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Objective: To compare and contrast the effect of delayed restoration and immediate restoration on the restoration after dental trauma. METHODS: Ninety patients with dental trauma admitted to our hospital from June 2021 to June 2022 were selected for the study and randomly divided into delayed group (n=45) and immediate group (n=45), which were treated with delayed and immediate dental implant restorations, and then compared the restorative effect, treatment period, aesthetics and complications of the two groups. Results: After the restoration, the restorative effect, treatment period and aesthetics of the immediate group were significantly better than those of the delayed group and the comparison was statistically significant (P < 0.05). Conclusion: The immediate restoration had better restorative effect than the delayed restoration, shorter treatment period, lower complication rate, and could improve the aesthetic appearance of teeth, which is worth promoting.

Background: Little is known about the long-term risks of stroke and ischemic heart disease (IHD) in women who had a hysterectomy alone (HA) or with bilateral oophorectomy (HBO) for benign diseases, particularly in China where the burden of cardiovascular diseases (CVD) is high. We assessed mean levels of cardiovascular risk factors and relative risks of stroke and IHD in Chinese women who had a HA or HBO. Methods: A total of 302 510 women, aged 30 to 79 years were enrolled in the China Kadoorie Biobank from 2004 to 2008 and followed up for a mean of 9.8 years. The analysis involved premenopausal women without prior cardiovascular disease or cancer at enrollment. We calculated adjusted hazard ratios for incident cases of CVD and their pathological types (ischemic stroke, hemorrhagic stroke, and IHD) after HA and HBO. Analyses were stratified by age and region and adjusted for levels of education, household income, smoking status, alcohol consumption, physical activity, body mass index, systolic blood pressure, diabetes, self-reported health, and number of pregnancies. Results: Among 282 722 eligible women, 8478 had HA, and 1360 had HBO. Women who had HA had 9% higher risk of CVD after HA (hazard ratio, 1.09 [95% CI, 1.06–1.12]) and 19% higher risk of CVD after HBO (1.19 [95% CI, 1.12–1.26]) compared with women who did not. Both HA and HBO were associated with higher risks of ischemic stroke and IHD but not with hemorrhagic stroke. The relative risks of CVD associated with HA and HBO were more extreme at younger age of surgery. Conclusions: Women who had either HA or HBO have higher risks of ischemic stroke and IHD, and these risks should be evaluated when discussing these interventions. Additional screening for risk factors for CVD should be considered in women following HA and HBO operations, especially if such operations are performed at younger age.

The increasing prevalence of the chronic disease is of considerable concern to health-care organisations. Prevention programmes to patients with early chronic disease have the potential to improve individual health and quality of life through disease avoidance or delay and to save the medical cost of the health care system. Due to the limited budget in healthcare this study seeks to analyse the feasibility of a programme prior to implementation. A mathematical model is developed to determine incidence reduction rate at which the underlying cost break-even can be achieved; consequently, the programme would be feasible. We show the existence and uniqueness of the underlying incidence reduction and establish the feasibility frontier concerning the trade-offs between intervention effective period and incidence reduction rate. We use a diabetes prevention programme to demonstrate the efficiency and advantage of the model. The proposed model would inform decision-makers scientific principles in determining an intervention for implementation.

Survival analysis, aimed at investigating the relationships between covariates and event time, has exhibited profound effects on health service management. Longitudinal data with sequential patterns, such as electronic health records (EHRs), contain a large volume of patient treatment trajectories, and therefore, provide great potential for survival analysis. However, most existing studies address the survival analysis problem in a static manner, that is, they only utilize a fraction of longitudinal data, ignore the correlations between multiple visits, and usually may not be able to capture the latent representations of patient treatment trajectories. This inevitably deteriorates the performance of the survival analysis. To address this challenge, we propose an end-to-end contrastive-based model

