Health and disease belong to the category of biomedicine but also involve social, political and economic dimensions [22]. Our research summarized posts in the Crohns disease bar over the previous 12years and conducted a comprehensive analysis through two methods: grounded theory and the LAD topic model. In contrast to previous interview studies with small sample sizes, this study analyzed Chinese patients with Crohn's disease from the perspective of social media. An enormous and comprehensive dataset identified the prominent concerns of patients with Crohn's disease. This study provides novel insight into patients experiences with Crohn's disease and identifies actionable needs that may improve their quality of life.

The need for shared decision making in IBD has become a consensus among IBD physicians worldwide [23]. However, there is a large gap between doctors and patients in their knowledge and information about diseases. Apart from online consultation, Crohn's disease patients seem to have few ways to acquire such knowledge. Our study confirmed that 56.9% of Crohn's disease patients urgently want more information about the disease, including diagnosis, symptoms, pathology, complications, surgery, new therapies and professional treatment support. This need is more urgent for patients who have symptoms but have not been diagnosed or have difficulty in diagnosis. Consulting patients who have been diagnosed is the most common method. For instance, some people described their symptoms and indicated that they have undergone some physical examination (but had not received feedback). They were very afraid, especially after they searched for information about Crohn's disease on the internet. Some low-quality answers often have this effect. Patients' consultation of social media negatively influenced the diagnostic and therapeutic decisions. For example, some posts mentioned that the anesthetics used in painless enteroscopies would damage the memories. This misunderstanding has always existed in China and has negatively affected many people, causing them to suffer needlessly by refusing to undergo anesthesia during an enteroscopy. In addition, some posts mentioned consulting experts and hospitals with experience in treating Crohn's disease. Some patients find their disease progressing because of misdiagnosis, untimely treatment and nonstandard treatment.

Encouragingly, many Crohn's disease patients in China had shared their experiences through video platforms, such as the Chinese Tik Tok and Bilibili video platforms; some self-media medical accounts also disseminated Crohn's disease knowledge through popular science articles and videos. In recent years, the Chinese Crohn's and Colitis Foundation (CCCF) [24], a large nongovernmental public welfare organization that is committed to improvingthe quality of life of IBD patients in China by providing social resources, has made great contributions through patient education, public awareness, helping to train IBD specialists, etc. In addition, an increasing number of hospitals are actively training IBD specialists and establishing multidisciplinary teams (MDTs) [25].

Pharmacotherapy is the first step in treating IBD [26]. The main medicine for the management of Crohn's disease works by suppressing an overly active intestinal immune system [26]. Several monoclonal antibodies have been approved for the treatment of Crohn's disease, such as anti-TNF agents [27] and anti-integrin agents. In addition, the use of these biologics in combination with a conventional immunosuppressant may yield superior outcomes and improve the durability of therapy [28, 29]. In our analyses, we also found that more than 1/4 of the posts discussed the drug treatment of Crohn's disease, and seven subthemes were mentioned repeatedly. Biological agents, traditional therapeutic drugs, hormones and TCM were the drugs of most concern to patients. Other patients' medication experience (efficacy and recommendations) and side effects also affected their medication decisions. Medical insurance policies and their own financial situation restricted them from choosing better drugs.

Interestingly, Chinese patients with Crohn's disease were willing to use TCM for treatment, especially when biological agents failed. Cai et al. used semistructured interviews with 14 IBD patients using TCM and explored their reasons and experience of decision-making [30]. The results showed that patients initiated TCM treatment due to the unsatisfactory effects of other therapies. TCM has been widely used to treat IBD in China; however, systematically determining its efficacy in IBD treatment is still challenging [31].

The benefits and risks of treatment are the primary consideration of doctors, which also places huge decision-making pressure on patients. A previous network survey on Crohn's disease patients found that the acceptable risk of drug treatment for Crohn's disease patients depends on the severity of the disease and the expected benefits. Especially for patients with mild to moderate cases, the acceptance of risk is low [23]. Another study showed that when Crohn's disease patients decide to use biological agents, they will comprehensively consider the safety and efficacy of those agents. Among them, safety accounted for 54% of the attention and the efficacy only 28% [32]. Our results are consistent with these findings. Many patients posted questions about the side effects of drugs and expressed their concerns. The experience of other patients often affected their decisions about medicine.

In our study, financial burden was another important influencing factor of drug use decisions, which was closely related to medical insurance policies. A retrospective study of the medical expenses of Crohn's disease patients based on a medical insurance database in the United States showed that the average lifetime medical cost of Crohn's disease patients was $416,352 higher than that of non-IBD patients, and the younger the diagnosis age was, the higher the lifelong medical expenses [33]. One two-center study on the treatment costs of Chinese Crohn's disease patients found that by 2011, the average hospitalization expenses of Crohn's disease patients had risen to CNY25504.21, an increase of 237% over 10years ago [34]. The medical insurance policies of different provinces in China differ, and different reimbursement policies are formulated according to the severity of Crohn's disease, which also leads to different drug choices for patients.

Depression and anxiety are common in patients with IBD and are increasingly being recognized by gastroenterologists [35]. The psychological burden in IBD patients is threefold higher than that in the general population [36]. It is well documented that depression and anxiety may affect more than 25 to 30 percent of individuals with IBD [37, 38]. As expected, the results of the mixed methods in our study indicated that psychological burden is an unavoidable theme for patients with Crohn's disease. These psychological burdens come mainly from personal, family and social pressures. Some posts stated that the disease had caused many impacts on their families and made them vulnerable. These patients lived with low self-esteem, depression and anxiety. Patients with stoma mentioned suicide and death in some posts. A cohort study showed that intestinal surgery and stoma formation are positively associated with subsequent antidepressant medication use [39]. Some people could not support their parents and felt that they were a burden on their family, which caused them to bear a heavy mental burden. In addition, some patients had given up their original work, lifestyle and social contacts, and some had experienced great changes in their lives, such as breakups and divorce. IBD affects women differently than men. Trutas review summarized the impact of IBD, Crohn's disease and ulcerative colitis on women's health, and found that women with Crohn's disease report worse psychological wellbeing less resilience than men but develop more escape and avoidance strategies to cope with the disease [40]. Our results also support the conclusion. We also found that most women with Crohn's disease were concerned about pregnancy. This is usually an important factor affecting marital happiness and family harmony, as traditional Chinese families need children to carry on the family lineage. IBD frequently affects women of childbearing age and may have implications for pregnancy [41]. Therefore, preconception counseling is pertinent to provide patient education, medication review for risk of teratogenicity and objective disease assessment.

