Summary of the 2022 Report on Cardiovascular Health and Diseases in China.

ABSTRACT: Recent decades have seen the remarkable development of China in medical accessibility and quality index, and the application of a number of new advanced cardiovascular technologies benefits more patients. However, according to the Annual Report on Cardiovascular Health and Diseases in China published in this article, which was organized and summarized by National Center for Cardiovascular Diseases, there is still a huge population living with risk factors of cardiovascular diseases (CVD), and the morbidity and mortality of CVD are increasing. It is estimated that there are around 330 million patients suffering from CVD currently, including 245 million of hypertension, 13 million of stroke, 45.3 million of peripheral artery disease, 11.39 million of coronary heart disease (CHD), 8.9 million of heart failure, 5 million of pulmonary heart disease, 4.87 million of atrial fibrillation, 2.5 million of rheumatic heart disease, and 2 million of congenital heart disease. Tobacco use, diet and nutrition factors, physical activity, overweight and obesity, and psychological factors are what affect cardiovascular health, while hypertension, dyslipidemia, diabetes, chronic kidney disease, metabolic syndrome, and air pollution are the risk factors for CVD. In this article, in addition to risk factors for CVD, we also report the epidemiological trends of CVD, including CHD, cerebrovascular disease, arrhythmias, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary vascular disease and venous thromboembolism, and aortic and peripheral artery diseases, as well as the basic research and medical device development in CVD. In a word, China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.

Patient-Reported Outcomes Measurement Information System -29 Domains Interaction in Chronic Musculoskeletal Pain During Acupuncture: A Pilot Study.

Objective: This pilot study explored interactions of domains of physical, psychologic, and social factors in the Patient-Reported Outcomes Measurement Information System® (PROMIS®)-29 system and their dynamic changes during acupuncture treatment of chronic musculoskeletal pain. Materials and Methods: PROMIS-29 profile, version 2.1 was applied among participants with chronic musculoskeletal pain, who received acupuncture treatment for 5 weeks. Data from function-oriented and symptom-oriented domains as well as changes in pain intensity were evaluated at weeks 0, 3, and 5, in 9 patients who completed full sessions. Scores of the domains were analyzed by hierarchical cluster analysis at each timepoint to identify the patterns of interactions of PROMIS domains. Results: Hierarchical cluster analysis revealed the existence of 2 main clusters: one consisting of pain, fatigue, and emotional domains; the other comprising physical function and social domains. The general pattern was stable but interactions were found throughout the treatment. The score for sleep disturbance did not improve but was correlated with different domains at varying stages of treatment. Conclusions: Interaction between 2 clusters of pain with fatigue and emotional domains; and physical function with social domains showed that acupuncture produces holistic reductions in chronic musculoskeletal pain. However, the limitation of sample size and bias in this pilot study requires future research on the need to adopt an interdisciplinary and holistic approach to the recovery of patients with chronic musculoskeletal pain, who have dynamic needs.

China Health Related Outcomes Measures (CHROME): development of a descriptive system to support cardiovascular disease specific preference-based measure for the Chinese population.

PURPOSE: Preference-based measures have been increasingly recommended to measure health outcomes for economic evaluation. However, none of existing cardiovascular disease (CVD)-specific health-related quality of life (HRQoL) instruments are preference-based. This study aimed to develop the descriptive system of preference-based HRQoL instrument for Chinese patients with CVDs under the Initiative of China Health Related Outcomes Measures (CHROME). METHODS: Qualitative face-to-face interviews were conducted with Chinese patients with CVDs. Content analysis was employed to generate candidate items for the instrument. Then expert consultation and cognitive debriefing interviews were conducted to guide further selection and revision of the items. RESULTS: We interviewed 127 CVD patients with 67.7% being male and 63.8% living in the urban area. A hierarchical code book comprised of four themes, 20 categories, 62 sub-categories, and 207 codes, was developed. Candidate items were selected based on the criteria set by the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology and ISPOR PRO guidance. An online survey and meeting with an expert advisory panel (n = 15) followed by cognitive debriefing interviews with 20 patients and 13 physicians were conducted to further select and revise the candidate items. The descriptive system of CHROME-CVD consists of 14 items, namely frequency and severity of chest pain, chest tightness, palpitation, shortness of breath, dizziness, fatigue, appetite, sleeping, mobility, daily activities, depression, worry, and social relationship. Four or five level responses were selected based on cognitive debriefing results to each item. CONCLUSION: The current study developed the descriptive system (items and response options) of CHROME-CVD, the future CVD-specific preference-based HRQoL instrument for Chinese CVD patients.

