[Health Risk Assessment for an Arsenic-contaminated Site Based on Monte Carlo Simulation and Parameters Optimization].

Risk assessment is a critical part of risk management for contaminated sites. However， in the specific management practice of As-contaminated sites， it is difficult to obtain realistic health risks for contaminated sites based on the total amount of pollutants and determined values of the model， thus preventing the control requirements of later remediation to be met. An increasing number of studies have recently been conducting risk assessments by considering bioavailability， modification parameters， and combined probabilistic models. To improve the accuracy of risk assessment results， taking a large As-contaminated site as a case， 432 sampling sites were set up and collected at different depths to analyze the level and distribution characteristics of As pollution， and probabilistic risk assessment was conducted with the modification of model parameters through literature research and Monte Carlo simulation. Then， the impact of traditional methods and probabilistic methods on health risk assessment was explored in comparison. The results indicated that ω（As） in the top soil of the study area ranged from 2.70-97.0 mg·kg-1， with a spatial variation coefficient of 0.61 and weaker spatial continuity. The carcinogenic risk and hazard index obtained by the traditional risk assessment method were 2.12E-4 and 8.36， respectively， which obviously overestimated the actual risk level and were not conductive to the refined management of As-contaminated sites. Combined with modification of model parameters and probabilistic risk assessment， the non-carcinogenic risk for adults and children was found to be at an acceptable level， and the carcinogenic risk was reduced by nearly an order of magnitude compared to that in the conventional method. Considering the relative biological effectiveness （RBA） of As， the 95% quantile of the total carcinogenic risk was 1.24E-5， a reduction of up to 36.41% compared to the uncorrected corresponding risk value of 1.95E-5. The carcinogenic risk of soil As for adults and children in the study area exceeded acceptable risk levels 1E-6， with oral ingestion of soil being the primary route of exposure. In addition， the results of the sensitivity analysis of the parameters showed that As concentration， daily oral ingestion rate of soils， and exposure duration of children had relatively larger effects for health risks. This work will provide a methodological and theoretical basis for achieving accurate risk assessment of As-contaminated sites and provide concepts for refined risk management.

Protective mechanism of quercetin in alleviating sepsis-related acute respiratory distress syndrome based on network pharmacology and in vitro experiments.

BACKGROUND: Sepsis-related acute respiratory distress syndrome (ARDS) has a high mortality rate, and no effective treatment is available currently. Quercetin is a natural plant product with many pharmacological activities, such as antioxidative, anti-apoptotic, and anti-inflammatory effects. This study aimed to elucidate the protective mechanism of quercetin against sepsis-related ARDS. METHODS: In this study, network pharmacology and in vitro experiments were used to investigate the underlying mechanisms of quercetin against sepsis-related ARDS. Core targets and signaling pathways of quercetin against sepsis-related ARDS were screened and were verified by in vitro experiments. RESULTS: A total of 4,230 targets of quercetin, 360 disease targets of sepsis-related ARDS, and 211 intersection targets were obtained via database screening. Among the 211 intersection targets, interleukin-6 (IL-6), tumor necrosis factor (TNF), albumin (ALB), AKT serine/threonine kinase 1 (AKT1), and interleukin-1ß (IL-1ß) were identified as the core targets. A Gene Ontology (GO) enrichment analysis revealed 894 genes involved in the inflammatory response, apoptosis regulation, and response to hypoxia. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis identified 106 pathways. After eliminating and generalizing, the hypoxia-inducible factor-1 (HIF-1), TNF, nuclear factor-κB (NF-κB), and nucleotide-binding and oligomerization domain (NOD)-like receptor signaling pathways were identified. Molecular docking revealed that quercetin had good binding activity with the core targets. Moreover, quercetin blocked the HIF-1, TNF, NF-κB, and NOD-like receptor signaling pathways in lipopolysaccharide (LPS)-induced murine alveolar macrophage (MH-S) cells. It also suppressed the inflammatory response, oxidative reactions, and cell apoptosis. CONCLUSION: Quercetin ameliorates sepsis-related ARDS by binding to its core targets and blocking the HIF-1, TNF, NF-κB, and NOD-like receptor signaling pathways to reduce inflammation, cell apoptosis, and oxidative stress.

