Highly mutable and contagious influenza poses a serious health threat to university students and their close contacts. Although annual influenza vaccination is an effective way to prevent influenza, ...influenza vaccination rates among Chinese university students are still low due to vaccine hesitancy. This study investigated Chinese university students' hesitancy to receive influenza vaccine and its influencing factors during the COVID-19 pandemics based on WHO's vaccine hesitancy matrix.
A multicenter cross-sectional study of university students in four cities across China was conducted via a web-based questionnaire in June 2022. Binary logistic regression was adopted to determine the factors around contextual influences, individual and group influences, and vaccines/vaccination specific issues. The reliability and validity of the questionnaire were good, with a Kronbach alpha coefficient of 0.892 and a KMO coefficient of 0.957.
Of the 2261 Chinese university students surveyed, 44.7% had influenza vaccine hesitancy. Binary logistic regression showed that students considering high severity (OR = 0.946) or probability (OR = 0.942) of getting influenza, trusting vaccine-related advice from medical personnel (OR = 0.495) had lower odds of hesitancy. The odds of influenza vaccine hesitancy were higher if the students believed that vaccination was not necessary (OR = 4.040), had not been recommended by people around (OR = 1.476) and had no previous vaccinations or appointments (OR = 2.685).
Medical staff are suggested to provide health education, improve doctor-patient communication and recommend vaccinations to university students to increase their risk perception and willingness to get an influenza vaccination. Collective vaccination strategies can be implemented to reduce the vaccine hesitancy for students.
Cervical cancer poses a heavy health burden in China, with the second highest incidence and mortality rate among female tumors, yet human papillomavirus (HPV) vaccination rate among female university ...students remain remains low. This study conducted a cross-sectional survey to assess the degree of HPV vaccine hesitancy among female university students and to explore the potential association between knowledge, risk perception, trust, and HPV vaccine hesitancy.
A total of 1,438 female university students from four Chinese cities were recruited through stratified, multistage, cluster sampling method. The mediation model was constructed using the Bootstrap method, introducing trust and risk perception as mediating variables to examine the effect of knowledge on HPV vaccine hesitancy.
The study found that 8.9% (95%CI:7.4%∼10.4%) of the female university students exhibited HPV vaccine hesitancy. Pearson's correlation analysis revealed a negative association between vaccine hesitancy and knowledge, risk perception, and trust. The mediation model showed that knowledge had significant indirect effects on HPV vaccine hesitancy through trust (indirect effect: -0.224, 95% CI: -0.293 ∼ -0.167) and risk perception (indirect effect: -0.013, 95% CI: -0.033 ∼ -0.002).
HPV vaccine hesitancy among female university students has mitigated, but still needs to be addressed. In addition, trust and risk perception are mediators mediating the relationship between knowledge with HPV vaccine hesitancy. Therefore, there is a need to strengthen public health education to improve knowledge, with a particular focus on providing information about trust and risk perception to reduce HPV vaccine hesitancy.
Metal mining has caused the accumulation of waste mine tailing dumps from abandoned mines. The pollution of farmlands surrounding metal tailings by heavy metals has been a long-recognized problem. ...However, the distribution of antibiotic resistance genes (ARGs) in tailings and the main factors influencing this distribution have rarely been reported. In this study, a metagenomics approach was used to investigate the microbial community and ARGs present in farmland surrounding gold tailings in northern China. The results showed that the main pollutants in the farmland were As, Pb, and Cd. Proteobacteria and Actinobacteria were the dominant phyla of microbes in farmlands surrounding gold tailings. A total of 75 ARGs with 327 ARG subtypes were detected in soil samples. Macrolide-, lincosaminide-, and streptogramin B resistant genes accounted for the majority of ARGs in this study, and Actinobacteria, Proteobacteria, and Acidobacteria were the hosts of most ARGs. Partial least squares path modeling revealed that the microbial community was the most influential driver moderating the distribution of soil ARGs near tailings, and heavy metals have direct and partially indirect effects on these ARGs. In contrast to previous analyses of ARGs, our study found that mobile gene elements had a minimal impact on ARGs. Overall, this study presents a complete ARG survey that sheds light on the distribution and fate of ARGs under heavy metal contamination in farmland around gold tailings.
Display omitted
•We studied microbes and antibiotic resistance genes in farmland near gold tailings.•The main ARGs exhibited macrolide, lincosaminide, and streptogramin B resistance.•Actinobacteria, Proteobacteria, and Acidobacteria were the main carriers of ARGs.•The microbial community was the most important driver of soil ARG distribution.•Mobile gene elements had a minimal impact on ARG distribution and abundance.
