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BACKGROUND: This study aimed to investigate the biomechanical effects of different interventions on astronauts lumbar intervertebral discs in a microgravity environment during spaceflight and in a gravity environment when the astronaut returns.METHODS: A finite element model of the L4L5 lumbar segment was developed with eight loading schemes representing different interventions. The loading schemes included no intervention, wearing a penguin suit, sleeping in a fetal position, wearing a penguin suit combined with sleeping in the fetal position, reclining for 4 or 16 h/d, and maintaining upright posture for 4 or 16 h/d.RESULTS: Without intervention, the microgravity environment led to increased central pore pressure, radial displacement, and water content in the lumbar intervertebral disc. Wearing a penguin suit combined with sleeping in the fetal position can reduce disc pore pressure, axial stress, radial displacement, and water content to 0.156 MPa, 11.50 kPa, 0.538 mm, and 1.390%, respectively. When astronauts return to the gravity environment, staying upright for 4 h can reduce the pore pressure, axial stress, radial displacement, and water content of the intervertebral disc to 0.222 MPa, 10.72 kPa, 0.373 mm, and 0.219%, respectively.CONCLUSION: This study showed that wearing a penguin suit and sleeping in the fetal position both have the potential to protect the lumbar intervertebral disc from the negative effects caused by microgravity. Remaining in the upright posture for 4 h per day may help squeeze out the water in the intervertebral disc safely when astronauts return to the gravity environment.Zhang S, Wang K, Zhu R, Jiang C, Niu W. Penguin suit and fetal position finite element model to prevent low back pain in spaceflight. Aerosp Med Hum Perform. 2021; 92(5):312318.

Background China is making efforts to promote the equalization of National Essential Public Health Services (NEPHS) for internal migrants. Studies have demonstrated that the impacts of social capital on health services are different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of NEPHS for the internal migrants and provide reference for other countries. Methods Data from the China Migrant Dynamic Survey of 2017, involving 130,642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of NEPHS. Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such impacts are moderated by sex and education. Results (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different sexs and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by sex. However, a high education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclusion Social capital plays an important role in the access of migrants to NEPHS. Governments should vigorously promote the construction of regional social capital, encourage migrants to actively participate in community activities, especially pay attention to the enhancement of the migrants with low SES to the destination identity.

Background Injuries are of growing public health concern in China, and the trends of urban-rural injury mortality disparity for the last decade are still being explored. This study aims to analyze trends in injury mortality disparity between urban and rural areas of China by region, sex, and age from 2010 to 2016. Methods Using data from the Disease Surveillance Points system (DSPs) collected by the Chinese Center for Disease Control and Prevention (CDC) from 2010 to 2016, injury age-standardized mortality rates (ASMRs) and rate ratios (RRs) were calculated for different groups. Chi-square tests were used to compare differences in rates between urban and rural residents. The time trends of injury ASMRs were assessed via the annual percentage change (APC), and RRs were used to analyze urban-rural mortality disparity. Results The crude injury mortality rate of rural areas was 1.5 times higher than that of urban areas. The urban-rural RR of injury ASMR decreased from 1.8 to 1.5 (APC = 5.0%) over time, from 2.0 to 1.7 (APC = 4.7%) for eastern regions, from 1.9 to 1.5 (APC = 5.4%) and from 1.6 to 1.3 (APC = 4.5%) among males and females, respectively. Further decreases were from 2.0 to 1.4 (APC = 7.8%), from 1.9 to 1.6 (APC = 6.4%), and from 1.8 to 1.2 (APC = 5.7%) in the 5–14, 45–64, and 65+ year age groups, respectively. The urban-rural RRs of ASMRs for fall, drowning and suicide decreased from 1.3 to 1.2 (APC = − 3.0%), from 2.3 to 1.6 (APC = − 13.8%) and from 2.1 to 1.6 (APC = − 9.9%,), respectively. Conclusions The urban-rural injury mortality disparity was large, but showed a significant decreasing trend in China. Residents of eastern regions, males/females, 5–14/45+ year age groups in the urban-rural injury mortality disparity all decreased gradually during the investigated period.

IntroductionTelemedicine and blood pressure (BP) self-monitoring conduces to management of hypertension. Recent hypertension guidelines highly recommended single pill combination (SPC) for the initial treatment of essential hypertension. Based on this fact, an SPC-based telemedicine titration regimen with BP self-monitoring could be a better way in managing hypertension. This trial aims to elucidate whether telemedicine combined with BP self-monitoring is superior to self-monitoring alone during hypertension management.Methods and analysisThis study will be a multicentred, open-labelled, randomised controlled trial. A minimum sample of 358 hypertensive patients with uncontrolled BP from four centres will be included. The intervention group will include BP self-monitoring and tele-monitoring plus a free SPC-based telemedicine titration therapy for 6 months, they will be recommended to take BP measurements at least once every 7 days, in the meantime, researchers will call to give a consultation on lifestyle or titration advice once a fortnight. The control group will be required to self-monitor BP at the same time interval as intervention group, without any therapy change. Primary outcome of the trial will be the difference in systolic blood pressure at 6-month follow-up between intervention and control group, adjusted for baseline variables. Secondary outcomes such as BP control rate, major adverse cardiovascular events, medication adherence, quality of life will be investigated.Ethics and disseminationEthics approval was granted by Ethical Committee of Shanghai Tenth People’s Hospital (SHSY-IEC-4.1/20-194/01). The results will be disseminated in peer-reviewed literature, and to policy-makers and healthcare partners.Trial registration numberChiCTR2000037217.

