Global burden, trends, and cross-country inequalities of urinary tract infections in adolescents and young adults, 1990 to 2019.

BACKGROUND: Limited studies have evaluated the global burden, trends, and cross-country inequalities for urinary tract infections (UTIs) in adolescents and young adults (AYAs). METHODS: Age-standardized incidence rate, age-standardized mortality rate, and age-standardized Disability-Adjusted Life Years (DALYs) rate were used to describe the UTI burden. The estimated annual percentage changes were calculated to evaluate the temporal trends from 1990 to 2019. The slope index of inequality and concentration index were utilized to quantify the distributive inequalities. RESULTS: From 1990 to 2019, a significant increase in age-standardized incidence rate (estimated annual percentage change =0.22%, 95% confidence interval 0.19%-0.26%) was found for UTIs in AYAs, and the increasing trend was more pronounced in males than females. Significant decreases in age-standardized mortality rate and age-standardized DALY rate were found in females but not in males. The slope index of inequality changed from 21.80 DALYs per 100,000 in 1990 to 20.91 DALYs per 100,000 in 2019 for UTIs in AYAs. Moreover, the concentration index showed -0.23 in 1990 and -0.14 in 2019. DISCUSSION: Countries with lower sociodemographic development levels shouldered a disproportionately higher UTI burden. CONCLUSIONS: UTIs remain an ongoing health burden for AYAs globally, with substantial heterogeneities found across countries, sex, and age groups.

How do e-commerce platforms and retailers implement discount pricing policies under consumers are strategic?

In the era of the rapid development of e-commerce, many retailers choose to launch promotional activities to become consumers' first choice for shopping. Since price discounts can greatly attract consumers, the e-commerce platforms have also begun to implement discount pricing. It is urgent for e-commerce platforms and retailers to formulate reasonable discount strategies to achieve sustainable business. In this paper, we construct a dynamic game model for implementing discount pricing on an e-commerce platform and two retailers, we study the market equilibrium between the two retailers and the e-commerce platform under various scenarios that considering consumers' strategic waiting behavior and competition between the two retailers, we further discuss the effectiveness of retailer discount pricing and the double discount pricing of the platform and retailers. We show that the optimal pricing decreases as the difference in product quality narrows under both pricing strategies. Low-quality retailers implementing a double discount pricing strategy are in relatively higher demand only when the difference in product quality is small. High-quality retailers implementing the retailer discount pricing strategy are in relatively higher demand only when the product quality difference is large. Double discount pricing is desirable for both e-commerce platforms and retailers and can be used to effectively achieve Pareto improvement in the market by increasing their expected profit. Our results emphasize the role of product quality and the value of the double discount pricing strategy. The double discount pricing strategy weakens the profit advantage that retailers and platforms gain from it as the rebate intensity and rebate redemption rates increase.

A water quality assessment model involving novel fluorescence technology.

The reasonable utilization of water resources and real-time monitoring of water pollution are the core tasks of current world hydrological and water conservancy work. Novel technologies and methods for monitoring water pollution are important means to ensure water health. However, the absence of intuitive and simple analysis methods for the assessment of regional pollution in large-scale water bodies has prevented scientists from quickly grasping the overall situation of water pollution. In this study, we propose a strategy based on the unique combination of fluorescence technology and simple kriging (SK) interpolation (FL-SK) for the first time. This strategy could present the relative magnitude and distribution of the physicochemical indicators of a whole natural lake intuitively and accurately. The unique FL-SK model firstly offers a simple and effective water quality method that provides the pollution index of different sampling points in lakes. The macroscopic evaluation of large-scale water bodies by the FL-SK model primarily relies on the fluorescence response of the RDM-TPE to the comprehensive indicators of the water body, as experimental results have revealed a good correlation between fluorescent responses and six normalized physicochemical indicators. Multiple linear regression and fluorescence response experiments on RDM-TPE indicate that to some extent, the fluorescence signals of the FL-SK model may originate from a certain type of sulfide in the water body. Pattern discovery could enable the analysis of pollution levels in other ecosystems and promote early pollution assessment in the future.

