Survival After Out-of-Hospital Cardiac Arrest Before and After Legislation for Bystander CPR.

Importance: The lack of evidence-based implementation strategies is a major contributor to increasing mortality due to out-of-hospital cardiac arrest (OHCA) in developing countries with limited resources. Objective: To evaluate whether the implementation of legislation is associated with increased bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use and improved clinical outcomes for patients experiencing OHCA and to provide policy implications for low-income and middle-income settings. Design, Setting, and Participants: This observational cohort study analyzed a prospective city registry of patients with bystander-witnessed OHCA between January 1, 2010, and December 31, 2022. The Emergency Medical Aid Act was implemented in Shenzhen, China, on October 1, 2018. An interrupted time-series analysis was used to assess changes in outcomes before and after the law. Data analysis was performed from May to October 2023. Exposure: The Emergency Medical Aid Act stipulated the use of AEDs and CPR training for the public and provided clear legal guidance for OHCA rescuing. Main Outcomes and Measures: The primary outcomes were rates of bystander-initiated CPR and use of AEDs. Secondary outcomes were rates of prehospital return of spontaneous circulation (ROSC), survival to arrival at the hospital, and survival at discharge. Results: A total of 13 751 patients with OHCA (median [IQR] age, 59 [43-76] years; 10 011 men [72.83%]) were included, with 7858 OHCAs occurring during the prelegislation period (January 1, 2010, to September 30, 2018) and 5893 OHCAs occurring during the postlegislation period (October 1, 2018, to December 31, 2022). The rates of bystander-initiated CPR (320 patients [4.10%] vs 1103 patients [18.73%]) and AED use (214 patients [4.12%] vs 182 patients [5.29%]) increased significantly after legislation implementation vs rates before the legislation. Rates of prehospital ROSC (72 patients [0.92%] vs 425 patients [7.21%]), survival to arrival at the hospital (68 patients [0.87%] vs 321 patients [5.45%]), and survival at discharge (44 patients [0.56%] vs 165 patients [2.80%]) were significantly increased during the postlegislation period. Interrupted time-series models demonstrated a significant slope change in the rates of all outcomes. Conclusions and Relevance: These findings suggest that implementation of the Emergency Medical Aid Act in China was associated with increased rates of CPR and public AED use and improved survival of patients with OHCA. The use of a systemwide approach to enact resuscitation initiatives and provide legal support may reduce the burden of OHCA in low-income and middle-income settings.

Progress towards health equity in Vietnam: evidence from nationwide official health statistics, 2010-2020.

INTRODUCTION: One of the ultimate goals of strengthening the health system is to achieve health equity. Vietnam is considered one of the 'fast-track countries' to achieve the health-related Millennium Development Goals, but research on its equity strategies remains inadequate. METHODS: Using Vietnamese official health statistics, we investigated inequity in four dimensions including health resources, service delivery, service utilisation and residents' health status from the perspectives of income levels, poverty rates and subnational regions. The Slope Index of Inequality, concentration curve/Concentration Index, absolute difference and Theil Index were used. RESULTS: Four indicators showed 'pro-poor' inequality in health resources, including the per capita health budget, per capita health personnel, per capita health personnel at the community level and per capita hospital beds at the community level, while provincial hospital beds showed 'pro-rich' inequality. Two health service delivery indicators (delivery of antenatal care ≥3 times and proportion of community health service centres with medical doctors) show 'pro-rich' inequality, although two health status indicators, mortality and malnutrition rates for children under five, showed 'pro-poor' inequality. The Northern Midlands and Mountain Areas, and the Central Highlands were disadvantaged regarding service delivery and health status. Intraregional differences were the main factors contributing to the inequalities in delivery of antenatal care ≥3 times, provincial hospital beds and percentage of community health centres with medical doctors, with the Red River Delta and the South East region experiencing the greatest inequalities. CONCLUSION: The overall level of health equity in Vietnam has increased over the past decade, although inequality in health service delivery has hindered progress towards health equity based on income, poverty and subnational regions. Targeted policies need to be introduced to reduce inequities relating to the health workforce and service delivery capacity.