Assessment of potential, cost, and environmental benefits of CCS-EWR technology for coal-fired power plants in Yellow River Basin of China.

As an effective emission reduction approach, CO2 capture and storage (CCS) combined with enhanced water recovery (EWR) technology can not only reduce CO2 emissions, but can also recover deep saline water resources to relieve pressure on regional water resources, and can ensure the energy supply and both social and economic development. However, the environmental benefits and application costs of CCS-EWR are uncertain, and are determined by the technology level, geological conditions, and other physical factors. In this study, an optimal source-sink matching model and a techno-economic assessment model were developed to evaluate the contributions of CCS-EWR to carbon emission reduction and the increase of the water supply by considering various uncertain factors, as well as the corresponding costs. In addition, the Yellow River Basin (YRB) in China was selected as the research region because, while there are abundant coal-fired power plants (CFPPs) in the YRB, the water resources are scarce. The results revealed the following. (1) The maximum CO2 capture capacity of the 236 CFPPs in the YRB is about 738.77 Mt/a, and nearly 13.14 Gt of fresh water could be provided until the 236 CFPPs in the YRB retire, which can partially relieve the pressure on the supply of water resources. (2) With the consideration of the CCS-EWR benefits, the average cost of the 236 CFPPs in the YRB in their residual lifetime to reduce their CO2 emissions by 90% will be no more than 180 CNY/t. (3) The incentive effect of the increase of the industrial water price on the profits of CCS-EWR projects is not significant. CCS-EWR technology has better application prospects in China under the dual constraints of carbon-neutral targets and water shortages, and more policy support is required for its deployment.

PFAT5 stability assessment of Lipovenoes MCT in total nutrient admixtures.

BACKGROUND: The purpose of this study was to evaluate the effects of monovalent and divalent cations on the stability of a fat emulsion (Lipovenoes MCT) in total nutrient admixtures (TNAs) by testing the percentage of fat residing in globules >5 µm (PFAT5) values. METHODS: TNAs with different combinations of glucose (5% and 10%), amino acids (3.35 and 4.5 g/100 mL), Na+/K+ (100/39 mmol/L), Mg2+ (3.4 and 2.7 mmol/L), and fat emulsion (2.4%) were tested in triplicate at room temperature. The pH, mean droplet size (MDS), and PFAT5 were assessed at 0, 6, 12, 24, 36, and 48 h. RESULTS: In all seven groups, the TNA globule distribution was uniform, the pH value fluctuated in the range of 5.93-6.06, and the MDS met the limit of the United States Pharmacopeia (USP) within 48 h. The PFAT5 value of the control group 0 without electrolytes was the lowest; group 1 added monovalent ions of 139 mmol/L was significantly higher (P<0.05) but without exceed the USP limit after 48 h. Groups 2 and 3 added Mg2+ 3.4 and 2.7 mmol/L respectively, based on group 1. Group 4 increased the amino acid concentration from 3.35% to 4.5% based on group 2, and group 5 reduced the glucose concentration from 10% to 5% based on group 4. Group 6 removed monovalent ions and retained only Mg2+ based on group 5. The PFAT5 values of group 2, 3, 4, and 5 exceeded the limit after 6 h and group 6 after 12 h. There was no statistical difference between group 2 and 4 (P>0.05) or between group 4 and 5 (P>0.05). CONCLUSIONS: When the concentration of glucose is 10-25% and the amino acid is 2.5-4.5%, The addition of monovalent ions affects the stability of fat emulsion in TNAs, however when the concentrations of Na+ ≤100 mmol/L and K+ ≤39 mmol/L, the PFAT5 value will not exceed the USP limit within 24 h. Mg2+ has a significant effect, the PFAT5 value will exceed the USP limit after 6 h when the concentration ≥2.7 mmol/L, which may cause potential safety hazards.

A nationally quasi-experimental study to assess the impact of partial organized breast and cervical cancer screening programme on participation and inequalities.

