Progress towards health equity in Vietnam: evidence from nationwide official health statistics, 2010-2020.

INTRODUCTION: One of the ultimate goals of strengthening the health system is to achieve health equity. Vietnam is considered one of the 'fast-track countries' to achieve the health-related Millennium Development Goals, but research on its equity strategies remains inadequate. METHODS: Using Vietnamese official health statistics, we investigated inequity in four dimensions including health resources, service delivery, service utilisation and residents' health status from the perspectives of income levels, poverty rates and subnational regions. The Slope Index of Inequality, concentration curve/Concentration Index, absolute difference and Theil Index were used. RESULTS: Four indicators showed 'pro-poor' inequality in health resources, including the per capita health budget, per capita health personnel, per capita health personnel at the community level and per capita hospital beds at the community level, while provincial hospital beds showed 'pro-rich' inequality. Two health service delivery indicators (delivery of antenatal care ≥3 times and proportion of community health service centres with medical doctors) show 'pro-rich' inequality, although two health status indicators, mortality and malnutrition rates for children under five, showed 'pro-poor' inequality. The Northern Midlands and Mountain Areas, and the Central Highlands were disadvantaged regarding service delivery and health status. Intraregional differences were the main factors contributing to the inequalities in delivery of antenatal care ≥3 times, provincial hospital beds and percentage of community health centres with medical doctors, with the Red River Delta and the South East region experiencing the greatest inequalities. CONCLUSION: The overall level of health equity in Vietnam has increased over the past decade, although inequality in health service delivery has hindered progress towards health equity based on income, poverty and subnational regions. Targeted policies need to be introduced to reduce inequities relating to the health workforce and service delivery capacity.

Assessment of chimerism by next generation sequencing: A comparison to STR/qPCR methods.

Chimerism analysis is used to evaluate patients after allogeneic hematopoietic stem cell transplant (allo-HSCT) for engraftment and minimal measurable residual disease (MRD) monitoring. A combination of short-tandem repeat (STR) and quantitative polymerase chain reaction (qPCR) was required to achieve both sensitivity and accuracy in the patients with various chimerism statuses. In this study, an insertion/deletion-based multiplex chimerism assay by next generation sequencing (NGS) was evaluated using 5 simulated unrelated donor-recipient combinations from 10 volunteers. Median number of informative markers detected was 8 (range = 5 - 11). The limit of quantitation (LoQ) was determined to be 0.1 % recipient. Assay sample number/batch was 10-20 and total assay time was 19-31 h (manual labor = 2.1 h). Additionally, 50 peripheral blood samples from 5 allo-HSCT recipients (related: N = 4; unrelated: N = 1) were tested by NGS and STR/qPCR. Median number of informative markers detected was 7 (range = 4 - 12). Results from both assays demonstrated a strong correlation (Y = 0.9875X + 0.333; R2 = 0.9852), no significant assay bias (difference mean - 0.08), and 100 % concordant detection of percent recipient increase ≥ 0.1 % (indicator of increased relapse risk). NGS-based chimerism assay can support all allo-HSCT for engraftment and MRD monitoring and simplify clinical laboratory workflow compared to STR/qPCR.

Life-cycle and economic assessments of microalgae biogas production in suspension and biofilm cultivation systems.

Biogas production via anaerobic digestion is highly attractive for microalgae. The technology of microalgae cultivation has profound impacts on biogas production system as it is the most energy-consuming process. However, a comprehensive evaluation of the environmental and economic benefits of different cultivation systems has yet to be sufficiently conducted. Here, life-cycle and economic assessments of open raceway ponds, photobioreactors and biofilm systems were investigated. Results showed greenhouse gas emissions of all systems were positive because more than two-thirds of carbon in fuel gas was lost and the fixed carbon in product gas and solid fertilizer was less than the emitted carbon during energy input. Particularly, biofilm system achieved the least greenhouse gas emissions (9.3 g CO2-eq/MJ), net energy ratio (0.7) and levelized cost of energy (0.9 $/kWh), indicating the optimum cultivation system. Open raceway ponds and photobioreactors failed to achieve positive benefits because of low harvesting efficiency and biomass concentration.