Fortunately, we also found that peer support can play a role in encouragement. Psychological support is not incorporated into the routine care of persons with IBD. Some patients shared their successful treatment experiences, which relieved stress and gave confidence to other patients. Peer support provides a unique perspective of shared experience that can instill hope and assist coping efforts of patients and family [42]. A systematic review found that psychotherapeutic interventions can improve quality of life in patients with IBD and that early intervention after diagnosis leads to better coping strategies and quality of life throughout life [43]. Cumulatively, based on these results, we confirm that psychotherapy is necessary for IBD patients with mental stress.

Diet and nutrition are increasingly becoming matters of interest for Crohn's disease treatment, although they formerly played a marginal role [44]. Decreased dietary intake, nutrient malabsorption and weight loss are some of the nutritional challenges that Crohn's disease patients face [45]. Paradoxically, dietary intake may also trigger the symptoms of Crohn's disease patients [46]. Indeed, a Western-style diet rich in saturated fat and low in fiber has been implicated in the onset of the disease. This leads patients to seek dietary solutions for disease management [47]. However, current dietary recommendations are based largely on low-quality studies. At present, no clear indications of a specific diet are available. However, personalized nutrition is considered a potential way to treat patients with Crohn's disease [44]. One study explored the experience of dietary practices of Chinese patients with IBD and believed that health care professionals should encourage patients to report diet modification and be aware of both personal and environmental barriers to diet modification. [48]. Our study showed that patients with Crohn's disease are confused about their diet. Some posts shared menus and diet experiences with other patients. Vegetables, meat, fruits and beverages were mentioned repeatedly in posts. Malnutrition is detected in approximately 6575% of patients with Crohn's disease [49]. Enteral nutrition (EN) and parenteral nutrition (PN) are recommended by the guidelines of the European Society of Clinical Nutrition and Metabolism (ESPEN) for malnourished patients [50]. Due to the high cost and side effects of PN, EN is often the first choice for Crohn's disease patients [51], and nasogastric feeding is the main EN method. One study explored the initial factors and experiences of nasogastric feeding by Crohn's disease patients from China, and the results suggested that many patients rejected nasogastric feeding due to fear, image and activity restrictions [52]. Nasogastric feeding is also an important term in our results. As mentioned above, the appearance problem caused by nasal feeding is one of the social pressures of Crohn's disease patients. Given womens more fragile profile, they tend to be more affected by the effects of the disease than men, so it is necessary to carry out personalized nursing for female patients and improve their quality of life [40].

Weight is one of the nutritional concerns of Crohn's disease patients, who can simply judge their nutritional status by weight changes. However, 15 to 40% of patients with IBD are obese, which may lead to the development of IBD and make colorectal surgery technically challenging [53]. Recently, an integrative review suggested that physical activity can improve quality of life, mental health, sleep quality, fatigue and body weight [54]. In our study, exercise was one of the topics of concern for people with Crohn's disease. Many Crohn's disease patients do not know what and how much exercise will be beneficial. This suggests that the treatment of Crohn's disease requires the participation of nutritionists and exercise scientists to provide a more reasonable plan.

Our results reveal the poor quality of life of patients with Crohn's disease who suffer from intestinal symptoms, systemic symptoms, emotional function, etc. The Inflammatory Bowel Disease Questionnaire (IBDQ) is a valuable disease-specific quality of life questionnaire, that aids in identifying clinical disorientation in patients [55]. The IBDQ has been translated into many languages since its inception [56, 57], and has been used in many ways given its good reliability and validity. It has greatly contributed to evaluating the quality of life of patients and promoting the improvement of IBD diagnosis and treatment strategies. The mainland Chinese IBDQ has proven to be a valid, discriminative, and reliable instrument for assessing health-related quality of life in patients with ulcerative colitis and Crohn's disease in mainland China [57].

COVID-19 has caused a global health crisis, precisely in the country that is the cradle of the COVID-19 infection. In this study, four topics emerged on social media as the ones most discussed by Crohn's disease patients. In the face of this pandemic, patients with Crohn's disease are eager to receive advice on prevention and protection measures. Some researchers have recently provided patients with suggestions on IBD management [58], but at the beginning of the pandemic, there were no suggestion to provide. In addition, patients with Crohn's disease expressed concern about the shortage of medical resources. A study from the Netherlands showed that patients with IBD showed an overall low health-related quality of life during the COVID-19 pandemic, especially the older patients, women and patients who underwent surgical procedures [59]. Many hospitals temporarily closed the biological reagent injection room for the sake of epidemic safety, which led to many patients not being treated on time. Some radical and unprecedented health policies, such as shielding, disrupted patientstreatment and lives. Mass vaccination programs provide the best opportunity for controlling transmission and protecting populations [60], but this is a difficult decision for IBD patients as no confirmed data are presently available regarding COVID-19 vaccines in this population due to their exclusion from the conducted clinical trials [61]. The good news is that some recent studies have provided some clinical evidence [62,63,64]. Drug use after COVID-19 infection has also become a psychological burden for Crohn's disease patients. A clinical study of 1439 IBD patients from 47 countries showed that combination therapy (TNF antagonist and thiopurine) and thiopurine drugs may increase the risk of severe COVID-19. No significant differences were observed when comparing classes of biological agents [65], although post-acute COVID-19 is characterized by gut viral antigen persistence in IBD [66]. More clinical and basic studies are needed to confirm the problem of drug use after COVID-19 infection.

