Assessing forest cover changes and fragmentation in the Himalayan temperate region: implications for forest conservation and management

This study comprehensively assessed long-term vegetation changes and forest fragmentation dynamics in the Himalayan temperate region of Pakistan from 1989 to 2019.Four satellite images,including Landsat-5 TM and Landsat-8 Operational Land Imager(OLI),were chosen for subsequent assessments in October 1989,2001,2011 and 2019.The classified maps of 1989,2001,2011 and 2019 were created using the maximum likelihood classifier.Post-classification comparison showed an overall accuracy of 82.5%and a Kappa coefficient of 0.79 for the 2019 map.Results revealed a drastic decrease in closed-canopy and open-canopy forests by 117.4 and 271.6 km^(2),respectively,and an increase in agriculture/farm cultivation by 1512.8 km^(2).The two-way ANOVA test showed statistically significant differences in the area of various cover classes.Forest fragmentation was evaluated using the Landscape Fragmentation Tool(LFT v2.0)between 1989 and 2019.The large forest core(>2.00 km^(2))decreased from 149.4 to 296.7 km^(2),and a similar pattern was observed in medium forest core(1.00-2.00 km^(2))forests.On the contrary,the small core(<1.00 km^(2))forest increased from 124.8 to 145.3 km^(2) in 2019.The perforation area increased by 296.9 km^(2),and the edge effect decreased from 458.9 to 431.7 km^(2).The frequency of patches also increased by 119.1 km^(2).The closed and open canopy classes showed a decreasing trend with an annual rate of 0.58%and 1.35%,respectively.The broad implications of these findings can be seen in the studied region as well as other global ecological areas.They serve as an imperative baseline for afforestation and reforestation operations,highlighting the urgent need for efficient management,conservation,and restoration efforts.Based on these findings,sustainable land-use policies may be put into place that support local livelihoods,protect ecosystem services,and conserve biodiversity.

Pricing Catastrophe Options with Credit Risk in a Regime-Switching Model

In this paper,we consider the price of catastrophe options with credit risk in a regime-switching model.We assume that the macroeconomic states are described by a continuous-time Markov chain with a finite state space.By using the measure change technique,we derive the price expressions of catastrophe put options.Moreover,we conduct some numerical analysis to demonstrate how the parameters of the model affect the price of the catastrophe put option.

List of 85 typical catastrophic landslides from March 2004 to February 2024

Landslides are one of the most dangerous natural hazards that cause significant property damage and loss of life.Landslides often destroy farmland,villages,houses,factories,schools,roads and other facilities,injuring humans and livestock.Sometimes,entire towns are devastated by landslides.Due to their pervasiveness,varied triggering factors,and sudden occurrence,landslides are currently one of the most challenging natural disasters to prevent and mitigate.

Optical facet coatings for high-performance LWIR quantum cascade lasers atλ∼8.5μm

We report on the performance improvement of long-wave infrared quantum cascade lasers(LWIR QCLs)by studying and optimizing the anti-reflection(AR)optical facet coating.Compared to the Al2O3 AR coat⁃ing,the Y_(2)O_(3)AR coating exhibits higher catastrophic optical mirror damage(COMD)level,and the optical facet coatings of both material systems have no beam steering effect.A 3-mm-long,9.5-μm-wide buried-heterostruc⁃ture(BH)LWIR QCL ofλ~8.5μm with Y_(2)O_(3)metallic high-reflection(HR)and AR of~0.2%reflectivity coating demonstrates a maximum pulsed peak power of 2.19 W at 298 K,which is 149%higher than that of the uncoated device.For continuous-wave(CW)operation,by optimizing the reflectivity of the Y_(2)O_(3)AR coating,the maximum output power reaches 0.73 W,which is 91%higher than that of the uncoated device.