How economic development affects healthcare access for people with disabilities: A multilevel study in China.

Meeting the healthcare needs of people with disabilities is an important challenge in achieving the central promise of "leave no one behind" during the Sustainable Development Goals era. In this study, we describe the accessibility of healthcare for people living with disabilities, as well as the potential influences of individuals' socioeconomic status and regional economic development. Our data covered 324 prefectural cities in China in 2019 and captured the access to healthcare services for people with disabilities. First, we used linear probability regression models to investigate the association between individual socioeconomic status, including residence, poverty status, education, and healthcare access. Second, we conducted an ecological analysis to test the association between prefectural economic indicators, including GDP (gross domestic product) per capita, urbanization ratio, average years of education, Engel's coefficient, and the overall prevalence of access to healthcare for people with disabilities within prefectures. Third, we used multilevel regression models to explore the association between the individual's socio-economic status, prefectural economic indicators, and access to healthcare at the individual level for people with disabilities. The results showed, first, that higher individual socioeconomic status (urban residence or higher educational level) was associated with better access to healthcare for people with disabilities. Second, regional economic indicators were positively associated with access to healthcare at the aggregate and individual levels. This study suggests that local governments, particularly in low- and middle-income countries, should promote economic development and conduct poverty alleviation policies to improve healthcare access for disadvantaged groups.

Research on industrial structure adjustment and spillover effect in resource-based regions in the post-pandemic era.

Resource-based regions support national economic development and are essential sources of basic energy and raw materials. In the post-pandemic era, however, there are practical situations to deal with, such as a fractured industrial chain, a weaker industrial structure, and a sharp reduction in economic benefits. Based on data collected from 68 cities in China, from 2010 to 2021, with 816 observations, this paper explores the industrial development process of resource-based regions in China and the change in the toughness of the industrial structure under the impact of COVID-19. The paper studies and analyzes industrial development trends, industrial structure toughness, and spatial spillover effects. The methods used are the Markov chain model and the Industrial Structure Advancement Index. By building the spatial Dubin model, the paper analyzes the spatial spillover effect of regional industrial development. It decomposes the spillover effect using the partial differential model based on regression. The results show that, during the study period, the comprehensive development level of industries in resource-based regions in China was slowly improving and tended to stabilize after entering the post-pandemic era. The evolution of an advanced industrial structure is significantly heterogeneous among regions, and each region has different toughness. The impact of COVID-19 has reduced the toughness of China's resource-based regions' industrial structure. The spatial spillover effect of regional industrial development is significant. Labor force, technology input, and industrial-structure optimization have different impacts on the industrial development of neighboring regions. In the post-pandemic era, China has used new management methods for more innovation. In order to achieve low-carbon, environmental protection, and sustainable development of resources, realize the rapid recovery of the toughness of industrial structure in China's resource-based cities, and reduce the impact of the COVID-19 pandemic, China proposes to expand the supply of resources, improve the allocation of resources, optimize the direction, promote the rational flow and efficient aggregation of various factors, and enhance the impetus for innovation and development.

Boosted Photocatalytic Performance for Antibiotics Removal with Ag/PW12/TiO2 Composite: Degradation Pathways and Toxicity Assessment.

