PSYCHOLOGICAL DISTRESS OVER 12 MONTHS POST-DIAGNOSIS IN A NATIONAL EARLY INFLAMMATORY ARTHRITIS COHORT

BackgroundIn inflammatory arthritis patients, the concomitant decline of their mental wellbeing is an increasing concern[1,2]. It is important to not only describe the trajectory of psychological distress in early disease stages, but also understand which clinical outcome measures are most associated with these changes.ObjectivesUsing data from the National Early Inflammatory Arthritis Audit (NEIAA), we assessed trends in psychological wellbeing over 12 months after initial diagnosis and mapped these against clinical outcomes to identify significant associations.MethodsNEIAA collects data from patients referred with suspected early inflammatory arthritis in rheumatology services in England and Wales. We used data provided by 20,472 patients eligible for follow-up (diagnosis of inflammatory arthritis) between May 1st, 2018, and April 1st, 2022. Data items included baseline demographics e.g., age and gender, and clinical variables e.g., rheumatic disease comorbidity index (RDCI), DAS28, and patient reported outcomes.Psychological distress was measured by the sum score of Patient Health Questionnaire Anxiety and Depression Screener (PHQ4ADS). Using mixed effects regression models, we analysed the co-variability of PHQ4ADS with demographic factors and clinical outcomes over 12 months. Time was included as a dummy-coded covariant.ResultsThe analysis included 36% of patients (7,378 out of 20,472) who completed the baseline patient outcome survey. In this cohort, PHQ4ADS scores decreased from a baseline average of 4.7 (CI: [4.6, 4.8]) to 2.62 (CI: [2.5, 2.8]) at 12 months post-diagnosis. The proportion of patients screening positive decreased from 50.0% (CI: [48.9, 51.1]) at baseline to 23.8% (CI: [21.8, 25.9]) at 12 months.At baseline, psychological distress correlated significantly with age, gender, ethnicity, RDCI, prior depression diagnosis, and baseline DAS28 (Figure 1). No significant correlations were found between psychological distress and working diagnosis, seropositivity, or the assessment being recorded after the start of the COVID-19 pandemic. Younger ages were nonlinearly associated with higher distress levels (coefficient per decade: -0.006;p<0.001;CI: [-0.009, -0.003]) (Figure 1a). Distress levels in females were higher than that of males (coefficient: 0.5;p<0.001;CI: [0.4, 0.7]) (Figure 1b). White patients reported lower PHQ4ADS scores compared to non-white patients (coefficient: -0.7;p<0.001;CI: [-1.0, -0.4]) (Figure 1c). Higher distress levels were also associated with higher RDCI (coefficient: 0.2;p<0.001;CI: [0.1, 0.3]) and prior diagnosis of depression (coefficient: 1.8;p<0.001;CI: [1.5, 2.2]) (Figure 1d, 1e). Furthermore, higher baseline DAS28 scores correlated with more severe psychological distress (coefficient: 0.8;p<0.001;CI: [0.7, 0.8]) (Figure 1f).By 12-months, psychological distress decreased significantly overall, which correlated significantly with ethnicity (coefficient: 0.8;p=0.005;CI: [0.3, 1.4]) and baseline DAS28 (coefficient: -0.5;p<0.001;CI: [-0.6, -0.4]). Compared to white patients, the reduction was significantly greater for non-white patients, but the level of distress was no longer different at 12 months (Figure 1c). While those with higher baseline DAS28 showed a greater reduction in psychological distress, the distress levels remained higher at 12 months (Figure 1f).Figure 1.Changes in psychological distress correlated with age, gender, ethnicity, RDCI, prior depression diagnosis, and baseline DAS28.[Figure omitted. See PDF]ConclusionIn this early inflammatory arthritis cohort, mental health burden was high. Age, gender, ethnicity, RDCI, prior depression diagnosis and baseline DAS28 significantly correlated with psychological distress at baseline. Supporting mental health should be a focus of clinical care for this population and it may be beneficial to use an approach that is culturally valid for non-white patients and accounts for multimorbidity.References[1]Euesden, J, et al. Psychosomatic medicine 79.6 (2017): 638.[2]Lwin, MN, et al. Rheumatology and therapy 7.3 (2020): 457-471.AcknowledgementsThe authors would like to thank the Healthcare Quality Improvement Partnership (HQIP) as the commisioner of NEIAA, British Society for Rheumatology as the audit providers, Net Solving as the audit platform developers, and the Wellcome Trust (ST12406) for funding to support L.Z..Disclosure of InterestsLucy Zhao: None declared, James Galloway Speakers bureau: Has received honoraria from AbbVie Celgene, Chugai, Gillead, Janssen, Eli Lilly, Pfizer, Roche, and UCB, Jo Ledingham: None declared, Sarah Gallagher: None declared, Neena Garnavos: None declared, Paul Amlani-Hatcher: None declared, Nicky Wilson: None declared, Lewis Carpenter Consultant of: Statistical consultancy for Pfizer, Kirsty Bannister: None declared, Sam Norton Speakers bureau: Has received honoraria from Janssen and Pfizer.

