[Spatial-temporal Evolution and Driving Factors Analysis of Ecological Environment Quality in Daihai Basin based on AWRSEI].

Watersheds are an important ecological security barrier and social and economic development area. In order to evaluate the ecological environment quality of arid and semi-arid watersheds more objectively and accurately, based on the remote sensing ecological index (RSEI), the salinity index was introduced to construct a remote sensing ecological index (AWRSEI) suitable for arid and semi-arid watersheds, and the Daihai watershed was taken as an example to analyze its applicability. Based on the AWRSEI model, four phases of Landsat TM/OLI composite images were used to quantitatively evaluate the ecological and environmental quality of the Daihai Basin from 2001 to 2020. The spatio-temporal evolution of the ecological and environmental quality of the Daihai Basin was analyzed using the coefficient of variation and spatial autocorrelation, and the cause analysis and driving factor explanation power analysis were carried out using geographic detectors. The results showed that:① the average correlation coefficient between AWRSEI and various ecological factors was 0.860, which was more representative than that of a single index component. The load positive and negative values and ranking of the first principal component were consistent with those of RSEI, the contribution rate of eigenvalues was 3.69% higher than those of RSEI, and the evaluation results were closer to the real surface conditions, which is suitable for the ecological environment quality assessment of arid watersheds. ② The annual average of the AWRSEI index in the Daihai Basin from 2001 to 2020 was 0.427, which indicated a poor ecological environment quality basis. During the study period, the average of AWRSEI showed a fluctuating trend and reached the highest value of 0.502 in 2020. The overall ecological environment quality improved significantly, the deterioration area decreased by 20.51%, and the improvement area increased by 12.71%. In terms of spatial distribution, the ecological environment quality of forest land in the southern and northwestern high-altitude areas of the Daihai Basin was good, whereas that in the northern and southern mid-altitude areas was poor, and that in the northern area was better than that in the southern area. ③ The average variation coefficient of AWRSEI in the Daihai Basin was 0.280, the ecological environment quality was stable, and the overall change fluctuation was small; the high fluctuation was mainly concentrated in the southern part of the lake and the residential area. There was a significant spatial autocorrelation in the ecological environment quality of the Daihai Basin, and the high-high agglomeration area was mainly distributed in the forest area at high altitude and the cultivated land area at low altitude. Low-low concentration areas were scattered in the middle altitude area. ④ The improvement of the ecological environment in Daihai Basin from 2001 to 2020 was mainly due to the increase in NDVI and the decrease in NDBSI and NDSI. NDVI and NDBSI were the combination with the strongest interaction and the strongest interpretation of the ecological environment. Land use was the dominant factor of AWRSEI and had the strongest explanatory power. The combination of land use and meteorological factors was the strongest interaction, and the relationship between each driving factor was enhanced.

Enhanced performance of EEG-based brain-computer interfaces by joint sample and feature importance assessment.

Electroencephalograph (EEG) has been a reliable data source for building brain-computer interface (BCI) systems; however, it is not reasonable to use the feature vector extracted from multiple EEG channels and frequency bands to perform recognition directly due to the two deficiencies. One is that EEG data is weak and non-stationary, which easily causes different EEG samples to have different quality. The other is that different feature dimensions corresponding to different brain regions and frequency bands have different correlations to a certain mental task, which is not sufficiently investigated. To this end, a Joint Sample and Feature importance Assessment (JSFA) model was proposed to simultaneously explore the different impacts of EEG samples and features in mental state recognition, in which the former is based on the self-paced learning technique while the latter is completed by the feature self-weighting technique. The efficacy of JSFA is extensively evaluated on two EEG data sets, i.e., SEED-IV and SEED-VIG. One is a classification task for emotion recognition and the other is a regression task for driving fatigue detection. Experimental results demonstrate that JSFA can effectively identify the importance of different EEG samples and features, leading to enhanced recognition performance of corresponding BCI systems.

The effect of internal salary incentives based on insurance payment on physicians' behavior: experimental evidence.