Background Tobacco smoking is estimated to account for more than 1 million annual deaths in China, and the epidemic continues to increase in men. Large nationwide prospective studies linked to different health records can help to periodically assess disease burden attributed to smoking. We aimed to examine associations of smoking with incidence of and mortality from an extensive range of diseases in China. Methods We analysed data from the prospective China Kadoorie Biobank, which recruited 512 726 adults aged 30–79 years, of whom 210 201 were men and 302 525 were women. Participants who had no major disabilities were identified through local residential records in 100–150 administrative units, which were randomly selected by use of multistage cluster sampling, from each of the ten diverse study areas of China. They were invited and recruited between June 25, 2004, and July 15, 2008. Upon study entry, trained health workers administered a questionnaire assessing detailed smoking behaviours and other key characteristics (eg, sociodemographics, lifestyle, and medical history). Participants were followed up via electronic record linkages to death and disease registries and health insurance databases, from baseline to Jan 1, 2018. During a median 11-year follow-up (IQR 10–12), 285 542 (55·7%) participants were ever hospitalised, 48 869 (9·5%) died, and 5252 (1·0%) were lost to follow-up during the age-at-risk of 35–84 years. Cox regression yielded hazard ratios (HRs) associating smoking with disease incidence and mortality, adjusting for multiple testing. Findings At baseline, 74·3% of men and 3·2% of women (overall 32·4%) ever smoked regularly. During follow-up, 1 137 603 International Classification of Diseases, 10th revision (ICD-10)-coded incident events occurred, involving 476 distinct conditions and 85 causes of death, each with at least 100 cases. Compared with never-regular smokers, ever-regular smokers had significantly higher risks for nine of 18 ICD-10 chapters examined at age-at-risk of 35–84 years. For individual conditions, smokers had significantly higher risks of 56 diseases (50 for men and 24 for women) and 22 causes of death (17 for men and nine for women). Among men, ever-regular smokers had an HR of 1·09 (95% CI 1·08–1·11) for any disease incidence when compared with never-regular smokers, and significantly more episodes and longer duration of hospitalisation, particularly those due to cancer and respiratory diseases. For overall mortality, the HRs were greater in men from urban areas than in men from rural areas (1·50 [1·42–1·58] vs 1·25 [1·20–1·30]). Among men from urban areas who began smoking at younger than 18 years, the HRs were 2·06 (1·89–2·24) for overall mortality and 1·32 (1·27–1·37) for any disease incidence. In this population, 19·6% of male (24·3% of men residing in urban settings and 16·2% of men residing in rural settings) and 2·8% of female deaths were attributed to ever-regular smoking. Interpretation Among Chinese adults, smoking was associated with higher risks of morbidity and mortality from a wide range of diseases. Among men, the future smoking-attributed disease burden will increase further, highlighting a pressing need for reducing consumption through widespread cessation and uptake prevention. Funding British Heart Foundation, Cancer Research UK, Chinese Ministry of Science and Technology, Kadoorie Charitable Foundation, UK Medical Research Council, National Natural Science Foundation of China, Wellcome Trust.

Our aim was to explore optimal treatment decisions for HbA1c control for type 2 diabetes mellitus patients and assess the impact on potential improvements in quality of life compared with current guidelines. We analyzed a large dataset of HbA1c levels, diabetes-related key risk factors and medication dispensed to 70,069 patients with type 2 diabetes from polyclinics and a large public hospital in Singapore during January 1, 2008, to December 31, 2015. A Markov decision process (MDP) model was developed to determine the optimal treatment policy concerning medication management for glycemic control over a long-term treatment period. We assessed the model performance by comparing quality-adjusted life years (QALYs) gained by the model with those derived by a conventional Markov model informed by current clinical guidelines. Numerical results showed that optimal treatment strategies derived by the MDP model could increase the total expected QALYs by as much as 0.27 years for patients at higher risk such as old age, high HbA1c levels and smokers. In particular, the improvements in QALYs gained for patients with HbA1c levels of 9% (75 mmol/mol) and above were higher than those with lower HbA1c levels. However, the potential improvements appeared to be marginal for patients at lower risk compared with current guidelines. Use of data-driven prescriptive analytics would help clinicians make evidence-based treatment decisions for HbA1c control for patients with type 2 diabetes, in particular for those at high risk.

This study examines a two-echelon supply chain consisting of two competing manufacturers and one retailer that has the channel power, in which one manufacturer is engaged in sustainable technology to curb carbon emissions under the cap-and-trade regulation while the other one operates its business as usual in a traditional manner. Two different supply chain configurations concerning risk attributes of the agents are considered, that is, (ⅰ) two risk-neutral manufacturers with one risk-averse retailer; and (ⅱ) two risk-averse manufacturers with one risk-neutral retailer. Under the mean-variance framework, we use a retailer-leader game optimization approach to study operational decisions of these two systems. Specifically, optimal operational decisions of the agents are established in closed-form expressions and the corresponding profits and carbon emissions are assessed. Numerical experiments are conducted to analyze the impact of risk aversion of the underlying supply chains. The results show that each risk-averse agent would benefit from a low scale risk aversion. Further, low carbon emissions could be attainable if risk aversion scale of the underlying manufacturer is small or moderate. In addition, the carbon emissions might increase when risk aversion of the traditional manufacturer or the retailer is of small or moderate scale.

