Affordability, Accessibility, and Quality of Maternal Health Care Services and Level of Satisfaction of Mothers in Rural Areas in China

Objective:This study aimed to understand the affordability,accessibility,and quality of maternal and child health services for postpartum mothers,and their impact on satisfaction.Methods:The study utilized the Anderson model and revised the Maternal Pregnancy and Perinatal Health Service Questionnaire.A survey was conducted among 289 mothers aged 20–49 in Feicheng City.Results:Regarding accessibility,most respondents(133)reported that travel time to healthcare services exceeded 60 minutes,while 99 respondents indicated a travel time of 16–30 minutes.The issue of affordability was highlighted,with 86.85%of participants perceiving maternal healthcare services as costly,indicating a significant financial burden.More than 50%of respondents were satisfied with two specific dimensions(P<0.05)regarding the quality of maternal healthcare services.Conclusion:The study found that accessibility,affordability,and quality significantly affect mothers’satisfaction with maternal health services.Future research should focus on developing more suitable service pathways for rural mothers.

Spatial Disparity in Availability of Tuberculosis Diagnostic Services Based on Sector and Level of Care in Nigeria

Background: Delay in Tuberculosis (TB) diagnosis can contribute to late presentation, severe disease, and continued transmission. KNCV TB Foundation Nigeria through the United States Agency for International Development (USAID) funded the TB Local Organization Network (LON) 1 and 2 projects that explored the availability of Tuberculosis services based on sector and levels of care. Methods: TB Patient Pathway Analysis was carried out in 14 states comprising 92 facilities. It involved primary, secondary, and tertiary levels of health care in both the public and private sectors. This was a cross-sectional study under program implementation. Proforma was used to collect data on the available TB diagnostic services. Results: In public health facilities, GeneXpert was available at 100% in tertiary facilities in 8 (57%) states;up to 82% in 4 (33%) states, 50% available at secondary facilities in 2 states, and There is none at the primary facilities. Smear microscopy was available at 100% in tertiary facilities in 9 (64%) states and 3 (25%) states have 50% to 82%;secondary -10 (71%) states have > 70% at facilities;primary 1 (7%) state has it in 61% of facilities. Loop-mediated isothermal amplification (TB-LAMP) in tertiary 2 (17%) states have 20% and 100% respectively;secondary 4 (<30%) states have in 1 or 2 facilities;none for primary facilities. In private health facilities, 79% of states have Smear microscopy at both primary and secondary facilities, and only 2 states (14%) at tertiary facilities. Only 1 (7%) state has GeneXpert in all tertiary facilities, 2 (14%) states have secondary facilities, and 4 states in about 1% of facilities. TB LAMP was not available in any tertiary facility, one (7%) state at secondary with coverage of 1%, and 2 (14%) states at primary both with 4% overall facility coverage. Conclusions: There is an inequitable distribution of TB diagnostic services in both sectors and levels of care in Nigeria. TB care and control will improve with enhanced equitable distribution of TB diagnostic services across the health system.

Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China

BACKGROUND Within the normal range,elevated alanine aminotransferase(ALT)levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease(MAFLD).AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected.The incidence rate,cumulative times,and equally and unequally weighted cumulative effects of excess high-normal ALT levels(ehALT)were measured.Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.RESULTS A total of 83.13%of participants with MAFLD had normal ALT levels.The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group.Compared with those in the low-normal ALT group,the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651[95%confidence interval(CI):1.199-2.273]and 1.535(95%CI:1.119-2.106)in the third quartile and 1.616(95%CI:1.162-2.246)and 1.580(95%CI:1.155-2.162)in the fourth quartile,respectively.CONCLUSION Most participants with MAFLD had normal ALT levels.Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.