Photocatalyst is the core of photocatalysis and directly determines photocatalytic performance. However, low quantum efficiency and low utilization of solar energy are important technical problems in the application of photocatalysis. In this work, a series of polyoxometalates (POMs) [H3PW12O40] (PW12)-doped titanium dioxide (TiO2) nanofibers modified with various amount of silver (Ag) nanoparticles (NPs) were prepared by utilizing electrospinning/photoreduction strategy, and were labelled as x wt% Ag/PW12/TiO2 (abbr. x% Ag/PT, x = 5, 10, and 15, respectively). The as-prepared materials were characterized with a series of techniques and exhibited remarkable catalytic activities for visible-light degradation tetracycline (TC), enrofloxacin (ENR), and methyl orange (MO). Particularly, the 10% Ag/PT catalyst with a specific surface area of 155.09 m2/g and an average aperture of 4.61 nm possessed the optimal photodegradation performance, with efficiencies reaching 78.19% for TC, 93.65% for ENR, and 99.29% for MO, which were significantly higher than those of PW12-free Ag/TiO2 and PT nanofibers. Additionally, various parameters (the pH of the solution, catalyst usage, and TC concentration) influencing the degradation process were investigated in detail. The optimal conditions are as follows: catalyst usage: 20 mg; TC: 20 mL of 20 ppm; pH = 7. Furthermore, the photodegradation intermediates and pathways were demonstrated by HPLC-MS measurement. We also investigated the toxicity of products generated during TC removal by employing quantitative structure-activity relationship (QSAR) prediction through a toxicity estimation software tool (T.E.S.T. Version 5.1.2.). The mechanism study showed that the doping of PW12 and the modification of Ag NPs on TiO2 broadened the visible-light absorption, accelerating the effective separation of photogenerated carriers, therefore resulting in an enhanced photocatalytic performance. The research provided some new thoughts for exploiting efficient and durable photocatalysts for environmental remediation.

Investigating and improving the ecological efficiency of urban agglomeration based on Super-SBM model.

The management of ecological efficiency (eco-efficiency) is of great significance to promote the sustainable development of urban agglomerations. The objective of this research is to evaluate the eco-efficiency of urban agglomerations. Taking the Yangtze River Delta Urban Agglomeration (YRDUA) as a case study, this study evaluated the spatio-temporal evolution characteristics of the eco-efficiency by using the Super-SBM model. Additionally, the factors that affect the efficiency fluctuations are analyzed by decomposing the Global Malmquist-Luenberger (GML) index and the input-output redundancy rates are measured. The study additionally put forth a conceptual framework aimed at evaluating eco-efficiency within the context of urban agglomerations. The findings indicated that the eco-efficiency of the YRDUA had not reached the effective level with noticeable variations across different regions. The resource redundancy of the YRDUA was severe and negatively correlated with eco-efficiency. Environmental pollution was the primary cause of efficiency loss. Technological progress was the main driving factor of regional total factor productivity (TFP), but technical efficiency still needed to be improved. Therefore, it is urgent for the YRDUA to improve the efficiency of its industrial structure and foster the harmonious growth of various sectors, in order to achieve the sustainable utilization of natural resources and the preservation of the ecological environment.

Long-term economic evaluation of the recombinant Mycobacterium tuberculosis fusion protein (EC) test for the diagnosis of Mycobacterium tuberculosis infection.

Background: Tuberculosis continues to be a significant global burden. Purified protein derivative of tuberculin (TB-PPD) is one type of tuberculin skin test (TST) and is used commonly for the auxiliary diagnosis of tuberculosis. The recombinant Mycobacterium tuberculosis fusion protein (EC) test is a new test developed in China. Objective: Evaluate the long-term economic implications of using the EC test compared with the TB-PPD test to provide a reference for clinical decision-making. Methods: The target population was people at a high risk persons of being infected with Mycobacterium tuberculosis. The outcome indicator was quality-adjusted life years (QALY). A cost-utility analysis was used to evaluate the long-term economic implications of using the EC test compared with the TB-PPD test. We employed a decision tree-Markov model from the perspective of the whole society within 77 years. Results: Compared with the TB-PPD test, the EC test had a lower cost but higher QALY. The incremental cost-utility ratio was -119,800.7381 CNY/QALY. That is, for each additional QALY, the EC test could save 119,800.7381 CNY: the EC test was more economical than the TB-PPD test. Conclusion: Compared with the TB-PPD test, the EC test would be more economical in the long term for the diagnosis of M. tuberculosis infection according our study.

