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Despite growing awareness of the mental health damage caused by air pollution, the epidemiologic evidence on impact of air pollutants on major mental disorders (MDs) remains limited. We aim to explore the impact of various air pollutants on the risk of major MD.
Methods
This prospective study analyzed data from 170 369 participants without depression, anxiety, bipolar disorder, and schizophrenia at baseline. The concentrations of particulate matter with aerodynamic diameter ≤ 2.5 μm (PM2.5), particulate matter with aerodynamic diameter > 2.5 μm, and ≤ 10 μm (PM2.5–10), nitrogen dioxide (NO2), and nitric oxide (NO) were estimated using land-use regression models. The association between air pollutants and incident MD was investigated by Cox proportional hazard model.
Results
During a median follow-up of 10.6 years, 9 004 participants developed MD. Exposure to air pollution in the highest quartile significantly increased the risk of MD compared with the lowest quartile: PM2.5 (hazard ratio [HR]: 1.16, 95% CI: 1.09–1.23), NO2 (HR: 1.12, 95% CI: 1.05–1.19), and NO (HR: 1.10, 95% CI: 1.03–1.17). Subgroup analysis showed that participants with lower income were more likely to experience MD when exposed to air pollution. We also observed joint effects of socioeconomic status or genetic risk with air pollution on the MD risk. For instance, the HR of individuals with the highest genetic risk and highest quartiles of PM2.5 was 1.63 (95% CI: 1.46–1.81) compared to those with the lowest genetic risk and lowest quartiles of PM2.5.
Conclusions
Our findings highlight the importance of air pollution control in alleviating the burden of MD.
A high-energy pulsed vacuum ultraviolet (VUV) solid-state laser at 177 nm with high peak power by the sixth harmonic of a neodymium-doped yttrium aluminum garnet (Nd:YAG) amplifier in a KBe2BO3F2 prism-coupled device was demonstrated. The ultraviolet (UV) pump laser is a 352 ps pulsed, spatial top-hat super-Gaussian beam at 355 nm. A high energy of a 7.12 mJ VUV laser at 177 nm is obtained with a pulse width of 255 ps, indicating a peak power of 28 MW, and the conversion efficiency is 9.42% from 355 to 177 nm. The measured results fitted well with the theoretical prediction. It is the highest pulse energy and highest peak power ever reported in the VUV range for any solid-state lasers. The high-energy, high-peak-power, and high-spatial-uniformity VUV laser is of great interest for ultra-fine machining and particle-size measurements using UV in-line Fraunhofer holography diagnostics.
We present a practical verification method for safety analysis of the autonomous driving system (ADS). The main idea is to build a surrogate model that quantitatively depicts the behavior of an ADS in the specified traffic scenario. The safety properties proved in the resulting surrogate model apply to the original ADS with a probabilistic guarantee. Given the complexity of a traffic scenario in autonomous driving, our approach further partitions the parameter space of a traffic scenario for the ADS into safe sub-spaces with varying levels of guarantees and unsafe sub-spaces with confirmed counter-examples. Innovatively, the partitioning is based on a branching algorithm that features explainable AI methods. We demonstrate the utility of the proposed approach by evaluating safety properties on the state-of-the-art ADS Interfuser, with a variety of simulated traffic scenarios, and we show that our approach and existing ADS testing work complement each other. We certify five safe scenarios from the verification results and find out three sneaky behavior discrepancies in Interfuser which can hardly be detected by safety testing approaches.
This study aimed to investigate the effects of esketamine (Esk) combined with dexmedetomidine (Dex) on postoperative delirium (POD) and quality of recovery (QoR) in elderly patients undergoing thoracoscopic radical lung cancer surgery.
Methods
In this prospective, randomized, and controlled study, 172 elderly patients undergoing thoracoscopic radical lung cancer surgery were divided into two groups: the Esk + Dex group (n = 86) and the Dex group a (n = 86). The primary outcome was the incidence of POD within 7 days after surgery and the overall Quality of Recovery−15 (QoR − 15) scores within 3 days after surgery. Secondary outcomes included postoperative adverse reactions, extubation time, PACU stay, and hospitalization time. Serum levels of IL-6, IL-10, S100β protein, NSE, CD3+, CD4+, and CD8+ were detected from T0 to T5.
