Non-invasive geophysical methods for monitoring the shallow aquifer based on time-lapse electrical resistivity tomography, magnetic resonance sounding, and spontaneous potential methods.

The Ningdong coalfield has played a pivotal role in advancing local economic development and meeting national energy. Nevertheless, mining operations have engendered ecological challenges encompassing subterranean water depletion, land desertification, and ground subsidence, primarily stemming from the disruption of coal seam roof strata. Consequently, the local ecosystem has incurred substantial harm. Water-preserved coal mining presently constitutes the pivotal technology in mitigating this problem. The primary challenge of this technique lies in identifying critical aquifer layers and understanding the heights of water-conducting fracture zones. To obtain a precise comprehension of the seepage patterns within the upper coal seam aquifer during mining, delineate the extent of water-conducting fracture zones, non-invasive geophysical techniques such as time-lapse electrical resistivity tomography (TL-ERT), magnetic resonance sounding (MRS), and spontaneous potential (SP) have been employed to monitor alterations within the shallow coalfield's aquifer throughout the mining process in the Ningdong coalfield. By conducting meticulous examinations of fluctuations in resistivity, moisture content, and self-potential within the superjacent strata during coal seam extraction, the predominant underground water infiltration strata were ascertained, concurrently enabling the estimation of the development elevation of water-conducting fracture zones. This outcome furnishes a geophysical underpinning for endeavors concerning local water-preserved coal mining and ecological rehabilitation.

Response of hydrological ecosystem services to land-use change and risk assessment in Jiangxi Province, China.

Water bodies provide humans with important hydrological ecosystem services (HESs), directly or indirectly. Water yield, water conservation, and soil conservation are essential to HESs. Since China's reform and opening up, and with its rapid socio-economic development, land use in Jiangxi Province has undergone drastic change, resulting in threats to the ecological environment. This paper evaluates three HESs, water yield, water conservation, and soil conservation, in Jiangxi Province based on land use and rainfall data, quantifies the impacts of different land classes on each ecosystem, predicts future land use using the patch-generating land use simulation (PLUS) model, and finally, discusses the ecological risks in the study area. The following results were obtained: (1) The HESs in the basin increased and then decreased from 2000 to 2020, and the spatial distribution of water yield and water conservation was greatly influenced by rainfall. Soil conservation was mostly consistent with the elevation distribution. (2) Over time, the overall aggregation of HESs in the study area increased. There were small differences in the effects of various land uses on water yield and water conservation, and large differences in the effects on soil conservation. (3) The distribution of ecological risks was not affected by different land use strategies, with the lower ecological risk level 1 dominating. Most risk areas were present in Ganzhou, Ji'an, Shangrao, and Jiujiang. The ecological risk from urban sprawl (US) accounted for the most significant proportion, and that from the ecological protection (EP) strategy accounted for the lowest proportion. This study provides reference for sustainable land use development and ecological risk prevention in the study area.

Construction of an economical xylose-utilizing Saccharomyces cerevisiae and its ethanol fermentation.

Traditional industrial Saccharomyces cerevisiae could not metabolize xylose due to the lack of a specific enzyme system for the reaction from xylose to xylulose. This study aims to metabolically remould industrial S. cerevisiae for the purpose of utilizing both glucose and xylose with high efficiency. Heterologous gene xylA from Piromyces and homologous genes related to xylose utilization were selected to construct expression cassettes and integrated into genome. The engineered strain was domesticated with industrial material under optimizing conditions subsequently to further improve xylose utilization rates. The resulting S. cerevisiae strain ABX0928-0630 exhibits a rapid growth rate and possesses near 100% xylose utilization efficiency to produce ethanol with industrial material. Pilot-scale fermentation indicated the predominant feature of ABX0928-0630 for industrial application, with ethanol yield of 0.48 g/g sugars after 48 hours and volumetric xylose consumption rate of 0.87 g/l/h during the first 24 hours. Transcriptome analysis during the modification and domestication process revealed a significant increase in the expression level of pathways associated with sugar metabolism and sugar sensing. Meanwhile, genes related to glycerol lipid metabolism exhibited a pattern of initial increase followed by a subsequent decrease, providing a valuable reference for the construction of efficient xylose-fermenting strains.