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Patients' perspectives on, experience with and concerns about ... - BMC Gastroenterology

MSD not only causes GRD, but also easily leads to the disconnection between the shaft, bunton and GR. The GRD characteristics are analyzed under the normal connection between them, the disconnection of the shaft from the bunton, and the disconnection of the bunton from the GR. The instability of the hoisting conveyance is mainly caused by the horizontal deformation of the GR. It can be seen from Fig.6 that the horizontal deformation of the guide rail in the same direction as the shaft deformation has a good follow-up to the shaft deformation, is highly correlated with the shaft deformation trend, and other horizontal directions are relatively low, so the main focus is on the deformation characteristic and law of the GR corresponding to the shaft deformation in the horizontal direction. Owing to the action mechanism of vertical compression deformation of shaft is different from other deformation types, it mainly focuses on inclination, bending, dislocation and horizontal section deformation of the shaft.

Starting from the position of 250m, the shaft is inclined in the positive direction of the x-axis, and the inclination rates are 0.2, 0.4, 0.6, 0.8 and 1mm/m, respectively. The GRD corresponding to the x-direction is shown in Fig.9. It can be found that the GRD is roughly linear and basically consistent with the shaft deformation. Its maximum deformation values are 49.1, 97.9, 146.5, 195.5 and 244.2mm, and it is reduced to a certain extent compared with the shaft inclination deformation. The GR within a certain depth from the upper surface of the shaft has both linear and fluctuating deformation. The period of the fluctuation deformation is 4m, which is the interval between adjacent buntons, and its amplitude and deformation range increase with the aggravation of the inclination deformation. The GR below the starting position of the inclination deformation only produces fluctuation deformation with a period of 4m, and the amplitude increases with the aggravation of the inclination deformation.

GRD in x-direction under inclination.

The lower GR has a stretching action on the upper part, but the support action of the bunton on the GR hinders the stretching, which leads to the reverse deformation of the GR with the bunton as the center, forming the fluctuation deformation in the upper part. The GR above the starting position of the inclined deformation makes the lower part tend to incline, and the constraint of the bunton on the GR restricts this deformation, resulting in the fluctuation deformation of the lower part. With the aggravation of the inclination deformation, the GRD basically increases linearly, and the amplitude and range of the fluctuation deformation increase, which has a good characterization relationship for the type and degree of the inclination deformation of the shaft.

To make the disconnection representative between bunton, GR and shaft under inclined deformation, the disconnection positions are selected at the upper, middle and lower parts of the shaft, which are 239, 119, 71 and 11m respectively. Figure10 shows the x-direction deformation of the GR under inclined deformation when the bunton is disconnected from the GR. In Fig.10a, the deformation is basically the same as the normal connection except near the disconnection position. At the disconnected position 239m, it is stepped with heights of 0.4, 1.8, 2.3, 4.3 and 4.9mm, respectively. It increases with the aggravation of the inclination deformation, and the change rate first increases and then decreases. The disconnected position is affected by the inclined deformation of the shaft, and the accumulated length of the GR below it is relatively small, resulting in a relatively small cumulative deformation energy of the GR near the lower part of the disconnection position, but the deformation energy near the upper part of the disconnection position is much larger than that of the lower part. When the bunton is disconnected from the GR, the deformation energy is released, so that the deformation of the GR in the upper part of the disconnection position is larger than that in the lower part, forming a stepped shape.

GRD in x-direction under inclination when bunton is disconnected from GR.

The deformation law near the disconnected position at 119 and 71m is basically the same, as shown in Fig.10b,c, with a sawtooth shape, the height increases with the aggravation of inclined deformation, and its minimum value is 3.1mm and the maximum value is 9.4mm. Since the disconnection position is located in the middle of the inclination deformation of the shaft, the difference in the accumulated deformation energy near the upper and lower part of the disconnection position is relatively small, and the deformation caused by the release of the deformation energy is basically the same, so it has a sawtooth shape. When the bunton and GR are disconnected at 11m as shown in Fig.10d, the GR on both sides of the disconnected position is deformed in reverse, showing a two-way sawtooth. The peak-to-peak value of the two-way sawtooth increases with the aggravation of the inclined deformation, and the minimum value is 9.8mm and the maximum value is 36.5mm, which far exceeds the allowable value of the GRD stipulated by the coal mine safety regulations. The stretching of the upper GR to the lower causes the upper bunton to be greatly stretched downward, induces the bunton to bend downward. When the upper bunton is disconnected from the GR, the bending deformation of the bunton at the disconnected position is greatly released, and the deformation at other positions is reduced to a certain extent, but the curvature is still large. Under the action of bending deformation, GR deforms to the side with smaller curvature, that is, the negative x-axis direction, forming a two-way sawtooth. Through the above analysis, it is found that the deformation laws of GR corresponding to different disconnected position are distinct. The bottom is stepped, the middle is sawtooth, and the upper part is two-way sawtooth. As the inclination deformation increases, its deformation amplitude augments. The disconnection position near ground has the greater impact on the GRD and is easy to cause hoisting accidents.

When the bunton is disconnected from the shaft at different positions, the x-direction deformation of the GR under inclination deformation is shown in Fig.11. The GRD law is basically unchanged at the disconnected position of 239, 119 and 71m, and the overall GRD law is fundamentally the same as that in the normal connection state. The period becomes 8m at 11m, as shown in Fig.11d, and it is twice the distance between adjacent buntons, but the amplitude basically unchanged. The disconnection between the shaft and the bunton loses its supporting effect on the bunton, the constraining effect of the disconnected bunton on the GR is invalid, and the GR deforms under the action of the interval bunton, which finally causes the period of the GRD to change at this position. Since the supporting effect of the upper bunton on the GR is much stronger than that of the middle and lower parts, the upper disconnection position easily affects the guide deformation. The disconnection of the bunton and shaft has less influence on the GRD than the separation of the bunton and GR, hence the attention should be paid to the connection state of the bunton and GR under the inclined deformation of the shaft.

GRD in x-direction under inclination when bunton is disconnected from Shaft.

