Effect of separation pretreatment on environmental and economic performance of sludge resource utilization.

As a new technology for accurate utilization of sludge resources, sludge inorganic-organic matter separation (IOMS) has attracted wide attention. This study examined the impact of this pretreatment on environmental and economic performance of sludge composting and incineration using life cycle assessment (LCA) and whole life costing (WLC). LCA results indicated that IOMS pretreatment reduced the energy conservation and emission reduction (ECER) values of composting and incineration by 56 % and 76 %, respectively. Meanwhile, WLC exhibited that IOMS pretreatment could cut the break-even year of incineration from 11 years to 4 years. The combination of organic sludge incineration/composting with inorganic sludge sintering ceramsite reveals excellent environmental and economic performance. The application optimization hypothesis analysis of these two routes in various provinces of China indicates that Jiangsu has the greatest development potential and should become a major promotion region.

A "food insecurity poverty line" to replace the official threshold in Canadian rural and urban settings? A single-person household perspective.

Household food insecurity is associated with both low income and high cost of living, it is a potentially better measure for consumption compared to income. We use data on food insecurity and income from 10 years of the Canadian Community Health Survey (2007-2017) of single-person households (n = 145,044) to estimate the probability of being food insecure at the Canadian poverty thresholds (Market Basket Measure thresholds, or MBMs), and determine the income required to reach that probability in each MBM region, aggregated by province and rural/urban status. A regression model shows the probability of being food insecure at the MBM is approximately 30% which we call the Food Insecurity Poverty Line (FIPL). The income required to meet the FIPL is substantially different from the MBM, sometimes 1.25 times the MBM. This implies that food insecurity is a potential sentinel measure for poverty.

Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China.

BACKGROUND: Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR. METHODS: This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021. RESULTS: COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098-0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05). CONCLUSIONS: Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation.

Bibliometric and visualization analysis of risk management in the doctor-patient relationship: A systematic quantitative literature review.

OBJECTIVES: This paper analyzed the research on risk management in the doctor-patient relationship (DPR) based on a systematic quantitative literature review approach using bibliometric software. It aims to uncover potential information about current research and predict future research hotspots and trends. METHODS: We conducted a comprehensive search for relevant publications in the Scopus database and the Web of Science Core Collection database from January 1, 2000 to December 31, 2023. We analyzed the data using CiteSpace 6.2.R2 and VOSviewer 1.6.19 software to examine the annual number of publications, countries/regions, journals, citations, authors, and keywords in the field. RESULTS: A total of 553 articles and reviews that met the criteria were included in this study. There is an overall upward trend in the number of publications issued; in terms of countries/regions, the United States and the United Kingdom are the largest contributors; Patient Education and Counseling is the most productive journal (17); Physician communication and patient adherence to treatment: a meta-analysis is the most cited article (1637); the field has not yet to form a stable and obvious core team; the analysis of high-frequency keywords revealed four main research directions: the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the keyword burst analysis revealed several shifts in the research hotspots for risk management in the DPR, suggesting that chronic disease management, is a future research direction for the continued development of risk management in the DPR. CONCLUSIONS: The visualization analysis of risk management literature in the DPR using CiteSpace and VOSviewer software provides insights into the current research status and highlights future research directions.

[Spatial-temporal Distribution and Source Analysis of Polycyclic Aromatic Hydrocarbons in the Sediments of Poyang Lake].

The concentrations, spatial-temporal distribution, and influencing factors of 16 polycyclic aromatic hydrocarbons (PAHs) in the sediments of Poyang Lake were studied, and a quantitative source analysis of PAHs in different areas of the lake was conducted. PAHs were widespread within the sediments. The concentrations of ∑16PAHs in the surface sediments of all sites ranged from 203 to 2 318 µg·kg-1. The concentrations of PAHs in the surface sediments of the lake body were higher than those in the surface sediments of the inlet rivers. The ratio of PAHs in Poyang Lake was 4 rings > 5 rings > 6 rings > 3 rings > 2 rings; the composition of 4-ring PAHs was dominant, and its content accounted for 86.11% of ∑16PAHs. The 2- and 3-ring and some 4-ring PAHs, including Flua and Pyr, were more susceptible to SOM, and the 4 through 6-ring PAHs were more susceptible to ORP and heavy metals and other environmental factors. Spatially, the higher concentration of ∑16PAHs occurred in the area of the lake adjacent to Duchang County and Poyang County, where the terrain was relatively closed, and the water exchange with the surrounding area was less than that in other sections, which was not conducive to the migration, transformation, and degradation of pollutants. In the temporal distribution, the changes in PAHs concentration level and the development of GDP in Jiangxi Province showed high consistency, and the influence of economic development and human activities might have been the main reason for the increasing PAHs concentration level. The main sources of PAHs in surface sediments of Poyang Lake included petroleum pollution and oil and coal and biomass combustion sources, and there were some spatial differences in PAHs sources in different regions. This study can provide a reference for PAHs pollution in surface sediments of Poyang Lake, which is important for the ecological environmental protection and management of Poyang Lake.

