Characterizing the relationship between MRI radiomics and AHR expression and deriving a predictive model for prognostic assessment in glioblastoma.

PURPOSE: Aryl hydrocarbon receptor (AHR), a crucial molecular marker associated with glioma, is a potential therapeutic target. We aimed to establish a non-invasive predictive model for AHR through radiomics. METHODS: Contrast-enhanced T1-weighted (T1W) MRI and the corresponding and clinical variables of glioblastoma patients from The Cancer Genome Atlas (TCGA) and The Cancer Imaging Archive (TCIA) were obtained for analysis. KM curves and Cox regression analyses were used to assess the prognostic value of AHR expression. The radiomics features were screened by Max-Relevance and Min-Redundancy (mRMR) and recursive feature elimination (RFE), followed by the construction of two predictive models using logistic regression (LR) and a support vector machine (SVM). RESULTS: The expression levels of AHR in tumour patients were significantly higher than those in the control group, and higher AHR expression was associated with worse prognosis (P<0.05). AHR remained a risk factor for poor prognosis in glioblastoma after multivariate adjustment (HR: 1.61, 95% CI: 1.085-2.39, P<0.05). The radiomics models constructed using LR and SVM based on three selected features achieved area under the curve (AUC) values of 0.887 and 0.872, respectively. Radiomics score emerged as a key factor influencing overall survival (OS) after multivariate adjustment in the Cox model (HR: 3.931, 95% CI: 1.272-12.148, P < 0.05). CONCLUSION: The radiomics models could effectively distinguish the expression levels of AHR and predict prognosis in patients with glioblastoma, which may serve as a powerful tool to assist clinical assessment and precision treatment.

Disparities in Mistreatment During Childbirth.

Importance: Lack of respectful maternity care may be a key factor associated with disparities in maternal health. However, mistreatment during childbirth has not been widely documented in the US. Objectives: To estimate the prevalence of mistreatment by health care professionals during childbirth among a representative multistate sample and to identify patient characteristics associated with mistreatment experiences. Design, Setting, and Participants: This cross-sectional study used representative survey data collected from respondents to the 2020 Pregnancy Risk and Monitoring System in 6 states and New York City who had a live birth in 2020 and participated in the Postpartum Assessment of Health Survey at 12 to 14 months' post partum. Data were collected from January 1, 2021, to March 31, 2022. Exposures: Demographic, social, clinical, and birth characteristics that have been associated with patients' health care experiences. Main Outcomes and Measures: Any mistreatment during childbirth, as measured by the Mistreatment by Care Providers in Childbirth scale, a validated measure of self-reported experiences of 8 types of mistreatment. Survey-weighted rates of any mistreatment and each mistreatment indicator were estimated, and survey-weighted logistic regression models estimated odds ratios (ORs) and 95% CIs. Results: The sample included 4458 postpartum individuals representative of 552 045 people who had live births in 2020 in 7 jurisdictions. The mean (SD) age was 29.9 (5.7) years, 2556 (54.4%) identified as White, and 2836 (58.8%) were commercially insured. More than 1 in 8 individuals (13.4% [95% CI, 11.8%-15.1%]) reported experiencing mistreatment during childbirth. The most common type of mistreatment was being "ignored, refused request for help, or failed to respond in a timely manner" (7.6%; 95% CI, 6.5%-8.9%). Factors associated with experiencing mistreatment included being lesbian, gay, bisexual, transgender, queer identifying (unadjusted OR [UOR], 2.3; 95% CI, 1.4-3.8), Medicaid insured (UOR, 1.4; 95% CI, 1.1-1.8), unmarried (UOR, 0.8; 95% CI, 0.6-1.0), or obese before pregnancy (UOR, 1.3; 95% CI, 1.0-1.7); having an unplanned cesarean birth (UOR, 1.6; 95% CI, 1.2-2.2), a history of substance use disorder (UOR, 2.6; 95% CI, 1.3-5.1), experienced intimate partner or family violence (UOR, 2.3; 95% CI, 1.3-4.2), mood disorder (UOR, 1.5; 95% CI, 1.1-2.2), or giving birth during the COVID-19 public health emergency (UOR, 1.5; 95% CI, 1.1-2.0). Associations of mistreatment with race and ethnicity, age, educational level, rural or urban geography, immigration status, and household income were ambiguous. Conclusions and Relevance: This cross-sectional study of individuals who had a live birth in 2020 in 6 states and New York City found that mistreatment during childbirth was common. There is a need for patient-centered, multifaceted interventions to address structural health system factors associated with negative childbirth experiences.