BACKGROUND: Understanding how physicians respond to payment methods is crucial for designing effective incentives and enhancing the insurance system. Previous theoretical research has explored the effects of payment methods on physician behavior based on a two-level incentive path; however, empirical evidence to validate these theoretical frameworks is lacking. To address this research gap, we conducted a laboratory experiment to investigate physicians' behavioral responses to three types of internal salary incentives based on diagnosis-related-group (DRG) and fee-for-service (FFS). METHODS: A total of 150 medical students from Capital Medical University were recruited as participants. These subjects played the role of physicians in choosing the quantity of medical services for nine types of patients under three types of salary incentives-fixed wage, constant fixed wage with variable performance wage, and variable fixed wage with variable performance wage, of which performance wage referred to the payment method balance under FFS or DRG. We collected data on the quantities of medical services provided by the participants and analyzed the results using the Friedman test and the fixed effects model. RESULTS: The results showed that a fixed wage level did not have a significant impact on physicians' behavior. However, the patients benefited more under the fixed wage compared to other salary incentives. In the case of a floating wage system, which consisted of a constant fixed wage and a variable performance wage from the payment method balance, an increase in performance wage led to a decrease in physicians' service provision under DRG but an increase under FFS. Consequently, this resulted in a decrease in patient benefit. When the salary level remained constant, but the composition of the salary varied, physicians' behavior changed slightly under FFS but not significantly under DRG. Additionally, patient benefits decreased as the ratio of performance wages increased under FFS. CONCLUSIONS: While using payment method balance as physicians' salary may be effective in transferring incentives of payment methods to physicians through internal compensation frameworks, it should be used with caution, particularly when the measurement standard of care is imperfect.

The impact of city financial ecology on firm financing efficiency: Evidence from China's strategic emerging industries.

Based on the concept of bionics and the connotation of city financial ecology, this study constructs a 3-level and 27-indicator evaluation index system, including financial ecology growth, soil, and air. This study uses the entropy-TOPSIS model to weigh indicators objectively and evaluate the financial ecology of 343 China's prefecture-level cities during 2009-2016. This study uses the DEA-Tobit method to assess the financing efficiency of 4013 China's strategic emerging listed firms during 2010-2017 and runs random-effect Tobit panel regressions. Regression results suggest that a city's financial ecology overall has a positive effect on strategic emerging firms' financing efficiency. Therefore, the government should: improve the multi-tiered financial market system and encourage financial innovation; transform the economic growth model and optimize the industrial structure; establish an information-sharing mechanism and construct a social credit system.

Technical guidelines for risk assessment of heavy metals in traditional Chinese medicines.

BACKGROUND: Heavy metals are considered a global concern because they can deteriorate human health. This guideline aims to scientifically evaluate health risk of heavy metals in TCM and to propose a reference for decision making in developing TCM-related health policies. METHODS: Using a multidisciplinary approach, a steering committee oversaw the development of the guideline. To obtain a reasonable and accurate risk assessment, key exposure assessment parameters for TCM, e.g., exposure frequency (EF), exposure duration (ED), and daily ingestion rate (IR) were obtained from surveys. In addition, transfer rates for heavy metals from Chinese medicinal materials (CMM) to decoctions or preparations were examined. RESULTS: Based on the scientific theory of risk control, the guideline was designed systematically, and principles and procedures for the risk assessment of heavy metals in TCM were identified. The guideline can be utilized to assess the risk of heavy metals in CMM and Chinese patent medicines (CPM). CONCLUSION: This guideline may help standardize the risk assessment of heavy metals in TCM, advance regulatory standards for heavy metals in TCM, and ultimately improve human health through scientific TCM usage in clinic.

Efficacy and safety of Lianhua Qingwen capsules combined with standard of care in the treatment of adult patients with mild to moderate COVID-19 (FLOSAN): protocol for a randomized, double-blind, international multicenter clinical trial.