Residual Feature Attentional Fusion Network for Lightweight Chest CT Image Super-Resolution

The diagnosis of COVID-19 requires chest computed tomography (CT). High-resolution CT images can provide more diagnostic information to help doctors better diagnose the disease, so it is of clinical importance to study super-resolution (SR) algorithms applied to CT images to improve the reso-lution of CT images. However, most of the existing SR algorithms are studied based on natural images, which are not suitable for medical images;and most of these algorithms improve the reconstruction quality by increasing the network depth, which is not suitable for machines with limited resources. To alleviate these issues, we propose a residual feature attentional fusion network for lightweight chest CT image super-resolution (RFAFN). Specifically, we design a contextual feature extraction block (CFEB) that can extract CT image features more efficiently and accurately than ordinary residual blocks. In addition, we propose a feature-weighted cascading strategy (FWCS) based on attentional feature fusion blocks (AFFB) to utilize the high-frequency detail information extracted by CFEB as much as possible via selectively fusing adjacent level feature information. Finally, we suggest a global hierarchical feature fusion strategy (GHFFS), which can utilize the hierarchical features more effectively than dense concatenation by progressively aggregating the feature information at various levels. Numerous experiments show that our method performs better than most of the state-of-the-art (SOTA) methods on the COVID-19 chest CT dataset. In detail, the peak signal-to-noise ratio (PSNR) is 0.11 dB and 0.47 dB higher on CTtest1 and CTtest2 at x3 SR compared to the suboptimal method, but the number of parameters and multi-adds are reduced by 22K and 0.43G, respectively. Our method can better recover chest CT image quality with fewer computational resources and effectively assist in COVID-19.

Games and Playfulness: Bodiless solidarity in Hong Kong and Mainland China

As China undergoes its digital revolution with the rapid developments of new media and technology on a massive scale, the bodies which used to be the sites for acclaiming for socio-political demands are now shifted to the digital sphere. However, social activists have discovered alternative ways to raise their voices through the virtual and cyber space. They have interwoven a hybrid body of solidarity in games and digital platforms. This article takes the 2020 Hong Kong resistance in Nintendo game Animal Crossing and the legacy of Covid-19 ‘Whistle blower' Li Wenliang on Chinese social media as cases, aiming to develop a comprehensive and comparative analysis on the performativity and solidarity that emerge with gamification and playfulness in contemporary Sino-sphere. © 2023 Informa UK Limited, trading as Taylor & Francis Group.

Impact of La3+doping on temperature coefficient of resistivity and peak temperature of La x Ca0.89-xSr0.11MnO3 films prepared by sol-gel spin coating method

Herein, refined LaxCa0.89-xSr0.11MnO3 (LCSMO, x = 0.65, 0.68, 0.71 and 0.74) films were prepared through the sol-gel spin-coating. The influence of La3+ content on the structural properties of LCSMO films was investigated by X-ray diffraction and Atomic force microscope, demonstrating that LCSMO films can grow well on SrTiO3 (00l) substrate. Besides, X-ray photoemission spectroscopy verified the double exchange (DE) effect was weakened with La3+ dopant. The La3+ doping and interconnected grains boundaries (GBs) led to the weakening DE effect and GBs scattering, respectively. Due to superior GBs connectivity, the resistivity of LCSMO films was less than 7.1 x 10(-4) Omega.cm at low temperature of 100 K. Importantly, it is an effective control method to keep the temperature (T-k) corresponding to temperature coefficient of resistivity (TCR) at room temperature with Sr2+ content as constant in LCSMO films. At x = 0.71, the peak TCR value was found to be 8.84%/K and corresponding T-k was 283.15 K. These results are beneficial for advanced application of uncooling infrared bolometer.