Results
Compared with the Dex group, the incidence of POD in the Esk + Dex group was significantly lower at 7 days after surgery (14.6% vs 30.9%; P = 0.013). The QoR − 15 score was significantly increased 3 days after surgery (P < 0.01). Levels of IL-6 and CD8+ were significantly decreased, and IL − 10 levels were significantly increased at T1-T2 (P < 0.05). At T1-T4, NSE levels were significantly decreased, while CD3+ and CD4+/CD8+ values were significantly increased (P < 0.01). At T1-T5, serum S100β protein concentration decreased significantly, and CD4+ value increased significantly (P < 0.01). The incidence of nausea/vomiting and hyperalgesia decreased significantly 48 hours after surgery (P < 0.01). The duration of extubation, PACU stay, and postoperative hospitalization were significantly shortened.
Conclusions
Esketamine combined with dexmedetomidine can significantly reduce the POD incidence and improve the QoR in patients undergoing thoracoscopic radical lung cancer surgery, which may be related to the improvement of cellular immune function.
We aimed to evaluate the association of coffee consumption with different additives, including milk and/or sweetener (sugar and/or artificial sweetener), and different coffee types, with new-onset acute kidney injury (AKI), and examine the modifying effects of genetic variation in caffeine metabolism. 194 324 participants without AKI at baseline in the UK Biobank were included. The study outcome was new-onset AKI. During a median follow-up of 11·6 years, 5864 participants developed new-onset AKI. Compared with coffee non-consumers, a significantly lower risk of new-onset AKI was found in coffee consumers adding neither milk nor sugar to coffee (hazard ratio (HR), 0·86; 95 % CI, 0·78, 0·94) and adding only milk to coffee (HR,0·83; 95 % CI, 0·78, 0·89), but not in coffee consumers adding only sweetener (HR,1·14; 95 % CI, 0·99, 1·31) and both milk and sweetener to coffee (HR,0·96; 95 % CI, 0·89, 1·03). Moreover, there was a U-shaped association of coffee consumption with new-onset AKI, with the lowest risk at 2–3 drinks/d, in unsweetened coffee (no additives or milk only to coffee), but no association was found in sweetened coffee (sweetener only or both milk and sweetener to coffee). Genetic variation in caffeine metabolism did not significantly modify the association. A similar U-shaped association was found for instant, ground and decaffeinated coffee consumption in unsweetened coffee consumers, but not in sweetened coffee consumers. In conclusion, moderate consumption (2–3 drinks/d) of unsweetened coffee with or without milk was associated with a lower risk of new-onset AKI, irrespective of coffee type and genetic variation in caffeine metabolism.
Caused by multiple risk factors, heavy burden of major depressive disorder (MDD) poses serious challenges to public health worldwide over the past 30 years. Yet the burden and attributable risk factors of MDD were not systematically known. We aimed to reveal the long-term spatio-temporal trends in the burden and attributable risk factors of MDD at global, regional and national levels during 1990–2019.
Methods
We obtained MDD and attributable risk factors data from Global Burden of Disease Study 2019. We used joinpoint regression model to assess the temporal trend in MDD burden, and age–period–cohort model to measure the effects of age, period and birth cohort on MDD incidence rate. We utilized population attributable fractions (PAFs) to estimate the specific proportions of MDD burden attributed to given risk factors.
Results
During 1990–2019, the global number of MDD incident cases, prevalent cases and disability-adjusted life years (DALYs) increased by 59.10%, 59.57% and 58.57%, respectively. Whereas the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized DALYs rate (ASDR) of MDD decreased during 1990–2019. The ASIR, ASPR and ASDR in women were 1.62, 1.62 and 1.60 times as that in men in 2019, respectively. The highest age-specific incidence, prevalence and DALYs rate occurred at the age of 60–64 in women, and at the age of 75–84 in men, but the maximum increasing trends in these age-specific rates occurred at the age of 5–9. Population living during 2000–2004 had higher risk of MDD. MDD burden varied by socio-demographic index (SDI), regions and nations. In 2019, low-SDI region, Central sub-Saharan Africa and Uganda had the highest ASIR, ASPR and ASDR. The global PAFs of intimate partner violence (IPV), childhood sexual abuse (CSA) and bullying victimization (BV) were 8.43%, 5.46% and 4.86% in 2019, respectively.
