Results of a Pilot External Quality Assessment Scheme for Genetic Testing of Newborns with Spinal Muscular Atrophy.

BACKGROUND: This study aims to evaluate the ability of laboratories to perform spinal muscular atrophy (SMA) genetic testing in newborns based on dried blood spot (DBS) samples, and to provide reference data and advance preparation for establishing the pilot external quality assessment (EQA) scheme for SMA genetic testing of newborns in China. METHODS: The pilot EQA scheme contents and evaluation principles of this project were designed by National Center for Clinical Laboratories (NCCL), National Health Commission. Two surveys were carried out in 2022, and 5 batches of blood spots were submitted to the participating laboratory each time. All participating laboratories conducted testing upon receiving samples, and test results were submitted to NCCL within the specified date. RESULTS: The return rates were 75.0% (21/28) and 95.2% (20/21) in the first and second surveys, respectively. The total return rate of the two examinations was 83.7% (41/49). Nineteen laboratories (19/21, 90.5%) had a full score passing on the first survey, while in the second survey twenty laboratories (20/20, 100%) scored full. CONCLUSIONS: This pilot EQA survey provides a preliminary understanding of the capability of SMA genetic testing for newborns across laboratories in China. A few laboratories had technical or operational problems in testing. It is, therefore, of importance to strengthen laboratory management and to improve testing capacity for the establishment of a national EQA scheme for newborn SMA genetic testing.

Assessment of equity and efficiency of magnetic resonance imaging services in Henan Province, China.

BACKGROUND: By evaluating equity and effectiveness, this study provides evidence-based knowledge for scientific decision-making and the optimization of magnetic resonance imaging (MRI) configuration and utilization at the provincial level. METHODS: Using data from 2017, we applied a Gini coefficient to analyze the equity of MRI services in 11 sample cities in Henan province. An agglomeration degree was then applied to measure equity from the perspective of population and geography, and a data envelopment analysis was used to evaluate MRI efficiency. RESULTS: The overall Gini coefficient of MRI allocation by population in the 11 sample cities is 0.117; however, equity varies considerably among the sample cities. The sample's comprehensive efficiency is only 0.732, indicating the overall ineffectiveness of provincial MRI utilization. The pure technical and scale efficiencies of four sample cities are below 1, indicating lower MRI effectiveness than the rest. CONCLUSIONS: Although the overall equity of configuration at the provincial level is relatively good, equity varies at the municipal level. Our results demonstrate a low MRI utilization efficiency; accordingly, policymakers should dynamically adjust the policy based on equity and efficiency.

How does heterogeneous environmental regulation affect net carbon emissions: Spatial and threshold analysis for China.

The Chinese government has made great efforts in air pollutant reduction and carried out strict regulation policies. Since numerous air pollutants and CO2 tend to have the same root, source, and process, recent studies argue that environmental regulation may also contribute to reducing carbon emissions. To investigate how various types of environmental regulations affect carbon emissions reduction, this paper constructs the spatial Durbin model and panel threshold model based on provincial panel data in China during 2003-2019. The main findings are as follows: First, China's net carbon emissions show a decreasing trend from east to west, displaying significant spatial agglomeration characteristics. Then, formal and informal environmental regulations have inverted U-shaped impacts on net carbon emissions. The "green paradox" and "reverse emission reduction" effects come into play at different stages. Finally, the threshold model reveals that with the improvement of regional technological innovation levels, the carbon-reducing effect of environmental regulation will increasingly come to the fore. These research findings are conducive to providing theoretical guidance for government to formulate and implement environmental regulation policies rationally.

A novel implantable device for sensory and affective assessment of orofacial pain in rats.

Background and objective: Orofacial pain, in particular, chronic orofacial pain remains a great challenge in clinical practice. To better understand the underlying mechanism of disease, it is essential to apply a feasible and stable preclinical measurement of facial pain. Here, we introduced a novel electrical noxious stimulator in freely behavioral rodents and examined its validation in both naïve and chronic orofacial pain animals. Methods: One subcutaneous device of electrical stimulator was implanted in the facial region for delivery of the nociceptive input. The sensory component of orofacial pain was assessed by response scoring tool, and conditioned place aversion (CPA) paradigm for pain affect respectively. To confirm its usage in chronic pain state, the chronic constriction injury of the infraorbital nerve (ION-CCI) model was then applied. Results: We found that responsive scores increased with stimulation intensity, and acted in a dosage-dependent manner, which can be attenuated by the administration of morphine intraperitoneally. Naïve rats displayed significant aversive reaction to the noxious electrical stimulation (25V) in the CPA testing. In addition, an obvious sensory hypersensitivity to electrical stimulation was confirmed by the increased response scores in ION-CCI rats. Furthermore, ION-CCI animal showed significant avoidance to electrical stimulation at relatively low intensity (10V), which was innoxious to naïve rats. Conclusion: Our findings may provide an alternative pre-clinical measurement of orofacial pain, to quantitively assess both sensory and affective component of orofacial pain.