Real-world effectiveness of a new powered stapling system with gripping surface technology on the intraoperative clinical and economic outcomes of gastrectomy for gastric cancer.

BACKGROUND: Surgical staplers have been widely used to facilitate surgeries, and this study aimed to examine the real-world effectiveness of a new powered stapling system with Gripping Surface Technology (GST) on intraoperative outcomes of gastrectomy for gastric cancer. METHOD: The data were extracted from the Fourth Hospital of Hebei Medical University's (FHHMU) medical records system. Participants (N = 121 patients) were classified into the GST (n = 59) or non-GST group (n = 62), based on the use of the GST system. The intraoperative outcomes such as bleeding were assessed by reviewing video records. T-tests, Chi-square tests, and Mann-Whitney-U tests were used to compare the baseline characteristics between groups. Multivariate logistic regression was conducted for adjusting outcomes to study the effect of variables. RESULTS: Compared with the non-GST group, the GST group had significantly lower risks for intraoperative bleeding, intraoperative anastomosis intervention rate, intraoperative suture, and intraoperative pression (aORs: 0.0853 (p < 0.0001), 0.076 (p = 0.0003), 0.167 (p = 0.0012), and 0.221 (p = 0.0107), respectively). The GST group also consumed one fewer cartridge than the non-GST group (GST:5 vs non-GST: 6, p = 0.0241). CONCLUSION: The use of the GST system was associated with better intraoperative outcomes and lower cartridge consumption in Chinese real-world settings.

Machine learning models for abstract screening task - A systematic literature review application for health economics and outcome research.

OBJECTIVE: Systematic literature reviews (SLRs) are critical for life-science research. However, the manual selection and retrieval of relevant publications can be a time-consuming process. This study aims to (1) develop two disease-specific annotated corpora, one for human papillomavirus (HPV) associated diseases and the other for pneumococcal-associated pediatric diseases (PAPD), and (2) optimize machine- and deep-learning models to facilitate automation of the SLR abstract screening. METHODS: This study constructed two disease-specific SLR screening corpora for HPV and PAPD, which contained citation metadata and corresponding abstracts. Performance was evaluated using precision, recall, accuracy, and F1-score of multiple combinations of machine- and deep-learning algorithms and features such as keywords and MeSH terms. RESULTS AND CONCLUSIONS: The HPV corpus contained 1697 entries, with 538 relevant and 1159 irrelevant articles. The PAPD corpus included 2865 entries, with 711 relevant and 2154 irrelevant articles. Adding additional features beyond title and abstract improved the performance (measured in Accuracy) of machine learning models by 3% for HPV corpus and 2% for PAPD corpus. Transformer-based deep learning models that consistently outperformed conventional machine learning algorithms, highlighting the strength of domain-specific pre-trained language models for SLR abstract screening. This study provides a foundation for the development of more intelligent SLR systems.

[Effects of Pesticides Use on Pesticides Residues and Its Environmental Risk Assessment in Xingkai Lake（China）].

Xingkai Lake, located in Heilongjiang Province, is an important fishery and agricultural base and is seriously polluted by agricultural non-point sources. To clarify the residual status of many pesticides in the surface water of Xingkai Lake, 27 types of pesticides, herbicides, and their degradation products were analyzed in rice paddy, drainage, and surface water around Xingkai Lake (China) during the rice heading and maturity periods. The results showed that all 27 types of pesticides, herbicides, and their degradation products were detected during the rice heading period, and the total concentration ranged from 247.97 to 6 094.49 ng·L-1. Additionally, 25 species were detected during the rice maturity period, and the total concentration ranged from 485.36 to 796.23 ng·L-1. In comparison, more pesticides, herbicides, and derived degradation products were detected during the heading period, and their total concentration was higher as well. During the rice heading period, atrazine, simetryn, and paclobutrazol were the main detected pesticides, atrazine and isoprothiolane were the main pesticides detected during the maturity period. The distribution characteristics of pesticides and herbicides in the surface water around Xingkai Lake (China) was similar to that in drainage, so they were probably imported from the drainage and rice paddy. The average risk quotient (RQ) values of atrazine, simetryn, prometryn, butachlor, isoprothiolane, and oxadiazon were higher than 0.1 in drainage and Xingkai Lake (China), which showed a potential risk to aquatic organisms.

Acute effects of different Tai Chi practice protocols on cardiac autonomic modulation.