Conclusions
Over the past 30 years, the global ASIR, ASPR and ASDR of MDD had decreased trends, while the burden of MDD was still serious, and multiple disparities in MDD burden remarkably existed. Women, elderly and populations living during 2000–2004 and in low-SDI regions, had more severe burden of MDD. Children were more susceptible to MDD. Up to 18.75% of global MDD burden would be eliminated through early preventing against IPV, CSA and BV. Tailored strategies-and-measures in different regions and demographic groups based on findings in this studywould be urgently needed to eliminate the impacts of modifiable risk factors on MDD, and then mitigate the burden of MDD.
This paper retrospectively analysed the prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) in some parts of China. Between January 2013 and December 2019, we collected 4,145 respiratory samples, including pharyngeal swabs and alveolar lavage fluid. The highest PCR-positive rate of M. pneumoniae was 74.5% in Beijing, the highest resistance rate was 100% in Shanghai, and Gansu was the lowest with 20%. The highest PCR-positive rate of M. pneumoniae was 74.5% in 2013, and the highest MRMP was 97.4% in 2019; the PCR-positive rate of M. pneumoniae for adults in Beijing was 17.9% and the MRMP was 10.48%. Among the children diagnosed with community-acquired pneumonia (CAP), the PCR-positive and macrolide-resistant rates of M. pneumoniae were both higher in the severe ones. A2063G in domain V of 23S rRNA was the major macrolide-resistant mutation, accounting for more than 90%. The MIC values of all MRMP to erythromycin and azithromycin were ≥ 64 μg/ml, and the MICs of tetracycline and levofloxacin were ≤ 0.5 μg/ml and ≤ 1 μg/ml, respectively. The macrolide resistance varied in different regions and years. Among inpatients, the macrolide-resistant rate was higher in severe pneumonia. A2063G was the common mutation, and we found no resistance to tetracycline and levofloxacin.
Genes involved in melanin production directly impact insect pigmentation and can affect diverse physiology and behaviours. The role these genes have on sex behaviour, however, is unclear. In the present study, the crucial melanin pigment gene black was functionally characterised in an urban pest, the German cockroach, Blattella germanica. RNAi knockdown of B. germanica black (Bgblack) had no effect on survival, but did result in black pigmentation of the thoraxes, abdomens, heads, wings, legs, antennae, and cerci due to cuticular accumulation of melanin. Sex-specific variation in the pigmentation pattern was apparent, with females exhibiting darker coloration on the abdomen and thorax than males. Bgblack knockdown also resulted in wing deformation and negatively impacted the contact sex pheromone-based courtship behaviour of males. This study provides evidence for black function in multiple aspects of B. germanica biology and opens new avenues of exploration for novel pest control strategies.
As an important component of prehistoric subsistence, an understanding of bone-working is essential for interpreting the evolution of early complex societies, yet worked bones are rarely systematically collected in China. Here, the authors apply multiple analytical methods to worked bones from the Longshan site of Pingliangtai, in central China, showing that Neolithic bone-working in this area, with cervid as the main raw material, was mature but localised, household-based and self-sufficient. The introduction of cattle in the Late Neolithic precipitated a shift in bone-working traditions but it was only later, in the Bronze Age, that cattle bones were utilised in a specialised fashion and dedicated bone-working industries emerged in urban centres.