Microalgae cultivation with recycled harvesting water achieved economic and sustainable production of biomass and lipid: Feasibility assessment and inhibitory factors analysis.

This study was conducted to achieve economic and sustainable production of biomass and lipids from Chlorella sorokiniana by recirculating cultivation with recycled harvesting water, to identify the major inhibitory factors in recirculating culture, and to analyze accordingly economic benefits. The results showed that recirculating microalgae cultivation (RMC) could obtain 0.20-0.32 g/L biomass and lipid content increased by 23.1 %-38.5 %. Correlation analysis showed that the extracellular polysaccharide (PSext), chemical oxygen demand (COD) and chromaticity of recirculating water inhibited photosynthesis and induced oxidative stress, thus inhibiting the growth of C. sorokiniana. In addition, the economic benefits analysis found that circulating the medium twice could save about 30 % of production cost, which is the most economical RMC solution. In conclusion, this study verified the feasibility and economy of RMC, and provided a better understanding of inhibitory factors identification in culture.

Assessment of the impact of wetland changes on carbon storage in coastal urban agglomerations from 1990 to 2035 in support of SDG15.1.

The quantitative assessment and spatial representation of wetland carbon storage, which play a critical role in the global carbon cycle and human production, can provide useful data and knowledge for decision-making in achieving sustainable development goals (SDGs). Currently, human activities and climate change impacts pose a challenge for the assessment of wetland carbon storage in coastal urban clusters. We proposed a "past-present-future" long time series refined wetland carbon storage assessment model using Guangxi Beibu Gulf (GBG) and Guangdong, Hong Kong, Macao and the Greater Bay Area (GBA) as the study area. The CLUE-S and InVEST models were coupled to conduct a comparative analysis of the spatial and temporal changes in wetland carbon storage and the spatial identification of damages from 1990 to 2035 and finally explore the sensitivity of wetland changes to carbon storage and quantitatively assess the SDG15.1 target. The results showed that (1) both urban clusters are characterized by many reservoirs/farming ponds, large river areas and few lakes. 1990-2035 rivers, shallow waters and mudflats have a decreasing trend to be distributed in the middle of their respective regions, mangroves are on an increasing trend, GBG is mainly distributed in the Maowei Sea and GBA is mainly distributed in Shenzhen Bay. (2) Wetland carbon storage of the two urban clusters show an overall fluctuating downward trend, with rivers, lakes and beaches all showing a downward trend. The multiyear average carbon storage of the GBG are 3.2 times higher than those of the GBA. In ecological protection scenario (EPS) policy planning, it is reasonable to help wetland carbon sequestration in coastal urban clusters. (3) The trend of wetland change from 1990 to 2020 was positive for carbon storage. The rate of recovery of wetland carbon stocks is lower in GBA than in GBG under the natural increase scenario (NIS) and the ecological protection scenario (EPS). The economic development scenario (EDS) contributes least to the realisation of SDG15.1 for the coastal urban agglomeration. The ecological protection scenario (EPS) contributes the most to the realisation of SDG15.1 for the coastal urban agglomeration.

Validation of a Brief Dietary Questionnaire for Use in Clinical Practice: Mini-EAT (Eating Assessment Tool).