Availability of essential medicines, progress and regional distribution in China: a systematic review and meta-analysis.

Background: Essential medicines are the backbone of healthcare and meet the priority healthcare needs of the population. However, approximately one-third of the global population does not have access to essential medicines. Although China formulated essential medicine policies in 2009, the progress of availability of essential medicines and regional variations remains unknown. Therefore, this study was conducted to evaluate the availability of essential medicines, their progress, and regional distribution in China in the last decade. Methods: We searched eight databases from their inception to February 2022, relevant websites, and reference lists of included studies. Two reviewers selected studies, extracted data, and evaluated the risk of bias independently. Meta-analyses were performed to quantify the availability of essential medicines, their progress, and regional distribution. Results: Overall 36 cross-sectional studies conducted from 2009 to 2019 were included, with regional data for 14 provinces. The availability of essential medicines in 2015-2019 [28.1%, 95% confidence interval (CI): 26.4-29.9%] was similar to that in 2009-2014 (29.4%, 95% CI: 27.5-31.3%); lower in the Western region (19.8%, 95% CI: 18.1-21.5%) than Eastern (33.8%, 95% CI: 31.6-36.1%) and Central region (34.5%, 95% CI: 30.6-38.5%); very low for 8 Anatomical Therapeutic Chemical (ATC) categories (57.1%), and low for 5 categories (35.7%) among all ATC groups. Conclusion: The availability of essential medicines in China is low compared with the World Health Organization goal, has not changed much in the last decade, is unequal across regions, and lacks data for half of provinces. For policy-making, the monitoring system of the availability of essential medicines is to be strengthened to enable long-term surveillance, especially in provinces where the data has been missing. Meanwhile, Joint efforts from all stakeholders are warranted to improve the availability of essential medicines in China toward the universal health coverage target. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=315267, identifier: PROSPERO CRD42022315267.

The price and affordability of essential medicines, progress and regional distribution in China: a systematic review.

Background: Essential medicine is a vital component to assure universal access to quality healthcare. However, the trend of affordability to essential medicines in China and its regional differences were not yet fully understood. This study aimed to systematically evaluate the price and affordability of essential medicines, their progress, and regional distribution in China in the last decades. Methods: We searched seven databases and three websites for potentially eligible studies from inception until March 2022. Studies on the price and affordability of essential medicines investigated in China were included. Median and interquartile range (IQR) was used to describe the price and affordability of essential medicines, and compared in three periods, before 2009, from 2009 to 2014, and from 2015 to 2019. Subgroup analysis was performed to examine the price and affordability by regions, health facilities, and ATC categories of medicines. The study was registered with PROSPERO (CRD42022310173). Results: A total of 65 studies including 11,639 health facilities investigated between 2006 and 2019 were included in this review. Median price ratios (MPR) and affordability of essential medicines were reported in 44 studies and 50 studies, respectively. The median MPRs of essential medicines in China was 1.59 (IQR: 5.39), with a tendency to rise first and then fall from 2006 to 2019. And the median affordability was equal to 0.88 (IQR: 2.58) days' wage of the lowest paid unskilled government worker, but steadily rose from 2006 to 2019. Subgroup analysis showed that the affordability in the western region (1.40, IQR: 2.88), urban area (0.95, IQR: 2.80), private sector (0.90, IQR: 2.30), of originator brands (OB) (2.90, IQR: 6.68), and antineoplastic and immunomodulating agents (5.68, IQR: 56.47) were worse than their counterparts. Conclusion: The prices of essential medicine were higher than international level, the overall affordability of essential medicines in China is acceptable but poor in the western region, for OB drugs and anti-cancer medicines. Further national essential medicine policies are needed to reduce regional disparities and improve the affordability of expensive drugs. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#recordDetails.

Recombinant mycobacterium tuberculosis fusion protein for diagnosis of mycobacterium tuberculosis infection: a short-term economic evaluation.