Water, Sanitation and Hygiene in Lower-Level Health Care Facilities of Dar es Salaam Region in Tanzania: Status towards Achieving the Sustainable Development Goals and Way Forward

Background: Improving Water, Sanitation and Hygiene in health care settings is a critical prerequisite for achieving national health goals and Sustainable Development Goals (SDGs). The World Health Organization (WHO) has set a target for each United Nations member state to reach by 2030. Each member state is required to reach by 2022, 2025 and 2030 at least 60%, 80% and 100%, respectively of basic level of service of the five elements which are water, sanitation, hygiene, waste management and environmental cleaning. Methods: This study aimed to evaluate and document the current state of basic water, sanitation, and hygiene services in all lower-level health care facilities in the Dar es Salaam region of Tanzania as of July 2022. A cross-sectional study was conducted in 99 public dispensaries in the Dar es Salaam region’s five councils: Ubungo, Kigamboni, Kinondoni and Temeke Municipalities, and Ilala City. The interviewee form and observational checklists were both digitalized using the Kobo tool software. The respondents were health care facility in-charges or nurse in-charges. Data were downloaded, validated, and imported to Stata version 15 for analysis. Results: The basic WASH level per JMP is far below the target in 2022. Each member state by 2022 is required to reach at least 60% of the basic level of service of each element. We found a low coverage of basic WASH in the 99 dispensaries included in this study. The basic WASH coverage was met in only 10 (10.1%) of the dispensaries, while the remaining 89 (89.9%) dispensaries fall on limited WASH services. Conclusion: This study revealed lower coverage of basic WASH services in dispensaries. An urgent need is required to improve the status of WASH in all the dispensaries and facilitate the provision of quality health care services, patient safety and reduce health care associated infections.

Shaping a New Level of Bus Service under a Novel Concept of Bus Interaction: A Meta-Review

Public transport services, particularly bus services, play an important role in a sustainable transportation system. However, despite various efforts, bus ridership has decreased. The appearance of shared and on-demand vehicle services is one of the main reasons for this issue. In addition, bus tourism services have been successfully developed to meet the exigent needs of tourists. Therefore, a new level of daily bus service is necessary to adapt to the changing demands of customers. Bus interaction (BI) plays an important role in bus services. Nevertheless, the conventional concept of BI mainly refers to users, physical interaction, and safety, but it does not address non-users, non-physical interactions, service quality, and other aspects. This study aims to elaborate on a new concept of bus services. Based on this, we developed a theoretical framework for BI. A meta-analysis was then conducted to identify the achievements and untouched aspects. The results of this study provide three main contributions. First, an unprecedented novel concept of BI is defined, including 13 types of interactions. Second, a comprehensive theoretical framework of BI is established based on the relationships between eight sustainable bus system sub-aspects and 13 BI types. Third, based on the theoretical framework and findings of the reviewed studies, a common finding comprehensive framework of BI is completed, which is accompanied by 1) key findings of the 13 BI types, 2) conclusions of traffic conditions affecting BI research, 3) BI research gaps, and 4) 16 main suggestions for future BI research.

An Investigation Into the Needs and Challenges of County-Level Family Education Guidance Services and Corresponding Improvement Measures

The delivery of targeted family education guidance services is essential for establishing a three-in-one education model that encompasses families,schools,and communities.It is also the key to creating a favorable educational environment that promotes the comprehensive and healthy development of individual students.To gain a comprehensive understanding of family education characteristics and trends in Chinese counties,accurately tap into the educational needs of parents,and effectively identify strengths and weaknesses in family education guidance services,this paper employed a quantitative research method based on a questionnaire survey and interview data from J district of C city after years of continuous monitoring of the quality of family education in the area,aiming to explore these issues and put forward several suggestions for improvement.The results indicate that the family learning environment and atmosphere in the district are generally favorable,while parental educational competence requires further improvement.Parents express a strong desire for interactive,systematic,and fragmented family education guidance from schools.Most parents acknowledge the significance of receiving guidance on family education,yet they are disinclined to actively engage in learning-related activities.While the operational mechanisms of county-level family education guidance services have been continuously improved,there is a need for greater overall coordination.Furthermore,the potential of school-led family education guidance services has yet to be fully tapped,and the scientific and professional standards of such guidance need to be further enhanced.Based on the aforementioned findings,we propose recommendations for improvement.Using J district’s effective improvement practices in management,curriculum,and teams as an example,we intend to explore practical ways to promote county-level family education guidance services and provide a valuable reference for the establishment of a comprehensive and effective system to improve such services.

