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Background Real-world performance of COVID-19 diagnostic tests under Emergency Use Authorization (EUA) must be assessed. We describe overall trends in the performance of serology tests in the context of real-world implementation. Methods Six health systems estimated the odds of seropositivity and positive percent agreement (PPA) of serology test among people with confirmed SARS-CoV-2 infection by molecular test. In each dataset, we present the odds ratio and PPA, overall and by key clinical, demographic, and practice parameters. Results A total of 15,615 people were observed to have at least one serology test 14–90 days after a positive molecular test for SARS-CoV-2. We observed higher PPA in Hispanic (PPA range: 79–96%) compared to non-Hispanic (60–89%) patients; in those presenting with at least one COVID-19 related symptom (69–93%) as compared to no such symptoms (63–91%); and in inpatient (70–97%) and emergency department (93–99%) compared to outpatient (63–92%) settings across datasets. PPA was highest in those with diabetes (75–94%) and kidney disease (83–95%); and lowest in those with auto-immune conditions or who are immunocompromised (56–93%). The odds ratios (OR) for seropositivity were higher in Hispanics compared to non-Hispanics (OR range: 2.59–3.86), patients with diabetes (1.49–1.56), and obesity (1.63–2.23); and lower in those with immunocompromised or autoimmune conditions (0.25–0.70), as compared to those without those comorbidities. In a subset of three datasets with robust information on serology test name, seven tests were used, two of which were used in multiple settings and met the EUA requirement of PPA ≥87%. Tests performed similarly across datasets. Conclusion Although the EUA requirement was not consistently met, more investigation is needed to understand how serology and molecular tests are used, including indication and protocol fidelity. Improved data interoperability of test and clinical/demographic data are needed to enable rapid assessment of the real-world performance of in vitro diagnostic tests.

Abstract Gubser flow is an evolution with cylindrical and boost symmetries, which can be best studied by mapping the future wedge of Minkowski space (R3,1) to dS3 × ℝ in a conformal relativistic theory. Here, we sharpen our previous analytic results and validate them via the first numerical exploration of the Gubser flow in a holographic conformal field theory. Remarkably, the leading generic behavior at large de Sitter time is free-streaming in transverse directions and the sub-leading behavior is that of a color glass condensate. We also show that Gubser flow can be smoothly glued to the vacuum outside the future Minkowski wedge generically given that the energy density vanishes faster than any power when extrapolated to early proper time or to large distances from the central axis. We find that at intermediate times the ratio of both the transverse and longitudinal pressures to the energy density converge approximately to a fixed point which is hydrodynamic only for large initial energy densities. We argue that our results suggest that the Gubser flow is better applied to collective behavior in jets rather than the full medium in the phenomenology of heavy ion collisions and can reveal new clues to the mechanism of confinement.

Background: Anthropometric foot data is important in designing and manufacturing shoes. Wearing inappropriate shoes increases the likelihood of problems like ankle injuries, corns, chronic pain, and foot blisters. As yet there is no accurate database on Indian feet till today for the Indian Footwear Industry to develop more comfortable footwear. Objectives: This study aimed to measure the dimensions of the feet of Indian adults to analyze the anthropometric variations between the Right and Left feet within and between genders. Method: This cross-sectional study was carried out with 117 participants (69 male and 48 female) aged 18 to 50 years. Different anthropometric foot parameters were measured by using a 3D foot scanner. Result: Results showed significant gender differences in most parameters but no significant differences between the left and right foot of each gender. Conclusion: This investigation emphasizes the importance of using size data for designing comfortable and well-fitting footwear. The obtained foot anthropometric data can serve as a reference for designing footwear 'Last' for Indian adults, ensuring better comfort and fit. The findings are intended to assist the Indian footwear industry fill the current data gap for the Indian population during the ‘Last’ preparation. This could lead to the prevention of foot problems caused by ill-fitting footwear, as well as improved general foot health.

Abstract Background Tuberculosis in cattle is caused by Mycobacterium tuberculosis complex (MTBC) species. Apart from MTBC, different Nontuberculous Mycobacteria (NTM) species have also been isolated from cattle. The presence of NTM infection in bovines makes the diagnosis of bovine tuberculosis (bTB) a cumbersome task. Therefore, a cross sectional study was conducted to isolate and characterize different Mycobacterium spp. from a slaughterhouse situated in Kolkata, a city in the eastern part of India. Results Out of 258 morbid samples, 98 isolates were found to be positive for bacterial growth, and 35% (n = 34) were positive for Mycobacterium. 94% of Mycobacterial cultural isolates were NTM (n = 32), and the rest (n = 2) were found to be MTBC. Species-level identification of the isolates by hsp65 sequencing revealed that out of 32 isolates, 24 were M. fortuitum, three were M. abscessus, two each were M. chelonae and M. parascrofulaceum, and one was M. novocastrense. A phylogenetic tree with partial hsp65 gene sequences was also constructed to determine the relatedness of the unknown isolates to the reference strains. Conclusion Both NTM species and MTBCs were identified from TB-like lesions in cattle that were slaughtered at the Kolkata abattoir. This discovery may indicate that NTM contributes to the development of lesions in cattle. Also, we recommend implication of more specific diagnostic tests for bTB.

