Digital economy: an effective path for promoting residents' health in China.

The primary prerequisite for socioeconomic growth is good health, hence promoting residents' health is a vital objective of public policies. It is yet up for debate whether or not the digital economy (DE), which will be crucial to future economic growth, will eventually result in improvements in residents' health. Utilizing the China Family Panel Studies (CFPS) data in 2020, we explore how the DE affects residents' health. The findings reveal that residents' health is greatly enhanced by the DE. The eastern region sees a more dramatic improvement in residents' health as a result of the DE. Additionally, the DE can improve residents' health through the promotion of regional green development. The study's findings add to our knowledge of how the DE impacts residents' health while also offering recommendations for achieving universal health.

Fuel source shift or cost reduction: Context-dependent adaptation strategies in closely related Neodon fuscus and Lasiopodomys brandtii against hypoxia.

Oxygen is essential for most life forms. Insufficient oxygen supply can disrupt homeostasis and compromise survival, and hypoxia-induced cardiovascular failure is fatal in many animals, including humans. However, certain species have adapted and evolved to cope with hypoxic environments and are therefore good models for studying the regulatory mechanisms underlying responses to hypoxia. Here, we explored the physiological and molecular responses of the cardiovascular system in two closely related hypoxia-adapted species with different life histories, namely, Qinghai voles ( Neodon fuscus) and Brandt's voles ( Lasiopodomys brandtii), under hypoxic (10% O 2 for 48 h) and normoxic (20.9% O 2 for 48 h) exposure. Kunming mice ( Mus musculus) were used for comparison. Qinghai voles live in plateau areas under hypoxic conditions, whereas Brandt's voles only experience periodic hypoxia. Histological and hematological analyses indicated a strong tolerance to hypoxia in both species, but significant cardiac tissue damage and increased blood circulation resistance in mice exposed to hypoxia. Comparative transcriptome analysis revealed enhanced oxygen transport efficiency as a coping mechanism against hypoxia in both N. fuscus and L. brandtii, but with some differences. Specifically, N. fuscus showed up-regulated expression of genes related to accelerated cardiac contraction and angiogenesis, whereas L. brandtii showed significant up-regulation of erythropoiesis-related genes. Synchronized up-regulation of hemoglobin synthesis-related genes was observed in both species. In addition, differences in cardiometabolic strategies against hypoxia were observed in the rodents. Notably, M. musculus relied on adenosine triphosphate (ATP) generation via fatty acid oxidation, whereas N. fuscus shifted energy production to glucose oxidation under hypoxic conditions and L. brandtii employed a conservative strategy involving down-regulation of fatty acid and glucose oxidation and a bradycardia phenotype. In conclusion, the cardiovascular systems of N. fuscus and L. brandtii have evolved different adaptation strategies to enhance oxygen transport capacity and conserve energy under hypoxia. Our findings suggest that the coping mechanisms underlying hypoxia tolerance in these closely related species are context dependent.

Cost-effectiveness of artificial intelligence screening for diabetic retinopathy in rural China.

BACKGROUND: Diabetic retinopathy (DR) has become a leading cause of global blindness as a microvascular complication of diabetes. Regular screening of diabetic retinopathy is strongly recommended for people with diabetes so that timely treatment can be provided to reduce the incidence of visual impairment. However, DR screening is not well carried out due to lack of eye care facilities, especially in the rural areas of China. Artificial intelligence (AI) based DR screening has emerged as a novel strategy and show promising diagnostic performance in sensitivity and specificity, relieving the pressure of the shortage of facilities and ophthalmologists because of its quick and accurate diagnosis. In this study, we estimated the cost-effectiveness of AI screening for DR in rural China based on Markov model, providing evidence for extending use of AI screening for DR. METHODS: We estimated the cost-effectiveness of AI screening and compared it with ophthalmologist screening in which fundus images are evaluated by ophthalmologists. We developed a Markov model-based hybrid decision tree to analyze the costs, effectiveness and incremental cost-effectiveness ratio (ICER) of AI screening strategies relative to no screening strategies and ophthalmologist screening strategies (dominated) over 35 years (mean life expectancy of diabetes patients in rural China). The analysis was conducted from the health system perspective (included direct medical costs) and societal perspective (included medical and nonmedical costs). Effectiveness was analyzed with quality-adjusted life years (QALYs). The robustness of results was estimated by performing one-way sensitivity analysis and probabilistic analysis. RESULTS: From the health system perspective, AI screening and ophthalmologist screening had incremental costs of $180.19 and $215.05 but more quality-adjusted life years (QALYs) compared with no screening. AI screening had an ICER of $1,107.63. From the societal perspective which considers all direct and indirect costs, AI screening had an ICER of $10,347.12 compared with no screening, below the cost-effective threshold (1-3 times per capita GDP of Chinese in 2019). CONCLUSIONS: Our analysis demonstrates that AI-based screening is more cost-effective compared with conventional ophthalmologist screening and holds great promise to be an alternative approach for DR screening in the rural area of China.