Tai Chi serves as an effective exercise modality for enhancing autonomic regulation. However, a majority of existing studies have employed the single routine (SR) protocol as the basis for health interventions. The extent to which the gong routine application (GRA) protocol achieves similar levels of exercise load stimulation as traditional single practice routines remains uncertain. Therefore, this study the distinct characteristics of autonomic load stimulation in these different protocols, thus providing a biological foundation to support the development of Tai Chi health promotion intervention programs. we recruited a cohort of forty-five university students to participate in the 15 min GRA protocol and SR protocol. We collected heart rate and heart rate variability indicators during periods of rest, GRA protocol, and SR protocol utilizing the Polar Scale. Additionally, we assessed the mental state of the participants using the BFS State of Mind Scale. In summary, the autonomic load is lower in the GRA protocol compared to the SR protocol, with lower sympathetic activity but higher parasympathetic activity in the former. Results are specific to college students, additional research is necessary to extend support for frail older adults. It is advised to incorporate GRA protocol alongside SR protocol in Tai Chi instruction. This approach is likely to enhance Tai Chi skills and yield greater health benefits.

Characterization and in-vitro assessment of silicon-based apatite microspheres for bone tissue engineering applications.

In the field of bone tissue engineering, silicon (Si) has been found as an essential element for bone growth. However, the use of silicon in bioceramics microspheres remains limited. In this work, different weight percentages (0.8, 1.6, and 2.4 wt %) of silicon was incorporated into hydroxyapatite and fabricated into microspheres. 2.4 wt % of Si incorporated into HAp microspheres (2.4 SiHAp) were found to enhance functional properties of the microspheres which resulted in improved cell viability of human mesenchymal stem cells (hMSCs), demonstrating rapid cell proliferation rates resulting in high cell density accumulated on the surface of the microspheres which in turn permitted better hMSCs differentiation into osteoblasts when validated by bone marker assays (Type I collagen, alkaline phosphatase, osteocalcin, and osteopontin) compared to apatite microspheres of lower wt % of Si incorporated and non-substituted HAp (2.4 SiHAp >1.6 SiHAp >0.8 SiHAp > HAp). SEM images displayed the densest cell population on 2.4 SiHAp surfaces with the greatest degree of cell stretching and bridging between neighboring microspheres. Incorporation of silicon into apatite microspheres was found to accelerate the rate and number of apatite nucleation sites formed when subjected to physiological conditions improving the interface between the microsphere scaffolds and bone forming cells, facilitating better adhesion and proliferation.

Site-scale groundwater pollution risk assessment using surrogate models and statistical analysis.

Petroleum pollution in soil and groundwater has emerged as a significant environmental concern worldwide. As a sustainable and cost-effective in-situ remediation technique, Monitored Natural Attenuation (MNA) exhibits significant promise in addressing sites contaminated by petrochemicals. This study specifically targets a typical petrochemical-contaminated site in northern China and employs GMS software to establish a comprehensive physical model. The model relies on time-series monitoring data of phenol concentrations spanning from 2018 to 2020, effectively simulating both the leakage and natural attenuation of phenol. Within this study, the adsorption coefficient and maximum adsorption capacity emerge as the foremost influential factors shaping the outcomes of the model. Given the inherent heterogeneity of the site and the variability of hydrochemical conditions, parameters such as dispersion, porosity, and adsorption coefficient exhibit significant uncertainties. Consequently, relying on traditional deterministic models to predict the feasibility of MNA technology is not reliable. Therefore, this study employs machine learning (ML) methods to construct stochastic parameter models based on physical processes. The Random Forest Regression (RFR) algorithm, after trained, demonstrates strong alignment with numerical model output, exhibiting an average Nash-Sutcliffe Efficiency (NSE) >0.96. Using a stochastic approach, RFR iteratively computes phenol concentration across 6000 sets of parameters. Applying probability statistics, the model shows a notable reduction in the likelihood of phenol concentrations exceeding a threshold, dropping from 64.0% to 15.7% before and after natural attenuation. In parameter uncertainty, the stochastic model emphasizes natural attenuation's efficacy in mitigating phenol pollution risk (porosity being the most influential factor). This case study proposed a novel method to quickly assess the pollution risks at petrochemical sites under the influence of the uncertainty of pollutant transport and reaction parameters. The results can provide a reference for the pollution risk assessment at petrochemical sites, especially in sites with high stratigraphic heterogeneity or insufficient transport parameter data.