Contamination status, partitioning behavior, ecological risks assessment of legacy and emerging per- and polyfluoroalkyl substances in a typical heavily polluted semi-enclosed bay, China.

The contaminant status, spatial distribution, partitioning behavior, and ecological risks of 26 legacy and emerging perfluoroalkyl and polyfluoroalkyl substances (PFASs) in Laizhou Bay, China were investigated. The concentrations of ∑PFASs in surface and bottom seawater ranged from 37.2 to 222 ng/L and from 34.2 to 305 ng/L with an average of 116 ± 62.7 and 138 ± 93.8 ng/L, respectively. There were no significant differences in the average concentrations between the surface and bottom seawater (P > 0.05). Perfluorooctanoic acid (PFOA) and short-chain PFASs dominated the composition of PFASs in seawater. The concentrations of ∑PFASs in sediments ranged from 0.997 to 7.21 ng/g dry weight (dw), dominated by perfluorobutane sulfonate (PFBS), perfluorobutanoic acid (PFBA), and long-chain PFASs. The emerging alternatives of perfluoro-1-butane-sulfonamide (FBSA) and 6:2 fluorotelomer sulfonic acid (6:2 FTSA) were detected for the first time in Laizhou Bay. The ∑PFASs in seawater in the southwest of the bay were higher than those in the northeast of the bay. The ∑PFASs in sediments in the northeast sea area were higher than those in the inner area of the bay. Log Kd and log Koc values increased with increasing carbon chain length for PFASs compounds. Ecological risk assessments indicated a low ecological risk associated with HFPO-DA but a moderate risk associated with PFOA contamination in Laizhou Bay. Positive matrix factorization (PMF) analysis revealed that fluoropolymer manufacturing, metal plating plants, and textile treatments were identified as major sources contributing to PFASs contamination.

Assessment of the Diagnostic Performance of Clinical Examinations and High-Frequency Ultrasound in Patients With Pigmented Skin Tumors.

OBJECTIVES: To investigate whether the integration of high-frequency ultrasound (HFUS) to routine clinical examinations could improve diagnostic performance and management decision for pigmented skin tumors. METHODS: Three general practitioners trained previously and a dermatologist independently assessed pigmented skin tumors and rendered management decision based on clinical examinations alone or clinical examinations integrating HFUS. RESULTS: After integrating HFUS, the diagnostic area under the curve (AUC) (0.658-0.693 versus 0.848, all P < .05) and specificity (46.6-58.6% versus 89.7%, all P < .05) for pigmented skin malignancies were improved for general practitioners, meanwhile unnecessary biopsy rate reduced (42.9-53.6% versus 10.7%, P < .001). To the dermatologist, the diagnostic AUC (0.822 versus 0.949, P < .001), sensitivity (81.7% versus 96.7%, P = .012) and specificity (0.828 versus 0.931, P = .031) improved significantly, meanwhile both missed biopsy rate (14.5% versus 4.8%, P = .031) and unnecessary biopsy rate (19.6% versus 7.1%, P = .016) decreased. Additionally, the diagnostic performance of the general practitioner with integrating HFUS could be comparable with the dermatologist based on clinical examinations alone (all P > .05). CONCLUSIONS: As a complementary tool of clinical examinations, HFUS could help physicians differentiate pigmented skin malignancies and manage decision.

Sample size requirements for testing treatment effect heterogeneity in cluster randomized trials with binary outcomes.

Cluster randomized trials (CRTs) refer to a popular class of experiments in which randomization is carried out at the group level. While methods have been developed for planning CRTs to study the average treatment effect, and more recently, to study the heterogeneous treatment effect, the development for the latter objective has currently been limited to a continuous outcome. Despite the prevalence of binary outcomes in CRTs, determining the necessary sample size and statistical power for detecting differential treatment effects in CRTs with a binary outcome remain unclear. To address this methodological gap, we develop sample size procedures for testing treatment effect heterogeneity in two-level CRTs under a generalized linear mixed model. Closed-form sample size expressions are derived for a binary effect modifier, and in addition, a computationally efficient Monte Carlo approach is developed for a continuous effect modifier. Extensions to multiple effect modifiers are also discussed. We conduct simulations to examine the accuracy of the proposed sample size methods. We present several numerical illustrations to elucidate features of the proposed formulas and to compare our method to the approximate sample size calculation under a linear mixed model. Finally, we use data from the Strategies and Opportunities to Stop Colon Cancer in Priority Populations (STOP CRC) CRT to illustrate the proposed sample size procedure for testing treatment effect heterogeneity.