Objectives: Recombinant Mycobacterium tuberculosis fusion protein (EC) was anticipated to be used for the scale-up of clinical application for diagnosis of Mycobacterium tuberculosis infection in China, but it lacked a head-to-head economic evaluation based on the Chinese population. This study aimed to estimate the cost-utility and the cost-effectiveness of both EC and tuberculin pure protein derivative (TB-PPD) for diagnosis of Mycobacterium tuberculosis infection in the short term. Methods: From a Chinese societal perspective, both cost-utility analysis and cost-effectiveness analysis were performed to evaluate the economics of EC and TB-PPD for a one-year period based on clinical trials and decision tree model, with quality-adjusted life years (QALYs) as the utility-measured primary outcome and diagnostic performance (including the misdiagnosis rate, the omission diagnostic rate, the number of patients correctly classified, and the number of tuberculosis cases avoided) as the effective-measured secondary outcome. One-way and probabilistic sensitivity analyses were performed to validate the robustness of the base-case analysis, and a scenario analysis was conducted to evaluate the difference in the charging method between EC and TB-PPD. Results: The base-case analysis showed that, compared with TB-PPD, EC was the dominant strategy with an incremental cost-utility ratio (ICUR) of saving 192,043.60 CNY per QALY gained, and with an incremental cost-effectiveness ratio (ICER) of saving 7,263.53 CNY per misdiagnosis rate reduction. In addition, there was no statistical difference in terms of the omission diagnostic rate, the number of patients correctly classified, and the number of tuberculosis cases avoided, and EC was a similar cost-saving strategy with a lower test cost (98.00 CNY) than that of TB-PPD (136.78 CNY). The sensitivity analysis showed the robustness of cost-utility and cost-effectiveness analysis, and the scenario analysis indicated cost-utility in EC and cost-effectiveness in TB-PPD. Conclusion: This economic evaluation from a societal perspective showed that, compared to TB-PPD, EC was likely to be a cost-utility and cost-effective intervention in the short term in China.

Application of High-Pressure Homogenization for Apple Juice: An Assessment of Quality Attributes and Polyphenol Bioaccessibility.

In the current work, the influence of high-pressure homogenization (HPH) (200, 250, and 300 MPa) on pH, Brix, turbidity, viscosity, particle size distribution (PSD), zeta potential, color, polyphenol oxidase (PPO), peroxidase (POD), polyphenol profile and bioaccessibility of total phenolic compounds was studied. The results show no change in the apple juice's pH, TSS and density. In contrast, other physiochemical properties of apple juice treated with HPH were significantly changed. Besides total phenolic content (15% degradation) in the HPH-treated apple juice at 300 MPa, the PPO and POD activities were reduced by a maximum of 70 and 35%, respectively. Furthermore, among different digestion stages, various values corresponding to PSD and zeta potential were recorded; the total phenolic content was gradually reduced from the mouth to the intestine stage. The polyphenol bioaccessibility of HPH-treated apple juice was 17% higher compared to the untreated apple juice.

How Low-Carbon Pilots Affect Chinese Urban Energy Efficiency: An Explanation from Technological Progress.

This study uses the low-carbon city pilot (LCCP) policy as a quasi-natural experiment, combined with the panel data of 281 prefecture-level and above cities in China from 2003 to 2018, and the difference-in-differences model to investigate the specific impact and mechanism of the LCCP on regional energy efficiency. The study showed that LCCP policies can significantly improve regional energy efficiency. The heterogeneity test found that, for cities with larger scales, high pollutant emission intensities, and fewer financial constraints, the implementation of LCCP policies could effectively improve energy efficiency. Based on the mechanical test of the technological progress path, it was concluded that LCCP policies could effectively improve energy efficiency by promoting technological innovation and transformation of enterprises. In the field of technological innovation, implementing LCCP policies helps promote green technological innovation, as well as increasing bias. Furthermore, this study evaluates the emission reduction effects of LCCP policies. The results found that, although LCCP could reduce regional carbon emissions by improving energy efficiency, the impact of energy rebound dramatically reduced the emission reduction effects of LCCP. This study provides empirical evidence and policy enlightenment for China's accelerating "carbon-peak" and "carbon-neutral" goals.