The 140 to 120m segment of the shaft acts on the given of x-direction bending deformation, which is cosine type, the amplitudes are 1, 2, 3, 4 and 5mm in turn. The GRD in the x-direction is shown in Fig.12, there is approximately symmetrical bending from 146 to 119m, and the deformation ranges are (143.1, 119.1), (147.1, 119.1), (147.9, 119.1), (148.7, 119.1) and (149.8, 119.1) m, which are larger than the bending deformation range of the shaft. The maximum value of GRD is 0.99, 1.96, 2.93, 3.90, and 4.87mm, the corresponding position is 130.2m, and it is maximum deflection position of the shaft. There are differences in the GRD law on both sides of the maximum deflection, the right side is a smooth curve, and the left side is an inclined stepped curve. The inclined stepped curve is mainly due to the asymmetry of the bunton with respect to the maximum deflection position of the shaft. The bunton closest to the maximum deflection position of the shaft is located on its lower side, the maximum deflection of GR appears near the bunton under its action, and the distance relationship causes the above action on the lower side of the maximum deflection of the shaft to be much greater than the upper side, so the attenuation rate of the guide deformation is relatively slowly above the maximum deflection position of the shaft. Nevertheless, the effect of the farther upper adjacent bunton on it further increases its attenuation rate and it becomes the stepped shape. There is a corresponding relationship between the GRD and the bending deformation of the shaft. As the amplitude of the bending deformation of the shaft increases, the amplitude and range of the bending deformation of the GR enlarge, and the deformation law is the same. It indicates the sensitivity and reliability of the GRD to characterize the bending deformation of shaft.

GRD in x-direction under bending.

GRD appears periodic weak fluctuation outside a certain distance from the shaft bending region, its period is 4m, and its amplitude basically does not change with shaft bending deformation, which indicates that its influence on the GR is limited. From 119 to 106m, the deformation generally exhibits an inverted arch, and its amplitude is larger than other positions of the fluctuation deformation and it increases with the aggravation of the shaft bending deformation. The buntons constraint on the bending deformation of the GR makes it subject to a force in the negative x-direction, and drives the GR to move along the negative x-direction within a certain range, and finally the inverted arch occurs. The fluctuation is mainly caused by the constraint effect of bunton on the GR. The action of gravity leads the GR to deform in the vertical direction, and the constraints limit this deformation, which makes the upper half of the GR between adjacent buntons deforms along the negative x-direction, the lower half deforms along the positive x-direction, and the joint has the smallest deformation and is the starting point of periodic fluctuation. The maximum amplitude of the above fluctuations is only 0.02mm, the verticality and straightness meet the requirements of the GR installation specification, and it is generally straight, which further indicates the rationality of the initial connection parameters of the bunton, GR and shaft.

The disconnection positions are 11, 47, 83, 107, 119, 131, 143, 155, 179, 215 and 251m in sequence, and are all over the bending position and both sides of the shaft. Owing to the same of GRD law under different degrees of shaft bending deformation, it is studied that the shaft bending deformation amplitude of 1mm on disconnection. Figure13 shows the GRD law when the bunton is disconnected from the GR under bending action. The GR at the disconnected position deforms in opposite direction, and its amplitude is 0.38mm outside the range of shaft bending deformation, which is about 7 times the amplitude of the fluctuation deformation. The maximum amplitude occurs at 119m, and it is about 14 times the amplitude. This disconnection position is located at the junction of the shaft bending deformation, and the bunton below it is situated in the action area of the shaft bending deformation, so the GR below it is subjected to the above action, resulting in its abnormally prominent amplitude. The disconnected position at 131m is located in the middle of the bending deformation area of the shaft, the GR above it produces the reverse deformation and its amplitude is 5 times that of the fluctuation deformation, and the deformation below it is basically the same as that of the normal connection. Due to the bending deformation of the shaft, the end of the adjacent bunton at the disconnected position is bend towards the inside of the shaft, it causes the bunton near the disconnection position is bent downward, the lower GR is bent in the positive x-direction, and the upper GR is deformed in the opposite direction, which eventually leads to the GR occurs opposite deformation at the disconnected position between the bunton and GR.

GRD in x-direction under bending when bunton is disconnected from GR.

When the bunton is disconnected from the shaft under the action of the shaft bending deformation, the GRD is shown in Fig.14. When the disconnection is outside the shaft bending deformation, the period of the fluctuation deformation changes at the disconnection position and becomes 8m, and the amplitude basically does not change. When the disconnected position is located at 119m at the upper junction of the shaft bending deformation, the GRD law on the lower side of the disconnected position is basically the same as the normal connection. The deformation on the upper side of the disconnected position extends in the negative x-direction, which is mainly due to the bending effect of the lower GR in the positive x-direction and the reverse restraint effect of the upper GR in the disconnected position. When the disconnected position is located at 143m at the lower junction, the deformation decreases on the upper side near the disconnected position, and it increases on the lower side. The GR above this disconnected position is located in the bending deformation area of the shaft, it acts on the GR with an active force in the positive x-direction, thereby producing a pulling effect on the lower GR in the positive x-direction. The bunton at this disconnection position is located outside the bending deformation area of the shaft. When it is normal connection, it produces a negative x-direction constraint on the GR to slow down its attenuation rate of the bending deformation, the above restraint is eliminated under the disconnection state cause an increase in the attenuation rate of the GR bending deformation, which induces a diminution in the upper GRD near the disconnected position. and the bending deformation range of the GR and the deformation value below it increases.

GRD in x-direction under bending when bunton is disconnected from shaft.

When the disconnected position is 131m in the bending deformation area of the shaft, the deformation law near the disconnected position is basically the same as the normal connection, and the period and amplitude do not change significantly. When the disconnected bunton is located in the bending deformation area of the shaft, and the adjacent bunton has a strong bending deformation force on the GR at the same time, so even if a single bunton is disconnected from the GR, its force condition is basically unchanged, resulting in basically no change in its deformation law and amplitude. When the disconnected bunton is outside the bending deformation range of the shaft, the GR deformation period at the disconnected position changes, but the amplitude does not change. When the disconnected bunton is located at the junction of the shaft bending deformation, the deformation and period at the disconnected position change at the same time. The disconnection between the bunton and shaft under the bending deformation action has little influence on the deformation law of the GR, and the connection between the bunton and the GR should be focused on.