Farmers perceive diminishing ecosystem services, but overlook dis-services in intensively used agricultural landscapes in the North China Plain.

The UN sustainable development goals ask countries to advance sustainable production methods in agriculture. While the need for a transition to sustainable agricultural production is widely felt, there is little insight into local stakeholders' perceptions regarding agroecosystem (dis)services in areas with intensive production methods. The North China Plain is an agricultural production area with intensive production systems and simplified agricultural landscapes. We conducted a survey with 267 farmers in Quzhou county in the North China Plain in 2020 to measure the perceived level of agroecosystem (dis)services supply and the changes therein between 2015 and 2020. We analyzed which explanatory factors were associated with farmers' perceptions. Provisioning services were at a high level, while the regulating and supporting ecosystem services were considered to be in low supply, as evidenced by low scores for the presence of natural enemies and earthworms, and for natural habitats such as hedgerows and windbreaks. Most of the participants did not perceive dis-services from agriculture. Differences in perception between villages with contrasting biophysical and socio-economic conditions highlight the relevance of contextualized policy development for agricultural landscape composition and configuration to manage ecosystem (dis)services.

Sample Size Requirements to Test Subgroup-Specific Treatment Effects in Cluster-Randomized Trials.

Cluster-randomized trials (CRTs) often allocate intact clusters of participants to treatment or control conditions and are increasingly used to evaluate healthcare delivery interventions. While previous studies have developed sample size methods for testing confirmatory hypotheses of treatment effect heterogeneity in CRTs (i.e., targeting the difference between subgroup-specific treatment effects), sample size methods for testing the subgroup-specific treatment effects themselves have not received adequate attention-despite a rising interest in health equity considerations in CRTs. In this article, we develop formal methods for sample size and power analyses for testing subgroup-specific treatment effects in parallel-arm CRTs with a continuous outcome and a binary subgroup variable. We point out that the variances of the subgroup-specific treatment effect estimators and their covariance are given by weighted averages of the variance of the overall average treatment effect estimator and the variance of the heterogeneous treatment effect estimator. This analytical insight facilitates an explicit characterization of the requirements for both the omnibus test and the intersection-union test to achieve the desired level of power. Generalizations to allow for subgroup-specific variance structures are also discussed. We report on a simulation study to validate the proposed sample size methods and demonstrate that the empirical power corresponds well with the predicted power for both tests. The design and setting of the Umea Dementia and Exercise (UMDEX) CRT in older adults are used to illustrate our sample size methods.

Spatial spillover effects of a carbon trading policy on green technology innovation in China.

A carbon market is a widely used policy tool worldwide. This study employs a difference-in-differences (DID) model to estimate the impact of a carbon trading policy on green technology innovation and applies a spatial DID (SDID) model to investigate its spatial spillover effects. The findings suggest that China's carbon market effectively promotes green technology innovation, as green invention patent applications for listed enterprises increase by 28.8% when implementing the carbon trading policy. Moreover, implementing a carbon trading policy promotes local green technology innovation and has spatial spillover effects on neighboring cities. Furthermore, heterogeneity test results show that the spatial spillover effects differ by geographical region, economic development levels, ownership type (state-owned and non-state-owned enterprises), and degree of government intervention. Therefore, we suggest enhancing enterprises' technological innovation by providing policy support and prioritizing the development of carbon markets in regions with high economic development levels.

Technical efficiency of the urban gas industry in china.

China's Paris Agreement Pledge and recent introduction of an Emissions Trading Scheme have created a need for information on where it makes the most economic sense to use different sources of energy. With lower carbon dioxide emissions, natural gas and liquefied petroleum gas provide cleaner sources of energy relative to coal. Although it is practically crucial to investigate the use of these two sources, empirical studies are limited due to lack of data. To fill the research gap, this paper studies the efficiency of natural gas and liquefied petroleum gas sector in China by using data from 24 major province-level divisions over the years 2006-2015. Efficiency is defined as the utility's ability to produce the highest output given fixed inputs. We find that: (1) GDP per capita and high customer density are associated with higher levels of efficiency and (2) utilities that serve higher proportions of households (as opposed to industry and firms) are associated with lower levels of efficiency. Policy makers can use this information to address China's energy needs due to rapid urbanization while also pursuing Paris Agreement goals.

