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Drilling robot for rockburst prevention is a necessary equipment for achieving unmanned pressure relief in coal mines with high in-situ stress. Developing a reliable drilling trajectory measurement system while drilling is an important measure to ensure the effectiveness of drilling pressure relief. Based on analysis of basic principle of drilling trajectory measurement while drilling, a drilling trajectory measurement drill rod based on wireless electromagnetic transmission technology is developed. The spectral efficiency and anti-noise performance of different electromagnetic signal modulation methods are analyzed, and the FSK modulation and demodulation process for drill rod attitude signals are designed, so as to develop a weak signal conditioning system that amplifies before filtering. The Corresponding functional circuits are designed and tested using Multisim software, and each circuit module met the design requirements. A comparative analysis is conducted on the accuracy and execution efficiency of five trajectory calculation algorithms, and the mean angle full range method is chosen for drilling trajectory calculation. The vibration error processing method for inertial measurement unit measurement data based on wavelet filtering is studied, and the effectiveness of wavelet filtering algorithm in improving attitude angle calculation accuracy is also verified. A drilling depth measurement method based on wire displacement sensors and robot action markers is proposed, and the surface and underground experiments are conducted. The experimental results show that the designed weak signal conditioning system can achieve the reception and processing of weak signals in underground coal mines. The drilling depth measurement method based on wire displacement sensors and robot action markers can improve the fitting accuracy of the drilling trajectory.

Abstract Background Despite major primary health care (PHC) reforms in China with the 2009 launch of the National Essential Public Health Service Package, the country experiences many challenges in improving the management of non-communicable diseases in PHC facilities. “EMERALD” is a multifaceted implementation strategy to strengthen the management of hypertension and type-2 diabetes mellitus (T2DM) in PHC facilities. The study aims to: (1) examine the effectiveness of EMERALD in improving hypertension and T2DM management; (2) evaluate the implementation of the interventions; and (3) use the study findings to model the long-term health economic impact of the interventions. Methods The EMERALD intervention components include: (1) empowerment for PHC providers through training and capacity building; (2) empowerment for patient communities through multi-media health education; and (3) empowerment for local health administrators through health data monitoring and strengthening governance of local PHC programs. An interrupted time series design will be used to determine the effectiveness of the interventions based on routinely collected health data extracted from local health information systems. The primary effectiveness outcome is the guideline-recommended treatment rates for people with hypertension and T2DM. Secondary effectiveness outcomes include hypertension and T2DM diagnosis and control rates, and enrolment and adherence rates to the recommended care processes in the National Essential Public Health Service Package. A mixed-methods process evaluation will be conducted to evaluate the implementation of the interventions, including the reach of the target population, adequacy of adoption, level of implementation fidelity, and maintenance. Qualitative interviews with policy makers, health administrators, PHC providers, and patients with hypertension and/or T2DM will be conducted to further identify factors influencing the implementation. In addition, health economic modelling will be performed to explore the long-term incremental costs and benefits of the interventions. Discussion This study is expected to generate important evidence on the effectiveness, implementation, and health economic impact of complex PHC interventions to strengthen the primary care sector’s contribution to addressing the growing burden of non-communicable diseases in China. Trial registration The study has been registered on Chinese Clinical Trial Registry at https://www.chictr.org.cn/ (Registration number ChiCTR2400082036, on March 19th 2024).

Abstract Background This study sought to assess socioeconomic-related inequalities in health care use among arthritis patients in China and to analyze factors associated with this disparity. Methods This study used data from the 2018 China Health and Retirement Longitudinal Study. 3255 arthritis patients were included. The annual per capita household expenditure was used to divide individuals into five categories. We calculated actual, need-predicted, and need-standardized distributions of health care use by socioeconomic groups among people with arthritis. The concentration index (Cl) was used to assess inequalities in health service use. Influencing factors of inequalities were measured with the decomposition method. Results The outpatient and inpatient service use rates among 3255 arthritis patients were 23.13% and 21.41%, respectively. The CIs for actual outpatient and inpatient services use were 0.0449 and 0.0985, respectively. The standardized CIs for both outpatient and inpatient services use increase (CI for outpatient services use = 0.0537; CI for inpatient services use = 0.1260), indicating the emergence of a significant pro-rich inequity. Annual per capita household expenditure was the chief positive contributor to inequity for both outpatient (104.45%) and inpatient services use (105.74%), followed by infrequently social interaction (22.60% for outpatient services use) and Urban Employee Basic Medical Insurance (UEBMI) (11.90% for inpatient services use). By contrast, UEBMI also provided a high negative contribution to outpatient services use (-15.99%). Conclusions There are significant pro-rich inequalities in outpatient and inpatient services use among patients with arthritis, which are exacerbated by widening economic gaps. Interventions to address inequalities should start by improving the economic situation of lower socioeconomic households.

Abstract Background Air pollution poses a significant threat to global public health. While broad mitigation policies exist, an understanding of the economic consequences, both in terms of health benefits and mitigation costs, remains lacking. This study systematically reviewed the existing economic implications of air pollution control strategies worldwide. Methods A predefined search strategy, without limitations on region or study design, was employed to search the PubMed, Scopus, Cochrane Library, Embase, Web of Science, and CEA registry databases for studies from their inception to November 2023 using keywords such as “cost–benefit analyses”, “air pollution”, and “particulate matter”. Focus was placed on studies that specifically considered the health benefits of air pollution control strategies. The evidence was summarized by pollution control strategy and reported using principle economic evaluation measurements such as net benefits and benefit–cost ratios. Results The search yielded 104 studies that met the inclusion criteria. A total of 75, 21, and 8 studies assessed the costs and benefits of outdoor, indoor, and mixed control strategies, respectively, of which 54, 15, and 3 reported that the benefits of the control strategy exceeded the mitigation costs. Source reduction (n = 42) and end-of-pipe treatments (n = 15) were the most commonly employed pollution control methodologies. The association between particulate matter (PM) and mortality was the most widely assessed exposure-effect relationship and had the largest health gains (n = 42). A total of 32 studies employed a broader benefits framework, examining the impacts of air pollution control strategies on the environment, ecology, and society. Of these, 31 studies reported partially or entirely positive economic evidence. However, despite overwhelming evidence in support of these strategies, the studies also highlighted some policy flaws concerning equity, optimization, and uncertainty characterization. Conclusions Nearly 70% of the reviewed studies reported that the economic benefits of implementing air pollution control strategies outweighed the relative costs. This was primarily due to the improved mortality and morbidity rates associated with lowering PM levels. In addition to health benefits, air pollution control strategies were also associated with other environmental and social benefits, strengthening the economic case for implementation. However, future air pollution control strategy designs will need to address some of the existing policy limitations.

In the field of drilling in coal mine underground, drilling rate (DR) is one of the most effective indicators for assessing drilling operations. Accurate prediction of DR is a prerequisite for the realization of intelligent drilling in coal mines, which is of great significance for optimizing drilling parameters, reducing operational costs, and ensuring safe and efficient drilling. In the present research, the influence of drilling parameters on DR are investigated and the intelligent prediction methods are developed to achieve accurate DR predictions with different machine learning algorithms based on several drilling parameters, including weight on bit, rotation speed, torque, and drilling depth. Initially, micro-drilling experiments are conducted to analyze the impact of coal rock mechanical properties, weight on bit, rotation speed, and drilling depth on torque and drilling rate. The experimental results indicate that during the underground coal mining drilling process, drilling rate gradually rises with the increasing weight on bit. Under higher rotation speed conditions, the influence of weight on bit on drilling speed becomes more pronounced. Increasing the rotational speed is advantageous for improving drilling speed, but the impact of rotational speed on drilling speed is more significant in softer coal seams. Subsequently, three different machine learning algorithms, namely K–Nearest Neighbors (KNN), Support Vector Regression (SVR), and Random Forest Regression (RFR), are used to build drilling rate prediction models based on on-site drilling data from underground coal mining, and the hyperparameters of those models are optimized with Particle Swarm Optimization (PSO) method. Finally, the prediction results of three drilling rate models, PSO–KNN, PSO–SVR, and PSO–RFR, are analyzed comparatively. The results show that PSO–RFR model offers the highest accuracy, with R2 of 0.963, MSE of 29.742. On the other hand, the PSO–SVR model exhibits the best robustness, with minimal changes in evaluation metrics after withstanding adversarial attacks. This study is beneficial for the realization of precise DR prediction, providing theoretical support for the optimization of intelligent drilling parameters in underground coal mining operations.

