Job Satisfaction by Chinese Primary Care Doctors Following Health Care Reform

The purpose of this study is to compare primary care doctors’ job satisfaction and factors associated with it before and after the latest health care reform in China. Data for the study were obtained from China Primary Care Workforce Surveys conducted in 2008 and 2011. Compared to results from the 2008 survey, primary care doctors (PCDs) in the 2011 survey were more satisfied with their jobs overall as well as work conditions and equipment, but less satisfied with their income. In both surveys rural CHC and village clinic doctors were less satisfied than their urban counterparts with their jobs overall, income, work condition, and equipment. Logistic regressions showed that practice setting (i.e. urban, rural, or village) and educational level were two important factors associated with job satisfaction. These findings demonstrated both significant achievements and further efforts to be made to strengthen primary care workforce and enhance their job satisfaction

A Joint Design for Full-duplex OFDM AF Relay System with Precoded Short Guard Interval

In-band full-duplex relay (FDR) has attracted much attention as an effective solution to improve the coverage and spectral efficiency in wireless communication networks. The basic problem for FDR transmission is how to eliminate the inherent self-interference and re-use the residual self-interference (RSI) at the relay to improve the end-to-end performance. Considering the RSI at the FDR, the overall equivalent channel can be modeled as an infinite impulse response (IIR) channel. For this IIR channel, a joint design for precoding, power gain control and equalization of cooperative OFDM relay systems is presented. Compared with the traditional OFDM systems, the length of the guard interval for the proposed design can be distinctly reduced, thereby improving the spectral efficiency. By analyzing the noise sources, this paper evaluates the signal to noise ratio (SNR) of the proposed scheme and presents a power gain control algorithm at the FDR. Compared with the existing schemes, the proposed scheme shows a superior bit error rate (BER) performance.Comment: 16 pages, 5 figure

GADY: Unsupervised Anomaly Detection on Dynamic Graphs

Anomaly detection on dynamic graphs refers to detecting entities whose behaviors obviously deviate from the norms observed within graphs and their temporal information. This field has drawn increasing attention due to its application in finance, network security, social networks, and more. However, existing methods face two challenges: dynamic structure constructing challenge - difficulties in capturing graph structure with complex time information and negative sampling challenge - unable to construct excellent negative samples for unsupervised learning. To address these challenges, we propose Unsupervised Generative Anomaly Detection on Dynamic Graphs (GADY). To tackle the first challenge, we propose a continuous dynamic graph model to capture the fine-grained information, which breaks the limit of existing discrete methods. Specifically, we employ a message-passing framework combined with positional features to get edge embeddings, which are decoded to identify anomalies. For the second challenge, we pioneer the use of Generative Adversarial Networks to generate negative interactions. Moreover, we design a loss function to alter the training goal of the generator while ensuring the diversity and quality of generated samples. Extensive experiments demonstrate that our proposed GADY significantly outperforms the previous state-of-the-art method on three real-world datasets. Supplementary experiments further validate the effectiveness of our model design and the necessity of each module

Strengthening health system to improve immunization for migrants in China.

BACKGROUND: Immunization is the most cost-effective method to prevent and control vaccine-preventable diseases. Migrant population in China has been rising rapidly, and their immunization status is poor. China has tried various strategies to strengthen its health system, which has significantly improved immunization for migrants. METHODS: This study applied a qualitative retrospective review method aiming to collect, analyze and synthesize health system strengthening experiences and practices about improving immunizations for migrants in China. A conceptual framework of Theory of Change was used to extract the searched literatures. 11 searched literatures and 4 national laws and policies related to immunizations for migrant children were carefully studied. RESULTS: China mainly employed 3 health system strengthening strategies to significantly improve immunization for migrant population: stop charging immunization fees or immunization insurance, manage immunization certificates well, and pay extra attentions on immunization for special children including migrant children. These health system strengthening strategies were very effective, and searched literatures show that up-to-date and age-appropriate immunization rates were significantly improved for migrant children. CONCLUSIONS: Economic development led to higher migrant population in China, but immunization for migrants, particularly migrant children, were poor. Fortunately various health system strengthening strategies were employed to improve immunization for migrants in China and they were rather successful. The experiences and lessons of immunization for migrant population in China might be helpful for other developing countries with a large number of migrant population