Influence of Commercial Insurance Purchase on the Health Status of Chinese Residents.

Under the context of rapid economic and social development, and growing demands for a better life, Chinese residents have been increasingly concerned with their health status and issues. In this study, the internal relations between the purchase of commercial insurance by residents and their health status are analyzed and studied with a polytomous logit model based on the data of Chinese General Social Survey (CGSS) in 2015. According to the research result, purchase of commercial insurance significantly improved the health status of residents, with an improving effect for rural residents apparently better than that among urban residents. In addition, purchase of commercial insurance can promote the health status of residents by increasing their household income. This research will provide an effective reference for the innovative development and medical reform of the commercial insurance of China in the future, which is theoretically and practically significant to the implementation of the Healthy China Strategy.

Assessment of the impact of hydrolysis on bound sulfonamide residue determination in honey using stable isotope dilution ultrahigh performance liquid chromatography tandem mass spectrometry.

In this study, an analytical method based on isotope dilution-liquid chromatography tandem mass spectrometry (ID-LC-MS/MS) was developed as a candidate reference method for the determination of sulfonamides (SAs) in honey. To guarantee the accuracy and authenticity, the impact of hydrolysis on bound SA residues was first investigated by enabling (i) identification of sugar-bound SAs, (ii) clarifying the binding reaction rule between the SAs and sugar, (iii) detection of free SAs and sugar-bound SAs, and (iv) preparation of SA-contaminated honey. Thus, the efficiency of different hydrolysis conditions was assessed by comparing the bound SA content before and after hydrolysis. In addition, optimization of the sample pretreatment procedures and LC conditions to minimize matrix effects by separation from significant matrix interferences was also performed. Satisfactory results in terms of hydrolysis efficiency (approximately 88.3%-99.2%), extraction efficiency (84.2%-105.3%), recovery (95.9%-103.1%), and limit of quantification (0.6-1.5 µg·kg-1) were obtained.

A High-Fat Diet Increases Gut Microbiota Biodiversity and Energy Expenditure Due to Nutrient Difference.

A high-fat diet (HFD) can easily induce obesity and change the gut microbiota and its metabolites. However, studies on the effects of high-fat diets on the host have drawn inconsistent results. In this study, the unexpected results showed that the refined HFD increased gut microbiota diversity and short-chain fatty acids (SCFAs), causing an increase in energy metabolism. Further analysis revealed these changes were caused by the different fiber content in these two diets. Male C57BL/6J mice (4-5 weeks old) were fed either HFD or refined low-fat diet (LFD) for 14 weeks. The metabolic rates, thermogenesis, gut microbiome, and intestinal SCFAs were tested. The HFD triggered obesity and disturbed glucose homeostasis. Mice fed HFD ingested more fiber than mice fed LFD (p < 0.0001), causing higher intestinal SCFA concentrations related to the increased abundances of specific bacteria in the HFD group. Also, the HFD increased metabolic heat and up-regulated thermogenesis genes uncoupling protein 1(Ucp-1), peroxisome proliferator-activated receptor-γ coactivator-1α (Pgc-1α) expression in the brown adipose tissue (BAT). It was revealed by 16S rRNA gene sequencing that the HFD increased gut microbial diversity, which enriched Desulfovibrionaceae, Rikenellaceae RC9 gut group, and Mucispirillum, meanwhile, reduced the abundance of Lactobacillus, Bifidobacterium, Akkermansia, Faecalibaculum, and Blautia. The predicted metabolic pathways indicated HFD increased the gene expression of non-absorbed carbohydrate metabolism pathways, as well as the risks of colonization of intestinal pathogens and inflammation. In conclusion, the HFD was obesogenic in male C57BL/6J mice, and increased fiber intake from the HFD drove an increase in gut microbiota diversity, SCFAs, and energy expenditure. Meanwhile, the differences in specific nutrient intake can dissociate broad changes in energy expenditure, gut microbiota, and its metabolites from obesity, raising doubts in the previous studies. Therefore, it is necessary to consider whether differences in specific nutrient intake will interfere with the results of the experiments.