Research progress of severe acute respiratory syndrome coronavirus 2 in ocular surface infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, is much more difficult to transmit through the ocular surface than that through the mouth and nose. However, the available evidence has suggested the possibility of ocular surface transmission, especially in medical staff. In this paper, we describe the existing SARS-CoV-2 ocular surface symptoms, the possible mechanism of SARS-COV-2 entering ocular surface cells and SARS-COV-2 transmission through ocular surface. In addition, the existing and future possible research directions of SARS-CoV-2 transmission through ocular surface were analyzed, so as to provide new ideas and methods for clinical treatment of SARS-CoV-2 from the perspective of ocular surface.Copyright © 2021, Xinxiang Medical University. All rights reserved.

Investigation on health and professional consciousness and mental health of military medical students during coronavirus disease 2019 epidemic.

Objective To understand the health and professional consciousness and mental health of military medical students during coronavirus disease 2019 (COVID-19) epidemic. Methods From Feb. 17 to Feb. 20, 2020, an electronic questionnaire was used to investigate the attitudes and coping styles of military medical students towards quarantine and delay of school opening, their attitudes towards online teaching, and health and professional consciousness during COVID-19 epidemic;and their mental health status was scored by symptom checklist 90 (SCL-90). Results A total of 2 736 valid questionnaires were collected. The students basically understood and agreed with the quarantine and delay of school opening during the epidemic, and 70.83% (1 938/2 736) supported online teaching. During the quarantine period, 85.31% (2 334/2 736) of the students chose to listen to music or watch TV series for relaxation, and 64.69% (1 770/2 736) insisted on learning, reading literatures or writing papers. Students could basically form the habits of washing hands frequently and wearing masks, and their consciousness of health protection was higher than that before the epidemic. For military medical students, their professional beliefs and determination have been strengthened during the epidemic, and many students wanted to join in the fight against the epidemic. The survey found that 12.94% (354/2 736) of the students had mental health symptoms, and the top 3 SCL-90 factors were obsessive-compulsive disorder (78.53%, 278/354), interpersonal sensitivity (64.12%, 227/354), and depression (44.07%, 156/354). Conclusion During the epidemic, military medical students can generally adapt to the difficult environment and improve themselves. The mental health problems of military medical students have their own characteristics, special attention must to be paid, and the humanistic education of medical students should be strengthened.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Investigation on health and professional consciousness and mental health of military medical students during coronavirus disease 2019 epidemic

Objective To understand the health and professional consciousness and mental health of military medical students during coronavirus disease 2019 (COVID-19) epidemic. Methods From Feb. 17 to Feb. 20, 2020, an electronic questionnaire was used to investigate the attitudes and coping styles of military medical students towards quarantine and delay of school opening, their attitudes towards online teaching, and health and professional consciousness during COVID-19 epidemic;and their mental health status was scored by symptom checklist 90 (SCL-90). Results A total of 2 736 valid questionnaires were collected. The students basically understood and agreed with the quarantine and delay of school opening during the epidemic, and 70.83% (1 938/2 736) supported online teaching. During the quarantine period, 85.31% (2 334/2 736) of the students chose to listen to music or watch TV series for relaxation, and 64.69% (1 770/2 736) insisted on learning, reading literatures or writing papers. Students could basically form the habits of washing hands frequently and wearing masks, and their consciousness of health protection was higher than that before the epidemic. For military medical students, their professional beliefs and determination have been strengthened during the epidemic, and many students wanted to join in the fight against the epidemic. The survey found that 12.94% (354/2 736) of the students had mental health symptoms, and the top 3 SCL-90 factors were obsessive-compulsive disorder (78.53%, 278/354), interpersonal sensitivity (64.12%, 227/354), and depression (44.07%, 156/354). Conclusion During the epidemic, military medical students can generally adapt to the difficult environment and improve themselves. The mental health problems of military medical students have their own characteristics, special attention must to be paid, and the humanistic education of medical students should be strengthened.Copyright © 2022, Second Military Medical University Press. All rights reserved.

