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Background: Gonorrhea has long been a serious public health problem in mainland China that requires attention, modeling to describe and predict its prevalence patterns can help the government to develop more scientific interventions. Methods: Time series (TS) data of the gonorrhea incidence in China from January 2004 to August 2022 were collected, with the incidence data from September 2021 to August 2022 as the validation. The seasonal autoregressive integrated moving average (SARIMA) model, long short-term memory network (LSTM) model, and hybrid SARIMA-LSTM model were used to simulate the data respectively, the model performance were evaluated by calculating the mean absolute percentage error (MAPE), root mean square error (RMSE), and mean absolute error (MAE) of the training and validation sets of the models. Results: The Seasonal components after data decomposition showed an approximate bimodal distribution with a period of 12 months. The three models identified were SARIMA(1,1,1) (2,1,2)12, LSTM with 150 hidden units, and SARIMA-LSTM with 150 hidden units, the SARIMA-LSTM model fitted best in the training and validation sets, for the smallest MAPE, RMSE, and MPE. Conclusions: The overall incidence trend of gonorrhea in mainland China has been on the decline since 2004, with some periods exhibiting an upward trend. The incidence of gonorrhea displays a seasonal distribution, typically peaking in July and December each year. The SARIMA model, LSTM model, and SARIMA-LSTM model can all fit the monthly incidence time series data of gonorrhea in mainland China. However, in terms of predictive performance, the SARIMA-LSTM model outperforms the SARIMA and LSTM models, with the LSTM model surpassing the SARIMA model. This suggests that the SARIMA-LSTM model can serve as a preferred tool for time series analysis, providing evidence for the government to predict trends in gonorrhea incidence. The model's predictions indicate that the incidence of gonorrhea in mainland China will remain at a high level in 2024, necessitating that policymakers implement public health measures in advance to prevent the spread of the disease. [ABSTRACT FROM AUTHOR]

Non-alcoholic fatty liver disease (NAFLD) is replacing hepatitis B as the leading cause of chronic liver disease in China. The purpose of this study is to select good tools to identify NAFLD from the body composition, anthropometry and related routine clinical parameters. A total of 5076 steelworkers, aged 22–60 years, was included in this study. Body fat mass was measured via bioelectrical impedance analysis (BIA) and fat mass index (FMI) was derived. Ultrasonography method was used to detect hepatic steatosis. Random forest classifier and best subset regression were used to select useful parameters or models that can accurately identify NAFLD. Receiver operating characteristic (ROC) curves were used to describe and compare the performance of different diagnostic indicators and algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) in NAFLD screening. ROC analysis indicated that FMI can be used with high accuracy to identify heavy steatosis as determined by ultrasonography in male workers [area under the curve (AUC) 0.95, 95% CI 0.93–0.98, sensitivity 89.0%, specificity 91.4%]. The ability of single FMI to identify NAFLD is no less than that of combination panels, even better than the combination panel of HSI. The best subset regression model that including FMI, waist circumference, and serum levels of triglyceride and alanine aminotransferase has moderate accuracy in diagnosing overall NAFLD (AUC 0.83). FMI and the NAFLD best subset (BIC) score seem to be good tools to identify NAFLD in Chinese steelworkers. [ABSTRACT FROM AUTHOR]

Populus wilsonii is an important species of section Leucoides, and the natural populations mainly grow in southwest China. In this study, a single genotype of wild P. wilsonii was sequenced and assembled at genome size of 477.35 Mb in 19 chromosomes with contig N50 of 16.3 Mb. A total of 38,054 genes were annotated, and 49.95% of the genome was annotated as repetitive elements. Phylogenetic analysis identified that the divergence between P. wilsonii and the ancestor of P. deltoides and P. trichocarpa was 12 (3–23) Mya. 4DTv and Ks distributions supported the occurrence of the salicoid WGD event (~65 Mya). The highly conserved collinearity supports the close evolutionary relationship among these species. Some key enzyme-encoding gene families related to the biosynthesis of lignin and flavonoids were expanded and highly expressed in the stems or leaves, which probably resist the damage of the natural environment. In addition, some key gene families related to cellulose biosynthesis were highly expressed in stems, accounting for the high cellulose content of P. wilsonii variety. Our findings provided deep insights into the genetic evolution of P. wilsonii and will contribute to further biological research and breeding as well as for other poplars in Salicaceae. A genome assembly for the Chinese poplar tree, Populus wilsonii, provides a unique resource to guide research into poplar development and breeding efforts. [ABSTRACT FROM AUTHOR]

