Risk Factors for Occupational Blood Exposure, Compliance with Policies of Infection Prevention and Control, and Costs Associated with Post Exposure Management Among Nursing Staff.

Objective: To examine the risk factors linked with occupational blood exposure (OBE) among nursing staff (NS), we pinpoint deficiencies in the compliance with policies of infection prevention and control, and assess the expenditures associated with infection prevention and control. Methods: Healthcare workers that completed an "Occupational Blood Exposure Report Form" were divided into NS (observation) group and non-NS (control) group. Univariate and multivariable analyses were conducted to compare both groups in various aspects. We also explored design patents intended to minimize occupational exposure. Results: The highest incidence of OBE was observed in the department of neurosurgery. Among NS, OBE incidence was found to be influenced by independent risk factors, such as gender, age, occupational title, work location, and incidence of sharps injuries. Protective factors against OBEs included the use of arterial blood gas needles and suture needles. Personal protective equipment (PPE) usage rates were low in both groups prior to OBEs (0.74% vs 0.00%, P > 0.05). Correct emergency management could be improved promptly by both groups following an OBE (P > 0.05). However, the observation group exhibited a higher proportion of blood expression after a sharps injury and a higher re-evaluation rate at 6 months post-exposure compared to the control group (P < 0.05). In 2018, the per capita costs of infection prevention and control for NS were the Chinese Yuan (RMB) 339.43 per individual. In response to these findings, two utility model patents have been authorized. Conclusion: The risk and protective factors related to the occurrence of OBEs were investigated in this study, suggesting that there is a need for improvement in the rate of PPE usage and the re-evaluation rate of OBEs among NS. Additionally, focused training on emergency blood expression and compliance with policies among non-NS personnel is deemed necessary.

Impact path of digital economy on carbon emission efficiency: Mediating effect based on technological innovation.

The digital economy (DIE), a new economic form with digitalization at its core, has become an important driving force for promoting regional economy development. In the context of the COVID-19 pandemic, exploring the impact path of the DIE on carbon emission efficiency (CEE) is conducive to giving full play to the "carbon-reduction-and-efficiency-enhancement" role of the DIE, and to promoting the realization the "dual carbon" goal of carbon peak and carbon neutrality. In this paper, the Yellow River Basin (YRB) and the Yangtze River Economic Belt (YREB) are taken as study areas, the panel Tobit model is used to explore the impact of the DIE on CEE, and the intermediary-effect model and threshold-effect model are constructed to test the intermediary and threshold effects of technological innovation, respectively. The results show that the DIE has a U-shaped nonlinear impact on CEE in both the YRB and the YREB and that the impact has regional heterogeneity. Technological innovation can play a mediating effect between the DIE and CEE, whereas the mediating effect in the YRB is stronger than that in the YREB. Technological innovation has a threshold effect on the DIE to improve CEE, while the threshold value in the YREB is higher than that in the YRB. Furthermore, this paper proposes some suggestions to guide regional low-carbon and sustainable development.

[Assessment of the current invasive situation of alien plants in semi-arid area of Northeast China]. / ä¸œåŒ—åŠå¹²æ—±åŒºå¤–æ¥æ¤ç‰©å ¥ä¾µçŽ°çŠ¶è¯„ä¼°.

Alien invasive plants have been found in the semi-arid region of Northeast China for a long time, but the overall invasion situation is rarely reported. In this study, we established a database of alien invasive plants in the semi-arid area of Northeast China through field investigation, specimen collection, research of specimen online information platform and literature. The results showed that there were 34 species of alien invasive plants belonging to 26 genera and 10 families in the semi-arid area of Northeast China, among which the Composite family had the largest number of richness, with 9 genera (34.6%) and 11 species (32.4%). There were 15 species (44.1%) in 11 genera (42.3%) of Legumes, Solanaceae and Gramineae. In all the alien invasive plants, 33 species were herbaceous plants, being overwhelmingly dominant (97.1%). There were both 7 species of countrywide invasive plants with invasive grade 1 and 2, each accounting for 20.6% of the total. The number of species with invasive grade 4 was the largest, 17 species, accounting for 50% of the total. The invasive plants originated in North America and Europe was the most, accounting for 64.7%, while those from South America, Asia and Africa accounted for 35.3%. Totally, 44.1% of all the invasive alien plants were intentionally introduced, while 55.9% were unintentionally introduced. In the semi-arid area of Northeast China, 81.3% of the counties (cities) had the distribution of alien invasive plants, and the invasion situation was very serious.

Can greater openness improve green economy efficiency of countries along the Belt and Road Initiative?