Exploring the Molecular Mechanism by which Kaempferol Attenuates Sepsis-related Acute Respiratory Distress Syndrome Based on Network Pharmacology and Experimental Verification.

BACKGROUND: Sepsis-related acute respiratory distress syndrome (ARDS) is a fatal disease without effective therapy. Kaempferol is a flavonoid compound extracted from natural plant products; it exerts numerous pharmacological effects. Kaempferol attenuates sepsis-related ARDS; however, the underlying protective mechanism has not been elucidated completely. OBJECTIVE: This study aimed to use network pharmacology and experimental verification to investigate the mechanisms by which kaempferol attenuates sepsis-related ARDS. METHODS: We screened the targets of kaempferol by PharMapper, Swiss Target Prediction, and CTD database. We identified the targets of sepsis-related ARDS by GeneCards, DisGeNet, OMIM, and TTD. The Weishengxin platform was used to map the targets of both kaempferol and sepsis-related ARDS. We created a Venn diagram to identify the intersection targets. We constructed the "component-intersection targets-disease" network diagram using Cytoscape 3.9.1 software. The intersection targets were imported into the STRING database for developing the protein-protein interaction network. Metascape was used for the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. We selected the leading 20 KEGG pathways to establish the KEGG relationship network. Finally, we performed experimental verification to confirm our prediction results. RESULTS: Through database screening, we obtained 502, 360, and 78 kaempferol targets, disease targets of sepsis-related ARDS, and intersection targets, respectively. The core targets consisted of tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, albumin (ALB), IL-1ß, and AKT serine/ threonine kinase (AKT)1. GO enrichment analysis identified 426 items, which were principally involved in response to lipopolysaccharide, regulation of inflammatory response, inflammatory response, positive regulation of cell migration, positive regulation of cell adhesion, positive regulation of protein phosphorylation, response to hormone, regulation of reactive oxygen species (ROS) metabolic process, negative regulation of apoptotic signaling pathway, and response to decreased oxygen levels. KEGG enrichment analysis identified 151 pathways. After eliminating the disease and generalized pathways, we obtained the hypoxia-inducible factor 1 (HIF-1), nuclear factor κB (NF-κB), and phosphoinositide 3-kinase (PI3K)-Akt signaling pathways. Our experimental verification confirmed that kaempferol blocked the HIF-1, NF-κB, and PI3K-Akt signaling pathways, diminished TNF-α, IL-1ß, and IL-6 expressions, suppressed ROS production, and inhibited apoptosis in lipopolysaccharide (LPS)-induced murine alveolar macrophage (MH-S) cells. CONCLUSION: Kaempferol can reduce inflammatory response, ROS production, and cell apoptosis by acting on the HIF-1, NF-κB, and PI3K-Akt signaling pathways, thereby alleviating sepsis- related ARDS.

Development of the mirror-image sensitivity for different object categories-Evidence from the mirror costs of object images in children and adults.

Object recognition relies on a multitude of factors, including size, orientation, and so on. Mirrored orientation, particularly due to children's mirror confusion in reading, holds special significance among various object orientations. Brain imaging studies suggest that the visual ventral and dorsal streams exhibit distinct orientation sensitivity across diverse object categories. Yet, it remains unclear whether mirror orientation sensitivity also varies among these categories during development at the behavioral level. Here, we explored the mirror sensitivity of children and adults across five distinct categories, which encompass tools that activate both the visual ventral stream for function information and the dorsal stream for manipulation information, and animals and faces that mainly activate the ventral stream. Two types of symbols, letters and Chinese characters, were also included. Mirror sensitivity was assessed through mirror costs-that is, the additional reaction time or error rate in the mirrored versus the same orientation condition when judging the identity of object pairs. The mirror costs in reaction times and error rates consistently revealed that children exhibited null mirror costs for tools, and the mirror costs for tools in adults were minimal, if any, and were smaller than those for letters and characters. The mirror costs reflected in absolute reaction time and error rate were similar across adults and children, but when the overall difference in reaction times was considered, adults showed a larger mirror cost than children. Overall, our investigation unveils categorical distinctions and development in mirror sensitivity of object recognition across the ventral and dorsal streams.