BACKGROUND: Organized breast and cervical cancer screening programme could only provide services at no cost for a fraction of socioeconomic-deprived women in China and other low-resource countries, however, little evidence exists for whether such a programme effectively affect the participation and inequalities at the population level. METHODS: We used individual-level data from a nationally cross-sectional survey in 2014-2015 for breast and cervical cancer screening participation. Data for intervention and comparison grouping were from 2009 to 2014 national breast and cervical cancer screening programme, and counties covered by the programme were divided into intervention group. We assessed the impact of the intervention on the participation rates and the magnitude of inequalities with two approaches: multivariable multilevel logistic regressions adjusting for individual- and region-level covariates; and a difference analysis combined with propensity score matching that estimated the average intervention effect. RESULTS: Of 69,875 included women aged 35-64 years, 21,620 were classified into the intervention group and 43,669 into the comparison group for breast cancer screening; and 31,794 into the intervention group, and 33,682 into the comparison group for cervical cancer screening. Participation rate was higher in intervention group than comparison group for breast cancer screening (25.3, 95% confidential interval [CI], 22.8-27.7%, vs 19.1, 17.4-20.7%), and cervical cancer screening (25.7, 23.8-27.7%, vs 21.5, 19.6-23.5%), respectively. Intervention significantly increased the likelihood of participation for both breast cancer and cervical cancer screening in overall women, rural women and urban women, whereas the effect was significantly higher in rural women than urban women. The average intervention effect on the participation rate was an increase of 7.5% (6.7-8.2%) for breast cancer screening, and 6.8% (6.1-7.5%) for cervical cancer screening, respectively. The inequalities were significantly decreased by 37-41% (P < 0.001) between rural and urban, however, were slightly decreased or even increased in terms of age, education status, and household income. CONCLUSIONS: Organized breast and cervical cancer screening programme targeting for a fraction of women could increase the participation rates at population level, however, it could not significantly affect socioeconomic-introduced inequalities. Further studies are need to conduct time-series analyses and strengthen the causal correlation.

Inequality of household energy and water consumption in China: An input-output analysis.

Household consumption activities affect energy and water consumption directly and indirectly. Based on input-output modeling, this paper divided Chinese urban and rural residents into 12 groups, and investigated the impact of the consumption activities of residents with different levels of income on China's energy and water consumption from the perspective of consumers. Two main results were found. 1) In 2012, the energy consumption caused by the consumption activities of the highest-income urban residents accounted for 17.3% of the total energy consumption. For water resources, the per capita water withdrawal and consumption of the highest-income urban residents reached 481.21 m3 and 284.45 thousand m3, 6 times more than that of the low-income rural residents. 2) We identified medium and medium-high income urban residents as the key groups of residents. From the perspective of the industrial sectors, the key sectors for high energy consumption and water usage included the Electricity and Agricultural sectors, and we identified the Electricity sector as the key sector for the water and energy nexus of the residential sectors. The conclusions of this paper have pertinence for policymaking, and they provide an appropriate policy basis for guiding residents' energy and water consumption.

Geographical Disparity and Associated Factors of COPD Prevalence in China: A Spatial Analysis of National Cross-Sectional Study.

Purpose: COPD prevalence has rapidly increased in China, but the geographical disparities in COPD prevalence remain largely unknown. This study aimed to assess city-level disparities in COPD prevalence and identify the relative importance of COPD related risk factors in mainland China. Patients and Methods: A nationwide cross-sectional study of COPD recruited 66,752 adults across the mainland China between 2014 and 2015. Patients with COPD were ascertained by a post-bronchodilator pulmonary function test. We estimated the city-specific prevalence of COPD by spatial kriging interpolation method. We detected spatial clusters with a significantly higher prevalence of COPD by spatial scan statistics. We determined the relative importance of COPD associated risk factors by a nonparametric and nonlinear classification and regression tree (CART) model. Results: The three spatial clusters with the highest prevalence of COPD were located in parts of Sichuan, Gansu, and Shaanxi, etc. (relative risks (RRs)) ranging from 1.55 (95% CI 1.55-1.56) to 1.33 (95% CI 1.33-1.33)). CART showed that advanced age (≥60 years) was the most important factor associated with COPD in the overall population, followed by smoking. We estimated that there were about 28.5 million potentially avoidable cases of COPD among people aged 40 or older if they never smoked. PM2.5 was an important associated risk factor for COPD in the north, northeast, and southwest of China. After adjusting for age and smoking, the spatial cluster with the highest prevalence shifted to most of Sichuan, Gansu, Qinghai, and Ningxia, etc. (RR 1.65 (95% CI 1.63-1.67)). Conclusion: The spatial clusters of COPD at the city level and regionally varied important risk factors for COPD would help develop tailored interventions for COPD in China. After adjusting for the main risk factors, the spatial clusters of COPD shifted, indicating that there would be other potential risk factors for the remaining clusters which call for further studies.