Background: Effective anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) drugs are not only the next defense after vaccines but also the key part of establishing a multi-tiered coronavirus disease 2019 (COVID-19) prevention and control system. Previous studies had indicated that Lianhua Qingwen (LHQW) capsules could be an efficacious Chinese patent drug for treating mild to moderate COVID-19. However, pharmacoeconomic evaluations are lacking, and few trials have been conducted in other countries or regions to evaluate the efficacy and safety of LHQW treatment. So, this study aims to explore the clinical efficacy, safety, and economy of LHQW for treating adult patients with mild to moderate COVID-19. Methods: This is a randomized, double-blind, placebo-controlled, international multicenter clinical trial protocol. A total of 860 eligible subjects are randomized at a 1:1 ratio into the LHQW or placebo group to receive two-week treatment and follow-up visits on days 0, 3, 7, 10, and 14. Clinical symptoms, patient compliance, adverse effects, cost scale, and other indicators are recorded. The primary outcomes will be the measured median time to sustained improvement or resolution of the nine major symptoms during the 14-day observation period. Secondary outcomes regarding clinical efficacy will be evaluated in detail on the basis of clinical symptoms (especially body temperature, gastrointestinal symptoms, smell loss, and taste loss), viral nucleic acid, imaging (CT/chest X-ray), the incidence of severe/critical illness, mortality, and inflammatory factors. Moreover, we will assess health care cost, health utility, and incremental cost-effectiveness ratio (ICER) for economic evaluation. Discussion: This is the first international multicenter randomized controlled trial (RCT) of Chinese patent medicine for the treatment of early COVID-19 in accordance with WHO guidelines on COVID-19 management. This study will help clarify the potential efficacy and cost-effectiveness of LHQW in the treatment of mild to moderate COVID-19, facilitating decision-making by healthcare workers. Registration: This study is registered at the Chinese Clinical Trial Registry, with registration number: ChiCTR2200056727 (date of first registration: 11/02/2022).

Political uncertainty and high-quality economic development: Evidence from China.

We manually collated data on the turnover of party secretaries and mayors in 285 Chinese cities from 2003 to 2016 and calculated the quality of city economic development represented by environmental total factor productivity growth. We find that the political uncertainty caused by official turnover could significantly promote the improvement of the quality of economic development, and this positive can explained by the progress of production technology and government intervention. Moreover, the political uncertainty caused by the turnover of more educated officials, those with local hukou, promoted officials, and experienced officials could better promote high-quality economic development.

Risk factor analysis and clinical decision tree model construction for diabetic retinopathy in Western China.

BACKGROUND: Diabetic retinopathy (DR) is the driving force of blindness in patients with type 2 diabetes mellitus (T2DM). DR has a high prevalence and lacks effective therapeutic strategies, underscoring the need for early prevention and treatment. Yunnan province, located in the southwest plateau of China, has a high pre-valence of DR and an underdeveloped economy. AIM: To build a clinical prediction model that will enable early prevention and treatment of DR. METHODS: In this cross-sectional study, 1654 Han population with T2DM were divided into groups without (n = 826) and with DR (n = 828) based on fundus photography. The DR group was further subdivided into non-proliferative DR (n = 403) and proliferative DR (n = 425) groups. A univariate analysis and logistic regression analysis were conducted and a clinical decision tree model was constructed. RESULTS: Diabetes duration ≥ 10 years, female sex, standing- or supine systolic blood pressure (SBP) ≥ 140 mmHg, and cholesterol ≥ 6.22 mmol/L were risk factors for DR in logistic regression analysis (odds ratio = 2.118, 1.520, 1.417, 1.881, and 1.591, respectively). A greater severity of chronic kidney disease (CKD) or hemoglobin A 1c increased the risk of DR in patients with T2DM. In the decision tree model, diabetes duration was the primary risk factor affecting the occurrence of DR in patients with T2DM, followed by CKD stage, supine SBP, standing SBP, and body mass index (BMI). DR classification outcomes were obtained by evaluating standing SBP or BMI according to the CKD stage for diabetes duration < 10 years and by evaluating CKD stage according to the supine SBP for diabetes duration ≥ 10 years. CONCLUSION: Based on the simple and intuitive decision tree model constructed in this study, DR classification outcomes were easily obtained by evaluating diabetes duration, CKD stage, supine or standing SBP, and BMI.

A Study on the Willingness of Industrial Ecological Transformation from China's Zero Waste Cities Perspective.