The study added evidence for the potential role of shift work in promoting lipid metabolism disorders in atherosclerotic cardiovascular diseases. It is necessary to strengthen the examination of serum lipids and health management of blood pressure and BMI, so as to reduce the risk of ASCVD and protect workers' health. Objectives: To examine the association and potential mediators between rotating night shift work and serum lipid profiles in Chinese steelworkers. Methods: Different exposure metrics of night shifts collected through face-to-face personal interviews. Serum lipid profiles were measured using an automatic biochemical analyzer. Generalized linear models and mediation analyses were used to analyze the main associations. Results: Compared with day workers, the total cholesterol level in night-shift workers increased in those with 13 to 20 years of night shifts and in those with average frequency of four or more night shifts per month. The association between the duration of night shifts and the total cholesterol level was mediated by systolic and diastolic blood pressure and body mass index. Conclusions: Rotating night-shift work for 13 to 20 years was associated with an increase in the total cholesterol levels in steelworkers, and blood pressure and body mass index may be involved in the causal pathway. [ABSTRACT FROM AUTHOR]

Background: Insomnia is a common prevalent sleep disorder. Difficulty maintaining sleep or poor in quality in insomnia caused by disrupted or misaligned circadian rhythms may play an important role in the development of atherosclerosis. This study aimed to examine the association between insomnia and subclinical atherosclerosis in Chinese steelworkers.Methods: A total of 3240 subjects from a large enterprise located in northern China were included in this study. The Athens Insomnia Scale (AIS) was used to assess the status of insomnia. Subclinical atherosclerosis was evaluated using ultrasonographic measurements of carotid plaque. Multivariable logistic regression was used to identify association between insomnia and carotid atherosclerosis.Results: The overall prevalence of insomnia and carotid plaque were 35.3 and 31.7% in the study population. Compared with non-insomnia workers, significantly increased odds of carotid plaque were observed among insomnia workers after adjusting for potential confounders, odds ratio (OR) = 1.38, 95% confidence interval (CI): 1.17 to 1.63. Exposure to current shift work and insomnia simultaneously can significantly elevated the odds of carotid plaque.Conclusion: Insomnia is associated with elevated odds of carotid atherosclerosis in male steelworkers. Insomnia problems of workers should receive further attention in occupational worker health interventions. [ABSTRACT FROM AUTHOR]

Background: It is a daunting task to discontinue pertussis completely in China owing to its growing increase in the incidence. While basic to any formulation of prevention and control measures is early response for future epidemic trends. Discrete wavelet transform(DWT) has been emerged as a powerful tool in decomposing time series into different constituents, which facilitates better improvement in prediction accuracy. Thus we aim to integrate modeling approaches as a decision-making supportive tool for formulating health resources. Methods: We constructed a novel hybrid method based on the pertussis morbidity cases from January 2004 to May 2018 in China, where the approximations and details decomposed by DWT were forecasted by a seasonal autoregressive integrated moving average (SARIMA) and nonlinear autoregressive network (NAR), respectively. Then, the obtained values were aggregated as the final results predicted by the combined model. Finally, the performance was compared with the SARIMA, NAR and traditional SARIMA-NAR techniques. Results: The hybrid technique at level 2 of db2 wavelet including a SARIMA(0,1,3)(1,0,0)12modelfor the approximation-forecasting and NAR model with 12 hidden units and 4 delays for the detail d1-forecasting, along with another NAR model with 11 hidden units and 5 delays for the detail d2-forecasting notably outperformed other wavelets, SARIMA, NAR and traditional SARIMA-NAR techniques in terms of the mean square error, root mean square error, mean absolute error and mean absolute percentage error. Descriptive statistics exhibited that a substantial rise was observed in the notifications from 2013 to 2018, and there was an apparent seasonality with summer peak. Moreover, the trend was projected to continue upwards in the near future. Conclusions: This hybrid approach has an outstanding ability to improve the prediction accuracy relative to the others, which can be of great help in the prevention of pertussis. Besides, under current trend of pertussis morbidity, it is required to urgently address strategically within the proper policy adopted. [ABSTRACT FROM AUTHOR]