Intelligent shearer is a key equipment for a fully mechanized coal mine working face. For intelligent shearers, due to the internal space limitation of flameproof electric control box, there are usually mixed wiring situations with the cables of internal electronic and electrical components, inverter power, communication bus, etc., which seriously affects the stability and reliability of shearer bus by electromagnetic interference. As the installed power continues to increase and the shearer's intelligent demand becomes higher, the electromagnetic interference of the intelligent shearer's electronic and electrical control system bus becomes more severe. At present, the wiring process in the shearer’s electrical control box is mainly based on experience. There are still no effective estimation means for the electromagnetic environment and the research is limited on the coupling model of line field transmission in the shearer’s electrical control box, causing that it cannot provide technical support for improving the bus anti-interference ability of intelligent shearer control system. Therefore, to inhibit electromagnetic interference effectively and optimize the wiring process for improving the stability of bus communication has become an important problem to be solved urgently for intelligent shearer. According to the requirements of anti-interference technology of intelligent shearer bus, the radiation interference model of the power cable in the control box of intelligent shearer is established, and the rapid estimation method of the output-power-cable electromagnetic radiation is proposed. Furthermore, the electromagnetic radiation of the output power cable of the frequency converter is analyzed, which is influenced by switching frequency, output voltage, and starting state. Then, the analysis model of the shearer CAN bus crosstalk characteristics based on the double conductor transmission line is established, the crosstalk estimation method of the shearer CAN bus based on the crosstalk influence factor is proposed, and the relationship between the crosstalk effect of bus and wiring distance, cable type, height from the ground, and other factors is studied. Based on the analysis mentioned above, a bus anti-interference optimization wiring process and a shearer bus anti-interference test visual system are developed for an intelligent shearer electric control box. To verify the feasibility of the proposed method, the bus interference test experiments are designed and carried out before and after the wiring optimization of the electric control box. The results show that the deviation degree of the CAN bus data frame waveform before and after the optimization is 0.149 3 and 0.030 5, respectively, and the disturbance rate before and after optimization is 56.07% and 35.33%, respectively.

The drilling robot for rock-burst prevention is the key equipment for pressure relief in rock-burst mines, and its accurate map construction and stable navigation under complex working conditions are the basis and premise for realizing intelligent drilling operations. Based on the analysis of the causes of point cloud distortion of LiDAR and the defects of classical SLAM algorithm, a point cloud distortion correction method based on the IMU continuous time trajectory is proposed, a data fusion model of LiDAR and IMU is established, and the positioning and mapping process of drilling robot based on the IMU-LiDAR tight coupling is designed. A closed ramp model is built based on the characteristics of coal mine pressure relief roadways, and the simulation analysis of the mapping effect is conducted. The results show that the proposed mapping algorithm outperforms existing commonly used methods in terms of positioning accuracy and trajectory error. On this basis, a dynamic path planning method based on the improved artificial potential field and rapidly-exploring random tree is proposed, and a path planning and navigation fusion scheme suitable for drilling robot is designed. Two simulation motion scenarios are then designed, and the results indicate that the proposed path planning method has a better comprehensive performance in terms of average path length, average running time, and average number of generated nodes in both global and dynamic path planning. In order to further verify the practicality of the positioning and navigation method, multiple comparative experiments are conducted in a simulated roadway, ground experimental base and underground pressure relief roadway, and the results indicate that after tightly coupling IMU data with LiDAR data, the positioning accuracy of the proposed method is significantly improved and has a superior positioning performance in feature degradation scenarios. In addition, the planning path has better performance in terms of computational efficiency and cost. The results prove the feasibility and superiority of the proposed positioning and navigation method in various scenarios.

For the technical problem of low intelligence in the process of drilling and pressure relief in high stress mines, the research status of pressure relief technology and equipment at home and abroad is summarized and analyzed in this study. It is pointed out that the development of high-performance, highly reliable, and efficient fully autonomous drilling system of anti-impact drilling robot is an important development direction to solve the problem of rock burst prevention and control. To this end, the five key technologies that affect the performance of the drilling system, namely “the precise recognition of hole position, the precise perception of drilling tool posture, the wireless electromagnetic intelligent detection, the intelligent recognition of drilling tool operation status, and the precise control of the drilling system” have been summarized, and the solutions and methods have been provided. In response to the problem of accurate identification of pressure relief holes in complex and harsh environments, a SinGAN model for pressure relief hole image sample expansion is developed, which integrates image size adjustment and multi-stage training modes. The Faster RCNN optimized by multi-layer feature fusion is introduced, and a hole position recognition model based on an improved SqueezeNet lightweight network architecture is constructed to achieve an accurate and fast recognition of pressure relief hole positions. To address the issue of precise perception of drilling tool posture, the unscented Kalman filter optimized by improved gradient descent algorithm is designed for the initial alignment of Inertial Measurement Unit (IMU). Multiple IMU spatial array layouts are designed, and a BP neural network-based compensation method for drilling tool posture error is studied, aiming to improve the accuracy of drilling tool posture calculation and achieve a precise drilling pressure relief. Aiming at the precise detection of drilling conditions in complex geological environments, a wireless elec-tromagnetic transmission system architecture for underground measurement while drilling in coal mines has been established. The principles of adaptive modulation of weak electromagnetic wave signals and high-speed bidirec-tional electromagnetic transmission technology have been explored, and the measurement principles and imple-mentation processes of geological parameters, geological parameters, and engineering parameters at the bottom of the hole have been investigated. To address the issue of identifying the operational status of drilling systems, a multi-domain feature extraction architecture for drilling signals in the time domain, frequency domain, and time frequency domain, as well as a deep network advanced feature extraction architecture, have been constructed. In addition, the key component health status assessment and fault diagnosis techniques for drilling systems have been proposed, and a prediction model for sticking risk factors based on an improved bat optimized long-term and short-term memory network has been built to accurately predict the stuck status of pressure relief drilling tools. In terms of the issue of precise control of drilling systems, the working principle of the hydraulic system of the drilling system is analyzed, and a precise control scheme for the drilling system considering the characteristics of coal and rock is formulated. The principle of solving the optimal control parameters of the drilling system based on torque and position is explored, aiming to achieve intelligent collaborative control and parallel operation of the drilling return system and feed system.

Abstract Background and aims Uncertainty persists over the effects of blood pressure (BP) lowering in acute stroke. The INTEnsive ambulance-delivered blood pressure Reduction in hyper-Acute stroke Trial (INTERACT4) aims to determine efficacy and safety of hyperacute intensive BP lowering in patients with suspected acute stroke. Given concerns over the safety of this treatment in the pre-hospital setting, particularly in relation to patients with intracerebral hemorrhage, we provide an update on progress of the study and profile of participants to date. Methods INTERACT4 is an ongoing multicentre, ambulance-delivered, randomized, open-label, blinded endpoint trial of pre-hospital BP lowering in patients with suspected acute stroke and elevated BP in China. Patients are randomized via a mobile phone digital system to intensive (target systolic BP [SBP]

Abstract Obesity, a worldwide epidemic in recent years, is mainly due to the uncontrolled development of adipose tissues, which includes adipocyte hypertrophy and hyperplasia. Adipocyte differentiation is a process involving multiple transcription factor cascades, and the exact mechanism has not yet been defined. As a bHLH transcription factor, Twist1 exerts its activity by forming homo- or heterodimers with other factors. In this study, we showed Twist1 restricts adipogenesis through PPARγ. Expression of various differentiation markers (including PPARγ and adiponectin) and triglyceride-containing lipid droplets were decreased with overexpression of Twist1. Pathway enrichment analysis of RNA-seq data showed that differentially expressed genes (DEGs) caused by Twist1 overexpression were significantly related to lipolysis and PPARγ signaling. This implicates that Twist1 plays important regulatory roles in these processes. ChIP and dual luciferase assays showed that Twist1 could bind either PPARγ or adiponectin promoter to repress their respective transcription or directly to PPARγ protein to regulate its transcriptional activity. Furthermore, Twist1 directly interacted RXRα, which usually forms heterodimer with PPARγ to regulate adipogenesis. Taken together, our results suggest that Twist1 is an inhibitory modulator of adipogenesis and its function is likely through direct interaction with PPARγ protein or its gene promoter.