Decomposition analysis of energy-related CO2 emission in the industrial sector of China: Evidence from the LMDI approach.

Energy consumption and increasing CO2 emissions in China are mainly indorsed to the industrial sector. The objective of this study was to explore the main factors driving CO2 emissions in China's industry throughout 1991-2016. Based on the log-mean Divisia index (LMDI) method, this study decomposes the change of industry-related CO2 emissions into energy structure effect, income effect, energy intensity effect, carbon emission, and labor effect. The core results indicate that CO2 emissions in China's industry experienced a significant increase from 738.5 to 7271.8 Mt during 1991-2013, while it decreased to 6844.0 Mt in 2016. The income effect and labor effect are the top two emitters, which accounted for increases of 351.8 Mt and 57.8 Mt in CO2 emissions respectively. Additionally, the energy structure effect also played a role in increasing CO2 emissions. Energy intensity and carbon emission effects are the most important factors in reducing CO2 emissions. The policy suggestions about the different period-wise analyses in terms of economic growth, energy structure, and energy intensity are provided.

Long-term unmet needs after stroke: systematic review of evidence from survey studies.

OBJECTIVES: To synthesise evidence on longer term unmet needs perceived by stroke survivors, and psychometric properties of the tools used to evaluate unmet care needs after stroke. DESIGN: Systematic review. SETTING: Community or patients' home. PARTICIPANTS: Stroke survivors. METHODS: We searched PubMed, PsycINFO, CINAHL, EMBASE from inception to 31 March 2018 to identify survey studies that evaluated unmet needs perceived by stroke survivors after hospital discharge. Reported unmet needs were categorised under three domains: body functioning, activity/participation and environmental factors. Ranges of prevalence rates of unmet needs reported in studies were presented. RESULTS: We included 19 eligible studies, with considerable heterogeneity in patients, survey methods and results. Psychometric properties of two stroke-specific tools were formally evaluated, indicating their moderate reliability and content/concurrent validity. The median number of reported unmet needs per stroke survivor was from two to five, and the proportion of stroke survivors with at least one unmet needs was on average 73.8% (range 19.8%- 91.7%). Unmet needs perceived by stroke survivors included 55 records of unmet body functioning needs, 47 records of unmet activities/participatory needs and 101 records of unmet environmental needs. Common unmet service needs were unmet information needs (3.1%- 65.0%), transport (5.4%-53.0%), home help/personal care (4.7%-39.3%) and therapy (2.0%-35.7%). CONCLUSIONS: The prevalence of unmet long-term needs is high among stroke survivors, and there is considerable heterogeneity in type and frequency of specific unmet needs. More research is required to link regular assessment of long-term unmet needs of stroke survivors with the provision of cost-effective patient-centred health and social care services.

Comparative study on the influence of final use structure on carbon emissions in the Beijing-Tianjin-Hebei region.

The Beijing-Tianjin-Hebei region's rapid economic development has led to a dramatic increase in its CO2 emissions, which is closely related to various regions' consumption habits and structures. In this paper, the decomposition analysis method based on input and output (IO-SDA) was applied to decompose the CO2 emissions change of the Beijing-Tianjin-Hebei region from 1997 to 2012 into five driving factors: population, carbon emission efficiency, production structure, final use structure and per capita regional GDP, and then the final use structure factor was further analyzed. The results show that: (1) the population and per capita regional GDP promote the CO2 emissions of all regions; Carbon emission efficiency is the biggest offsetting factor; The effect of final use structure changes on the growth of CO2 emissions in Beijing and Hebei remains unchanged. The effect on Tianjin was from 0.7Mt offset to 0.8Mt promotion. (2) Urban household consumption is the most important factor offsetting CO2 emissions in Beijing. Investment and export are the most important final use types for promoting the growth of CO2 emissions in Tianjin and Hebei, with the contribution of 95.78% and 88.09%, respectively. (3) From the sectoral perspective: The construction sector has the greatest impact on the total capital formation of the three regions. In terms of exports, Beijing's tertiary industry has the largest offsetting effect, while Tianjin and Hebei mainly rely on the promotion of metal smelting and other manufacturing industries. Finally, some policy implications for low carbonization are proposed in the Beijing-Tianjin-Hebei region.