IntroductionWe examined the associations between long-term usual random plasma glucose (RPG) levels and cause-specific mortality risks among adults without known diabetes in China.Research design and methodsThe China Kadoorie Biobank recruited 512,891 adults (59% women) aged 30–79 from 10 regions of China during 2004–2008. At baseline survey, and subsequent resurveys of a random subset of survivors, participants were interviewed and measurements collected, including on-site RPG testing. Cause of death was ascertained via linkage to local mortality registries. Cox regression yielded adjusted HR for all-cause and cause-specific mortality associated with usual levels of RPG.ResultsDuring median 11 years’ follow-up, 37,214 deaths occurred among 452,993 participants without prior diagnosed diabetes or other chronic diseases. There were positive log-linear relationships between RPG and all-cause, cardiovascular disease (CVD) (n=14,209) and chronic kidney disease (CKD) (n=432) mortality down to usual RPG levels of at least 5.1 mmol/L. At RPG ConclusionsAmong Chinese adults without diabetes, higher RPG levels were associated with higher mortality risks from several major diseases, with no evidence of apparent thresholds below the cut-points for diabetes diagnosis.

In order to realize the integrated function of sluice management and control, S7-1200 PLC is used as the master control unit and S7-200 smart is used as the slave control unit. The load, opening degree, water level and other data of the sluice are collected through the special instrument, and the data is transmitted to PLC for storage and processing through MODBUS-RTU protocol. MCGS human-computer interface is designed, and data exchange with PLC through Modbus-TCP protocol is implemented, and the efficiency and intelligence of the sluice operation are greatly improved.

A few prospective studies have suggested that tea, alcohol, and fruit consumption may reduce the risk of kidney stones. However, little is known whether such associations and their combined effect persist in Chinese adults, for whom the popular tea and alcohol drinks are different from those investigated in the aforementioned studies. The present study included 502,621 participants from the China Kadoorie Biobank (CKB). Information about tea, alcohol, and fruit consumption was self-reported at baseline. The first documented cases of kidney stones during follow-up were collected through linkage with the national health insurance system. Cox regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI). During a median of 11.1 years of follow-up, we collected 12,407 cases of kidney stones. After multivariable adjustment, tea, alcohol, and fruit consumption were found to be negatively associated with kidney stone risk, but the linear trend was only found in tea and fruit consumption. Compared with non-tea consumers, the HR (95% CI) for participants who drank ≥7 cups of tea per day was 0.73 (0.65–0.83). Compared with non-alcohol consumers, the HR (95% CI) was 0.79 (0.72–0.87) for participants who drank pure alcohol of 30.0–59.9 g per day but had no further decrease with a higher intake of alcohol. Compared with less-than-weekly consumers, the HR (95% CI) for daily fruit consumers was 0.81 (0.75–0.87). Even for those who did not drink alcohol excessively, increasing tea and fruit consumption could also independently reduce the stone risk. Among Chinese adults, tea, alcohol, and fruit consumption was associated with a lower risk of kidney stones.

In this paper, we propose a projection based Newton-type algorithm for solving the variational inequality problems. A comprehensive study is conducted to analyze both global and local convergence properties of the algorithm. In particular, the algorithm is shown to be of superlinear convergence when the solution is a regular point. In addition, when the Jacobian matrix of the underlying function is positive definite at the solution or the solution is a non-degenerate point, the algorithm still possesses its superlinear convergence. Compared to the relevant projection algorithms in literature, the proposed algorithm is of remarkable advantages in terms of its generalization and favorable convergence properties under relaxed assumptions.

Bilayer interdiffusion heterojunction with the structure of a donor-rich region near the anode and an acceptor-rich region near the cathode could weaken the energy-level barrier between the active ...