Based on the practice of a circular economy, China officially put forward the goal of building a "Zero Waste City" in 2018 and has formulated a series of measures to promote energy savings and emissions reduction in various sectors among which industry has received key attention due to its long-term high energy consumption and high pollution. The growth of an urban economy cannot be supported by industry, but the high energy consumption and high pollution of industry have become the keys to urban environmental management, and the need for ecological transformation of industry is very urgent. Based on the construction background of zero waste cities in China, this study analyzes the transformation factors of industrial producers' willingness to make ecological transformation. The factors that influence industrial producers to make ecological transformation are perception of participation, perception of cost, perception of identity, and perception of government intervention. These factors have a positive moderating effect on the adoption of transformation strategies by industrial producers among which the perception of government involvement also plays a mediating role and has an important influence on the promotion of active ecological transformation by industrial producers.

Effects of fee-for-service, diagnosis-related-group, and mixed payment systems on physicians' medical service behavior: experimental evidence.

BACKGROUND: Healthcare reforms in many countries have shown a movement from pure payment systems to mixed payment systems. However, there remains an insufficient understanding of how to design better mixed payment systems and how such systems, especially Diagnosis-Related-Group (DRG)-based systems, benefit patients. We therefore designed a controlled laboratory experiment to investigate the effects of fee-for-service (FFS), DRG, and mixed payment systems on physicians' service provision. METHODS: A total of 210 medical students were recruited from Capital Medical University as subjects. They, in the role of physicians, were randomly divided into seven groups and chose the quantity of medical services for different patient types under pure FFS, pure DRG, or mixed payment schemes that included two FFS-based mixed payment schemes and three DRG-based mixed payment schemes. There were five rounds of each group of experiments, and each subject made 18 decisions per round. The quantity of medical services provided by subjects were collected. And relevant statistics were computed and analyzed by nonparametric tests and random effects model. RESULTS: The results showed that the physicians' overprovision (underprovision) of services under FFS (DRG) schemes decreased under mixed payment schemes, resulting in higher benefit to patients under mixed payment schemes. Patients' health conditions also affected physicians' behavior but in different directions. Higher disease severity was associated with higher deviation of physicians' quantity choices from the optimal quantity under DRG and DRG-based mixed payment schemes, while the opposite was found for FFS and FFS-based mixed payment schemes. CONCLUSIONS: Mixed payment systems are a better way to balance physicians' profit and patients' benefit. The design of mixed payment systems should be adjusted according to the patient's health conditions. When patients are in lower disease severity and resource consumption is relatively small, prospective payments or mixed systems based on prospective payments are more suitable. While for patients in higher disease severity, retrospective payments or mixed systems based predominantly on retrospective payments are better.

Reliability assessment of the upper urinary tract dilation grading system based on magnetic resonance urography in patients with neurogenic bladder.

BACKGROUND: To assess the inter-observer and intra-observer reliability of the magnetic resonance urography (MRU)-upper urinary tract dilation (UUTD) grading system. METHODS: A total of 40 patients with a diagnosis of NB were enrolled in this study. The images were assembled in an electronic presentation randomly. The presentations were reviewed and graded by 4 junior and 4 senior urologists. One week later, the images were randomized again and reassessed. The inter-observer reliability was estimated by Kendall's coefficient of concordance and intra-class correlation coefficient (ICC), and the intra-observer reliability was estimated by weighted Cohen's kappa. RESULTS: The inter-observer reliability strength was excellent for all urologists, with the ICC value of 0.939 (0.908-0.963) and Kendall's W value of 0.967. The highest agreement was shown in Grade 4 at 92.50%, and the lowest in Grade 2 at 82.14%. All disagreements were within one grade of difference. Moreover, the Intra-observer reliability was excellent, with the weighted kappa value ranging from 0.904 to 0.954. CONCLUSIONS: The inter-observer and intra-observer reliability of this novel MRU-UUTD grading system is confirmed, providing adequate evidence for broader clinical application.

Impact of detector selection on commissioning of Leipzig surface applicators with improving immobilization in high-dose-rate brachytherapy.