For a given shaft dislocation deformation in the x-direction from 130 to 90m, the amplitude is 1, 2, 3, 4 and 5mm at dislocation position of 130m and becomes 0mm at the 90m, and the attenuation rate is 0.025, 0.05, 0.075, 0.010 and 0.0125mm/m. The GRD under dislocation action is shown in Fig.15. The maximum deformation of the GR is 0.94, 1.88, 2.82, 3.78 and 4.72mm, and its position is 126.2m, which is higher than the dislocation position of the shaft, but its amplitude is basically unchanged compared with the dislocation amplitude of the shaft. The distance between the adjacent bunton makes it difficult to coincide with the position of the dislocation deformation of the shaft, and the dislocation deformation effect is transmitted to the GR through the bunton, so this effect causes the maximum deformation of the GR to occur near the bunton, and its position is moved up than the dislocation position of the shaft. The influence range of the dislocation deformation on the GRD is (143.5, 88.3), (143.9, 88.3), (146.7, 88.3), (146.9, 88.3) and (146.9, 88.3) m, which is much larger than the action scope of the shaft dislocation deformation. The shaft above the dislocation interface produces a stretching effect on the lower part, its lower part moves to the positive x-direction and expands the shaft deformation range, but the resistance from the SRSM to shaft restricts the transmission range of the above effect, which induces the deformation range of the GR is much larger than the action range of the shaft dislocation deformation. There are differences in the deformation law of the GR on both sides of the maximum amplitude, the upper side shows the attenuation trend of inclination deformation, and its attenuation rate is basically the same as the shaft dislocation deformation, accompanied by fluctuation deformation. The lower side has a bending deformation trend, and the attenuation rate first increases and then decreases as it moves away the maximum amplitude, which is mainly caused by the follow-up deformation of the shaft below the dislocation interface. The GRD corresponding to the shaft dislocation is a combination of inclination and bending. With the increase of the dislocation deformation, the slope of the inclined deformation of GR, the curvature of the bending deformation and the maximum amplitude increase, which are obviously different from the deformation feature of GR under shaft bending or inclination, and there is a good mapping relationship for the shaft dislocation.

GRD in x-direction under dislocation.

Figure16a shows the x-direction deformation of the GR when it is disconnected from the bunton under the action of the shaft dislocation, its position is 11, 47, 83, 107, 119, 131, 143, 155, 179, 215 and 251m, and the GR in the disconnected position generates the opposite deformation. The peak-to-peak value of the opposite deformation outside the shaft dislocation range is about 0.4mm, and it is about 20 times fluctuation deformation, which is mainly caused by the release of the interaction between the GR and bunton under the action of gravity. When the disconnection between the bunton and GR is 107 and 119m in the shaft dislocation area, the peak-to-peak value of the opposing deformation is 0.53 and 0.57mm, respectively, and its value increases less compared to outside of the shaft dislocation deformation region. Moreover, the peak-to-peak value at the junction of the shaft bending deformation is basically the same as that outside the shaft dislocation area. When the bunton is disconnected from the shaft at different positions, the GRD is shown in Fig.16b. The deformation decreases near the upper side of the disconnected position of 143m, the lower side augments, and its deformation mechanism is the same as at this position under the action of the bending deformation of the shaft, hence the explanation is not repeated here. Other disconnected position is basically unchanged in amplitude, and only the period becomes twice the fluctuation deformation. The deformation law is basically the same as the normal connection except the above disconnection position, hence the influence of shaft dislocation deformation on the GR has no obvious attenuation due to the disconnection between the bunton and GR.

GRD in x-direction under dislocation when connection is abnormal.

The shaft of the 130 to 110m segment imposes a given displacement in the x-direction so that its cross-section is approximately elliptical, the short axis is the x-axis and the long axis is the y-axis, and the amplitude occurs at the intersection of the outer wall of the shaft and x-axis. It attenuates uniformly on both sides along the y-axis and becomes 0mm at the intersection of the shaft and y-axis, and the attenuation curve is cosine. Figure17 shows the GRD when the amplitudes of the horizontal section change of the shaft are 1, 2, 3, 4 and 5mm in turn. The GRD from 134.9 to 107.4m is mainly affected by the horizontal section change, and the interval is basically unchanged with the aggravation of the horizontal section change. The deformation is generally trapezoidal, the middle section is a horizontal straight line accompanied by fluctuation deformation, and the transition area decays rapidly, generally an inclined straight line. With the increase of the deformation amplitude of the horizontal section change, the GRD from 134.9 to 130.5m shows the local arching phenomenon, which becomes more severe with the aggravation of the above deformation. The above phenomenon occurs near the junction of the action and influence zone of the horizontal section change. The bunton in action area follows the shaft to deform in the positive x-direction, and the GRD in the affected aera is less affected by the horizontal section change of shaft and bunton in affected area has a strong constraining effect on the guide deformation in the positive x-direction, and the GR in action area exists a strong stretching effect on GR in this position, which induces the local arching phenomenon.

GRD in x-direction under horizontal section change.

The amplitudes of the GRD are 0.33, 0.70, 1.04, 1.38, and 1.73mm corresponding to each horizontal section change, and it is a large attenuation relative to the shaft deformation. The fluctuation deformation amplitude from 107.4 to 73.1m augments with the aggravation of the horizontal section change, its amplitude is no obvious change rule from 73.1 to 46.9m, and the amplitude of 46.9 to 0m decreases. The above phenomenon is mainly caused by the strong constraint effect of bunton of the transition zone on the GR, and the strong stretching effect of the lower GR on the upper part. The deformation law of the GR is basically the same under the different amplitude of horizontal section change of the shaft, but there are obvious differences in the amplitude, which exists a good corresponding relationship between the horizontal section change of the shaft and the deformation law of the GR.

When the bunton is disconnected from GR, its position is 11, 47, 83, 107, 119, 131, 143, 179, 215 and 251m, respectively, and the GRD is shown in Fig.18a under horizontal section change. It generates the opposite deformation at the disconnected position, and its maximum peak to peak occurs in the transition zone of the horizontal section change at 107m and its value is 0.94mm. The disconnected bunton in the transition area locates in the outside of the shaft deformation and has little deformation effect on the GR, and the bunton below the transition area locates in the shaft deformation area and follows the shaft deformation to drive the GRD, which causes a large difference in force between adjacent buntons, and the maximum peak-to-peak value appears. In the horizontal section change area of the shaft at 119m, the peak-to-peak value is 0.43mm, and its value is basically the same as the disconnection position outside action area of the horizontal section change of the shaft. The disconnection between the bunton and GR in the transition area has the greatest influence on the GRD, which can easily lead to the abnormal deformation.