Abstract We demonstrate that the solutions of three-dimensional gravity obtained by gluing two copies of a spacetime across a junction constituted of a tensile string are in one-to-one correspondence with the solutions of the Nambu-Goto equation in the same spacetime up to a finite number of rigid deformations related to worldsheet and spacetime isometries. The non-linear Nambu-Goto equation satisfied by the average of the embedding coordinates of the junction emerges directly from the junction conditions along with the rigid deformations and corrections due to the tension. Therefore, the equivalence principle generalizes non-trivially to the string. Our results are valid both in three-dimensional flat and AdS spacetimes. In the context of AdS3/CFT2 correspondence, our setup could be used to describe a class of interfaces in the conformal field theory featuring relative time reparametrization at the interface which encodes the solution of the Nambu-Goto equation corresponding to the bulk junction.

Abstract Acid sphingomyelinase (ASM) inhibitors are widely used for the treatment of post-stroke depression. They promote neurological recovery in animal stroke models via neurorestorative effects. In a previous study, we found that antidepressants including amitriptyline, fluoxetine, and desipramine increase cerebral angiogenesis post-ischemia/reperfusion (I/R) in an ASM-dependent way. To elucidate the underlying mechanisms, we investigated the effects of the functional ASM inhibitor amitriptyline in two models of I/R injury, that is, in human cerebral microvascular endothelial hCMEC/D3 cells exposed to oxygen-glucose deprivation and in mice exposed to middle cerebral artery occlusion (MCAO). In addition to our earlier studies, we now show that amitriptyline increased mitochondrial reactive oxygen species (ROS) formation in hCMEC/D3 cells and increased ROS formation in the vascular compartment of MCAO mice. ROS formation was instrumental for amitriptyline’s angiogenic effects. ROS formation did not result in excessive endothelial injury. Instead, amitriptyline induced a profound metabolic reprogramming of endothelial cells that comprised reduced endothelial proliferation, reduced mitochondrial energy metabolism, reduced endoplasmic reticulum stress, increased autophagy/mitophagy, stimulation of antioxidant responses and inhibition of apoptotic cell death. Specifically, the antioxidant heme oxygenase-1, which was upregulated by amitriptyline, mediated amitriptyline’s angiogenic effects. Thus, heme oxygenase-1 knockdown severely compromised angiogenesis and abolished amitriptyline’s angiogenic responses. Our data demonstrate that ASM inhibition reregulates a complex network of metabolic and mitochondrial responses post-I/R that contribute to cerebral angiogenesis without compromising endothelial survival.

Abstract This study provides a comparative analysis of feasible architectures of Power Pulsating Buffer (PPB) as an actively controlled energy storage solution alternative to the electrolytic capacitors in a single‐stage isolated, single‐phase 120 V AC 60Hz grid‐connected photovoltaic (PV) microinverter for a 400 W rated system with 20–40 V input range. The comparison encompasses key factors including energy density, volume reduction, efficiency, frequency operation, and system stability. The findings shed light on the primary advantages and disadvantages of the buck‐ and boost‐derived PPB under study. The results indicate that the boost PPB exhibits enhanced stability, a more compact design, and higher power efficiency compared to the buck PPB. However, for low switching frequency operations, the buck PPB proves to be more effective in mitigating DC port voltage ripple and ensuring controller over microinverter load variation.

Abstract Studies on the neural correlates of navigation in 3D environments are plagued by several issues that need to be solved. For example, experimental studies show markedly different place cell responses in rats and bats, both navigating in 3D environments. In this study, we focus on modelling the spatial cells in rodents in a 3D environment. We propose a deep autoencoder network to model the place and grid cells in a simulated agent navigating in a 3D environment. The input layer to the autoencoder network model is the HD layer, which encodes the agent’s HD in terms of azimuth (θ) and pitch angles (ϕ). The output of this layer is given as input to the Path Integration (PI) layer, which computes displacement in all the preferred directions. The bottleneck layer of the autoencoder model encodes the spatial cell-like responses. Both grid cell and place cell-like responses are observed. The proposed model is verified using two experimental studies with two 3D environments. This model paves the way for a holistic approach using deep neural networks to model spatial cells in 3D navigation.

Abstract Control of heat flow is critical for thermal logic devices and thermal management and has been explored theoretically. However, experimental progress on active control of heat flow has been limited. Here, we describe a nanoscale radiative thermal transistor that comprises of a hot source and a cold drain (both are ~250 nm-thick silicon nitride membranes), which are analogous to the source and drain electrodes of a transistor. The source and drain are in close proximity to a vanadium oxide (VOx)-based planar gate electrode, whose dielectric properties can be adjusted by changing its temperature. We demonstrate that when the gate is located close (

The establishment of the National Administration of Disease Prevention and Control has initiated the reform of China′s disease prevention and control system. Clarifying and optimizing the responsibilities of disease prevention and control institutions is the core of implementing the reform of the disease prevention and control system and serves as a compass for institutional capacity building and work implementation. Through literature review and policy document analysis, this article discusses the historical development, current challenges, and development directions of the responsibilities of disease prevention and control institutions.

Sphingolipids comprise a class of lipids, which are composed of a sphingoid base backbone and are essential structural components of cell membranes. Beyond their role in maintaining cellular integrity, several sphingolipids are pivotally involved in signaling pathways controlling cell proliferation, differentiation, and death. The brain exhibits a particularly high concentration of sphingolipids and dysregulation of the sphingolipid metabolism due to ischemic injury is implicated in consecutive pathological events. Experimental stroke studies revealed that the stress sphingolipid ceramide accumulates in the ischemic brain post-stroke. Specifically, counteracting ceramide accumulation protects against ischemic damage and promotes brain remodeling, which translates into improved behavioral outcome. Sphingomyelin substantially influences cell membrane fluidity and thereby controls the release of extracellular vesicles, which are important vehicles in cellular communication. By modulating sphingomyelin content, these vesicles were shown to contribute to behavioral recovery in experimental stroke studies. Another important sphingolipid that influences stroke pathology is sphingosine-1-phosphate, which has been attributed a pro-angiogenic function, that is presumably mediated by its effect on endothelial function and/or immune cell trafficking. In experimental and clinical studies, sphingosine-1-phosphate receptor modulators allowed to modify clinically significant stroke recovery. Due to their pivotal roles in cell signaling, pharmacological compounds modulating sphingolipids, their enzymes or receptors hold promise as therapeutics in human stroke patients.