Subarachnoid hemorrhage misdiagnosed as acute coronary syndrome leading to catastrophic neurologic injury: A case report

BACKGROUND Elevated levels of cardiac troponin and abnormal electrocardiogram changes are the primary basis for clinical diagnosis of acute coronary syndrome(ACS).Troponin levels in ACS patients can often be more than 50 times the upper reference limit.Some patients with subarachnoid hemorrhage(SAH)also show electrocardiogram abnormalities,myocardial damage,and elevated cardiac biomarkers.Unlike ACS patients,patients with SAH only have a slight increase in troponin,and the use of anticoagulants or antiplatelet drugs is prohibited.Because of the opposite treatment modalities,it is essential for clinicians to distinguish between SAH and ACS.CASE SUMMARY A 56-year-old female patient was admitted to the emergency department at night with a sudden onset of severe back pain.The final diagnosis was intraspinal hematoma in the thoracic spine.We performed an emergency thoracic spinal canal hematoma evacuation procedure with the assistance of a microscope.Intraoperatively,diffuse hematoma formation was found in the T7-T10 spinal canal,and no obvious spinal vascular malformation changes were observed.Postoperative head and spinal magnetic resonance imaging(MRI)showed a small amount of SAH in the skull,no obvious abnormalities in the cervical and thoracic spinal canals,and no abnormal signals in the lumbar spinal canal.Thoracoab-dominal aorta computed tomography angiography showed no vascular malfor-mation.Postoperative motor system examination showed Medical Research Council Scale grade 1/5 strength in both lower extremities,and the patient experienced decreased sensation below the T12 rib margin and reported a Visual Analog Scale score of 3.CONCLUSION Extremely elevated troponin levels(more than 50 times the normal range)are not unique to coronary artery disease.SAH can also result in extremely high troponin levels,and antiplatelet drugs are contraindicated in such cases.Emergency MRI can help in the early differential diagnosis,as a misdiagnosis of ACS can lead to catastrophic neurological damage in patients with spontaneous spinal SAH.

This pain drives me crazy:Psychiatric symptoms in women with interstitial cystitis/bladder pain syndrome

BACKGROUND Interstitial cystitis/bladder pain syndrome(IC/BPS)is an at least 6-mo noninfectious bladder inflammation of unknown origin characterized by chronic suprapubic,abdominal,and/or pelvic pain.Although the term cystitis suggests an inflammatory or infectious origin,no definite cause has been identified.It occurs in both sexes,but women are twice as much affected.AIM To systematically review evidence of psychiatric/psychological changes in persons with IC/BPS.METHODS Hypothesizing that particular psychological characteristics could underpin IC/BPS,we investigated in three databases the presence of psychiatric symptoms and/or disorders and/or psychological characteristics in patients with IC/BPS using the following strategy:("interstitial cystitis"OR"bladder pain syndrome")AND("mood disorder"OR depressive OR antidepressant OR depression OR depressed OR hyperthymic OR mania OR manic OR rapid cyclasterisk OR dysthymiasterisk OR dysphoriasterisk).RESULTS On September 27,2023,the PubMed search produced 223 articles,CINAHL 62,and the combined PsycLIT/PsycARTICLES/PsycINFO/Psychology and Behavioral Sciences Collection search 36.Search on ClinicalTrials.gov produced 14 studies,of which none had available data.Eligible were peer-reviewed articles reporting psychiatric/psychological symptoms in patients with IC/BPS,i.e.63 articles spanning from 2000 to October 2023.These studies identified depression and anxiety problems in the IC/BPS population,along with sleep problems and the tendency to catastrophizing.CONCLUSION Psychotherapies targeting catastrophizing and life stress emotional awareness and expression reduced perceived pain in women with IC/BPS.Such concepts should be considered when implementing treatments aimed at reducing IC/BPS-related pain.

Deep learning algorithm featuring continuous learning for modulation classifications in wireless networks

Although modulation classification based on deep neural network can achieve high Modulation Classification(MC)accuracies,catastrophic forgetting will occur when the neural network model continues to learn new tasks.In this paper,we simulate the dynamic wireless communication environment and focus on breaking the learning paradigm of isolated automatic MC.We innovate a research algorithm for continuous automatic MC.Firstly,a memory for storing representative old task modulation signals is built,which is employed to limit the gradient update direction of new tasks in the continuous learning stage to ensure that the loss of old tasks is also in a downward trend.Secondly,in order to better simulate the dynamic wireless communication environment,we employ the mini-batch gradient algorithm which is more suitable for continuous learning.Finally,the signal in the memory can be replayed to further strengthen the characteristics of the old task signal in the model.Simulation results verify the effectiveness of the method.