Research on the risk governance of fraudulent reimbursement of patient consultation fees.

Background: The fundamental medical insurance fund, often referred to as the public's "life-saving fund," plays a crucial role in both individual well-being and the pursuit of social justice. Medicare fraudulent claims reduce "life-saving money" to "Tang's monk meat", undermining social justice and affecting social stability. Methods: We utilized crawler technology to gather textual data from 215 cases involving fraudulent health insurance claims. Simultaneously, statistical data spanning 2018 to 2021 was collected from the official websites of the China Medical Insurance Bureau and Anhui Medical Insurance Bureau. The collected data underwent comprehensive analysis through Excel, SPSS 26.0 and R4.2.1. Differential Auto-Regressive Moving Average Model (ARIMA (p, d, q)) was used to fit the fund safety forecast model, and test the predictive validity of the forecast model on the fund security data from July 2021 to October 2023 (the fund security data of Anhui Province from September 2021 to October 2023). Results: The outcomes revealed that fraudulent claims by health insurance stakeholders adversely impact the equity of health insurance funds. Furthermore, the risk management practices of Medicare fund administrators influence the publication of fraudulent claims cases. Notably, differences among Medicare stakeholders were observed in the prevalence of fraudulent claims. Additionally, effective governance of fraudulent claims risks was found to have a positive impact on the overall health of healthcare funds. Moreover, the predictive validity of the forecast model on the national and Anhui province's fund security data was 92.86% and 100% respectively. Conclusion: We propose four recommendations for the governance of health insurance fraudulent claims risk behaviors. These recommendations include strategies such as "combatting health insurance fraudulent claims to preserve the fairness of health insurance funds", "introducing initiatives for fraud risk governance and strengthening awareness of the rule of law", "focusing on designated medical institutions and establishing a robust long-term regulatory system", and "adapting to contemporary needs while maintaining a focus on long-term regulation".

R&D mode and coordination of green products in sustainable supply chain considering power structures.

Green product R&D has a significant impact on the sustainable development of the economy and environment, and green product R&D can be carried out by manufacturers, retailers, third-party companies, and enterprise alliances. The decision-making order in the supply chain depends on the power structures, which can affect the choice of the supply chain decision-making. To study the optimal choice of green product R&D mode in different power structures and the influence of power structure on product price, market demand, green level, and enterprise profits, This paper compares five modes including green product R&D by manufacturers, green product R&D by retailers, green product R&D outsourced by manufacturers to third-party companies, green product R&D outsourced by retailers to third-party companies and green product R&D by manufacturers and retailers in the three power structures of manufacturers as core enterprises, retailers as core enterprises, and equal power between manufacturers and retailers to study the selection strategy of green product R&D modes in the sustainable supply chain. The conclusion provides a strategic reference for the selection of green product R&D mode in different power structures. The findings indicate that when manufacturers are core enterprises, retailers' green product R&D is better than that of manufacturers. When retailers are core enterprises, manufacturers' green product R&D is better than that of retailers. In the same power structure, manufacturers' green product R&D is better than outsourcing to third-party companies, retailers' green product R&D is better than outsourcing to third-party companies, and manufacturers and retailers jointly conduct green product R&D better than manufacturers or retailers alone. When manufacturers and retailers have equal power, the market demand and the product green level are the highest, and the retail price is the lowest. When manufacturers are core enterprises, manufacturers' profits are the highest. When retailers are core enterprises, retailers' profits are the highest. Finally, a two-part pricing contract is used to coordinate the optimal selection strategies.