Background There is a scarcity of validated rapid dietary screening tools for patient use in the clinical setting to improve health and reduce cardiovascular risk. The Healthy Eating Index (HEI) 2015 measures compliance with the 2015 to 2020 Dietary Guidelines for Americans but requires completion of an extensive diet assessment to compute, which is time consuming and impractical. The authors hypothesize that a 19-item dietary survey assessing consumption of common food groups known to affect health will be correlated with the HEI-2015 assessed by a validated food frequency questionnaire and can be further reduced without affecting validity. Methods and Results A 19-item Eating Assessment Tool (EAT) of common food groups was created through literature review and expert consensus. A cross-sectional survey was then conducted in adult participants from a preventive cardiology clinic or cardiac rehabilitation and in healthy volunteers (n=661, mean age, 36 years; 76% women). Participants completed an online 156-item food frequency questionnaire, which was used to calculate the HEI score using standard methods. The association between each EAT question and HEI group was analyzed by Kruskal-Wallis test. Linear regression models were subsequently used to identify univariable and multivariable predictors for HEI score for further reduction in the number of items. The final 9-item model of Mini-EAT was validated by 5-fold cross validation. The 19-item EAT had a strong correlation with the HEI score (r=0.73) and was subsequently reduced to the 9 items independently predictive of the HEI score: fruits, vegetables, whole grains, refined grains, fish or seafood, legumes/nuts/seeds, low-fat dairy, high-fat dairy, and sweets consumption, without affecting the predictive ability of the tool (r=0.71). Conclusions Mini-EAT is a 9-item validated brief dietary screener that correlates well with a comprehensive food frequency questionnaire. Future studies to test the Mini-EAT's validity in diverse populations and for development of clinical decision support systems to capture changes over time are needed.

A multistage multimodal deep learning model for disease severity assessment and early warnings of high-risk patients of COVID-19.

The outbreak of coronavirus disease 2019 (COVID-19) has caused massive infections and large death tolls worldwide. Despite many studies on the clinical characteristics and the treatment plans of COVID-19, they rarely conduct in-depth prognostic research on leveraging consecutive rounds of multimodal clinical examination and laboratory test data to facilitate clinical decision-making for the treatment of COVID-19. To address this issue, we propose a multistage multimodal deep learning (MMDL) model to (1) first assess the patient's current condition (i.e., the mild and severe symptoms), then (2) give early warnings to patients with mild symptoms who are at high risk to develop severe illness. In MMDL, we build a sequential stage-wise learning architecture whose design philosophy embodies the model's predicted outcome and does not only depend on the current situation but also the history. Concretely, we meticulously combine the latest round of multimodal clinical data and the decayed past information to make assessments and predictions. In each round (stage), we design a two-layer multimodal feature extractor to extract the latent feature representation across different modalities of clinical data, including patient demographics, clinical manifestation, and 11 modalities of laboratory test results. We conduct experiments on a clinical dataset consisting of 216 COVID-19 patients that have passed the ethical review of the medical ethics committee. Experimental results validate our assumption that sequential stage-wise learning outperforms single-stage learning, but history long ago has little influence on the learning outcome. Also, comparison tests show the advantage of multimodal learning. MMDL with multimodal inputs can beat any reduced model with single-modal inputs only. In addition, we have deployed the prototype of MMDL in a hospital for clinical comparison tests and to assist doctors in clinical diagnosis.

Improving Innovation and Access to Combination Vaccines for Childhood Immunization in China.

BACKGROUND: combination vaccines can improve timely vaccination coverage and mitigate the social and economic burdens of both caregivers and health systems. Compared to other countries with high immunization performance, China remains behind the curve in promoting the inclusion of new combination vaccines into national vaccination schedules. The domestic research and development pipeline faces many technical obstacles, regulatory pressures, and competitive opposition. In addition to this, health disparities regarding combination vaccines exist in each dimension of access and their determinants, including availability, accessibility, acceptability, and quality. Our study aims to provide a cross-disciplinary analysis of China's combination vaccines (from innovation to access) and identify the main factors that affect the attitudes and behavior choices for combination vaccines. METHOD: systematic reviews and secondary data analysis will be conducted to map the landscape of combination vaccines in China and the determinants influencing their innovation and access. A cross-sectional survey will be performed in seven provinces of China based on geo-economic representativeness among caregivers with children that are between 2 and 24 months old and are registered in the national immunization system. Questionnaires will be used to examine the relationship between each dimension of access and their determinants. These questionnaires will cover the caregivers' knowledge, attitude, and willingness to pay for combination vaccines, as well as their perceptions about vaccination services. Semi-structured interviews with the suppliers (public and private) and healthcare providers will help identify research gaps and the key challenges they face when developing and introducing combination vaccines in China. DISCUSSION: using a combined approach, with cross-country and multi-disciplinary support from experts, our research is designed to fill the information gaps in China's combination vaccine industry across the innovation-access spectrum. It will lead to evidence-based recommendations which will foster greater access to innovation-enhancing combination vaccines for childhood immunization in China. Moreover, the multi-dimensional approach could also be adapted beyond combination vaccines to assess innovation and other public goods for health among disadvantaged groups in the future.