Climate change and the emergence and exacerbation of infectious diseases:A review

Experts expressed severe concerns over the possibility of increasing burden of infectious diseases as the planet’s climate began to change years ago.There have been increased rates of climate-related catastrophes and as global temperatures rise,emergence of certain viruses has become a serious concern.Vectors are susceptible to changing temperatures as they exhibit innate responses to thermal stress to increase survivability.Climate change impacts virus reservoirs,increasing transmission rates of vectors.Vector-borne diseases have already witnessed increasing numbers compared to before.Certain non-endemic areas are encountering their first-ever infectious disease cases due to increasing temperatures.Tick-borne diseases are undergoing transformations provoking a heightened prevalence.Food-borne illnesses are expected to increase owing to warmer temperatures.It is important to recognize that climate change has a multivariable impact on the transmission of viruses.With climate change comes the potential of increasing interspecies interactions promoting jumps.These factors must be considered,and an informed strategy must be formulated.Adaptation and mitigation strategies are required to curb these diseases from spreading.Despite significant evidence that climate change affects infectious diseases,gaps in research exist.We conducted this review to identify the potential role climate change plays in the emergence of new viruses.

Assessment of the Indirect Cost of Drug Resistant Tuberculosis Treatment to Patients in a High Burden, Low Income Setting in Mozambique

Introduction: Tuberculosis is closely linked to poverty, with patients facing significant indirect treatment costs. Treating drug-resistant tuberculosis further increases these expenses. Notably, there is a lack of published data on the indirect costs incurred by patients with drug-resistant tuberculosis in Mozambique. Objective: To assess the indirect costs, income reduction, and work productivity incurred by patients undergoing diagnosis and treatment for Drug-Resistant Tuberculosis (DRTB) in Mozambique during their TB treatment. Methods: As part of a comprehensive mixed-methods study conducted from January 2021 to April 2023, this research utilized a descriptive cross-sectional approach, incorporating both quantitative and qualitative methods. The primary goal was to evaluate the costs incurred by the national health system due to drug-resistant TB. Additionally, to explore the indirect costs experienced by patients and their families during treatment, semi-structured interviews were conducted with 27 individuals who had been undergoing treatment for over six months. Results: All survey participants unanimously reported a significant decline in labour productivity, with 70.3% experiencing a reduction in their monthly income. Before falling ill, the majority of respondents (33.3%) earned up to $76.92 monthly, representing the minimum earnings range, while 29.2% had a monthly income above $230.77, the maximum earnings range. Among those who experienced income loss, the majority (22.2%) reported a decrease of up to $76.92 per month, and 18.5% cited a loss exceeding $230.77 per month. Notably, patients with Drug-Resistant Tuberculosis (DRTB) have not incurred the direct costs of the disease, as these are covered by the government. Conclusion: The financial burden of treating Drug-Resistant Tuberculosis (DRTB), along with the income reduction it causes, is substantial. Implementing a patient-centred, multidisciplinary, and multisector approach, coupled with strong psychosocial support, can significantly reduce the catastrophic costs DRTB patients incur.

Hyper Catastrophe on 4-Dimensional Canards

When discovering the potential of canards flying in 4-dimensional slow-fast system with a bifurcation parameter, the key notion “symmetry” plays an important role. It is of one parameter on slow vector field. Then, it should be determined to introduce parameters to all slow/fast vectors. It is, however, there might be no way to explore for another potential in this system, because the geometrical structure is quite different from the system with one parameter. Even in this system, the “symmetry” is also useful to obtain the potentials classified by R. Thom. In this paper, via the coordinates changing, the possible way to explore for the potential will be shown. As it is analyzed on “hyper finite time line”, or done by using “non-standard analysis”, it is called “Hyper Catastrophe”. In the slow-fast system which includes a very small parameter , it is difficult to do precise analysis. Thus, it is useful to get the orbits as a singular limit. When trying to do simulations, it is also faced with difficulty due to singularity. Using very small time intervals corresponding small , we shall overcome the difficulty, because the difference equation on the small time interval adopts the standard differential equation. These small intervals are defined on hyper finite number N, which is nonstandard. As and the intervals are linked to use 1/N, the simulation should be done exactly.