Burden of Stroke Attributable to Nonoptimal Temperature in 204 Countries and Territories: A Population-Based Study, 1990-2019.

BACKGROUND AND OBJECTIVES: Stroke attributable to nonoptimal temperature needs more attention with dramatic climate change. The aim of this study was to estimate the global burden and distribution characteristics of the burden. METHODS: In this ecological study, we collected data from the Climate Research Unit Gridded Time Series, the World Bank databases, and the Global Burden of Diseases study to estimate the distribution of burden. We used the joinpoint model, decomposition analysis, age-period-cohort model, panel data analysis, and health inequality analysis to assess the different types of stroke burden attributable to different climatic conditions. RESULTS: The burden of stroke attributable to nonoptimal temperature continued to grow, and aging was a key factor in this increase. In 2019, 521,031 (95% uncertainty interval [UI] 402,433-663,996) deaths and 9,423,649 (95% UI 7,207,660-12,055,172) disability-adjusted life years [DALYs] attributable to stroke due to nonoptimal temperature were recorded globally. Globally, men (age-standardized mortality rate [ASMR] 7.70, 95% UI 5.80-9.73; age-standardized DALY rate [ASDR] 139.69, 95% UI 102.96-178.54 in 2019) had a heavier burden than women (ASMR 5.89, 95% UI 4.50-7.60; ASDR 96.02, 95% UI 72.62-123.85 in 2019). Central Asia (ASMR 18.12, 95% UI 13.40-24.53; ASDR 327.35, 95% UI 240.24-440.61 in 2019) had the heaviest burden at the regional level. In the national level, North Macedonia (ASMR 32.97, 95% UI 20.57-47.44 in 2019) and Mongolia (ASDR 568.54, 95% UI 242.03-1,031.14 in 2019) had the highest ASMR/ASDR, respectively. Low temperature currently contributes to the main burden (deaths 474,002, 95% UI 355,077-606,537; DALYs 8,357,198, 95% UI 6,186,217-10,801,911 attributable to low temperature vs deaths 48,030, 95% UI 5,630-104,370; DALYs 1,089,329, 95% UI 112,690-2,375,345 attributable to high temperature in 2019). However, the burden due to high temperature has increased rapidly, especially among people aged older than 10 years, and was disproportionately concentrated in low sociodemographic index (SDI) regions such as Africa. In addition, the rapid increase in the stroke burden due to high temperature in Central Asia also requires special attention. DISCUSSION: This is the first study to assess the global stroke burden attributed to nonoptimal temperature. The dramatic increase in the burden due to high temperature requires special attention, especially in low-SDI countries.

Biomechanical assessment of different transforaminal lumbar interbody fusion constructs in normal and osteoporotic condition: a finite element analysis.