BACKGROUND Absenteeism has been shown to be a valid indicator for influenza surveillance. In China, it is common for students to attend school while ill, so a surveillance system that focuses only on absentees may lead to error. Therefore, the development of a system for both absenteeism and attendance is necessary. OBJECTIVE The objective is to design and implement an influenza symptom surveillance system (SSS) based on absenteeism (collected by face recognition) and temperature of attending students (measured by infrared thermometer), and to evaluate the effectiveness of the system. METHODS An influenza SSS was deployed by extending the functionality of an existing application for student health management. The system used infrared thermometers for temperature screening while counting absent students by facial recognition. The operation of the system was investigated in participating schools in China, the weekly absenteeism and fever rates (WAR and WFR) were calculated and compared with the weekly positive rate of influenza virus (WPRIV) released by the China National Influenza Center to inspect the data reliability and operation feasibility of this system. The system was implemented in two primary schools and one junior high school in the Yangtze River Delta, with a total of approximately 3,500 students participating. The period was from March 1, 2021 to January 14, 2022, with 174 effective days. RESULTS A significant positive correlation between WAR and WPRIV (r=0.868, p CONCLUSIONS The feasibility of the proposed system, which calculates absenteeism through face recognition and the temperature of attending students with infrared thermometers, was shown in the present paper. Compared with similar existing systems, this system has advantages of simplicity, acceptability, security, sensitivity and timeliness. CLINICALTRIAL The data used in this study were anonymized, so the Tongji University Review Board designated this study as non-human subject research.

Run-up of granular debris flows against slit dams on slopes is a complex process that involves deceleration, deposition, and discharge. It is imperative to understand the run-up mechanism and to predict the maximum run-up height for the engineering design and hazard mitigation. However, the interaction between granular flows and slit dams, which significantly affects the run-up height, is still not well understood. In this study, an analytical model based on the momentum approach was derived to predict the run-up heights of granular debris flows. A numerical investigation of granular debris flow impacting slit dams using the discrete element method (DEM) was then conducted. The influence of the Froude number (NFr) and the relative post spacing (R) on run-up height were studied. This study illustrates that the analytical model based on the momentum approach can predict the run-up heights well within a certain range of Froude numbers. There is a critical value of relative post spacing (RC): within the critical value, the maximum run-up height is insensitive to the relative post spacing; once R exceeds the critical value, the maximum run-up height decreases rapidly as the relative post spacing increases.

Background China is promoting the equalization of National Essential Public Health Services (NEPHS) for the internal migrants (IMs). Studies have analyzed the impact of migration range (MR) and regional economic development level (REDL) on the IMs' NEPHS utilization (NEPHSU), but no studies have explored the interaction of MR and REDL on it. Methods Data from the China Migrant Dynamic Survey of 2017, involving 122656 IMs. Per capita GDP was set as the indicator for REDL, and 28 provinces were divided into three groups according to REDL: affluent, medium and poor. The MR was divided into inter-province and intra-province, and social capital (SC) was distinguished into cognitive (CSC) and structural social capital (SSC). Awareness of NEPHS (ANEPHS) and establishment of health record (EHR) were selected as indexes of NEPHSU. Multiple line charts and hierarchical logistic regression were used to investigate the interaction of MR, REDL and SC on NEPHSU. Results (1) The socioeconomic status (SES) and social capital (SC) of inter-provincial IMs were significantly lower than those of intra-provincial IMs, and the gap was most prominent in affluent areas. (2) From low to high, the NEPHSU of inter-provincial IMs was ranked as affluent, medium and poor, while the corresponding order of intra-provincial IMs was medium, poor and affluent areas, and the gap of NEPHSU between inter-provincial and intra-provincial IMs was the largest in affluent areas. (3) SC could significantly promote the IMs' NEPHSU, but there was a gap between inter-provincial and intra-provincial IMs, and the gap was the largest in affluent areas. Conclution: REDL can significantly affect the gaps of SES and SC among subgroups of IMs with different MR. Inter-provincial migrants in affluent areas have relatively lower SES and SC, which may be a major barrier to their access to NEPHS, and the government should pay special attention to this vulnerable group when promoting equalization of NEPHS for IMs.