Abstract Background Induced abortion among adolescent girls is a global public health issue and a serious challenge in China, but still remains under-examined. We aimed to examine the overall trend and characteristics of induced abortions among Chinese adolescent girls and to investigate the factors associated with induced abortion. Study design Based on the 2017 China Fertility Survey, this study examined the trend and characteristics of induced abortions among adolescent girls with statistical analysis and multiple indicators of descriptive statistics from period and cohort perspectives, including induced abortion proportion and rate, age-specific cumulative proportion, and age-specific cumulative number of induced abortions in adolescent girls. Results Between 1996 and 2016, the proportion and rate of adolescent induced abortions first increased and then decreased, and the mean age at the time of induced abortions among adolescent girls declined. The cumulative proportion of women who had experienced induced abortion at the age of 15–19 in a cohort is less than 2.5% but shows an upward trend. Over 70% of all adolescent induced abortions are premarital. The proportion of women with unintended pregnancy experiences increased and is higher among rural, less educated, and ethnic minority women. Similarly, the prevalence of induced abortion is higher among adolescent girls who live in rural areas, are less educated, and come from ethnic minorities. The cumulative number of induced abortions and premarital abortions increased with later cohorts. Conclusions This study shows an upward trend in adolescent-induced abortion and a decline in the age at the time of the induced abortion. Women in later birth cohort have a higher proportion of having experienced adolescent induced abortion. Adolescent girls who live in rural areas, who are less educated, or who are from ethnic minorities, are more likely to undergo induced abortions at the age of 15–19. More appropriate educational efforts and interventions are urgently needed to reduce the incidence of adolescent induced abortions.

Abstract Background Multimorbidity and frailty represent emerging global health burdens that have garnered increased attention from researchers over the past two decades. We conducted a scientometric analysis of the scientific literature on the coexistence of multimorbidity and frailty to assess major research domains, trends, and inform future lines of research. Methods We systematically retrieved scientific publications on multimorbidity and frailty from the Web of Science Core Collection, spanning from 2003 to 2023. Scientometric analysis was performed using CiteSpace and VOSviewer, enabling the visualization and evaluation of networks comprising co-citation references, co-occurring keywords, countries, institutions, authors, and journals. Results A total of 584 eligible publications were included in the analysis. An exponential rise in research interest in multimorbidity and frailty was observed, with an average annual growth rate of 47.92% in publications between 2003 and 2022. Three major research trends were identified: standardized definition and measurement of multimorbidity and frailty, comprehensive geriatric assessment utilizing multimorbidity and frailty instruments for older adults, and the multifaceted associations between these two conditions. The United States of America, Johns Hopkins University, Fried LP, and the Journal of the American Geriatrics Society were identified as the most influential entities within this field, representing the leading country, institution, author, and journal, respectively. Conclusions Scientometric analysis provides invaluable insights to clinicians and researchers involved in multimorbidity and frailty research by identifying intellectual bases and research trends. While the instruments and assessments of multimorbidity and frailty with scientific validity and reliability are of undeniable importance, further investigations are also warranted to unravel the underlying biological mechanisms of interactions between multimorbidity and frailty, explore the mental health aspects among older individuals with multimorbidity and frailty, and refine strategies to reduce prescriptions in this specific population.

Abstract Background Cardiovascular disease (CVD) is a leading cause of morbidity and mortality globally. The extent to which CVD affects the population’s health varies across countries. Moreover, quantitative estimates of the trend of inequalities in CVD burden remain unclear. The objective of our study was to assess the socioeconomic inequalities and temporal trends of CVD burden across 186 countries and territories from 2000 to 2019. Methods We extracted data from the Global Burden of Disease, Injuries, and Risk Factors Study (GBD) 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the burden of CVDs, and gross national income (GNI) per capita was used to approximate the socioeconomic development. Concentration curves and concentration indexes (CIs) were generated to evaluate the cross-national socioeconomic inequality of CVD burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of CVD burden from 2000 to 2019. Results The age-standardized DALY rates of CVDs decreased in 170 (91%) of 186 countries from 2000 to 2019. The concentration curves of the age-standardized DALY rates of CVDs were above the equality line from 2000 to 2019, indicating a disproportional distribution of CVD burden in low-income countries. The CIs declined from − 0.091 (95% CI: −0.128 to − 0.054) in 2000 to − 0.151 (95% CI: −0.190 to − 0.112) in 2019, indicating worsened pro-poor inequality distributions of CVD burden worldwide. A four-phase trend of changes in the CIs of age-standardized DALY rates for CVD was observed from 2000 to 2019, with an average annual percentage change (AAPC) of − 2.7% (95% CI: −3.0 to − 2.4). Decreasing trends in CIs were observed in all CVD subcategories but endocarditis, with AAPC ranging from − 6.6% (95% CI: −7.3 to − 5.9) for ischemic heart disease to − 0.2% (95% CI: −0.4 to − 0.1) for hypertensive heart disease. Conclusions Globally, the burden of CVD has decreased in more than 90% of countries over the past two decades, accompanied by an increasing trend of cross-country inequalities. Moreover, the overall burden of CVD continues to fall primarily on low-income countries.

Objective To quantify the trends in systolic and diastolic blood pressure (BP) among adults in Shenzhen from 1997 to 2018.Design Cross-sectional study.Settings The data were collected from all districts in Shenzhen, China in the years of 1997, 2009 and 2018 by multistage cluster sampling procedure.Participants Participants were residents aged 18–69 years in Shenzhen, China. A total of 26 621 people were included: 8266 people in 1997, 8599 people in 2009 and 9756 people in 2018.Primary and secondary outcome measures All participants were surveyed about their sociodemographic and lifestyle information. BP was measured by trained physicians using a mercury sphygmomanometer. Hypertension was defined as systolic BP of at least 140 mm Hg and diastolic BP of at least 90 mm Hg, self-reported use of antihypertensive medications or both. Hypertension control was defined as systolic BP values of less than 140 mm Hg and diastolic BP values of less than 90 mm Hg.Result Age-adjusted mean systolic BP increased from 117±16 mm Hg to 123±15 mm Hg (p

Background. The Diabetes Remission Clinical Trial (DiRECT) study demonstrated that an intensive and structured weight management program in UK primary care resulted in high rates of diabetes remission in adults with recent onset type 2 diabetes mellitus (T2DM). This study was aimed at evaluating the translation of the DiRECT intervention into an Australian primary care setting. Methods. All patients enrolled in the DiRECT-Australia Type 2 Diabetes Remission Service in a region of Sydney (Macarthur region, South Western Sydney, Australia) were included. Eligible participants were aged 20–70 years, noninsulin treated, with T2DM of ≤6 years’ duration, and body mass index BMI≥27 kg/m2. Total diet replacement of 825-853 kcal/day using meal replacements was implemented for 12 weeks, followed by an ongoing structured program until 52 weeks, with regular follow-up with a general practitioner, dietitian, and/or practice nurse. Results. Of 39 recruited participants, 32 (82.1%) and 27 (69.2%) completed 12 weeks and 52 weeks of the structured program, respectively. Decrease in weight by -12.0 kg (95% CI: -9.6, -14.4; p

Introduction The willingness to pay per quality-adjusted life year gained (WTP/Q) is commonly used to determine whether an intervention is cost-effective in health technology assessment. This study aimed to evaluate the WTP/Q for different disease scenarios in a Chinese population.Methods The study employed a quadruple-bounded dichotomous choice contingent valuation method to estimate the WTP/Q in the general public. The estimation was conducted across chronic, terminal and rare disease scenarios. Face-to-face interviews were conducted in a Chinese general population recruited from Jiangsu province using a convenience sampling method. Interval regression analysis was performed to determine the relationship between respondents’ demographic and socioeconomic conditions and WTP/Q. Sensitivity analyses of removing protest responses and open question analyses were conducted.Results A total of 896 individuals participated in the study. The WTP/Q thresholds were 128 000 Chinese renminbi (RMB) ($36 364) for chronic diseases, 149 500 RMB ($42 472) for rare diseases and 140 800 RMB ($40 000) for terminal diseases, equivalent to 1.76, 2.06 and 1.94 times the gross domestic product per capita in China, respectively. The starting bid value had a positive influence on participants’ WTP/Q. Additionally, residing in an urban area (p