Openness is the core concept of the Belt and Road initiative (BRI), which plays a significant role in promoting the sustainable economic development of countries along the BRI. This study uses the entropy method to measure openness based on six dimensions: trade, investment, finance, tourism, technology, and information. Simultaneously, a super-SBM model with undesired output is proposed to measure green economy efficiency (GEE). Using the panel data of 66 countries along the BRI from 2008 to 2019, we empirically examine the impact of openness on GEE. The results are as follows: (1) The openness level of countries along the BRI is generally increasing, but the relative differences between countries tend to widen. (2) Openness has a significant U-shaped nonlinear effect on GEE, and the conclusion is still valid after considering the robustness test; (3) The spatial econometric model shows that openness not only affects the GEE of the local country, but also has a spillover effect on neighboring countries. Therefore, we believe that BRI countries should strengthen policy communication, break down border barriers, actively promote the orderly flow and diffusion of openness elements, and pay attention to the quantity and quality of openness development, which is key to the high-quality construction of the BRI.

Factors influencing the satisfaction of community senior care services in China: an analysis based on an extended Anderson model.

Community-based senior care, as a convenient and promising care model, has gradually been accepted by the public. However, community services developed to facilitate older adults often fail to achieve the expected effect. With the fast-growing aging population in China, the problems of underutilization and low service satisfaction of senior care facilities need to be resolved urgently. In this study, we further developed an extended Anderson behavior model by incorporating social psychological factors, and the vertical and horizontal fairness perceptions. In addition, a binary logistic regression model was used to analyze factors affecting the satisfaction of older adults in life care services, health care services, and mental and spiritual comfort services. The study used data from a survey of 322 urban area seniors in Shaanxi Province. The results showed that factors influencing older adults' satisfaction of different service categories are different. Moreover, with the addition of the social psychological factors, we observed that the vertical fairness perception of the survey respondents affected their satisfaction of senior care services significantly more than the horizontal fairness perception.

Brain MRI correlations with disease burden and biomarkers in Fabry disease.

OBJECTIVE: To quantitatively evaluate cerebral small vessel disease (CSVD) in brain magnetic resonance imaging (MRI) and its correlation with disease burden and markers in Fabry disease, a rare X-linked lysosomal storage disease. METHODS: We collected brain MRI data from seventy-one Chinese patients with Fabry disease. CSVD was evaluated using an age-related white matter change rating scale, Fazekas scale, enlarged perivascular spaces grading scale, lacunar infarction scale, Microbleed Anatomical Rating Scale, global cortical atrophy scale, and small-vessel disease score. Factors associated with MRI lesions, including sex, clinical subtype, disease severity, disease burden, genotype, and biomarkers, were also analyzed. RESULTS: Of 71 patients, 16 (22.5%) experienced ischemic stroke. The incidences of lacunar infarctions, white matter hyperintensities, and cerebral microbleeds were 55%, 62%, and 33%, respectively. The abnormal MRI group had later disease onset, longer disease duration, and a higher Mainz Severity Score Index (p < 0.05) than the normal MRI group. Patients with more severe clinical phenotypes also had higher CVSD-related scores. Sex and GLA mutational type were not closely associated with brain MRI lesions. Of the disease markers, the Mainz Severity Score Index and plasma globotriaosylsphingosine (Lyso-Gb3) were closely correlated with the majority of the MRI scores, whereas α-galactosidase A activity was not. CONCLUSION: Brain MRI revealed progressive lacunar infarctions, white matter hyperintensities, and decreased brain volume in patients with Fabry disease. Brain MRI lesions were closely related to onset-age; disease duration, severity, burden; and plasma Lyso-Gb3. However, they were not associated with sex, α-galactosidase A activity, or GLA mutation type.

The patterns and driving forces of dengue invasions in China.