Autistic characteristics in eating disorders: Treatment adaptations and impact on clinical outcomes.

OBJECTIVE: Autistic people with eating disorders (EDs) may have special needs that are not met in standard ED treatment, raising the need for treatment adaptations to accommodate co-existing autism spectrum condition (ASC). Little is currently known about the nature of existing treatment options or adaptations for this population. We conducted a pre-registered systematic review to: (1) identify research articles describing existing interventions for patients with ED and comorbid ASC, and to critically review evidence of their clinical effectiveness and cost-effectiveness (Review 1); (2) review the impact of ASC comorbidity on ED clinical outcomes (Review 2). METHOD: Peer-reviewed studies published until the end of December 2020 were identified through a systematic search of the electronic databases: Medline, Embase, PsycINFO, Web of Science, CINAHL, Scopus and Cochrane Library. RESULTS: Only one clinical pathway of treatment adaptations (the 'PEACE' pathway) was identified in Review 1 with early evidence of cost-savings and favourable treatment outcomes. ASC characteristics were shown in Review 2 to have no direct impact on physical outcomes or ED symptoms, but could be associated with higher rates of comorbidities and greater use of intensive ED treatment. Additionally, patients with ASC characteristics may benefit more from individual sessions, rather than group sessions. CONCLUSIONS: Any new treatments or treatment adaptations may not directly impact on ED symptoms, but may be better able to support the complex needs of the ASC population, thus reducing subsequent need for intensive treatment. Future research is warranted to explore evidence of clinical and cost-effectiveness of interventions for this population.

Immunization Against Inhibin Promotes Fertility in Cattle: A Meta-Analysis and Quality Assessment.

Superovulation and embryo transfer techniques are important methods in cattle breeding. Combined with traditional superovulation protocols, immunization against inhibin can further improve follicular development and embryo yield. The aim of this study is to determine the efficacy of immunization against inhibin in improving the fertility of cattle through meta-analysis and to provide better clinical veterinary practice guidance. Three English databases (PubMed, EMBASE, Web of Science) were searched for research articles of immunizations against inhibin influence on cattle fertility. Literature screening, data extraction, and meta-analysis were conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. In addition, the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) risk-of-bias (RoB) tool was used to assess the risk of bias of the included animal studies. Potentially relevant studies (317) were identified, and finally 14 eligible studies (all in English) were included. The results of meta-analysis revealed that immunization against inhibin has significant effects on improving the number of ovulations [mean difference (MD) = 0.44, 95% confidence interval (CI) = (0.31, 0.56)], embryos and unfertilized ova [MD = 4.51, 95% CI = (2.28, 6.74)], follicles of the three size categories, the incidence of multiple ovulations [OR = 22.50, 95% CI = (8.13, 62.27)], and the conception rate [OR = 2.36, 95% CI = (1.26, 4.40)]. Moreover, it improved the production of embryos [grades 1 embryos: MD = 3.84, (3.54, 4.15); grade 2 embryos: MD = -0.73, (-0.89, -0.57); grade 3 embryos: MD = -0.50, (-0.75, -0.25); degenerated embryos: MD = 1.16, (-0.51, 2.82); transferable embryos: MD = 2.67, (2.03, 3.31)] and the number of corpora lutea [MD = 1.25, 95% CI = (0.79, 1.71)]. In the above indicators, the differences between the two groups were statistically significant (all p < 0.0001). Additionally, according to the quality evaluation results, the risk of bias in the included studies is relatively high. The quality evaluation of the results of the included studies showed that the risk of bias mainly concentrated in the selective, performance, detection, and reporting of bias aspects.