Accessibility of essential anticancer medicines for children in the Sichuan Province of China.

Background: Compared with high-income countries, the survival rate of childhood cancer is lower in low- and middle-income countries. Access to essential anticancer medicines is an indispensable component of pediatric cancer treatment, which is still a big challenge in low- and middle-income countries. Objective: To assess the accessibility of essential anticancer medicines for children in public hospitals in the Sichuan Province of China. Methods: Based on the data of the Sichuan Province Drug Use Monitoring Platform in 2020, a retrospective study was conducted to investigate the original brands and generics of 34 anticancer and three supportive essential medicines for children (a total of 97 specific strengths) in Sichuan Province. The availability, price, and affordability of surveyed medicines were evaluated in all 152 tertiary public hospitals (120 general hospitals, 31 children's hospitals, and one cancer hospital) that could diagnose and treat cancer for children. Results: The average availability of generics and original brands was 18.5% and 2.6%, respectively. In regions with different gross domestic product (GDP) per capita levels, the average availability was similar, but the city with lower GDP per capita levels had fewer tertiary public hospitals. The prices of most original brands were higher than the lowest-priced generics, and the median price ratios of 31 lowest-priced generics and 16 original brands were 0.744 (P25~P75, 0.446~2.791) and 2.908 (1.719~6.465). After paying medical insurance for medicines, the affordability of essential anticancer medicines was improved. The monthly medicine cost did not exceed 10% of the monthly household income for 78.9% (30/38) of the lowest-priced generics and 50.0% (8/16) of the original brands. Conclusion: The availability of lowest-priced generics was higher than original brands in public hospitals, but the availability of both was low, which was similar to previous studies in low- and middle-income countries. About half of the lowest-priced generics and 87.5% of the original brands cost more than 1.5 times the International Reference Price. Although the National Basic Medical Insurance greatly improved the affordability of essential anticancer medicines for children, higher subsidies for essential medicines for cancer treatment to limit catastrophic health expenditures are still recommended.

Skin dose distributions between Stanford and rotational techniques in total skin electron therapy (TSET).

PURPOSE: Total skin electron therapy (TSET) has proven to be one of the most effective treatments for advanced-stage cutaneous T-cell lymphoma. Two most used techniques are the Stanford six-field and rotational techniques. This study compares patient skin dose distributions as a function of depth between these two techniques. METHODS: The EGSnrc system was used to simulate electron beams and calculate patient dose distributions. The calculations assumed the same patient standing on a platform, and the patient's different postures were ignored for the Stanford technique in the comparison of dose distributions. The skin doses were analyzed as a function of skin depth-dose coverage and evaluated using dose-volume-histograms (DVH). The comparisons were performed in three realistic clinical settings in which dual-field were used for patients treated at extended distances of 316 and 500 cm, and a single field was used at 700 cm. In all cases the realistic patient treatment beam delivery geometry was simulated. RESULTS: Although small dose differences were observed in some local areas, no clinically significant differences were found in the patient 3D dose distributions between the Stanford and rotational techniques. Virtually the same DVH curves between two the techniques were observed for mean dose to skin depth of 0-5, 5-10, and 10-15 mm from the skin surface, respectively. It is found that the skin depth dose coverage is 2 mm shallower for patient treatment at 500 cm compared to at 316 cm due to the additional air attenuation. However, very similar dose coverage and uniformity can be achieved at these two different extended treatment distances by adjusting the thickness of acrylic scatter plate. Adequate thickness of a scattering plate improves the skin dose uniformity. CONCLUSION: Both the Stanford and rotational techniques deliver very similar skin dose coverage in DVH plots, and only small differences are seen in local areas. It is worth to emphasize that the DVH is a graphical representation of the distribution of dose within a structure, and it does not contain spatial information. Therefore, comparison of entire skin dose using DVH may mask some variations at different locations of the surface area. In addition, the comparison did not consider different patient postures of the Stanford technique. Including the different patient postures in the calculation may affect the result of doses to the limbs.