Satellite remote sensing technology has been widely applied in various fields due to its efficient data acquisition speed, short period and significant benefit ratio. This article summarizes and analyzes the application of satellite remote sensing technology in the field of health at home and abroad by searching the relevant literature in recent years. From epidemiology, environmental health, medical and health management to public health emergency response, satellite remote sensing technology has shown strong application potential in the field of health. It is recommended to draw on international experience and further expand the application scope of satellite remote sensing technology in China's health field, including expanding the scope of epidemic monitoring, establishing the relationship between environmental factors and health outcomes, and promoting cross-application research in various fields. This will provide more comprehensive and accurate data support for the high-quality development of China's health and wellness initiatives.

Abstract Background Supplemental private health insurance (PHI) plays a crucial role in complementing China’s social health insurance (SHI). However, the effectiveness of incorporating PHI as supplementary coverage lacks conclusive evidence regarding its impact on healthcare utilization and seeking behavior among SHI-covered individuals. Therefore, investigating the effects of supplementary PHI on health care utilization and seeking behavior of residents covered by social health insurance is essential to provide empirical evidence for informed decision-making within the Chinese healthcare system. Methods Data from the 2018 China National Health Services Survey were analyzed to compare outpatient and inpatient healthcare utilization and choices between PHI purchasers and non-purchasers across three SHI schemes: urban employee-based basic medical insurance (UEBMI), urban resident-based basic medical insurance (URBMI), and the new rural cooperative medical scheme (NRCMS). Using the Andersen Healthcare Services Utilization Behavior Model as the theoretical framework,binary logistic regression and multinomial logistic regression (MNL) models were employed to assess the impact of PHI on healthcare utilization and provider preferences. Results Among UEBMI, URBMI, and NRCMS participants with PHI, outpatient visit rates were 17.9, 19.8, and 21.7%, and inpatient admission rates were 12.4, 9.9, and 12.9%, respectively. Participants without PHI exhibited higher rates for outpatient visits (23.6, 24.3, and 25.6%) and inpatient admissions (15.2, 12.8, and 14.5%). Binomial logistic regression analyses revealed a higher probability of outpatient visits and inpatient admissions among UEBMI participants with PHI (p

Abstract Gubser flow is an axis-symmetric and boost-invariant evolution in a relativistic quantum field theory which is best studied by mapping $$\textbf{R}^{3,1}$$ R 3 , 1 to $$dS_{3}\times \textbf{R}$$ d S 3 × R when the field theory has conformal symmetry. We show that at late de-Sitter time, which corresponds to large proper time and central region of the future wedge within $$\textbf{R}^{3,1}$$ R 3 , 1 , the holographic conformal field theory plasma can reach a state in which $$\varepsilon = P_T = - P_L$$ ε = P T = - P L , with $$\varepsilon $$ ε , $$P_T$$ P T and $$P_L$$ P L being the energy density, transverse and longitudinal pressures, respectively. We further determine the full sub-leading behaviour of the energy–momentum tensor at late time. Restricting to flows in which the energy density decays at large transverse distance from the central axis in $$\textbf{R}^{3,1}$$ R 3 , 1 , we show that this decay should be faster than any power law. Furthermore, in this case the energy density also vanishes in $$\textbf{R}^{3,1}$$ R 3 , 1 faster than any power as we go back to early proper time. Hydrodynamic behavior can appear in intermediate time.

Abstract Universal health coverage relies on providing essential medical services and shielding individuals from financial risks. Our study assesses the progressivity of out-of-pocket (OOP) payments, identifies factors contributing to healthcare expenditure inequality, and examines catastrophic health expenditures (CHE) prevalence in Kazakhstan from 2018 to 2021. Using retrospective analysis of National Statistics Bureau data, we employed STATA 13 version for calculations CHE incidence, progressivity, Lorenz and concentration curves. In 2020–2021, OOP expenditures in Kazakhstan decreased, reflecting a nearly twofold reduction in the CHE incidence to 1.32% and 1.24%, respectively. However, during these years, we observe a transition towards a positive trend in the Kakwani index to 0.003 and 0.005, respectively, which may be explained by household size and education level factors. Increased state financing and quarantine measures contributed to reduced OOP payments. Despite a low healthcare expenditure share in gross domestic product, Kazakhstan exhibits a relatively high private healthcare spending proportion. The low CHE incidence and proportional expenditure system suggest private payments do not significantly impact financial resilience, prompting considerations about the role of government funding and social health insurance in the financing structure.

Abstract Hybrid fluid models, consisting of two sectors with more weakly and more strongly self-interacting degrees of freedom coupled consistently as in the semi-holographic framework, have been shown to exhibit an attractor surface for Bjorken flow. Retaining only the simple viscid fluid descriptions of both sectors, we find that, on the attractor surface, the hydrodynamization times of both subsectors decrease with increasing total energy density at the respective point of hydrodynamization following a conformal scaling, reach their minimum values, and subsequently rise rapidly. The minimum values are obtained when the respective energy densities are of the order of the inverse of the dimensionful inter-system coupling. Restricting to attractor curves which can be matched to glasma models at a time set by the saturation scale for both p-p and Pb-Pb collisions, we find that the more weakly coupled sector hydrodynamizes much later, and the strongly coupled sector hydrodynamizes earlier in p-p collisions, since the total energy densities at the respective hydrodynamization times of these sectors fall inside and outside of the conformal window. This holds true also for phenomenologically relevant solutions that are significantly away from the attractor surface at the time we match to glasma models.