BACKGROUND CONTEXT: With the aging population, osteoporosis, which leads to poor fusion, has become a common challenge for lumbar surgery. In addition, most people with osteoporosis are elderly individuals with poor surgical tolerance, and poor bone quality can also weaken the stability of internal fixation. PURPOSE: This study compared the fixation strength of the bilateral traditional trajectory screw structure (TT-TT), the bilateral cortical bone trajectory screw structure (CBT-CBT), and the hybrid CBT-TT (CBT screws at the cranial level and TT screws at the caudal level) structure under different bone mineral density conditions. STUDY DESIGN: A finite element (FE) analysis study. METHODS: Above all, we established a healthy adult lumbar spine model. Second, under normal and osteoporotic conditions, three transforaminal lumbar interbody fusion (TLIF) models were established: bilateral traditional trajectory (TT-TT) screw fixation, bilateral cortical bone trajectory (CBT-CBT) screw fixation, and hybrid cortical bone trajectory screw and traditional trajectory screw (CBT-TT) fixation. Finally, a 500-N compression load with a torque of 10 N/m was applied to simulate flexion, extension, lateral bending, and axial rotation. We compared the range of motion (ROM), adjacent disc stress, cage stress, and posterior fixation stress of the different fusion models. RESULTS: Under different bone mineral density conditions, the range of motion of the fusion segment was significantly reduced. Compared to normal bone conditions, the ROM of the L4-L5 segment, the stress of the adjacent intervertebral disc, the surface stress of the cage, and the maximum stress of the posterior fixation system were all increased in osteoporosis. Under most loads, the ROM and surface stress of the cage and the maximum stress of the posterior fixation system of the TT-TT structure are the lowest under normal bone mineral density conditions. However, under osteoporotic conditions, the fixation strength of the CBT-CBT and CBT-TT structures are higher than that of the TT-TT structures under certain load conditions. At the same time, the surface stress of the intervertebral fusion cage and the maximum stress of the posterior fixation system for the two structures are lower than those of the TT-TT structure. CONCLUSION: Under normal bone mineral density conditions, transforaminal lumbar interbody fusion combined with TT-TT fixation provides the best biomechanictability. However, under osteoporotic conditions, CBT-CBT and CBT-TT structures have higher fixed strength compared to TT-TT structures. The hybrid CBT-TT structure exhibits advantages in minimal trauma and fixation strength. Therefore, this seems to be an alternative fixation method for patients with osteoporosis and degenerative spinal diseases. CLINICAL SIGNIFICANCE: This study provides biomechanical support for the clinical application of hybrid CBT-TT structure for osteoporotic patients undergoing TLIF surgery.

Occurrence and risk assessment of glycidyl and 3-monochloropropanediol esters in infant formulas marketed in Taiwan.

Glycidyl esters (GEs) and 3-monochloropropanediol esters (3-MCPDEs) are process contaminants commonly found in refined edible oils which are often added to infant formulas. The Taiwan Food and Drug Administration (TFDA) launched regulations for GEs in infant formulas that went into effect on 1 July 2021. To investigate levels of GEs and 3-MCPDEs in infant formula powder, 45 products were sampled and analysed during 2020-2021. The contents of GEs and 3-MCPDEs in formulas of different brands significantly varied, but their concentrations in all of the formulas complied with European Union (EU) regulations. Infant formulas containing palm oil had significantly higher 3-MCPDE levels in both extracted oils and milk powder than those without palm oil. Concentrations of GEs and 3-MCPDEs in infant formula powder and extracted oils were significantly lower in products from Europe than those from Australia and New Zealand. Infants aged 0-1 years in Taiwan who consumed only infant formula showed a margin of exposure (MoE) exceeding 25,000. Mean consumer exposures to 3-MCPDEs stayed below the tolerable daily intake (TDI), while high exposures at the 95th percentile (P95) exceeded the TDI by 1.7-fold. Herein, we present the changing trends in the risk assessment results of infant formula across various countries in the decade. Implementation of regulations and mitigation strategy effectively reduced the risk of infants being exposed to GEs and 3-MCPDEs through infant formula.

Probabilistic risk assessment for determining nonessential metals in commercial infant formula products in Taiwan.

During the early months of life, infant formula plays a crucial role as a primary source of both food and essential nutrients for infants, serving as a replacement for or supplement to breast milk. However, nonessential metals in infant formulas are a concern because infants are highly vulnerable to chemical exposure. The aim of this study was to investigate infant exposure to nonessential metals in infant formula products in Taiwan and assess the associated health risks. In this study, concentrations of arsenic (As), barium (Ba), cadmium (Cd), manganese (Mn), lead (Pb), and vanadium (V) in 45 formula products for 0-1-year-old infants were determined by inductively coupled plasma mass spectrometry. The mean As, Ba, Cd, Mn, Pb, and V concentrations were 6.42, 280, 3.72, 1425, 20.4, and 21.9 µg/kg, respectively. According to our probabilistic simulation of the estimated daily intake of metals, the proportion of hazard quotients exceeding one was 7.69% for As and 3.29% for Mn, and that of hazard index (HI) values exceeding 1 was >17% for metals. Arsenic had the largest HI contribution (46.9%), followed by Mn (22.3%) and Pb (12.7%). The nonessential metals content in infant formula raises potential noncarcinogenic health concerns for infants in Taiwan. Therefore, regulations for nonessential metals must be imposed on related food products in Taiwan, with a particular focus on As and Mn.