Heat and carbon co-activated persulfate to regenerate gentamicin-laden activated carbon: Performance, mechanism, and safety assessment.

Activated carbon enriched with high concentrations of gentamicin (ACG) was generated in the production process of gentamicin. Inappropriate handling methods for ACG not only squanders carbon resource, but also seriously hinders achieving global carbon neutrality and hazardous to human health. In the present work, thermal and carbon co-activated persulfate method (TC-PS) was developed to regenerate ACG with degrading gentamicin. The results showed that ACG was effectively regenerated by TC-PS, restoring the adsorption performance for gentamicin. When the treatment temperature was 80 °C, the persulfate dosage was 20 mM and the initial pH was 3.0, the degradation efficiency of gentamicin reached 100%. The HO• and SO4•- were the major reactive species for gentamicin degradation. The possible degradation routes of gentamicin were proposed and the safety assessment indicated that the produced intermediates during the regeneration process of ACG by TC-PS have insignificant impact on the biological and ecological environment.

Epidemiology of Nontuberculous Mycobacteria in Tuberculosis suspects, Southwest of China, 2017-2022.

Objectives: This study summarizes the epidemiological characteristics, species distribution, and drug sensitivity of clinical nontuberculous mycobacteria (NTM) isolates at the Public Health Clinical Center of Chengdu, China, from January 2017 to December 2022. Methods: We retrospectively analyzed data from patients with clinically isolated NTM strains. Chi-square analysis assessed the rate of Mycobacterium strain isolation over 6 years. Results: The number of samples tested for Mycobacterium tuberculosis (MTB) and/or NTM increased each year, while MTB detection decreased and NTM detection rose significantly each year (P=0.03). The average age of NTM patients was 51 ± 17.53 years, with a 14.1% HIV infection rate. The predominant isolates were Mycobacterium avium-intracellulare (MAC) and M. chelonae/M. abscessus, with 96.4% of cases being of Han ethnicity. Amikacin, moxifloxacin, and clarithromycin were effective against M. avium and M. intracellulare; linezolid, amikacin, and cefoxitin were effective against M. chelonae/M. abscessus. Over 90% of NTM cases originated from the respiratory tract. Conclusion: The NTM isolation rate in Southwest China has risen in recent years, primarily among elderly patients with a high HIV co-infection rate. The main NTM isolates were MAC and M. chelonae/M. abscessus. Amikacin, moxifloxacin, clarithromycin, and linezolid exhibited strong antibacterial activity against SGM, while amikacin and linezolid displayed relatively better antibacterial activity against RGM. The prevalence of NTM infection may be positively associated with regional economic development and health conditions.

3D Printed Conformal Strain and Humidity Sensors for Human Motion Prediction and Health Monitoring via Machine Learning.

Wearable sensors have garnered considerable attention due to their flexibility and lightweight characteristics in the realm of healthcare applications. However, developing robust wearable sensors with facile fabrication and good conformity remains a challenge. In this study, a conductive graphene nanoplate-carbon nanotube (GC) ink is synthesized for multi jet fusion (MJF) printing. The layer-by-layer fabrication process of MJF not only improves the mechanical and flame-retardant properties of the printed GC sensor but also bolsters its robustness and sensitivity. The direction of sensor bending significantly impacts the relative resistance changes, allowing for precise investigations of joint motions in the human body, such as those of the fingers, wrists, elbows, necks, and knees. Furthermore, the data of resistance changes collected by the GC sensor are utilized to train a support vector machine with a 95.83% accuracy rate for predicting human motions. Due to its stable humidity sensitivity, the sensor also demonstrates excellent performance in monitoring human breath and predicting breath modes (normal, fast, and deep breath), thereby expanding its potential applications in healthcare. This work opens up new avenues for using MJF-printed wearable sensors for a variety of healthcare applications.

Temporal trends in inequalities of the burden of cardiovascular disease across 186 countries and territories.

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.

The impact of city financial ecology on firm financing efficiency: Evidence from China's strategic emerging industries.