Estimation of disability free life expectancy in non small cell lung cancer based on real world data.

To quantify the societal impact of disability in patients with non-small cell lung cancer (NSCLC), this study estimated the disability-free life expectancy (DFLE), loss-of-DFLE and explored their associations with quality-adjusted life expectancy (QALE) and loss-of-QALE. We interlinked national databases and applied a rolling-over algorithm to estimate the lifetime survival function for patients with NSCLC. Using the EuroQOL-5 Dimension (EQ-5D) and Barthel index (BI), we repeatedly measured the quality-of-life and disability functions of NSCLC patients who visited our hospital from 2011 to 2020. Age-, sex-matched referents were simulated from lifetables of the same calendar year of diagnosis. We categorized BI scores ≤ 70 as in need of long-term care and constructed linear mixed models to estimate the utility values and disability scores. We collected 960 cases and 3088 measurements. The proportions of measurements without disability at age 50-64 and in stage I-IIIa, 50-64 and stage IIIb-IV, 65-89 and stage I-IIIa and 65-89 and stage IIIb-IV were 97.3%, 89.3%, 94.8%,78.3%, corresponding to DFLEs of 15.3, 2.4, 6.8, 1.2 years and losses-of-DFLE of 8.1, 20.7, 4.0, 8.6 years, respectively, indicating that advanced stage had a stronger effect than old age. Survivors in advanced stages showed increased demands for assistance in almost all subitems. The DFLEs seemed to be approximate to the QALEs and the latter were shorter than the former due to discomfort and depression. From a societal perspective, future health technology assessment should consider the impact of lifetime duration of functional disability. Early diagnosis of NSCLC may decrease the burden of long-term care.

Association of Marital/Partner Status with Hospital Readmission Among Young Adults With Acute Myocardial Infarction.

Introduction: Despite evidence supporting the benefits of marriage on cardiovascular health, the impact of marital/partner status on the long-term readmission of young acute myocardial infarction (AMI) survivors is less clear. We aimed to examine the association between marital/partner status and 1-year all-cause readmission, and explore sex differences, among young AMI survivors. Methods: Data were from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), which enrolled young adults aged 18-55 years with AMI (2008-2012). The primary end point was all-cause readmission within 1 year of hospital discharge, obtained from medical record, patient interviews, and adjudicated by a physician panel. We performed Cox proportional hazards models with sequential adjustment for demographic, socioeconomic, clinical and psychosocial factors. Sex-marital/partner status interaction was also tested. Results: Of the 2,979 adults with AMI (2002 women [67.2%]; mean age 48 [interquartile range, 44-52] years), unpartnered individuals were more likely to experience all-cause readmissions compared with married/partnered individuals within the first year after hospital discharge (34.6% versus 27.2%, hazard ratio [HR]=1.31; 95% confidence interval [CI], 1.15-1.49). The association attenuated but remained significant after adjustment for demographic and socioeconomic factors (adjusted HR, 1.16; 95%CI, 1.01-1.34), and was not significant after further adjusting for clinical factors and psychosocial factors (adjusted HR, 1.10; 95%CI, 0.94-1.28). Sex-marital/partner status interaction was not significant (p=0.69). Sensitivity analysis using data with multiple imputation, and restricting outcomes to cardiac readmission yielded comparable results. Conclusions: In a cohort of young adults aged 18-55 years, unpartnered status was associated with 1.3-fold increased risk of all-cause readmission within 1 year of AMI discharge. Further adjustment for demographic, socioeconomic, clinical and psychosocial factors attenuated the association, suggesting that these factors may explain disparities in readmission between married/partnered versus unpartnered young adults. Whereas young women experienced more readmission compared to similar-aged men, the association between marital/partner status and 1-year readmission did not vary by sex.

Brain MRI correlations with disease burden and biomarkers in Fabry disease.