Exploring the changes and driving forces of water footprints in China from 2002 to 2012: A perspective of final demand.

Due to economic development and population growth, the water shortage in China has gradually become increasingly severe. In this paper, by developing an environmentally expanded input-output (IO) model, water footprint in China during 2002-2012 is calculated from the perspective of final demand. Furthermore, a structural decomposition analysis (SDA) model is used to study the driving factors of the water footprint of rural and urban household consumption, gross fixed capital formation and exports. The findings indicate that: 1) the water footprint driven by final demand in China increased by 18.3% during 2002-2012, reaching 617.68 billion m3 in 2012, of which urban household consumption accounts for the highest proportion. 2) Of the different sectors, agricultural commodities have the highest water footprint, accounting for 35% of national water footprint in 2012. 3) In terms of the driving factors, water efficiency inhibits the increase of water footprint regardless of final demand types, while GDP per capita makes a great contribution to its rise. 4) As for rural household consumption, the most important driving factor is the inhibition effects of consumption pattern in water footprint. For urban household consumption, the water footprint is inhibited by consumption pattern but promoted by production structure during 2002-2010. However, it is no longer the case during 2010-2012 that consumption pattern becomes a promoting factor, with production structure being inhibiting one. 5) Regarding gross fixed capital formation, its water footprint increase driven by consumption pattern is only 12.4 billion m3 during 2007-2010. As for exports, consumption pattern causes the decline of water footprint after 2005 and the overall water footprint of exports declines during 2007-2012. Finally, this paper provides policy implications with respect to the promotion of China's water footprint conservation.

Chronic obstructive pulmonary disease in China: a nationwide prevalence study.

BACKGROUND: Because of the rapid change in economic development and lifestyle in China, and the ageing population, concerns have grown that chronic obstructive pulmonary disease (COPD) could become epidemic. An up-to-date nationwide estimation of COPD prevalence in China is needed. METHODS: We did a cross-sectional survey of a nationally representative sample of individuals from mainland China aged 40 years or older. The primary outcome was COPD, defined according to the 2017 Global Initiative for Chronic Obstructive Lung Disease (GOLD) lung function criteria. FINDINGS: Between Dec 29, 2014, and Dec 31, 2015, 66 752 adults were recruited to the study population. The estimated standardised prevalence of COPD was 13·6% (95% CI 12·0-15·2). The prevalence of COPD differed significantly between men and women (19·0%, 95% CI 16·9-21·2 vs 8·1%, 6·8-9·3; p<0·0001), mainly because of a significant difference in smoking status between men and women (current smokers 58·2% vs 4·0%). The prevalence of COPD differed by geographic region, with the highest prevalence in southwest China (20·2%, 95% CI 14·7-25·8) and the lowest in central China (10·2%, 8·2-12·2). Among adults with COPD, 56·4% (95% CI 53·7-59·2) had mild disease (GOLD stage I), 36·3% (34·3-38·3) had moderate disease (GOLD stage II), 6·5% (5·5-7·4) had severe disease (GOLD stage III), and 0·9% (0·6-1·1) had very severe disease (GOLD stage IV). INTERPRETATION: In a large, nationally representative sample of adults aged 40 years or older, the estimated overall prevalence of COPD in China in 2014-15 was 13·6%, indicating that this disease has become a major public-health problem. Strategies aimed at prevention and treatment of COPD are needed urgently. FUNDING: Chinese Central Government, the Ministry of Science and Technology of The People's Republic of China, and the National Natural Science Foundation of China.

Association Between Combined TMPRSS2:ERG and PCA3 RNA Urinary Testing and Detection of Aggressive Prostate Cancer.