Based on the concept of bionics and the connotation of city financial ecology, this study constructs a 3-level and 27-indicator evaluation index system, including financial ecology growth, soil, and air. This study uses the entropy-TOPSIS model to weigh indicators objectively and evaluate the financial ecology of 343 China's prefecture-level cities during 2009-2016. This study uses the DEA-Tobit method to assess the financing efficiency of 4013 China's strategic emerging listed firms during 2010-2017 and runs random-effect Tobit panel regressions. Regression results suggest that a city's financial ecology overall has a positive effect on strategic emerging firms' financing efficiency. Therefore, the government should: improve the multi-tiered financial market system and encourage financial innovation; transform the economic growth model and optimize the industrial structure; establish an information-sharing mechanism and construct a social credit system.

Mitigation strategies for excessive cadmium in rice.

Cadmium (Cd)-contaminated rice is a human food safety problem that lacks a clear solution. A large amount of rice having an excessive Cd content is processed yearly, but it cannot be discarded and placed in landfills because it will cause secondary pollution. How do we best cope with this toxic rice? From the perspectives of food safety, food waste prevention, and human hunger eradication, the use of contemporary physical, chemical, and biological techniques to lower the Cd content in postharvest Cd-contaminated rice so that it can be used safely is the best course of action. In this review, the contamination, chemical speciation, and distribution of Cd in rice are analyzed and discussed, as are the methods of Cd removal from rice, including a comparison of the advantages and disadvantages of various techniques. Owing to the limitations of current technology, research and technological development recommendations for removing Cd from rice grain are presented. The chemical and biological methods produce higher Cd-removal rates than physical methods. However, they are limited to small-scale laboratory applications and cannot be applied on a large industrial scale. For the efficient safe removal of Cd from food, mixed fermentation with lactic acid bacteria and yeast has good application prospects. However, limited strains having high Cd-removal rates have been screened. In addition, modern biotechnology has rarely been applied to reduce rice Cd levels. Therefore, applying genetic engineering techniques to rapidly obtain microorganisms with high Cd-removal rates in rice should be the focus of future research.

Assessment of eHealth literacy to reduce financial toxicity and improve shared decision-making in cancer patients: A cross-sectional study.

Objectives: This study aimed to investigate the associations between eHealth literacy, preferences for financial decision-making, and financial toxicity (FT) in a sample of Chinese cancer patients. Methods: Eligible cancer patients were invited to participate in a cross-sectional survey from January to April 2021. Three measures (eHealth literacy scale, control preference scale, and COST) were used to analyze patients' eHealth literacy, decisional preferences, and FT, respectively. Wilcoxon signed-rank test and Kruskal-Wallis H test assessed the differences between population subgroups. Binary logistic and multivariate linear regression models were used to assess the relationships between eHealth literacy, decisional preferences, and FT. Results: A total of 590 cancer patients completed the questionnaire. We found that high FT was associated with poor ECOG performance, severe cancer stage, and longer cancer duration. Patients who preferred to adopt collaborative attitude toward decision-making showed a significantly higher eHealth literacy. However, there was an inverse relationship between eHealth literacy and a patient-driven attitude toward decision-making in female cancer patients. Regression analysis indicated that patients who were highly educated and actively employed might report a higher eHealth literacy. A significant relationship was found between high eHealth literacy and low FT. However, this relationship became insignificant when the background characteristics of cancer patients were taken into account. Conclusions: A relationship between enhanced eHealth literacy, preference for collaborative decision-making, and low risk of FT is identified. Practical implication: Interventions to improve patients' ability to use quality and reliable web-based information on cancer care should be encouraged.

Study on web pillar failure mechanism during auger mining and its associated risk assessment.

To safely and efficiently recover trapped coal under final endwalls in open cut mines, theoretical analysis and numerical calculation were used to study the stability of web pillar during auger mining. The partial ordered set (poset) evaluation model was used to develop a risk assessment methodology, and auger mining at Pingshuo Antaibao open cut coal mine was used as a field example for validation. Based on the catastrophe theory, the failure criterion of web pillar was established. From the limit equilibrium theory, the maximum allowable plastic yield zone width and minimum web pillar width were proposed under various Factor of Safety (FoS) thresholds. This in turn provides a new method for web pillar design. Based on the poset theory and combining with the risk evaluation and proposed hazard levels, input data were standardized and weighted. Subsequently, the comparison matrix, HASSE matrix and HASSE diagram were established. The study shows that: when the width of the plastic zone of web pillar exceeds 88% of the total width, web pillar may be unstable. Based on the calculation formula for the required width of web pillar, the required pillar width was 4.93 m and it was deemed as "mostly stable". This was consistent with the field condition on site. Such that this method was validated.