Family doctors, serving as gatekeepers, are the core of primary health care to meet basic health needs, provide accessible care, and improve attainable health. The study objective was to evaluate the ...impact of the family doctor system on health service utilization among patients with hypertension and diabetes in China.
Difference-in-Differences (DID) models are constructed to estimate the net effect of the family doctor system, based on the official health management records and medical insurance claim data of patients with hypertension and diabetes in an eastern city of China.
The family doctor system significantly increases follow-up visits (hypertension patients coef. = 0.13, diabetes patients coef. = 0.08, both p < 0.001) and outpatient visits (hypertension patients coef. = 0.08, diabetes patients coef. = 0.05, both p < 0.001) among the contracted compared to the non-contracted. The proportion of outpatient visits in community health centers among the contracted significantly rose (hypertension patients coef. = 0.02, diabetes patients coef. = 0.04, both p < 0.001) due to significantly more outpatient visits in community health centers and fewer in secondary and tertiary hospitals. It also significantly mitigates the increase in inpatient admissions among hypertension patients but not among diabetes patients.
The examined family doctor system strengthens primary care, both by increasing follow-up visits and outpatient visits and promoting a rationalized structure of outpatient utilization in China.
Prophylaxis therapy for children with moderate and severe hemophilia A (HA) is the optimal treatment regimen. The real-world treatment regimens, patient-reported outcomes, and health-related quality ...of life (HRQoL) in children with moderate and severe HA in China are less known.
This study aimed to describe real-world treatment regimens and evaluate the association of treatment regimens with comprehensive patient-reported outcomes including bleeds, chronic pain, target joints, disability, and HRQoL in children under 18 years old with HA in China.
Real-world data of a nationwide online cross-sectional survey in 2021 and patients' coagulation factor utilization data from self-management records from 2020 to 2021 were merged. 373 eligible children were included and categorized by treatment regimens according to the Chinese guideline: on-demand, short-term prophylaxis, and long-term prophylaxis treatment.
Currently, in China, 4.8% of children with HA are receiving full-dose long-term prophylaxis treatment. Prophylaxis treatment was a significant positive predictor of better patient-reported outcomes and HRQoL. For children with prophylaxis treatment, there were significantly fewer annual bleeds (p < 0.001), lower frequency of chronic pain(p < 0.001), and higher health utility scores(p < 0.01) and EQ-VAS scores(p < 0.05) than children with on-demand treatment.
Accessible long-term prophylaxis treatment should be promoted for children with moderate and severe HA in China and regular monitoring of their outcomes and HRQoL should be carried out.
China is in the process of integrating the new cooperative medical scheme (NCMS) and the urban residents' basic medical insurance system (URBMI) into the urban and rural residents' basic medical ...insurance system (URRBMI). However, how to integrate the financing policies of NCMS and URBMI has not been described in detail. This paper attempts to illustrate the differences between the financing mechanisms of NCMS and URBMI, to analyze financing inequity between urban and rural residents and to identify financing mechanisms for integrating urban and rural residents' medical insurance systems.
Financing data for NCMS and URBMI (from 2008 to 2015) was collected from the China health statistics yearbook, the China health and family planning statistics yearbook, the National Handbook of NCMS Information, the China human resources and social security statistics yearbook, and the China social security yearbook. "Ability to pay" was introduced to measure inequity in health financing. Individual contributions to NCMS and URBMI as a function of per capita disposable income was used to analyze equity in health financing between rural and urban residents.
URBMI had a financing mechanism that was similar to that used by NCMS in that public finance accounted for more than three quarters of the pooling funds. The scale of financing for NCMS was less than 5% of the per capita net income of rural residents and less than 2% of the per capita disposable income of urban residents for URBMI. Individual contributions to the NCMS and URBMI funds were less than 1% of their disposable and net incomes. Inequity in health financing between urban and rural residents in China was not improved as expected with the introduction of NCMS and URBMI. The role of the central government and local governments in financing NCMS and URBMI was oscillating in the past decade.
The scale of financing for URRBMI is insufficient for the increasing demands for medical services from the insured. The pooling fund should be increased so that it can better adjust to China's rapidly aging population and epidemiological transitions as well as protect the insured from poverty due to illness. Individual contributions to the URBMI and NCMS funds were small in terms of contributors' incomes. The role of the central government and local governments in financing URRBMI was not clearly identified. Individual contributions to the URRBMI fund should be increased to ensure the sustainable development of URRBMI. Compulsory enrollment should be required so that URRBMI improves the social medical insurance system in China.