Bioequivalence and Safety Assessment of 2 Formulations of Low-Dose Metformin Hydrochloride under Fasting Conditions in Healthy Chinese Participants: A Randomized Phase 1 Clinical Trial.

The incidence of type 2 diabetes is high, and the existing metformin hydrochloride (MH) tablets of 250 mg cannot meet the demands of the Chinese drug market. This study aimed to evaluate the bioequivalence and safety of generic formulations of MH tablets (test formulation [T], 250 mg/tablet) and innovative products (reference formulation [R], 250 mg/tablet) under fasting conditions. This was an open-label, single-dose, 2-period, 2-sequence crossover, single-center, randomized phase I clinical trial. T and R were considered bioequivalent if the adjusted geometric mean ratios (GMRs) and 90% confidence intervals of the area under the curve (AUC) and maximum concentration (Cmax ) were within the range of 0.8-1.25. Thirty-five participants completed the trial. The T/R adjusted GMRs (95.7% for Cmax , 98.7% for AUC0→t , 98.8% for AUC0→∞ ) were within the acceptable bioequivalence range of 80%-125%. No serious adverse events or suspected or unexpected serious adverse reactions occurred during this trial. The study findings confirmed that generic MH is a well-tolerated and bioequivalent alternative to innovative products under fasting conditions in healthy Chinese participants. (www.chinadrugtrials.org.cn; registration no. CTR20190356).

In vitro inhalation bioaccessibility and health risk assessment of difenoconazole in the atmosphere.

BACKGROUND: Assessment of the risk of pesticide inhalation in populations around farmland is necessary because inhalation is one of the ways in which pesticides can risk human health. This study aimed to identify the inhalation risk of difenoconazole on humans by using dose-response and exposure assessments. RESULTS: In the field simulation application, respiratory exposure in populations around farmland ranged from 71 to 430 ng/m3 . Using response surface methodology, the maximum bioaccessibility of difenoconazole in three simulated lung fluids was 35.33% in Gamble's solution (GS), 34.12% in artificial lysosomal fluid (ALF), and 42.06% in simulated interstitial lung fluid (SLF). Taking the proliferation activity of the A549 cell model as the endpoint, the benchmark dose limit and benchmark dose of difenoconazole on A549 cells were 16.36 and 5.60 mg/kg, respectively. The margin of exposure to difenoconazole in GS, ALF and SLF were, respectively, 8.66 × 105 to 5.28 × 106 , 8.97 × 105 to 5.47 × 106 and 7.28 × 105 to 4.44 × 106 . CONCLUSION: The risk assessment results indicate that under all circumstances, applying difenoconazole is safe for populations around farmland. However, a fan-shaped nozzle, suspension concentrate and greater inhalation height increase the risk of inhalation. © 2023 Society of Chemical Industry.

The Health And Social Needs Of Medicaid Beneficiaries In The Postpartum Year: Evidence From A Multistate Survey.

As of September 2023, thirty-seven states and Washington, D.C., had adopted the option in the American Rescue Plan Act of 2021 to extend pregnancy Medicaid eligibility to one year postpartum. To inform state initiatives to support this newly covered population, we conducted a representative survey of postpartum people in six states and New York City from January 2021 to March 2022. Compared with respondents who had commercial insurance at the time of childbirth, Medicaid respondents were less likely to have a usual source of care and reported less use of primary, specialty, and dental care in the postpartum year. Depression symptoms and social concerns such as food insecurity, intimate partner violence, and financial strain were significantly higher in the Medicaid population. Rates of anxiety symptoms, delaying or not getting needed care, and unsatisfactory child care were similar in both populations. Our findings suggest that postpartum Medicaid extensions should be coupled with state initiatives to address beneficiaries' health and social needs. National investments in data collection on postpartum people will be critical to support evidence-based policy making to improve maternal health and well-being.

Disaster response strategies of governments and social organizations: From the perspective of infrastructure damage and asymmetric resource dependence.

