Health System Barriers and Facilitators to Delivering Additional Vaccines through the National Immunisation Programme in China: A Qualitative Study of Provider and Service-User Perspectives.

In China, there are two categories of vaccines available from the Chinese Center for Disease Control and associated public health agencies. Extended Program of Immunization (EPI) vaccines are government-funded and non-EPI vaccines are voluntary and paid for out-of-pocket. The government plans to transition some non-EPI vaccines to EPI in the coming years, which may burden public health system capacity, particularly in terms of budget, workforce, supply chains, and information systems. Our study explored vaccinator and caregiver perspectives on introducing non-EPI vaccines into routine immunization and perceived facilitators and barriers affecting this transition. We conducted a qualitative study from a realist perspective, analysing semi-structured interviews with 26 vaccination providers and 160 caregivers in three provinces, selected to represent regional socioeconomic disparities across Eastern, Central, and Western China. Data were analysed thematically, using deductive and inductive coding. Most participants were positive about adding vaccines to the national schedule. Candidate EPI vaccines most frequently recommended by participants were varicella, mumps vaccine, and hand-foot-mouth disease. Providers generally considered existing workspaces, cold-chain equipment, and funding sufficient, but described frontline staffing and vaccine information systems as requiring improvement. This is the first qualitative study to explore interest, barriers, and facilitators related to adding vaccines to China's national schedule from provider and caregiver perspectives. Findings can inform government efforts to introduce additional vaccines, by including efforts to retain and recruit vaccine programme staff and implement whole-process data management and health information systems that allow unified nationwide data collection and sharing

Co-infusion of haplo-identical CD19-chimeric antigen receptor T cells and stem cells achieved full donor engraftment in refractory acute lymphoblastic leukemia

Abstract Background Elderly patients with relapsed and refractory acute lymphoblastic leukemia (ALL) have poor prognosis. Autologous CD19 chimeric antigen receptor-modified T (CAR-T) cells have potentials to cure patients with B cell ALL; however, safety and efficacy of allogeneic CD19 CAR-T cells are still undetermined. Case presentation We treated a 71-year-old female with relapsed and refractory ALL who received co-infusion of haplo-identical donor-derived CD19-directed CAR-T cells and mobilized peripheral blood stem cells (PBSC) following induction chemotherapy. Undetectable minimal residual disease by flow cytometry was achieved, and full donor cell engraftment was established. The transient release of cytokines and mild fever were detected. Significantly elevated serum lactate dehydrogenase, alanine transaminase, bilirubin and glutamic-oxalacetic transaminase were observed from days 14 to 18, all of which were reversible after immunosuppressive therapy. Conclusions Our preliminary results suggest that co-infusion of haplo-identical donor-derived CAR-T cells and mobilized PBSCs may induce full donor engraftment in relapsed and refractory ALL including elderly patients, but complications related to donor cell infusions should still be cautioned. Trial registration Allogeneic CART-19 for Elderly Relapsed/Refractory CD19+ ALL. NCT0279955

Expert Consensus on Microtransplant for Acute Myeloid Leukemia in Elderly Patients -Report From the International Microtransplant Interest Group

Recent studies have shown that microtransplant (MST) could improve outcome of patients with elderly acute myeloid leukemia (EAML). To further standardize the MST therapy and improve outcomes in EAML patients, based on analysis of the literature on MST, especially MST with EAML from January 1st, 2011 to November 30th, 2022, the International Microtransplant Interest Group provides recommendations and considerations for MST in the treatment of EAML. Four major issues related to MST for treating EAML were addressed: therapeutic principle of MST (1), candidates for MST (2), induction chemotherapy regimens (3), and post-remission therapy based on MST (4). Others included donor screening, infusion of donor cells, laboratory examinations, and complications of treatment

Optimization of Performance Evaluation of Urban Road Pavement

In recent years, urbanization has developed rapidly, and urban road play a vital role as the premise. Due to the good effectiveness of asphalt pavement, which is more popular in urban road, and road maintenance demands are also increasing. In order to make the maintenance work appropriate, accurate pavement performance evaluation is the premise. This paper collects the data of a road pavement condition in Shanghai and calculates the sub-indexes of each section. We use the entropy weight method to obtain the influence degree of each sub-index. Then we use the revised set pair analysis to construct the comprehensive performance evaluation model of urban road pavement. The analysis shows that compared with the standard method and the set pair analysis, the revised model is more objective, in line with the actual use of the road

Human Health and Ecological Risk Assessment of 16 Polycyclic Aromatic Hydrocarbons in Drinking Source Water from a Large Mixed-Use Reservoir