ObjectivesOur study aimed to examine whether the family doctor system can improve continuity of care for patients with diabetes.DesignRegistry-based, population-level longitudinal cohort ...study.SettingLinked data from the administrative Health Information System and the Health Insurance Claim Databases in a sample city in eastern China.Participants30 451 insured patients who were diagnosed with diabetes before January 2015 in the sample city, with ≥2 outpatient visits per year during 2014–2017. Diabetics in the intervention group had been registered with family doctor teams from 2015 to 2017, while those who had not registered were taken as the control group.InterventionsThe family doctor system was established in China mainly to strengthen primary care and rebuild referral systems. Residents were encouraged to register with family doctors to obtain continuous health management especially for chronic disease management.Outcome measuresContinuity of care was measured by the Continuity of Care Index (COCI), Usual Provider Continuity Score (UPCS) and Sequential Continuity of Care Index (SECON) in 2014–2017.ResultsCOCI, UPCS and SECON of all diabetics in this study increased between 2014 and 2017. A difference-in-difference approach was applied to measure the net effect of the family doctor system on continuity of care. Our model controlled for demographic and socioeconomic characteristics, and severity of disease at baseline. Compared with the control group, diabetics registered with family doctors obtained an average 0.019 increase in COCI (SE 0.002) (p<0.01), a 0.016 increase in UPCS (SE 0.002) (p<0.01) and a 0.018 increase in SECON (SE 0.002) (p<0.01).ConclusionThis study provides evidence that the family doctor system can effectively improve continuity of care for patients with diabetes, which has substantial policy implications for further primary care reform in China.
Warm zone rainstorms and frontal rainstorms are two types of rainstorms that often occur in the rainy season in Jiangxi (located in the eastern part of China). The ability to correctly identify the ...type of rainstorms is important for accurate forecasting of rainstorms. Two heavy rainstorms took place in Jiangxi province. The first heavy rainstorm occurred from 20:00 BJT (Beijing Time) on 6 June to 20:00 BJT on 9 June (referred to as the “6.9” process) and another heavy rainstorm occurred from 20:00 BJT on 21 June to 20:00 BJT on 22 June (referred to as the “6.9” process), 2019. We analyzed the two rainstorms’ processes by using ground-based observation data, NCEP/FNL reanalysis data, ECMWF and CMA-SH9 numerical forecasting products. The results show that: “6.9” process is a warm area rainstorm, and a strong northeast cold vortex exists at 500 hPa geopotential height. The northwesterly flow behind the northeast cold vortex trough is stronger. The position of the northern edge of the subtropical high pressure is more south than that at “6.22” process. The rainstorm is in the precipitation zone of the warm temperature ridge over 925 hPa geopotential height, and with more convective character than “6.22” process. The process of “6.22” is a frontal rainstorm. The convective character of precipitation is weaker. The rainstorm precipitation zones are in a strong temperature front area at 925 hPa geopotential height and there is a tendency for vertical convection to develop into oblique upward convection in the late stage of the rainstorm. The precipitation location and intensity forecast by CMA-SH9 at the “6.9” process is better than that of ECMWF, while ECMWF’s prediction of the precipitation zone and weather condition of the “6.22” process is better.
A highly sensitive and flexible hydrogen sensor based on organic nanofibers decorated by Pd nanoparticles (NPs) was designed and fabricated for low-concentration hydrogen detection. Pd NPs were ...deposited on organic nanofiber materials by DC magnetron sputtering. The temperature dependence of the sensitivity at 25 ppm H₂ was characterized and discussed, and the maximum response of the sensor increased linearly with increasing measurement temperature. Performances of the hydrogen sensor were investigated with hydrogen concentration ranging from 5 ppm to 50 ppm. This sensor exhibits high sensitivity, with the response up to 6.55% for H₂ as low as 5 ppm, and the output response of the hydrogen sensor increased linearly with the square root of hydrogen concentration. A cycling test between pure nitrogen and 25 ppm hydrogen concentration was performed, and the hydrogen sensor exhibited excellent consistency.
With the increasing popularity of deep learning, enterprises are replacing traditional inefficient and non-robust defect detection methods with intelligent recognition technology. This paper utilizes ...TL (transfer learning) to enhance the model’s recognition performance by integrating the Adam optimizer and a learning rate decay strategy. By comparing the TL-ResNet50 model with other classic CNN models (ResNet50, VGG19, and AlexNet), the superiority of the model used in this paper was fully demonstrated. To address the current lack of understanding regarding the internal mechanisms of CNN models, we employed an interpretable algorithm to analyze pre-trained models and visualize the learned semantic features of defects across various models. This further confirms the efficacy and reliability of CNN models in accurately recognizing different types of defects. Results showed that the TL-ResNet50 model achieved an overall accuracy of 99.4% on the testing set and demonstrated good identification ability for defect features.
PDF