Objective: The association between shift schedules and liver enzymes is unclear. This study aims to explore the effect of rotating night shift work on increased liver enzymes., Methods: The in-service workers of Tangsteel Company who participated in occupational health examination in Tangshan in 2017 were selected as the research objects. Multifaceted exposure metrics of night shift work and comprehensive liver enzymes were used to evaluate rotating night shift work and liver enzymes-associated abnormalities, respectively., Results: There were positive associations between the odds of all liver enzymes-associated abnormalities and duration of night shifts. Different exposure metrics of night shift work were significantly associated with higher odds of elevated alanine aminotransferase (ALT), elevated gamma-glutamyl transaminase (GGT) and increased liver enzymes. Compared with those who never worked night shift, the groups of current night shift, duration of night shifts ≤ 18 years, duration of night shifts > 18 years, cumulative number of night shifts ≤ 1643 nights, cumulative number of night shifts > 1643 nights and average frequency of night shifts > 7 nights/month had an OR of increased liver enzymes of 1.31 (95% CI 1.08-1.58), 1.28 (95% CI 1.05-1.58), 1.27 (95% CI 1.04-1.55), 1.28 (95% CI 1.04-1.58), 1.27 (95% CI 1.04-1.55), 1.32 (95% CI 1.08-1.60) after adjusting for all confounders, respectively. No significant association was found between rotating night shift work and liver enzymes-associated abnormalities among female steelworkers., Conclusions: Rotating night shift work is associated with elevated ALT, elevated GGT and increased liver enzymes in male steelworkers., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study aims to investigate the association between metabolically healthy obesity (MHO) and the early stages of renal dysfunction and whether systemic inflammation affects the study's outcome. Male steelworkers in northern China were investigated in this cross-sectional survey ( n = 6309). A decrease in estimated glomerular filtration rate (eGFR) was used as the primary outcome, which was defined as an eGFR of ≤89 mL/min/1.73 m 2 . A BMI ≥ 25 kg/m 2 was used to determine obesity. In the definition of metabolic health, the absence of metabolic syndrome components is considered metabolically healthy. An assessment of inflammation was carried out using a surrogate marker called high-sensitivity C-reactive protein (hs-CRP). The adjusted odds ratio (OR) and confidence intervals (CIs) were estimated using the multivariable logistic regression model. After adjusting for hs-CRP, MHO (OR = 1.97; 95% CI: 1.21 to 3.21) was significantly associated with decreased eGFR compared to metabolically healthy non-obesity (MHNO). With the MHNO/hs-CRP ≤ 0.01 mg/dL group as a reference, the OR was 2.17 (95% CI: 1.17 to 4.02) for decreased eGFR in the group with MHO/hs-CRP > 0.01 mg/dL. MHO is associated with renal dysfunction at an early stage. To some degree, this risk can be explained by the level of inflammation.

Objective: This study aimed to examine the association between rotating night shift work and subclinical athero-sclerosis among Chinese steelworkers., Methods: We evaluated 3582 steelworkers who participated in the legally required health examination in 2017. Carotid intima-media thickness (CIMT) was measured using ultrasonography. Different exposure metrics of night shifts collected by face-to-face personal interviews were used to examine the relationship between night shift work and the mean CIMT., Results: The mean CIMT values were 0.66 (standard deviation 0.22) mm in the study population. Current shift workers shown higher mean CIMT compared to day workers. There were no significant associations between the current shift status, the duration of night shifts, the cumulative number of night shifts, the average frequency of night shifts, and the mean CIMT after all confounding factors adjusted both in male and female., Conclusions: Rotating night shift work is not associated with subclinical atherosclerosis among steelworkers. Further large-scale prospective longitudinal studies are warranted to confirm our findings.

This study aimed to examine the association between rotating night shift work and carotid atherosclerosis in Chinese steelworkers. A total of 3582 subjects were included in this study. Different exposure metrics of night shifts, including current shift status, duration of night shifts (years), the cumulative number of night shifts (nights), cumulative length of night shifts (hours) and average frequency of night shifts (nights/month), were used to examine the relationship between night shift work and carotid atherosclerosis, including carotid plaque and carotid plaque scores. The prevalence of carotid plaque was 29.9% in the study population. Compared with day workers, significantly increased odds of carotid plaque were observed among shift workers in each quartile of the duration of night shifts after adjusting for potential confounders, especially in the third and fourth quartiles: odds ratio (OR) = 1.91, 95% confidence interval (CI): 1.46 to 2.49, in the third quartiles; OR = 1.69, 95% CI: 1.30 to 2.20, in the fourth quartiles. Positive associations of different exposure metrics of night shifts (continuous) with the odds of carotid plaque and the carotid plaque score were observed in the restricted cubic spline (RCS) models. No significant association was found in female workers between night shift work and carotid plaque. Rotating night shift work is associated with elevated odds of carotid atherosclerosis in male steelworkers., (© 2022. The Author(s), under exclusive licence to The Japanese Society of Hypertension.)