Effect of epoxy value on the rheological properties and microcosmic mechanism of WER emulsified asphalt.

Waterborne epoxy resin (WER), a cleaning material with exceptional high-temperature resistance, has attracted much attention to modify emulsified asphalt in the pavement material field. Epoxy value is the critical characteristic index of WER. In this research, three WER with the epoxy values of 0.20 eq/100g, 0.44 eq/100g, and 0.51 eq/100g were utilized as asphalt modifiers. The influence of epoxy value on WER-EA was investigated by comparing the rheological properties of three kinds of WER emulsified asphalt (WER-EA). The modification mechanism of WER-EA has been analyzed using FTIR and SEM. The results demonstrate that different WER-EA resulted in significantly different rheological properties. WER-EA with the epoxy value of 0.20 eq/100g (E20) performed best at high temperatures, with a maximum increase of 17477% in G*/sinδ compared to the neat asphalt and a maximum increase of 66.3% in G*/sinδ compared to the other two WER-EA. WER-EA with 0.44 eq/100g epoxy value (E44) performed best at low temperatures, with a maximum increase in m value of 39.4% and a maximum decrease in S value of 33.3% compared to the other two WER-EA. In addition, the interpenetrating polymer network (IPN) in E20 was observed to be more solid and stable, and IPN in E44 was more uniform. To summarize, lower epoxy value led to a higher degree of WER reaction and higher content of rigid groups, which is more conducive to optimizing the high-temperature property of WER-EA. WER with moderate epoxy value resulted in a low content of polar bonds and thus high content of flexible segments, which helps emulsified asphalt to form a more uniform IPN.

Three-Dimensional Reconstruction for the Whole Lung with Early Multiple Pulmonary Nodules.

For patients with early multiple pulmonary nodules, it is essential, from a diagnostic perspective, to determine the spatial distribution, size, location, and relationship with surrounding lung tissue of these nodules throughout the entire lung. This is crucial for identifying the primary lesion and developing more scientifically grounded treatment plans for doctors. However, pattern recognition methods based on machine vision are susceptible to false positives and false negatives and, therefore, cannot fully meet clinical demands in this regard. Visualization methods based on maximum intensity projection (MIP) can better illustrate local and individual pulmonary nodules but lack a macroscopic and holistic description of the distribution and spatial features of multiple pulmonary nodules. Therefore, this study proposes a whole-lung 3D reconstruction method. It extracts the 3D contour of the lung using medical image processing technology against the background of the entire lung and performs 3D reconstruction of the lung, pulmonary artery, and multiple pulmonary nodules in 3D space. This method can comprehensively depict the spatial distribution and radiological features of multiple nodules throughout the entire lung, providing a simple and convenient means of evaluating the diagnosis and prognosis of multiple pulmonary nodules.

Establishment of Functional PCR-Based Markers against Bacterial Leaf Blight Disease in Rice Landraces of Yunnan Province of China.

Bacterial leaf blight is a devastating disease of rice worldwide. The resistant genes are routinely transferred from landraces to cultivated varieties through backcross breeding along with marker-assisted selection. In the present study, we use the gene-specific markers to screen the rice landraces in Yunnan Province of China. We collected 404 representative samples of 24 different rice landraces from Yunnan Province of China. The initial PCR-based screening suggested that the leaf blight resistance was not evenly distributed in Yunnan Province. Our results indicate that there is a complete loss of resistance for landraces based on xa5 and xa13 genes. On the other hand, landraces harboring Xa7 and Xa21 showed a high level of resistance. Using gene-specific PCR-based data, we were able to identify the resistant, susceptible and heterozygous populations across Yunnan Province. The widely used Xa21 gene alone showed a remarkable level of resistance throughout the province, indicating its potential to develop broad-spectrum resistance in rice germplasm. The key aspects of bacterial blight spread according to local sites in Yunnan Province and the resistance conferred by different landraces due to the presence of different resistance genes are discussed.

