is certain.

Objective: We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. Methods: A national representative sample from the 2015 China Health and Pension Tracking Survey (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. Results： The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. Conclusion： The original poverty -promoting policies has not reached the maximum point of convergence with China ‘s current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance.

Background We examined the physiological, household, and spatial agglomeration characteristics of the health poverty population in China. We identified weak links that affect the implementation of the medical insurance and further improve its effectiveness for health poverty alleviation. Methods A national representative sample from the China Health and Retirement Longitudinal Study (CHARLS) was analyzed. The WHO recommended method was adopted to calculate catastrophic health expenditure (CHE) and impoverishment by medical expenses (IME). We created a binary indicator for IME as the outcome variable and applied the treatment-effect model to analyze the determinants of IME. Results The incidence of IME was 7.2% of the overall population, compared to 20.3% of the sample households trapped in CHE. The incidence of IME enrolled in insurance schemes was 7.4% higher than that of uninsured families (4.8%). Economic level, living area, family size, age of household head, having hospitalized members, and participating in insurance were statistically significant for the occurrence of IME. Conclusions The original poverty-promoting policies has not reached the maximum point of convergence with China’s current demand for health. The overlapped health vulnerabilities exacerbated the risk of poverty among the elderly and households with high health needs and utilization. In addition, the medical insurance schemes have proven to be insufficient for protection against economic burden of poor households. So, special health needs, age, and household capacity to pay should be comprehensively considered while strengthening the connection between the disease insurance scheme with supplementary insurance.

Integration reforms have been piloted as key policies to address the fragmented health insurance system in China. They are also regarded as a better choice for realizing a Universal Basic Medical Insurance System (UBMIS). This study has attempted to explore the determinants that may affect respondents' dissatisfaction with the reforms. The aim is to provide evidence for more effective policy adjustment during the next round of nationwide integration reforms in China. A cross-sectional questionnaire survey was conducted in Ningbo, Chongqing and Heilongjiang from 2014 to 2015. A stratified cluster sampling method was adopted. A total of 1644 respondents, working in units related to health insurance, were selected. A multivariate logistic regression model was employed to identify any association between dissatisfaction and the features of the ongoing integration reforms of health insurance schemes. Overall, about 47.6% of the respondents reported dissatisfaction with the ongoing integration reforms. This high level of dissatisfaction was found to be associated with ineffective outcomes of the integration reforms in achieving management system improvement [odds ratio (OR) = 1.846], inequity reduction (OR = 1.464) and actual coverage expansion (OR = 1.350), as perceived by the respondents. Those who were satisfied with the previously separated health insurance schemes (OR = 0.643), and those who preferred other policy options for achieving a UBMIS (OR = 1.471) were more likely to report dissatisfaction with the current reforms. Higher expectations of the risk-pooling level (with ORs ranging from 1.361 to 1.661) also significantly contributed to dissatisfaction. Health insurance managers in China have conflicting opinions about the performance of piloted integration reforms. Many believe that these reforms have failed significantly to improve the management systems, narrow inequity and expand actual benefit coverage. Various strategies should be undertaken in order to address these issues, such as clarifying the administrative institution behind the merged schemes at the central level, unifying the insurance information network, developing consistent policies and bridging the differences in benefits among schemes and regions.

In order to improve the corrosion resistance of aluminum alloy, anodic oxide/perfluorooctyltriethoxysilane/graphene oxide (AAO/POTS/GO) composite film was designed through molecular dynamics simulation and quantum chemical calculation, and the composite film was prepared by anodizing and self-assembly technology. The morphology, composition and structure of the film were characterized by SEM, EDS, Raman, XRD and XPS, and the corrosion resistance was characterized by electrochemical test and salt spray test. The impedance of the AAO/POTS/GO composite film is 4 orders of magnitude higher than that of the AAO film, reaching 5.17 × 109 Ω•cm2. The corrosion current density is 3 orders of magnitude lower than that of AAO film. The corrosion resistance efficiency reaches 99.98%, and the corrosion rate is 5.494 × 10−5 mm/year, and the salt spray test does not appear until the 40th day. Theoretical simulation shows that the chemical bond of Si-O-Al is formed by the interaction between the hydrolyzed Si-O-C2H5 and the metal surface atoms. This result is consistent with the final result of the experiment in this paper.