[Quality Control and Biological Assessment of Automated Synthesized 3'-deoxy-3'-¹8F-fluorothymidine using CFN-MPS-200 Module].

OBJECTIVES: To synthesize 3'-deoxy-3'-¹8F-fluorotyhymidine)(¹8F-FLT) using CFN-MPS-200 automatic synthesis module, and evaluate its distribution in Wistar rats. METHODS: We used 3-N-Boc-5!d-O-dimethoxytrityl-3!d-O-nosyl-thymidine (Boc-FLT)-percursor as raw material to synthesize ¹8F-FLT without residual solvents. Its radiochemical purity was confirmed with radio-HPLC and thin layer chromatography (TLC). Normal Wistar rats were injected with 18 F-FLT and underwent PET scanning. RESULTS: The entire preparation procedure took about 60 min, which resulted in a radio chemical yield of (24±5)% (after attenuation correction, n =20) and radiochemical purity of over 99%, with 1.11×108 Bq/mL specific activity. The ¹8F-FLT solution was colorless and had a pH value between 7.0-8.0. ¹8F-FLT was mainly concentrated in the kidney, bladder, liver, bone marrow and Liver of normal Wistar rats. CONCLUSION: Automated synthesis of ¹8F-FLT using CFN-MPS-200 is a stable method, with high yield, safety without solvent, and acceptable quality.

[Optimum population analysis of Jilin Province, China based on comprehensive carrying capacity.] / 基于综合承载力的吉林省适度人口分析.

The regional moderate population model was constructed using state-space method, and the weights of relevant factors were obtained using principal component analysis. The optimum population of Jilin Province during 2005-2014 was calculated and the causes for its formation were discussed. The results showed that the optimum population of Jilin Province was in deficit from 2005-2014, and the imbalance existed between the population, resources and environment. The resources carrying population was significantly higher than the economic carrying and the ecological carrying population, indicating that the economic development of Jilin Province was established at the expense of destroying the environment. Moreover, the land resources carrying population was substantially higher than the water and energy carrying population, which was at a deficit, indicating that the economic development of Jilin Province was based on the depletion of energy and water resources. In the future, water resources carrying capacity should be improved according to the local conditions, the energy efficiency should be enhanced via the development of new energy sources, the extensive and consumption-based resource utilization should be transformed to the intensive and low-carbon type, and the production mode and consumption patterns should be changed to protect the ecological environment.

Epidemiology Characteristics, Methodological Assessment and Reporting of Statistical Analysis of Network Meta-Analyses in the Field of Cancer.

Because of the methodological complexity of network meta-analyses (NMAs), NMAs may be more vulnerable to methodological risks than conventional pair-wise meta-analysis. Our study aims to investigate epidemiology characteristics, conduction of literature search, methodological quality and reporting of statistical analysis process in the field of cancer based on PRISMA extension statement and modified AMSTAR checklist. We identified and included 102 NMAs in the field of cancer. 61 NMAs were conducted using a Bayesian framework. Of them, more than half of NMAs did not report assessment of convergence (60.66%). Inconsistency was assessed in 27.87% of NMAs. Assessment of heterogeneity in traditional meta-analyses was more common (42.62%) than in NMAs (6.56%). Most of NMAs did not report assessment of similarity (86.89%) and did not used GRADE tool to assess quality of evidence (95.08%). 43 NMAs were adjusted indirect comparisons, the methods used were described in 53.49% NMAs. Only 4.65% NMAs described the details of handling of multi group trials and 6.98% described the methods of similarity assessment. The median total AMSTAR-score was 8.00 (IQR: 6.00-8.25). Methodological quality and reporting of statistical analysis did not substantially differ by selected general characteristics. Overall, the quality of NMAs in the field of cancer was generally acceptable.