The Application of Equivalent Method for Cost Accounting and Performance Management in Community Healthcare Institutions

Background During the promotion of category-based management for community healthcare institutions （class 1 institutions obtain the financial security，and class 2 institutions implement a performance management system），how to appropriately determine the security level and scientifically evaluate the performance is a difficulty to tackle for health administrative departments. Objective To assess the operational efficiency of community healthcare institutions with the data envelopment analysis（DEA） using the information of costs of these institutions calculated using the equivalent method，then attempt to develop an input and management model of integrating cost accounting and performance management for these institutions，providing a theoretical basis for accurate and scientific input of various resources into the community through cost measurement with equivalent method，and a data basis for performance assessment in communities with different characteristics through efficiency evaluation. Methods The real data（financial status and staffing） of 14 community healthcare institutions during 2019 to 2020 were collected from their financial reports，hospital information system，maternal and child healthcare information system，chronic disease management information system，as well as focus group interviews. The equivalent method was used to calculate the total costs of medical services and public health services. The super-efficiency DEA was used to evaluate and analyze the operational efficiency of the 14 sample institutions. Results （1）The average cost of one equivalent service（a general medical outpatient service lasting for 15 minutes was defined as one standard service equivalent unit） was 67.64 yuan in 2019 and 69.80 yuan in 2020 for the 14 institutions. The average cost of one equivalent essential medical service was higher than that of one equivalent public health service in both 2019（167.14 yuan vs 18.86 yuan） and 2020（215.43 yuan vs 19.78 yuan）. The institutions demonstrated significant differences in the average cost of one equivalent essential medical service and the average cost of one equivalent public health service. （2）Each institution had its own peculiar characteristics. For example，S1 institution mainly provided essential medical services，and had higher total equivalent essential medical services and efficiency than other institutions，while S9 institution focused on providing public health services，and had the highest efficiency in delivering public health services. （3）In 2020，the 14 institutions provided 134 800 equivalent COVID-19-related services，with a cost of 1.037 8 million yuan. （4）In 2019 and 2020，only two institutions were relatively overall efficient，and ≥ 50.0% institutions were pure technically efficient. The institutions with overall operational inefficiency were mainly caused by scale inefficiency primarily due to increasing returns to scale. Conclusion The equivalent method provides a relatively unified "scale" to standardize the service efficiency of different types of community healthcare institutions，provides support for health administrative departments implementing category-based compensation for the institutions，benefiting the featured and high-level development of community healthcare institutions. Either institutions delivering essential medical services or those delivering public health services，mainly present increasing returns to scale，suggesting that the efficiency of these institutions can be improved by increasing the human/financial/material input into the institutions and providing precise compensation for them. © 2023 Chinese General Practice. All rights reserved.

Introduction

Despite having impacted the world profoundly, the COVID-19 pandemic cannot change the course of economic globalization but will instead accelerate the new round of economic globalization. Economic globalization is a double-edged sword, which accelerates scientific and technological development and promotes economic growth and world peace but at the same time also contributes to imbalances. As an initiator, promoter, and one of the most important major countries in the new round of economic globalization, China is expected by the international community to play a greater role in reconstructing international economic and trade rules and reforming the global governance system. In the post-pandemic era, the challenges facing the international community lie not only in economic recovery and development but also in the reconstruction and innovation of international economic and trade rules and the reform and improvement of the global governance system. Actively participating in the reconstruction and innovation of international rules and promoting the reform and improvement of the global governance system is not only an important strategic choice for China to realize the Chinese Dream of national rejuvenation but also the expectation of the international community that China can play a more significant role in the world. The development of the global value chains in the post-pandemic era demands profound adjustment and improvement of itself, calling for the reconstruction and innovation of international economic and trade rules and the reform and improvement of the global economic governance system. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Global Value Chains in the Post-pandemic Era

Global value chains (GVCs) are a huge network connecting the world as a whole in different stages of the production process. GVCs are significant in terms of creating jobs, improving the production efficiency of enterprises, and promoting overall national and global economic growth. As different links in value chains are located across countries and regions, global economic ties have been strengthened. But many problems of GVCs appeared even before the outbreak of COVID-19. Marginalized countries are less involved in GVCs, leading to an imbalance in the distribution of economic benefits. High technology is replacing and cutting down the demand for human labor, and trade protectionism hinders the further development of GVCs. After the pandemic, industries in the GVCs are also hit severely, especially on the production side. Considering technological, political, and security factors, more countries tend to locate their production in regions close to their borders or final consumption markets, forming a more fragmented production layout. At the same time, de-globalization sentiment is growing and developing countries, influenced by the digital economy, are under bigger pressure to catch up with developed countries. The sustainable development of GVCs in the post-pandemic era calls for the reconstruction and innovation of international economic and trade rules. More open and fair international rules will contribute to an effective, transparent, and inclusive international rule system. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Cross-Border E-Commerce and Digital Trade Rules