Research progress of pain catastrophizing in patients with lumbar disc herniation

Pain catastrophization is one of the negative emotional factors and an important psychological factor associated with patients with lumbar disc herniation(LDH).Currently,the concept of pain catastrophization of LDH is relatively mature abroad;however,there are only few research studies on this in China.To understand the status quo of pain catastrophization(PC)in patients with LDH and its influencing factors,the intervention measures of PC and their efficacy were further analyzed.In the present paper,the research status of PC at home and abroad is briefly expounded,and the influencing factors and clinical intervention measures for PC are analyzed.This paper reviews the concept of PC,the assessment tools,influencing factors,and the relevant intervention measures.In order to evaluate the pain degree of patients,understand the incidence of pain in patients,and improve the cure rate and quality of life of patients,the basic situation of patients with pain disaster is summarized to provide reference for medical personnel.

Physical Analysis of Atmospheric Phenomena Associated with Climatic Storms: Approach Study Related to Climate Change on Earth

Atmospheric phenomena are physical phenomena resulting from the correlation of atmospheric parameters of natural origin. They are associated with climatic storms and include lightning, thunder, global warming, wind, evaporation, rain, clouds, and snow. The formation and evolution of these phenomena remain complex according to their natural reference parameters. The numerical models defined in this study are equations based on models of atmospheric parameters. Applied in the atmosphere, they yield the equation of the key atmospheric phenomena. The distribution of these phenomena across the entire planet is the origin of the formation of climatic regions. Indeed, the constants obtained are 275.16 km/s for the speed of lightning, 3.99 GJ for the discharge energy of a thunderbolt, 276.15˚K for the temperature of global warming, 3.993 Km/h for the formation speed of winds and cyclones, 2.9963 Km/h for the speed of evaporation, 278.16˚K for the formation of rain, 274.1596˚K for the formation of clouds, and 274.1632˚K for snow formation. Moreover, this research conducts an analytical study approach to the phenomenon of climate change in the current era of industrialization, specifically analyzing the direct effects of global warming on atmospheric phenomena. Thus, with a temperature of 53.45˚C, global warming is considered maximal and will lead to very abundant rain and snow precipitations with maximum PW at 12.5 and 11.1 g/cm2 of water, surface water evaporation fluxes significantly above normal at a speed of 6.55 Km/h, increasingly violent winds at speeds far exceeding 5.43 Km/h, and catastrophic climatic effects. In summary, the aim of this research is to define the main natural phenomena associated with global climatic storms and to study the real impact of climate change on Earth.

上海市耐多药结核病患者经济负担研究

目的基于上海市近年结核病诊疗费用减免政策,探索耐多药结核病(multidrug resistant tuberculosis,MDR-TB)患者疾病经济负担及其影响因素,为优化MDR-TB诊疗费用减免政策和综合管理模式提供依据。方法收集上海市2017—2019年确诊MDR-TB患者情况和诊疗费用减免情况数据,开展针对疾病经济负担的问卷调查,建立涵盖患者人口和社会经济情况、临床特征、疾病经济负担和诊疗费用减免情况数据库,明确患者疾病经济负担和灾难性卫生支出(catastrophic health expenditure)发生情况。以多元线性回归法分析可能影响患者疾病经济负担的因素,以多因素logistic回归法分析不同比例下灾难性卫生支出发生的影响因素。结果196例纳入研究分析的MDR-TB患者平均年龄为(44±16)岁,男性139例(占70.9%),上海户籍占46.4%,49%的患者为家庭主要劳动力。治疗期间,患者自付诊疗费用中位数为4.0(四分位数区间2.0~6.5)万元。113例患者获得减免诊疗,减免费用中位数为2.6(四分位数区间1.3~4.9)万元。若自付费用占家庭年收入的40%及以上,有47.8%的患者会发生灾难性支出;若不考虑减免政策,有59.8%的患者发生灾难性卫生支出。上海户籍(OR=0.3,95%CI为0.1~1.0)、更低家庭收入水平(P_(trend)=0.002)、医疗保险类型[(农村合作医疗保险/外来人口综合保险(OR=13.3,95%CI为1.0~171.2),无医疗保险(OR=17.5,95%CI为2.7~113.0)]和既往结核病治疗史(OR=3.3,95%CI为1.1~10.0)可能影响灾难性卫生支出的发生。结论上海市MDR-TB患者的自付诊疗费用较高。医疗保障力度较小和家庭经济情况不佳的患者更易发生高额自付费用,导致灾难性卫生支出。上海市MDR-TB诊疗费用减免政策有效降低了患者的经济负担。