OBJECTIVE: To quantitatively evaluate cerebral small vessel disease (CSVD) in brain magnetic resonance imaging (MRI) and its correlation with disease burden and markers in Fabry disease, a rare X-linked lysosomal storage disease. METHODS: We collected brain MRI data from seventy-one Chinese patients with Fabry disease. CSVD was evaluated using an age-related white matter change rating scale, Fazekas scale, enlarged perivascular spaces grading scale, lacunar infarction scale, Microbleed Anatomical Rating Scale, global cortical atrophy scale, and small-vessel disease score. Factors associated with MRI lesions, including sex, clinical subtype, disease severity, disease burden, genotype, and biomarkers, were also analyzed. RESULTS: Of 71 patients, 16 (22.5%) experienced ischemic stroke. The incidences of lacunar infarctions, white matter hyperintensities, and cerebral microbleeds were 55%, 62%, and 33%, respectively. The abnormal MRI group had later disease onset, longer disease duration, and a higher Mainz Severity Score Index (p < 0.05) than the normal MRI group. Patients with more severe clinical phenotypes also had higher CVSD-related scores. Sex and GLA mutational type were not closely associated with brain MRI lesions. Of the disease markers, the Mainz Severity Score Index and plasma globotriaosylsphingosine (Lyso-Gb3) were closely correlated with the majority of the MRI scores, whereas α-galactosidase A activity was not. CONCLUSION: Brain MRI revealed progressive lacunar infarctions, white matter hyperintensities, and decreased brain volume in patients with Fabry disease. Brain MRI lesions were closely related to onset-age; disease duration, severity, burden; and plasma Lyso-Gb3. However, they were not associated with sex, α-galactosidase A activity, or GLA mutation type.

Driving forces and relationship between air pollution and economic growth based on EKC hypothesis and STIRPAT model: evidence from Henan Province, China.

The aim of this research is to analyze the main influencing factors and relationship between atmospheric environment and economic society. Using the panel data of 18 cities in Henan Province from 2006 to 2020, this paper employed some advanced econometric estimation included entropy method, extended environmental Kuznets curve (EKC) and STIRPAT model to conduct empirical estimations. The results show that most regions in Henan Province have verified the existence of the EKC hypothesis; and the peak of air pollution level in all cities of Henan Province generally occurred in around 2014. Multiple linear Ridge regression indicated that the positive driving forces of air pollution in most cities in Henan Province are industrial structure and population size; the negative driving forces are urbanization level, technical level and greening degree. Finally, we used the grey GM (1, 1) model to predict the atmospheric environment of Henan Province in 2025, 2030, 2035 and 2040. What should pay close attention to is that air pollution levels in northeastern and central Henan Province will continue to remain high.

Can China achieve its 2030 and 2060 CO2 commitments? Scenario analysis based on the integration of LEAP model with LMDI decomposition.

China's ambitious targets of peaking its Carbon dioxide (CO2) emissions on or before 2030 and achieving carbon neutrality by 2060 have been a topic of discussion in the international community. This study innovatively combines the logarithmic mean Divisia index (LMDI) decomposition method and the long-range energy alternatives planning (LEAP) model to quantitatively evaluate the CO2 emissions from energy consumption in China from 2000 to 2060. Using the Shared Socioeconomic Pathways (SSPs) framework, the study designs five scenarios to explore the impact of different development pathways on energy consumption and related carbon emissions. The LEAP model scenarios are based on the result of LMDI decomposition, which identifies the key influencing factors on CO2 emissions. The empirical findings of this study demonstrate that the energy intensity effect is the primary factor of the 14.7 % reduction in CO2 emissions observed in China from 2000 to 2020. Conversely, the economic development level effect has been the driving factor behind the increase of 50.4 % in CO2 emissions. Additionally, the urbanization effect has contributed 24.7 % to the overall change in CO2 emissions during the same period. Furthermore, the study investigates potential future trajectories of CO2 emissions in China up to 2060, based on various scenarios. The results suggest that, under the SSP1 scenarios. China's CO2 emissions would peak in 2023 and achieve carbon neutrality by 2060. However, under the SSP4 scenarios, emissions are expected to peak in 2028, and China would need to eliminate approximately 2000 Mt of additional CO2 emissions to reach carbon neutrality. In other scenarios, China is projected to be unable to meet the carbon peak and carbon neutrality goals. The conclusions drawn from this study offer valuable insights for potential policy adjustments to ensure that China could fulfill its commitment to peak carbon emissions by 2030 and achieve carbon neutrality by 2060.