Background It has been a risk of the internal migrants' (IMs') health that their utilization of National Essential Public Health Services (NEPHS) was inadequate. Studies have analyzed the impact of migration range (MR) or regional economic development level (REDL) on the IMs' utilization of NEPHS, but no studies have explored the interaction of MR and REDL on it. Methods Data from the China Migrant Dynamic Survey of 2017, involving 122656 IMs. Per capita GDP was set as the indicator for REDL, and all provinces were divided into three groups according to REDL: affluent, medium and poor. The MR was divided into inter-province and intra-province, and social capital (SC) was distinguished into cognitive (CSC) and structural social capital (SSC). Awareness of NEPHS (ANEPHS) and establishment of health record (EHR) were selected as indexes of NEPHS utilization. Then we used multiple line charts and hierarchical logistic regression to investigate the interaction of MR, REDL and SC on NEPHS utilization. Results (1) The socioeconomic status (SES) and social capital (SC) of the inter-provincial IMs were significantly lower than those of the intra-provincial IMs, and the gap was most prominent in the affluent areas. (2) From low to high, the NEPHS utilization of inter-provincial IMs was ranked as affluent, medium and poor, while the corresponding order of intra-provincial IMs was medium, poor and affluent areas. (3) SC could significantly promote the IMs' utilization of NEPHS, but there was a gap between the inter-provincial and intra-provincial IMs, and the gap was the largest in the affluent areas. Conclution: The IMs' SES, SC and NEPHS utilization were influenced by MR and REDL. The gaps of SES, SC and NEPHS utilization between the inter-provincial and the intra-provincial IMs in affluent areas were much larger than that in medium and poor areas. The government should pay more attention to the inter-provincial IMs in affluent areas.

Background: China is making every effort to promote equal access to public health services(PHS) for the internal migrants. Studies have demonstrated that the impact of social capital on PHS is different among subgroups of people. Clarifying these differences will help China accurately promote the equalization of PHS for the internal migrants and provide reference for other developing countries.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 130642 migrants in 31 provinces were used to clarify the complex relationship between social capital and the utilization of National Essential Public Health Services (NEPHS). Social capital was divided into regional cognitive social capital (RCSC), regional structural social capital (RSSC), individual cognitive social capital (ICSC), and individual structural social capital (ISSC). Then, multi-level logistic regression was conducted to analyze their impacts on the utilization of NEPHS of the migrants, and whether such effects are moderated by gender and education. Results: The results suggest: (1) There are significant differences in the levels of CSC, SSC, and NEPHS utilization between different genders and educational subgroups of the migrants, among which the educational difference is more prominent. (2) An interaction exists between the levels and dimensions of social capital and NEPHS projects. Also, the impact of SSC on NEPHS is always greater than that of CSC at the same level. (3) The effects of RCSC, RSSC, ICSC, and ISSC on NEPHS utilization by migrants are not moderated by gender. However, education could weaken the relationship between RCSC and health education, ISSC and health education, and RSSC and health records but strengthen the correlation between RSSC and health education. Conclution: This study demonstrated complex interactions between the dimensions and levels of social capital, NEPHS projects, and the population characteristics of migrants. As the government strives towards the equalization of NEPHS, these interactions should be fully considered.

Background: China has about 240 million internal migrants(IMs), and they face lots of mental health risks. The government is actively promoting mental health education for IMs. Previous studies have focused more on the relation between social capital and mental health, but ignored the impact of social capital on the accessibility to mental health services.Methods: Data from the China Migrant Dynamic Survey of 2017, involving 138939 IMs in 31 provinces were used to explore the interaction of social capital, life stress index and gender on acceptance of mental health education(AMHE). Social capital was divided into cognitive(CSC) and structural social capital (SSC). Multiple line charts and multi-level logistic regression were conducted to analyze their impacts on AMHE, and whether such impacts were moderated by gender and life stress index(LSI). Results: The results suggest: (1) The SSC ranking of IMs with different LSI levels was "moderate (3.62 ± 1.736), mild(3.53 ± 1.755), severe(3.53 ± 1.755)", SSC was positively correlated with AMHE(OR=1.320, 95%CI 1.305 to 1.336), but the correlation would decrease with the increase of LSI(OR=0.969, 95%CI 0.953 to 0.985; OR=0.949, 95%CI 0.934 to 0.964); (2) Males’ SSC(3.67 ± 1.780) was significantly higher than that of females(3.36 ± 1.614), but its influence on AMHE of females was higher(OR=1.050, 95%CI 1.036 to 1.064); (3) The CSC ranking of IMs with different LSI levels was "mild(3.71 ± 2.096), moderate(3.71 ± 2.076), severe(3.42 ± 2.024)", there was no significant gender difference in CSC, and CSC was positively correlated with AMHE(OR=1.087, 95%CI 1.076 to 1.098), but gender and LSI had no significant moderating effect on it.Conclution: Gender and LSI were associated with social capital, but only the relationship between SSC and AMHE was moderated by them. SSC had both a main effect and a buffering effect, while CSC only showed a main effect. The government should pay attention to enhancing their positive identity to the city and at the same time improve their civic participation and social participation.

Background: Research suggests that young working students are at higher risk for substance use. However, most studies have focused on students from middle-class families, with few investigations co...

Additional file 1. The ICD-10 codes for types of injury.

Additional file 2. Map of China with geographical divisions. Red: eastern region; blue: central region; white: western region. Source: Zhang L, Li Z, Li X, et al. Study on the trend and disease burden of injury deaths in Chinese population, 2004–2010. PLoS One. 2014;9(1):e85319. doi:https://doi.org/10.1371/journal.pone.0085319. This original figure is under a Creative Commons Attribution License.