Digital Divide of the Shattered "Iron Rice Bowl": Economic Insecurity and ICT Access in China.

Although economic factors account for the digital divide, the effect of economic insecurity on information communication technology (ICT) access has not been determined. The market-oriented reform of Chinese state-owned enterprises in the 1990s resulted in massive layoffs, encouraging us to investigate the relationship between economic insecurity and the digital divide. We draw on data from the China Health and Retirement Longitudinal Study (CHARLS). To handle the endogeneity related to economic insecurity, we use experience in a management position and the number of siblings as instruments for economic insecurity. With the introduction of these two instrumental variables, we find a negative relationship between economic insecurity and ICT access. This study provides insight into ICT policies involving underprivileged people in developing countries.

Association Between Diet Quality and Cardiometabolic Risk Factor Clustering Stratified by Socioeconomic Status Among Chinese Children.

BACKGROUND: Few studies have evaluated the long-term relationship between diet quality and cardiometabolic risk factor clustering among children. The moderating effect of socio-economic status (SES) is of interest. OBJECTIVE: To investigate the association between diet quality with cardiometabolic risk among Chinese children and to explore the moderating effect of SES. DESIGN: In this cohort study, 5 waves (1997-2009) of the China Health and Nutrition Survey were used. Diet quality was measured by a modified version of the Chinese Children Dietary Index (mCCDI) based on Dietary Guidelines for Chinese. PARTICIPANTS: Children between the ages of 7 and 17 (n = 2903) who completed at least 2 surveys were included. Those who missed measures or had hypertension or diabetes at baseline were excluded. MAIN OUTCOME MEASURES: The fasting blood samples were collected in 2009. Waist circumference (WC) and blood pressure (BP) were measured in each survey. STATISTICAL ANALYSIS PERFORMED: A continuous cardiometabolic risk score (MetScore) was derived by a confirmatory factor analysis of 5 components: WC, BP, glucose, triglycerides, and high-density lipoprotein cholesterol. Considering the latency period of the effect of behaviors, the mCCDI was lagged by the period between surveys. Linear regression was used to analyze the association of mCCDI with MetScore and its components. Mixed effect linear regression and lagged mCCDI were used for WC and BP models. RESULTS: Higher mCCDI was independently associated with a lower MetScore at follow-up (ß: -.11; 95% CI: -.18 to -.04). Higher lagged mCCDI over time was associated with a lower WC z score overall (ß: -.05; 95% CI: -.08 to -.01) and among children in the low SES group (ß: -.09; 95% CI: -.14 to -.04) but not those in the high SES group. When examining the 15 mCDDI components separately, scores for 5 components: more grains, vegetables, soybeans and its products; less sugar-sweetened beverages; and more diet variety were significantly associated with a lower MetScore. CONCLUSIONS: Among Chinese children, higher diet quality measured by mCCDI was independently associated with a lower MetScore at follow-up.

A novel approach for autism spectrum condition patients with eating disorders: Analysis of treatment cost-savings.