Inequity of maternal-child health services in ASEAN member states from 1993 to 2021.

INTRODUCTION: Inequity in maternal-child health services is a challenge to global health as it hinders the achievement of Sustainable Development Goals (SDGs) and Universal Health Coverage. Though the Association of Southeast Asian Nations (ASEAN) has made remarkable achievements in maternal-child health, there remain gaps in reaching global goals. This study aimed to compare and investigate the inequity in maternal-child health (MCH) services in ASEAN member states to help guide policy decisions to improve equitable health services in the SDG era and beyond. METHODS: Using the WHO Health Inequality Monitor, we identified inequity summary measures for five MCH services in ASEAN member states from 1993 to 2021: antenatal care, births attended by skilled health personnel, diphtheria, tetanus and pertussis (DTP3) immunization, measles immunization, and polio immunization. We divided the analysis dimension of inequity into urban-rural inequity, economic status inequity, and sub-regional inequity. Trends of absolute and relative inequity in every dimension of MCH services in ASEAN member states were examined with the principal component analysis (PCA). RESULTS: The mean coverages of MCH services are 98.80% (Thailand), 86.72% (Cambodia), 84.54% (Viet Nam), 78.52 (Indonesia), 76.94% (Timor-Leste), 72.40% (Lao PDR), 68.10% (Philippines) and 48.52% (Myanmar) in 2021. Thailand have the lowest MCH services absolute inequity indexes of -1.945, followed by Vietnam (-1.449). Lao PDR and Myanmar have relatively higher MCH services absolute inequity indexes of 0.852 and 0.054 respectively. The service in Cambodia, Indonesia, and the Philippines is pro-specific regions (with subnational region absolute inequity indexes of -0.02, 0.01, and 1.01 respectively). The service in Myanmar is pro-rich (with economic status absolute inequity index of 0.43). The service in Lao PDR and Timor-Leste is pro-urban areas, pro-rich, and pro-specific regions. CONCLUSION: The inequity of MCH services in ASEAN persists but is in a declining trend. Thailand and Vietnam have performed well in ensuring MCH services equity, while Laos and Myanmar are still facing serious inequity dilemmas. The progress of MCH service equity in Myanmar, Cambodia, the Philippines, and Indonesia is uneven. It is acceptable to learn from the successful experiences of Thailand and Vietnam to improve the equities in other ASEAN countries. Policies should be developed according to the specific types of MCH inequity in member states to improve equity levels.

High frequency measurement of carbon emissions based on power big data: A case study of Chinese Qinghai province.

In this paper, we build the electricity­carbon model with techniques of frequency transformation, and statistical modeling. With macro statistical data released by Statistics Bureau of Qinghai Province and high-frequency power big data provided by State Grid Qinghai Electric Power Company, based on the electricity­carbon model we apply the inventory method to measure the monthly carbon emissions of Qinghai Province and its prefectural-level cities, as well as its industry, construction, and other five industries. Additionally, we apply the same method to measure the emission reduction contribution of green power by using the data of proportion of "green power". The results show that first there is a "double imbalanced" phenomenon for the distribution of Qinghai's carbon emissions, which means that the distribution of carbon emissions of Qinghai's prefectural-level cities is imbalanced and the distribution of carbon emissions of Qinghai's industries is also imbalanced. Second, the emission reduction effect of "green power" is significant. And the quantity of its reduction accounts for 54 % of Qinghai's total emission. Third, in comparison with the seven institutions' relative error rate which is about 7 % for measuring China's carbon emissions, our results are reliable.

Mechanism and security of UV driven sodium percarbonate for sulfamethoxazole degradation using DFT and metabolomic analysis.