Cost-effectiveness analysis of sorafenib, lenvatinib, atezolizumab plus bevacizumab and sintilimab plus bevacizumab for the treatment of advanced hepatocellular carcinoma in China.

BACKGROUND AND OBJECTIVE: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide, especially in China. According to the 2021 Chinese Society of Clinical Oncology guidelines, sorafenib, lenvatinib, atezolizumab combined with bevacizumab, and sintilimab combined with bevacizumab are recommended as first-line treatment options for advanced HCC. This study provides a cost-effectiveness analysis of these treatments from the patient perspective. METHODS: A partitioned survival model was established using the TreeAge 2019 software to evaluate the cost-effectiveness. The model includes three states, namely progression-free survival, progressive disease, and death. Clinical data were derived from three randomized controlled studies involving patients with advanced HCC who received the following treatment: sorafenib and lenvatinib (NCT01761266); atezolizumab in combination with bevacizumab (NCT03434379); and sintilimab in combination with bevacizumab (NCT03794440). Cost and clinical preference data were obtained from the literature and interviews with clinicians. RESULTS: All compared with sorafenib therapy, lenvatinib had an incremental cost-effectiveness ratio (ICER) of US$188,625.25 per quality-adjusted life year (QALY) gained; sintilimab plus bevacizumab had an ICER of US$75,150.32 per QALY gained; and atezolizumab plus bevacizumab had an ICER of US$144,513.71 per QALY gained. The probabilistic sensitivity analysis indicated that treatment with sorafenib achieved a 100% probability of cost-effectiveness at a threshold of US$36,600/QALY. One-way sensitivity analysis revealed that the results were most sensitive to the medical insurance reimbursement ratio and drug prices. CONCLUSIONS: In this economic evaluation, therapy with lenvatinib, sintilimab plus bevacizumab, and atezolizumab plus bevacizumab generated incremental QALYs compared with sorafenib; however, these regimens were not cost-effective at a willingness-to-pay threshold of US$36,600 per QALY. Therefore, some patients may achieve preferred economic outcomes from these three therapies by tailoring the regimen based on individual patient factors.

The Impact of Land Use Structure Change on Utilization Performance in Henan Province, China.

Because of the trends in population growth and rapid industrialization and urbanization, the intensity and structure of land use are undergoing great changes. Henan Province is an important economic province and a major grain producing and energy consumption area, and its land use plays a key role in the sustainable development of the whole of China. This study takes Henan Province as the research object, selects panel statistical data from 2010 to 2020, and discusses the land use structure (LUS) in Henan Province in terms of three aspects: information entropy, analysis of land use dynamic change, and land type conversion matrix. Based on the indicator system "social economy (SE)-ecological environment (EE)-agricultural production (AP)-energy consumption (EC)", a land use performance (LUP) evaluation model was constructed to judge the performance of various land use types in Henan Province. Finally, the relational degree between LUS and LUP was calculated through the grey correlation. The results show that among the eight land use types in the study area since 2010, land used for water and water conservancy facilities increased by 4%. In addition, transport and garden land changed significantly, and was mainly converted from cultivated land (decreased by 6674 km2) and other land. From the perspective of LUP, the increase in ecological environment performance is the most obvious, while agriculture performance is lagging behind; it is worth paying attention to the energy consumption performance, which is decreasing year by year. There is an obvious correlation between LUS and LUP. LUS in Henan Province presents a gradually stable state, and the transformation of land types promotes LUP. Proposing an effective and convenient evaluation method to explore the relationship between LUS and LUP is very beneficial in helping stakeholders to actively focus more on optimizing land resource management and decision making for the coordinated and sustainable development among agricultural, socio-economic, eco-environmental, and energy systems.

Health equity considerations in pragmatic trials in Alzheimer's and dementia disease: Results from a methodological review.