An exploration of spatial human health risk assessment of soil toxic metals under different land uses using sequential indicator simulation.

A modified method was proposed which integrates the spatial patterns of toxic metals simulated by sequential indicator simulation, different exposure models and local current land uses extracted by remote-sensing software into a dose-response model for human health risk assessment of toxic metals. A total of 156 soil samples with a various land uses containing farm land (F1-F25), forest land (W1-W12) and residential land (U1-U15) were collected in a grid pattern throughout Xiandao District (XDD), Hunan Province, China. The total Cr and Pb in topsoil were analyzed. Compared with Hunan soil background values, the elevated concentrations of Cr were mainly located in the east of XDD, and the elevated concentrations of Pb were scattered in the areas around F1, F6, F8, F13, F14, U5, U14, W2 and W11. For non-carcinogenic effects, the hazard index (HI) of Cr and Pb overall the XDD did not exceed the accepted level to adults. While to children, Cr and Pb exhibited HI higher than the accepted level around some areas. The assessment results indicated Cr and Pb should be regarded as the priority pollutants of concern in XDD. The first priority areas of concern were identified in region A with a high probability (>0.95) of risk in excess of the accepted level for Cr and Pb. The areas with probability of risk between 0.85 and 0.95 in region A were identified to be the secondary priority areas for Cr and Pb. The modified method was proved useful due to its improvement on previous studies and calculating a more realistic human health risk, thus reducing the probability of excessive environmental management.

[Transportation and risk assessment of heavy metal pollution in water-soil from the Riparian Zone of Daye Lake, China].

Each 20 water samples and soil samples (0-10 cm, 10-20 cm) were collected from the riparian zone of Daye Lake in dry season during March 2013. Heavy metals (Cu, Ph, Cd, Zn) have been detected by flame atomic absorption spectrometric (FAAS). The results showed that the average concentrations of Cu, Pb, Cd, Zn in the water were 7.14, 25.94, 15.72 and 37.58 microg x L(-1), respectively. The concentration of Cu was higher than the five degree of the surface water environment quality standard. The average concentrations of Cu, Pb, Cd, Zn in soil(0-10 cm) were 108.38, 53.92, 3.55, 139.26 mg x kg(-1) in soil (10-20 cm) were 93.00, 51.72, 2.08, 171.00 mg x kg(-1), respectively. The Cd concentrations were higher than the three grade value of the national soil environment quality standard. The transportation of Pb from soil to water was relatively stable, and Zn was greatly influenced by soil property and the surrounding environment from soil to water. The transformation of heavy metal in west riparian zone was higher than that of east riparian zone. The potential environmental risk was relatively high. Cu, Pb, Cd, Zn were dominated by residue fraction of the modified BCR sequential extraction method. The overall migration order of heavy metal element was: Pb > Cu > Cd > Zn. There were stronger transformation and higher environmental pollution risk of Cu, Pb. The index of assessment and potential ecological risk coefficient indicated that heavy metal pollution in soil (0-10 cm) was higher than the soil (10-20 cm), Cd was particularly serious.

[Land use change dynamics and driving forces of the vulnerable ecological region in northwestern Shanxi Province, China].

By using remote sensing and GIS technology, this paper collected land use information of 1980, 1990, 2000 and 2010 and the relevant statistical data, and analyzed the characteristics of land use change and its driving forces in northwestern Shanxi Province, the typical ecological fragile area. The results showed that there were significant changes in land use patterns in the past 30 years. During 1980-1990, 1990-2000 and 2000-2010 periods, the area of farmland decreased continuously, while the areas of grassland and woodland experienced increase-decrease-increase and decrease-increase-decrease patterns of change, respectively. The areas of industrial and resident lands increased continuously, but the water body and unused land decreased. The farmland was mainly transformed to grassland and woodland, and the areas of industrial and resident lands increased from the farmland. The lost area of water body was transformed to grassland and farmland. The decrease of unused land was due to the implementation of ecological engineering and urban ex-panding. In general, the changes of land use types were significantly higher before 2000 than after 2000. The industrial and resident lands, unused land and grassland changed drastically. The relationships between land use types and driving forces indicated that population pressure and economic development led to the changes of industrial land and farmland; policy of forestry ecological engi- neering drove the changes of woodland and grassland; the drought-characterized climate was the major cause inducing the decrease of water area and hindering the restoration of forest.