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.

The role of AFAP1-AS1 in mitotic catastrophe and metastasis of triple-negative breast cancer cells by activating the PLK1 signaling pathway

Triple-negative breast cancer(TNBC)is characterized by fast growth,high metastasis,high invasion,and a lack of therapeutic targets.Mitosis and metastasis of TNBC cells are two important biological behaviors in TNBC malignant progression.It is well known that the long noncoding RNA AFAP1-AS1 plays a crucial role in various tumors,but whether AFAP1-AS1 is involved in the mitosis of TNBC cells remains unknown.In this study,we investigated the functional mechanism of AFAP1-AS1 in targeting Polo-like Kinase 1(PLK1)activation and participating in mitosis of TNBC cells.We detected the expression of AFAP1-AS1 in the TNBC patient cohort and primary cells by in situ hybridization(ISH),northern blot,fluorescent in situ hybridization(FISH)and cell nucleus/cytoplasm RNA fraction isolation.High AFAP1-AS1 expression was negatively correlated with overall survival(OS),disease-free survival(DFS),metastasis-free survival(MFS)and recurrence-free survival(RFS)in TNBC patients.We explored the function of AFAP1-AS1 by transwell,apoptosis,immunofluorescence(IF)and patient-derived xenograft(PDX)models in vitro and in vivo.We found that AFAP1-AS1 promoted TNBC primary cell survival by inhibiting mitotic catastrophe and increased TNBC primary cell growth,migration and invasion.Mechanistically,AFAP1-AS1 activated phosphorylation of the mitosis-associated kinase PLK1 protein.Elevated levels of AFAP1-AS1 in TNBC primary cells increased PLK1 pathway downstream gene expression,such as CDC25C,CDK1,BUB1 and TTK.More importantly,AFAP1-AS1 increased lung metastases in a mouse metastasis model.Taken together,AFAP1-AS1 functions as an oncogene that activates the PLK1 signaling pathway.AFAP1-AS1 could be used as a potential prognostic marker and therapeutic target for TNBC.

Squeezing More Past Knowledge for Online Class-Incremental Continual Learning

Continual learning(CL)studies the problem of learning to accumulate knowledge over time from a stream of data.A crucial challenge is that neural networks suffer from performance degradation on previously seen data,known as catastrophic forgetting,due to allowing parameter sharing.In this work,we consider a more practical online class-incremental CL setting,where the model learns new samples in an online manner and may continuously experience new classes.Moreover,prior knowledge is unavailable during training and evaluation.Existing works usually explore sample usages from a single dimension,which ignores a lot of valuable supervisory information.To better tackle the setting,we propose a novel replay-based CL method,which leverages multi-level representations produced by the intermediate process of training samples for replay and strengthens supervision to consolidate previous knowledge.Specifically,besides the previous raw samples,we store the corresponding logits and features in the memory.Furthermore,to imitate the prediction of the past model,we construct extra constraints by leveraging multi-level information stored in the memory.With the same number of samples for replay,our method can use more past knowledge to prevent interference.We conduct extensive evaluations on several popular CL datasets,and experiments show that our method consistently outperforms state-of-the-art methods with various sizes of episodic memory.We further provide a detailed analysis of these results and demonstrate that our method is more viable in practical scenarios.