The new century has witnessed the booming of the Internet economy and the rising of cross-border e-commerce as a new driving force of the global economy. However, the rule-based international system for cross-border e-commerce is confronted with new challenges in the categorization of products, market access, tariff collection, and intellectual property. Therefore, to keep a secure and ordered system, international organizations, regional economic organizations, countries and regions have participated in researching and developing cross-border e-commerce rules. With new characteristics and development trends, they manifest the change from trade in products to trade in services and from focusing on regional areas to expanding to global areas, and put emphasis on digital trade, information security, and intellectual property rights, behind-the-border regulatory cooperation, the interests of developing countries, and the catalyst of the COVID-19 pandemic. China also attaches great importance to international law and rules of cross-border e-commerce and digital trade. With the high-quality implementation of China's 14th Five-Year Plan, cross-border e-commerce and digital trade should take domestic development as the mainstay, with domestic and international development reinforcing each other. Today, China is deepening its cooperation with countries in e-commerce to help narrow the digital divide and offer the world more Chinese wisdom and contribution. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

The Reconstruction and Innovation of International Economic and Trade Rules

In the 21st century, the international political and economic landscape has undergone significant changes, but current international economic and trade rules have lagged behind the development of the global economy, trade, and investment. A new international landscape, an emerging economic mode, and the damage from trade protectionism and COVID-19 all call for the reconstruction and innovation of international economic and trade rules. At the same time, the WTO multilateral trading system is suffering institutional problems in decision-making, the Dispute Settlement System, and regulations. Externally, countries are shifting their interest to regional trade agreements and paying less attention to the WTO. Moreover, the WTO fails to keep pace with the new rule-making in emerging fields and does not balance the distribution of benefits between developed and developing countries. With the deepening of economic globalization that centers on global industrial and value chains, all systems and institutions of international economic and trade rules have witnessed profound adjustments and transformations featuring the rising status of regional trade agreements and developing economies such as China. The key issues in the reconstruction of international economic and trade rules have turned to green and sustainable development, social protection for labor, and behind-the-border measures. The optimal way to reconstruction is adherence to the multilateral framework with the WTO as its core and, in the meantime, appropriately draw on the beneficial components of regional and plurilateral trade agreements to promote the development of international economic and trade rules at multiple levels. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Online Education Innovation Using the CEPHEI E-learning Platform in the New Pandemic Situation

The Covid-19 pandemic has posed major challenges to the education of innovation for students at university, and to the links between industry and university. This chapter describes an innovation-based blended course, the education practices of students staying in different countries, and links the model of academia–industry in the new pandemic situation in China. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Investigation on the blood glucose management of diabetic patients during COVID-19 in Wuhan.

Objective: To investigate the blood glucose management of diabetic patients during the fight against corona virus disease 2019 (COVID-19) in Wuhan, China. Method(s): A questionnaire survey was conducted on diabetic patients receiving hypoglycemic drugs in wuhan, hubei province from February 16, 2020 to February 20, 2020. The questionnaire included participants' basic information, the management of blood glucose, and the prevention and control of COVID-19. SPSS 19.0 was used for statistical analysis, and chi2 test was used for comparison between the two groups. Result(s): A total of 152 valid questionnaires were retrieved. 86 cases (56.6%) diabetic patients achieved glycemic control. 80 cases (52.6%) could regularly monitor their blood glucose. 48 cases (31.6%) had the difficulty in the management of blood glucose for purchasing medicines. They also had the difficulties in adjusting blood glucose in the outpatient of endocrinology departments (31 cases, 20.4%), adherence to appropriate exercise (28 cases, 18.4%) and eating the balanced diet (16 cases, 10.5%). When faced with medical problems, 73 cases (48.0%) seek help from hospital out-patient clinics. Nearby pharmacies (78 case, 51.3%) or hospital outpatient (63 cases, 41.5%) were the main ways to purchase medicines for diabetic patients. 133 cases (87.5%) took medicines regularly. 39 cases (25.7%) and 17 (11.2%) diabetic patients were affected by the COVID-19 epidemic and changed or discontinued the original treatments. There was statistically significant in the proportion of discontinuation of hypoglycemic drugs between different drug treatment regiments and subgroups with diabetes course (chi2=13.30, P<0.01;chi2=8.72, P<0.05). Only 16 cases (10.5%) showed that their community health service organizations had specially trained diabetic management team. Conclusion(s): This survey suggests that the diabetic patients in Wuhan had not paid enough attention to blood glucose monitoring, and their blood glucose control standards need to be further improved. In terms of the present problems, more comprehensive blood glucose management measures need to be developed to help diabetic patients fighting against COVID-19.Copyright © 2020 by the Chinese Medical Association.