Comprehensive assessment of food waste treatment emission reduction in China: a life cycle perspective.

Food waste (FW) treatment has attracted increasing attention since waste classification occurred in China. Analyzing the environmental and economic impacts of different FW treatment technologies is required. In this study, four FW treatments, i.e., anaerobic digestion, black soldier fly (BSF) bioconversion, composting, and landfill, were evaluated using life cycle assessment (LCA) and life cycle cost (LCC). LCA results show that anaerobic digestion outperforms the other technologies, while LCC results indicate anaerobic digestion has the lowest economic benefits ($5.16) and landfill has the highest ($14.22). Bioconversion has the highest product revenue ($37.98). FW anaerobic digestion followed by treating digestate and waste crude oil was employed to investigate the environmental differences between waste classification and mixed incineration. Digestate gasification and conversion of waste crude oil to biodiesel are found to be environmentally friendly, and waste classification outperforms mixed incineration. Furthermore, we explored national-level environmental emission reduction with anaerobic digestion as the dominant technology via increasing resource utilization rate and applying household FW disposers. Results display that a 60% resource utilization rate decreases the overall environmental impact by 36.68% compared with current situation, and treating household FW separately at the source can further lead to emission reduction. This study provides a reference for selecting FW technologies for countries worldwide from environmental and economic perspectives, as well as a direction of resource utilization for how to reduce environmental emissions from treating the total FW produced by all humanity.

Secular trends of health care resource utilization and costs between Brugada syndrome and congenital long QT syndrome: A territory-wide study.

BACKGROUND: Health care resource utilization (HCRU) and costs are important metrics of health care burden, but they have rarely been explored in the setting of cardiac ion channelopathies. HYPOTHESIS: This study tested the hypothesis that attendance-related HCRUs and costs differed between patients with Brugada syndrome (BrS) and congenital long QT syndrome (LQTS). METHODS: This was a retrospective cohort study of consecutive BrS and LQTS patients at public hospitals or clinics in Hong Kong, China. HCRUs and costs (in USD) for Accident and Emergency (A&E), inpatient, general outpatient and specialist outpatient attendances were analyzed between 2001 and 2019 at the cohort level. Comparisons were made using incidence rate ratios (IRRs [95% confidence intervals]). RESULTS: Over the 19-year period, 516 BrS (median age of initial presentation: 51 [interquartile range: 38-61] years, 92% male) and 134 LQTS (median age of initial presentation: 21 [9-44] years, 32% male) patients were included. Compared to LQTS patients, BrS patients had lower total costs (2 008 126 [2 007 622-2 008 629] vs. 2 343 864 [2 342 828-2 344 900]; IRR: 0.857 [0.855-0.858]), higher costs for A&E attendances (83 113 [83 048-83 177] vs. 70 604 [70 487-70 721]; IRR: 1.177 [1.165-1.189]) and general outpatient services (2,176 [2,166-2,187] vs. 921 [908-935]; IRR: 2.363 [2.187-2.552]), but lower costs for inpatient stay (1 391 624 [1 391 359-1 391 889] vs. 1 713 742 [1 713 166-1 714 319]; IRR: 0.812 [0.810-0.814]) and lower costs for specialist outpatient services (531 213 [531 049-531 376] vs. 558 597 [558268-558926]; IRR: 0.951 [0.947-0.9550]). CONCLUSIONS: Overall, BrS patients consume 14% less health care resources compared to LQTS patients in terms of attendance costs. BrS patients require more A&E and general outpatient services, but less inpatient and specialist outpatient services than LQTS patients.

Identification of Gut Microbiome and Metabolites Associated with Acute Diarrhea in Cats.