GRD in x-direction under horizontal section change when connection is abnormal.

Figure18b is the GRD corresponding the disconnection between the bunton and shaft under the horizontal section change of the shaft. The disconnection outside the action and transition area of the shaft deformation only changes the fluctuation deformation period near the disconnection position and its value is 8m, and the amplitude is basically unchanged. In the shaft deformation action area, the maximum peak-to-peak value is 1.12mm at disconnection position of 119m, and the peak-to-peak value at 107 and 131m in the upper and lower transition areas are 0.57 and 0.62mm respectively. The buntons on both sides of the disconnected position are located in the shaft deformation action area, are subjected to the pulling effect of the shaft in the positive x-direction, but the bunton at the disconnection position lacks the above effect, which eventually leads to local inverted arch near the position. The deformation principle of the GR at the disconnection position of the transition zone is the same as the above, except that one side of the bunton is located in the action zone, and the other side is located in the transition zone. However, the effect in transition zone is relatively weak, resulting in a relative lower peak-to-peak value. When the bunton is disconnected from the GR or shaft, the horizontal section change has a great influence on the GRD, so attention should be paid to the connection state.

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NJ New Jersey, USA -- (SBWIRE) -- 04/05/2023 -- Global Reinsurance Services Market Report from AMA Research highlights deep analysis on market characteristics, sizing, estimates and growth by segmentation, regional breakdowns & country along with competitive landscape, player's market shares, and strategies that are key in the market. The exploration provides a 360 view and insights, highlighting major outcomes of the industry. These insights help the business decision-makers to formulate better business plans and make informed decisions to improved profitability. In addition, the study helps venture or private players in understanding the companies in more detail to make better informed decisions.

Major Players in This Report Include,Munich Reinsurance Company (Germany), Swiss Re Ltd. (Switzerland), Hannover Re (Germany), SCOR S.E. (France), Berkshire Hathaway Inc. (United States), China Reinsurance (Group) Corporation (China), Lloyd's (United Kingdom), Canada Life Re (Canada), Reinsurance Group of America Inc. (United States), Korean Reinsurance Company (South Korea).

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Reinsurance gives more security to the insurer for its equity and solvency by enhancing its ability to withstand the financial burden when unusual events occur. Reinsurance Services provides stability during financial stress and is good for the insurance business. Reinsurance is a valuable investment. It acts as a safeguard from natural calamities and other disasters. Reinsurance is an agreement between two property-casualty insurers to share the financial consequences of a loss.

Opportunities-New Platform based Investments like Crowed Funding Marketplaces will Provide Opportunities to the Reinsurance Services Investors

Market Drivers-Rising Demand for Reinsurance Services from Insurers-Increasing Clients Focus on Reducing the Burden of Risk with Their Life and General Things

Market Trend-Advancement in New Technologies including Cloud Storage, External Data Mining and Analytics and Others

Challenges-Major Players Tighten Their Grip on Premiums and Small Players

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On 14th September 2021, Swiss Re. enters partnership with BlaBlaCar, the world's leading community-based travel platform, and motor insurance specialist L'olivier Assurance to launch the innovative digital motor product in France.According to the Insurance Regulatory and Development Authority of India (IRDAI), "The Reinsurance Services must be governing the licensing and functioning of insurers, reinsurers and insurance intermediaries.

In this research study, the prime factors that are impelling the growth of the Global Reinsurance Services market report have been studied thoroughly in a bid to estimate the overall value and the size of this market by the end of the forecast period. The impact of the driving forces, limitations, challenges, and opportunities has been examined extensively. The key trends that manage the interest of the customers have also been interpreted accurately for the benefit of the readers.

The Reinsurance Services market study is being classified by Type (Facultative Reinsurance, Treaty Reinsurance, Proportional Reinsurance, Non-proportional Reinsurance, Others), Application (Reinsurance General, Reinsurance Life), End-Use Verticals (Institutional, Individual), Sales (Direct, Agent)

The report concludes with in-depth details on the business operations and financial structure of leading vendors in the Global Reinsurance Services market report, Overview of Key trends in the past and present are in reports that are reported to be beneficial for companies looking for venture businesses in this market. Information about the various marketing channels and well-known distributors in this market was also provided here. This study serves as a rich guide for established players and new players in this market.

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Extracts from Table of ContentsReinsurance Services Market Research ReportChapter 1 Reinsurance Services Market OverviewChapter 2 Global Economic Impact on IndustryChapter 3 Global Market Competition by ManufacturersChapter 4 Global Revenue (Value, Volume*) by RegionChapter 5 Global Supplies (Production), Consumption, Export, Import by RegionsChapter 6 Global Revenue (Value, Volume*), Price* Trend by TypeChapter 7 Global Market Analysis by Application.continued

This report also analyzes the regulatory framework of the Global Markets Reinsurance Services Market Report to inform stakeholders about the various norms, regulations, this can have an impact. It also collects in-depth information from the detailed primary and secondary research techniques analyzed using the most efficient analysis tools. Based on the statistics gained from this systematic study, market research provides estimates for market participants and readers.

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Reinsurance Services Market Projected to Show Strong Growth ... - Digital Journal

PRESS RELEASE

Published April 5, 2023

A worldwideVagus Nerve Stimulation Marketresearch report is a verified and reliable source of information that gives a telescopic view of the existing market trends, emerging products, situations, and opportunities that drives the business toward success. This global market research report is organized by collecting market research data from different corners of the globe with an experienced team of language resources. The report serves the clients to tackle every strategic aspect including product development, product specification, exploring niche growth opportunities, application modeling, and new geographical markets. The universal market report also provides company profiles and contact information of the key market players in the key manufacturers section.

The vagus nerve is a prominent component of the autonomic nervous system that regulates metabolic homeostasis and functions as a crucial component of the neuroendocrine-immune axis in maintaining homeostasis via its afferent and efferent pathways. Any approach that stimulates the vagus nerve, including manual or electrical stimulation, is referred to as Vagus Nerve Stimulation (VNS). For refractory epilepsy and treatment-resistant depression, left cervical VNS is an approved therapy.

According to the WHO, neurological diseases are responsible for 4.5% to 11% of all illnesses worldwide. Vagus nerve stimulators are also used to treat patients suffering from epilepsy,depression, asthma, and cardiovascular disorders.