OBJECTIVE: In the current economic context, it is critical to ensure that eating disorder (ED) treatments are both effective and cost-effective. We describe the impact of a novel clinical pathway developed to better meet the needs of autistic patients with EDs on the length and cost of hospital admissions. METHOD: The pathway was based on the Institute for Healthcare's Model of Improvement methodology, using an iterative Plan, Do, Study, Act format to introduce change and to co-produce the work with people with lived experience and with healthcare professionals. We explored the change in length and cost of admissions before and after the pathway was introduced. RESULTS: Preliminary results suggest that the treatment innovations associated with this pathway have led to reduced lengths of admission for patients with the comorbidity, which were not seen for patients without the comorbidity. Estimated cost-savings were approximately £22,837 per patient and approximately £275,000 per year for the service as a whole. CONCLUSION: Going forward, our aim is to continue to evaluate the effectiveness and cost-effectiveness of investment in the pathway to determine whether the pathway improves the quality of care for patients with a comorbid ED and autism and is good value for money.

Independent and Joint Use of Statins and Metformin by Elderly Patients With Diabetes and Overall Survival Following HCC Diagnosis.

GOAL: To investigate associations of prediagnosis and postdiagnosis use of statins and metformin on overall survival of patients with diabetes who later developed HCC. BACKGROUND: Statins and metformin have received considerable interest as potential chemopreventive agents against hepatocellular carcinoma (HCC) development in individuals with type 2 diabetes mellitus (T2DM); however, their impact on overall survival of patients with T2DM who later develop HCC (diabetic HCC patients) is unclear. STUDY: Data on 2499 elderly diabetic HCC patients obtained from the SEER-Medicare program (2009 to 2013) were analyzed. Patients were categorized based on use of statins only, metformin only, both, or neither (reference for all comparisons). The patients were further categorized based on: (1) metformin dose: ≤1500 or >1500 mg/d; (2) statins functional form: hydrophilic (pravastatin and rosuvastatin) or lipophilic (atorvastatin, fluvastatin, lovastatin, and simvastatin); (3) statins potency: high (atorvastatin, rosuvastatin, and simvastatin) or low (fluvastatin, lovastatin, and pravastatin); and (4) individual statins type. Multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models. RESULTS: Prediagnosis use of metformin dose ≤1500 mg/d was associated with lower risk of death after HCC diagnosis in patients with T2DM (HR, 0.72; 95% CI, 0.58-0.91), adjusting for postdiagnosis metformin dose, diabetes severity, Charlson comorbidity index, tumor characteristics, and other relevant factors. No association was found for prediagnosis metformin dose >1500 mg/d or postdiagnosis metformin use. Further, no association was found for either prediagnosis or postdiagnosis statins use. CONCLUSIONS: Prediagnosis use of metformin dose ≤1500 mg/d is associated with longer overall survival of elderly diabetic HCC patients.

Risk Assessment of Sarcopenia in Patients With Type 2 Diabetes Mellitus Using Data Mining Methods.

Purpose: Sarcopenia is a geriatric syndrome, and it is closely related to the prevalence of type 2 diabetes mellitus (T2DM). Until now, the diagnosis of sarcopenia requires Dual Energy X-ray Absorptiometry (DXA) scanning. This study aims to make risk assessment of sarcopenia with support vector machine (SVM) and random forest (RF) when DXA is not available. Methods: Firstly, we recruited 132 patients aged over 65 and diagnosed with T2DM in Changchun, China. Clinical data were collected for predicting sarcopenia. Secondly, we selected 3, 5, and 7 features out of over 40 features of patient's data with backward selection, respectively, to train SVM and RF classification models and regression models. Finally, to evaluate the performance of the models, we performed leave one out and 5-fold cross validation. Results: When training the model with 5 features, the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) were favorable, and it was better than the models trained with 3 features and 7 features. Area under the receiver operating characteristic (ROC) curve (AUC) were over 0.7, and the mean AUC of SVM models was higher than that of RF. Conclusions: Using SVM and RF to make risk assessment of sarcopenia in the elderly is an option in clinical setting. Only 5 features are needed to input into the software to run the algorithm for a primary assessment. It cannot replace DXA to diagnose sarcopenia, but is a good tool to evaluate sarcopenia.