Recently, sodium percarbonate (SPC) as a solid substitute for H2O2 has aroused extensive attention in advanced oxidation processes. In current work, the degradation kinetics and mechanisms of antibiotic sulfamethoxazole (SMX) by ultraviolet (UV) driven SPC system were explored. The removal efficiency of SMX was enhanced as the increasing dosage of SPC. Moreover, hydroxyl radical (•OH), carbonate radical (CO3•-) and superoxide radical (O2•-) were verified to be presented by scavenger experiments and •OH, CO3•- exhibited a significant role in SMX degradation. Reactions mediated by these radicals were affected by anions and natural organic matters, implying that an incomplete mineralization of SMX would be ubiquitous. The screening four intermediates and transformation patterns of SMX were verified by DFT analysis. Metabolomic analysis demonstrated that a decreasing negative effect in E. coli after 24 h exposure was induced by intermediates products. In detail, SMX interfered in some key functional metabolic pathways including carbohydrate metabolism, pentose and glucuronate metabolism, nucleotide metabolism, arginine and proline metabolism, sphingolipid metabolism, which were mitigated after UV/SPC oxidation treatment, suggesting a declining environmental risk of SMX. This work provided new insights into biological impacts of SMX and its transformation products and vital guidance for SMX pollution control using UV/SPC technology.

Temporal trends in the burden of non-communicable diseases in countries with the highest malaria burden, 1990-2019: Evaluating the double burden of non-communicable and communicable diseases in epidemiological transition.

BACKGROUND: Non-communicable diseases (NCDs) are rapidly increasing in sub-Saharan African countries, where 96% of global malaria deaths occur. This study aimed to investigate the disease burden of NCDs in countries with the current highest malaria mortality. METHODS: Data for this study were obtained from the Global Burden of Disease 2019 study (1990-2019). We selected the ten countries with malaria's highest age-standardised mortality rate (ASMR) and identified and ranked the five NCDs with the highest ASMR in each country. Measures of the NCDs disease burden included ASMR, age-standardised disability-adjusted life-years (DALY), years of life lost (YLL) and years lost due to a disability (YLD). The Estimated annual percentage change (EAPC) was used to examine the trends of the NCDs disease burden from 1990 to 2019. RESULTS: As of 2019, the ASMR of chronic liver disease, kidney disease, diabetes mellitus, Alzheimer's disease and other dementias, hypertensive heart disease and stroke were higher than the global average. From 1990 to 2019, the ASMR for Alzheimer's disease and other dementias, type II diabetes mellitus, and chronic kidney disease increased by 3.0%, 10.8%, 13.3%, and the age-standardised DALY rate increased by 3.7%, 27.6%, 6.3%, and the increases tended to be in younger populations. CONCLUSION: The double burden of non-communicable and communicable diseases is crippling the health systems of many sub-Saharan African countries and is often neglected. The prevention, surveillance, and control of diseases require an integrated strategy, with governments and non-government organisations aligned and supported by the global initiative.

Voting with Their Thumbs: Assessing Communication Technology Use by Medical, Nursing, Midwifery, and Allied Health Clinicians.

BACKGROUND: Timely multidisciplinary communication is crucial to prevent patient harm related to miscommunication of clinical information. Many health care organizations provide secure communications systems; however, clinicians often use unapproved platforms on personal devices to communicate asynchronously. OBJECTIVE: The aim of the study is to assess clinical communication behaviors by clinicians in a hospital setting. METHODS: Medical, nursing and allied health staff working across seven hospital sites of a large health care organization were invited to complete an anonymous survey on the methods, behaviors, and rationale for clinical communication technology use. The survey included questions on communication methods used by clinicians for intra- and inter-disciplinary communication and sending and receiving clinical information or images. Demographics and qualitative comments were also collected. RESULTS: A total of 836 surveys were completed (299 medical, 317 nursing, and 220 allied health staff). Staff in all clinical groups reported using an unapproved messaging platform to communicate patient information more than three times per day (medical staff n = 167, 55.9%; nursing staff n = 106, 33.4%; allied health staff n = 67, 30.5%). Not one medical staff member indicated they only use the approved methods (n = 0, 0%) while one-third of nursing and allied health respondents only used approved methods (n = 118, 37.2% and n = 64, 29.1%, respectively). All clinician groups reported wasted time from communications sent with missing information, or time spent waiting for responses for further information. Qualitative comments expressed dissatisfaction and frustration with current clinical communication methods and a desire for improved systems. CONCLUSION: Workarounds are being used by all clinician groups to send text and image clinical communications. There are high levels of dissatisfaction with this situation and clinicians are keen for consistency and to have the right tools available. There is a need to ensure standardized clinical communication methods and approved digital platforms are in place and utilized to provide safe, high-quality patient care.