Natural disaster response is commonly regarded as a dynamic process that reflects intricate relationships between physical and social factors. The resilience of physical infrastructure impacts the availability of emergency resources, while asymmetric resource dependence among emergency cooperation organizations influences the effectiveness of the coordinated emergency response. This study has formulated differential game encompassing three emergency response models: autonomous participation, government-led, and collaborative response. These models have been designed to account for scenarios involving infrastructure damage and asymmetric resource dependence scenarios to compute the optimal level of emergency response efforts by both government and social organizations, the government cost-sharing ratio, the optimal level of emergency resource availability, and disaster response performance. The results indicated that, under specific conditions, government cost-sharing can motivate social organizations to actively engage in disaster response, leading to improvement in disaster response performance. The collaborative emergency response model outperformed the other models regarding optimal emergency response strategy and disaster response performance. Notably, infrastructure damage and asymmetric resource dependence lead to a reduction in the optimal level of emergency response efforts and system disaster response performance for both parties. Furthermore, the impact of infrastructure damage on disaster response performance and the optimization of emergency resource availability levels are shown to be more substantial than the effects of asymmetric resource dependence. This research provided theoretical support for strategic decision-making in natural disaster response and is more aligned with disaster response.

Impact of access to childhood health services on healthy life expectancy of the older population.

Background: Life course theory provides new perspectives on the impact of early experiences on health in old age, where unfortunate childhood experiences can alter an individual's health trajectory. This study aims to calculate the healthy life expectancy of the older population in China under different childhood experiences, and to explore the influence of childhood medical and health services on the health level of older adults. Methods: Differences in healthy life expectancy of the older population under different childhood experiences were analyzed using the multi-state life table method to calculate the healthy life expectancy by sex and place of birth, based on the cohort data of Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018. Results: The probability of the transition risk from health to non-health gradually increased with age, while the probability of the transition risk from non-health to health decreased with age; In both urban and rural areas, on the probability of the transition risk from health to non-health, the older adults who were able to receive timely medical and health services in childhood were lower than those who failed to receive medical services in time (Z = -5.833, P < 0.05), but the probability of the transition risk from non-health to health was the opposite (Z = -5.334, P < 0.05); The probability of the transition risk from health to death is also higher in older adults who were unable to receive timely medical care in childhood (Z = -5.88, P < 0.05); The healthy life expectancy and its proportion in the remaining life expectancy of older people who received medical and health services in time during childhood were significantly higher than those of their peers (Z = -5.88, P < 0.05). Conclusions: The lack of medical services in childhood has a negative effect on the health of older adults. The healthy life expectancy and its proportion of remaining life expectancy were higher for rural older adults than for urban older adults under the same health care conditions in childhood; the health benefits of good access to health care environment or conditions in childhood were greater for rural older females.

Seawater quality criteria and ecotoxicity risk assessment of zinc oxide nanoparticles based on data of resident marine organisms in China.

Water quality criteria (WQC) for zinc oxide nanoparticles (ZnO NPs) are crucial due to their extensive industrial use and potential threats to marine organisms. This study conducted toxicity tests using marine organisms in China, revealing LC50 or EC50 values for ZnO NPs ranging from 0.36 to 95.6 mg/L across seven species, among which the salinity lake crustacean zooplankton Artemia salina exhibited the highest resistance, while diatom Phaeodactylum tricornutum the most sensitive. Additionally, the EC10 or maximum acceptable toxicant concentration (MATC) values for ZnO NPs were determined for five species, ranging from 0.03 to 2.82 mg/L; medaka Oryzias melastigma demonstrated the highest tolerance, while mysis shrimp Neomysis awatschensis the most sensitive. Based on the species sensitivity distribution (SSD) method, the derived short-term and long-term WQC for ZnO NPs were 138 µg/L and 8.37 µg/L, respectively. These values were further validated using the sensitive species green algae Chlorella vulgaris, confirming effective protection. There is no environmental risk observed in Jiaozhou Bay, Yellow River Estuary and Laizhou Bay in the northern coastal seas of China. This study provides important reference data for the establishment of water quality standards for nanoparticles.

Freshwater environment risk assessment and derivation of human health ambient water quality criteria for SCCPs in China.