Development of rail technology for high speed railway in China

Purpose – The purpose of this paper is to summarize the status and characteristics of rail technology of high-speed railway in China, and point out the development direction of rail technology of high-speed railway. Design/methodology/approach – This study reviews the evolution of high-speed rail standards in China, comparing their chemical composition, mechanical attributes and geometric specifications with EN standards. It delves into the status of rail production technology, shifts in key performance indicators and the quality characteristics of rails. The analysis further examines the interplay between wheels and rails, the implementation of grinding technology and the techniques for inspecting rail service conditions. It encapsulates the salient features of rail operation and maintenance within the high-speed railway ecosystem. The paper concludes with an insightful prognosis of high-speed railway technology development in China. Findings – The rail standards of high-speed railway in China are scientific and advanced, highly operational and in line with international standards. The quality and performance of rail in China have reached the world’s advanced level. The 60N profile guarantees the operation quality of wheel–rail interaction effectively. The rail grinding technology system scientifically guarantees the long-term good service performance of the rail. The rail service state detection technology is scientific and efficient. The rail technology will take “more intelligent” and “higher speed” as the development direction to meet the future needs of high-speed railway in China. Originality/value – The development direction of rail technology for high-speed railway in China is defined, which will promote the continuous innovation and breakthrough of rail technology

Association between sarcopenia and osteoporosis: the cross-sectional study from NHANES 1999–2020 and a bi-directions Mendelian randomization study

BackgroundOsteoporosis (OP) and sarcopenia are prevalent musculoskeletal conditions among the elderly. Nevertheless, the causal relationship between sarcopenia and OP remains a subject of controversy and uncertainty. In this study, we employed cross-sectional analysis and Mendelian randomization (MR) to investigate the intricate relationship between sarcopenia and OP.MethodsThe cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2020, which involved in 116,876 participants. It assessed the correlation between sarcopenia, osteoporosis (OP), and bone mineral density (BMD) using Chi-square tests, T-tests, and a multiple logistic regression model. Additionally, we conducted Mendelian randomization (MR) analysis to investigate the causal effects of sarcopenia-related characteristics (ALM) on OP. We employed IVW, sensitivity analysis, heterogeneity testing, and other methods for MR. The ALM data was sourced from the UK Biobank (n=450,243), while the aggregated data on OP was obtained from GWAS statistics (n=53,236).ResultsIn this cross-sectional analysis, we observed that in the multivariate logistic regression model, without adjusting for any variables, OP emerged as a risk factor for sarcopenia [OR 95% CI = 1.90 (1.13-3.18), P = 0.02]. Following adjustments for gender, age, BMI, and biochemical variables, OP retained its status as a risk factor for sarcopenia [OR 95% CI = 3.54 (1.91-6.54), P < 0.001]. Moreover, after accounting for all variables, OP emerged as an independent risk factor for sarcopenia [OR 95% CI = 4.57 (1.47-14.22), P = 0.01].In the MR analysis, we uncovered that femoral neck BMD (FN BMD), lumbar spine BMD (LS BMD), and forearm bone mineral density (FA BMD) exerted a direct causal influence on ALM [FA BMD: OR 95% CI = 1.028 (1.008, 1.049), p = 0.006; FN BMD: OR (95% CI) = 1.131 (1.092, 1.170), p = 3.18E-12; LS BMD: OR (95% CI) = 1.080 (1.062, 1.098), p = 2.86E-19].ConclusionOur study has revealed a positive correlation between OP and the prevalence of sarcopenia. It suggests a potentially robust causal relationship between OP and sarcopenia. Notably, OP appears to be associated with a higher likelihood of losing ALM, and a significant loss of ALM may contribute to a decline in LS BMD