Background and objective The objective of this study was to investigate the effect of incorporating various passive elements, which could represent combined or individual effects of intervertebral disc, facet articulation and ligaments, on the prediction of lumbar muscle activation and L4-L5 intradiscal pressure. Methods The passive elements representing the intervertebral disc, facet articulations, and ligaments were added to the existed lumbar musculoskeletal model with nonlinear rotational stiffness or force-strain relationships. The model was fed with kinematics of trunk flexion, extension, axial rotation and lateral bending to calculate muscle activation and L4-L5 intradiscal pressure. Results In the trunk axial rotation, the intradiscal pressure values predicted by the models with elements representing facet articulation were much higher than that predicated by models removing these elements. In the trunk flexion, the models with passive elements showed lower muscle activation of extensors than model with no passive elements. At the end of trunk flexion, extension, axial rotation and lateral bending, the intradiscal pressure values predicted by model with intact passive elements were 120.6%, 92.5%, 334.8% and 74.9% of the values predicted by model with no passive elements, respectively. Conclusions Caution must be taken while modeling facet articulation as elements with rotational stiffness, as they may lead to overestimation of intradiscal pressure in trunk axial rotation. The inclusion of ligaments as spring-like elements may improve the simulation of flexion-relaxation phenomenon in trunk flexion. Future models considering detailed properties of passive elements are needed to allow more access to understanding the mechanics of the lumbar spine.

At Tongji University School of Medicine we established affiliation relationships with community health centers (CHCs) in Shanghai, which was unprecedented in China. During the process, we assisted CHCs in strengthening their portfolio through the improvement of public trust, working environment

There has been much debate on how prophylactic ankle supports (PASs) may influence the vertical ground reaction force (vGRF) during landing. Therefore, the primary aims of this meta-analysis were to systematically review and synthesize the effect of PASs on vGRF, and to understand how PASs affect vGRF peaks (F1, F2) and the time from initial contact to peak loading (T1, T2) during landing. Several key databases, including Scopus, Cochrane, Embase, PubMed, ProQuest, Medline, Ovid, Web of Science, and the Physical Activity Index, were used for identifying relevant studies published in English since inception to April 1, 2015. The computerized literature search and cross-referencing the citation list of the articles yielded 3,993 articles. Criteria for inclusion required that 1) the study was conducted on healthy adults; 2) the subject number and trial number were known; 3) the subjects performed landing with and without PAS; 4) the landing movement was in the sagittal plane; 5) the comparable vGRF parameters were reported; and 6) the F1 and F2 must be normalized to the subject’s body weight. After the removal of duplicates and irrelevant articles, 6, 6, 15 and 11 studies were respectively pooled for outcomes of F1, T1, F2 and T2. This study found a significantly increased F2 (.03 BW, 95% CI: .001, .05) and decreased T1 (-1.24 ms, 95% CI: -1.77, -.71) and T2 (-3.74 ms, 95% CI: -4.83, -2.65) with the use of a PAS. F1 was not significantly influenced by the PAS. Heterogeneity was present in some results, but there was no evidence of publication bias for any outcome. These changes represented deterioration in the buffering characteristics of the joint. An ideal PAS design should limit the excessive joint motion of ankle inversion, while allowing a normal range of motion, especially in the sagittal plane.

Objective. Existing research shows a serious scarcity of EBPH practice in China and other developing regions; as an exploratory study, this study aimed to assess the current EBPH implementation status in Shanghai of China qualitatively.Methods. Using semistructured key informant interviews, we examined the status of and impediments to the lagging EBPH in China. Data were analyzed based on the Consolidated Framework for Implementation Research (CFIR).Results. Chinese public health practitioners knew more about evidence-based medicine but less about EBPH. The situation was worse in community healthcare centers. Participants perceived that evidence sources were limited and the quality of evidence was low. Concerning the inner setting factors, the structural characteristics, networks and communications, implementation climate, and leadership engagement were confronted with many problems. Among the outer setting factors, external government policies and incentives and low patient compliance were the key problems. Additionally, public health practitioners in Shanghai lacked sufficient awareness of EBPH. Furthermore, the current project-based EBPH lacks a systematic implementation system.Conclusions. Existing practical perspectives on EBPH indicate a lag in the advocacy of this new ideology in China. It would be advisable for healthcare institutions to take the initiative to explore feasible and multiple methods of EBPH promotion.

BACKGROUND CONTEXT Anterior vertebral body osteophytes are common with degeneration but their biomechanical influence on the whole lumbar spine remains unclear. PURPOSE To investigate the biomechanical influence of anterior vertebral body osteophytes on the whole lumbar spine. STUDY DESIGN/SETTING This is a study using finite element analysis. OUTCOME MEASURES Intersegmental rotation, maximum Mises stress, and intradiscal pressure on the intervertebral discs of different lumbar levels were calculated. METHODS A finite element model of an intact lumbar spine was constructed and validated against in vitro studies. The modified models, which had different degrees of anterior vertebral body osteophyte formation (OF) in combination with disc space narrowing, were applied with physiological loadings. RESULTS The lumbar levels with various degrees of OF altered the kinematics of these levels, which also affected the whole lumbar spine. In flexion and lateral bending, the segment that was one level inferior to the vertebra with OF showed a trend towards increased range of motion. On the intervertebral discs that were one level inferior to the OF level, a trend towards increase in the maximum von Mises stress was found on the annulus. CONCLUSIONS Segments adjacent to levels with anterior vertebral body osteophytes showed increased intersegmental rotation and maximum stress. Further clinical observation should be performed to verify the results in vivo.