We report an experimental study of the formation and evolution of laminar thermal structures generated by a small heat source, with a focus on their correlation to the thermal boundary layer and effects of heating time $t_{heat}$. The experiments are performed over the flux Rayleigh number ($Ra_f$) range $2.1\times 10^6 \leq Ra_f \leq 3.6\times 10^{7}$ and the Prandtl number ($Pr$) range $28.6 \leq Pr \leq 904.7$. The corresponding Rayleigh number ($Ra= t_{heat}\,Ra_{f}/\tau _0\,Pr$) range is $900 \leq Ra \leq 4\times 10^{4}$, where $\tau _0$ is a diffusion time scale. For thermal structures generated by continuous heating (i.e. starting plumes), their formation process exists three characteristic times that are well reflected by changes in the thermal boundary layer thickness. These characteristic times, denoted as $t_{emit}$, $t_{recover}$ and $t_{static}$, correspond to the moments when the plume emission begins and completes, and when the thermal boundary layer becomes quasi-static, respectively. Their $Ra_f$–$Pr$ dependencies are found to be $t_{emit}/\tau _0\sim Ra_f^{-0.41}\,Pr^{0.41}$, $t_{recover}/\tau _0\sim Ra_f^{-0.48}\,Pr^{0.48}$ and $t_{static}/\tau _0\sim Ra_f^{-0.49}\,Pr^{0.33}$, respectively. Thermal structures generated by finite $t_{heat}$ exhibit similar evolution dynamics once $t_{heat} \ge t_{emit}$, with the accelerating stage behaving like starting plumes and the decay stage like thermals (i.e. a finite amount of buoyant fluids). It is further found that their maximum rising velocity experiences a transition in the $Ra$-dependence from $Ra$ to $(Ra\ln Ra)^{0.5}$ at $Ra \simeq 6000$; and their maximum acceleration reaches the value of starting plumes at $t_{heat}\simeq t_{recover}$, and remains unchanged for larger $t_{heat}$. In particular, the maximum rising velocity for the cases with $t_{heat} = t_{recover}$ follows a scaling relation $Ra_f^{0.37}\,Pr^{-0.37}$, in contrast to the relation $Ra_f^{0.48}\,Pr^{-0.48}$ for starting plumes. This study provides a more comprehensive understanding of laminar thermal structures, which are relevant to a range of processes in nature and laboratory systems such as Rayleigh–Bénard convection.
A deployable manipulator has the characteristics of a small installation space and a large workspace, which has great application prospects in small unmanned platforms. Most existing deployable manipulators are designed based on rigid links, whose complexity and mass inevitably increase sharply with increasing numbers of rigid links and joints. Inspired by the remarkable properties of tape springs, this paper proposes novel deployable parallel tape-spring manipulators with low mass, simple mechanics, and a high deployed-to-folded ratio. First, a double C-shaped tape spring is presented to improve the stability of the structure. The combined fixed drive component (CFDC) and combined mobile drive component (CMDC) are designed. Then, novel 2-DOF and 3-DOF deployable translational parallel manipulators are proposed based on the CFDC and CMDC, and their degrees-of-freedom (DOFs), kinematics, and stability are analyzed. The coiled tape spring is regarded as an Archimedean spiral, which can significantly improve the accuracy of kinematic analysis. The correction coefficient of the Euler formula is obtained by comparison with simulation results and experimental results. Furthermore, the stability spaces of the 2-DOF and 3-DOF deployable parallel manipulators are given. Finally, a prototype is fabricated, and experiments are conducted to validate the proposed design and analysis.
Adherence to post-exposure prophylaxis and post-exposure vaccination (PEV) is an important measure to prevent rabies. The purpose of this study was to explore the adherence to the vaccination protocol and its influencing factors among rabies-exposed patients in Shenzhen, China. A cross-sectional survey was conducted in a tertiary hospital in Shenzhen, China, to obtain epidemiological characteristics of patients; knowledge, attitude, and practice scores of rabies prevention; and medical records. A total of 326 patients requiring full rabies PEV were included in this study, and only 62% (202) completed the full course of vaccination according to the norms of the vaccination guidelines. After multifactor logistic regression, the factors influencing adherence to vaccination were as follows: age 31 to 40 years, time spent to reach the nearest rabies prevention clinic was >60 min, the time of injury was at night to early morning, the place of injury was a school/laboratory, the animal causing injury was a cat, the health status of the animal causing injury could not be determined, and patients with higher practice scores (all p<0.05). Understanding the factors influencing rabies vaccination adherence among rabies-exposed patients in urban areas of China and promote changes in patients’ practice toward rabies prevention is essential for rabies elimination by 2030.