Short-chain chlorinated paraffins (SCCPs, CxH2x+2-yCly, where x = 10 to 13 and y = 3 to x) are a complex family of emerging contaminants that have been identified as persistent, bioaccumulative and toxic (PBT) substances. Because of their persistence, high toxicity, bioaccumulation and long-distance mobility, SCCPs were added to the list of controlled POPs in the Stockholm Convention in 2017. China is the largest producer and user of SCCPs all over the world, thus SCCPs have been widely distributed in the freshwater environment. But the ecological risk and human health risk of SCCPs in China were still less evaluated. This study collected and screened the exposure data of SCCPs in freshwater environment in China, and then evaluated the freshwater and sediments ecological risk of SCCPs by risk quotient (RQ) method and the human health risk by margin of exposure (MOE) method. Our results showed that the pollution of SCCPs in the freshwater environment in China was not optimistic. The ecological risks and human health risks had occurred, and even there were high ecological risks occurred in some regions in China. Besides, because of the absence of the concentration threshold of SCCPs to protect human health in freshwater at present, we derived the human health ambient water quality criteria (AWQC) values of SCCPs based on exposure data and bioaccumulation factor (BAF) in China. The human health AWQC values of SCCPs ranged from 14.99 ng L-1 to 154.54 ng L-1 in different regions in China, and the national human health AWQC value was determined as 24.08 ng L-1. This study will provide the scientific references for the management and control of SCCPs in China, especially for the formulation of standard of water environmental quality for SCCPs.

Multimodal Assessment of Schizophrenia Symptom Severity From Linguistic, Acoustic and Visual Cues.

Assessing the condition of every schizophrenia patient correctly normally requires lengthy and frequent interviews with professionally trained doctors. To alleviate the time and manual burden on those mental health professionals, this paper proposes a multimodal assessment model that predicts the severity level of each symptom defined in Scale for the Assessment of Thought, Language, and Communication (TLC) and Positive and Negative Syndrome Scale (PANSS) based on the patient's linguistic, acoustic, and visual behavior. The proposed deep-learning model consists of a multimodal fusion framework and four unimodal transformer-based backbone networks. The second-stage pre-training is introduced to make each off-the-shelf pre-trained model learn the pattern of schizophrenia data more effectively. It learns to extract the desired features from the view of its modality. Next, the pre-trained parameters are frozen, and the light-weight trainable unimodal modules are inserted and fine-tuned to keep the number of parameters low while maintaining the superb performance simultaneously. Finally, the four adapted unimodal modules are fused into a final multimodal assessment model through the proposed multimodal fusion framework. For the purpose of validation, we train and evaluate the proposed model on schizophrenia patients recruited from National Taiwan University Hospital, whose performance achieves 0.534/0.685 in MAE/MSE, outperforming the related works in the literature. Through the experimental results and ablation studies, as well as the comparison with other related multimodal assessment works, our approach not only demonstrates the superiority of our performance but also the effectiveness of our approach to extract and integrate information from multiple modalities.

The Mechanism of Socioeconomic Status Effects on Cognition.

Socioeconomic status (SES) is a measurement of the sociological and economic statuses of individuals compared to others within the social and economic hierarchies. The common indicators of SES are income, education, and occupation statuses. Recently, researchers have used mixed measurements of SES, such as the MacArthur Scale. Numerous researches have proven the influence of SES on human development. Individuals who are less educated, have lower job status, and earn less or no income are at greater risk of poor health than their higher SES counterparts. SES has also been proven to influence life satisfaction, academic achievement, emotion regulation, cognitive function, and decision-making tendencies. SES has life span influence, which correlates with the level of cognition, rate of cognitive decline, and incidence of Alzheimer's disease among elderly individuals. Besides the individual level of SES, neighborhood SES can also affect cognitive function as an environmental factor. Low-SES individuals exhibit hypoactivation of the executive network and hyperactivation of the reward network, indicating low-SES individuals tend to focus more on monetary issues, while neglecting other non-monetary issues, which is consistent with the scarcity hypothesis.

The development of assistive product policies in China from the perspective of the assistive product industry.