PURPOSE: Commission and treatment setup of Leipzig surface applicators, because of the steep dose gradient and lack of robust immobilization, is challenging. We aim to improve commissioning reliability by investigating the impact of detector choice on percentage depth dose (PDD) verifications, and to enhance accuracy and reproducibility in calibration/treatment setup through a simple and novel immobilization device. METHODS AND MATERIALS: PDD distributions were measured with radiochromic films, optically stimulated luminescent dosimeters (OSLDs), a diode detector, and both cylindrical and parallel plate ionization chambers. The films were aligned to the applicators in parallel and transverse orientations. PDD data from a benchmarking Monte Carlo (MC) study were compared with the measured results, where surface doses were acquired from extrapolation. To improve setup accuracy and reproducibility, a custom-designed immobilization prototype device was made with cost-effective materials using a 3D printer. RESULTS: The measured PDD data with different detectors had an overall good agreement (<±10%). The parallel plate ionization chamber reported unreliable doses for the smallest applicator. There was no remarkable dose difference between the two film setups. The two-in-one prototype device provided a rigid immobilization and a flexible positioning of the applicator. It enhanced accuracy and reproducibility in calibration and treatment setup. CONCLUSION: We recommend using radiochromic films in the transverse orientation for a reliable and efficient PDD verification. The applicator's clinical applicability has been limited by a lack of robust immobilization. We expect this economical, easy-to-use prototype device can promote the use of Leipzig applicators in surface brachytherapy.

Several explorations on how to construct an early warning system for local government debt risk in China.

This paper aims to explore several ways to construct a scientific and comprehensive early warning system (EWS) for local government debt risk in China. In order to achieve this goal, this paper studies the local government debt risk from multiple perspectives, i.e., individual risk, contagion risk, static risk and dynamic risk. Firstly, taking China's 30 provinces over the period of 2010~ 2018 as a sample, this paper establishes early warning indicators for individual risk of local government debt, and uses the network model to establish early warning indicators for contagion risk of local government debt. Then, this paper applies the criteria importance though intercrieria correlation (CRITIC) method and coefficient of variation method to obtain the proxy variable Ⅰ, which combines the above two risks. Secondly, based on the proxy variable Ⅰ, both the Markov-switching autoregressive (MS-AR) model and coefficient of variation method are used to obtain the proxy variable Ⅱ, which comprehensively considers the individual risk, contagion risk, static risk and dynamic risk of local government debt. Finally, machine learning algorithms are adopted to generalize the EWS designed in this paper. The results show that: (1) From different perspectives of local government debt risk, the list of provinces that require early warning is different; (2) The support vector machines can well generalize our EWS.

[Pollution and Potential Ecological Risk Assessment of Heavy Metals in Surface Sediments of Tangxun Lake].

In order to understand the pollution characteristics, spatial distribution, potential sources, and ecological risk of heavy metals in the sediments of Tangxun Lake, the contents of heavy metals (As, Hg, Cd, Cr, Cu, Pb, Zn, and Ni) in the surface sediments of Tangxun Lake were analyzed, and the pollution status and potential ecological risk degree of heavy metals in the sediments were evaluated using the geo-accumulation index and potential ecological risk index. The potential sources of heavy metal pollutants were analyzed by correlation and principal component analysis. The results showed that except for Cr, the contents of other heavy metals were higher than their background values. The contents of Hg, Cd, Zn, and Cu were higher in the southwest and northeast corners of the lake, which may come from the combined pollution of sewage discharge, fisheries, and surrounding industrial and agricultural activities. The geo-accumulation index and potential ecological risk showed that Hg and Cd were in moderate pollution; Cu, Pb, and Zn were in non-light pollution; and As, Cr, and Ni were in non-pollution. Except for Hg and Cd, there were serious and serious potential ecological risks, and the other elements were at a low risk level. The heavy metals in the surface sediments of Tangxun Lake showed a high ecological risk level.

Age-specific disparity in life loss per death attributable to ambient temperature: A nationwide time-series study in China.