The problem of coal-gangue identification is one of the technical problems that have not been effectively solved for a long time in the coal industry. By analyzing the characteristics and limitations of existing coal-gangue identification methods, the feasibility of coal-gangue identification based on microwave detection technology is discussed. Firstly, the electromagnetic parameters of different coals and gangues are measured and analyzed to provide a basis for the subsequent analysis of sample test results. Then, in order to explore the influence of coal gangue size parameters on microwave propagation, the propagation law of coal gangue dielectric samples with different thickness and cross-sectional area on different frequency bands is studied. Because the coal-gangue mixture is a multi-scale medium composed of coal, gangue and air, the volume and shape are different, and the spatial distribution and mixing form are complex and changeable. The scattering effect in the microwave irradiation area is very complex, resulting in obvious differences in the transmission characteristics of electromagnetic waves in different coal-gangue mixtures. Finally, in order to explore the variation law of microwave propagation characteristics in different coal-gangue media, some microwave detection experiments of coal-gangue mixture under different microwave frequency bands, different particle sizes and different gangue contents are carried out. The results show that: the electromagnetic parameters, thickness and sectional area have obvious influence on the propagation law of microwave in the media. Different particle size and gangue rate have certain influence on microwave propagation in coal-gangue mixture. When microwave with frequency greater than 4 GHz irradiates the coal gangue mixture, the increase of particle size will gradually increase the intensity values of S11 and S21 and the amplitude of O21 signal. When the electromagnetic parameters of coal and gangue in the mixed medium are quite different, after the frequency is greater than 3.5 GHz, the increase of particle size reduces the S21 intensity from −35.3 dB to −38.2 dB, and the O21 signal amplitude from 1.6 mV to 1.26 mV, with certain time delay characteristics. Through the experimental analysis, the differences of the transmitted wave signal intensity value, the time-domain transmitted wave signal amplitude and the transmitted wave signal delay at the sensitive frequency points can be mastered, so as to provide a new idea and method for accurate identification of coal and gangue in top coal caving face.

Abstract Background The Global Burden of Disease, Injuries, and Risk Factors Study (GBD) has reported that HIV/AIDS continues to take a disproportionate toll on global health. However, the trends in global inequality of HIV/AIDS burden have remained ambiguous over the past two decades. The objectives of our study were to assess the socioeconomic inequalities, and temporal trends of HIV/AIDS across 186 countries and territories from 2000 to 2019. Methods We extracted data from the GBD 2019, and conducted a cross-national time-series analysis. Age-standardized disability-adjusted life-year (DALY) rates were used to measure the global burden of HIV/AIDS. Gross national income (GNI) per capita was used to approximate the national socioeconomic status. Linear regression analysis was conducted to investigate the relationship between age-standardized DALY rates due to HIV/AIDS and GNI per capita. The concentration curve and concentration index (CI) were generated to evaluate the cross-national socioeconomic inequality of HIV/AIDS burden. A joinpoint regression analysis was used to quantify the changes in trends in socioeconomic inequality of HIV/AIDS burden from 2000 to 2019. Results A decrease in age-standardized DALY rates for HIV/AIDS occurred in 132 (71%) of 186 countries/territories from 2000 to 2019, of which 52 (39%) countries/territories achieved a decrease in DALYs of more than 50%, and 27 (52%) of the 52 were from sub-Saharan Africa. The concentration curves of the age-standardized DALY rates of HIV/AIDS were above the equality line from 2000 to 2019. The CI rose from − 0.4625 (95% confidence interval − 0.6220 to -0.2629) in 2000 to -0.4122 (95% confidence interval − 0.6008 to -0.2235) in 2019. A four-phase trend of changes in the CIs of age-standardized DALY rates for HIV/AIDS was observed across 2000 to 2019, with an average increase of 0.6% (95% confidence interval 0.4 to 0.8, P

Abstract Background Hepatocellular carcinoma (HCC) is the fastest increasing cause of cancer death in Australia. A recent Australian consensus guidelines recommended HCC surveillance for cirrhotic patients and non-cirrhotic chronic hepatitis B (CHB) patients at gender and age specific cut-offs. A cost-effectiveness model was then developed to assess surveillance strategies in Australia. Methods A microsimulation model was used to evaluate three strategies: biannual ultrasound, biannual ultrasound with alpha-fetoprotein (AFP) and no formal surveillance for patients having one of the conditions: non-cirrhotic CHB, compensated cirrhosis or decompensated cirrhosis. One-way and probabilistic sensitivity analyses as well as scenario and threshold analyses were conducted to account for uncertainties: including exclusive surveillance of CHB, compensated cirrhosis or decompensated cirrhosis populations; impact of obesity on ultrasound sensitivity; real-world adherence rate; and different cohort’s ranges of ages. Results Sixty HCC surveillance scenarios were considered for the baseline population. The ultrasound + AFP strategy was the most cost-effective with incremental cost-effectiveness ratios (ICER) compared to no surveillance falling below the willingness-to-pay threshold of A$50,000 per quality-adjusted life year (QALY) at all age ranges. Ultrasound alone was also cost-effective, but the strategy was dominated by ultrasound + AFP. Surveillance was cost-effective in the compensated and decompensated cirrhosis populations alone (ICERs < $30,000), but not cost-effective in the CHB population (ICERs > $100,000). Obesity could decrease the diagnostic performance of ultrasound, which in turn, reduce the cost-effectiveness of ultrasound ± AFP, but the strategies remained cost-effective. Conclusions HCC surveillance based on Australian recommendations using biannual ultrasound ± AFP was cost-effective.

A walking trajectory tracking control approach for a walking electrohydraulic control system is developed to reduce the walking trajectory tracking deviation and enhance robustness. The model uncertainties are estimated by a designed state observer. A saturation function is used to attenuate sliding mode chattering in the designed sliding mode controller. Additionally, a walking trajectory tracking control strategy is proposed to improve the walking trajectory tracking performance in terms of response time, tracking precision, and robustness, including walking longitudinal and lateral trajectory tracking controllers. Finally, simulation and experimental results are employed to verify the trajectory tracking performance and observability of the model uncertainties. The results testify that the proposed approach is better than other comparative methods, and the longitudinal and lateral trajectory tracking average absolute errors are controlled in 10.23 mm and 22.34 mm, respectively, thereby improving the walking trajectory tracking performance of the walking electrohydraulic control system for the coal mine drilling robot for rockburst prevention.

In this paper, the development of a high-power continuous wave (CW) fiber laser near 980 nm is reviewed. This review is focused primary on the power evolution resulting from the designation of Yb-doped fibers, which is important in the suppression of the amplified spontaneous emission (ASE) around 1030 nm. Current studies on the in-band ASE as the power limitation of the Yb-doped fiber lasers near 980 nm are also summarized in this review.

This study develops an adaptive sliding mode control approach for a drilling tool attitude adjustment system, aiming at solving the problems of model uncertainties and insufficient ability of disturbance suppression during the regulation behavior. To further improve the performance of the position-tracking loop in terms of response time, tracking accuracy, and robustness, a state observer based on an improved radial basis function is designed to approximate the model uncertainties, a valve dead-zone compensate controller is used to reduce control deviation, an adaptive sliding mode controller is designed to improve the position-tracking precision and attenuate sliding mode chattering. Finally, simulation and experimental results are carried out to verify the observability of the model uncertainties and position-tracking errors of the drilling tool attitude adjustment system, which can effectively improve the position-tracking performance and robustness of the drilling tool attitude adjustment system.