Multimodal neuroimage data fusion based on multikernel learning in personalized medicine.

Neuroimaging has been widely used as a diagnostic technique for brain diseases. With the development of artificial intelligence, neuroimaging analysis using intelligent algorithms can capture more image feature patterns than artificial experience-based diagnosis. However, using only single neuroimaging techniques, e.g., magnetic resonance imaging, may omit some significant patterns that may have high relevance to the clinical target. Therefore, so far, combining different types of neuroimaging techniques that provide multimodal data for joint diagnosis has received extensive attention and research in the area of personalized medicine. In this study, based on the regularized label relaxation linear regression model, we propose a multikernel version for multimodal data fusion. The proposed method inherits the merits of the regularized label relaxation linear regression model and also has its own superiority. It can explore complementary patterns across different modal data and pay more attention to the modal data that have more significant patterns. In the experimental study, the proposed method is evaluated in the scenario of Alzheimer's disease diagnosis. The promising performance indicates that the performance of multimodality fusion via multikernel learning is better than that of single modality. Moreover, the decreased square difference between training and testing performance indicates that overfitting is reduced and hence the generalization ability is improved.

Application Based on Artificial Intelligence in Substation Operation and Maintenance Management.

To fulfill state grid Industry's demands for smart and digitized business growth, traditional technological approaches have fallen short. Artificial intelligence (AI) technology enables coming up with solutions because electricity business types and volumes are constantly expanding and developing. Intelligent automation was a part of China's smart grid development from the outset, and it continues to grow in the country's electricity system. Smart substation operations and maintenance could benefit from the use of this system. There are new technological tools and theoretical concepts for the repair and control of power equipment owing to AI's advancements in performance, accuracy, and self-learning capacity in the detection, forecasting, improvement, and judgment jobs. Substation operations and maintenance management are examined in this research using a new hybridized convolutional neural network and tweaked long short-term memory (HCNN-TLSTM) technique. Normalization is used to gather and preprocess the data immediately. Kernel-based linear discriminant analysis (K-LDA) is used to extract the features. A substation's functioning and maintenance can then be investigated using the new approach. The genetic algorithm (GA) is used to improve the effectiveness of the proposed method. Finally, the presented technique's performance is analyzed and compared with specific current models to achieve the largest performance in the proposed method for the management of substation operation and upkeep.

Adoption of mobile health services using the unified theory of acceptance and use of technology model: Self-efficacy and privacy concerns.

Mobile health (mHealth) services have been widely used in medical services and health management through mobile devices and multiple channels, such as smartphones, wearable equipment, healthcare applications (Apps), and medical platforms. However, the number of the users who are currently receiving the mHealth services is small. In China, more than 70% of internet users have never used mHealth services. Such imbalanced situation could be attributed to users' traditional concept of medical treatment, psychological factors (such as low self-efficacy) and privacy concerns. The purpose of this study is to explore the direct and indirect effects of mHealth users' self-efficacy and privacy concerns on their intention to adopt mHealth services, providing guidelines for mHealth service providers to enhance users' intention of adoption. A questionnaire was designed by the research team and 386 valid responses were collected from domestic participants in China. Based on the unified theory of acceptance and use of technology (UTAUT) model, a research model integrated self-efficacy and privacy concerns was constructed to investigate their effects on users' intention to adopt mobile mHealth services. The results show that self-efficacy could facilitate users' intention to adopt mHealth services, and had a significantly positive effect on perceived ubiquity, effort expectancy, performance expectancy and subjective norm. This study verifies the direct and indirect effects of self-efficacy and privacy concerns on users' intention to adopt mHealth services, providing a different perspective for studying mHealth adoption behavior. The findings could provide guidelines for mHealth service providers to improve their service quality and enhance users' intention of adoption.