Occupational exposure to heat stress and noise at the workplace are widespread physical hazards and have been associated with an increase in both morbidity and mortality. This study aims to examine the association between occupational heat stress and noise exposure and carotid atherosclerosis in Chinese steelworkers. A total of 3471 subjects were included in this study. Carotid plaque was measured using ultrasonography. The occupational information was collected by face-to-face personal interviews and all of the reported information was verified with the company's records. Workers were divided into non-exposure and exposure groups according to the company's records regarding previous and/or current heat stress and noise exposure status in the workplace. The prevalence of carotid plaque was 30.1% in the study population and workers exposed to both occupational heat stress and noise had the highest prevalence of carotid plaque at 37.2%. The odds of carotid plaque in individuals of different exposure status were significantly elevated after adjustment for potential confounders, especially in the heat stress and noise exposure combination group: OR = 1.32, 95% CI: 1.06 to 1.65, in individuals who had experienced heat stress exposure; OR = 1.49, 95% CI: 1.18 to 1.88, in individuals who had experienced noise exposure; OR = 2.02, 95% CI: 1.60 to 2.56, in the combination group. No significant association in female workers and no significant multiplicative or additive interactions were found between occupational heat stress and noise exposure and carotid plaque. Exposure to occupational heat stress and noise are statistically associated with carotid atherosclerosis among male steelworkers.

Objectives: This study aimed to evaluate the separate and combined effects of rotating night shift work and lifestyle factors with elevated gamma-glutamyl transpeptidase (GGT) among steelworkers., Design, Setting and Participants: This cross-sectional study used the baseline information from a Chinese occupational cohort. The in-service workers of the production department of Tangsteel Company who participated in the occupational health examination in Tangshan from February to June 2017 were selected as the research objects., Main Outcome Measures: The separate and combined effects of rotating night shift work and lifestyle factors with elevated GGT among steelworkers., Results: The information of 7031 subjects from the production department of Tangsteel Company was analysed. Results showed that the current shift workers and the workers with the duration of night shifts>19 years, the cumulative number of night shifts>1774 nights, the average frequency of night shifts≤7 nights/month and the average frequency of night shifts>7 nights/month had elevated odds of elevated GGT, compared with those who never worked night shifts, and ORs, (95% CIs) were 1.39, (1.10 to 1.75), 1.46, (1.15 to 1.86), 1.46, (1.15 to 1.85), 1.34, (1.04 to 1.73) and 1.37, (1.09 to 1.74) after adjustment for potential confounders. The independent effect of shorter sleep duration (<7 hours/day) on elevated GGT was not statistically significant. Among workers who had shorter sleep duration, the association between rotating night shift work and elevated GGT was statistically significant, but no associations were found among workers with the sleep duration of ≥7 hours/day. In addition, other lifestyle factors affected the association between rotating night shift work and elevated GGT., Conclusions: Rotating night shift work is associated with elevated GGT among steelworkers. In particular, the effect of rotating night shift work on elevated GGT was affected by sleep duration and other lifestyle factors., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The aim of this study was to evaluate the associations of rotating night shift work with body fat percentage (BF%) and fat mass index (FMI). A cross-sectional study was conducted among 435 female steelworkers, aged 26-57 years in Tangshan, China. BF% was assessed via bioelectrical impedance analysis and FMI was calculated. Different exposure metrics of night shift work were used to examine the effects of night shift work on BF% and FMI. The duration (years), cumulative number (nights), and cumulative length of night shifts (hours) were positively correlated with FMI and BF%, and these relationships were independent of body mass index (BMI). Compared with day workers, night shift workers with an average frequency of night shifts >7 nights/month (odds ratio (OR) 2.50, 95% confidence interval (CI) 1.17 to 5.35) and percentage of hours on night shifts >30% (OR 2.55, 95% CI 1.21 to 5.39) had elevated odds of obesity (BF% ≥ 35.0%). Nonobese night shift workers by the BMI criterion should also be alert to the risk of the excess accumulation of body fat, which is actually responsible for most obesity-associated adverse health consequences. Health interventions for related populations need to be improved, which is currently more focused on overall weight control., Competing Interests: The authors declare no conflict of interest.

