Properties of Ni-Al2O3 composite coating by laser-assisted pulse electrodeposition.

To study the influence of laser process parameters on the surface properties of the coating, N i-A l 2 O 3 composite coatings on 304 stainless-steel sheets with laser-assisted pulsed electrodeposition was proposed in this paper. Laser single pulse energy and scanning speed were selected as research factors. Single-factor experiments were performed to investigate the effect of various factors on the surface morphology, particle mass fraction, microhardness, surface roughness, and corrosion resistance of the composite coating. The experimental results show that the surface properties of the composite coating first increase and then decrease with increasing laser single pulse energy. When the laser single pulse energy is 11 µJ, the minimum surface roughness value is 0.380 µm with a smooth and uniform coating surface and the best surface morphology. Moreover, as the scanning speed increases, the corrosion resistance of the composite coating initially increases and then decreases. The corrosion resistance of the composite coatings is best with a scanning speed of 1000 mm/s. When the scanning speed was 1500 mm/s, the particle mass fraction in the coating reached a maximum of 1.984%; meanwhile, the highest hardness of the composite coating was obtained with the value of 476.38 HV.

[Study on medication regularity of chronic atrophic gastritis in Beijing-Tianjin-Hebei region based on latent structure model].

To explore the etiology, pathogenesis, distribution of syndromes and the rule of medication of chronic atrophic gastritis(CAG) in Beijing-Tianjin-Hebei region based on the latent structure model. Chronic atrophic gastritis of 279 cases in Beijing-Tianjin-Hebei region were extracted from the established database of spleen and stomach diseases of famous veteran Chinese medicine experts. The latent structure models of symptoms and drugs of chronic atrophic gastritis were constructed by using Lantern 3.1.2 software, and the latent structure models were interpreted. SAS 10.0 software was used to mine association rules of drugs and symptoms. The constitutional characteristics of patients with chronic atrophic gastritis in Beijing-Tianjin-Hebei region were "turbid toxin and damaging Yin". The common syndromes were turbid toxin, deficiency of stomach Yin, stagnation of liver and stomach, stagnation of liver and stomach Qi, obstruction of stomach collaterals and blood stasis, and weakness of spleen and stomach. Common medicines are Lobeliae Chinensis Herba, Scutellariae Barbatae Herba, Amomi Fructus Rotundus, Amomi Fructus, Poria, Isatidis Radix, Artemisiae Scopariae Herba, Scorpio, Coptidis Rhizoma, Lilii Bulbus, Linderae Radix, Phragmitis Rhizoma, Ophiopogonis Radix, Pogostemonis Herba, Eupatorii Herba, Magnoliae Officinalis Cortex, Aurantii Fructus Immaturus. Common prescriptions are Baihe Wuyao Powder, Danggui Shaoyao Powder, Xiaoyao Pills, Xiangsu Powder, Dachengqi Decoction, Zuojin Pills, Qingzhong Decoction, Zhishi Daozhi Pills, etc. The application of latent structure model and correlation analysis in the empirical study of famous and veteran Chinese medicine experts is in line with the research direction of modern Chinese medicine "traditional Chinese medicine + X". The conclusions obtained effectively tap the experience of famous and veteran TCM experts, and provide a data and visual clinical reference and prescription compatibility for young TCM physicians in the treatment of chronic atrophic gastritis based on syndrome differentiation.

Patients' choice and preference for common disease diagnosis and diabetes care: A discrete choice experiment.

OBJECTIVE: To examine the impact of policy incentives on patient's choice of health-care providers for primary care and to capture the preferences for general practitioner (GP) care. STUDY DESIGN: Discrete choice experiment. METHODS: A random sample of 704 adults and of 181 diabetics were independently surveyed to elicit patients' preferences for common disease diagnosis and diabetes care. Mixed logit regression was used for the analysis. RESULTS: On average, the most valued attribute in GP care are the organizational factors related to whether the provider has sufficient medicine and equipment to provide capable primary care service. Policy incentives, such as reducing waiting time, providing prior expert access, and increasing Medicare reimbursement, can facilitate the utilization of the GP system. Significant preference heterogeneity was identified; specifically, patient preferences significantly differ with regard to demand for common disease diagnosis and diabetes care. CONCLUSION: The identification of the preferences of specific groups in regard to GP care is an organizational and political imperative. Policy incentives are useful tools to guide patients' health care seeking behavior. To change the perceptions of Chinese patients with regard to health care, policy makers should consider the heterogeneous responses of residents to policy incentives and focus their efforts on key cohorts.