Neural Network-Based State Estimation for Nonlinear Systems With Denial-of-Service Attack Under Try-Once-Discard Protocol

Dear Editor,This letter deals with state estimation issues of discrete-time nonlinear systems subject to denial-of-service(DoS)attacks under the try-once-discard(TOD)protocol.More specifically,to reduce the communication burden,a TOD protocol with novel update rules on protocol weights is designed for scheduling measurement outputs.In addition,unknown nonlinear functions vulnerable to DoS attacks are considered due to the openness and vulnerability of the network.

Deep Reinforcement Learning-Based Task Offloading and Service Migrating Policies in Service Caching-Assisted Mobile Edge Computing

Emerging mobile edge computing(MEC)is considered a feasible solution for offloading the computation-intensive request tasks generated from mobile wireless equipment(MWE)with limited computational resources and energy.Due to the homogeneity of request tasks from one MWE during a longterm time period,it is vital to predeploy the particular service cachings required by the request tasks at the MEC server.In this paper,we model a service caching-assisted MEC framework that takes into account the constraint on the number of service cachings hosted by each edge server and the migration of request tasks from the current edge server to another edge server with service caching required by tasks.Furthermore,we propose a multiagent deep reinforcement learning-based computation offloading and task migrating decision-making scheme(MBOMS)to minimize the long-term average weighted cost.The proposed MBOMS can learn the near-optimal offloading and migrating decision-making policy by centralized training and decentralized execution.Systematic and comprehensive simulation results reveal that our proposed MBOMS can converge well after training and outperforms the other five baseline algorithms.

Detection of Real-Time Distributed Denial-of-Service (DDoS) Attacks on Internet of Things (IoT) Networks Using Machine Learning Algorithms

The primary concern of modern technology is cyber attacks targeting the Internet of Things.As it is one of the most widely used networks today and vulnerable to attacks.Real-time threats pose with modern cyber attacks that pose a great danger to the Internet of Things(IoT)networks,as devices can be monitored or service isolated from them and affect users in one way or another.Securing Internet of Things networks is an important matter,as it requires the use of modern technologies and methods,and real and up-to-date data to design and train systems to keep pace with the modernity that attackers use to confront these attacks.One of the most common types of attacks against IoT devices is Distributed Denial-of-Service(DDoS)attacks.Our paper makes a unique contribution that differs from existing studies,in that we use recent data that contains real traffic and real attacks on IoT networks.And a hybrid method for selecting relevant features,And also how to choose highly efficient algorithms.What gives the model a high ability to detect distributed denial-of-service attacks.the model proposed is based on a two-stage process:selecting essential features and constructing a detection model using the K-neighbors algorithm with two classifier algorithms logistic regression and Stochastic Gradient Descent classifier(SGD),combining these classifiers through ensemble machine learning(stacking),and optimizing parameters through Grid Search-CV to enhance system accuracy.Experiments were conducted to evaluate the effectiveness of the proposed model using the CIC-IoT2023 and CIC-DDoS2019 datasets.Performance evaluation demonstrated the potential of our model in robust intrusion detection in IoT networks,achieving an accuracy of 99.965%and a detection time of 0.20 s for the CIC-IoT2023 dataset,and 99.968%accuracy with a detection time of 0.23 s for the CIC-DDoS 2019 dataset.Furthermore,a comparative analysis with recent related works highlighted the superiority of our methodology in intrusion detection,showing improvements in accuracy,recall,and detection time.

Dynamics of information diffusion and disease transmission in time-varying multiplex networks with asymmetric activity levels

While the interaction between information and disease in static networks has been extensively investigated,many studies have ignored the characteristics of network evolution.In this study,we construct a new two-layer coupling model to explore the interactions between information and disease.The upper layer describes the diffusion of disease-related information,and the lower layer represents the disease transmission.We then use power-law distributions to examine the influence of asymmetric activity levels on dynamic propagation,revealing a mapping relationship characterizing the interconnected propagation of information and diseases among partial nodes within the network.Subsequently,we derive the disease outbreak threshold by using the microscopic Markov-chain approach(MMCA).Finally,we perform extensive Monte Carlo(MC)numerical simulations to verify the accuracy of our theoretical results.Our findings indicate that the activity levels of individuals in the disease transmission layer have a more significant influence on disease transmission compared with the individual activity levels in the information diffusion layer.Moreover,reducing the damping factor can delay disease outbreaks and suppress disease transmission,while improving individual quarantine measures can contribute positively to disease control.This study provides valuable insights into policymakers for developing outbreak prevention and control strategies.