Changes in diet and environment can lead to acute diarrhea in companion animals, but the composition and interactions of the gut microbiome during acute diarrhea remain unclear. In this multicenter case-control study, we investigated the relationship between intestinal flora and acute diarrhea in two breeds of cats. Acutely diarrheic American Shorthair (MD, n = 12) and British Shorthair (BD, n = 12) and healthy American Shorthair (MH, n = 12) and British Shorthair (BH, n = 12) cats were recruited. Gut microbial 16S rRNA sequencing, metagenomic sequencing, and untargeted metabolomic analysis were performed. We observed significant differences in beta-diversity (Adonis, P < 0.05) across breeds and disease state cohorts. Profound differences in gut microbial structure and function were found between the two cat breeds. In comparison to healthy British Shorthair cats, Prevotella, Providencia, and Sutterella were enriched while Blautia, Peptoclostridium, and Tyzzerella were reduced in American Shorthair cats. In the case-control cohort, cats with acute diarrhea exhibited an increased abundance of Bacteroidota, Prevotella, and Prevotella copri and a decreased abundance of Bacilli, Erysipelotrichales, and Erysipelatoclostridiaceae (both MD and BD cats, P < 0.05). Metabolomic analysis identified significant changes in the BD intestine, affecting 45 metabolic pathways. Moreover, using a random forest classifier, we successfully predicted the occurrence of acute diarrhea with an area under the curve of 0.95. Our findings indicate a distinct gut microbiome profile that is associated with the presence of acute diarrhea in cats. However, further investigations using larger cohorts of cats with diverse conditions are required to validate and extend these findings. IMPORTANCE Acute diarrhea is common in cats, and our understanding of the gut microbiome variations across breeds and disease states remains unclear. We investigated the gut microbiome of two cat breeds (British Shorthair and American Shorthair) with acute diarrhea. Our study revealed significant effects of breeds and disease states on the structure and function of the gut microbiota in cats. These findings emphasize the need to consider breed-related factors in animal nutrition and research models. Additionally, we observed an altered gut metabolome in cats with acute diarrhea, closely linked to changes in bacterial genera. We identified a panel of microbial biomarkers with high diagnostic accuracy for feline acute diarrhea. These findings provide novel insights into the diagnosis, classification, and treatment of feline gastrointestinal diseases.

Cost-effectiveness of Nivolumab Plus Cabozantinib Versus Cabozantinib as First-Line Treatment of Metastatic Renal Cell Carcinoma.

OBJECTIVES: We first evaluated the cost-effectiveness of nivolumab plus cabozantinib compared with cabozantinib alone as a first-line treatment of metastatic renal cell carcinoma (mRCC) from a US healthcare payer perspective. In the present study, we found that nivolumab plus cabozantinib was not cost-effective compared with cabozantinib alone for first-line treatment of mRCC. METHODS: This economic evaluation study used a 3-state partitioned survival model to assess the cost-effectiveness of nivolumab plus cabozantinib versus cabozantinib alone. The observed Kaplan-Meier curves for overall survival and PFS were digitized from the CheckMate 9ER and CABOSUN trials and the long-term survivals (over a lifetime horizon) beyond the end of the trial were extrapolated using the Log-Logistic model. The cost and health preference data were collected from published literature before. RESULTS: The estimated cost for nivolumab plus cabozantinib group was 654 851.32 USD, which was higher than 312 360.47 USD estimated for cabozantinib alone group, resulting in an incremental cost (IC) of 342 490.85 USD. Compared with cabozantinib alone group, nivolumab plus cabozantinib group gains 1.19 QALYs, resulting the ICER was 288 443.23 USD per QALY. One-way sensitivity analysis suggested the cost of nivolumab, the discount rate, and the cost of cabozantinib had a great impact on the ICER. The cost-effectiveness acceptability curves showed the probability of nivolumab plus cabozantinib being cost-effective was 9.9% at a threshold of 150,000 USD per QALY. CONCLUSION: The findings of this economic evaluation suggest nivolumab plus cabozantinib is unlikely to be cost-effective compared with cabozantinib alone as first-line treatment for mRCC at WTP thresholds of 150,000 USD per QALY from the perspective of US payers. A substantial price reduction for nivolumab would be needed to achieve favorable cost-effectiveness.

[Scenario Simulation and Effects Assessment of Co-control on Pollution and Carbon Emission Reduction in Beijing].