Objective: To examine the associations of rotating night shift work with hyperhomocysteinaemia (HHcy) odds by different exposure metrics., Design: Cross-sectional study., Setting: Occupational physical examination centre for steel production workers, Tangshan, China., Participants: A total of 6846 steelworkers, aged 22-60 years, from the baseline survey of a Chinese occupational cohort., Primary and Secondary Outcome Measures: Different exposure metrics of night shift work, including current shift status, duration of night shifts (years), cumulative number of night shifts (nights), cumulative length of night shifts (hours), average frequency of night shifts (nights/month), average length of night shifts (hours/night) and percentage of hours on night shifts, were used to examine the effects of past and current night shift work on HHcy odds. The total homocysteine concentration in the plasma above 15 µmol/L was defined as HHcy., Results: Compared with those who never worked night shifts, current night shift workers had elevated odds of HHcy (OR 1.23, 95% CI 1.06 to 1.44). Considering a person's lifetime work schedule and compared with individuals who never worked night shifts, duration of night shifts >28 years (OR 1.35, 95% CI 1.12 to 1.61), average frequency of night shifts >7 nights/month (OR 1.25, 95% CI 1.07 to 1.47) and percentage of hours on night shifts >30% (OR 1.23, 95% CI 1.05 to 1.43) were associated with higher HHcy odds. The duration of night shifts >20 years and the average frequency of night shifts >7 nights/month could significantly increase the odds of HHcy regardless of whether the average length of night shifts was greater than 8 hours/night. After stratification by sex, no significant association was found in female workers between different exposure metrics of night shift work and HHcy., Conclusions: Long duration and high frequency of night shift work are associated with higher HHcy odds among male steelworkers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The misalignment between the circadian clock and behavioral cycles has been implicated in pathogenesis of many diseases. The main purpose of this study is to examine the association between rotating night shift work, exposure to light at night, and glomerular filtration rate among steelworkers in north China. A total of 6869 steelworkers, aged 22 to 60 years, were included in this study. Multivariable logistic regression was used to examine the association between night shift work, the brightness of bedroom ambient light at night (LAN), and estimated glomerular filtration rate (eGFR), with adjustment for potential confounders. Mediation analysis was performed to examine the mediation effect of potential mediators on the association of duration of night shifts and eGFR. Long duration of night shift work (≥29 years) had elevated odds of decreased eGFR (≤89 mL/min/1.73 m 2 ) (odds ratio (OR), 1.37, 95% confidence interval (CI) 1.09-1.73) compared with day work after adjustment for potential confounders. The association between duration of night shifts and eGFR (continuous) was partially modified by diastolic blood pressure (average causal mediation effect (ACME), -0.077, 95% CI -0.134 to -0.030, p < 0.001). No significant associations were observed among the different brightness of bedroom ambient light levels: middle level (OR, 0.90, 95% CI 0.77-1.05), lightest level (OR, 0.94, 95% CI 0.75-1.18), and decreased eGFR compared with the darkest level. Long-term night-shift work, rather than the brightness of bedroom ambient LAN, is associated with early stage of renal dysfunction in steelworkers, and blood pressure may mediate the relationship between night shift work and decreased eGFR.