[Potential Source Identification and Ecological Risk Assessment of Heavy Metals in Surface Soil of Heze Oil Peony Planting Area Based on PMF-PCA/APCS and PERI].

To study the sources and potential risks of heavy metals in soils of characteristic agricultural product producing areas is of great significance for the scientific management and safe utilization of soil and crop resources. The contents of heavy metals As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn in the 254 surface soil samples collected from the Heze oil peony planting area were determined. The content characteristics and correlation of heavy metals were analyzed using multivariate statistical methods. The sources of heavy metals in topsoil were analyzed using Igeo, PMF, and PCA/APCS. The ecological risks of the eight heavy metals were assessed through the potential ecological risk index (PERI). The results showed that the average contents of seven heavy metals in the soil were basically consistent with the background values of soil elements in Heze City, except that the average value of Cd was 1.44 times higher than the background value in Heze City. Correlation analysis and cluster analysis revealed that Pb, Hg, and Cd elements in the soil were greatly affected by human activities in the later period. The sources of eight heavy metals in the study area were natural sources, agricultural fertilizer sources, industrial coal sources, and domestic transportation sources, with the contribution rates of 81.31%, 15.45%, 2.74%, and 0.50%, respectively; 84.25% of the sites in the study area were at slight ecological risk, whereas the moderate risk and strong risk sites accounted for 14.96% and 0.79%, respectively. Among them, Cd and Hg were the dominant elements of ecological risk in the study area.

Analyzing the carbon emission effect and systematic emission reduction mechanism of the Sino-USA manufacturing trade.

This study analyzed the theoretical mechanism of the carbon emission effect embodied in the Sino-USA manufacturing trade. We constructed a trade and carbon emission input-output model for 16 manufacturing sub-sectors in China and the USA from 2000 to 2018. A comprehensive empirical test of the systematic emission reduction mechanism was conducted. There were four main findings: (1) indirect and direct carbon emissions indicators can comprehensively analyze the link between production and demand across sectors; (2) indirect carbon emissions are higher than direct carbon emissions in half of the sectors in both China and the USA, and other sectors bear part of the carbon emissions for these sectors; (3) compared to 2000, the change in net exports of both countries is the main reason for the change in indirect carbon emissions, while the change in net exports of intermediate goods is the main reason for the change in direct carbon emissions; and (4) the Sino-USA trade surplus comes at the expense of China's environmental losses, while the USA obtains environmental benefits. Overall, the theoretical analytical framework not only comprehensively considers the interlinkages between production and demand across sectors but also provides a more reasonable evaluation of the environmental effects of Sino-USA trade. Additionally, this study provides a solid theoretical and empirical basis for China to achieve its dual-cycle and dual-carbon goals, thus promoting the rapid transformation of China's economy toward green and high-quality development.

Nutrition management by a multidisciplinary team for prevention of nutritional deficits and morbidity following esophagectomy.

This study evaluated the effects of perioperative nutrition management by a multidisciplinary team on nutrition and postoperative complications of patients with esophageal cancer. A total of 239 patients with esophageal cancer who underwent esophagectomy and gastric conduit reconstruction for esophageal or esophagogastric junction cancer between February 2019 and February 2020 were included in the study. They were divided into the experimental group (120 patients) and the control group (119 patients) using the random number table method. Control group patients received routine diet management and experimental group patients received perioperative nutrition management by a multidisciplinary team. The differences of nutriture and postoperative complications between the two groups were compared. At 3 and 7 days after surgery, the experimental group patients had higher total protein and albumin levels (P<0.05), shorter postoperative anal exhaust time (P<0.05), lower incidence of postoperative gastrointestinal adverse reactions, pneumonia, anastomotic fistula, hypoproteinemia (P<0.05), and lower hospitalization costs (P<0.05) than the control group. Nutrition management by a multidisciplinary team effectively improved the nutriture of patients, promoted the rapid recovery of postoperative gastrointestinal function, reduced postoperative complications, and reduced hospitalization costs.