Focused on the key areas of energy, buildings, industry, and transportation, with 2020 as the base year and 2035 as the target year, we respectively designed the baseline scenario, policy scenario, and enhanced scenario, calculated the emission reduction potential of air pollutants and CO2 of Beijing, and constructed an assessment method of co-control effect gradation index to evaluate the co-control effect of air pollutants and CO2 in the policy scenario and enhanced scenario. The results showed that in the policy scenario and enhanced scenario, the reduction rates of air pollutants emissions will reach 11%-75% and 12%-94%, respectively, and reduction rates of CO2 emissions will reach 41% and 52%, respectively, compared with those from the baseline scenario. Optimizing vehicle structure had the largest contribution to the emission reduction of NOx, VOCs, and CO2, and the emission reduction rates will reach 74%, 80%, and 31% in the policy scenario and 68%, 74%, and 22% in the enhanced scenario, respectively. Replacing coal-fired with clean energy in rural areas had the largest contribution to the emission reduction of SO2; the emission reduction rates will reach 47% and 35% in the policy scenario and enhanced scenario, respectively. Improving the green level of new buildings had the largest contribution to the emission reduction of PM10; the emission reduction rates will reach 79% and 74% in the policy scenario and enhanced scenario, respectively. Optimizing travel structure and promoting green development of digital infrastructure had the best co-control effect. The co-control effect of replacing coal-fired with clean energy in rural areas, optimizing vehicle structure, and promoting green upgrading of the manufacturing industry will be improved to a better status in the enhanced scenario. More attention should be paid to improving the proportion of green trips, implementing the promotion of new energy vehicles, and the green transportation of goods to reduce emissions in the field of transportation. At the same time, with the continuous improvement in electrification level in the end energy consumption structure, the proportion of green electricity should be increased by expanding local renewable energy power production and increasing external green electricity transmission capacity, to enhance the co-control effect of pollution and carbon reduction.

The stereoselective toxicity of dinotefuran to Daphnia magna: A systematic assessment from reproduction, behavior, oxidative stress and digestive function.

Dinotefuran is a promising neonicotinoid insecticide with chiral structure. In the present study, the stereoselective toxicity of dinotefuran to Daphnia magna (D. magna) was studied. The present result showed that S-dinotefuran inhibited the reproduction of D. magna at 5.0 mg/L. However, both R-dinotefuran and S-dinotefuran had no genotoxicity to D. magna. Additionally, neither R-dinotefuran nor S-dinotefuran had negative influences on the motor behavior of D. magna. However, S-dinotefuran inhibited the feeding behavior of D. magna at 5.0 mg/L. Both R-dinotefuran and S-dinotefuran induced oxidative stress effect in D. magna after exposure. R-dinotefuran significantly activated the activities of superoxide dismutase (SOD) and glutathione S-transferase (GST), while S-dinotefuran showed the opposite effect. S-dinotefuran had more obvious activation effect on the acetylcholinesterase (AchE) activity and trypsin activity compared to R-dinotefuran. The transcriptome sequencing results showed that S-dinotefuran induced more DEGs in D. magna, and affected the normal function of ribosome. The DEGs were mainly related to the synthesis and metabolism of biomacromolecules, indicating the binding mode between dinotefuran enantiomer and biomacromolecules were different. Additionally, the present result indicated that the digestive enzyme activity and digestive gene expression levels in D. magna were greatly enhanced to cope with the inhibition of S-dinotefuran on the feeding.

Cost-effectiveness analysis of pembrolizumab versus chemotherapy for microsatellite instability-high or mismatch repair-deficient metastatic colorectal cancer.

The aim of this study was to assess the cost-effectiveness of pembrolizumab versus chemotherapy for metastatic colorectal cancer (mCRC) patients with mismatch-repair deficiency or microsatellite instability-high (dMMR/MSI-H) in China. A partitioned survival model was constructed to determine the costs and effects of pembrolizumab and chemotherapy based on KEYNOTE-177 trial outcomes data. Health outcomes were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The Chinese health service system perspective was considered. A willing-to-pay threshold was set at 35,832 USD/QALY, which was three times the gross domestic product (GDP) per capita of China in 2021. We examined the robustness of the model in the one-way and probabilistic sensitivity analysis. Pembrolizumab was associated with better health outcomes than chemotherapy (5.30 vs 3.37 QALYs). Compared with chemotherapy, the pembrolizumab strategy yielded an incremental cost of $16 032.57, which resulted in an ICER of $8285 per QALY. The cost of pembrolizumab and chemotherapy had the largest impact on the ICER. The parameters with less influence on the ICER were utility values of the Post-PFS state. Compared to chemotherapy, pembrolizumab had the economic advantage as the first-line treatment of mCRC patients with dMMR/MSI-H in China.