The Zika virus, a member of the Flaviviridae family, is a mosquito-borne disease-causing virus that gained worldwide attention after a severe outbreak in Brazil in 2015. During this outbreak, some alarming evidence suggests that fetal microcephaly and other neuro-developmental disorders were associated with Zika infection. The virus also causes multi-organ failure and thrombocytopenia and also affects the eyes, leading to a potentially inflammatory disease called uveitis in adult individuals. It could be transmitted through sexual intercourse or the transplacental route, which is not commonly observed in other flaviviruses. In this review, we are interested in discovering the specific role of microglia in the pathogenesis of Zika virus-induced neuroinflammation. The virus comes into contact with microglial cells through the blood and causes activation and neuroinflammatory consequences, leading to the death of developing neurons and ultimately resulting in altered neuron-glia interaction. Despite its severity, there is still no specific medicine or vaccine available to combat the Zika infection. An essential aspect of this review is to identify cost-effective treatment strategies and accurate diagnostic methods for broader populations. In conclusion, an understanding of the cellular basis of Zika pathogenesis can help ensure potential treatment strategies to combat the global outbreak of the Zika virus.

Electric vehicle (EV) charging station (CS) congestion is highly dependent on the EV owner’s behavior and their selected CS as charging choice. A fixed pricing strategy causes some CSs to be congested with EVs waiting in line to charge, while there are some other CSs with available electric plugs, which adversely affects both charging station operator (CSO) revenue and EV users’ welfare. To solve this problem, this paper presents a dynamic pricing strategy aimed at conducting EVs from congested CSs to the uncongested ones through controlling the charging prices of CSs at different times. The problem is formulated as a scenario-based stochastic optimization with the objective of maximizing overall revenue of the CSO. Moreover, an attraction function model is developed to quantify the charging choice of the EV owners by considering the effective parameters of CSs in EV charging choice decisions. QGIS software is used in this work to formulate a realistic modeling for CS locations and EV routes to calculate the distances from EVs to CSs. Three scenarios are designed to evaluate the performance of the proposed framework and to compare the results with the fixed pricing approach. The results indicate that the proposed dynamic pricing strategy mitigates the congestion of CSs while facilitating an increased number of charged EVs up to 48% as well as increasing the overall revenue of the CSO.

Selenium-yeast was mixed with the basal diet of treatment groups of birds at the dose rate of 0.15 mg/kg diet in treatment-I (T-I), 0.225 mg/kg in treatment-II (T-II) and 0.30 mg/kg in treatment-III (T-III) group. The body weight and weekly weight gain increased and, feed conversion ratio improved significantly (p

In this article, a high-efficiency and high-density 2.5 kW four-level interleaved flying capacitor multilevel (FCML) totem-pole bridgeless power-factor-correction (PFC) rectifier with 200 V GaN devices is analyzed, designed, and tested. This 2.5 kW four-level continuous conduction mode (CCM) GaN totem pole PFC operates with three times inductor current ripple frequency than that of the switching frequency which significantly reduces the size of the inductors while also supporting switching loss reduction. This article compares the loss of the two-level CCM GaN totem-pole PFC, four-level non-interleaved FCML PFC and interleaved four-level FCML PFC with the same ripple frequency (300 kHz) and shows that the interleaved four-level CCM GaN PFC has much less device loss. In addition, this article discusses the detailed EMI spectrum analysis and derivation of the mathematical model for determining the attenuation requirement of the four-level interleaved FCML PFC converter followed by volumetric co-optimization of AC-side passives i.e., the boost inductor and differential mode (DM) EMI filter. A 2.5 kW four-level interleaved FCML GaN totem-pole PFC prototype with an optimized 94 kHz switching frequency is developed and tested in this article. The converter exhibits a peak efficiency of 99.14% with system power density reaching 89.47 W/inch3.

Objectives: To calculate the case fatality rates (CFR) of COVID‐19 during epidemic periods of different variants of concern (VOC) by continents. Methods: We systematically searched five authoritative databases (Web of Science, PubMed, Embase, Cochrane Library, and MedRxiv) for epidemiological studies on the CFR of COVID-19 published between January 1, 2020, and March 31, 2023. After identifying the epidemic trends of variants, we used a random-effects model to calculate the pooled CFRs during periods of different VOCs. This meta-analysis was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and registered with PROSPERO (CRD42023431572). Results: There were variations in the CFRs among different variants of COVID-19 (Alpha: 2.62%, Beta: 4.19%, Gamma: 3.60%, Delta: 2.01%, Omicron: 0.70%), and disparities in CFRs also existed among continents. On the whole, the CFRs of COVID-19 in Europe and Oceania were slightly lower than in other continents. There was a statistically significant association between the variant, HDI value, age distribution, coverage of full vaccination of cases, and the CFR. Conclusions: The CFRs of COVID-19 varied across the epidemic periods of different VOCs, and disparities existed among continents. The CFR value reflected combined effects of various factors within a certain context. Caution should be exercised when comparing CFRs due to disparities in testing capabilities and age distribution among countries, etc.