Spatial spillover and impacting factors of green development: A study based on China's provincial data.

Green development, an essential part of sustainable development transformation, is spatially correlated intra- and inter-regionally. However, previous research has not fully addressed the spatial characteristics of green development. This study investigates the spatial correlation structures, core-peripheral positions, and factors impacting the spatial network formation of China's green development. Based on the green development evaluation index system modified by the entropy method, this study applies social network analysis, block model analysis, and quadratic assignment procedure analysis to data from 30 provinces in China. The results confirm the spatial spillover effect is overwhelmingly present in China's green development. The findings further distinguish the core roles of provinces including Hunan, Tianjin, Zhejiang, Henan, and Xinjiang, and underline factors of green economic growth, governmental policy support, spatial adjacency, and geographic distance as significantly affecting the spatial network formation of China's green development. Policy recommendations for green development are then put forward.

Source-oriented probabilistic health risk assessment of soil potentially toxic elements in a typical mining city.

Identifying potential sources of soil potentially toxic elements (PTEs) and developing source-oriented health risk assessments in typical mining cities are key for pollution prevention and risk management. To this end, a case study was conducted to explore the pollution characteristics, potential sources, and human health risks of PTEs in Daye City, China. Indices, including the pollution factor (PF), pollution load index (PLI), and geo-accumulation index (Igeo), were applied to assess PTE pollution. Cd had the highest value among the detected PTEs, and 82.93% of the sampling sites had moderate pollution levels, with the highest mean Igeo value for Cd (2.30). Four potential sources were determined. Cr and Ni originated mainly from natural sources. Zn (91.5%) was exclusively and then Cd (33.1%) was moderately derived from industrial activities. The mixed source of various mineral exploitation smelting, and coal-fired traffic emissions leaded to the accumulation of As, Cd, and Pb. Cu was associated with Cu-related mining and smelting activities. The probabilistic health risk assessment indicated that the non-carcinogenic risks for populations were negligible. Overall, this work provides scientific information for environmental managers to manage soil PTE pollution through the effective management of anthropogenic sources with limited resources and costs.

Nutrition management by a multidisciplinary team for prevention of nutritional deficits and morbidity following esophagectomy

This study evaluated the effects of perioperative nutrition management by a multidisciplinary team on nutrition and postoperative complications of patients with esophageal cancer. A total of 239 patients with esophageal cancer who underwent esophagectomy and gastric conduit reconstruction for esophageal or esophagogastric junction cancer between February 2019 and February 2020 were included in the study. They were divided into the experimental group (120 patients) and the control group (119 patients) using the random number table method. Control group patients received routine diet management and experimental group patients received perioperative nutrition management by a multidisciplinary team. The differences of nutriture and postoperative complications between the two groups were compared. At 3 and 7 days after surgery, the experimental group patients had higher total protein and albumin levels (P<0.05), shorter postoperative anal exhaust time (P<0.05), lower incidence of postoperative gastrointestinal adverse reactions, pneumonia, anastomotic fistula, hypoproteinemia (P<0.05), and lower hospitalization costs (P<0.05) than the control group. Nutrition management by a multidisciplinary team effectively improved the nutriture of patients, promoted the rapid recovery of postoperative gastrointestinal function, reduced postoperative complications, and reduced hospitalization costs.

Homeownership, Depression, and Life Satisfaction in China: The Gender and Urban-Rural Disparities.