Attendance-related Healthcare Resource Utilisation and Costs in Patients With Brugada Syndrome in Hong Kong: A Retrospective Cohort Study.

Understanding health care resource utilisation and its associated costs are important for identifying areas of improvement regarding resource allocations. However, there is limited research exploring this issue in the setting of Brugada syndrome (BrS).This was a retrospective territory-wide study of BrS patients from Hong Kong. Healthcare resource utilisation for accident and emergency (A&E), inpatient and specialist outpatient attendances were analyzed over a 19-year period, with their associated costs presented in US dollars. A total of 507 BrS patients with a mean presentation age of 49.9 ± 16.3 years old were included. Of these, 384 patients displayed spontaneous type 1 electrocardiographic (ECG) Brugada pattern and 77 patients had presented with ventricular tachycardia/ventricular fibrillation (VT/VF). At the individual patient level, the median annualized costs were $110 (52-224) at the (A&E) setting, $6812 (1982-32414) at the inpatient setting and $557 (326-1001) for specialist outpatient attendances. Patients with initial VT/VF presentation had overall greater costs in inpatient ($20161 [9147-189215] vs $5290 [1613-24937],P < 0.0001) and specialist outpatient setting ($776 [438-1076] vs $542 [293-972],P = 0.015) compared to those who did not present VT. In addition, patients without Type 1 ECG pattern had greater median costs in the specialist outpatient setting ($7036 [3136-14378] vs $4895 [2409-10554],p=0.019). There is a greater health care demand in the inpatient and specialist outpatient settings for BrS patients. The most expensive attendance type was inpatient setting stay at $6812 per year. The total median annualized cost of BrS patients without VT/VF presentation was 78% lower compared to patients with VT/VF presentation.

Insecticidal efficacy and risk assessment of different neuropeptide analog combinations against the peach-potato aphid following topical exposure.

BACKGROUND: Insect neuropeptides control essential physiological metabolic activities. In our previous studies, Capability/CAP2b (PK/CAPA) analog 1895 applied alone or as a combination of CAPA analogs (1895 + 2315) was reported to decrease aphid fitness. While this was obtained with the combination of two peptide analogs of the same neuropeptide class, the effect of combining peptide analogs of different neuropeptide classes has not been explored so far. RESULTS: In this study, we assessed the effect of combinations of the PK/CAPA analog 1895 with neuropeptide analogs of four different classes [adipokinetic hormone (AKH) analog: 2271; myosuppressin analog: 2434; kinin analog: 2460; tachykinin-related peptide analog: 2463] on the fitness of aphids. We found that the combination of 1895 and AKH analog 2271 was the most effective one to control Myzus persicae. The triple combination 1895 + 2271 + 2315 provided a synergistic effect by further increasing aphid mortality and reducing reproduction relative to 1895 + 2315. Additionally, a biosafety assessment of the combination 1895 + 2271 + 2315 showed no significant lethal nor sub-lethal effects on survival rates and food intake for the pollinator (Bombus terrestris) and the two representative natural enemies (Harmonia axyridis and Nasonia vitripennis). CONCLUSION: These results could facilitate establishment of the triple combination 1895 + 2271 + 2315, and/or inclusion of second generation analogs, as alternatives to broad spectrum and less friendly insecticides. © 2022 Society of Chemical Industry.

Analysis of the Operational Efficiency of Basic Medical Insurance for Urban and Rural Residents: Based on a Three-Stage DEA Model.

Following the integration of the urban residents' medical insurance into the new rural cooperative medical insurance in 2016, China has now formed a basic medical insurance system with the urban workers' basic medical insurance system and the rural residents' basic medical insurance system as the main entities. With the development of basic medical insurance, the protection for residents is becoming more and more comprehensive, and its fund expenditure also increases, so it is necessary to research the efficiency of the medical insurance fund expenditure. This paper conducts a three-stage DEA analysis of the efficiency of basic health insurance for urban and rural residents in 31 provinces, based on a Chinese panel data from 2017 to 2020. It is found that China's health insurance operation is still in the development stage, with four regions in the efficiency frontier and Guizhou province having the lowest efficiency value nationwide. The GDP and fiscal investment on social security effectively reduce the input redundancy in the basic health insurance operation, which contributes to the efficiency of the health insurance operation. This study further proposes suggestions and countermeasures to improve the operational efficiency of China's basic health insurance, based on the empirical results: (1) develop the economy and broaden the financing sources; (2) improve the level of health care services and improve the efficiency driven by quality; and (3) improve the level of health insurance supervision through multiple measures.