Abstract We study how the black hole complementarity principle can emerge from quantum gravitational dynamics within a local semiclassical approximation. Further developing and then simplifying a microstate model based on the fragmentation instability of a near-extremal black hole, we find that the key to the replication (but not cloning) of infalling information is the decoupling of various degrees of freedom. The infalling matter decouples from the interior retaining a residual time-dependent quantum state in the hair which encodes the initial state of the matter non-isometrically. The non-linear ringdown of the interior after energy absorption and decoupling also encodes the initial state, and transfers the information to Hawking radiation. During the Hawking evaporation process, the fragmented throats decouple from each other and the hair decouples from the throats. We find that the hair mirrors infalling information after the decoupling time which scales with the logarithm of the entropy (at the time of infall) when the average mass per fragmented throat (a proxy for the temperature) is held fixed. The decoding protocol for the mirrored information does not require knowledge of the interior, and only limited information from the Hawking radiation, as can be argued to be necessitated by the complementarity principle. We discuss the scope of the model to illuminate various aspects of information processing in a black hole.

Abstract Background The intravenous delivery of adult neural precursor cells (NPC) has shown promising results in enabling cerebroprotection, brain tissue remodeling, and neurological recovery in young, healthy stroke mice. However, the translation of cell-based therapies to clinical settings has encountered challenges. It remained unclear if adult NPCs could induce brain tissue remodeling and recovery in mice with hyperlipidemia, a prevalent vascular risk factor in stroke patients. Methods Male mice on a normal (regular) diet or on cholesterol-rich Western diet were exposed to 30 min intraluminal middle cerebral artery occlusion (MCAO). Vehicle or 106 NPCs were intravenously administered immediately after reperfusion, at 3 day and 7 day post-MCAO. Neurological recovery was evaluated using the Clark score, Rotarod and tight rope tests over up to 56 days. Histochemistry and light sheet microscopy were used to examine ischemic injury and brain tissue remodeling. Immunological responses in peripheral blood and brain were analyzed through flow cytometry. Results NPC administration reduced infarct volume, blood–brain barrier permeability and the brain infiltration of neutrophils, monocytes, T cells and NK cells in the acute stroke phase in both normolipidemic and hyperlipidemic mice, but increased brain hemorrhage formation and neutrophil, monocyte and CD4+ and CD8+ T cell counts and activation in the blood of hyperlipidemic mice. While neurological deficits in hyperlipidemic mice were reduced by NPCs at 3 day post-MCAO, NPCs did not improve neurological deficits at later timepoints. Besides, NPCs did not influence microglia/macrophage abundance and activation (assessed by morphology analysis), astroglial scar formation, microvascular length or branching point density (evaluated using light sheet microscopy), long-term neuronal survival or brain atrophy in hyperlipidemic mice. Conclusions Intravenously administered NPCs did not have persistent effects on post-ischemic neurological recovery and brain remodeling in hyperlipidemic mice. These findings highlight the necessity of rigorous investigations in vascular risk factor models to fully assess the long-term restorative effects of cell-based therapies. Without comprehensive studies in such models, the clinical potential of cell-based therapies cannot be definitely determined.

Cancer has become an important public health problem affecting the health of Chinese residents, as well as residents all over the world. With the improvement of cancer prevention and treatment, the growth of the mortality rate of cancers has slowed down gradually, but the incidence rate is still increasing rapidly, and cancers still impose heavy disease and economic burdens. Cancer screening and early cancer diagnosis and treatment are important ways to reduce the burden of cancer-related diseases. At present, various projects for early cancer diagnosis and treatment have been implemented in China. With the expansion of the coverage of these projects, the problems related to project implementation, operation, and management have emerged gradually. In recent years, emerging information technologies have been applied in the field of health and have facilitated health management and clinical decision-making. Meanwhile, China announced multiple policies to encourage and promote the application of information technologies in the field of health. Therefore, combined with the analysis of major problems in cancer prevention and control projects, this paper probes into how to apply information technologies such as biological information mining, artificial intelligence, and electronic information collection technology to various stages of cancer prevention and control. Information technologies realize the integrated management of prevention and control processes, for example, mobilization and preliminary identification, high-risk assessment, clinical screening, clinical diagnosis and treatment, tracking and follow-up, and biological sample management of high-risk groups, and promote the efficient implementation of cancer prevention and control projects in China.

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The establishment of the National Administration of Disease Prevention and Control marks the beginning of the reform of disease prevention and control system in China. With the transformation of the functions of centers for disease prevention and control (CDCs), the evaluation system on CDCs′ performance should also be adjusted accordingly. In this paper, we systematically summarize the development process of the evaluation system on CDCs′ performance in China; we also analyze current problems for the evaluation system in detail, including untimely update of evaluation policy documents, lack of theoretical basis for the establishment of evaluation indicators, coexistence of multiple problems in evaluation methods, insufficiency of horizontal comparability and vertical dynamics of the evaluation indexes. At last, we put forward suggestions for improving the evaluation system.

Government efforts and reforms in health financing systems in various countries are aimed at achieving universal health coverage. Household spending on healthcare plays a very important role in achieving this goal. The aim of this systematic review was to assess out-of-pocket health expenditure inequalities measured by the FIA across different territories, in the context of achieving UHC by 2030. A comprehensive systematic search was conducted in the PubMed, Scopus, and Web of Science databases to identify original quantitative and mixed-method studies published in the English language between 2016 and 2022. A total of 336 articles were initially identified, and after the screening process, 15 articles were included in the systematic review, following the removal of duplicates and articles not meeting the inclusion criteria. Despite the overall regressivity, insurance systems have generally improved population coverage and reduced inequality in out-of-pocket health expenditures among the employed population, but regional studies highlight the importance of examining the situation at a micro level. The results of the study provide further evidence supporting the notion that healthcare financing systems relying less on public funding and direct tax financing and more on private payments are associated with a higher prevalence of catastrophic health expenditures and demonstrate a more regressive pattern in terms of healthcare financing, highlighting the need for policy interventions to address these inequities. Governments face significant challenges in achieving universal health coverage due to inequalities experienced by financially vulnerable populations, including high out-of-pocket payments for pharmaceutical goods, informal charges, and regional disparities in healthcare financing administration.