Age-specific discrepancy of mortality burden attributed to temperature, measured as years of life lost (YLL), has been rarely investigated. We investigated age-specific temperature-YLL rates (per 100,000) relationships and quantified YLL per death caused by non-optimal temperature in China. We collected daily meteorological data, population data and daily death counts from 364 locations in China during 2006-2017. YLL was divided into three age groups (0-64 years, 65-74 years, and ≥75 years). A distributed lag non-linear model was first employed to estimate the associations of temperature with age-specific YLL rates in each location. Then we pooled the associations using a multivariate meta-analysis. Finally, we calculated age-specific average YLL per death caused by temperature by cause of death and region. We observed greater effects of cold and hot temperature on YLL rates for the elderly compared with the young population by region or cause of death. However, YLL per death due to non-optimal temperature for different regions or causes of death decreased with age, with 2.0 (95 % CI:1.5, 2.5), 1.2 (1.1, 1.4) and 1.0 years (0.9, 1.2) life loss per death for populations aged 0-64 years, 65-74 years and over 75 years, respectively. Most life loss per death results from moderate temperature, especially moderate cold for all age groups. The effect of non-optimal temperature on YLL rates is smaller for younger populations than older ones, while the temperature-related life loss per death was more prominent for younger populations.

Urban-rural disparity of the short-term association of PM2.5 with mortality and its attributable burden.

Although studies have investigated the associations between PM2.5 and mortality risk, evidence from rural areas is scarce. We aimed to compare the PM2.5-mortality associations between urban cities and rural areas in China. Daily mortality and air pollution data were collected from 215 locations during 2014-2017 in China. A two-stage approach was employed to estimate the location-specific and combined cumulative associations between short-term exposure to PM2.5 (lag 0-3 days) and mortality risks. The excess risks (ER) of all-cause, respiratory disease (RESP), cardiovascular disease (CVD), and cerebrovascular disease (CED) mortality for each 10 µg/m3 increment in PM2.5 across all locations were 0.54% (95% confidence interval [CI]: 0.38%, 0.70%), 0.51% (0.10%, 0.93%), 0.74% (0.50%, 0.97%), and 0.52% (0.20%, 0.83%), respectively. Slightly stronger associations for CVD (0.80% versus 0.60%) and CED (0.61% versus 0.26%) mortality were observed in urban cities than in rural areas, and slightly greater associations for RESP mortality (0.51% versus 0.43%) were found in rural areas than in urban cities. A mean of 2.11% (attributable fraction [AF], 95% CI: 1.48%, 2.76%) of all-cause mortality was attributable to PM2.5 exposure in China, with a larger AF in urban cities (2.89% [2.12%, 3.67%]) than in rural areas (0.61% [-0.60%, 1.84%]). Disparities in PM2.5-mortality associations between urban cities and rural areas were also found in some subgroups classified by sex and age. This study provided robust evidence on the associations of PM2.5 with mortality risks in China and demonstrated urban-rural disparities of PM2.5-mortality associations for various causes of death.

[Characteristics and Health Risk Assessment of Heavy Metals in PM2.5 Under Winter Haze Conditions in Central China: A Case Study of Huanggang, Hubei Province].

To explore the pollution characteristics and potential health risks of heavy metals in PM2.5 on haze days in Central China, PM2.5 samples were collected from the Huanggang monitoring station, a regional observation point in Central China, between January 13 and 24, 2018. The contents of Cr, Mn, Co, Ni, Cu, Zn, As, Cd, Sn, and Pb in PM2.5 were analyzed by inductively coupled plasma mass spectrometry(ICP-MS), and the enrichment factor method was used to determine the potential risk based on the exposure model recommended by the Environmental Protection Administration(EPA). The results showed that during the observation period, the concentrations of Zn in PM2.5 were highest, and the concentrations of the carcinogens As and Cd were higher than the secondary standard limits of China's ambient air quality standard(GB 3095-2012), with 70% of these elemental concentrations accounting for the largest proportion in the middle haze period. The enrichment factor analysis showed that Cd, Sn, Co, Pb, and Zn were the most abundant elements, especially during the middle haze period, and were mostly derived from transportation and coal combustion. The results of the human health risk assessment showed that exposure via hand-mouth feeding was the main non-carcinogenic risk, and the exposure and non-carcinogenic risks of children were significantly higher than those of adults. Pb poses a non-carcinogenic risk to children, while heavy metals in PM2.5 pose no non-carcinogenic risks to adults and carcinogenic heavy metals pose no carcinogenic risks.

Parental Self-Efficacy and Behavioral Problems in Children with Autism During COVID-19: A Moderated Mediation Model of Parenting Stress and Perceived Social Support.