The objective of this study was to investigate the effect of dropping height on the forces of joints and muscles in lower extremities during landing. A total of 10 adult subjects were required to landing from three different heights (32 cm, 52 cm, and 72 cm), and the ground reaction force and kinematics of lower extremities were measured. Then, the experimental data were input into the AnyBody Modeling System, in which software the musculoskeletal system of each subject was modeled. The reverse dynamic analysis was done to calculate the joint and muscle forces for each landing trial, and the effect of dropping-landing on the results was evaluated. The computational simulation showed that, with increasing of dropping height, the vertical forces of all the hip, knee, and ankle joints, and the forces of rectus femoris, gluteus maximus, gluteus medius, vastii, biceps femoris and adductor magnus were all significantly increased. The increased dropping height also resulted in earlier activation of the iliopsoas, rectus femoris, gluteus medius, gluteus minimus, and soleus, but latter activation of the tibialis anterior. The quantitative joint and muscle forces can be used as loading conditions in finite element analysis to calculate stress and strain and energy absorption processes in various tissues of the lower limbs.

Recent developments in the treatment of HIV-1 have improved the disease prognosis from a terminal disease to a chronic disease. The number of HIV-1-infected patients who require surgery has become more common. The main threat to HIV-1-infected patients following surgery is the development of sepsis. In this study, we collected a large number of clinical recordings of HIV-1-infected patients from two hospitals in China, specializing in HIV-1 treatment in order to summarize the risk indicators of sepsis in HIV-1-infected patients. We compared the significant risk indicators between the sepsis and non-sepsis groups. Using logistic regression based on the indicators of four separate surgery-based diseases, we generally found that low CD4 and hypoalbuminemia counts prior to surgery were the significant risk factors for developing sepsis. The morbidity of sepsis in trauma patients was approximately 10 times higher than the dysfunction group, whereas the tumor and the infection groups were approximately 1.5 and 2 times higher, respectively. Based on the comparison between the sepsis and non-sepsis groups for each surgery-based disease, we found that the severity of trauma is a critical risk factor for trauma patients; therefore, limiting the size of the wound during surgery is crucial. HIV-1-infected patients often develop postoperative sepsis due to immunodeficiency and complications due to the surgery. We hope that this study can help to reduce the risk of developing sepsis due to surgery and improve the survival rate of HIV-1-infected patients.

An accurate estimation of a casualty rate is critical in response to earthquake disasters, and could allow an increase in the survival rate. Building damage is considered to be a major cause of earthquake casualties in developing countries. High-resolution satellite imagery (HRSI) can be used to detect the building damage in a period of a short time. This makes it possible to use a model to estimate earthquake casualties immediately after the occurrence of an earthquake. With respect to the capability of HRSI, this study built a new model for estimating the casualty rate in an earthquake disaster based on remote sensing and a geographical information system. Three groups of earthquake data, the 2003 Bam earthquake, the 2008 Wenchuan earthquake, and the 2010 Yushu earthquake, were used to evaluate this model. The results indicated that our new model significantly improved the accuracy in predicting the casualty rate. The parameters used in the model vary between developed and developing countries. This study could provide valuable information for a more efficient rescue operation in response to earthquakes.

From a disaster relief perspective, an immediate and efficient rescue operation after an earthquake can greatly increase the number of survivors. An effective rescue operation depends on two key elements: localisation of the affected areas and estimation of the number of casualties in these areas. Many more studies have been conducted on the localisation of affected areas than on casualty estimation. Consequently, this study develops a model for rapidly estimating the number of casualties using satellite remote sensing (SRS). The model is based on the attributes of damaged buildings, as these buildings cause the greatest harm to inhabitants and they can be detected by SRS. The model uses the damage index (DI) of buildings computed by a numerical damage model derived from SRS images to assess the extent of damage. The DI is then combined with the building’s materials and structure index, which is calculated using information from the local geographic information system, to compute the joint casualty index (JCI). Finally, the number of casualties is estimated by the product of the JCI multiplied by the number of people inside the damaged buildings at the time of the earthquake. The model is then applied to three towns in Dujiangyan City, as these were the areas that most severely affected by the Wenchuan earthquake. Preliminary results showed that there was little difference between the actual and estimated number of casualties. It is recommended that more casualty data should be included in the model to improve the accuracy of estimation.