Background/objectives: Emotional exhaustion is the most common feature of overall burnout among primary care physicians. The purpose of our study is to identify professional burnout among doctors and nurses of the highest level. Methods: The data were obtained using a social survey of doctors and nurses in primary health care organizations. Using the MBI questionnaire. The study locations were medical centers in urban and rural areas in eight regions of Kazakhstan. A total of 612 urban and 244 rural primary health care workers took part. Results: Mean score ±standard deviation on the exhaustion subscale was 32.6 ± 13.5, on the depersonalization subscale — 14.4 ± 6.1, on the personal achievement subscale — 42.2 ± 7.5. Overall, the high prevalence of emotional exhaustion, depersonalization, and personal achievement was 57.4%, 64.6%, and 65.0%, respectively. Statistically significant predictors for emotional burnout were such as the location of work, urban or rural (OR = 1.973; p

Aim: The present study aimed to perform validation and assessment of psychometric indicators of the Kazakh version of the Brief Index of Affective Job Satisfaction on the academic faculty staff. Material and methods: The translation of the Brief Index of Affective Job Satisfaction was performed following the World Health Organization guidelines on the translation and adaptation of research instruments. 715 medical educators of Kazakhstani medical universities represented the study population. Preliminary statistical analysis included Cronbach’s alpha calculation. The psychometric properties of the instrument were examined using exploratory and confirmatory factor analysis. Results: Cronbach’s alpha obtained 0.83. The Kaiser-Meyer-Olkin index reached 0.830, which indicated meritorious sample adequacy. CFA identified good factorial validity of the scale: all model fit indices exceeded the threshold values. The inter-item correlation index varied between r=0.616 and r=0.716, designating an acceptable correlation between variables. The total job satisfaction level was moderate (3.15±0.78). Women reported lower rates of job satisfaction, although the difference was not statistically significant (p Conclusion: Our findings provide support to the psychometric properties of the Kazakh version of the BIAJS as an instrument for the assessment of job satisfaction. The major advantages of the BIAJS are that it is optimally brief, highly affective, and has good internal validity.

This article presents a precisely synthesized full order as well as reduced order continuous time large signal and small signal model of a hybrid phase-duty controlled triple-active bridge (TAB) converter based on higher order harmonic frequency inclusive averaging model. Such model helps to accurately predict the steady state circuit parameters such as inductor current, average output voltage, output voltage ripple etc. that in turn can be used to formulate the loss minimized optimal phase-duty modulation strategy for a TAB. Further, the derived full order small signal model can specifically model the high frequency dynamics of the converter which are neglected in the reduced order modeling. Moreover, in order to facilitate decoupled power flow in a TAB, a decoupler network is formulated based on meticulously modeled converter plant considering higher order harmonics of the bridge voltages into calculation. Finally, a controller-based decoupled power management strategy is proposed in this study that decouples the TAB control loops and facilitates faster transient performance with two independent PI controllers. An 800 W TAB converter proof-of-concept is designed, fabricated, and tested to verify the established modeling techniques and the proposed controller decoupling action. With the implementation of the decoupled control under an 80% load transient at the 2nd output port, the experimental results show 30% improvement in overshoot compared to the fundamental harmonic based decoupling method.

With an objective to reduce the switching losses in a bidirectional resonant CLLC DC/DC converter for electric vehicle (EV) charging applications, this paper presents an elaborate frequency dependent general harmonic approximation (GHA) based secondary side turnoff current minimization technique by investigating the optimum operating point to achieve synchronous rectification (SR). Formulation of an accurate all-inclusive gain model is presented, specifically focusing on effect of parasitic components on the resultant gain-frequency trend, backed with thorough experimental validation. Further, meticulous modeling of the GHA based state equations is presented to obtain a contour of feasible operational frequencies and corresponding phase shifts to ascertain accurate SR operation with a multi-dimensional optimization technique to ensure reduced switching losses. In addition to that, to precisely characterize the resonant tank equivalent circuit, stressing on its effect on SR phase calculation, a detailed 3D finite element analysis (FEA) based R-L-C modelling of the employed high frequency planar transformer (HFPT) is explained. To validate and benchmark the performance of the proposed gain model while ensuring accurate SR operation, a 1 kW all-GaN based CLLC experimental prototype is developed for a resonant frequency of 500 kHz, with a power density of 106 W/inch3. Experimental waveforms at corner conditions are presented for a wide-gain bidirectional operation, portraying a peak converter efficiency of 98.49%.