Adsorption of nanoparticles on minerals affects the fate and transport of nanoparticles directly and is of great significance to many fields, including research into ore deposits, geochemistry, the environment and mineral materials. Whereas many previous studies have been conducted under the equilibrium pH and low solid (mineral) to liquid (nanoparticle suspension) ratio conditions, adsorption processes under initial pH and high solid/liquid ratio conditions may represent many important yet underexamined complex scenarios. To fill in this research gap, the adsorption of gold nanoparticles on illite was investigated experimentally at a relatively high solid/liquid ratio of 5 g L–1 and the effects of initial pH, ionic strength, citrate concentration, temperature and illite particle size were evaluated. The adsorbed amount of gold nanoparticles (from <5% to nearly 100%) increased with increasing ionic strength, temperature and citrate concentration and decreased with increasing pH and illite particle size. The presence of illite resulted in the dynamic evolution of the pH of the suspension, which, along with solution chemistry parameters, controlled the electrostatic interaction of illite and gold nanoparticles. The adsorption results, scanning electron microscopy observations and surface properties of illite suggest that the negatively charged gold nanoparticles were adsorbed predominantly on the positive illite edges through electrostatic interaction. The electrostatic attraction between illite and gold nanoparticles appeared to be strong, supported by the minor amount of desorption. These research findings are expected to provide a valuable reference regarding many critical issues in the geosciences as well as for industrial applications.
In this work, we investigate the characteristics of wind turbine wakes for three different blade designs (i.e. the NREL-Ori, NREL-Root and NREL-Tip designs, where the NREL-Ori refers to the baseline offshore 5 MW wind turbine designed by the US National Renewable Energy Laboratory) under turbulent inflows using large-eddy simulations with the actuator surface model. The load on the blade is higher near the blade root/tip for the NREL-Root/NREL-Tip designs when compared with the NREL-Ori design, while their thrust coefficients are the same. The results show that the blade designs influence the velocity deficit in the near wake, turbulence kinetic energy and wake meandering (both amplitude and frequency). In the near-wake region, the magnitude of the velocity deficit from the NREL-Root design is higher. As for the turbulence kinetic energy, its maximum in the near wake is higher for the NREL-Tip design, while in the far wake, it is higher for the NREL-Root design. Analyses of the instantaneous spanwise wake centre positions show higher meandering amplitude for the NREL-Root design, with the magnitudes of the low-frequency components approximately the same as the other two designs under the same inflow. The dominant meandering frequencies from different designs are different, with lower values for the NREL-Root design for which the vortex structures near the hub of low frequency play leading roles, and higher values for the NREL-Tip design for which the flow structures of high frequency in the tip shear layer are more important.
A blunted hypothalamic–pituitary–adrenal (HPA) axis response to acute stress is associated with psychiatric symptoms. Although the prefrontal cortex and limbic areas are important regulators of the HPA axis, whether the neural habituation of these regions during stress signals both blunted HPA axis responses and psychiatric symptoms remains unclear. In this study, neural habituation during acute stress and its associations with the stress cortisol response, resilience, and depression were evaluated.
Methods
Seventy-seven participants (17–22 years old, 37 women) were recruited for a ScanSTRESS brain imaging study, and the activation changes between the first and last stress blocks were used as the neural habituation index. Meanwhile, participants' salivary cortisol during test was collected. Individual-level resilience and depression were measured using questionnaires. Correlation and moderation analyses were conducted to investigate the association between neural habituation and endocrine data and mental symptoms. Validated analyses were conducted using a Montreal Image Stress Test dataset in another independent sample (48 participants; 17–22 years old, 24 women).
Results
Neural habituation of the prefrontal cortex and limbic area was negatively correlated with cortisol responses in both datasets. In the ScanSTRESS paradigm, neural habituation was both positively correlated with depression and negatively correlated with resilience. Moreover, resilience moderated the relationship between neural habituation in the ventromedial prefrontal cortex and cortisol response.
Conclusions
This study suggested that neural habituation of the prefrontal cortex and limbic area could reflect motivation dysregulation during repeated failures and negative feedback, which might further lead to maladaptive mental states.
Recent studies suggest that heterogeneous bilingual experiences implicate different executive functions (EF) in children. Using a latent profile analysis, we conducted a more nuanced investigation of multifaceted bilingual experiences. By concurrently considering numerous bilingual indicators – age of L1 and L2 acquisition, interactional contexts of verbal exchanges, L1 and L2 proficiency, balance of language use at home and school, and receptive vocabulary – we identified three latent profiles (subgroups): balanced dual-language, dominant single-language, and mixed-interaction. We found that the balanced dual-language and dominant single-language profiles predicted significantly better switching than the mixed-interaction profile. However, no profile differences were found in working memory, prepotent response inhibition, or inhibitory control. These results held true when multiple covariates (age, sex, household income, and nonverbal intelligence) were controlled for. Using a person-centered approach, our study underscores that disparate bilingual experiences asymmetrically predict the shifting facet of EF during early childhood.