PURPOSE: COVID-19 pandemic has been verified as a public health emergency of international concern. During the special period, the health of vulnerable groups, such as children with autism, should be concerned. Some studies have been carried out to investigate the behavioral problems of children with autism during the COVID-19, but underlying mechanisms behind it is not clear. This study examines the role of parenting stress as a mediator in the relationship between parental self-efficacy and behavioral problems in Chinese children as well as the role of perceived social support as a moderator for this mediation effect. METHODS: A total of 439 parents of children with autism (mean age=40.17, SD=5.26) were surveyed and completed five questionnaires (Conners Parent Symptom Questionnaire, Parental Self-Efficacy Questionnaire, Parenting Stress Index-Short Form 15, Perceived Social Support Questionnaire, and Neuroticism Extraversion Openness Five Factor Inventory). The statistical analyses were conducted by SPSS 26.0 and SPSS PROCESS macro. RESULTS: Controlling for neuroticism, which is highly associated with psychological changes in parents, the study found that parental self-efficacy was significantly and negatively correlated with behavioral problems in children with autism. In addition, the relationship between parental self-efficacy and behavioral problems was mediated by parenting stress. Furthermore, parenting stress moderated the indirect relationship between parental self-efficacy and behavioral problems via perceived social support. CONCLUSION: These results provide direct evidences for the inextricable relationship between family, social factors and behavioral problems of children with autism. It suggest that improving perceived social support to enhance parental self-efficacy is critical to buffering against parenting stress and stabilizing children with autism during the COVID-19 pandemic.

The impact of carbon market pilots on air pollution: evidence from China.

As China's economic development enters a transitional stage, the government has put forward higher requirements for efficient air pollution control. Different from the traditional environmental regulation methods, China's carbon market pilots (CMP) can use market mechanism to achieve carbon emission reduction policy goals while also providing more efficient control methods for air pollution. Using the unique daily air pollution data of 324 prefecture-level and above cities in China from December 1, 2013, to December 18, 2017, and matching them with the daily data of carbon allowance trading in each CMP, we employ the time-varying difference-in-differences (DID) method to explore the casual relationship between CMP and air pollution, and its influence mechanism. Our results show that (1) the establishment of CMP can reduce air pollution by at least 4.9%, especially on sulfur dioxide, inhalable particulate matter, fine particles, and carbon monoxide. This conclusion is still robust after we use the instrumental variable (IV) method to deal with endogeneity. (2) Mechanism analysis shows that the reducing effect of CMP on air pollution is achieved mainly through three channels, including energy consumption reducing, technological progressing, and industrial structure upgrading. (3) Since CMP have just been established, government regulation plays a stronger role than the market mechanism in the process of CMP affecting air pollution. However, with the continuous improvement of CMP, the market mechanism has also played an increasingly important dynamic effect.

Heritability Estimation and Environmental Risk Assessment for Type 2 Diabetes Mellitus in a Rural Region in Henan, China: Family-Based and Case-Control Studies.

Objective: The prevalence of type 2 diabetes mellitus (T2DM) varies greatly in different regions and populations. This study aims to assess the heritability and environmental risk factors of T2DM among rural Chinese adults. Methods: Thousand five hundred thirty three participants from 499 extended families, which included 24 nuclear families, were recruited in the family-based study to assess the heritable risk of T2DM. Heritability of T2DM was estimated by the Falconer method. Using conditional logistic regression model, couple case-control study involving 127 couples were applied to assess the environmental risk factors of T2DM. Results: Compared with the Henan Rural Cohort, T2DM was significantly clustered in the nuclear families (OR: 8.389, 95% CI: 5.537-12.711, P < 0.001) and heritability was 0.74. No association between the heredity of T2DM and sex was observed between the extended families and the Henan Rural Cohort. Besides, results from the couple case-control study showed that physical activity (OR: 0.482, 95% CI: 0.261-0.893, P = 0.020) and fat intake (OR: 3.036, 95% CI: 1.070-8.610, P = 0.037) was associated with T2DM, and the proportion of offspring engaged in medium and high physical activity was higher than that of mothers in mother-offspring pairs. Conclusion: People with a family history of T2DM may have a higher risk of developing T2DM, however, there was no difference in genetic risk between males and females. Adherence to active physical activity and low fat intake can reduce the risk of T2DM.