Abstract Over the last 25 years, holographic duality has revolutionised our understanding of gauge theories, quantum many-body systems and also quantum black holes. This topical issue is a collection of review articles on recent advances in fundamentals of holographic duality and its applications with special focus on a few areas where it is inter-disciplinary to a large measure. The aim is to provide a sufficient background on relevant phenomenology and other theoretical areas such as quantum information theory to researchers whose primary expertise is in quantum fields, strings and gravity, and also the necessary concepts and methods of holography to researchers in other fields, so that these recent developments could be grasped and hopefully further developed by a wider community. The topics relating to fundamental aspects include understanding of bulk spacetime reconstruction in holography in the framework of quantum error correction along with the spectacular advances in resolution of the information paradoxes of quantum black holes; quantum complexity and its fundamental role in connecting holography with quantum information theory; theoretical and experimental advances in quantum simulators for information mirroring and scrambling in quantum black holes, and teleportation via wormholes; and a pedagogical review on wormholes also. The topics related to applied holography include applications to hydrodynamic attractor and its phenomenological implications, modelling of equation of state of QCD matter in neutron stars, and finally estimating hadronic contribution to light-by-light scattering for theoretical computation of the muon’s $$g-2$$ g - 2 .

BackgroundResearchers have conducted a considerable number of epidemiological studies on dyslipidemia in China over recent years. Nevertheless, a representative study to comprehensively appraise for the epidemiological status of dyslipidemia is still lacked. This meta-analysis is intended to explore the pooled prevalence, rates of awareness, treatment, and control of dyslipidemia among adults in Chinese Mainland.Materials and methodsA systematic review was performed on relevant cross-sectional studies published since January 2012 by searching six authoritative literature databases. Meta-analyses were conducted in included studies based on a random-effect model to summarize the epidemiological status of dyslipidemia in China. A potential source of heterogeneity was detected by subgroup analysis and meta-regression. Publication bias was assessed by Egger's test and funnel plots. A sensitivity analysis was conducted to examine the study quality's influence on the pooled estimate of prevalence and rates of awareness, treatment, and control.ResultsForty-one original researches with a total of 1,310,402 Chinese participants were finally included in the meta-analysis. The prevalence, rates of awareness, treatment, and control of dyslipidemia were 42.1%, 18.2%, 11.6%, and 5.4%, respectively. With a pooled prevalence estimate at 24.5%, low HDL-C was the most prevalent among various dyslipidemia types, followed by hypertriglyceridemia (TG) (15.4%), hypercholesterolemia (TC) (8.3%), and high LDL-C (7.1%). The pooled prevalence of elevated serum lipoprotein(a) [Lp(a)] was 19.4%. By gender, the prevalence of dyslipidemia was 47.3% in males and 38.8% in females. Subgroup analyses revealed that the prevalence in southern and urban areas were higher than their counterparts. Females and population in urban areas tended to possess higher rates of awareness, treatment, and control. Meta-regression analyses suggested that the year of screening influenced prevalence estimates for dyslipidemia. The impact of the study's quality on the pooled estimates is insignificant.ConclusionOur study suggested a severe epidemic situation of dyslipidemia among adults in Chinese Mainland. More importantly, the awareness, treatment, and control rates were extremely low, revealing that dyslipidemia is a grave health issue. Consequently, we should attach more importance to the management of dyslipidemia, especially in economically underdeveloped areas.Systematic review registrationPROSPERO [CRD42022366456].

Hospital waste is a special category of waste that is quite detrimental as it may contain infectious and contaminated substances thus posing serious threats to the environment and public health. The knowledge of quantities and characteristics of hospital waste, helps in proper management. This study aimed at waste quantification, characterization, and assessment of the general waste management patterns at Mulago referral hospital, Uganda. The experiment was carried out for 30 consecutive days and solid waste generated within 24 hours were collected from different departments of the Mulago hospital in designated containers, sorted and weighed then grouped into general waste and clinical waste. The study established that general waste comprises 72% while clinical waste is 28% of the total waste generated in the facility. The average solid waste generation rate was found to be at 111.4kg per day with wards producing the highest quantities, followed by operating theatres, kitchen, public areas, laundry, and administration. Using the individualized Rapid Assessment Tool (I-RAT), it was found that Mulago hospital's authorities are aware of policies surrounding the handling and disposal methods of waste and gaps were observed in compliance. The average solid waste sorting compliance in the hospital was found very low, 37.4%, with the highest compliance in operating theatres at 62.8%, followed by the administration 51.7%, kitchen 32%, wards 27.3%, public areas 25.6%, and laundry 25%. The analysis of the discharged liquid waste revealed that Lead, Nitrate, COD, and BOD concentrations were beyond the permissible limits. Therefore, we recommend commitment on compliance with policies and legislation measures to safeguard the workers and environment. Technically, we recommend a bio-chemical pre-treatment of wastewater for the abatement of the pollutants prior to discharging it into the environment. Also, to minimize waste mixing and spillage at the waste generation points as a result of inappropriate bins, we recommend a combined 0.062 m3 capacity containers for general waste and 0.024 m3 for clinical waste in all hospital units.

One of the outstanding problems in the holographic approach to many-body physics is the explicit computation of correlation functions in nonequilibrium states. We provide a new and simple proof that the horizon cap prescription of Crossley-Glorioso-Liu for implementing the thermal Schwinger-Keldysh contour in the bulk is consistent with the Kubo-Martin-Schwinger periodicity and the ingoing boundary condition for the retarded propagator at any arbitrary frequency and momentum. The generalization to the hydrodynamic Bjorken flow is achieved by a Weyl rescaling in which the dual black hole's event horizon attains a constant surface gravity and area at late time although the directions longitudinal and transverse to the flow expand and contract, respectively. The dual state's temperature and entropy density thus become constants (instead of the perfect fluid expansion) although no time-translation symmetry emerges at late time. Undoing the Weyl rescaling, the correlation functions can be computed systematically in a large proper time expansion in inverse powers of the average of the two reparametrized proper time arguments. The horizon cap has to be pinned to the nonequilibrium event horizon so that regularity and consistency conditions are satisfied. Consequently, in the limit of perfect fluid expansion, the Schwinger-Keldysh correlation functions with space-time reparametrized arguments are simply thermal at an appropriate temperature. A generalized bilocal thermal structure holds to all orders. We argue that the Stokes data (which are functions rather than constants) for the hydrodynamic correlation functions can decode the quantum fluctuations behind the horizon cap pinned to the evolving event horizon, and thus the initial data.