To investigate the relationship between the environmental tobacco smoke (ETS) and lung cancer by Meta-analysis.We used "lung cancer/lung neoplasm", "non-smoking/non-smoker", "China/Chinese", "case-control/case control", "risk factor", "environmental tobacco smoke/passive smoking" as key words, to search papers in databases including Chinese BioMedical Literature (CBM), China National Knowledge Internet (CNKI), Wanfang, Vip Citation Databases (VIP), PubMed and Web of Science databases, and collected the case-control studies on ETS and lung cancer among Chinese non-smokers from January 1999 to December 2013. A total of 129 research papers were collected. RevMan 5.2 software was used to calculate combined odds radio (OR) and 95% CI.Qualified 18 literatures were included, total cases 6 145 and controls 8 132. Consolidated results showed that ETS exposure could increase the risk of lung cancer, combined OR (95% CI) = 1.52 (1.42-1.64). Stratified analysis showed that ETS exposure was found to be significantly associated with an increasing risk of the lung cancer on non-smoking women and men, and combined OR (95% CI) were 1.58 (1.42-1.75) and 1.34 (1.08-1.65), respectively; the ETS exposure from family or the working environment could increase the risk of lung cancer, and combined OR (95% CI) were 1.48 (1.20-1.82) and 1.38 (1.13-1.69) respectively; childhood exposure and adult exposure were no significant statistical significance, and combined OR (95% CI) were 1.37 (0.98-1.91), and 1.34 (0.97-1.85) respectively.Environmental tobacco smoke exposure was a significant risk factor of lung cancer among non-smokers in China.

(1) To systematically review peak vertical ground reaction force (PvGRF) during two-leg drop landing from specific drop height (DH), (2) to construct a mathematical model describing correlations between PvGRF and DH, and (3) to analyze the effects of some factors on the pooled PvGRF regardless of DH.A computerized bibliographical search was conducted to extract PvGRF data on a single foot when participants landed with both feet from various DHs. An innovative mathematical model was constructed to analyze effects of gender, landing type, shoes, ankle stabilizers, surface stiffness and sample frequency on PvGRF based on the pooled data.Pooled PvGRF and DH data of 26 articles showed that the square root function fits their relationship well. An experimental validation was also done on the regression equation for the medicum frequency. The PvGRF was not significantly affected by surface stiffness, but was significantly higher in men than women, the platform than suspended landing, the barefoot than shod condition, and ankle stabilizer than control condition, and higher than lower frequencies.The PvGRF and root DH showed a linear relationship. The mathematical modeling method with systematic review is helpful to analyze the influence factors during landing movement without considering DH.

China has a competing situation in that the increase of alcohol consumption and the lowering rates of traffic injuries caused by drink driving coexist. In addition, the zero tolerance law was announced in January 2013. Under the above complex background, this study aims to unveil the truth about drink driving and the effects of the related policies in China.This research was a retrospective examination of the data from the National Disease Surveillance System in Shandong Province of China from 2011 to 2013. Descriptive statistics were used to find the summary of mortality caused by drink driving and the traits of the deceased subjects.The drink driving situation in China was found to be much more alarming than the initial official prediction. In this research, the rate should be around 18.45% to 26.61%, compared to only 4.02% to 4.80% from the Ministry of Public Security. However, with the introduction of the zero tolerance law at the beginning of 2013, a significant change was observed; that is, a sharp decrease in traffic fatalities caused by drink driving between 2012 and 2013, with a drop of 6.81% (from 25.26% to 18.45%). According to the data, more attention should be paid to young adults, male drivers, those with low education, and the unemployed because the drink driving deaths increased for these populations during 2011 to 2013.In reality, the drink driving situation in China is much more serious than official prediction and the laws were efficient.

Injuries are a growing public health concern in China, accounting for more than 30% of all Person Years of Life Lost (PYLL) due to premature mortality. This study analyzes the trend and disease burden of injury deaths in Chinese population from 2004 to 2010, using data from the National Disease Surveillance Points (DSPs) system, as injury deaths are classified based on the International Classification of Disease-10(th) Revision (ICD-10). We observed that injury death accounted for nearly 10% of all deaths in China throughout the period 2004-2010, and the injury mortality rates were higher in males than those in females, and higher in rural areas than in urban areas. Traffic crashes (33.79-38.47% of all injury deaths) and suicides (16.20-22.01%) were the two leading causes of injury deaths. Alarmingly, suicide surpassed traffic crashes as the leading cause of injury mortality in rural females, yet adults aged 65 and older suffered the greatest number of fatal falls (20,701 deaths, 2004-2010). The burden of injury among men (72.11%) was about three times more than that of women's (28.89%). This study provides indispensible evidence that China Authority needs to improve the surveillance and deterrence of three major types of injuries: Traffic-related injury deaths should be targeted for injury prevention activities in all population, people aged 65+ should be encouraged to take individual fall precautions, and prevention of suicidal behavior in rural females should be another key priority for the government of China.

BACKGROUND: Primary health care and patient triage are two basic functions of rural hospitals. As a routine test, the diagnostic radiology is still unavailable in some rural hospitals in China. Therefore, high-level hospitals are often the first choice of rural residents when they feel unwell. It brings serious social problems. This study was designed to propose an on-the-job drilling schema with integration of practical medical recordings and experienced radiological doctors as tutors to improve skills in diagnostic radiology of rural physicians. METHODS: The information technology was used to help the contact between rural doctors and tutors. In a longitudinal pre/post-test control study design, a cohort of 20 young physicians, each of whom was working in a rural hospital and had a work experience less than two years, were established as the trial group over one year. Another 20 similar counterparts were established as the control group. Participants' performances were evaluated in four categories at five-time point (TP). RESULTS: The trial group significantly outscored the control group on the style of writing at the second TP (d = 2.28); on the accuracy of the image description at final TP (d = 1.11); on the accuracy of the diagnosis at the fourth TP (d = 3.62); and on the correct treatment selection at the third TP (d = 6.45). The aspects with the most improvement were the accuracies of the diagnosis and the treatment selection. CONCLUSION: This study provided the detailed evidences that applying the on-the-job drilling schema has a significant effect on the skills improvement in diagnostic radiology of rural physicians. It was also concluded that the educational intervention based on practical cases was better than that only based on didactic slides presentation.