BACKGROUND: Global connectivity and environmental change pose continuous threats to dengue invasions from worldwide to China. However, the intrinsic relationship on introduction and outbreak risks of dengue driven by the landscape features are still unknown. This study aimed to map the patterns on source-sink relation of dengue cases and assess the driving forces for dengue invasions in China. METHODS: We identified the local and imported cases (2006-2020) and assembled the datasets on environmental conditions. The vector auto-regression model was applied to detect the cross-relations of source-sink patterns. We selected the major environmental drivers via the Boruta algorithm to assess the driving forces in dengue outbreak dynamics by applying generalized additive models. We reconstructed the internal connections among imported cases, local cases, and external environmental drivers using the structural equation modeling. RESULTS: From 2006 to 2020, 81,652 local dengue cases and 12,701 imported dengue cases in China were reported. The hotspots of dengue introductions and outbreaks were in southeast and southwest China, originating from South and Southeast Asia. Oversea-imported dengue cases, as the Granger-cause, were the initial driver of the dengue dynamic; the suitable local bio-socioecological environment is the fundamental factor for dengue epidemics. The Bio8 [odds ratio (OR) = 2.11, 95% confidence interval (CI): 1.67-2.68], Bio9 (OR = 291.62, 95% CI: 125.63-676.89), Bio15 (OR = 4.15, 95% CI: 3.30-5.24), normalized difference vegetation index in March (OR = 1.27, 95% CI: 1.06-1.51) and July (OR = 1.04, 95% CI: 1.00-1.07), and the imported cases are the major drivers of dengue local transmissions (OR = 4.79, 95% CI: 4.34-5.28). The intermediary effect of an index on population and economic development to local cases via the path of imported cases was detected in the dengue dynamic system. CONCLUSIONS: Dengue outbreaks in China are triggered by introductions of imported cases and boosted by landscape features and connectivity. Our research will contribute to developing nature-based solutions for dengue surveillance, mitigation, and control from a socio-ecological perspective based on invasion ecology theories to control and prevent future dengue invasion and localization.

The Interactive Relationship between Street Centrality and Land Use Intensity-A Case Study of Jinan, China.

It is of great significance to study the interactive relationship between urban transportation and land use for promoting the healthy and sustainable development of cities. Taking Jinan, China, as an example, this study explored the interactive relationship between street centrality (SC) and land use intensity (LUI) in the main urban area of Jinan by using the spatial three-stage least squares method. The results showed that the closeness centrality showed an obvious "core-edge" pattern, which gradually decreased from the central urban area to the edge area. Both the betweenness centrality and the straightness centrality showed a multi-center structure. The commercial land intensity (CLUI) showed the characteristics of multi-core spatial distribution, while the residential land intensity (RLUI) and public service land intensity (PLUI) showed the characteristics of spatial distribution with the coexistence of large and small cores. There was an interactive relationship between SC and LUI. The closeness centrality and straightness centrality had positive effects on LUI, and LUI had a positive effect on closeness centrality and straightness centrality. The betweenness centrality had a negative impact on LUI, and LUI also had a negative impact on betweenness centrality. Moreover, good location factors and good traffic conditions were conducive to improving the closeness and straightness centrality of the regional traffic network. Good location factors, good traffic conditions and high population density were conducive to improving regional LUI.

Association Between Hydrological Conditions and Dengue Fever Incidence in Coastal Southeastern China From 2013 to 2019.

Importance: Dengue fever is a climate-sensitive infectious disease. However, its association with local hydrological conditions and the role of city development remain unclear. Objective: To quantify the association between hydrological conditions and dengue fever incidence in China and to explore the modification role of city development in this association. Design, Setting, and Participants: This cross-sectional study collected data between January 1, 2013, and December 31, 2019, from 54 cities in 4 coastal provinces in southeast China. The Standardized Precipitation Evapotranspiration Index (SPEI) was calculated from ambient temperature and precipitation, with SPEI thresholds of 2 for extreme wet conditions and -2 for extreme dry conditions. The SPEI-dengue fever incidence association was examined over a 6-month lag, and the modification roles of 5 city development dimensions were assessed. Data were analyzed in May 2022. Exposures: City-level monthly temperature, precipitation, SPEI, and annual city development indicators from 2013 to 2019. Main Outcomes and Measures: The primary outcome was city-level monthly dengue fever incidence. Spatiotemporal bayesian hierarchal models were used to examine the SPEI-dengue fever incidence association over a 6-month lag period. An interaction term between SPEI and each city development indicator was added into the model to assess the modification role of city development. Results: Included in the analysis were 70 006 dengue fever cases reported in 54 cities in 4 provinces in China from 2013 to 2019. Overall, a U-shaped cumulative curve was observed, with wet and dry conditions both associated with increased dengue fever risk. The relative risk [RR] peaked at a 1-month lag for extreme wet conditions (1.27; 95% credible interval [CrI], 1.05-1.53) and at a 6-month lag for extreme dry conditions (1.63; 95% CrI, 1.29-2.05). The RRs of extreme wet and dry conditions were greater in areas with limited economic development, health care resources, and income per capita. Extreme dry conditions were higher and prolonged in areas with more green space per capita (RR, 1.84; 95% CrI, 1.37-2.46). Highly urbanized areas had a higher risk of dengue fever after extreme wet conditions (RR, 1.80; 95% CrI, 1.26-2.56), while less urbanized areas had the highest risk of dengue fever in extreme dry conditions (RR, 1.70; 95% CrI, 1.11-2.60). Conclusions and Relevance: Results of this study showed that extreme hydrological conditions were associated with increased dengue fever incidence within a 6-month lag period, with different dimensions of city development playing various modification roles in this association. These findings may help in developing climate change adaptation strategies and public health interventions against dengue fever.