PURPOSE: The aim was to develop targeted and complete policy structure of China's assistive products, and to provide recommendations for boosting the matching rate of assistive products and driving the benign development of China's assistive product market. METHODS: This paper establishes a theoretical framework of the development logic of assistive product policies. Then it adopts the text quantification method to review 81 relevant documents on these policies issued from 1988 to 2019 systematically. RESULTS: We found that environmental policy tools account for the largest proportion with regard to policy tool, and can provide a good policy environment; the role of demand-based policy tools in creating market activity and stimulating industrial development needs to be elevated. The policies concerning assistive products industry in China show a rising trend. This paper is centred on the relatively stable theme of policy issuing. Coordination with various ministries can maximize the benefits. In the early period, the targeted policy objectives are put forward for assistive products industry; in the later period, the focus is on the combination with the policies concerning the elderly. Division of labour and proper coordination are required to coordinate type of policies. CONCLUSION: The key to the industrial development lies in promoting the change of consumption concepts, and the difficulty lies in how to coordinate the contradiction interests between product suppliers and demanders through policy intervention. IMPLICATIONS FOR REHABILITATION: The relatively disadvantaged position of users of assistive products determines certain public goods attributes of the products, which mean that the operation of the market cannot rely entirely on the price mechanism. That is, non-market mechanisms (especially the administrative mechanism) need to play their roles in the case of a market failure.After more than 30 years of development, assistive product policies in China covered various policy tools such as supply-based, demand-based and environment-based ones, and the assistive product industry has developed significantly. However, the recipients of assistive products are mainly among disadvantaged groups such as persons with disabilities and the elderly. The products have social welfare attributes. The policies involve profound changes in economic conditions, industrial models and institutional mechanisms. The key to the industrial development lies in promoting the change of consumption concepts, and the difficulty lies in how to coordinate the contradiction in interests between product suppliers and demanders through policy intervention at this stage.This paper systematically analyzes the development logic and practice of China's industry policies of assistive products and put forward suggestions that more attention of policies can be paid to the demand side and develop a demand-pull model, the consumption of universal products can be encouraged and guided by policies, and attempts in policies can be made to guide the consumption concept of assistive products.

Analogous plasmon-induced absorption based on an end-coupled MDM structure with area-cost-free cavities.

We theoretically investigate an end-coupled metal-dielectric-metal (MDM) structure that achieves analogous plasmon-induced absorption (APIA) in an area-cost-free manner. First, a squared ring is set to end-couple with MDM input and output waveguides, generating three Lorentzian-like peaks in the spectrum. Then, two APIA windows as well as two Fano resonances can be induced via appropriately arranging two area-free cavities. Numerous numerical results demonstrate that the proposed structure has remarkable sensing and phase characteristics. Our proposed PIA-based MDM structure is promising in potential applications of bio-chemical sensing, slow light devices, optical switching, and chip-scale plasmonic devices.

Bioequivalence and safety evaluation of two preparations of metformin hydrochloride sustained-release tablets (Boke® and Glucophage®-XR) in healthy Chinese volunteers: a randomized phase I clinical trial.