Solvent additive can effectively regulate the phase-separated morphology of the active layer and improve the power conversion efficiency of polymer solar cells. In this study, the influence of solvent additives 1,8-dichlorooctane (DClO), 1,8-dibromooctane (DBrO) and 1,8-diiodooctane (DIO) on the morphology of PTB7:PC71BM active layer films is investigated systematically, and the photovoltaic performance of the prepared bulk heterojunction polymer solar cells is analyzed detailedly. The DIO and DBrO additives facilitate PC71BM diffusing into the PTB7 polymer network and forming interpenetrated bulk heterojunction junction morphology, while the DClO additive deteriorates the active layer morphology. The optimized morphology of DIO and DBrO additives promotes exciton dissociation efficiency, improves charge transport and collection efficiency. The optimum performances were obtained in the devices with DIO additive.

The proportion of patients who reattended emergency department (ED) within 72 hours is an important indicator of quality of care. This study develops a practical framework to predict patients who will reattend ED in 72 hours from clinical perspectives. We analyze 328,733 ED patients from 1 January 2011 to 31 December 2013, with an average of 4.6% reattendances. We feature over 100 factors including demographics, diagnosis, patient acuity, chief complaints, selected laboratory tests, summarized vital signs. Using univariate analysis, a pool of risk variables is selected for subsequent factor selection. We then apply filter methods to derive a set of candidate factors. With these factors in combination with suggestions from ED clinicians, a mixed integer programming model based on discriminant analysis is proposed to determine a classification rule for 72-hour reattendance. In numerical experiments, various small subsets of risk factors are used for classification and prediction. The results show that favorable predicting performances can be achieved in both training and test sets.

The vast Tarim basin is surrounded by Tian Shan Mountains in the north, West Kunlun Mountains in the southwest, and the Altyn Mountains in the southeast. The southwestern Tarim Basin developed within the foreland of the West Kunlun Mountains and cumulated up to 10 km of Cenozoic strata. Despite several decades of geological studies its structural styles and details of its geological evolution are still being debated. In this study, we used seven regional seismic transects from the Yecheng - Hotan area calibrated by deep wells to assess lateral variations of a structural style and syn-tectonic sedimentation in this part of the basin.The basement of the SW Tarim Basin is covered by Paleozoic and Cenozoic strata, as revealed by several deep calibration wells. The regional north-directed basement thrust together with two evaporitic detachments including the Middle Cambrian evaporites (Awatage Formation) and Paleogene evaporites (Aertashi Formation) controlled the overall tectonic framework and structural evolution of this part of the basin. The visible growth strata on seismic data indicate progressive development of the structural wedge within the frontal W Kunlun Mountains from the Late Miocene to the Present day.Four main Cenozoic evolutionary stages of the W Kunlun Mountains and adjacent SW Tarim Basin have been determined. At the end of Paleogene, evaporites of the Aertashi Formation have been deposited in SW Tarim Basin; their thickness, as indicated by seismic data, increases towards the Kunlun orogenic wedge which suggests their deposition within the flexural foreland basin. Then, during the Early to Middle Miocene, about 4000m of sediments have been deposited in rapidly subsiding foreland basin. Towards the end of Late Miocene-Pliocene, tectonic wedging along thrust front led to significant uplift of the Kunlun Mountains that presently form S margin of the Tarim Basin. Quaternary migration of compressional deformations towards the North, towards the basin interior led to formation of the intra-basinal Jade anticline that was re-interpreted as a thin-skinned syn-depositional “fish tail” structure detached within the Paleogene evaporites. Present-day activity along some deeply buried thrusts of the Kunlun Mts. tectonic wedge might be related to current earthquakes.

Background and aims Observational studies have associated resting heart rate with incident diabetes. Whether the associations are causal remains unclear. We aimed to examine the shape and strength of the associations and assessed the causal relevance of such associations in Chinese adults. Methods and results The China Kadoorie Biobank enrolled 512,891 adults in China. Cox proportional hazard regression models was conducted to estimate hazard ratios (HRs) for the associations of resting heart rate with type 2 diabetes and total diabetes. Among 92,724 participants, 36 single-nucleotide polymorphisms (SNPs) related to resting heart rate were used to construct genetic risk score. We used Mendelian randomization analyses to make the causal inferences. During a median follow-up of 9 years, 7872 incident type 2 diabetes and 13,349 incident total diabetes were documented. After regression dilution bias adjustment, each 10 bpm higher heart rate was associated with about a 26% higher risk of type 2 diabetes (HR, 1.26 [95% CI, 1.23, 1.29]) and 23% higher risk of total diabetes (HR, 1.23 [95% CI, 1.20, 1.26]). Instrumental variable analyses showed participants at top quintile compared with those at bottom quintile had 30% higher risk for type 2 diabetes (HR, 1.30 [95% CI, 1.17, 1.43]), and 10% higher risk for total diabetes (HR, 1.10 [95% CI, 1.02, 1.20]). Conclusions This study provides evidence that resting heart rate is an important risk factor for diabetes risk. The results suggest that novel treatment approaches targeting reduction of high heart rate for incidence of diabetes may be worth further investigation.