Abstract Background Fibromuscular dysplasia (FMD) has a high prevalence of associated nontraumatic carotid artery dissection, which could further result in transient ischaemic attack (TIA) or stroke. Limb shaking TIA is an unusual form of TIA that is commonly discribed in elderly patients with atherosclerotic backgrounds, while there are limited data about it in patients with FMD. Furthermore, discussions of limb shaking TIA in nonelderly patients are scarce. Case presentation An Asian 47-year-old female presented with intermittent involuntary movement of the left upper limb accompanied by neck torsion. The episode stopped soon after changing to the supine position. On native source images of time-of-flight magnetic resonance angiography (TOF-MRA), the right internal carotid artery showed a "dual lumen sign" with an intimal flap. On contrast-enhanced magnetic resonance angiography and sagittal black-blood T1WI, an intravascular haematoma with irregular lumen stenosis was observed, which overall indicated right internal carotid artery dissection. Digital subtraction angiography showed the characteristic “string-of-beads” appearance in the left internal carotid artery, and the presence of this sign pointed to the diagnosis of FMD. The patient was finally diagnosed with limb shaking TIA due to internal carotid dissection with fibromuscular dysplasia. The patient was prescribed dual anti-platelet therapy. The limb shaking vanished soon after admission with no reoccurrence in the three-month follow-up. Conclusions This case demonstrates that limb shaking TIA can present in patients with FMD. Limb shaking TIA in nonelderly patients can be caused by multiple diseases, and more detailed patient guidance is required in clinical practice.

Abstract Background Universal health coverage is a challenge to horizontal equity in healthcare financing. Since 1998, China has extended its healthcare insurance schemes, and individuals with equal incomes but different attributes such as social status, profession, geographic access to health care, and health conditions, are covered by the same health insurance scheme. This study aims to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 using data from two national household health surveys. Methods Multi-stage stratified random sampling was used to select 3,946 households with 13,619 individuals in 2002, and 3,958 households with 12,973 individuals in 2007. A decomposition method was used to measure the horizontal inequity and reranking in healthcare finance. Results Over the period 2002–2007, the absolute value of horizontal inequity in total healthcare payments decreased from 997.83 percentage points to 199.87 percentage points in urban areas, and increased from 22.28 percentage points to 48.80 percentage points in rural areas. The horizontal inequity in social health insurance remained almost the same in urban areas, at around 27 percentage points, but decreased from 110.90 percentage points to 7.80 percentage points in rural areas. Horizontal inequity in out-of-pocket payments decreased from 178.43 percentage points to 80.96 percentage points in urban areas, and increased from 26.06 percentage points to 41.40 percentage points in rural areas. Conclusion The horizontal inequity of healthcare finance in China over the period 2002–2007 was reduced by general taxation and social insurance, but strongly affected by out-of-pocket payments. Increasing the benefits from social health insurance would help to reduce horizontal inequity.

Introduction Minimal trauma fractures (MTFs) often occur in older patients with osteoporosis and may be precipitated by falls risk-increasing drugs. One category of falls risk-increasing drugs of concern are those with sedative/anticholinergic properties. Collaborative medication management services such as Australia’s Home Medicine Review (HMR) can reduce patients’ intake of sedative/anticholinergics and improve continuity of care. This paper describes a protocol for an randomised controlled trial to determine the efficacy of an HMR service for patients who have sustained MTF.Method and analysis Eligible participants are as follows: ≥65 years of age, using ≥5 medicines including at least one falls risk-increasing drug, who have sustained an MTF and under treatment in one of eight Osteoporosis Refracture Prevention clinics in Australia. Consenting participants will be randomised to control (standard care) or intervention groups. For the intervention group, medical specialists will refer to a pharmacist for HMR focused on reducing falls risk predominately through making recommendations to reduce falls risk medicines, and adherence to antiosteoporosis medicines. Twelve months from treatment allocation, comparisons between groups will be made. The main outcome measure is participants’ cumulative exposure to sedative and anticholinergics, using the Drug Burden Index. Secondary outcomes include medication adherence, emergency department visits, hospitalisations, falls and mortality. Economic evaluation will compare the intervention strategy with standard care.Ethics and dissemination Approval was obtained via the New South Wales Research Ethics and Governance Information System (approval number: 2021/ETH12003) with site-specific approvals granted through Human Research Ethics Committees for each research site. Study outcomes will be published in peer-reviewed journals. It will provide robust insight into effectiveness of a pharmacist-based intervention on medicine-related falls risk for patients with osteoporosis. We anticipate that this study will take 2 years to fully accrue including follow-up.Trial registration number ACTRN12622000261718.

Objectives Despite the availability of general and national guidelines for the conduct and reporting of economic evaluations, there is heterogeneity in economic evolutions concerning spine surgery. This is partly the result of differing levels of adherence to the existing guidelines and the lack of disease-specific recommendations for economic evaluations. The extensive heterogeneity in study design, follow-up duration and outcome measurements limit the comparability of economic evaluations in spine surgery. This study has three objectives: (1) to create disease-specific recommendations for the design and conduct of trial-based economic evaluations in spine surgery, (2) to define recommendations for reporting economic evaluations in spine surgery as a complement to the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist and (3) to discuss methodological challenges and defining the need for future research.Design A modified Delphi method according to the RAND/UCLA Appropriateness Method.Setting A four-step process was followed to create and validate disease-specific statements and recommendations for the conduct and reporting of trial-based economic evaluations in spine surgery. Consensus was defined as >75% agreement.Participants A total of 20 experts were included in the expert group. Validation of the final recommendations was obtained in a Delphi panel, which consisted of 40 researchers in the field who were not included in the expert group.Primary and secondary outcome measures The primary outcome measure is a set of recommendations for the conduct and reporting, as a complement to the CHEERS 2022 checklist, of economic evaluations in spine surgery.Results A total of 31 recommendations are made. The Delphi panel confirmed consensus on all of the recommendations in the proposed guideline.Conclusion This study provides an accessible and practical guideline for the conduct of trial-based economic evaluations in spine surgery. This disease-specific guideline is a complement to existing guidelines, and should aid in reaching uniformity and comparability.

IntroductionSecondary prevention of stroke is a leading challenge globally and only a few strategies have been tested to be effective in supporting stroke survivors. The system-integrated and technology-enabled model of care (SINEMA) intervention, a primary care-based and technology-enabled model of care, has been proven effective in strengthening the secondary prevention of stroke in rural China. The aim of this protocol is to outline the methods for the cost-effectiveness evaluation of the SINEMA intervention to better understand its potential economic benefits.MethodsThe economic evaluation will be a nested study based on the SINEMA trial; a cluster-randomized controlled trial implemented in 50 villages in rural China. The effectiveness of the intervention will be estimated using quality-adjusted life years for the cost-utility analysis and reduction in systolic blood pressure for the cost-effectiveness analysis. Health resource and service use and program costs will be identified, measured, and valued at the individual level based on medication use, hospital visits, and inpatients' records. The economic evaluation will be conducted from the perspective of the healthcare system.ConclusionThe economic evaluation will be used to establish the value of the SINEMA intervention in the Chinese rural setting, which has great potential to be adapted and implemented in other resource-limited settings.

Objective This study aimed to investigate the preferences regarding risks, benefits and other treatment attributes of patients with type 2 diabetes mellitus (T2DM) in China when selecting a second-line anti-hyperglycaemic medicine.Methods A discrete choice experiment with hypothetical anti-hyperglycaemic medication profiles was performed using a face-to-face survey administered to patients with T2DM. The medication profile was described using seven attributes: treatment efficacy, hypoglycaemia risk, cardiovascular benefits, gastrointestinal (GI) adverse events, weight change, mode of administration and out-of-pocket cost. Participants chose between medication profiles by comparing attributes. Data were analysed using a mixed logit model with marginal willingness to pay (mWTP) and maximum acceptable risk (MAR) calculated. The preference heterogeneity within the sample was explored using a latent class model (LCM).Results A total of 3327 respondents from five major geographical regions completed the survey. Treatment efficacy, hypoglycaemia risk, cardiovascular benefits and GI adverse events were major concerns among the seven attributes measured. Weight change and mode of administration were of lesser concern. Regarding mWTP, respondents would pay ¥236.1 (US$36.6) for an anti-hyperglycaemic medication with an efficacy of 2.5% points reduction in HbA1c, while they were willing to accept a weight gain of 3 kg only if they received a compensation of ¥56.7 (US$8.8). Respondents were willing to accept a relatively large increase in hypoglycaemia risk (MAR=15.9%) to improve treatment efficacy from intermediate (1.0% points) to high (1.5% points). LCM identified the following four unobserved subgroups: trypanophobia, cardiovascular-benefits-focused, safety-focused and efficacy-focused and cost-sensitive.Conclusion Patients with T2DM prioritised free out-of-pocket costs, highest efficacy, no hypoglycaemia risk and cardiovascular benefits over weight change and mode of administration. There exists great preference heterogeneity among patients, which should be taken into account in healthcare decision-making processes.