This study examines how depression and life satisfaction are associated with assets in the form of homeownership in China and whether their relationships differ between men and women, and between urban and rural areas. While the psychological benefits of homeownership are well-documented, how gender makes a difference in this relationship remains unclear. Given the dynamic housing market conditions characterized by the urban-rural divide and the notable gender gap in psychological well-being, China can provide a relevant context to address this knowledge gap. A series of linear regression analyses based on the China Family Panel Studies (CFPS) data show that homeownership is positively associated with life satisfaction and negatively related to depression, and this relationship is driven by men. While the homeownership-life satisfaction relation does not differ between urban and rural areas, the negative association between homeownership and depression is seen only among rural residents. The gender difference could be explained by the salient role of the financial security obtained from homeownership, whereas the regional difference seems to be supported by the social comparison theory. This study contributes to the knowledge of how a biological determinant, i.e., gender, interacts with a social determinant, i.e., homeownership, to affect psychological well-being.

Straw mulching for enhanced water use efficiency and economic returns from soybean fields in the Loess Plateau China.

Water shortages threaten agricultural sustainability in the semi-arid areas of the Loess Plateau. Judicious mulching management can improve water conservation practices to alleviate this issue while increasing crop productivity. We investigated the effect of straw strip mulching and film mulching on soil water consumption, temperature, growth, grain yield, and economic income of soybean [Glycine max(Linn.) Merr.] from 2017 to 2018 in Qingyang on the semi-arid Loess Plateau in China using four treatments: (a) alternating ridges and furrows with ridges mulched with white polyethylene film (PMP), (b) alternating flat and bare land with only the plat mulched by white polyethylene film (PMF), (c) alternating strips mulched with maize (Zea mays L.) straw (SM), and (d) traditional land planting without mulching (CK). The mulching treatments (PMP, PMF, and SM) increased soil water consumption and soil water use efficiency. The SM, PMF, and PMP treatments had 12.3-12.5, 16.8-22.1, and 23.2-24.2 mm higher soil water consumption (0-120 cm depth) than CK, most of which occurred in the 60-120 cm soil layer. Compared with CK, PMP and PMF significantly increased soil temperature by 1.30-1.31 °C and 0.76-1.00 °C, soybean grain yield by 38.6-39.0 % and 38.8-44.2 %, and water use efficiency (WUE) by 27.7-32.8 % and 30.8-37.5 %, respectively, while SM significantly decreased soil temperature by 0.96-1.15 °C, and increased grain yield by 21.8-25.4 % and WUE by 16.9-21.9 %. PMP and PMF did not significantly change soil water consumption, WUE, or grain yield. The SM treatment increased net income by 501.3-691.7 and 1914.5-2244.9 CNY ha-1 relative to PMP and CK, respectively, but PMF and SM did not significantly differ. Therefore, the SM system could help increase grain yields and economic returns in dryland soybean production, avoiding the adverse effects of the increasingly popular plastic mulching approach.

Subjective Social Mobility among Migrant Children in China.

Little scholarly attention has been paid to the relationship between children's subjective social mobility and their "social ecology". Children's subjective social mobility is about how they perceive their future social position compared to their parents'. Social ecology refers to the influential multi-layered surrounding factors, including family, school, and community. We analyzed data from structured questionnaires completed by 2221 migrant children (1296 boys and 925 girls, with a mean age of 11.7 years) from three private schools in Guangzhou and Foshan, China. The findings indicate that participants anticipated a significant improvement in their future social status. Of the factors influencing this belief, community integration has the most significant impact (TE = 0.246), followed by school integration (TE = 0.220) and family socioeconomic status (TE = 0.053). We also found that children's self-concept plays a role in their perceptions of social mobility. Based on the study results, we propose recommendations to provide migrant children additional protection and enhance their living environment.

Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases.