Economic evaluations of clinical pharmacy services in China: a systematic review.

OBJECTIVE: This article reviewed research conducted on economic evaluations of clinical pharmacy services (CPS) in China. We aimed to identify the types of CPS and the possible economic effects of these services and to hopefully provide some suggestions for designing future economic evaluations of pharmacy interventions in the region. DESIGN: Systematic review. DATA SOURCES: Several English databases (PubMed, Embase, The Cochrane Library, National Health Service Economic Evaluation Database), Chinese databases (China National Knowledge Infrastructure, VIP, Chinese Biomedical Literature Database and WanFang Data) and search engines (Google Scholar and BaiDu Scholar) were searched through December 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies with an economic assessment of CPSs in China were included. DATA EXTRACTION AND SYNTHESIS: Two reviewers independently screened the studies, extracted the data, assessed the quality of the included studies and then qualitatively analysed the results. RESULTS: Forty articles were included in the final analysis. Most studies were performed in hospitals and the intervention populations mainly included adults. The types of pharmaceutical services included antimicrobial management, chronic disease state management and multidimensional clinical pharmaceutical services. A positive economic benefit associated with CPS was noted in 80% (n=32) of these articles, showing that CPS were associated with cost savings and improved patient outcomes. However, only three studies were full economic evaluations, using the method of cost-effectiveness analysis. CONCLUSION: CPS was associated with cost savings and generated positive economic value. With the expanding role of pharmacists in the healthcare sector, it is suggested that new pharmaceutical services be used in future studies and that high-quality full economic evaluations capturing both expenses and cost savings be conducted.

Evaluation of adsorptive desulfurization performance and economic applicability comparison of activated carbons prepared from various carbon sources.

Adsorptive desulfurization (ADS) using activated carbon (AC) as adsorbent presents competitive potential in separating thiophenic sulfur from liquid fuels with high selectivity under mild operation conditions. It is also a highly economic remedy in ultra-low sulfur content situations. Most importantly, a suitable feedstock for macroscopic quantity preparation of AC adsorbents with good adsorptive desulfurization performance and low-cost is required to satisfy the requirements of this field. In this work, four representative substances (i.e., coal, coconut shell, polyurethane plastic waste, and petroleum coke) were selected as the carbon source for the preparation of various AC adsorbents. The physicochemical properties of the prepared AC adsorbents were characterized using BET, SEM, XRD, XPS, elemental analysis and Boehm's method. The corresponding adsorptive desulfurization performance was investigated. The corresponding desulfurization capacity obtained was in the order: CS-ACA > PUPW-ACA > PC-ACA > AT-ACA. Under the optimal conditions of 30 °C and 30 min contact time, the desulfurization rate of 0.5 g PUPW-ACA can reach about 98%. The HHV of non-condensable gas generated during the experiment was calculated, and the HHV of the pyrolysis oil was measured. The results showed that the by-products produced by PC had the highest HHV. The economics of the desulfurization of the four kinds of activated carbon were analyzed and evaluated. From a comprehensive analysis, PUPW-ACA has the highest economic production value and has the potential for industrial production. This plays a dual role in environmental protection.

Predicting 1-year cardiac transplantation survival using a donor-recipient risk-assessment tool.

OBJECTIVE: Many donor and recipient factors influence 1-year survival of patients after cardiac transplantation. To date, a statistical model has not been developed to assess the interplay of these factors in predicting outcomes, so we developed a risk-assessment tool to enhance decision-making. METHODS: We analyzed 29 variables that were reported in the United Network for Organ Sharing database for 24,540 cardiac transplantations performed between January 1, 2000, and June 30, 2015. For one half of the patients (the prediction population), a multivariable Cox regression model and the bootstrap resampling method were used to devise a scoring system predicting 1-year survival. The other half (the validation population) were stratified by score into 3 risk categories: high risk, medium risk, and low risk. One-year survival was compared among the 3 groups. RESULTS: Eleven variables were statistically significant in predicting 1-year survival. One-year survival for patients with risk scores of less than or equal to 8, 9 to 15, and greater than 15 were 91.2%, 81.7%, and 64.6%, respectively (P < .001). The C index of the Cox regression model was calculated at 0.62 when using risk score as a continuous predictor. CONCLUSIONS: Donor and recipient risk factors influence patient survival after cardiac transplantation. Long-term outcomes may be optimized with a statistically based risk model to improve donor-recipient matching.