Abstract Objective To assess the impacts of changing a model of care and employing general practitioners (GPs) within residential aged care facilities (RACFs) on costs to the aged care provider (ACP) and state and federal governments of Australia. Methods This study was a cost analysis of a prospective, stepped-wedge, cluster randomised trial. All financial data from the ACP for every RACF involved, before and after implementation of the new model were obtained. Costs of hospital transfers, admissions, ambulance usage and GP consultations were calculated. Costs of new infrastructure, recruiting and training new staff were accounted for. Costs were standardised to 2019 Australian Dollars per occupied bed day (OBD). Results Implementation of the new model of care resulted in overall cost savings of $9.7 per OBD to the ACP, with increased salary costs offset by increased federal government subsidies and Medicare claims income. Costs to the federal government increased by $19.6 per OBD, driven by increases in subsides. Costs savings of $3.0 per OBD to state governments were seen, driven by decreased costs of hospital transfers. Conclusions Implementation of a model of care including GPs employed at RACFs had a mixed impact on costs depending on perspective, with overall savings to the ACP and state government perspective.

Abstract Signal denoising is a crucial step in signal analysis. Various procedures have been attempted by researchers to remove the noise while preserving the effective components of the signal. One of the most successful denoising methods currently in use is the variational mode decomposition (VMD). Unfortunately, the effectiveness of VMD depends on the appropriate selection of the decomposition level and the effective modes to be reconstructed, and, like many other traditional denoising methods, it is often ineffective when the signal is non‐linear and non‐stationary. In view of these problems, this study proposes a new denoising method that consists of three steps. First, an improved VMD method is used to decompose the original signal into an optimal number of intrinsic mode functions (IMFs). Second, the energy variation ratio function is applied to distinguish between the effective and non‐effective IMFs. Third, the valuable components are retained while the useless ones are removed, and the denoised signal is obtained by reconstructing the useful IMFs. Simulations and experiments on various noisy non‐linear and non‐stationary signals demonstrated the superior performance of the proposed method over existing denoising approaches.

Abstract Background Early pre-hospital initiation of blood pressure (BP) lowering could improve outcomes for patients with acute stroke, by reducing hematoma expansion in intracerebral hemorrhage (ICH), and time to reperfusion treatment and risk of intracranial hemorrhage in ischemic stroke (IS). We present the design of the fourth INTEnsive ambulance-delivered blood pressure Reduction in hyper-ACute stroke Trial (INTERACT4). Methods A multi-center, ambulance-delivered, prospective, randomized, open-label, blinded endpoint (PROBE) assessed trial of pre-hospital BP lowering in 3116 hypertensive patients with suspected acute stroke at 50+ sites in China. Patients are randomized through a mobile phone digital system to intensive BP lowering to a target systolic BP of

BackgroundCancer, the leading cause of mortality in China, is a significant burden on patients, their families, the medical system, and society at large. However, there is minimal data on health service utilization and catastrophic health expenditure (CHE) among cancer patients in China. The objective of this study was to identify factors associated with health care utilization and CHE in Chinese cancer patients.MethodsThe 2018 wave of a nationally representative dataset, the China Health and Retirement Longitudinal Study, was used in our study. Of 18,968 respondents recruited for the analysis, 388 were clinically diagnosed with cancer. CHE was defined as household health expenditure that exceeded 40% of non-food household expenses. A binary logistic regression model was used to identify the risks of cancer exposure among all participants, along with the likelihood of CHE in households with cancer patients at the 40% threshold. A negative binomial regression model was used to identify determinants of health service utilization among cancer patients.ResultsContracting a family physician (incidence rate ratio IRR: 2.38, 1.18–4.77), Urban Employee Basic Medical Insurance (IRR: 4.02, 1.91–8.46, compared to the uninsured), Urban and Rural Resident Basic Medical Insurance (IRR: 3.08, 1.46–6.49, compared to the uninsured), and higher per-capita household consumption were positively associated with inpatient service utilization. Patients with a college education and above reported a greater number of outpatient visits (IRR: 5.78, 2.56–13.02) but fewer inpatient hospital days (IRR: 0.37, 0.20–0.67). Being diagnosed with a non-cancer chronic non-communicable disease was associated with an increased number of outpatient visits (IRR: 1.20, 1.10–1.31). Of the 388 participants, 50.1% of households had CHE, which was negatively correlated with a larger household size (odds ratio OR: 0.52, 0.32–0.86) and lower socioeconomic status [for quintile 5 (lowest group) OR: 0.32, 0.14–0.72].ConclusionsThe socioeconomic characteristics of cancer patients had a considerable impact on their healthcare utilization. Individualized and targeted strategies for cancer management should be implemented to identify high-risk populations and trace the utilization of care among Chinese cancer patients. Strategic purchasing models in cancer care and social health insurance with expanded benefits packages for cancer patients are crucial to tackling the cancer burden in China.

In this paper, we proposed a strategy for achieving all-fiber single-frequency amplifiers with near-diffraction-limited beam quality by using confined-doped fiber. Benefiting from the large mode area (LMA) and mode selection properties of the confine-doped fiber, the stimulated Brillouin scattering (SBS) and transverse mode instability (TMI) effects were comprehensively suppressed. Based on this confined-doped fiber assisted amplifier, a 322 W SBS-limited single-frequency laser was obtained with M2 factor of 1.25/1.33 for the x/y direction. Comparing with the full-doped fiber assisted one, the TMI threshold of the confined-doped one is improved more than 1.6 times. Overall, the technique of confined-doped in the fiber core provides a promising approach for the power scaling and single-mode operation of all-fiber single-frequency lasers.

Introduction Productivity loss may contribute to a large proportion of costs of health conditions in an economic evaluation from a societal perspective, but there is currently a lack of methodological consensus on how productivity loss should be measured and valued. Despite the research progress surrounding this issue in other countries, it has been rarely discussed in China.Methods We reviewed the official guidelines on economic evaluations in different countries and regions and screened the literature to summarise the extent to which productivity loss was incorporated in economic evaluations and the underlying methodological challenges.Results A total of 48 guidelines from 46 countries/regions were included. Although 32 (67%) guidelines recommend excluding productivity loss in the base case analysis, 23 (48%) guidelines recommend including productivity loss in the base case or additional analyses. Through a review of systematic reviews and the economic evaluation studies included in these reviews, we found that the average probability of incorporating productivity loss in an economic evaluation was 10.2%. Among the economic evaluations (n=478) that explicitly considered productivity loss, most (n=455) considered losses from paid work, while only a few studies (n=23) considered unpaid work losses. Recognising the existing methodological challenges and the specific context of China, we proposed a practical research agenda and a disease list for progress on this topic, including the development of the disease list comprehensively consisting of health conditions where the productivity loss should be incorporated into economic evaluations.Conclusion An increasing number of guidelines recommend the inclusion of productivity loss in the base case or additional analyses of economic evaluation. We optimistically expect that more Chinese researchers notice the importance of incorporating productivity loss in economic evaluations and anticipate guidelines that may be suitable for Chinese practitioners and decision-makers that facilitate the advancement of research on productivity loss measurement and valuation.