Abstract Background Multidrug-resistant (MDR) Mycobacterium tuberculosis complex (MTBC) strains are a serious health problem in India, also contributing to one-fourth of the global MDR tuberculosis (TB) burden. About 36% of the MDR MTBC strains are reported fluoroquinolone (FQ) resistant leading to high pre-extensively drug-resistant (pre-XDR) and XDR-TB (further resistance against bedaquiline and/or linezolid) rates. Still, factors driving the MDR/pre-XDR epidemic in India are not well defined. Methods In a retrospective study, we analyzed 1852 consecutive MTBC strains obtained from patients from a tertiary care hospital laboratory in Mumbai by whole genome sequencing (WGS). Univariate and multivariate statistics was used to investigate factors associated with pre-XDR. Core genome multi locus sequence typing, time scaled haplotypic density (THD) method and homoplasy analysis were used to analyze epidemiological success, and positive selection in different strain groups, respectively. Results In total, 1016 MTBC strains were MDR, out of which 703 (69.2%) were pre-XDR and 45 (4.4%) were XDR. Cluster rates were high among MDR (57.8%) and pre-XDR/XDR (79%) strains with three dominant L2 (Beijing) strain clusters (Cl 1–3) representing half of the pre-XDR and 40% of the XDR-TB cases. L2 strains were associated with pre-XDR/XDR-TB (P

Analysis of fecal samples from patients and mice, shows that chronic multisymptom illness which affects a subsection of elderly and war Veterans, is associated with alteration in genes related to antibiotic resistance.

PurposeBy serving and providing a guide for other regional places, this study aims to advance and guide the epidemic prevention and control methods, and practices and strengthen people’s ability to respond to COVID-19 and other future potential public health risks.Design/methodology/approachA comparative analysis was conducted that the COVID-19 epidemic development trend and prevention and control effects both in Beijing and Shanghai. In fact, regarding the COVID-19 policy and strategic areas, the differences between governmental, social, and professional management were discussed and explored. To prevent and be ready for potential pandemics, experience and knowledge were used and summarized.FindingsThe strong attack of the Omicron variant in early 2022 has posed challenges to epidemic prevention and control practices in many Chinese cities. Shanghai, which had achieved relatively good performance in the fight against the epidemic, has exposed limitations in its epidemic prevention and control system in the face of Omicron. In fact, the city of Beijing has undertaken prompt and severe lockdown measures and achieved rather good results in epidemic prevention and control because of learning from Shanghai’s experience and lessons; adhering to the overall concept of “dynamic clearing,” implementing precise prevention and monitoring, enhancing community control, and making emergency plans and preparations. All these actions and measures are still essential in the shift from pandemic response to pandemic control.Research limitations/implicationsDifferent places have introduced different urgent policies to control the spread of the pandemic. Strategies to control COVID-19 have often been based on preliminary and limited data and have tended to be slow to evolve as new evidence emerges. Hence, the effects of these anti-epidemic policies need to be further tested.

Abstract This article reviews the progress in our understanding of the reconstruction of the bulk spacetime in the holographic correspondence from the dual field theory including an account of how these developments have led to the reproduction of the Page curve of the Hawking radiation from black holes. We review quantum error correction and relevant recovery maps with toy examples based on tensor networks, and discuss how it provides the desired framework for bulk reconstruction in which apparent inconsistencies with properties of the operator algebra in the dual field theory are naturally resolved. The importance of understanding the modular flow in the dual field theory has been emphasized. We discuss how the state-dependence of reconstruction of black hole microstates can be formulated in the framework of quantum error correction with inputs from extremal surfaces along with a quantification of the complexity of encoding of bulk operators. Finally, we motivate and discuss a class of tractable microstate models of black holes which can illuminate how the black hole complementarity principle can emerge operationally without encountering information paradoxes, and provide new insights into generation of desirable features of encoding into the Hawking radiation.

Convalescent plasma therapy (CPT) is used to treat patients with Covid-19, but evidence for clinical benefit from clinical trials is divergent. Here the authors report in that CPT treatment does not affect mortality in patients with severe Covid-19 in phase 2 single center open label randomised controlled trial.

This study investigates the dynamic behaviour of a rice field ecosystem and aims to define its integral features using the stability concept of an ecological goal function. This function is based on the extremal principles of thermodynamics, which assume that certain energetic processes of ecosystems—such as the rate of exergy destruction—are directed by the self-organizing informatics of the systems towards maxima or minima. In our study, we exploit the availability of substantially long time-series data relating to a rice field ecosystem to gain an evocative understanding of its growth trajectory in light of the thermodynamic principles. We accomplished this by constructing a model based on the STELLA 9.0 software and calculating the extremal values of growth rates (storage) and those of exergy destruction and entropy creation. The results showed that the values of both maximum dissipation and maximum exergy progressed apace with that of maximum storage till the maturation of rice and became stable thereafter, whereas maximum residence time and maximum specific dissipation values initially decreased before their asymptotic rise. A similar pattern was also observed for the maximum specific exergy. However, the maximum power dissipation curve followed a highly fluctuated course before becoming stable on the maturation of rice.