Invasiveness is a major predictor of surgical outcome and long-term prognosis in patients with pituitary adenomas (PAs). We assessed PA invasiveness via radiological, surgical and histological perspectives to establish a classification scheme for predicting invasive behavior and poor prognosis. We retrospectively analyzed 903 patients who underwent transnasal-transsphenoidal surgery between January 2013 and December 2019. Radiological (hazard ratio (HR) 5.11, 95% confidence interval (CI): 3.98−6.57, p < 0.001) and surgical (HR 6.40, 95% CI: 5.09−8.06, p < 0.001) invasiveness better predicted gross-total resection (GTR) and recurrence/progression-free survival (RPFS) rates than did histological invasiveness (HR 1.44, 95% CI: 1.14−1.81, p = 0.003). Knosp grades 2 (HR 4.63, 95% CI: 2.13−10.06, p < 0.001) and 3 (HR 2.23, 95% CI: 1.39−3.59, p = 0.011) with surgical invasiveness were better predictors of prognosis than corresponding Knosp grades without surgical invasiveness. Classifications 1 and 2 were established based on radiological, surgical and histological invasiveness, and Knosp classification and surgical invasiveness, respectively. Classification 2 predicted RPFS better than Knosp classification and Classification 1. Overall, radiological and surgical invasiveness were clinically valuable as prognostic predictors. The convenience and good accuracy of Invasiveness in Classification 2 is useful for identifying invasive PAs and facilitating the development of treatment plans.

Becoming Urban Citizens: A Three-Phase Perspective on the Social Integration of Rural-Urban Migrants in China.

This article attempts to provide an integrated conceptual framework for understanding how rural-urban migrants in China integrate into urban society. We propose a three-phase conceptual framework in which the social integration of rural-urban migrants is categorized into circular migration, urban settlement, and urban integration. We argue that the three phases differ with respect to the aims of migration, the identity of migrants, the key dimensions of social integration, the role of government, and the hukou policy. While the transition from circular migration to urban settlement is an outcome of economic development and change in demographic structure, as reflected by the economic conditions of rural-urban migrants, welfare expansion also plays a critical role during this process. We further hypothesize that the transition from urban settlement to urban integration will be a result of the social interaction between rural-urban migrants and local urbanites, within which social capital and cultural factors are vital. Since most rural-urban migrants are currently at the phase of urban settlement, we suggest that the Chinese government should enlarge welfare provisions to support their settlement in cities. This study contributes to improving the understanding of how to facilitate social integration of internal migrants in developing countries.

A randomised controlled study: efficacy of ICU nursing risk management combined with the cluster nursing model and its effect on quality of life and inflammatory factor levels of patients with acute respiratory distress syndrome and ventilator-associated pneumonia.

BACKGROUND: The purpose was to investigate the effect on quality of life and inflammatory factor levels of patients with acute respiratory distress syndrome (ARDS) and ventilator-associated pneumonia (VAP). METHODS: A total of 110 ARDS patients with VAP were randomly divided into an experimental group and control group. The control group received routine nursing while the experimental group received ICU nursing risk management combined with the cluster nursing model to compare the clinical efficacy in the two groups of patients. RESULTS: There were no significant differences in general information (P>0.05). The total clinical effective rate of patients in the experimental group was significantly higher than that of the control group (P<0.05). The Acute Physiology and Chronic Health Evaluation (APACHE II) scores of all patients after nursing were significantly lower than those before nursing (P<0.001), and the APACHE II score in the experimental group after nursing was significantly lower than that in the control group (P<0.001). The interleukin-8 (IL-8), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levels of all patients after nursing were significantly lower than those before nursing (P<0.001), and the levels in the experimental group after nursing were significantly lower than those in the control group (P<0.001). The vital capacity (VC), total lung capacity (TLC), and forced expiratory volume 1 second (FEV1)/forced vital capacity (FVC) levels of all patients after nursing were significantly higher than those before nursing (P<0.001), and the levels in the experimental group after nursing were significantly higher than those in the control group (P<0.001). The MOS 36-item short form health survey (SF-36) scores of all patients after nursing were significantly higher than those before nursing (P<0.001), and the scores in the experimental group after nursing was higher than that in the control group (P<0.001). CONCLUSIONS: ICU nursing risk management combined with the cluster nursing model can effectively and significantly reduce inflammatory reactions, improve pulmonary function, and enhance the quality of life of ARDS patients with VAP, making it worthy of promotion and application. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100048112.