Network analysis of posttraumatic stress disorder symptoms among adolescent survivors of a major disaster in China.

Objective: Children and adolescents are found to be more vulnerable to developing PTSD than adults over time after major disasters. This study aims to investigate the network structures of PTSD and the directions of relationships between symptoms among adolescent survivors in the year after the Yancheng Tornado in China. Method: A total of 395 youth survivors completed the Child PTSD Symptom Scale (Foa et al., 2001) at 3 months and 12 months following the tornado. Network analysis was used to compare networks of PTSD symptoms and changes over time. Results: Different centrality symptoms existed at different time points. Anger, startle responses, and physiological reactivity were important to the maintenance of PTSD symptoms arising from the tornado at 3 months, while dreams/nightmares and distancing/avoidance were important to maintaining PTSD symptoms at 12 months. Analysis suggested that sleep difficulty and intrusive thoughts were the key PTSD symptoms to be treated at 3 months; sleep remained to be the key symptoms to be treated at 12 months. Conclusions: Our findings suggest that sleep difficulty could be a main cause of other symptoms and trigger the entire symptom system into undesirable psychopathological development among adolescent survivors in the year following major disasters. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Influence of Avoidant Coping on Posttraumatic Stress Symptoms and Job Burnout Among Firefighters: The Mediating Role of Perceived Social Support.

OBJECTIVE: The study aims to explore the effects of avoidant coping on posttraumatic stress symptoms (PTSS) and job burnout among firefighters, and to examine the mediating role of perceived social support on the relationship between avoidant coping and PTSS and job burnout. METHOD: Assessments including the posttraumatic stress disorder checklist for DSM-5 (PCL-5), Maslach Burnout Inventory-General Survey (MBI-GS), Coping Style Inventory (CSI), and Perceived Social Support Scale (PSSS) were conducted among 431 firefighters studying in a school specializing in training firemen in Nanjing, China. RESULT: The results show that: (1) Avoidant coping was positively related to PTSS and job burnout among firefighters; and (2) avoidant coping was positively related to PTSS and job burnout through the mediating effect of perceived social support. CONCLUSION: These findings not only provide guiding information for relevant departments to prevent mental health issues of firefighters in the future, but also enlighten the psychological intervention for firefighters, that is, to encourage firefighters to actively face and solve problems and adopt positive coping styles, as well as offer them more care and support whenever possible.

Disparities in COVID-19 Vaccination among Low-, Middle-, and High-Income Countries: The Mediating Role of Vaccination Policy.

Inequity in the access to and deployment of the coronavirus disease 2019 (COVID-19) vaccines has brought about great challenges in terms of resolving the pandemic. Aiming to analyze the association between country income level and COVID-19 vaccination coverage and explore the mediating role of vaccination policy, we conducted a cross-sectional ecological study. The dependent variable was COVID-19 vaccination coverage in 138 countries as of May 31, 2021. A single-mediator model based on structural equation modeling was developed to analyze mediation effects in different country income groups. Compared with high-income countries, upper-middle- (ß = -1.44, 95% CI: -1.86--1.02, p < 0.001), lower-middle- (ß = -2.24, 95% CI: -2.67--1.82, p < 0.001), and low- (ß = -4.05, 95% CI: -4.59--3.51, p < 0.001) income countries had lower vaccination coverage. Vaccination policies mediated 14.6% and 15.6% of the effect in upper-middle- (ß = -0.21, 95% CI: -0.39--0.03, p = 0.020) and lower-middle- (ß = -0.35, 95% CI: -0.56--0.13, p = 0.002) income countries, respectively, whereas the mediation effect was not significant in low-income countries (ß = -0.21, 95% CI: -0.43-0.01, p = 0.062). The results were similar after adjusting for demographic structure and underlying health conditions. Income disparity remains an important cause of vaccine inequity, and the tendency toward "vaccine nationalism" restricts the functioning of the global vaccine allocation framework. Stronger mechanisms are needed to foster countries' political will to promote vaccine equity.