[Impact of topical application of autologous platelet-rich gel on medical expenditure and length of stay in hospitals in diabetic patients with refractory cutaneous ulcers].

OBJECTIVE: To evaluate the potential financial benefit of topical application of autologous platelet-rich gel (APG) in treating diabetic refractory cutaneous ulcers. METHODS: A single-center prospective randomized controlled trial was undertaken, with 117 patients with proven diabetic refractory cutaneous ulcers participating in the study. The patients who gave informed consents were randomly assigned into standard care group (n = 58) or standard care plus topical application of APG treatment group (n = 59). The outcome of healing and the medical expenditur and length of stay in the patients were compared between the two groups. RESULTS: The APG-treated group had better healing outcomes than the standard-treated group. The APG-treated group had 84.750 (50/59) complete healing and 98.31% improvement, higher than the 68.97% (40/58) and 75.86%, respectively, in the standard-treated group (P = 0.026). The median length for healing in the APG-treated patients was 36 days, shorter than the 45 days in the standard-treated patients (P = 0.012). The total medical expenditure and length of stay in hospitals were not significantly different between APG-treated patients [yen 38223 (23070-57398); 57 (41-94) days] and standard-treated patients [yen 35070 (24436-53649); 58 (31.75-58.50) days) (P = 0.455 and 0.301 respectively). Spendings on items such as medicine, artificial treatment, materials, interventional operation, surgical procedures, laboratory tests and other auxiliary examination, accommodations, meals, nursing care and debridement and dressing change were similar between the two groups (P > 0.05). CONCLUSION: There is an advantage for the topical application of APG on diabetic refractory cutaneous ulcers in terms of the healing outcomes. APG is a cost-effective choice for patients with diabetic refractory cutaneous ulcers.

Study of the cost-benefit analysis of electronic medical record systems in general hospital in China.

Electronic medical record (EMR) systems have been proposed as technology to improve the quality of patient care, decrease medical errors, control and reduce medical expenditure, however the financial effects have not yet been as well documented in China. We presented a net financial cost-benefit analysis of implementing electronic medical record systems in general hospital in China. The data, which were obtained from studies of the general hospital and the published literature, collected from 15 consecutive fiscal months from May 1, 2009 to August 30, 2010. We performed a perspective cost-benefit study to analyze the financial effects of EMR system implementing. The reference strategy for comparisons was the traditional paper-based medical record. The net financial benefits or costs for a 6-year period were calculated. All data were adjusted for inflation. The totally assessed net benefit from implementing an EMR system for a 6-year period was $559,025 in the general hospital. Benefits accrue primarily from savings in new medical record creation, decreased full-time-equivalent (FTE) employees, saving of adverse drug events (ADEs) and dose errors, improved charge capture and decreased billing errors. In this model, the time of return on investment is 3.00 years. In one-way sensitivity analysis, the model was most sensitive in new medical record creation; the net benefit varied from $398,057 to $719,992. The five-way sensitivity analysis with the most pessimistic and optimistic assumptions showed results ranging from a $76,970 net cost to a $1,062,122 net benefit; the pessimistic time of return on investment is 5.38 years. An EMR system cost-benefit analysis can rapidly demonstrate a positive return on investment when implemented in hospitals. The magnitude of the return is sensitive to several key factors.

[Contribution rates of landscape driving factors in coastal reclamation zone based on CLUE-S model validation].

Based on the TM images, social-economic data, and field investigation data in 1990, 2000, and 2009, and by adopting redundancy analysis (RDA) and principal component analysis (PCA), this paper analyzed the contribution rates of landscape driving forces in coastal area of Fengxian reclamation zone at Yangtze Estuary. Kappa index was used to validate the simulation effectiveness of CLUE-S model. In the study area, anthropogenic landscape driving factors had a higher contribution rate than natural landscape driving factors (57.1% vs. 42.9%). The prediction accuracy rate of CLUE-S model was above 82%, the Kappa index of the main landscape types (farm land, unutilized land, and breeding ponds) was greater than 0.75, the simulation results were acceptable, and the landscape driving forces selected could better simulate the spatial distribution patterns of the abrupt transformation of the main landscape types.