Motivated by traffic congestion and air pollution, Beijing is one of several major cities to restrict vehicle ownership by requiring residents to win a lottery for the right to obtain an additional car. We examine the welfare cost of preventing people from owning cars because of misallocation: under a lottery, some individuals with low willingness to pay (WTP) for cars can obtain cars, while other individuals with high WTP cannot. We estimate welfare costs using a new contingent valuation method survey of Beijing lottery participants which we designed and conducted explicitly for this purpose. We find that restricting vehicle ownership reduced private welfare by 26 billion yuan. Back-of-the-envelope calculations suggest that the benefits of lower congestion and pollution roughly equal the costs. Our WTP estimates indicate a net welfare gain of approximately 32 billion yuan if Beijing’s lottery were replaced with an auction, which is similar to previous estimates.
We aimed to investigate the association of metabolic obesity phenotypes with all-cause mortality risk in a rural Chinese population. This prospective cohort study enrolled 15 704 Chinese adults (38·86 % men) with a median age of 51·00 (interquartile range: 41·00–60·00) at baseline (2007–2008) and followed up during 2013–2014. Obesity was defined by waist circumference (WC: ≥ 90 cm for men and ≥ 80 cm for women) or waist-to-height ratio (WHtR: ≥ 0·5). The hazard ratio (HR) and 95 % CI for the risk of all-cause mortality related to metabolic obesity phenotypes were calculated using the Cox hazards regression model. During a median follow-up of 6·01 years, 864 deaths were identified. When obesity was defined by WC, the prevalence of participants with metabolically healthy non-obesity (MHNO), metabolically healthy obesity (MHO), metabolically unhealthy non-obesity (MUNO) and metabolically unhealthy obesity (MUO) at baseline was 12·12 %, 2·80 %, 41·93 % and 43·15 %, respectively. After adjusting for age, sex, alcohol drinking, smoking, physical activity and education, the risk of all-cause mortality was higher with both MUNO (HR = 1·20, 95 % CI 1·14, 1·26) and MUO (HR = 1·20, 95 % CI 1·13, 1·27) v. MHNO, but the risk was not statistically significant with MHO (HR = 0·99, 95 % CI 0·89, 1·10). This result remained consistent when stratified by sex. Defining obesity by WHtR gave similar results. MHO does not suggest a greater risk of all-cause mortality compared to MHNO, but participants with metabolic abnormality, with or without obesity, have a higher risk of all-cause mortality. These results should be cautiously interpreted as the representation of MHO is small.
Hand, foot and mouth disease (HFMD) is a common infection in the world, and its epidemics result in heavy disease burdens. Over the past decade, HFMD has been widespread among children in China, with Shanxi Province being a severely affected northern province. Located in the temperate monsoon climate, Shanxi has a GDP of over 2.5 trillion yuan. It is important to have a comprehensive understanding of the basic features of HFMD in those areas that have similar meteorological and economic backgrounds to northern China. We aimed to investigate epidemiological characteristics, identify spatial clusters and predict monthly incidence of HFMD. All reported HFMD cases were obtained from the Shanxi Center for Disease Control and Prevention. Overall HFMD incidence showed a significant downward trend from 2017 to 2020, increasing again in 2021. Children aged < 5 years were primarily affected, with a high incidence of HFMD in male patients (relative risk: 1.316). The distribution showed a seasonal trend, with major peaks in June and July and secondary peaks in October and November with the exception of 2020. Other enteroviruses were the predominant causative agents of HFMD in most years. Areas with large numbers of HFMD cases were primarily in central Shanxi, and spatial clusters in 2017 and 2018 showed a positive global spatial correlation. Local spatial autocorrelation analysis showed that hot spots and secondary hot spots were concentrated in Jinzhong and Yangquan in 2018. Based on monthly incidence from September 2021 to August 2022, the mean absolute error (MAE), mean absolute percentage error (MAPE), and root mean square error (RMSE) of the long short-term memory (LSTM) and seasonal autoregressive integrated moving average (SARIMA) models were 386.58 vs. 838.25, 2.25 vs. 3.08, and 461.96 vs. 963.13, respectively, indicating that the predictive accuracy of LSTM was better than that of SARIMA. The LSTM model may be useful in predicting monthly incidences of HFMD, which may provide early warnings of HFMD epidemics.