Reaction of [Pt2(μ-S)2(PPh3)4] (1) with a mixture containing [Re2(CO)10], Me3NO·2H2O and MeOH at room temperature affords an oxidative methoxylation complex, [Pt2Re2(μ-OMe)2(μ3-S)2(PPh3)4(CO)6] (2), and a PtRe heterometallic salt, [Pt2Re(μ3-S)2(PPh3)4(CO)3]+[Re3(μ3-OMe)(μ-OMe)3(CO)9]− (3a). The core of the cation of 3a comprises a {Pt2ReS2} trigonal bipyramidal ‘cluster’ with weak PtRe bonding interactions and an apparently unsaturated Re(I) atom. The [BF4]− salt of this cation, 3b, can be prepared by the reaction of 1 with [Re(CO)5(H2O)][BF4], and the Mn analogue, [Pt2Mn(μ3-S)2(PPh3)4(CO)3][BF4] (4), can be similarly synthesised using [Mn(FBF3)(CO)5]. Addition of 1 to [M(I)2(CO)3(NCMe)2] (M=Mo, W) is accompanied by iodide migration to give the salts [Pt2M(μ3-S)2I(PPh3)4(CO)4][M(I)3(CO)4] (M=Mo, 5; W, 6a). With [Mo(CO)4(NCMe)2], 1 undergoes reductive carbonylation and desulfurization to give [Pt2(μ-S)(PPh3)3(CO)] (7). The above reactions represent the first examples of 1 as a metalloligand towards carbonyl complexes of the less electron-rich transition metals, and demonstrate that addition reactions of 1 can be complicated by ligand dissociation, ligand migration, or reductive desulphurization. The crystal structures of compounds 3a and 3b were determined.

Negative-ion electrospray mass spectrometry has been used to investigate the reactions of the dinuclear rhenium aggregates [Re2(μ-OH)3(CO)6]−1 and [Re2(μ-OMe)3(CO)6]−2 with a range of thiols, benzeneselenol, and some other sulfur-, phosphorus- and nitrogen-based ligands. Typically up to three of the hydroxo ligands are replaced by simple thiolates, giving the series of species [Re2(OH)2(SR)(CO)6]−, [Re2(OH)(SR)2(CO)6]−, and [Re2(SR)3(CO)6]−. Similarly, reaction of 1 with H2S gives the species [Re2(μ-SH)3(CO)6]−, which undergoes an analogous fragmentation process to [Re2(μ-OH)3(CO)6]−, at high cone voltages, by loss of H2S and formation of [Re2(S)(SH)(CO)6]−. With ligands which are good chelating agents (such as dithiocarbamates R2NCS2−, and thiosalicylic acid, HSC6H4CO2H) initial substitution of one or two OH groups readily occurs, but on standing the dimer is cleaved giving [Re(S2CNR2)2(CO)3]− and [Re(SC6H4CO2)(CO)3]−. The different reactivities of the dithiol reagents benzene-1,2- and benzene-1,4-dimethanethiol towards 1 are also described. Complex 1 also reacts with aniline, and with primary (but not secondary) amides RC(O)NH2, giving monosubstituted species [Re2(OH)2(NHPh)(CO)6]− and [Re2(OH)2{NHC(O)R}(CO)6]− respectively. The reactions with adenine and thymine, and with the inorganic anions thiocyanate and thiosulfate, are also described.

The rhenium hydroxy and methoxy carbonyl complexes [Re2(μ-OR)3(CO)6]− (R = H or Me) have been studied by negative-ion electrospray mass spectrometry (ESMS). The complexes undergo facile exchange reactions with protic compounds, including alcohols and phenols. With dimethyl malonate, ester hydrolysis occurs giving carboxylate-containing complexes, and with H2O2 or ButOOH, oxidation to ReO4− occurs. The feasibility and extent of these reactions can conveniently, rapidly, and unambiguously be determined by electrospray mass spectrometry, and is dependent on the acidity and steric bulk of the protic compound. The results also suggest that the complexes can be used as versatile starting materials for the synthesis of a wide range of analogous [Re2(μ-OR)3(CO)6]− complexes by simple reaction with an excess of the appropriate alcohol. By varying the applied cone voltage the fragmentation pathways have been investigated; the hydroxy complex undergoes dehydration followed by CO loss, whereas for the methoxy complex β-hydride elimination (and CO loss) is observed, with confirmation provided by deuterium labelling studies. Under ESMS conditions, the neutral complexes [Re2(μ-OR)2(μ-dppf)(CO)6] [R = H or Me; dppf = 1,1′-bis(diphenylphosphino)ferrocene] undergo substantial solvolysis and hydrolysis to give mainly mononuclear species; simple parent ions (e.g. [M + H]+) are not formed in appreciable abundance, probably due to the lack of an efficient ionisation pathway.