Characteristics and Risk Assessment of Soil Polluted by Lead around Various Metal Mines in China.

The contamination of soil by lead (Pb) is a serious and widespread problem in China, especially in mining areas. This paper summarized the available data regarding Pb-contaminated soils around various metal mines in China. Based on these data, the Pb concentration in the soil and its temporal and spatial changes were analyzed. Potential ecological hazards and adult lead models were also used to estimate ecological and health risks. The results indicated that the concentration of Pb was closely related with the type of mine. Compared with other types of mine, soil around lead-zinc (Pb-Zn) and tin (Sn) mines with high Pb contents in the metallic ores and high pollutant emission coefficient were more strongly polluted by Pb. The characteristic spatial and temporal variations of Pb pollution status in China were clarified, and the results showed that the concentration was high in the southern, southwestern, and central regions of China where many mining areas were located, and the mean value passed a turning point in 2012. Ecological risk assessments indicated that some areas around mines were at considerable to high risk, and the risk was relatively severe in Pb-Zn mining areas. According to the adult lead model, Pb-Zn mines had a greater impact on blood Pb concentration than the other types of mine.

Psychological Distress in Urbanizing China: How Does Local Government Effectiveness Matter?

Despite growing literature identifying key individual, family, community, and environmental factors as causes for mental disorders during the process of urbanization, the role played by local government has not been taken into account. In this article, we investigate how the effectiveness of local government affects residents' levels of psychological distress in areas of China undergoing urbanization. We measure the effectiveness of local governments according to their success in promoting access to the social security system through the distribution of social security cards among citizens. We hypothesize that higher local government effectiveness will reduce residents' psychological distress by alleviating worries about medical expenses and elder care. Drawing on data from the 2018 Urbanization and Quality of Life Survey (N = 3229) conducted in 40 localities undergoing rural-urban transition, we estimate three-level mixed-effects regression models to test the research hypotheses, allowing random effects at the township/county and neighborhood levels while controlling for a series of individual attributes. The results demonstrate that local government effectiveness is negatively associated with residents' psychological distress: effective local governments alleviate worries about medical expenses and elder care, and thereby reduce psychological distress. The findings indicate that, to reduce residents' worries and psychological distress during the process of rural-urban transition, it is essential to improve local government effectiveness, particularly in promoting residents' access to the social security system. Beyond demonstrating how local government effectiveness matters for residents' psychological distress, our research also illustrates how to properly model locational parameters in analyses of individual well-being.

Clinical observation and analysis on the significance of quick sequential organ failure assessment in 74 non-ICU patients with sepsis.

BACKGROUND: Sepsis is an important disease that endangers human health and is the main cause of death in ICU patients, which has been a focus of clinical treatment. This study aims to evaluate the significance of the readily available quick sequential organ failure assessment (qSOFA) score in clinical cases of sepsis. METHODS: A retrospective cross-sectional study of patients with sepsis treated in the Department of Infectious Diseases, the Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology from January 2015 to December 2016 was conducted, and the patients were divided into a high-score group (≥2 points) and the low-score group (<2 points) according to the diagnostic criteria for sepsis (Sepsis 3.0). The differences in disease outcome and inflammatory indicators were compared between groups. RESULTS: A total of 74 patients with sepsis were included in this study. When the cutoff qSOFA score was 2 points, the patients in the high-score group showed a higher mortality rate (71.43%), and the patients in the low-score group showed a higher improvement rate (87.76%). The inflammatory indicators did not show statistically significant differences between the two groups. CONCLUSIONS: The qSOFA score can better predict the prognoses of non-ICU patients with sepsis compared with traditional inflammatory indicators. Clinicians should raise their awareness about qSOFA and improving its accuracy.