Dynamic characteristics of coal specimens with varying static preloading levels under low-frequency disturbance load

The mechanical properties of residual coal pillars under the influence of upward mining disturbances significantly affect the safety of residual mining activities on working faces.This study conducted low-frequency disturbance dynamic uniaxial compression tests on coal specimens using a self-developed dynamic-static load coupling electro-hydraulic servo system,and studied the strength evolutions,surface deformations,acoustic emission(AE)characteristic parameters,and the failure modes of coal specimens with different static preloading levels were studied.The disturbance damage is positively correlated with the coal specimen static preload level.Specifically,the cumulative AE count rates of the initial accelerated damage stage for the coal specimens with static preloading level of 60%and 70%of the uniaxial compressive strength(UCS)were 2.66 and 3.19 times that of the 50%UCS specimens,respectively.Macroscopically,this behaviour manifested as a decrease in the compressive strength,and the mean strengths of the disturbance-damaged coal specimens with 60%and 70%of UCS static preloading decreased by 8.53%and 9.32%,respectively,compared to those of the specimens under pure static loading.The crack sources,such as the primary fissures,strongly control the dynamic response of the coal specimen.The difference between the dynamic responses of the coal specimens and that of dense rocks is significant.

Monitoring absolute vertical land motions and absolute sea-level changes from GPS and tide gauges data over French Polynesia

In this study,we estimate the absolute vertical land motions at three tidal stations with collocated Global Navigation Satellite System(GNSS)receivers over French Polynesia during the period 2007-2020,and obtain,as ancillary results,estimates of the absolute changes in sea level at the same locations.To verify our processing approach to determining vertical motion,we first modeled vertical motion at the International GNSS Service(IGS)THTI station located in the capital island of Tahiti and compared our estimate with previous independent determinations,with a good agreement.We obtained the following estimates for the vertical land motions at the tide gauges:Tubuai island,Austral Archipelago-0.92±0.17 mm/yr,Vairao village,Tahiti Iti:-0.49±0.39 mm/yr,Rikitea,Gambier Archipelago-0.43±0.17 mm/yr.The absolute variations of the sea level are:Tubuai island,Austral Archipelago 5.25±0.60 mm/yr,Vairao village,Tahiti Iti:3.62±0.52 mm/yr,Rikitea,Gambier Archipelago 1.52±0.23 mm/yr.We discuss these absolute values in light of the values obtained from altimetric measurements and other means in French Polynesia.

Sharing Smart Services,Jointly Promoting Trade Development

In 2024,the China International Fair for Trade in Services (hereinafter referred to as CIFTIS) opened in the China National Convention Center and Shougang Park on September 12th.The theme of the CIFTIS this time was"global services,shared prosperity",which is not only a window for allowing the world to discover the development of China's service trade,but is also a bridge for promoting global cooperation with regards to the service trade.As one of the world-famous service trade events,the CIFTIS has become an important business card allowing China to open up.The CIFTIS has attracted the attention of the whole world and become a bridge for all parties to share development opportunities,promote industrial growth,and strengthen communication.

Source and level of dietary iron influence semen quality by affecting inflammation, oxidative stress and iron utilization levels in boars