Introduction: To improve dementia care delivery for persons across all backgrounds, it is imperative that health equity is integrated into pragmatic trials. Methods: We reviewed 62 pragmatic trials of people with dementia published 2014 to 2019. We assessed health equity in the objectives; design, conduct, analysis; and reporting using PROGRESS-Plus which stands for Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, and other factors such as age and disability. Results: Two (3.2%) trials incorporated equity considerations into their objectives; nine (14.5%) engaged with communities; 4 (6.5%) described steps to increase enrollment from equity-relevant groups. Almost all trials (59, 95.2%) assessed baseline balance for at least one PROGRESS-Plus characteristic, but only 10 (16.1%) presented subgroup analyses across such characteristics. Differential recruitment, attrition, implementation, adherence, and applicability across PROGRESS-Plus were seldom discussed. Discussion: Ongoing and future pragmatic trials should more rigorously integrate equity considerations in their design, conduct, and reporting. Highlights: Few pragmatic trials are explicitly designed to inform equity-relevant objectives.Few pragmatic trials take steps to increase enrollment from equity-relevant groups.Disaggregated results across equity-relevant groups are seldom reported.Adherence to existing tools (e.g., IMPACT Best Practices, CONSORT-Equity) is key.

Quantitative assessment of oculomotor function by videonystagmography in multiple system atrophy.

OBJECTIVE: To quantitatively assess oculomotor impairments in multiple system atrophy (MSA) and to explore their correlation with clinical characteristics. METHODS: We recruited 45 patients with MSA, including 21 with dominant ataxia (MSA-C), 24 with dominant parkinsonism (MSA-P), and 40 age-matched healthy controls. Detailed oculomotor performance in the horizontal direction was measured using videonystagmography (VNG). RESULTS: We found that the proportion of abnormal eye movements in patients with MSA was 93.3% (37.7%, 51.1%, 73.3%, 71.1%, and 37.8% on fixation and gaze-holding, without fixation, saccade, smooth pursuit, and optokinetic nystagmus tests, respectively). Patients with MSA-C showed significantly lower gains in smooth pursuit test and optokinetic nystagmus test, and a higher incidence of hypermetria in the saccade test than patients with MSA-P (all P < 0.05). No oculomotor deficits were correlated with age, age of onset, sex, disease duration, or Unified Multiple System Atrophy Rating Scale (USMARS) (all r < 0.25, P > 0.1). CONCLUSIONS: An extremely high incidence of oculomotor impairments could be observed using VNG in both the MSA-C and MSA-P subtypes, although there were some differences between them. SIGNIFICANCE: A comprehensive oculomotor examination could serve as a valuable tool in the diagnostic workup of patients with MSA.

Assessment of the antimicrobial effects of sodium hypochlorite on Enterococcus faecalis by D2O-labeled single-cell Raman micro-spectroscopy.

OBJECTIVES: To systematically evaluate the feasibility of D2O-labeled single-cell Raman micro-spectroscopy in drug resistance research and test the susceptibility of Enterococcus faecalis (E. faecalis)to sodium hypochlorite. METHODS: 1) The growth of E. faecalis in different doses of D2O and the regularity of D2O intake were evaluated through absorbance measurement and D2O-labeled single-cell Raman micro-spectroscopy to examine the universality of D2O-labeled single-cell Raman micro-spectroscopy in bacterial resistance research. 2) Broth dilution method and absorbance measurement were performed to determine the minimum inhibitory concentration (MIC) of NaClO against E. faecalis and the MIC based on metabolic activity (MIC-MA) in vitro via D2O-labeled single-cell raman micro-spectroscopy. RESULTS: 1) The growth of E. faecalis was not significantly inhibited by ≤40% D2O in the medium. E. faecalis could actively metabolize D2O and exhibit a C-D ratio in specific areas of Raman micro-spectroscopy results. The C-D ratio of E. faecalis at the stationary phase was positively correlated with D2O concentration. 2) The MIC and MIC-MA of NaClO against E. faecalis were 0.45 and 0.9 g·L-1, respectively. The concentration of MIC-MA was twice that of MIC. CONCLUSIONS: D2O-labeled single-cell Raman micro-spectroscopy is important in screening antimicrobial agents and evaluating the efficacy of antimicrobial agents. It is suitable for evaluating the effect of drugs on bacterial metabolic activities. NaClO showed an effective antimicrobial activity against E. faecalis. E. faecalis ceased propagation yet remained highly metabolically active when it was exposed to NaClO at the MIC level. The metabolic activity of most cells was inhibited only when they were exposed to NaClO at the MIC-MA level.