Editorial for Special Issue: Machine Health Monitoring and Fault Diagnosis Techniques.

Machine health monitoring and fault diagnosis have played crucial roles in automatic and intelligent industrial plants [...].

Evaluating Indirect Economic Losses from Flooding Using Input-Output Analysis: An Application to China's Jiangxi Province.

Quantifying total economic impacts of flood disaster in a timely manner is essential for flood risk management and sustainable economic growth. This study takes the flood disaster in China's Jiangxi province during the flood season in 2020 as an example, and exploits the input-output method to analyze indirect economic impacts caused by the agricultural direct economic loss. Based on regional IO data and MRIO data, a multi-dimensional econometric analysis was undertaken in terms of inter-regional, multi-regional, and structural decomposition of indirect economic losses. Our study reveals that the indirect economic losses caused by the agricultural sector in other sectors in Jiangxi province were 2.08 times the direct economic losses, of which the manufacturing sector suffered the worst, accounting for 70.11% of the total indirect economic losses. In addition, in terms of demand side and supply side indirect losses, the manufacturing and construction industries were found to be more vulnerable than other industries, and the flood disaster caused the largest indirect economic loss in eastern China. Besides, the supply side losses were significantly higher than the demand side losses, highlighting that the agricultural sector has strong spillover effects on the supply side. Moreover, based on the MRIO data of the years 2012 and 2015, dynamic structural decomposition analysis was undertaken, which showed that changes in the distributional structure appear to be influential in the evaluation of indirect economic losses. The findings highlight the spatial and sectoral heterogeneity of indirect economic losses caused by floods, and have significant implications for disaster mitigation and recovery strategies.

Urban Flood Modeling and Risk Assessment with Limited Observation Data: The Beijing Future Science City of China.

The frequency of urban storms has increased, influenced by the climate changing and urbanization, and the process of urban rainfall runoff has also changed, leading to severe urban waterlogging problems. Against this background, the risk of urban waterlogging was analyzed and assessed accurately, using an urban stormwater model as necessary. Most studies have used urban hydrological models to assess flood risk; however, due to limited flow pipeline data, the calibration and the validation of the models are difficult. This study applied the MIKE URBAN model to build a drainage system model in the Beijing Future Science City of China, where the discharge of pipelines was absent. Three methods, of empirical calibration, formula validation, and validation based on field investigation, were used to calibrate and validate the parameters of the model. After the empirical calibration, the relative error range between the simulated value and the measured value was verified by the formula as within 25%. The simulated runoff depth was consistent with a field survey verified by the method of validation based on field investigation, showing the model has good applicability in the study area. Then, the rainfall scenarios of different return periods were designed and simulated. Simulation results showed that, for the 10-year return period, there are overflow pipe sections in northern and southern regions, and the number of overflow pipe sections in the northern region is more than that in the southern region. For the 20-year return period and 50-year return period, the number of overflow pipe sections and nodes in the northern region increased, while for the 100-year return period, the number of overflow nodes both increased. With the increase in the rainfall return period, the pipe network load increased, the points and sections prone to accumulation and waterlogging increased, and the regional waterlogging risk increased. The southern region is prone to waterlogging because the pipeline network density is higher than that in the northern region and the terrain is low-lying. This study provides a reference for the establishment of rainwater drainage models in regions with similar database limitations and provides a technical reference for the calibration and validation of stormwater models that lack rainfall runoff data.

Cost-Efficient Production of the Sphingan WL Gum by Sphingomonas sp. WG Using Molasses and Sucrose as the Carbon Sources.

The polysaccharide WL gum is produced by the marine microorganism Sphingomonas sp. WG and presents great commercial utility potential in many industries especially in oil industries. However, the high fermentation cost limits its wide application. Therefore, an efficient production system at a lower cost was established using beet molasses to partially replace the commonly used carbon sources. Four different molasses were screened and their composition was investigated. One-factor design and RSM statistical analysis were employed to optimize the WL gum fermentation medium. The effects of molasses on the rheological properties and gene expression of WL gum were also investigated. The results showed that the pretreated beet molasses generated both high broth viscosity and WL gum production (12.94 Pa·s and 11.16 g/L). Heavy metal ions and ash were found to be the key factors in unpretreated and pretreated molasses affecting WL production. The cost-efficient production medium contained (g/L): sucrose 61.79, molasses 9.95, yeast extract 1.23, K2HPO4 1, MgSO4 0.1, ZnSO4 0.1 and the WL gum production reached 40.25 ± 1.15 g/L. The WL gum product WL-molasses showed the higher apparent viscosity, and viscous modulus and elastic modulus than WL-sucrose and WL-mix, which might be related to its highest molecular mass. The higher expressional level of genes such as pgm, ugp, ugd, rmlA, welS, and welG in WL gum synthesis in the mixed carbon source medium caused the high production and broth viscosity. This work provided a cost-efficient method for WL gum production.