Objectives: In a 24/7 society, the negative metabolic effects of rotating night shift work have been increasingly explored. This study aimed to examine the association between rotating night shift work and non-alcoholic fatty liver disease (NAFLD) in steelworkers., Methods: A total of 6881 subjects was included in this study. Different exposure metrics of night shift work including current shift status, duration of night shifts (years), cumulative number of night shifts (nights), cumulative length of night shifts (hours), average frequency of night shifts (nights/month) and average length of night shifts (hours/night) were used to examine the relationship between night shift work and NAFLD., Results: Current night shift workers had elevated odds of NAFLD (OR, 1.23, 95% CI 1.02 to 1.48) compared with those who never worked night shifts after adjustment for potential confounders. Duration of night shifts, cumulative number of night shifts and cumulative length of night shifts were positively associated with NAFLD. Both the average frequency of night shifts (>7 nights/month vs ≤7 nights/month: OR, 1.24, 95% CI 1.06 to 1.45) and average length of night shifts (>8 hours/night vs ≤8 hours/night: OR, 1.27, 95% CI 1.08 to 1.51) were independently associated with overall NAFLD after mutually adjusting for the duration of night shifts and other potential confounders among night shift workers. No significant association was found in female workers between different exposure metrics of night shift work and NAFLD., Conclusions: Rotating night shift work is associated with elevated odds of NAFLD in male steelworkers., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: Tuberculosis (TB) remains a major deadly threat in mainland China. Early warning and advanced response systems play a central role in addressing such a wide-ranging threat. The purpose of this study is to establish a new hybrid model combining a seasonal autoregressive integrated moving average (SARIMA) model and a non-linear autoregressive neural network with exogenous input (NARNNX) model to understand the future epidemiological patterns of TB morbidity., Methods: We develop a SARIMA-NARNNX hybrid model for forecasting future levels of TB incidence based on data containing 255 observations from January 1997 to March 2018 in mainland China, and the ultimate simulating and forecasting performances were compared with the basic SARIMA, non-linear autoregressive neural network (NARNN) and error-trend-seasonal (ETS) approaches, as well as the SARIMA-generalised regression neural network (GRNN) and SARIMA-NARNN hybrid techniques., Results: In terms of the root mean square error, mean absolute error, mean error rate and mean absolute percentage error, the identified best-fitting SARIMA-NARNNX combined model with 17 hidden neurons and 4 feedback delays had smaller values in both in-sample simulating scheme and the out-of-sample forecasting scheme than the preferred single SARIMA(2,1,3)(0,1,1) 12 model, a NARNN with 19 hidden neurons and 6 feedback delays and ETS(M,A,A), and the best-performing SARIMA-GRNN and SARIMA-NARNN models with 32 hidden neurons and 6 feedback delays. Every year, there was an obvious high-risk season for the notified TB cases in March and April. Importantly, the epidemic levels of TB from 2006 to 2017 trended slightly downward. According to the projection results from 2018 to 2025, TB incidence will continue to drop by 3.002% annually but will remain high., Conclusions: The new SARIMA-NARNNX combined model visibly outperforms the other methods. This hybrid model should be used for forecasting the long-term epidemic patterns of TB, and it may serve as a beneficial and effective tool for controlling this disease., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The high incidence, seasonal pattern and frequent outbreaks of hand, foot, and mouth disease (HFMD) represent a threat for millions of children in mainland China. And advanced response is being used to address this. Here, we aimed to model time series with a long short-term memory (LSTM) based on the HFMD notified data from June 2008 to June 2018 and the ultimate performance was compared with the autoregressive integrated moving average (ARIMA) and nonlinear auto-regressive neural network (NAR). The results indicated that the identified best-fitting LSTM with the better superiority, be it in modeling dataset or two robustness tests dataset, than the best-conducting NAR and seasonal ARIMA (SARIMA) methods in forecasting performances, including the minimum indices of root mean square error, mean absolute error and mean absolute percentage error. The epidemic trends of HFMD remained stable during the study period, but the reported cases were even at significantly high levels with a notable high-risk seasonality in summer, and the incident cases projected by the LSTM would still be fairly high with a slightly upward trend in the future. In this regard, the LSTM approach should be highlighted in forecasting the epidemics of HFMD, and therefore assisting decision makers in making efficient decisions derived from the early detection of the disease incidents.

With the re-emergence of brucellosis in mainland China since the mid-1990s, an increasing threat to public health tends to become even more violent, advanced warning plays a pivotal role in the control of brucellosis. However, a model integrating the autoregressive integrated moving average (ARIMA) with Error-Trend-Seasonal (ETS) methods remains unexplored in the epidemiological prediction. The hybrid ARIMA-ETS model based on discrete wavelet transform was hence constructed to assess the epidemics of human brucellosis from January 2004 to February 2018 in mainland China. The preferred hybrid model including the best-performing ARIMA method for approximation-forecasting and the best-fitting ETS approach for detail-forecasting is evidently superior to the standard ARIMA and ETS techniques in both three in-sample simulating and out-of-sample forecasting horizons in terms of the minimum performance indices of the root mean square error, mean absolute error, mean error rate and mean absolute percentage error. Whereafter, an ahead prediction from March to December in 2018 displays a dropping trend compared to the preceding years. But being still present, in various trends, in the present or future. This hybrid model can be highlighted in predicting the temporal trends of human brucellosis, which may act as the potential for far-reaching implications for prevention and control of this disease.