BACKGROUND: As per the National Medical Products Administration (NMPA) requirements, the quality and efficacy of generic drugs must be consistent with those of the innovator drug. We aimed to evaluate the bioequivalence and safety of generic metformin hydrochloride sustained-release (MH-SR) tablets (Boke®) developed by Beijing Wanhui Double-crane Pharmaceutical Co. Ltd., China and the innovator product metformin hydrochloride extended-release tablets (Glucophage®-XR) manufactured by Bristol-Myers Squibb Company, New York, NY, in healthy Chinese volunteers. MATERIALS AND METHODS: We performed a bioequivalence and safety assessment of MH-SR (500 mg/tablet) and Glucophage®-XR (500 mg/tablet) tablets in a randomized, open-label, two-period, two-sequence crossover, single-dose oral study in 48 healthy Chinese adult participants under fasting conditions (Chinese Clinical Trial Registration No. CTR20171306). The washout period was seven days. Bioequivalence (80.00-125.00%) was assessed using adjusted geometric mean ratios (GMRs) and two-sided 90% confidence intervals (CIs) of the area under the curve (AUC) and maximum concentration (Cmax) for each component. RESULTS: The 90% CIs of the test/reference preparation for key pharmacokinetic parameters were 97.36-108.30% for AUC0→t, 97.26-108.09% for AUC0→∞ and 96.76-111.37% for Cmax. No severe adverse events (AEs) were observed. However, 38 adverse drug reactions (ADRs) occurred, including metabolic or nutritional conditions (n = 8), infections (n = 2), gastrointestinal conditions (n = 10) and abnormal inspection (n = 18). No significant difference was observed between MH-SR (23 ADRs, 10 participants) and Glucophage®-XR (15 ADRs, 12 participants) (p = .500). Bioequivalence was concluded since the 90% CIs of the main pharmacokinetic parameters were within the equivalence interval (80.00-125.00%). CONCLUSIONS: MH-SR (500 mg/tablet) and Glucophage®-XR (500 mg/tablet) were found to be bioequivalent and safe under fasting conditions in healthy Chinese participants. Thus, the market demand for MH-SR tablets (500 mg/tablet) can be met using the generic alternative.KEY MESSAGESGeneric MH-SR tablets (500 mg, Beijing Wanhui Double-crane Pharmaceutical Co. Ltd., Beijing, China) and innovator MH-SR tablets (Glucophage®-XR, 500 mg, Bristol-Myers Squibb Company, New York, NY, USA) were bioequivalent and safe in healthy Chinese volunteers under single-dose administration and fasting conditions.The main goal of this study is to support an increase in the supply of MH-SR tablets in China by proving the efficacy and safety of a generic alternative.Although no sugar was administered in the BE trial of the MH-SR tablets under fasting conditions, no hypoglycaemic event occurred. The method used in this study is expected to serve as a reference for BE studies of different MH-SR formulations.

Comprehensive assessment of the impact of land use and hydrogeological properties on the groundwater quality in Taiwan using factor and cluster analyses.

This study aims at making a comprehensive assessment of the impact of land use and the hydrogeological properties on groundwater quality. First, factor analysis (FA) is applied to reveal the main pollutant sources and hydrogeological processes controlling the groundwater quality. FA identifies the four most important factors. Factor 1 (seawater salinization) is characterized by a medium loading of land use type of aquaculture. It is recognized that the high scores for factor 1 in coastal areas are due to over-pumping from aquafarms. Focused land use management is required to prevent saline-water intrusion in coastal aquifers. Factor 3 (nitrate pollution) shows high correlations with the land use type of fruit farming and the gravel thickness in unsaturated layers. High scores for factor 3 are also found in the proximal area of the Chuoshui River Alluvial Fan and the northeastern mountain area in the Pingtung Plain. Fruit farmers should be educated to reduce the application of fertilizers and promote the organic fruit farming. The impacts of land use and the hydrogeological properties on both Factor 2 (arsenic enrichment) and Factor 4 (reductive dissolution of Fe2+ and Mn2+) are negligible. Second, cluster analysis (CA) is performed on computed scores of the four main factors to separates 123 monitoring wells into cluster 1 (low polluted zone), cluster 2 (nitrate polluted zone) and cluster 3 (hybrid polluted zone). The results obtained from CA provide practical applications such as reduce agrichemical use in the areas of cluster 2 and enforce intensive monitoring in the prioritizing areas of cluster 3. This study successively uses the FA and CA to extract the meaningful information present by geographical visualization of scores for 4 main factors and 3 distinct clusters zones. The results are essential for formulating sound groundwater resource and land use management policies to ensure groundwater sustainability.

Does green environmental innovation really matter for carbon-free economy? Nexus among green technological innovation, green international trade, and green power generation.

This study examines the association among the green energy production (GEP), green technological innovation (GTI), and green international trade (GIT) on the ecological footprints (EFP). In addition, this research applies fully modified least square (FMOLS) to estimate the empirical outcomes, while dynamic least square (DOLS) is used to check the robustness of the outcomes. Although, the selection of the assessment technique depends on the order of integration of the selected series. Before estimation, some diagnostic tests are also performed to ensure the reliability of the data set. Furthermore, the empirical outcomes of the present analysis are twofold: at begin, this research discovered a negative relationship between GEP and EFP. Secondly, this research reveals that GTI has also an adverse impact on EFP along with GIT, which is unsurprising. Results imply that advancement in green technological innovations tends to improve the EQ by reducing the level of EFP.