The global vagus nerve stimulation market is expected to grow in the forecast period of 2022 to 2029. Data Bridge Market Research analyzes that the market is growing with a CAGR of 15.0% in the forecast period of 2022 to 2029 and is expected to reach USD 2,424.01 million by 2029.

The vagus nerve is a long cranial nerve that runs from a persons brain stem into the neck, chest, and abdomen. It is a part of the parasympathetic nervous system, which is commonly referred to as the rest-and-digest system because it regulates body functions while a person is at rest. It delivers messages to a persons brain from their digestive system and organs such as their lungs, heart, and liver. It controls several organ functions, including digestion, heart rate, and respiratory rate. It is responsible for vasomotor activity and reflexes. It also regulates vocalization, mood, and immunity. It influences sensory functions in a persons ears, sinuses, and esophagus as well.

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Market Dynamics: Global Vagus Nerve Stimulation Market

Drivers

Increasing prevalence and incidence of neurological disorders

Neurological disorders cause 4.5% to 11% of all illnesses, whether in low or high-income countries. The impact is greater compared to that of malignancies, gastrointestinal diseases, or respiratory illnesses, and it is expected to grow over the next years. In the U.S., neurological illnesses have also seen a significant rise, and over the next 20 years, this growth tendency is anticipated to continue. The prevalence of these neurological illnesses has been reported to range from 0.9% to 4% (970-4100 per 100,000 population), with an average of roughly 2.3% (2390 per 100,000 population). One of the most common neurological conditions, epilepsy, affects almost every country on earth. Most people with this illness are seen among populations in nations like China and India. Due to this rising prevalence, there is a rising demand for a variety of tools and treatments, such as VNS. More neurological problems are being treated with VNS. In addition to other clinical uses, it aids in the treatment of neurological conditions like epilepsy and depression due to the significant prevalence of neurological conditions worldwide.

Innovative non-invasive vagus nerve stimulation devices introduced to meet demand

Traditional and conventional VNS devices are implanted in the patients body and leads are placed on the vagus nerves that provide electrical stimulation when required. Growing demand and technological advancement of innovative devices lead to the introduction of small-sized implantable VNS devices in the market. These small-sized implantable devices offer various clinical benefits to patients and healthcare providers. The introduction of innovative devices is anticipated to boost market growth.

Constant focus by market players to innovate and launch new products had led to the emergence of non-invasive VNS (nVNS) devices in the market. These devices are also known as transcutaneous VNS (tVNS) devices.

The rise in product approvals

The approval for VNS devices is governed by the U.S. FDA and the EU. The FDA issues a final protocol for filing a Pre-market Approval Application (PMA) or a notice of completion of a Product Development Protocol (PDP).

Opportunities

Strategic initiatives by the key market players

The demand for VNS devices is increasing in the market owing to the increased levels of R&D; along with that, the market growth is being aided by the desire for innovative medications. Thus, the top market players have implemented new strategies by developing new devices and equipment as well as collaborating with other players in the market and aimed at improving business operations and profitability.

The companies operating globally in this market are adopting collaboration as a strategy to increase their product portfolio with advanced technology-rich products to boost their business in various dimensions. Thus, increasing strategic initiatives by key market players are expected to offer significant opportunities for market players operating in the market.

Rising government initiatives for neurological disease

The purpose of funding for VNS devices is to encourage applications seeking to develop devices for various neurological disorders. Novel devices should move beyond existing electrical or magnetic stimulation and develop new stimulation techniques capable of increased spatiotemporal precision as well as multi-focal, closed-loop approaches. Therefore, the funding by the government would result in the safety of the patient and cost savings. In addition, hospitals and healthcare agencies would administer this treatment at a lower price through collaboration with government organizations. Hence, the advancements in R&D activities and funding by the government will act as an opportunity for this market growth.

Global Vagus Nerve Stimulation Market Scope

Global vagus nerve stimulation market is segmented into six notable segments based on product type, biomaterial, application, patient type, end user, and distribution channel. The growth amongst these segments will help you analyze meager growth segments in the industries and provide the users with a valuable market overview and market insights to make strategic decisions to identify core market applications.

Product Type

Implantable VNS Devices

External VNS Devices

Biomaterial

Ceramics

Metallic

Polymeric

Application

Pain Management

Epileptic Seizures

Obesity Management

Depression and Anxiety

Others

Patient Type

Adults

Pediatric

Geriatric

End User

Hospital

Ambulatory Surgery Centers

Specialty Centers

Others

Distribution Channel

Direct Tender

Retail Sales

Others

To Get a Detailed Table of Contents (TOC), please Click Here at @https://www.databridgemarketresearch.com/toc/?dbmr=global-vagus-nerve-stimulation-market

Global Vagus Nerve Stimulation Market Regional Analysis/Insights

The global vagus nerve stimulation market is analyzed and market size insights and trends are provided by country, product type, biomaterial, application, patient type, end user, and distribution channel as referenced above.

North America dominates the global vagus nerve stimulation market in terms of market share and revenue and will continue to flourish its dominance during the forecast period. This is due to the high prevalence and incidence of neurological disorders in the region, and growing R&D investments and the launch of new products are boosting the market growth.

The country section of the report also provides individual market-impacting factors and changes in regulations in the market that impact the current and future trends of the market. Data points, such as new and replacement sales, country demographics, disease epidemiology, and import-export tariffs, are some of the major pointers used to forecast the market scenario for individual countries. In addition, the presence and availability of global brands and their challenges faced due to competition from local and domestic brands and the impact of sales channels are considered while providing forecast analysis of the country data.

Competitive Landscape and Global Vagus Nerve Stimulation Market Share Analysis

The global vagus nerve stimulation market competitive landscape provides details by competitor. Details included are company overview, company financials, revenue generated, market potential, investment in R&D, new market initiatives, global presence, production sites and facilities, production capacities, company strengths and weaknesses, product launch, product width and breadth, and application dominance. The above data points provided are only related to the companies focus related to the market.