[Bayesian statistics in spatial epidemiology].

Through the multi-stage hierarchical Bayesian model and Markov Chain Monte Carlo methods, Bayesian statistics can be used in dependent spatial data analysis, including disease mapping in small areas, disease clustering, and geographical correlation studies. Recently, Bayesian spatial models have been developed with many types, which have made considerable progress in data analysis. This paper introduces several approaches that have been fully developed and applied, such as BYM model,joint model, semi-parameter model, moving average model and so on. Recently,many studies focused on the comparison work through Deviance Information criterion. Those results show that BYM model and MIX model of semi-parameter model could obtain better results. As more research going on, Bayesian statistics will have more space in applications of spatial epidemiology.

[Assessment of toxicity effects for cadmium contamination in soils by means of multi-indexes].

The genetic and eco-toxic effects of Cd (0-10 mg x kg(-1)) were studied with Vicia faba (broad bean) as the test species using meadow brown soil in pot experiments by means of several indexes, such as Vicia faba root tip micronucleus frequency (MCN), mitosis index (MI), and chromosomal aberrations frequency (CAF), antioxidant enzymes superoxide dismutases (SOD), peroxidases (POD), catalase (CAT) and phytohormone abscisic acid (ABA), gibberellic acid (GA3) and zeatin and zeatin riboside (Z&ZR). Results indicated the significant positive dose-response correlations were found between Cd2+ concentrations and the tested indexes (MI, MCN and CAF). Among of them, MCN is the most sensitive, and the MCN frequencies were 1.43-3.22 times higher in Cd treatment soils than that of in the controls. SOD and POD in seedling leaves of broad bean were response to the Cd stress, showing a trend of increase with Cd concentrations initially and then decreased. The CAT response to Cd in soils was opposite to that of SOD and POD. In addition, there were stimulation and inhabitation effects between Cd and ABA, GA3 and Z&ZR in lower and higher Cd concentrations. The highest contents of phytohormone (ABA, GA3 and Z&ZR) were found when Cd was at 2.5 mg x kg(-1), which was 6.6%, 4.0% and 12.6% higher than that in the control, respectively. Our study indicated that all indexes were response to the Cd stress in soils, but the sensitivity of each index was different from each other. All these indexes combined should be more efficiency in the diagnosis of geno-, and eco-toxicity of cadmium in soils.

[Scan statistic theory and its application in spatial epidemiology].

To introduce the basic concept of scan statistic, its computation method and application in the area of spatial epidemiology. Retrospective space-time permutation statistics for evaluating the clustering of disease monitoring program is illustrated, using data on recent acute onset of cardiovascular disease in Hangzhou, China. Calculations were performed with SaTScan Version 7.0.3. With 999 Monte Carlo replications, the program took 5 seconds to run on a 100-MHz Pentium PC. The geographical surveillance program on acute onset clusters of cardiovascular disease, data which showed statistical significance, would include: a) from January 1, 1997 to February 28, 2007 in Qiantan township, Jiande county (P = 0.001); b) highly significant between January 1, 1997 and February 28, 1999 for Lushan street, Lingqiao township in Fuyang county (P = 0.003); c) between March 1, 2001 and February 29, 2004 for Dayuan town, Xinyi town, Shouxiang town in Fuyang (P = 0.004); d) between March 1, 2004 and Feb 28, 2006 for Chengzhan street, Ziyang street, Hubin street, Qinbo street, Xiaoying street, Wangjiang street, Chaoming street, Changqing street, Wulin street, Tianshui street, Wenhui street and Shiqiao street in Hangzhou (P = 0.005), respectively. The retrospective space-time permutation statistics seems useful as a screening tool for identifying the cluster of disease. Scan statistics are practical and effective method for deciding which cluster alarms would merit further investigation and which clusters are probably chance occurrences in the study of spatial epidemiology.