Reservoirs play an important role in living water supply and irrigation of farmlands, thus the water quality is closely related to public health. However, studies regarding human health and ecological risk assessment of polycyclic aromatic hydrocarbons (PAHs) in the waters of reservoirs are very few. In this study, Shitou Koumen Reservoir which supplies drinking water to 8 million people was investigated. Sixteen priority PAHs were analyzed in a total of 12 water samples. In terms of the individual PAHs, the average concentration of Fla, which was 5.66 × 10−1 μg/L, was the highest, while dibenz(a,h)anthracene which was undetected in any of the water samples was the lowest. Among three PAH compositional patterns, the concentration of low-molecular-weight and 4-ring PAHs was dominant, accounting for 94%, and the concentration of the total of 16 PAHs was elevated in constructed-wetland and fish-farming areas. According to the calculated risk quotients, little or no adverse effects were posed by individual and complex PAHs in the water on the aquatic ecosystem. In addition, the results of hazard quotients for non-carcinogenic risk also showed little or no negative impacts on the health of local residents. However, it could be concluded from the carcinogenic risk results that chrysene and complex PAHs in water might pose a potential carcinogenic risk to local residents. Moreover, the possible sources of PAHs were identified as oil spills and vehicular emissions, as well as the burning of biomass and coal

GPS data cleaning and analysis based on YouSense mobile application

In the last decade, mobile communications technologies has pervaded our society. In order to assess and analyze the location of individuals and populations in this mobile world, mobile positioning or mobile telephone tracking is proposed as a monitoring tool to sense the movement of people. In this paper, a monitoring tool called YouSense, a movement and behavior data collection mobile application, has been used. Our work mainly focus on YouSense GPS data cleaning, including filtering out wrong location information and filling the gaps when GPS is switched off. We set up several filter criteria for general YouSense GPS data cleaning through statistic analysis of different users' dataset. After data cleaning, we have also analyzed the location of meaningful places for mobile users, such as home and work anchor points

Modeling the dynamic social relations of citizens based on daily GPS data

Smartphones or mobile phones are rapidly becoming the primary computer and communication device in everybody's daily lives. This research introduced some indices of dynamic interaction for detecting the wildlife animals. We applied the indices to explore the mankind interaction using smartphone daily GPS data. We program these indices in the statistical software R and got some simulation results. Besides, we put forward some method to solve the GPS data gaps problem and visualized the GPS data on 3D maps

An Investigation into the Effects of Temperature Gradient on the Soil Water–Salt Transfer with Evaporation

Temperature gradients exist in the field under brackish water irrigation conditions, especially in northern semi–arid areas of China. Although there are many investigators dedicated to studying the mechanism of brackish water irrigation and the effect of brackish water irrigation on crops, there are fewer investigations of the effects of temperature gradient on the water–salt transport. Based on the combination of a physical experiment and a mathematical model, this study was conducted to: (a) build a physical model and observe the redistribution of soil water–heat–salt transfer; (b) develop a mathematical model focused on the influence of a temperature gradient on soil water and salt redistribution based on the physical model and validate the proposed model using the measured data; and (c) analyze the effects of the temperature gradient on the soil water–salt transport by comparing the proposed model with the traditional water–salt model in which the effects of temperature gradient on the soil water–salt transfer are neglected. Results show that the soil temperature gradient has a definite influence on the soil water–salt migration. Moreover, the effect of temperature gradient on salt migration was greater than that of water movement

Changes of Reference Evapotranspiration and Its Relationship to Dry/Wet Conditions Based on the Aridity Index in the Songnen Grassland, Northeast China

Reference evapotranspiration (ET0) plays an important role in regional dry/wet conditions. Based on the Food and Agriculture Organization of the United (FAO) Penman-Monteith method and daily climate variables, ET0 was calculated for 21 stations in and around the Songnen Grassland, northeast China, during 1960–2014. The temporal and spatial variations of ET0 and precipitation (P) were analyzed in the annual, seasonal, and growing season (from April to October) time series using the Mann-Kendall test, Sen’s slope estimator, and linear regression coupled with a break trend analysis. A sensitivity analysis was used to detect the key climate parameter contributing to ET0 change. By linear regression analysis on the relationship between ET0, P, and the aridity index (AI), the role of ET0 in determining regional wet/dry conditions was analyzed. Results show a higher ET0 in the southwest and a lower ET0 in the northeast, but P was opposite to that of ET0. Evident decreasing trends of ET0 in the annual, seasonal, and growing season time series were detected in almost the entire region by the trend analysis methods. For the entire region, the decreasing trend of ET0 can be linked to the relative humidity and maximum air temperature. The positive contribution of increasing temperature to ET0 was offset by the effect of the significantly decreasing relative humidity, wind speed, and sunshine duration at the 0.05 level during 1960–2014. In addition, the value of ET0 was higher in drought years and lower in wet years

Modeling Coupled Water and Heat Transport in the Root Zone of Winter Wheat under Non-Isothermal Conditions

Temperature is an integral part of soil quality in terms of moisture content; coupling between water and heat can render a soil fertile, and plays a role in water conservation. Although it is widely recognized that both water and heat transport are fundamental factors in the quantification of soil mass and energy balance, their computation is still limited in most models or practical applications in the root zone under non-isothermal conditions. This research was conducted to: (a) implement a fully coupled mathematical model that contains the full coupled process of soil water and heat transport with plants focused on the influence of temperature gradient on soil water redistribution and on the influence of change in soil water movement on soil heat flux transport; (b) verify the mathematical model with detailed field monitoring data; and (c) analyze the accuracy of the model. Results show the high accuracy of the model in predicting the actual changes in soil water content and temperature as a function of time and soil depth. Moreover, the model can accurately reflect changes in soil moisture and heat transfer in different periods. With only a few empirical parameters, the proposed model will serve as guide in the field of surface irrigation