Epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China:a hospital-based retrospective study

Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.

Demand-Responsive Transportation Vehicle Routing Optimization Based on Two-Stage Method

Demand-responsive transportation(DRT)is a flexible passenger service designed to enhance road efficiency,reduce peak-hour traffic,and boost passenger satisfaction.However,existing optimization methods for initial passenger requests fall short in addressing real-time passenger needs.Consequently,there is a need to develop realtime DRT route optimization methods that integrate both initial and real-time requests.This paper presents a twostage,multi-objective optimization model for DRT vehicle scheduling.The first stage involves an initial scheduling model aimed at minimizing vehicle configuration,and operational,and CO_(2)emission costs while ensuring passenger satisfaction.The second stage develops a real-time scheduling model to minimize additional operational costs,penalties for time window violations,and costs due to rejected passengers,thereby addressing real-time demands.Additionally,an enhanced genetic algorithm based on Non-dominated Sorting Genetic Algorithm-II(NSGA-II)is designed,incorporating multiple crossover points to accelerate convergence and improve solution efficiency.The proposed scheduling model is validated using a real network in Shanghai.Results indicate that realtime scheduling can serve more passengers,and improve vehicle utilization and occupancy rates,with only a minor increase in total operational costs.Compared to the traditional NSGA-II algorithm,the improved version enhances convergence speed by 31.7%and solution speed by 4.8%.The proposed model and algorithm offer both theoretical and practical guidance for real-world DRT scheduling.

Fast saccharide mapping method for quality consistency evaluation of commercial xylooligosaccharides collected in China

Due to the extensive use of xylooligosaccharides(XOS)as functional food ingredients,many inferior goods and even adulterants are generally found in the market,which may pose a health hazard to certain populations.Chromatography method such as high-performance liquid chromatography(HPLC)and high-performance thin-layer chromatography(HPTLC)is traditionally applied for the quality analysis of XOS.However,it is time consuming due to the prolonged separation and pre-or post-derivatization procedure.In this study,a fast saccharide mapping method based on matrix-assisted laser desorption/time-of-flight mass spectrometry(MALDI-TOF-MS)was developed for the quality consistency analysis of 22 batches of XOS collected from different manufacturers in China.The time needed for saccharides analysis using MALDI-MS was less than 30 min for one plate,at least 6 times faster than that by the traditional HPTLC chromatography method.In addition,MALDI-MS possessed higher resolution for XOS with DP4-DP7 based on the difference of m/z,which is hardly separated using HPTLC.The results showed that XOS were present only in samples XY01-XY11,samples XY12-XY14 only consisted of hex oligosaccharides,and samples XY15-XY22 were free of oligosaccharides.These indicate that the quality consistency of XOS products in the China market was poor,which should be carefully investigated.