BackgroundCancer is a major public health problem worldwide and the leading cause of death in China, with increasing incidence and mortality rates. This study sought to assess socioeconomic-related inequalities in health care use among cancer patients in China and to analyze factors associated with this disparity.MethodsThis study used data collected for the China Health and Retirement Longitudinal Study in 2018. Patients who reported having cancer were included. The annual per capita household expenditure was classified into five groups by the quintile method. We calculated the distribution of actual, need-predicted, and need-standardized health care use across different socioeconomic groups among patients with cancer. The concentration index (CI) was used to evaluate inequalities in health care use. Influencing factors of inequalities were measured with the decomposition method.ResultsA total of 392 people diagnosed with cancer were included in this study. The proportion of cancer patients who utilized outpatient and inpatient services was 23.47% and 40.82%, respectively, and the CIs for actual outpatient and inpatient service use were 0.1419 and 0.1960. The standardized CIs (CI for outpatient visits = 0.1549; CI for inpatient services = 0.1802) were also both positive, indicating that affluent cancer patients used more health services. The annual per capita household expenditure was the greatest factor favoring the better-off, which contributed as much as 78.99% and 83.92% to the inequality in outpatient and inpatient services use, followed by high school education (26.49% for outpatient services) and living in a rural village (34.53% for inpatient services). Urban Employee Basic Medical Insurance exacerbated the inequality in inpatient services (21.97%) while having a negative impact on outpatient visits (−22.19%).ConclusionsThere is a pro-rich inequality in outpatient and inpatient services use among cancer patients in China. A lower socioeconomic status is negatively associated with cancer care use. Hence, more targeted financial protection for poor people would relieve cancer patients of the burden caused by the high cost of cancer care.

Abstract Background To examine the relationship between the main caregiver during the “doing-the-month” (a traditional Chinese practice which a mother is confined at home for 1 month after giving birth) and the risk of postpartum depression (PPD) in postnatal women. Methods Participants were postnatal women stayed in hospital and women who attended the hospital for postpartum examination, at 14–60 days after delivery from November 1, 2013 to December 30, 2013. Postpartum depression status was assessed using the Edinburgh Postnatal Depression Scale. Univariate and multivariable logistic regressions were used to identify the associations between the main caregiver during “doing-the-month” and the risk of PPD in postnatal women. Results One thousand three hundred twenty-five postnatal women with a mean (SD) age of 28 (4.58) years were included in the analyses. The median score (IQR) of PPD was 6.0 (2, 10) and the prevalence of PPD was 27%. Of these postnatal women, 44.5% were cared by their mother-in-law in the first month after delivery, 36.3% cared by own mother, 11.1% by “yuesao” or “maternity matron” and 8.1% by other relatives. No association was found between the main caregivers and the risk of PPD after multiple adjustments. Conclusions Although no association between the main caregivers and the risk of PPD during doing-the-month was identified, considering the increasing prevalence of PPD in Chinese women, and the contradictions between traditional culture and latest scientific evidence for some of the doing-the-month practices, public health interventions aim to increase the awareness of PPD among caregivers and family members are warranted.

To demonstrate the trends of hypercholesterolemia change in Shenzhen, China from 1997 to 2018. Participants were residents aged 18 to 69 years in Shenzhen, China, and were recruited using multi-stage cluster sampling. All participants were surveyed about their socio-demographics, lifestyle, occupation, mental health, and social support. Physical measurements and blood samples for subsequent measurements were collected according to a standardized protocol. A total of 26,621 individuals participated in the three surveys with 8,266 in 1997, 8,599 in 2009, and 9,756 in 2018. In both women and men, there was a significant downward linear trend in age-adjusted mean high-density lipoprotein-cholesterol (HDL-C) from 1997 to 2018 (women: 0.17 ± 0.06, p = 0.008 vs. men: 0.21 ± 0.04, p < 0.001). In contrast, the age-adjusted total triglycerides and total cholesterol in both sexes have demonstrated an increasing trend in the past two decades. However, no significant changes in age-adjusted low-density lipoprotein-cholesterol (LDL-C) in both men and women between 2009 and 2018 were found (women: 0.00 ± 0.02, p = 0.85 vs. men 0.02 ± 0.03, p = 0.34). The age-adjusted prevalence of hypercholesterolemia observed a rapid rise from 1997 to 2009 and appeared to be stabilized in 2018, which was similar to the trend of the prevalence of high total triglycerides in women. Changes in trends were varied by different types of lipids traits. Over the observed decades, there was a clear increasing trend of prevalence of low HDL-C (

BackgroundThe Spring Festival is one of the most important traditional festivals in China. This study aimed to estimate the mortality risk attributable to the Spring Festival.MethodsBetween 2013 and 2017, daily meteorological, air pollution, and mortality data were collected from 285 locations in China. The Spring Festival was divided into three periods: pre-Spring Festival (16 days before Lunar New Year's Eve), mid-Spring Festival (16 days from Lunar New Year's Eve to Lantern Festival), and post-Spring Festival (16 days after Lantern Festival). The mortality risk attributed to the Spring Festival in each location was first evaluated using a distributed lag nonlinear model (DLNM), and then it was pooled using a meta-analysis model.ResultsWe observed a dip/rise mortality pattern during the Spring Festival. Pre-Spring Festival was significantly associated with decreased mortality risk (ER: −1.58%, 95%CI: −3.09% to −0.05%), and mid-Spring Festival was unrelated to mortality risks, while post-Spring Festival was significantly associated with increased mortality risk (ER: 3.63%, 95%CI: 2.15–5.12%). Overall, a 48-day Spring Festival period was associated with a 2.11% (95%CI: 0.91–3.33%) increased mortality. We also found that the elderly aged over 64 years old, women, people with cardiovascular disease (CVD), and people living in urban areas were more vulnerable to the Spring Festival.ConclusionOur study found that the Spring Festival significantly increased the mortality risk in China. These findings suggest that it is necessary to develop clinical and public health policies to alleviate the mortality burden associated with the Spring Festival.

Objective: To estimate patient preferences for second-line antihyperglycemic medications in China.Methods: A face to face survey with the best-worst scaling (BWS) choices was administered in patients with diagnosed type 2 diabetes mellitus (T2DM). Study participants were asked to indicate which attribute they valued most and which attribute they valued least in 11 choice sets, each of which consisted of five alternatives out of 11 antihyperglycemic medication-specific attributes (treatment efficacy, weight change, hypoglycemic events, gastrointestinal side effects, cardiovascular health, urinary tract infection and genital infection side effects, edema, mode of administration, bone fracture, dosing frequency and out-of-pocket cost). A counting approach, a conditional logit model, and K-means clustering were used to estimate the relative importance of items and preference heterogeneity.Results: A total of 362 participants were included with a mean age of 63.6 (standard deviation: 11.8) years. There were 56.4% of participants were women, and 56.3% being diagnosed with diabetes for at least 5 years. Efficacy, cardiovascular health and hypoglycemic events were valued most, while dosing frequency, mode of administration and bone fracture were valued least. The K-means clustering further showed preference heterogeneity in out-of-pocket cost across the participants.Conclusion: Our study suggests that treatment efficacy, cardiovascular health and hypoglycemic events are valued most by Chinese patients with T2DM when selecting second-line antihyperglycemic medications. The study improves the understanding of patients’ preferences for second-line antihyperglycemic medications in China.

The drilling robot is the key equipment for pressure relief in rockburst mines, and the accurate recognition of a pressure relief hole is the premise for optimizing the layout of pressure relief holes and intelligent drilling. In view of this, a pressure relief hole recognition method for a drilling robot, based on single-image generative adversarial network (SinGAN) and improved faster region convolution neural network (Faster R-CNN), is proposed. Aiming at the problem of insufficient sample generation diversity and poor performance of the traditional SinGAN model, some improvement measures including image size adjustment, multi-stage training, and dynamically changing iteration times are designed as an improved SinGAN for the generation of pressure relief hole images. In addition, to solve the problem that the traditional depth neural network is not ideal for small-size target recognition, an improved Faster R-CNN based on multi-scale image input and multi-layer feature fusion is designed with the improved SqueezeNet as the framework, and the sample data collected from ground experiments are used for comparative analysis. The results indicate that the improved SinGAN model can improve the diversity of generated images on the premise of ensuring the quality of image samples, and can greatly improve the training speed of the model. The accuracy and recall rate of the improved Faster R-CNN model were able to reach 90.09% and 98.32%, respectively, and the average detection time was 0.19 s, which verifies the superiority of the improved Faster R-CNN model. To further verify the practicability of the proposed method, some field images were collected from the underground rockburst relief area in the coal mine, and a corresponding test analysis was carried out. Compared with three YOLO models, the accuracy and recall rate of improved Faster R-CNN model improved significantly, although the training time and recognition time increased to a certain extent, which proves the feasibility and effectiveness of the proposed method.