Additional file 1.

Simple Summary Thyroid hormones are extremely potent and exert a broad range of biological actions on many organ systems of all vertebrates including humans. Blood concentration of thyroid hormones mirrors thyroid status quite well. As thyroid hormone excess or deficiency can lead to serious diseases, it is crucial to ensure that measurement techniques of blood thyroid hormones are accurate and precise, especially during the treatment of an overactive or underactive thyroid. Until recently, many laboratories employ different methods of analysis of thyroid hormones, resulting in reports showing values calibrated to dissimilar normal ranges. This becomes a major issue for patients who are tested in different healthcare facilities as it is challenging to interpret their thyroid status and decide if any difference is due to a real change in hormone concentration or whether the variations occurred purely from calibration differences. In this study, we test the reliability of a mathematical system using linear transformation strategies to convert one value in one scale to another value in a separate scale. Via simultaneously analyzed unbound fraction of plasma thyroxine using three different techniques-immunoassay, mass spectrometry and equilibrium dialysis, we show that linear methods are quite successful in achieving accurate inter-scale thyroid hormone conversions. Abstract Clinicians often encounter thyroid function tests (TFT) comprising serum/plasma free thyroxine (FT4) and thyroid stimulating hormone (TSH) measured using different assay platforms during the course of follow-up evaluations which complicates reliable comparison and interpretation of TFT changes. Although interconversion between concentration units is straightforward, the validity of interconversion of FT4/TSH values from one assay platform to another with different reference intervals remains questionable. This study aims to establish an accurate and reliable methodology of interconverting FT4 by any laboratory to an equivalent FT4 value scaled to a reference range of interest via linear transformation methods. As a proof-of-concept, FT4 was simultaneously assayed by direct analog immunoassay, tandem mass spectrometry and equilibrium dialysis. Both linear and piecewise linear transformations proved relatively accurate for FT4 inter-scale conversion. Linear transformation performs better when FT4 are converted from a more accurate to a less accurate assay platform. The converse is true, whereby piecewise linear transformation is superior to linear transformation when converting values from a less accurate method to a more robust assay platform. Such transformations can potentially apply to other biochemical analytes scale conversions, including TSH. This aids interpretation of TFT trends while monitoring the treatment of patients with thyroid disorders.

Hollow B-SiO2@CaTiO3 nanocomposites were hydrothermally synthesized at a mild reaction temperature of 120 °C using calcium chloride and titanium (IV) isopropoxide as the starting materials and hollow B-SiO2 microspheres as the supports. CaTiO3 nanoparticles are anchored at the surfaces of hollow B-SiO2 microspheres through the formation of Ti–O–B and Ti–O–Si bonds. The interaction between the CaTiO3 nanoparticles and hollow B-SiO2 microspheres enlarged the band gap of CaTiO3 nanoparticles, giving a higher photocatalytic activity in ammonia nitrogen degradation at a lower catalyst loading and a wider range of ammonia nitrogen concentration. When the hollow B-SiO2@CaTiO3 (5wt%CaTiO3) photocatalyst was hydrothermally synthesized at 120 °C for 12 h, and the photocatalytic degradation reaction of ammonia nitrogen (50 mg L−1) in an aqueous solution was carried out under the simulated solar light irradiation at 25 °C for 4 h; the degradation extent of ammonium nitrogen reached 91%.