Some of the major players operating in the market are Medtronic, LivaNova PLC, electroCore, Inc., Cirtec, Brain Control Co. Limited, Soterix Medical Inc., SetPoint Medical, MicroTransponder Inc, Parasym Ltd, Neuropix Company Ltd., and tVNS Technologies GmbH among others.

Browse a Detailed Summary of the Research Report @https://www.databridgemarketresearch.com/reports/global-vagus-nerve-stimulation-market

Research Methodology

Data collection and base year analysis are done using data collection modules with large sample sizes. The market data is analyzed and estimated using market statistical and coherent models. In addition, market share analysis and key trend analysis are the major success factors in the market report. The key research methodology used by the DBMR research team is data triangulation which involves data mining, analysis of the impact of data variables on the market, and primary (industry expert) validation. Data models include Vendor Positioning Grid, Market Time Line Analysis, Market Overview and Guide, Company Positioning Grid, Company Market Share Analysis, Standards of Measurement, Global vs. Regional, and Vendor Share Analysis. Please request an analyst call in case of further inquiry.

FREQUENTLY ASKED QUESTIONS

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What is the product segment?

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About Data Bridge Market Research, Private Ltd

Data Bridge Market Research Pvt Ltd is a multinational management consulting firm with offices in India and Canada. As an innovative and neoteric market analysis and advisory company with unmatched durability levels and advanced approaches. We are committed to uncovering the best consumer prospects and fostering useful knowledge for your company to succeed in the market.Data Bridge Market Research is a result of sheer wisdom and practice that was conceived and built-in Pune in the year 2015. The company came into existence from the healthcare department with far fewer employees intending to cover the whole market while providing the best class analysis. Later, the company widened its departments, as well as expanded its reach by opening a new office in the Gurugram location in the year 2018, where a team of highly qualified personnel joins hands for the growth of the company. Even in the tough times of COVID-19 where the Virus slowed down everything around the world, the dedicated team of Data Bridge Market Research worked round the clock to provide quality and support to our client base, which also tells about the excellence in our sleeve.

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Vagus Nerve Stimulation Market is Estimated to Rise with a USD ... - Digital Journal

BEIJING, March 28, 2023 /PRNewswire/ -- WiMi Hologram Cloud Inc. (NASDAQ: WIMI) ("WiMi" or the "Company"), a leading global Hologram Augmented Reality ("AR") Technology provider, today announced that to address the limitations of existing tools and products in big data mining, a new artificial intelligence information management platform based on data mining algorithm is developed. It is user-friendly and supports efficient computation and fast integration in a distributed environment during data mining tasks.

WiMi's AI information management platform uses artificial intelligence, machine learning, and deep learning techniques to extract hidden, previously unknown, and potentially valuable information from massive amounts of data. Its main goal is to extract supersets of information from many data sources and fuse them to reveal their deep structure and internal connections. Building information on top of a distributed heterogeneous environment can significantly reduce the complexity that different physical environments bring to the task of constructing data analysis and make full use of the power of distributed computing to enhance the efficiency of data analysis. In addition, the platform's computing resources are dynamically increased or decreased, allowing it to adjust physical computing resources online according to the number of specific analysis tasks. Also, the friendly user interface provides excellent convenience for building different big data mining applications based on the platform.

The platform uses genetic algorithms, coarse sets, decision trees, and neural networks to divide the general steps of data mining into: analyzing the problem; extracting, cleaning, and validating the data; creating and debugging the model; and maintaining the data mining model.

Problem analysis can determine whether the source database meets the data mining criteria. Extraction, cleaning, and validation of the data to remove noise from the data and obtain complete and uniform data. Apply the selected data mining algorithm to the data to create a model, and use the data to verify and adjust the model. Then the platform can obtain a data model that meets the usage requirements. As the amount of data increases, some fundamental information changes may seriously affect the model's accuracy. The model needs to be adjusted and maintained, and the accuracy of the severe model and model maintenance is an essential part of data mining. Model maintenance can keep the vitality of the model and continuously improve the model.

Story continues

The advent of the big data era has led to an explosion of data accumulated in various industries. The demand for data mining will become stronger and stronger, and the combination with various professional fields will be more and more extensive. Whether in science or engineering, theoretical research, or real life, WiMi's data mining algorithm-based artificial intelligence information management platform will have a vast development prospect.

About WIMI Hologram Cloud

WIMI Hologram Cloud, Inc. (NASDAQ:WIMI) is a holographic cloud comprehensive technical solution provider that focuses on professional areas including holographic AR automotive HUD software, 3D holographic pulse LiDAR, head-mounted light field holographic equipment, holographic semiconductor, holographic cloud software, holographic car navigation and others. Its services and holographic AR technologies include holographic AR automotive application, 3D holographic pulse LiDAR technology, holographic vision semiconductor technology, holographic software development, holographic AR advertising technology, holographic AR entertainment technology, holographic ARSDK payment, interactive holographic communication and other holographic AR technologies.

Safe Harbor Statements

This press release contains "forward-looking statements" within the Private Securities Litigation Reform Act of 1995. These forward-looking statements can be identified by terminology such as "will," "expects," "anticipates," "future," "intends," "plans," "believes," "estimates," and similar statements. Statements that are not historical facts, including statements about the Company's beliefs and expectations, are forward-looking statements. Among other things, the business outlook and quotations from management in this press release and the Company's strategic and operational plans contain forwardlooking statements. The Company may also make written or oral forwardlooking statements in its periodic reports to the US Securities and Exchange Commission ("SEC") on Forms 20F and 6K, in its annual report to shareholders, in press releases, and other written materials, and in oral statements made by its officers, directors or employees to third parties. Forward-looking statements involve inherent risks and uncertainties. Several factors could cause actual results to differ materially from those contained in any forwardlooking statement, including but not limited to the following: the Company's goals and strategies; the Company's future business development, financial condition, and results of operations; the expected growth of the AR holographic industry; and the Company's expectations regarding demand for and market acceptance of its products and services.

Further information regarding these and other risks is included in the Company's annual report on Form 20-F and the current report on Form 6-K and other documents filed with the SEC. All information provided in this press release is as of the date of this press release. The Company does not undertake any obligation to update any forward-looking statement, except as required under applicable laws.

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WiMi Hologram Cloud Develops AI Information Management Platform Based on Data Mining Algorithm - Yahoo Finance