IMPORTANCE: Potential survival benefits from treating aggressive (Gleason score, ≥7) early-stage prostate cancer are undermined by harms from unnecessary prostate biopsy and overdiagnosis of indolent disease. OBJECTIVE: To evaluate the a priori primary hypothesis that combined measurement of PCA3 and TMPRSS2:ERG (T2:ERG) RNA in the urine after digital rectal examination would improve specificity over measurement of prostate-specific antigen alone for detecting cancer with Gleason score of 7 or higher. As a secondary objective, to evaluate the potential effect of such urine RNA testing on health care costs. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter diagnostic evaluation and validation in academic and community-based ambulatory urology clinics. Participants were a referred sample of men presenting for first-time prostate biopsy without preexisting prostate cancer: 516 eligible participants from among 748 prospective cohort participants in the developmental cohort and 561 eligible participants from 928 in the validation cohort. INTERVENTIONS/EXPOSURES: Urinary PCA3 and T2:ERG RNA measurement before prostate biopsy. MAIN OUTCOMES AND MEASURES: Presence of prostate cancer having Gleason score of 7 or higher on prostate biopsy. Pathology testing was blinded to urine assay results. In the developmental cohort, a multiplex decision algorithm was constructed using urine RNA assays to optimize specificity while maintaining 95% sensitivity for predicting aggressive prostate cancer at initial biopsy. Findings were validated in a separate multicenter cohort via prespecified analysis, blinded per prospective-specimen-collection, retrospective-blinded-evaluation (PRoBE) criteria. Cost effects of the urinary testing strategy were evaluated by modeling observed biopsy results and previously reported treatment outcomes. RESULTS: Among the 516 men in the developmental cohort (mean age, 62 years; range, 33-85 years) combining testing of urinary T2:ERG and PCA3 at thresholds that preserved 95% sensitivity for detecting aggressive prostate cancer improved specificity from 18% to 39%. Among the 561 men in the validation cohort (mean age, 62 years; range, 27-86 years), analysis confirmed improvement in specificity (from 17% to 33%; lower bound of 1-sided 95% CI, 0.73%; prespecified 1-sided P = .04), while high sensitivity (93%) was preserved for aggressive prostate cancer detection. Forty-two percent of unnecessary prostate biopsies would have been averted by using the urine assay results to select men for biopsy. Cost analysis suggested that this urinary testing algorithm to restrict prostate biopsy has greater potential cost-benefit in younger men. CONCLUSIONS AND RELEVANCE: Combined urinary testing for T2:ERG and PCA3 can avert unnecessary biopsy while retaining robust sensitivity for detecting aggressive prostate cancer with consequent potential health care cost savings.

The Neural Mechanism Exploration of Adaptive Motor Control: Dynamical Economic Cell Allocation in the Primary Motor Cortex.

Adaptive flexibility is of significance for the smooth and efficient movements in goal attainment. However, the underlying work mechanism of the cerebral cortex in adaptive motor control still remains unclear. How does the cerebral cortex organize and coordinate the activity of a large population of cells in the implementation of various motor strategies? To explore this issue, single-unit activities from the M1 region and kinematic data were recorded simultaneously in monkeys performing 3D reach-to-grasp tasks with different perturbations. Varying motor control strategies were employed and achieved in different perturbed tasks, via the dynamic allocation of cells to modulate specific movement parameters. An economic principle was proposed for the first time to describe a basic rule for cell allocation in the primary motor cortex. This principle, defined as the Dynamic Economic Cell Allocation Mechanism (DECAM), guarantees benefit maximization in cell allocation under limited neuronal resources, and avoids committing resources to uneconomic investments for unreliable factors with no or little revenue. That is to say, the cells recruited are always preferentially allocated to those factors with reliable return; otherwise, the cells are dispatched to respond to other factors about task. The findings of this study might partially reveal the working mechanisms underlying the role of the cerebral cortex in adaptive motor control, wherein is also of significance for the design of future intelligent brain-machine interfaces and rehabilitation device.

Editorial: Functional testing in the assessment of return to sports after anterior cruciate ligament reconstruction.