Background Boars fed a mixed form of inorganic and organic iron in excess of the NRC recommended levels still develop anemia,which suggested that the current level and form of iron supplementation in boar diets may be inappropriate.Therefore,56 healthy Topeka E line boars aged 15–21 months were randomly divided into 5 groups:basal diet supplemented with 96 mg/kg ferrous sulfate(FeSO_(4))and 54 mg/kg glycine chelated iron(Gly-Fe,control);80 mg/kg or 115 mg/kg Gly-Fe;80 mg/kg or 115 mg/kg methionine hydroxyl analogue chelated iron(MHA-Fe,from CalimetFe)for 16 weeks.The effects of dietary iron supplementation with different sources and levels on semen quality in boars were investigated.Results 1)Serum Fe and hemoglobin concentrations were not affected by reduced dietary iron levels in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups compared with the control group(P>0.05).2)Serum interleukin-6(IL-6)and sperm malondialdehyde(MDA)levels in the 80 mg/kg or 115 mg/kg MHA-Fe groups were lower than those in the control group(P<0.05),and higher serum superoxide dismutase levels and lower MDA levels in the 115 mg/kg MHA-Fe group(P<0.05).3)Boars in the 80 mg/kg or 115 mg/kg Gly-Fe and MHA-Fe groups had lower serum hepcidin(P<0.01),ferritin(P<0.05),and transferrin receptor(P<0.01)concentrations,and boars in the 115 mg/kg MHA-Fe group had higher seminal plasma Fe concentrations compared with the control group.4)Boars in the 80 mg/kg and 115 mg/kg MHA-Fe groups had lower abnormal sperm rate and in situ oscillating sperm ratio compared to the control group at weeks 12 and/or 16 of the trial.However,the effect of Gly-Fe on improving semen quality in boars was not evident.5)Serum IL-6 level was positively correlated with hepcidin concentration(P<0.05),which in turn was significantly positively correlated with abnormal sperm rate(P<0.05).Furthermore,significant correlations were also found between indicators of iron status and oxidative stress and semen quality parameters.Conclusions Dietary supplementation with 80 mg/kg or 115 mg/kg MHA-Fe did not induce iron deficiency,but rather reduced serum inflammatory levels and hepcidin concentration,alleviated oxidative stress,increased body iron utilization,and improved semen quality in adult boars.

Methodology for local correction of the heights of global geoid models to improve the accuracy of GNSS leveling

At present,one of the methods used to determine the height of points on the Earth’s surface is Global Navigation Satellite System(GNSS)leveling.It is possible to determine the orthometric or normal height by this method only if there is a geoid or quasi-geoid height model available.This paper proposes the methodology for local correction of the heights of high-order global geoid models such as EGM08,EIGEN-6C4,GECO,and XGM2019e_2159.This methodology was tested in different areas of the research field,covering various relief forms.The dependence of the change in corrected height accuracy on the input data was analyzed,and the correction was also conducted for model heights in three tidal systems:"tide free","mean tide",and"zero tide".The results show that the heights of EIGEN-6C4 model can be corrected with an accuracy of up to 1 cm for flat and foothill terrains with the dimensionality of 1°×1°,2°×2°,and 3°×3°.The EGM08 model presents an almost identical result.The EIGEN-6C4 model is best suited for mountainous relief and provides an accuracy of 1.5 cm on the 1°×1°area.The height correction accuracy of GECO and XGM2019e_2159 models is slightly poor,which has fuzziness in terms of numerical fluctuation.

Antibody Levels and Infection Status of Pertussis in the Population under Pertussis Resurgence in Guangxi in 2018:A Cross-Sectional Survey

Objective Pertussis cases have increased markedly since 2018 in Guangxi.The aim of this study was to evaluate antibody levels and the infection status of pertussis in the resident population.Method A total of 10,215 serum samples from residents were collected from August-November 2018 and tested for anti-pertussis IgG and toxin IgG using the enzyme-linked immunosorbent assay(ELISA).Results Of the collected samples,1,833(17.94%)tested positive for anti-pertussis IgG,with the median concentration of 16.06 IU/mL.Antibody level<10 IU/mL accounted for more than 60%in children under 4 years of age,but declined with age,whereas the percentages of the other three levels(10-40,40-50,and≥50 IU/mL)increased almost with age(P<0.001).Moreover,7,924 samples were selected for anti-pertussis toxin IgG,of which 653(8.24%)tested positive(≥40 IU/mL)with the median concentration of 5.89 IU/mL,and 204 participants(2.56%)had recent pertussis infection(≥100 IU/mL).Among the different age groups,the highest rates of positivity and recent infection were observed at 11-20 years of age,the lowest positivity rate at 5 years of age,and the lowest recent infection rate at 4 years of age(P<0.001,P=0.005,respectively).Conclusion The survey results showed that all age groups in Guangxi lacked immunity against pertussis,which was one of the main factors contributing to the resurgence of pertussis in 2018.In addition,the prevalence of pertussis is relatively high in Guangxi,and its incidence is seriously underestimated,especially in adolescents and adults.