The symptom structure of posttraumatic stress disorder and co-morbid depression among college students with childhood abuse experience: A network analysis.

BACKGROUND: Posttraumatic stress disorder (PTSD) and depression are highly co-morbid among individuals with childhood abuse history, while the mechanism of the co-morbidity is highly debated. This study sought to extent the work among college students with network analysis, which is a novel method that sees the co-morbidity from a symptom interacting perspective. METHODS: Data was collected from 476 college students who were assessed to have childhood abuse history, PTSD and depression at the same time, using Childhood Trauma Questionnaire- Short Form, PTSD Checklist for DSM-5 and The Center for Epidemiological Studies Depression. We created a Graphical Gaussian Model (GGM) network to show associations between symptom pairs and a Directed Acyclic Graph (DAG) to estimate potential casual relationships among symptoms. RESULTS: The GGM network was reliably stable, feeling sad (Depression) and trouble experiencing positive feelings (PTSD) were the most central nodes. Trouble experiencing positive feelings and several negative affect symptoms, sleep problems and difficulty in concentrating were acting as important bridging nodes. The DAG network suggested the key triggering roles of exaggerated startle (PTSD) and several re-experiencing symptoms. LIMITATIONS: The study used cross-sectional data and self-reported measures. Results from network analysis could be affected by scale factors and contain spurious correlations. CONCLUSIONS: In the childhood-abuse-related co-morbid structure, several negative affect symptoms both in PTSD and depression have pivotal roles, hyper-arousal symptoms and re-experiencing symptoms could trigger the co-morbid structure. Illustrating the strength and limitations of network analysis, this study help target the potentially influential symptoms for better clinical intervention.

Predicting Posttraumatic Stress and Depression Symptoms Among Frontline Firefighters in China.

To investigate the prevalence and comorbidity rate of potential posttraumatic stress disorder (PTSD) and depression in frontline firefighters in China, as well as to analyze the related predictive factors for PTSD and depression, our study included 261 firefighters who completed assessments including the Demographic Data Forum, PTSD Checklist for DSM-5, Center for Epidemiological Studies Depression Scale, Chinese version of Perceived Stress Scale, and Perceived Social Support Scale. Among the participants, 1.9% and 11.9% were identified as having potential PTSD and depression, respectively. There was a 9.1% chance of comorbid PTSD among the depressed firefighters and a 60% chance of comorbid depression among the firefighters with PTSD. Perceived stress positively predicted both PTSD and depression; perceived social support negatively predicted both PTSD and depression. Whereas family exogenous support predicted both PTSD and depression, family endogenous support only predicted depression. In addition, PTSD was predicted by rank. Soldiers and sergeants demonstrated higher level of PTSD than officers. Future studies on mental health of firefighters should take factors like perceived stress, social support, and rank into consideration.

Attitude Trajectory Optimization to Ensure Balance Hexapod Locomotion.

This paper proposes a simple attitude trajectory optimization method to enhance the walking balance of a large-size hexapod robot. To achieve balance motion control of a large-size hexapod robot on different outdoor terrains, we planned the balance attitude trajectories of the robot during walking and introduced how leg trajectories are generated based on the planned attitude trajectories. While planning the attitude trajectories, high order polynomial interpolation was employed with attitude fluctuation counteraction considered. Constraints that the planned attitude trajectories must satisfy during walking were well-considered. The trajectory of the swing leg was well designed with the terrain attitude considered to improve the environmental adaptability of the robot during the attitude adjustment process, and the trajectory of the support leg was automatically generated to satisfy the demand of the balance attitude trajectories planned. Comparative experiments of the real large-size hexapod robot walking on different terrains were carried out to validate the effectiveness and applicability of the attitude trajectory optimization method proposed, which demonstrated that, compared with the currently developed balance motion controllers, the attitude trajectory optimization method proposed can simplify the control system design and improve the walking balance of a hexapod robot.