Multiobjective optimization on cooperative control of autonomous emergency steering and occupant restraint system for enhancing occupant safety.

Occupant safety remains one of the most challenging and significant design considerations in the automotive and transportation industry. Nevertheless, independently developed active or passive safety systems may lead to unsatisfactory protective performance under the critical driving scenarios. This study aimed to conduct multiobjective optimization of the cooperative controls between autonomous emergency steering (AES) and occupant restraint system (ORS) to explore the potential occupant injury reduction capability as well as mechanisms subjected to a frontal collision. First, a multiple simulation approach comprising PreScan/Simulink, LS-DYNA, Madymo was used to correlate the control parameters of the safety systems and occupant injuries quantitatively. Then the control parameters of AES and ORS were selected as the design variables after sensitivity analysis, and injury responses of the sampling points were extracted by the multiple simulation approach. Surrogate models and multiobjective optimization algorithm were used to determine the optimum design in cooperative controls of AES and ORS maneuvers, from which in-depth effect mechanisms that contributed to the improvement of occupant protection were identified. Compared to the baseline design, the optimum control parameters of AES-ORS integration substantially decreased the occupant injuries of the head, chest and neck, and consequently led to a reduction of 33.02% in the overall injury risk. This study is anticipated to demonstrate a new design approach for the control system, thereby enhancing occupant safety.

Role of risk attitude and time preference in preventive aspirin use adherence.

BACKGROUND: Poor adherence to medication that is taken chronically for the prevention of cardiovascular disease (CVD) continues to occur. Poor adherence is a primary barrier to treatment success and affects not only the patient but also the health care system. OBJECTIVE: We aim to explore the impacts of risk attitudes and time preferences on the decisions of patients to begin and comply with aspirin therapy for CVD prevention. METHODS: Three hundred fifty-seven patients who used low-dose aspirin for CVD prevention under the guidance of their doctors completed the survey. The risk attitudes and time preferences of the patients were elicited using a multiple price list experiment. Logistic regression models were used to examine the predictors of adherence to aspirin use. RESULTS: Risk-seeking behaviours were significantly associated with both nonparticipation (P < .01) and lower compliance (P < .05) in patients. The coefficient for time preference was only significant at the 0.05 level for the decision to initiate aspirin use, which indicated that more impatient patients were less likely to begin with the use of aspirin. Forgetfulness in using aspirin on time and a lack of knowledge (as well as a lack of belief in the use of aspirin) could largely explain the poor adherence to aspirin therapy. CONCLUSIONS: The identification of risk seekers and of those individuals who discount the future to a lesser degree may help providers to formulate tailored strategies to their patients, thus effectively enhancing their adherence to treatment.

Exploring determinants of health provider choice and heterogeneity in preference among outpatients in Beijing: a labelled discrete choice experiment.

OBJECTIVE: For a long time in China, public hospitals have been the most prominent provider of healthcare. However, recent policy reforms mean the private sector is experiencing rapid development. Thus, the purpose of this study is to detect whether the policies published by the government aimed to improve the quality of healthcare services were catering to patient's preferences. PARTICIPANTS AND METHODS: Our work uses dental care as an example of services provided in outpatient setting and takes advantage of a labelled discrete choice experiment with a random sample of respondents from Beijing. Participants were asked to make a choice between four healthcare providers with different attributes. Mixed logit and latent class models were used for the analysis. RESULT: Care provided by high-level private hospitals and community hospitals were valued RMB154 and 216 less, respectively, than care provided by class A tertiary hospitals, while the most disliked provider was private clinics. This was the most valued attribute of dental care. Respondents also value: lower waiting times, the option to choose their doctor, lower treatment costs, shorter travel times and a clean waiting room. However, when the level of provider was analysed, the prevailing notion that patients in China were always likely to choose public services than private services no longer holds. Four classes of patients with distinct preferences for dental care provider choice were identified, which can partly be explained by age, income, experience and Hukou status-a household registration permit. DISCUSSION: The study to some extent challenged the overwhelming predominance of public healthcare providers in China. The preference heterogeneity we found was relatively large. Our findings are significant for providers in developing more specific services for patients and for policymakers in weighing the pros and cons of future initiatives in medical reform.