Reaction of the activated mixture of Re2(CO)10, Me3NO and MeOH with a 1:1 mixture of rac (d/l)- and meso-1,1,4,7,10,10-hexaphenyl-1,4,7,10-tetraphosphadecane (hptpd) yields a mixture of (d/l)- and meso-[{Re2(μ-OMe)2(CO)6}2(μ,μ′-hptpd)] 1. The diastereomers can be easily separated by selective dissolution of d/l-1 in benzene, and give clearly distinguishable 1H- and 31P-NMR spectra. The fluxional behavior of d/l-1 in solution has been studied by variable-temperature 1H- and 31P-{1H}-NMR spectroscopy. The crystal structures of both d/l- and meso-1 have been determined. Both molecules consist of two {Re2(μ-OMe)2(CO)6} moieties which are bridged by the two PCH2CH2P moieties of the hptpd ligand. Whilst the molecules of meso-1 possess crystallographic i-symmetry, those of d/l-1 do not have any crystallographic symmetry. These diastereomers therefore give clearly distinguishable Raman spectra in the solid state. Reaction of tris[2-(diphenylphosphino)ethyl]phosphine (tdppep) with the activated mixture affords the complex [{Re2(μ-OMe)2(CO)6}(μ,η2-tdppep)] 2, and the analogous reaction involving bis[2-diphenylphospinoethyl)phenylphosphine (triphos) gives [{Re2(μ-OMe)2(CO)6}(μ,μ′,η3-triphos){Re2(CO)9}] 3 and [{Re2(μ-OMe)2(CO)6}(μ,η2-triphos)] 4.

The complexes [Re2(μ-OR)2(μ-dppf)(CO)6] (R = H, 1; Me, 2; Et, 3; Ph, 4) were synthesized by the controlled acidolysis of the anions [Re2(μ-OR)3(CO)6]- (R = H, Me, Et) and [Re2(μ-OH)(μ-OPh)2(CO)6]- (5), respectively, in the presence of dppf (1,1‘-bis(diphenylphosphino)ferrocene). The dppf ligands in complexes 1−4 undergo a twisting motion in solution at room temperature, which, in the case of 3, is correlated with the restricted rotation of the ethyl groups about the O−CH2 bonds. Complex 3 is an interesting example of an organometallic complex in which the two exchanging positions of the methylene protons of an ethyl group are nonequivalent, while the exchanging positions of the methyl group are equivalent. Controlled acidolysis of [Re2(μ-OMe)3(CO)6]- under 1 atm of CO pressure affords the complex [Re3(μ-OMe)3(μ3-OMe)(CO)9]- (6), which consists of a Re3 triangle held together by one face-capping and three bridging methoxo groups, with no Re−Re bonds. The crystal structures of 1, 3, 5, and 6 were determined...

Oxidative decarbonylation of Re 2 (CO) 10 by Me 3 NO in a mixture of THF and phenol resulted in Re 3 (CO) 14 ( μ -H), 1 , and [Me 3 NH] + [Re 2 (CO) 6 ( μ -OPh) 3 ] − , 2 , in 30 and 17% yields respectively. In the analogous reaction in THF-MeOH mixture, a trinuclear complex, [Me 3 NH] + [Re 3 (CO) 9 ( μ -OH) 2 ( μ -OMe)( μ 3 -OMe)] − , 3 , was isolated instead. The structure of 3 was determined by single-crystal X-ray diffraction analysis: orthorhombic, space group Ama 2, a = 14.022(2), b = 18.003(5), c = 9.601(2) A, final R = 0.031 for 958 reflections. The anion contains a Re 3 triangle edge-bridged by one methoxy and two hydroxy ligands and capped by a methoxy group. No formal Re-Re bond (Re ⋯ Re 3.423 and 3.439 A is envisaged. Possible mechanisms for the formation of 1, 2 and 3 are proposed.

The level gap among different hospitals which exists in China is leading to a situation that doctors in different level hospital share uneven continuing medical education (CME) environment cause the diagnosis divide of doctors. The number of patients seen and guidance from experts had a strong correlation with improvement of the doctors’ clinical ability. The implementation of CME needs to consider the two factors. After a primary survey, this study made a systematic and detailed analysis about the current CME situation in different level hospitals. Hospitals are classified into 3 levels. CME patterns via information technique corresponding to different levels were proposed. With this hierarchy continuing medical education, it’s hoped that the diagnosis level of doctors in different level hospital should be similar so that each individual can acquire high quality medical service.

The People's Republic of China has significantly improved the general health of its people by a concerted effort in primary health care but trauma care and its prevention remains a problem. This paper provides an overview of the strengths and weaknesses of the trauma-care system in China and proposes a strategy for its future development. This includes public-health legislation, the integration of military and civilian practice to provide comprehensive care from the scene of the incident through to rehabilitation, medical audit, the introduction of postgraduate trauma-management training courses and international academic exchanges.

Exchange reactions of [Re2(µ-OR)3(CO)6]– (R = H, Me) with alcohols and phenol have been established by electrospray mass spectrometry (ESMS); dehydration of [Re2(µ-OH)3(CO)6]– and the β-hydride elimination reaction of [Re2(µ-OMe)3(CO)6]– have also been observed under ESMS conditions.