Epidemiological Investigation and Analysis of Bovine Coronavirus in Beef Cattle in Jilin Province.

In order to comprehensively understand the epidemiological situation of bovine coronavirus (BCoV) in beef cattle herds in Jilin Province, blood, nasal swabs, fecal swabs and tissue organs of clinically diseased and dead cattle were collected in different seasons from 12 counties and cities in the east, central and western regions of Jilin Province, using serological and molecular diagnostic testing techniques to conduct an epidemiological investigation of BCoV in the The epidemiological situation of BCoV in some areas of Jilin Province. A total of 1 298 clinical serum samples, 462 clinical samples (including fecal samples, liver, lung, spleen, trachea and other tissue samples) were collected, and PCR detection of clinical samples was performed by applying commercial BCoV antibody detection kits to detect serum antibodies and a novel detection technique of nano-PCR, and sequencing and analysis of positive results detected by nucleic acid. The results showed that the serum positive rate of BCoV antibodies was 1.08%, and the positive rate of clinical samples such as feces and liver was 21.10%. The BCoV prevalent strain in the investigated area was more than 99% homologous to the prevalent strain in Sichuan, China, after sequencing analysis. This study provides a comprehensive survey of BCoV prevalence in central Jilin Province, which enriches the epidemiological survey data of bovine coronavirus and lays the foundation for guiding the prevention and control of bovine coronavirus.Copyright © 2023 Acta Veterinaria et Zootechnica Sinica. All rights reserved.

Enhanced electrochemiluminescence immunoassay: 2. Enabling signal detection at an early stage of incubation for rapid point-of-care testing

Signal detection in a label-based immunoassay is performed normally when the antigen/antibody binding reaction reaches the equilibrium state during the incubation period of an assay process. Shortening the incubation period in an assay helps reduce the turnaround time and is particularly valuable for point-of-care testing, but the cost is the reduction of signal level and, possibly, measurement precision as well. This work demonstrates that the signal loss could be offset by the stronger emission of an electronically neutral ruthenium(II) complex label, Ru(2, 2′-bipyridine) (bathophenanthroline disulfonate)[4-(2, 2′-bipyridin-4-yl)butanoic acid], used in the electrochemiluminescence (ECL) immunoassay. Combined with the uniquely well-established flow-through washing process in the automated ECL analyzers and the precise control over liquid handling, the assays performed with a 5-minute incubation period showed the same signal level and measurement precision as those of conventional ECL assays. Additionally, the absence of biotin and streptavidin components in the reagent formulation avoids the biotin-streptavidin interaction during assay incubation and fundamentally eliminates the interference of biotin, especially when used in some high-dose therapies. The results obtained from the procalcitonin prototype kit and the supporting evidence from other preliminary reagents (for SARS-CoV-2 N protein and troponin T) are general. The nonequilibrium detection, along with the downsized instrument design, makes the enhanced ECL (EECL) technology a fast high-performance POCT platform that provides the same high-quality data as those generated from the widely deployed [Ru(bpy)3]2+ based laboratorial ECL systems. The anticipated regulatory approval and follow-up clinical implementation will be a significant stride in the decade-long pursuit of novel ECL labels. © 2023 The Author(s)

Integrated wearable smart sensor system for real-time multi-parameter respiration health monitoring