ObjectiveAim to examine the independent and joint associations of physical activity (PA) and sedentary leisure-time (SLT) with risk of diabetes and assess the extent to which these associations were mediated by adiposity.Research design and methodsThe prospective China Kadoorie Biobank recruited ~512 000 adults from 10 diverse areas across China. Self-reported PA was estimated based on type, frequency and duration of specific types of PA, covering four domains (occupation, leisure, household and commuting). SLT was defined as hours per day spent watching television, reading or playing card games. Stratified Cox proportional hazards models were used to estimate adjusted HRs (aHRs) for PA and SLT associated with incident diabetes. Analyses were stratified by age-at-risk (5-year intervals), sex and region and adjusted for household income, education, alcohol consumption, smoking, fresh fruit intake, self-reported general health status, family history of diabetes and body mass index (BMI) status. Analyses of total PA, occupational and non-occupational PA and SLT were mutually adjusted for each other, as appropriate.ResultsAfter ~9 years of follow-up, there were 14 940 incident diabetes cases among 460 736 participants without prior diabetes or cardiovascular diseases at baseline. The mean (SD) age at baseline was 51 (10.6) years, 59% were women and 43% resided in urban areas. Overall, the mean BMI was 23.5 (3.3) kg/m2, which differed by ~0.5 kg/m2 among individuals in the highest compared with the lowest PA and SLT groups. PA was inversely associated the risk of diabetes 16% (aHR: 0.84, 95% CI 0.81 to 0.88) lower in top than bottom fifth. After further adjustment for BMI this was attenuated to 0.99 (95% CI 0.98 to 1.00). SLT was positively associated with diabetes and each 1 hour per day higher usual level was associated with aHR of 1.13 (95% CI 1.09 to 1.17) for diabetes, attenuated to 1.05 (95% CI 1.01 to 1.09) after further adjustment for BMI.ConclusionsAmong Chinese adults, higher levels of PA and lower levels of SLT were associated with lower risks of diabetes with no evidence of effect modification by each other. These associations appeared to arise mainly through adiposity.

The berth allocation problem (BAP) has been extensively studied in the literature, which seeks to determine berths and times for upcoming ships. The previous studies do not distinguish berths and ships among different liner carriers. By taking into account the increasing use of dedicated berths in practice, this paper proposes a special BAP where berths and ships could be distinguished among different liner carriers. For our BAP under a cooperative environment, we propose a mixed-integer programming model. Based on an assignment model with binary variables, our BAP can be reduced to the liner carrier clustering problem. To generate stable liner carrier clusters used in our assignment model, queueing theory and core theory are applied. A three-stage optimization method is proposed to solve our BAP. Namely, stage I proposes a queueing theory approach for various liner carrier clusters, and based on core theory stage II determines the stability of different liner carrier clusters. Based on the results obtained in stages I and II, stage III solves the liner carrier clustering problem. Numerical experiments are carried out to demonstrate the effectiveness of the proposed method.

Timely access of care has been widely recognized as an important dimension of health care quality. Waiting times can affect patient satisfaction and quality of care in the emergency department (ED). This study analyzes a general patient waiting policy such that ED patients who wait beyond a threshold have their wait shortened. Assuming that the policy is implemented to accelerate the long-waiting cases within a short time interval, we transform the original waiting distribution to a piecewise distribution. The objective of this paper is to examine the reliability of the induced waiting system by minimizing the coefficient of variation (CV) of waiting time. We convert the CV minimization problem to an approximation counterpart using the sampling technique. With patient waiting time data from an emergency department in Singapore, we derive the optimal values of parameters, such as the threshold and the length of the underlying time interval, needed in the policy. Numerical results show that CV and variance of new waiting time will be reduced remarkably by 38% and 58% respectively, in comparison with the original ones.

The convex feasibility problem (CFP) is a classical problem in nonlinear analysis. In this paper, we propose an inertial parallel projection algorithm for solving CFP. Different from the previous algorithms, the proposed method introduces a sequence of parameters and uses the information of last two iterations at each step. To prove its convergence in a simple way, we transform the parallel algorithm to a sequential one in a constructed product space. Preliminary experiments are conducted to demonstrate that the proposed approach converges faster than the general extrapolated algorithms.