Introduction Cardiovascular diseases (CVDs) are the leading causes of death and disability worldwide. Reducing dietary salt consumption is a potentially cost-effective way to reduce blood pressure and the burden of CVD. To date, economic evidence has focused on sodium reduction in food industry or processed food with blood pressure as the primary outcome. This study protocol describes the planned within-trial economic evaluation of a low-sodium salt substitute intervention designed to reduce the risk of stroke in China.Methods and analyses The economic evaluation will be conducted alongside the Salt Substitute and Stroke Study: a 5-year large scale, cluster randomised controlled trial. The outcomes of interest are quality of life measured using the EuroQol-5-Dimensions and major adverse cardiovascular events. Costs will be estimated from a healthcare system perspective and will be sought from the routinely collected data available within the New Rural Cooperative Medical Scheme. Cost-effectiveness and cost-utility analyses will be conducted, resulting in the incremental cost-effectiveness ratio expressed as cost per cardiovascular event averted and cost per quality-adjusted life year gained, respectively.Ethics and dissemination The trial received ethics approval from the University of Sydney Ethics Committee (2013/888) and Peking University Institutional Review Board (IRB00001052-13069). Informed consent was obtained from each study participant. Findings of the economic evaluation will be published in a peer-reviewed journal and presented at international conferences.Trial registration number ClinicalTrials.gov Registry (NCT02092090).

Accurate recognition of coal-rock cutting state is a prerequisite for intelligent operation of shearer, so as to achieve safe and efficient production in coal mines. This paper takes the sound signal, Y-axis and Z-axis vibration signals as analytic objects and proposes a fusion recognition method for shearer coal-rock cutting state via the combination of improved radical basis function neural network (RBFNN) and Dempster-Shafer (D-S) evidence theory. First of all, on the basis of original fruit fly optimization algorithm (FOA), the location updating mechanism of moth-flame optimization (MFO) is used to improve the convergence performance and exploration ability of FOA. Thus, a hybrid optimization algorithm of MFO-FOA is accordingly designed and some simulations are conducted to verify the effectiveness and superiority. Then, the optimal network parameters of RBFNN are found out by using proposed MFO-FOA to realize the excellent generalization ability and predictive performance. Moreover, the collected signals are decomposed by variational mode decomposition, and the envelope entropy and kurtosis are used to extract the features of first three intrinsic mode function components. The feature vectors obtained from three-type sensor data are utilized to construct the RBFNN classifiers. Besides, the D-S evidence theory with evidence correlation coefficient is introduced to fuse the preliminary identification results of three RBFNN classifiers. Finally, a self-designed experimental platform for shearer cutting coal-rock is built and some experiments are provided. The experimental results based on measured data demonstrate that the proposed method can effectively identify the coal-rock cutting state with higher accuracy.

This paper assessed the transition probabilities between the stages of hypertension severity and the length of time an individual might spend at a particular disease state using the new American College of Cardiology/American Heart Association hypertension blood pressure guidelines. Data for this study were drawn from the Ghana WHO SAGE longitudinal study, with an analytical sample of 1884 across two waves. Using a multistate Markov model, we estimated a seven-year transition probability between normal/elevated blood pressure (systolic ≤ 129 mm Hg & diastolic

Exercise therapy including endurance training and resistance training is a promising non-pharmacological therapy in patients with multiple sclerosis (MS). Recent studies have revealed that exercise exerts beneficial impacts on gut microbiota. However, the role of gut microbiota in the immune benefits of strength exercise (SE; one of resistance training) in central nervous system (CNS) autoimmunity is barely known. Here, we observed that 60-min SE ameliorated disease severity and neuropathology in experimental autoimmune encephalomyelitis (EAE), an animal model of MS. SE increased the abundance and diversity of the gut microbiota, and decreased Firmicutes/Bacteroidetes ratio (F/B ratio) and intestinal mucosal permeability, and enrichment of several short-chain fatty acid (SCFA)-producing bacteria. Furthermore, SE reduced Th17 responses and increased Treg responses in the small intestine lymphoid tissues. Compared to the control group, microbiota-depleted mice receiving SE microbiome fecal transplants had lower disease severity and neuropathology scores. These results uncovered a protective role of SE in neuroimmunomodulation effects partly via changes to the gut microbiome.

Our research examines the development of social health insurance (SHI) in Vietnam between 1992 and 2016 and SHI's role as a financial mechanism towards achieving universal health coverage (UHC). We reviewed and analysed legislation from the Government of Vietnam (GoV) and performance data from the GoV and the World Bank. Stages of development were identified from legislative change leading to change in SHI functioning as a public financing mechanism: revenue collection, pooling of risk, and purchasing. Movement towards UHC was assessed relative to: population coverage, benefit coverage, and financial protection. Vietnam has implemented SHI through five stages: Stage I (1992–1998), Stage II (1998–2005), Stage III (2005–2008), Stage IV (2008–2014), and Stage V (2014 onwards). Coverage has widened from a compulsory scheme for civil servants and pensioners and a voluntary scheme for others, to a scheme that targets the entire population. However, UHC has not been achieved with 19% of the population uninsured in 2016 and high out-of-pocket payments. The benefit package includes a wide range of services and many expensive medications and considered to be generous. It is recommended that Vietnam focus on improving population coverage rather than further expanding the benefit package to achieve UHC.

Anti-leucine-rich glioma-inactivated 1 (anti-LGI1) encephalitis is a rare autoimmune encephalitis (AE). We investigated the clinical features and gut microbial alterations of anti-LGI1 encephalitis. Fifteen patients newly diagnosed with anti-LGI1 encephalitis were recruited in the study prior to the administration of immunotherapy. The control group contains 25 well-matched healthy controls (HCs). All participants were Han Chinese from South China. Their clinical data and fecal samples were collected. The diversity and composition of gut microbiota were analyzed by 16S ribosomal RNA (16S rRNA) gene sequencing. The results showed that anti-LGI1 encephalitis was characterized by cognitive impairment, faciobrachial dystonic seizures, hyponatremia, and psychiatric symptoms. Abnormal EEG and brain MRI were presented in 9 and 10 patients, respectively. Compared to HCs, the anti-LGI1 encephalitis patients exhibited a decreased microbial diversity and an altered overall composition of gut microbiome. At the phylum level, anti-LGI1 encephalitis patients exhibited a higher abundance of Proteobacteria and a lower abundance of Firmicutes. The alterations in the phylum level were associated with autoimmune and inflammatory disorders. At the genus level, there was an increase in Sphingomonas, Anaerofustis, Succinvibrio, Clostridium, and SMB53 (genera related to movement disorders, psychiatric diseases, and with proinflammatory effects). However, the Faecalibacterium, Roseburia, Lachnospira, Ruminococcus, and Blautia [genera with ability to produce short-chain fatty acids (SCFAs)] were obviously reduced in the patient group. Our results suggest that anti-LGI1 encephalitis is characterized by special clinical features and is accompanied by alterations in specific gut microbiota. For the limited sample size and non-applicability to other populations, further studies are warranted to explore the relationships between gut microbiota and anti-LGI1 encephalitis.

ObjectiveThe Da Qing Diabetes Prevention program (DQDP) was a randomized lifestyle modification intervention conducted in 1986 for the prevention and control of type 2 diabetes in individuals with impaired glucose tolerance. The current study estimated long-term cost-effectiveness of the program based on the health utilities from the Chinese population.MethodsA Markov Monte Carlo model was developed to estimate the impact of the intervention from the healthcare system perspective. The analysis was run over 30-year and lifetime periods and costs were estimated respectively as health management service costs. Baseline characteristics and intervention effects were assessed from the DQDP. Utilities and costs were generated from relevant literature. The outcome measures were program cost per quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio (ICER) of the intervention. Sensitivity analyses and threshold analyses were performed.ResultsUsing a 30-year horizon, the intervention strategy was cost-saving and was associated with better health outcomes (increase of 0.74 QALYs per intervention participant). Using a lifetime horizon, the intervention strategy was cost-saving and was associated with additional 1.44 QALYs. Sensitivity analyses showed that the overall ICER was most strongly influenced by the hazard ratio of cardiovascular disease event.ConclusionsThe Da Qing lifestyle intervention in a Chinese population with impaired glucose tolerance is likely to translate into substantial economic value. It is cost-saving over a 30-year time and lifetime frame.