Monitoring respiration is vital for personal diagnosis of chronic diseases. However, the existing respiratory sensors have severe limitations, such as single function, finite detection parameters, and lack of smart signal analysis. Here, we present an integrated wearable and low-cost smart respiratory monitoring sensor (RMS) system with artificial intelligence (AI)-assisted diagnosis of respiratory abnormality by detecting multi-parameters of human respiration. Coupling with intelligent analysis and data mining algorithms embedded in a phone app, the lighter system of 7.3 g can acquire real-time self-calibrated parameters, including breathing frequency, apnea hypopnea index (AHI), vital capacity (VC), peak expiratory flow (PEF), and other respiratory indexes with an accuracy >95.21%. The data can be wirelessly transferred to the user's data cloud terminal. The RMS system enables comprehensive multi-physiological parameters analysis for auxiliary diagnosing and classifying diseases, including sleep apnea, rhinitis, and chronic lung diseases, as well as rehabilitation of COVID-19, and exhibits advantages of portable healthcare. © 2022 The Authors

Maritime Disruption Impact Evaluation Using Simulation and Big Data Analytics

Disruptions in maritime networks may cause significant financial burden and damage to business. Recently, some international ports have been experiencing unprecedented congestions due to the COVID19 pandemic and other disruptions. It is paramount for the maritime industry to further enhance the capability to assess and predict impacts of disruptions. With more data available from industrial digitization and more advanced technologies developed for big data analytics and simulation, it is possible to build up such capability. In this study, we developed a discrete event simulation model backed with big data analytics for realistic and valid inputs to assess impacts of the Suez Canal blockage to the Port of Singapore. The simulation results reveal an interesting finding that, the blockage occurred in the Suez Canal can hardly cause significant congestion in the Port of Singapore. The work can be extended to evaluate impacts of other types of disruptions, even occurring concurrently. © 2022 IEEE.

The Application of Equivalent Method for Cost Accounting and Performance Management in Community Healthcare Institutions

Background During the promotion of category-based management for community healthcare institutions （class 1 institutions obtain the financial security，and class 2 institutions implement a performance management system），how to appropriately determine the security level and scientifically evaluate the performance is a difficulty to tackle for health administrative departments. Objective To assess the operational efficiency of community healthcare institutions with the data envelopment analysis（DEA） using the information of costs of these institutions calculated using the equivalent method，then attempt to develop an input and management model of integrating cost accounting and performance management for these institutions，providing a theoretical basis for accurate and scientific input of various resources into the community through cost measurement with equivalent method，and a data basis for performance assessment in communities with different characteristics through efficiency evaluation. Methods The real data（financial status and staffing） of 14 community healthcare institutions during 2019 to 2020 were collected from their financial reports，hospital information system，maternal and child healthcare information system，chronic disease management information system，as well as focus group interviews. The equivalent method was used to calculate the total costs of medical services and public health services. The super-efficiency DEA was used to evaluate and analyze the operational efficiency of the 14 sample institutions. Results （1）The average cost of one equivalent service（a general medical outpatient service lasting for 15 minutes was defined as one standard service equivalent unit） was 67.64 yuan in 2019 and 69.80 yuan in 2020 for the 14 institutions. The average cost of one equivalent essential medical service was higher than that of one equivalent public health service in both 2019（167.14 yuan vs 18.86 yuan） and 2020（215.43 yuan vs 19.78 yuan）. The institutions demonstrated significant differences in the average cost of one equivalent essential medical service and the average cost of one equivalent public health service. （2）Each institution had its own peculiar characteristics. For example，S1 institution mainly provided essential medical services，and had higher total equivalent essential medical services and efficiency than other institutions，while S9 institution focused on providing public health services，and had the highest efficiency in delivering public health services. （3）In 2020，the 14 institutions provided 134 800 equivalent COVID-19-related services，with a cost of 1.037 8 million yuan. （4）In 2019 and 2020，only two institutions were relatively overall efficient，and ≥ 50.0% institutions were pure technically efficient. The institutions with overall operational inefficiency were mainly caused by scale inefficiency primarily due to increasing returns to scale. Conclusion The equivalent method provides a relatively unified "scale" to standardize the service efficiency of different types of community healthcare institutions，provides support for health administrative departments implementing category-based compensation for the institutions，benefiting the featured and high-level development of community healthcare institutions. Either institutions delivering essential medical services or those delivering public health services，mainly present increasing returns to scale，suggesting that the efficiency of these institutions can be improved by increasing the human/financial/material input into the institutions and providing precise compensation for them. © 2023 Chinese General Practice. All rights reserved.