Comparative assessment of three methods to analyze MGMT methylation status in a series of 350 gliomas and gangliogliomas.

MGMT promoter methylation is considered as a prognostic and predictive biomarker indicating response to chemotherapy and radiotherapy in glioblastoma. A number of different methods and platforms including pyrosequencing (PSQ), quantitative methylation-specific PCR (qMSP) and immunohistochemistry (IHC), methylation-sensitive high resolution melting (MS-HRM) and NGS (Next Generation Sequencing) have been used to detect MGMT promoter methylation in gliomas. However, controversy remains about the most appropriate method to use for analyzing MGMT status. The MGMT promoter methylation status of a total of 350 gliomas and gangliogliomas was examined using PSQ, qMSP and IHC in parallel. Using PSQ as a recommended standard method, the sensitivity, specificity, positive/negative predictive value and correlation with the other assays were calculated. Among 350 glioma and ganglioglioma cases, the MGMT promoter tested positive for methylation in 53.1%, 55.4%, and 70.3% of the cases by PSQ, qMSP and IHC, respectively. The sensitivity and specificity of qMSP were 97.8% and 92.7%, respectively. Twelve cases that tested positive for methylation using qMSP were negative according to PSQ, and four cases that were negative according to qMSP tested positive according to PSQ. The concordance rate between PSQ and qMSP was 90.8%. The sensitivity and specificity of IHC for the detection of MGMT at the protein level were 84.4% and 45.7%, respectively. The concordance rate between PSQ and IHC was 30.8%. This study demonstrated that qMSP is an effective and rapid detection method for routine use in pathology laboratories for the identification of MGMT promoter methylation. A combination of IHC and qMSP assays can provide high sensitivity and specificity for the prediction of MGMT status. A few cases that tested negative with PSQ did harbor MGMT promoter methylation, as confirmed by qMSP and sequencing, and this subgroup of patients may benefit from temozolomide.

The assessment of Hantaan virus-specific antibody responses after the immunization program for hemorrhagic fever with renal syndrome in northwest China.

Xianyang city is one of the main hemorrhagic fever with renal syndrome (HFRS) epidemic areas in northwest China. Although the HFRS immunity program has been provided in this city, HFRS is still occurred every year. In order to implement the vaccination program effectively and to control HFRS, the analysis of antibody responses specific to Hantaan virus (HTNV) in individuals after vaccination is essential. In this study, a total of 100 subjects were divided into 5 groups: unvaccinated, 1, 3, 29 and 33 months after boost vaccination. The levels and the positive rates of HTNV-NP-specific IgM and IgG antibodies as well as HTNV neutralizing antibodies were significantly increased in the serum of the vaccinated individuals. The positive rates and levels of HTNV-NP-specific IgG and HTNV neutralizing antibody reached their highest values at 3 months respectively and could be sustained up to 33 months after vaccination. Moreover, the titres of HTNV-NP-specific IgM or IgG antibody and the titres of HTNV neutralizing antibody at 1 month after vaccination have a positive correlation. The level of HTNV-NP-specific IgG antibody was much higher than that of HTNV-NP-specific IgM antibody or HTNV neutralizing antibody. In addition, the strongest responses of antibody-secreting cells were observed at 3 months after vaccination, which was consistent with the serum results. Therefore, the HFRS immunization program is effective to induce humoral immunity in the population of northwest China.