Fundamental and speculative components of the cryptocurrency pricing dynamics

The driving forces behind cryptoassets’price dynamics are often perceived as being dominated by speculative factors and inherent bubble-bust episodes.Fundamental components are believed to have a weak,if any,role in the price-formation process.This study examines five cryptoassets with different backgrounds,namely Bitcoin,Ethereum,Litecoin,XRP,and Dogecoin between 2016 and 2022.It utilizes the cusp catastrophe model to connect the fundamental and speculative drivers with possible price bifurcation characteristics of market collapse events.The findings show that the price and return dynamics of all the studied assets,except for Dogecoin,emerge from complex interactions between fundamental and speculative components,includ-ing episodes of price bifurcations.Bitcoin shows the strongest fundamentals,with on-chain activity and economic factors driving the fundamental part of the dynam-ics.Investor attention and off-chain activity drive the speculative component for all studied assets.Among the fundamental drivers,the analyzed cryptoassets present their coin-specific factors,which can be tracked to their protocol specifics and are economi-cally sound.

Study of quantum well mixing induced by impurity-free vacancy in the primary epitaxial wafers of a 915 nm semiconductor laser

Output power and reliability are the most important characteristic parameters of semiconductor lasers.However,catas-trophic optical damage(COD),which usually occurs on the cavity surface,will seriously damage the further improvement of the output power and affect the reliability.To improve the anti-optical disaster ability of the cavity surface,a non-absorption window(NAW)is adopted for the 915 nm InGaAsP/GaAsP single-quantum well semiconductor laser using quantum well mix-ing(QWI)induced by impurity-free vacancy.Both the principle and the process of point defect diffusion are described in detail in this paper.We also studied the effects of annealing temperature,annealing time,and the thickness of SiO_(2) film on the quan-tum well mixing in a semiconductor laser with a primary epitaxial structure,which is distinct from the previous structures.We found that when compared with the complete epitaxial structure,the blue shift of the semiconductor laser with the primary epi-taxial structure is larger under the same conditions.To obtain the appropriate blue shift window,the primary epitaxial struc-ture can use a lower annealing temperature and shorter annealing time.In addition,the process is less expensive.We also pro-vide references for upcoming device fabrication.

Time to treat the climate and nature crisis as one in divisible global health emergency

Over 200 health journals call on the United Nations(UN),political leaders and health professionals to recognise that climate change and biodiversity loss are one indivisible crisis and must be tackled together to preserve health and avoid catastrophe.This overall environmental crisis is now so severe as to be a global health emergency.

Assessing the Impact of Health Insurance on Household Financial Protection in Togo

Context: To facilitate financial access to care for the population, health insurance mechanisms have been established, in particular the National Health Insurance Institute, which covers civil servants and their dependents. In addition, other voluntary and community mechanisms have been developed. After several years of implementation, the level of catastrophic health expenditures among insured individuals shows that there is still a considerable level of financial risk associated with health care. This study aims to assess the impact of health insurance in Togo on insured populations. Methodology: The data used in this study come from the harmonized survey on household living conditions carried out in 2018 by the National Institute of Statistics, Economic and Demographic Studies. The propensity score matching method was used according to the following steps: estimation of propensity scores, verification of the conditional independence hypothesis (balancing property) and estimation of the average treatment effect on treated. Stata V14.2 software was used. Findings: The average effect of health insurance on household financial protection is −0.012 for the nearest neighbor method, −0.013 for the matching radius method, −0.015 for the Kernel and −0.016 for the stratification method. Results showed that health insurance contributes to reducing catastrophic health expenditures, but their effect remains very limited. This could be explained by the level of care package covered and the cost covered. Conclusion: Health insurance contributes to the reduction of catastrophic health expenses for households. However, it is important to widen the range of care covered and the cost covered. In addition, measures to extend this coverage to a larger proportion of the population will make it possible to have a greater impact.