In this paper, a Al2O3 film doped with ZnO microspheres was successfully fabricated on aluminum foil by the sol-gel method. In order to improve the distribution of etched tunnels, the effects of Al2O3 film doped with ZnO microspheres on the surface morphology and electrochemical properties of aluminum foil were investigated. The results showed that, with a suitable concentration of Al2O3 film and ZnO microspheres, uniform distribution of etched tunnels could be obtained on the aluminum foil after the electrochemical etching. When the concentration of Al2O3 film and ZnO microspheres are 0.1 mol/L and 0.02 mol/L, respectively, the specific capacitance of the etched aluminum foil achieved the maximum. The above beneficial results were attributed to the improvement in pitting initiation sites on the aluminum foil coated by Al2O3 film doped with ZnO microspheres, which was supported by the experimental results of surface morphology and electrochemical testing. The etching mechanism was related to the dissolution of ZnO microspheres, the replacement of Zn crystal nucleus and the formation of active sites for pitting corrosion. This paper provides experimental and theoretical insights into the distribution improvement of etch tunnels, showing a significant engineering value for process design and properties optimization for aluminum foils.

Harmonious eco-environment and socioeconomic development is challenged by the difficulty of achieving sustainable development goals in rural areas in developing regions. Moreover, the exploratory strategy of the Ecological County Strategy and management practices of ecological restoration in these regions have not attracted sufficient academic attention. This study uses Meixian County as a case study. We use modified ecological footprint to characterize the ecological environment system of counties, and establish an evaluation index system that reflects the characteristics of counties’ socioeconomic development system. Based on the analysis of the dynamic characteristics of the per capita ecological footprint of Meixian, the grey correlation degree model and coupling degree model were used to analyze the key factors and the degree of coordination between the eco-environment and socioeconomy. The results show that the per capita ecological footprint of Meixian decreased from 0.5884 ha/cap to 0.4797 ha/cap from 2011 to 2016, the quality of the eco-environment has improved. The results of the grey correlation degree show that the ecological footprints of agricultural inputs and agricultural pollutants are important factors that restrict socioeconomic development. The local financial revenue (0.6898), per capita kiwifruit income (0.6842), and the coverage rate of pension insurance (0.7098) and medical insurance (0.6668) all have considerable effects on improving the eco-environment. The results of the coupling coordination degree show that the average annual growth rate of the coupling coordination between the eco-environment system and the economic system is 7.84%, which is in a coordinated or higher state. The average annual growth rate of the coupling coordination between the eco-environment and the social system is 15.25%, and the coordination level rose from imbalanced to highly coordinated state. This study confirms the positive role of the Ecological County Strategy in promoting the coordinated development of counties, and provides beneficial experience for counties in developing regions to improve the coordination between eco-environment and socioeconomy on the basis of ecological carrying capacity.

This paper presents an interplanetary optical navigation algorithm based on two spherical celestial bodies. The remarkable characteristic of the method is that key navigation parameters can be estimated depending entirely on known sizes and ephemerides of two celestial bodies, especially positioning is realized through a single image and does not rely on traditional terrestrial radio tracking any more. Actual Earth–Moon group photos captured by China’s Chang’e-5T1 probe were used to verify the effectiveness of the algorithm. From 430,000 km away from the Earth, the camera pointing accuracy reaches 0.01° (one sigma) and the inertial positioning error is less than 200 km, respectively; meanwhile, the cost of the ground control and human resources are greatly reduced. The algorithm is flexible, easy to implement, and can provide reference to interplanetary autonomous navigation in the solar system.

Background Integration of medical insurance schemes has been prioritized as one of the key strategies to address inequity in China’s health system. The first pilot attempt to integrate started in 2003 and later expanded nationwide. This study aims to assess its intended impact on inequity in inpatient service utilization and identify the main determinants contributing to its ineffectiveness. Methods A total of 49,365 respondents in the pilot integrated area and 77,165 respondents in the non-integration area were extracted from the Fifth National Health Services Survey. A comparative analysis was conducted between two types of areas. We calculate a concentration index (CI) and horizontal inequity index (HI) in inpatient service utilization and decompose the two indices. Results Insurance integration played a positive role in reducing inequality in inpatient service utilization to some extent. A 13.23% lower in HI, a decrease in unmet inpatient care and financial barriers to inpatient care in the pilot integrated area compared with the non-integration area; decomposition analysis showed that the Urban-Rural Residents Basic Medical Insurance, a type of integrated insurance, contributed 37.49% to reducing inequality in inpatient service utilization. However, it still could not offset the strong negative effect of income and other insurance schemes that have increased inequality. Conclusions The earlier pilot attempt for integrating medical insurance was not enough to counteract the influence of factors which increased the inequality in inpatient service utilization. Further efforts to address the inequality should focus on widening access to financing, upgrading the risk pool, reducing gaps within and between insurance schemes, and providing broader chronic disease benefit packages. Social policies that target the needs of the poor with coordinated efforts from various levels and agencies of the government are urgently needed.

The actual reimbursement rate for inpatient service of different medical insurance scheme (%). (DOCX 16 kb)