The paper entitled "Functional testing differences in anterior cruciate ligament (ACL) reconstruction patients released versus not released to return to sport" published in the American Journal of Sports Medicine (AJSM) assessed Functional Movement Screen (FMS) and the Lower Quarter Y Balance Test (YBT-LQ) as possible objective tools for evaluating a patient's readiness to return to sports after ACL reconstruction. The results suggest that many patients clinically cleared continue to have measurable function deficits and that both FMS and YBT-LQ may be used as additional tools for return to sports clearance.

Computational approach to seasonal changes of living leaves.

This paper proposes a computational approach to seasonal changes of living leaves by combining the geometric deformations and textural color changes. The geometric model of a leaf is generated by triangulating the scanned image of a leaf using an optimized mesh. The triangular mesh of the leaf is deformed by the improved mass-spring model, while the deformation is controlled by setting different mass values for the vertices on the leaf model. In order to adaptively control the deformation of different regions in the leaf, the mass values of vertices are set to be in proportion to the pixels' intensities of the corresponding user-specified grayscale mask map. The geometric deformations as well as the textural color changes of a leaf are used to simulate the seasonal changing process of leaves based on Markov chain model with different environmental parameters including temperature, humidness, and time. Experimental results show that the method successfully simulates the seasonal changes of leaves.

[Advanced schistosomiasis chemotherapy and assistance in Xinjian County, 2005-2009].

OBJECTIVE: To understand the status of chemotherapy and assistance for advanced schistosomiasis patients in Xinjian County, 2005-2009. METHODS: The data of chemotherapy and assistance for patients with advanced schistosomiasis in Xinjian County from 2005 to 2009 were collected and analyzed statistically by using The Information Management System for Advanced Schistosomiasis Chemotherapy and Assistance in Jiangxi Province. RESULTS: Among 636 cases, the sex ratio of male to female was 1.19: 1, and the average age was 61.52 +/- 11.2 years old. Ascites was the main symptoms of patients (93.71%), and the percentage of splenectomized ones was 32.38% among them. The IHA-positive rate, HBsAg-positive rate and repeat treatment rate were 31.6%, 24.37% and 44.50%, respectively. The clinical cure rate, recovery rate and death rate were 43.53%, 55.94% and 5.97%, respectively. CONCLUSION: The advanced schistosomiasis chemotherapy and assistance improves the symptoms and life quality of these patients.

Simultaneous analysis of amoxicillin and sulbactam in human plasma by HPLC-DAD for assessment of bioequivalence.

A simple and accurate high-performance liquid chromatography with diode array detection-based (HPLC-DAD) method has been developed and validated for simultaneous determination of amoxicillin and sulbactam in human plasma. Sample preparation was involved in protein precipitation with acetonitrile followed by one-step extraction procedure. Chromatographic separation was achieved on a C18 column with an isocratic mobile phase consisting of water (containing 30 mM potassium dihydrogen phosphate, pH 2.8) and acetonitrile. The detection wavelengths of a diode array detector were set at 210 nm for amoxicillin and sulbactam, and 263 nm for the internal standard (cefadroxil). The method was validated for linearity, accuracy, precision, and stability. The calibration curve was linear from 0.163 to 14.7 µg/mL with correlation coefficient squared of 0.9991 for amoxicillin and 0.250-15.0 µg/mL with correlation coefficient squared of 0.9988 for sulbactam using 500 µL plasma samples. The lower limit of quantification was 0.163 and 0.250 µg/mL for amoxicillin and sulbactam, respectively. The imprecisions of intra- and inter-day validations for amoxicillin and sulbactam were <11% and their accuracies (%) were within the range of 95.4-105.7%. Mean recoveries were 75.9, 72.8, and 70.0% for amoxicillin, sulbactam, and cefadroxil, respectively. The established method was successfully applied to a bioequivalence study of two combination formulations of amoxicillin and sulbactam pivoxil in healthy male volunteers.

Monte Carlo simulation of thermal fluctuations below the onset of Rayleigh-Bénard convection.

The density fluctuations below the onset of convection in the Rayleigh-Bénard problem are studied with the direct simulation Monte Carlo method. The particle simulation results clearly show the connection between the static correlation functions of fluctuations below the critical Rayleigh number and the flow patterns above the onset of convection for small Knudsen number flows (Kn=0.01 and Kn=0.005). Furthermore, the physical nature for no convection in the Rayleigh-Bénard problem under large Knudsen number conditions (Kn>0.028) is explained based on the dynamics of fluctuations.