Estimating the basic reproduction rate of HFMD using the time series SIR model in Guangdong, China

<div><p>Hand, foot, and mouth disease (HFMD) has caused a substantial burden of disease in China, especially in Guangdong Province. Based on notifiable cases, we use the time series Susceptible-Infected-Recovered model to estimate the basic reproduction rate (R0) and the herd immunity threshold, understanding the transmission and persistence of HFMD more completely for efficient intervention in this province. The standardized difference between the reported and fitted time series of HFMD was 0.009 (<0.2). The median basic reproduction rate of total, enterovirus 71, and coxsackievirus 16 cases in Guangdong were 4.621 (IQR: 3.907–5.823), 3.023 (IQR: 2.289–4.292) and 7.767 (IQR: 6.903–10.353), respectively. The heatmap of R0 showed semiannual peaks of activity, including a major peak in spring and early summer (about the 12^th week) followed by a smaller peak in autumn (about the 36^th week). The county-level model showed that Longchuan (R0 = 33), Gaozhou (R0 = 24), Huazhou (R0 = 23) and Qingxin (R0 = 19) counties have higher basic reproduction rate than other counties in the province. The epidemic of HFMD in Guangdong Province is still grim, and strategies like the World Health Organization’s expanded program on immunization need to be implemented. An elimination of HFMD in Guangdong might need a Herd Immunity Threshold of 78%.</p></div

Heatmap of bi-weekly R0 by city.

<p>The dendrogram on the left side was the result of the clustering analysis.</p

City-specific R0 and HIT of HFMD in Guangdong.

<p>City-specific R0 and HIT of HFMD in Guangdong.</p

Serotype-specific R0 and HIT of HFMD in Guangdong.

<p>Serotype-specific R0 and HIT of HFMD in Guangdong.</p

County-specific R0 of HFMD in Guangdong.

<p>This map was downloaded from OpenStreetMap (OpenStreetMap Foundation, London, United Kingdom) and processed by and R version 3.3.2 (R Core Team, Vienna, Austria).</p

Estimated <i>RR</i> for province.

<p>Fig 3a. Estimated unadjusted spatial <i>RR</i> for provinces, Fig 3b. Estimated spatial structured <i>RR</i> for provinces, Fig 3c. Estimated random effects <i>RR</i> of avtemp for provinces, Fig 3d. Estimated spatial unstructured <i>RR</i> for provinces(Fig 3a <i>RR</i> generated from null multilevel model unadjustment for spatial correlated strucuture effects and climatic varialbes, Fig 3b–3d <i>RR</i> generated from final multilevel model adjustment for spatial correlated effects and climatic variables).</p

Time series plot of weekly HFMD cases and climatic variables of China, 2008–2013.

<p>Pcase (weekly reported cases of HFMD), avtemp (weekly average temperature (°C)), maxtemp (weekly maximum temperature (°C)), mintemp (weekly minimum temperature (°C)), rainfall (weekly average 20–20 hours rainfall (0.1 millimeters)), mavhmd (weekly average relative humidity (0.1%)), hsun (weekly average hours of sunshine (0.1hours)), mavwspeed (weekly average wind speed (meters per second)).</p

Monolithic All-Phosphate Solid-State Lithium-Ion Battery with Improved Interfacial Compatibility

High interfacial resistance between solid electrolyte and electrode of ceramic all-solid-state batteries is a major reason for the reduced performance of these batteries. A solid-state battery using a monolithic all-phosphate concept based on screen printed thick LiTi₂(PO₄)₃ anode and Li₃V₂(PO₄)₃ cathode composite layers on a densely sintered Li_1.3Al_0.3Ti_1.7(PO₄)₃ solid electrolyte has been realized with competitive cycling performance. The choice of materials was primarily based on the (electro-)­chemical and mechanical matching of the components instead of solely focusing on high-performance of individual components. Thus, the battery utilized a phosphate backbone in combination with tailored morphology of the electrode materials to ensure good interfacial matching for a durable mechanical stability. Moreover, the operating voltage range of the active materials matches with the intrinsic electrochemical window of the electrolyte which resulted in high electrochemical stability. A highly competitive discharge capacity of 63.5 mAh g^–1 at 0.39 C after 500 cycles, corresponding to 84% of the initial discharge capacity, was achieved. The analysis of interfacial charge transfer kinetics confirmed the structural and electrical properties of the electrodes and their interfaces with the electrolyte, as evidenced by the excellent cycling performance of the all-phosphate solid-state battery. These interfaces have been studied via impedance analysis with subsequent distribution of relaxation times analysis. Moreover, the prepared solid-state battery could be processed and operated in air atmosphere owing to the low oxygen sensitivity of the phosphate materials. The analysis of electrolyte/electrode interfaces after cycling demonstrates that the interfaces remained stable during cycling

Spatial-Temporal Clusters and Risk Factors of Hand, Foot, and Mouth Disease at the District Level in Guangdong Province, China

<div><p>Objective</p><p>Hand, foot, and mouth disease (HFMD) has posed a great threat to the health of children and become a public health priority in China. This study aims to investigate the epidemiological characteristics, spatial-temporal patterns, and risk factors of HFMD in Guangdong Province, China, and to provide scientific information for public health responses and interventions.</p> <p>Methods</p><p>HFMD surveillance data from May 2008 to December 2011were provided by the Chinese Center for Disease Control and Prevention. We firstly conducted a descriptive analysis to evaluate the epidemic characteristics of HFMD. Then, Kulldorff scan statistic based on a discrete Poisson model was used to detect spatial-temporal clusters. Finally, a spatial paneled model was applied to identify the risk factors.</p> <p>Results</p><p>A total of 641,318 HFMD cases were reported in Guangdong Province during the study period (total population incidence: 17.51 per 10,000). Male incidence was higher than female incidence for all age groups, and approximately 90% of the cases were children years old. Spatial-temporal cluster analysis detected four most likely clusters and several secondary clusters (<i>P</i><0.001) with the maximum cluster size 50% and 20% respectively during 2008–2011. Monthly average temperature, relative humidity, the proportion of population years, male-to-female ratio, and total sunshine were demonstrated to be the risk factors for HFMD.</p> <p>Conclusion</p><p>Children years old, especially boys, were more susceptible to HFMD and we should take care of their vulnerability. Provincial capital city Guangzhou and the Pearl River Delta regions had always been the spatial-temporal clusters and future public health planning and resource allocation should be focused on these areas. Furthermore, our findings showed a strong association between HFMD and meteorological factors, which may assist in predicting HFMD incidence.</p> </div

Monthly reported cases of HFMD in Guangdong Province, China, 2008–2011.

<p>Monthly reported cases of HFMD in Guangdong Province, China, 2008–2011.</p