[Clinical trials and evaluation of Chinese patent medicine for influenza].

The clinical randomized controlled trial(RCT) of Chinese patent medicine in the treatment of influenza were reviewed and analyzed to provide basic information for clinical decision and related research. On the basis of the collection in the Traditional Chinese Medicine(TCM) Clinical Evidence Database System(EVDS), CNKI, Wanfang, VIP, SinoMed, EMbase, PubMed, and Cochrane Library were searched for RCTs of Chinese patent medicine for influenza published from database inception to July 25, 2021. The publication time, sample size, intervention and control measures, course of treatment, outcome indicators, and methodological quality of the trials were analyzed and evaluated. Ninety-two RCTs of Chinese patent medicine for influenza published between 2005 and 2021, were included, among which 17 RCTs(18.48%) had a sample size higher than 200 and the average sample size was about 145. Twenty-seven Chinese patent medicines were involved, including twenty-one oral medicines and six injections. The Chinese patent medicines in trials reported in more than five papers included Lianhua Qingwen Capsules/Gra-nules, Tanreqing Injection, and Reduning Injection. Fourteen intervention protocols were reported, of which Chinese patent medicine+western medicine+conventional treatment vs western medicine+conventional treatment(20.65%) was the most frequently employed. Additionally, 85.87% of the RCTs reported the course of treatment, and 80.43% of the RCTs determined 3-7 d as the intervention course. Forty-five outcome indicators were extracted, which were used 434 times, including symptoms/signs, physicochemical detection, safety events, TCM symptoms/syndromes, quality of life, long-term prognosis, and economic evaluation. Symptoms/signs(61.52%) exhibited the highest frequency. Methodological problems were prevalent in the included trials. The findings reveal that there are few clinical trials on influenza treatment by Chinese patent medicine, and the methodological problems are prominent, affec-ting the reliability and practicability of the trials. In the future research, the value characteristics of Chinese patent medicine should be highlighted and the quality control in the whole process should be strengthened based on the scientific and rigorous design.

Interictal EEG and ECG for SUDEP Risk Assessment: A Retrospective Multicenter Cohort Study.

Objective: Sudden unexpected death in epilepsy (SUDEP) is the leading cause of epilepsy-related mortality. Although lots of effort has been made in identifying clinical risk factors for SUDEP in the literature, there are few validated methods to predict individual SUDEP risk. Prolonged postictal EEG suppression (PGES) is a potential SUDEP biomarker, but its occurrence is infrequent and requires epilepsy monitoring unit admission. We use machine learning methods to examine SUDEP risk using interictal EEG and ECG recordings from SUDEP cases and matched living epilepsy controls. Methods: This multicenter, retrospective, cohort study examined interictal EEG and ECG recordings from 30 SUDEP cases and 58 age-matched living epilepsy patient controls. We trained machine learning models with interictal EEG and ECG features to predict the retrospective SUDEP risk for each patient. We assessed cross-validated classification accuracy and the area under the receiver operating characteristic (AUC) curve. Results: The logistic regression (LR) classifier produced the overall best performance, outperforming the support vector machine (SVM), random forest (RF), and convolutional neural network (CNN). Among the 30 patients with SUDEP [14 females; mean age (SD), 31 (8.47) years] and 58 living epilepsy controls [26 females (43%); mean age (SD) 31 (8.5) years], the LR model achieved the median AUC of 0.77 [interquartile range (IQR), 0.73-0.80] in five-fold cross-validation using interictal alpha and low gamma power ratio of the EEG and heart rate variability (HRV) features extracted from the ECG. The LR model achieved the mean AUC of 0.79 in leave-one-center-out prediction. Conclusions: Our results support that machine learning-driven models may quantify SUDEP risk for epilepsy patients, future refinements in our model may help predict individualized SUDEP risk and help clinicians correlate predictive scores with the clinical data. Low-cost and noninvasive interictal biomarkers of SUDEP risk may help clinicians to identify high-risk patients and initiate preventive strategies.