Environmental and economic assessment of rural domestic waste gasification models in China.

The dispersed sources and inconvenient transportation of rural domestic waste (RDW) lead to difficult centralized treatment. Gasification is suitable for decentralized waste treatment, which can effectively avoid RDW long-distance transportation and reduce dioxin emissions compared with small-scale incineration. Hence, economically-affordable and environmentally-friendly RDW treatment models with different gasification scales are required, and village, town and county models were compared via life cycle assessment (LCA) and life cycle cost (LCC) methods in this study. Furthermore, scenario analysis investigated waste sorting based on two food waste (FW) treatment technologies, different FW separate collection efficiency, and electricity recovery to explore the environmental and economic improvement potentials of three models. LCA results show that electricity consumption and direct emissions are significant contributors to environmental impacts, and the county model outperforms village and town models. Moreover, transportation accounts for 6% of the overall environmental impact in the county model. Scenario analysis reveals that waste sorting and electricity recovery can reduce the overall environmental impact by 29% to 146% for three models. LCC results demonstrate that the town model delivers the lowest economic cost, while the village model is the highest. In scenario analysis, resource utilization of FW and electricity recovery of other waste exhibit promising economic benefits. The findings provide comprehensive references for sustainable RDW treatment.

A remote mentorship model for empowering students to undertake electrocardiology research: Effects on gender equity.

Over the past years, there has been increasing awareness on female representation in cardiology, in particular senior academic ranks. Given the gender disparity in cardiology, female talents in cardiovascular academic medicine are significantly under-represented. In addition, whilst women have a slightly higher frequency of earning first authorships, it has been reported that women are 50% less likely to hold a senior authorship position. The drop in female representation in senior ranks of academic medicine may be contributed by a lack of female talent engagement, particularly during their early-career advancement, in high-impact journals and leadership roles. We present a remote, accessible-distributed research team model to help raise the female representation and tackle the challenges faced by female academics in the field of cardiovascular medicine. The group celebrates accessibility through open communication and collaboration, where mentees can seek research advice and ideas virtually from senior members and principal investigators. The decentralized system allows easy access for research guidance and inspirationand break down barriers in the lack of mentorship for early-career female talents. Students are empowered to lead their projects, and be involved in all phases- from the generation of study ideas to publication. The early development of holistic independent research skills equips students to become principal investigators and leaders in the future. The distributive element of the group is demonstrated through the decentralized research approach employed. Authorship is allocated based on intellectual contribution rather than on the acquisition of funding or seniority level.

Assessment of the temporal variability and health risk of atmospheric particle-phase polycyclic aromatic hydrocarbons in a northeastern city in China.

In this study, we examined the sources and temporal variability of 16 polycyclic aromatic hydrocarbons (PAHs) found in fine particulate matter (PM2.5) in a typical industrial city in northern China. We also evaluated the incremental lifetime cancer risk (ILCR) from the inhalation of these PAHs. Atmospheric PM2.5 samples were collected for 7 consecutive days each month from 2014 to 2019, and the 16 PAHs were measured using multiplex gas chromatography-tandem mass spectrometry. The carcinogenic risk of PAH exposure was assessed using the inhalation unit risk (IUR) and cancer slope factor (CSF) methods. The annual average concentrations of PM2.5 for each year from 2014 to 2019 were 102.87±55.25, 86.92±60.43, 69.17±37.74, 58.20±59.15, 56.01±34.52, and 52.54±58.15 µg m-3, and the annual average ΣPAH concentrations were 56.03±81.09, 47.99±79.30, 40.41±57.31, 33.57±51.79, 43.23±74.80, and 25.20±50.91 ng m-3, respectively. Source identification, using diagnostic ratio analysis, indicated that the major PAH sources were coal/biomass combustion, fuel combustion, and traffic emissions. A health risk assessment showed that the ILCR from PAH inhalation decreased throughout the study period and varied with age. The IUR and CSF methods both showed that the adult ILCR exceeded 1.0×10-6. These findings demonstrate the importance of addressing the carcinogenic risk of PM2.5-bound PAHs, particularly in adults.