Regional disparities and influencing factors of high quality medical resources distribution in China.

BACKGROUND: With the gradual increase of residents' income and the continuous improvement of medical security system, people's demand for pursuing higher quality and better medical and health services has been released. However, so far little research has been published on China's high quality medical resources (HQMR). This study aims to understand the spatiotemporal variation trend of HQMR from 2006 to 2020, analyze regional disparity of HQMR in 2020, and further explore the main factors influencing the distribution of HQMR in China. METHODS: The study selected Class III level A hospitals (the highest level medical institutions in China) to represent HQMR. Descriptive statistical methods were used to address the changes in the distribution of HQMR from 2006 to 2020. Lorentz curve, Gini coefficient (G), Theil index (T) and High-quality health resource density index (HHRDI) were used to calculate the degree of inequity. The geographical detector method was used to reveal the key factors influencing the distribution of HQMR. RESULTS: The total amount of HQMR in China had increased year by year, from 647 Class III level A hospitals in 2006 to 1580 in 2020. In 2020, G for HQMR by population was 0.166, while by geographic area was 0.614. T was consistent with the results for G, and intra-regional contribution rates were higher than inter-regional contribution rates. HHRDI showed that Beijing, Shanghai, and Tianjin had the highest allocated amounts of HQMR. The results of the geographical detector showed that total health costs, government health expenditure, size of resident populations, GDP, number of medical colleges had a significant impact on the spatial distribution of HQMR and the q values were 0.813, 0.781, 0.719, 0.661, 0.492 respectively. There was an interaction between the influencing factors. CONCLUSIONS: China's total HQMR is growing rapidly but is relatively inadequate. The distribution of HQMR by population is better than by geography, and the distribution by geography is less equitable. Population size and geographical area both need to be taken into account when formulating policies, rather than simply increasing the number of HQMR.

Assessment of Global Cardiac Function Using AutoSTRAIN Automatic Strain Quantitative Technology in Patients With Breast Cancer Undergoing Anthracycline-Based Chemotherapy.

In patients with breast cancer undergoing anthracycline-based chemotherapy, we investigated the deformational parameters of the left ventricle, right ventricle and left atrium, as well as the relationship between these parameters. Ninety-five patients with breast cancer who were treated with anthracycline-based chemotherapy were enrolled. The control group included 116 healthy female volunteers. Parameters including left ventricular global longitudinal strain (LV-GLS); right ventricular free wall longitudinal strain (RVFWSL) and global longitudinal strain (RV4CSL); and peak strain of the left atrium during LV systole (LASR), early LV diastole (LASCD) and late LV diastole (LASCT) were analyzed by speckle tacking echocardiography. LV-GLS, LASR, LASCD, RVFWSL and RV4CSL in the chemotherapy group decreased significantly by 15.6%, 13.8%, 19.8%, 21.8% and 13.2% (p < 0.05), respectively, when compared with the control group. LASCT was slightly increased in the chemotherapy group but the increase was not statistically significant (p > 0.05). Formulas for the influencing factors of LV-GLS were LV-GLS = -18.73738541 + 0.13961 × LVIDd + 0.09672 × LASCD + 0.18113 × RVFWSL in the control group and LV-GLS = -8.026302253 + 0.20811 × LASCD + 0.11084 × LASCT + 0.12153 × RVFWSL in the chemotherapy group. Both LV contraction and RV contraction were impaired after the completion of anthracycline-based therapy, and RVFWSL may be superior to LV-GLS in assessing cardiotoxicity. LA reserve and channel function were significantly reduced, while pump function was slightly increased. Compared with the results among healthy people, the influencing factor of LV-GLS varied after anthracycline treatment, and LA function had a greater impact on LV-GLS.