Estimation of economic burden throughout course of cervical squamous intraepithelial lesion and cervical cancer in China:A nationwide multicenter cross-sectional study

Objective: Cervical squamous intraepithelial lesion(SIL) and cervical cancer are major threats to females' health and life in China, and we aimed to estimate the economic burden associated with their diagnosis and treatment.Methods: A nationwide multicenter, cross-sectional, hospital-based survey was conducted in 26 qualified hospitals across seven administrative regions of China. We investigated females who had been pathologically diagnosed with SIL and cervical cancer, and included five disease courses(“diagnosis”, “initial treatment”,“chemoradiotherapy”, “follow-up” and “recurrence/progression/metastasis”) to estimate the total costs. The median and interquartile range(IQR) of total costs(including direct medical, direct non-medical, and indirect costs), reimbursement rate by medical insurance, and catastrophic health expenditures in every clinical stage were calculated.Results: A total of 3,471 patients in different clinical stages were analyzed, including low-grade SIL(LSIL)(n=549), high-grade SIL(HSIL)(n=803), cervical cancer stage ⅠA(n=226), ⅠB(n=610), ⅡA(n=487), ⅡB(n=282), Ⅲ(n=452) and Ⅳ(n=62). In urban areas, the estimated total costs of LSIL and HSIL were $1,637.7(IQR:$956.4-$2,669.2) and $2,467.1(IQR:$1,579.1-$3,762.3), while in rural areas the costs were $459.0(IQR:$167.7-$1,330.3) and $1,230.5(IQR:$560.6-$2,104.5), respectively. For patients with cervical cancer stage ⅠA,ⅠB, ⅡA, ⅡB, and Ⅲ-Ⅳ, the total costs were $15,034.9(IQR:$11,083.4-$21,632.4), $19,438.6(IQR:$14,060.0-$26,505.9), $22,968.8(IQR:$16,068.8-$34,615.9), $26,936.0(IQR:$18,176.6-$41,386.0) and $27,332.6(IQR:$17,538.7-$44,897.0), respectively. Medical insurance covered 43%-55% of direct medical costs for cervical cancer patients, while the coverage for SIL patients was 19%-43%. For most cervical cancer patients, the expense was catastrophic, and the extent of catastrophic health expenditure was about twice large for rural patients than that for urban patients in each stage.Conclusions: The economic burden of SIL and cervical cancer in China is substantial, with a significant proportion of the costs being avoidable for patients with LSIL. Even for those with medical insurance, catastrophic health expenditures are also a major concern for patients with cervical cancer, particularly for those living in rural areas.

Reconfigurable Muscle Strength Training Robot with Multi-mode Training for 17 Joint Movements

Different from limb rehabilitation training,the purpose of muscle strength training is to reduce muscle atrophy and increase muscle strength and tolerance through strength training of limb muscles,and then improve the muscle strength level of muscles(groups),mainly for sports fitness and muscle strengthening groups and patients with muscle atrophy or muscle weakness caused by various diseases.In this paper,we developed a new reconfigurable muscle strength training robot,a bionic robot by imitating physicians to conduct muscle strength training for patients,which was developed with six training modes for 17 joint movements,that is,the shoulder flexion/extension,the shoulder internal/external rotation,the shoulder adduction/abduction,the elbow flexion/extension,the wrist supination/pronation,the wrist flexion/extension,the wrist radial/ulnar deviation,the hip flexion/extension,the hip internal/external rotation,the hip adduction/abduction,the knee flexion/extension,the ankle dorsiflexion/plantarflexion,the ankle adduction/abduction,the ankle inversion/eversion,the waist flexion/extension,the waist left/right rotation,and the waist left/right flexion.The reconfigurable mechanism was designed with fully electric adjuster and reconfigurable adaptors deployed on the driving unit,and six training modes were developed,namely,continuous passive motion,active exercise,passive–active exercise,isotonic exercise,isometric exercise and isokinetic exercise.Experiments with knee joint and elbow joint have shown that the developed reconfigurable muscle strength training robot can realize the multi-mode trainings for the 17 joint movements.

Exploring the structural properties of cathode and anode materials in Li-ion battery via neutron diffraction technique

As a unique microprobe for structure and dynamics of materials,neutron possesses superior ability in penetration as well as sensitivity for light and magnetic elements in comparison with X-ray and electron.As for the research and development of lithium-ion batteries(LIBs),neutron diffraction techniques play an indispensable role in exploring the structural properties of various electrode materials,especially the detailed structural evolution of cathode and anode materials during electrochemical cycling.Moreover,based on thorough analysis of neutron diffraction results,an in-depth and systematic understanding of some fundamental mechanisms,such as the formation mechanism of defects and migration mechanism of lithium ions,could also be established,which is essential for the development of high-performance electrode materials for the next-generation LIBs.Nevertheless,that technique would not seem to be widely applied yet in comparison with the application of X-ray diffraction and more attention should be paid.To demonstrate the advantages of neutron diffraction technique in research of LIBs materials,this work systematically summarizes representative neutron diffraction studies on exploring structural details hidden in electrode materials and on probing structural evolution of electrode materials during charge/discharge processes.Prospects for further applications of neutron diffraction techniques in research of LIBs are also put forward.

Optimum design and preliminary experiments of a novel parallel end traction apparatus for upper-limb rehabilitation

Robot-assisted technology has been increasingly employed in the therapy of post stroke patients to deliver high-quality treatment and alleviate therapists5 burden.This paper introduces a novel parallel end traction apparatus(PETA)to supplement equipment selection.Considering the appearance and performance of the PETA,two types of special five-bar linkage mechanisms are selected as the potential configurations of the actuation execution unit because of their compact arrangement and parallel structure.Kinematic analysis of each mechanism,i.e.,position solutions and Jacobian matrix,is carried out.Subsequently,a comparative study between the two mechanisms is conducted.In the established source of nondimensional parameter synthesis,the singularity,maximum continuous workspace,and performance variation trends are analyzed.Based on the evaluation results,the final scheme with determined configuration and corresponding near-optimized non-dimensional parameters is obtained.Then,a prototype is constructed.By adding a lockable translational degree of freedom in the vertical direction,the PETA can provide 2D planar exercise and 3D spatial exercise.Finally,a control system is developed for passive exercise mode based on the derived inverse position solution,and preliminary experiments are performed to verify the applicability of the PETA.