Residents’perceptions of ecosystem services in an urbanizing basin:A case study in the Guanting Reservoir basin,China

Understanding stakeholders’differences in perceptions of ecosystem services(ES)is crucial for guiding ecolog-ical conservation and planning.However,the variations of ES perception amongst different types of residents in urbanizing areas along an urban-rural gradient are still poorly understood.Combining a questionnaire-based survey,redundancy analysis,and statistical tests,we delineated the urban-rural gradient according to local res-idents’socio-economic characteristics,and investigated the differences in local residents’perceptions of ES and potential factors affecting them in the Guanting Reservoir basin,a rapidly urbanizing basin in China.The results showed that residents living in urban-rural transitional areas attached great importance to provisioning services of providing food and domestic water,regulating services of carbon sequestration and air purification,and cul-tural services of providing education and training,which were 0.7%-13.1%,0.7%-9.1%and 2.5%-21.2%higher than that of residents in other areas,respectively.Age and occupation were major factors affecting residents’perceptions.In terms of land-use types that deliver ES,the difference in perceptions of ES delivered by grassland was the greatest amongst residents.Our results support recommendations for policymakers to take into account the stakeholders’diverse perceptions,thus promoting residents’sense of gain on ES.

Assessment of International GNSS Service Global Ionosphere Map products over China region based on measurements from the Crustal Movement Observation Network of China

The global ionosphere maps(GIM)provided by the International GNSS Service(IGS)are extensively utilized for ionospheric morphology monitoring,scientific research,and practical application.Assessing the credibility of GIM products in data-sparse regions is of paramount importance.In this study,measurements from the Crustal Movement Observation Network of China(CMONOC)are leveraged to evaluate the suitability of IGS-GIM products over China region in 2013-2014.The indices of mean error(ME),root mean square error(RMSE),and normalized RMSE(NRMSE)are then utilized to quantify the accuracy of IGS-GIM products.Results revealed distinct local time and latitudinal dependencies in IGS-GIM errors,with substantially high errors at nighttime(NRMSE:39%)and above 40°latitude(NRMSE:49%).Seasonal differences also emerged,with larger equinoctial deviations(NRMSE:33.5%)compared with summer(20%).A preliminary analysis implied that the irregular assimilation of sparse IGS observations,compounded by China’s distinct geomagnetic topology,may manifest as error variations.These results suggest that modeling based solely on IGS-GIM observations engenders inadequate representations across China and that a thorough examination would proffer the necessary foundation for advancing regional total electron content(TEC)constructions.

Dynamical distribution of continuous service time model involving non-Maxwellian collision kernel and value functions

The distribution of continuous service time in call centers is investigated.A non-Maxwellian collision kernel combining two different value functions in the interaction rule are used to describe the evolution of continuous service time,respectively.Using the statistical mechanical and asymptotic limit methods,Fokker–Planck equations are derived from the corresponding Boltzmann-type equations with non-Maxwellian collision kernels.The steady-state solutions of the Fokker–Planck equation are obtained in exact form.Numerical experiments are provided to support our results under different parameters.

Research progress and future prospects in the service security of key blast furnace equipment

The safety and longevity of key blast furnace(BF)equipment determine the stable and low-carbon production of iron.This pa-per presents an analysis of the heat transfer characteristics of these components and the uneven distribution of cooling water in parallel pipes based on hydrodynamic principles,discusses the feasible methods for the improvement of BF cooling intensity,and reviews the pre-paration process,performance,and damage characteristics of three key equipment pieces:coolers,tuyeres,and hearth refractories.Fur-thermoere,to attain better control of these critical components under high-temperature working conditions,we propose the application of optimized technologies,such as BF operation and maintenance technology,self-repair technology,and full-lifecycle management techno-logy.Finally,we propose further researches on safety assessments and predictions for key BF equipment under new operating conditions.