Background Lean body mass has been identified as a key determinant of left ventricular mass and wall thickness. However, the importance of lean body mass or other body‐size measures as normative determinants of carotid intima‐media thickness ( cIMT ), a widely used early indicator of atherosclerosis, has not been well established. Methods and Results Carotid artery ultrasound measurements of cIMT and carotid artery plaque burden (derived from plaque number and maximum size) and measurements of body size, including height, body mass index, weight, body fat proportion, and lean body mass ([1−body fat proportion]×weight), were recorded in 25 020 participants from 10 regions of China. Analyses were restricted to a healthy younger subset (n=6617) defined as never or long‐term ex‐regular smokers aged cIMT , but was not associated with plaque burden: overall, each 10 kg higher lean body mass was associated with a 0.03 (95% CI , 0.03–0.04) mm higher cIMT ( P =5×10 −33 ). Fat mass, height, and other body‐size measures were more weakly associated with cIMT . Conclusions The strong association of lean body mass with cIMT, but not with plaque burden, in healthy adults suggests a normative relationship rather than reflecting atherosclerotic pathology. Common mechanisms may underlie the associations of lean body mass with cIMT and with nonatherosclerotic vascular traits.

Background Few studies in China have examined personal ultraviolet radiation (UVR) exposure using polysulfone dosimetry. Methods In this study, 93 mother and adolescent child pairs (N = 186) from two locations in China, one rural (higher latitude) and one urban (lower latitude), completed 3 days of personal UVR dosimetry and a sun/clothing diary, as part of a larger pilot study. Results The average daily ambient UVR in each location as measured by dosimetry was 20.24 Minimal Erythemal Doses (MED) in the rural location and 20.53 MED in the urban location. Rural mothers had more average daily time outdoors than urban mothers (5.5 h, compared with 1.5 h, in urban mothers) and a much higher daily average personal UVR exposure (4.50 MED, compared with 0.78 MED in urban mothers). Amongst adolescents, rural males had the highest average daily personal UVR exposure, followed by rural females, urban females and urban males (average 2.16, 1.05, 0.81, and 0.48 MED, respectively). Conclusions Although based on small numbers, our findings show the importance of geographic location, age, work/school responsibilities, and sex of the adolescents in determining personal UVR exposure in China. These results suggest that latitude of residence may not be a good proxy for personal UVR exposure in all circumstances.

In this chapter, we introduce blockchain as an effective system to manage patient records and track medical drugs along the pharmaceutical supply chain. Blockchain technology, in short, is a digitalized and decentralized ledger that could be made public or private depending on the user where transactional data is being recorded and unable to be tampered with in the system. Blockchain offers a robust tracking solution for healthcare patients and medical drugs. The application of blockchain technology to healthcare is in its infancy, and there are still some challenges in deploying it in the healthcare sector.

This chapter presents an overview of the Internet of Things (IoT) and big data analytics in healthcare. The healthcare supply chain is introduced in order to understand the material and information flow and how healthcare data is utilized. The concept of IoT as an element of Industry 4.0 and the healthcare industry is explained. IoT aims to identify, track and authenticate objects and people, in particular medical devices and patient data, for further analysis, which is where big data analytics plays a major role. The chapter is followed by a discussion of how to use big data analytics in healthcare and the challenges of and strategies for implementing big data. It aims to bridge existing knowledge in the literature and draws upon a prior big data analytics project in Singapore as a case study. The chapter concludes by highlighting lessons learnt from the use of IoT and big data analytics case studies in the healthcare delivery system.

This chapter presents the role and significance of Artificial Intelligence, commonly known as AI, in the control and management of Tuberculosis (TB). The complexity of the disease and problems in TB diagnosis are introduced. Following this, initiatives and opportunities for using AI in TB diagnosis in Thailand are shown as a case study. The chapter concludes by discussing the current limitations of AI improvement, alternative models and key success factors in the implementation of AI in TB.

The Industry 4.0 revolution is already redefining how companies manufacture “things” today. It sets out the concepts for how companies can achieve faster innovation and increase efficiencies across the value chain. But, in the world of healthcare devices and services, which is burdened with regulatory compliance and is still largely dependent on paper-based processes, what does Industry 4.0 really mean? If healthcare services are to incorporate Industry 4.0 core principles, they require proper guidelines or a framework within which to incorporate the core principles. Based on the key factors determined from our research and based on the knowledge acquired from literature reviews, a set of emerging technologies is proposed for implementation in the healthcare sector.

This chapter discusses the use of operations research techniques such as optimization, simulations and predictive analytics in healthcare. The chapter introduces optimization problems in healthcare, from strategic resources and capacity planning to operational and clinical issues such as resource scheduling and treatment planning. Case studies using operations research in healthcare in Singapore will be presented, followed by some insights into improved healthcare delivery.