Temporal-spatial pattern and driving factors of cultivated land use transition at country level in Shaanxi province, China.

The county-level Cultivated Land Use Form index (CLUF) in Shaanxi province in 2000, 2005, 2010, and 2015 was measured with the entropy method and the linear combination method. Then, the spatial differentiation characteristics and driving mechanism of CLUF were characterized and identified through exploratory spatial data analysis, standard deviation ellipse model, kernel density estimation, multiple linear, and spatial regression analysis. The conclusions drawn from empirical results were as follows. First, the CLUF presented a spatial differentiation pattern of high in the middle and low in the north and south, and the CLUF had a strong positive spatial correlation. The local spatial patterns were mainly the high-high agglomeration and low-low agglomeration. Second, the gravity center of CLUF moves from northeast to southwest, but it is always located in the central part of Shaanxi province. The CLUF showed a trend from expansion and decentralization to contraction and centralization in geographical space, with an obvious spatial spillover effect. Third, the results of nuclear density estimation showed that the difference in the CLUF between counties displayed a trend of first shrinking and then expanding. Fourth, the cultivated land use transition was promoted by the combination of the natural environment, economic growth, and urbanization development, and factors of the driving mechanism of the cultivated land use transition are complicated. Finally, policy recommendations to promote the rationalization and cultivated land use transition were put forward, such as strengthening infrastructure construction, formulating differentiated policies, and giving play to the role of neighboring demonstrations.

The impact of trade and financial expansion on volatility of real exchange rate.

With the steady progress of China's opening-up policy, how to avoid the financial risks brought by opening-up is a valuable research topic at present while promoting economic development. As an innovative business model connecting the real economy and the virtual economy, the Internet of Things (IoT) finance provides standardized technical support for the expansion of trade and finance. In financial data analysis, deep learning (DL) has become an important means to predict financial market movements, process text information and improve trading strategies. Analysis is conducted on the influence of trade and financial opening on the volatility of real exchange rate. Through the empirical test of panel data of 45 major countries in the world, the pooled ordinary least square (OLS) method and instrumental variable method are used to evaluate the influence of trade and financial opening of sample countries on the volatility of real exchange rate. The main conclusions are that trade openness is negatively correlated with the volatility of real exchange rate, and financial openness is positively correlated with the volatility of real exchange rate. A certain reference is provided for reducing the fluctuation of real exchange rate in the process of opening to the world.

Access to medicines for children in China.

Access to essential medicines for children is a big challenge, particularly in low-income and middle-income countries. In China, the average availability of essential medicines for children is 1.6%-46.5%. The availability of generics was generally higher than original brands in public hospitals and the prices of generics were relatively lower and more reasonable (generics: availability, 27.3%-46.5%, prices, 0.52-4.28 times the international reference prices; original brands: 1.6%-33.0%, 2.59-11.38 times the international reference prices). In terms of affordability of medicines for children, generics were more affordable than original brands and tablets/capsules were more affordable than injections. Most commonly used anti-infective medicines (such as amoxicillin capsule, azithromycin tablet, cefuroxime tablet) and antipyretics (such as ibuprofen suspension) were relatively affordable. Six commonly used medicines in paediatrics, including amoxicillin/clavulanic acid, beclomethasone, cefazolin, ceftazidime, ceftriaxone, cyclosporine were unaffordable. Since August 2011, China has successively issued several policies to ensure the accessibility of medicines for children, covering research and development, production, procurement and prices of medicines. The accessibility of medicines for children has been partially improved, but still needs continuous improvement.