Human expansion into Asian highlands in the 21st Century and its effects.

Most intensive human activities occur in lowlands. However, sporadic reports indicate that human activities are expanding in some Asian highlands. Here we investigate the expansions of human activities in highlands and their effects over Asia from 2000 to 2020 by combining earth observation data and socioeconomic data. We find that ∼23% of human activity expansions occur in Asian highlands and ∼76% of these expansions in highlands comes from ecological lands, reaching 95% in Southeast Asia. The expansions of human activities in highlands intensify habitat fragmentation and result in large ecological costs in low and lower-middle income countries, and they also support Asian developments. We estimate that cultivated land net growth in the Asian highlands contributed approximately 54% in preventing the net loss of the total cultivated land. Moreover, the growth of highland artificial surfaces may provide living and working spaces for ∼40 million people. Our findings suggest that highland developments hold dual effects and provide new insight for regional sustainable developments.

The Effects of Acupressure on Improving Health and Reducing Cost for Patients Undergoing Thoracoscopic Surgery.

OBJECTIVES: This study aimed to assess the effectiveness of practicing acupressure on the Shenmen and Neiguan acupoints with a view to reduce anxiety and improve the comfort and physical health of patients undergoing thoracoscopic surgery. METHODS: A total of 100 hospitalized patients undergoing thoracoscopic surgery were assigned randomly into the experimental (n = 49) and control groups (n = 51). Subjects in the experimental group received routine care plus acupressure on the Shenmen and Neiguan acupoints, while those in the control group received regular routine care. The data were collected using demographic information, physical and surgical data, the Visual Analog Scale (VAS)-A, the State-Trait Anxiety Inventory Y Form (STAI-Y1), and Shortened General Comfort Questionnaire scores. The linear mixed model was used to examine the influences of acupressure on VAS-A and STAI-Y1 scores at different time points before and after the surgery to observe group-by-time interactions. RESULTS: The mean age of the subjects was 60.97 years. All subjects had mild-to-moderate anxiety after surgery and showed a statistically significant decline in regression coefficients on the first and second days after the intervention (ß = -11.61, p = 0.002; ß = -18.71, p < 0.001). Similarly, for STAI-YI scores, the data showed a significant difference in the pre-test and post-test interactions between the two groups (ß = 4.72, p = 0.031). Conversely, acupressure did not have a statistically significant difference on comfort (F = 2.953, p = 0.057). Compared with the control subjects, the experimental subjects used less morphine and developed side effects less frequently (p < 0.01). They were also able to get out of bed after surgery 163.79 min earlier (p < 0.05). CONCLUSIONS: Acupressure is a simple and easy-to-practice treatment. Acupressure on the Shenmen and Neiguan acupoints reduces anxiety and improves recovery in patients after undergoing thoracoscopic surgery.

Management of gestational weight gain in obese or overweight women based on resting energy expenditure: A pilot cohort study.

Resting energy expenditure (REE) comprises 60% of total energy expenditure and variations may be associated with gestational weight gain (GWG). This study aims to explore the usability and feasibility of REE guided intervention for GWG in obese and overweight women. We conducted a prospective cohort study in LuHe Hospital of Capital Medical University in Beijing, China between May 1, 2017 and May 31, 2018. Obese/overweight women who had routine prenatal care visit at 10 to 13 weeks of gestation, were recruited after written informed consent was obtained. The intervention group (those women who were recruited between January 1 and May 31, 2018) used REE calculated daily total energy to manage GWG, while the control group (those women who were recruited between May 1 and December 31, 2017) used prepregnancy body mass index calculated daily total energy to manage GWG. GWG and daily total energy between the 2 groups were recorded from 10 to 13 weeks of gestation to delivery. A total of 68 eligible women (35 in intervention group and 33 in control group) were included in the final analysis. Daily total energy in the intervention group increased less than the control group, especially from 2nd trimester to 3rd trimester (1929.54 kcal/d vs. 2138.33 kcal/d). The variation of daily total energy from 1st trimester to 3rd trimester in the intervention group was lower than the control group (226.17 kcal/d vs 439.44 kcal/d). Overall GWG of the intervention group (13.45 kg) was significantly lower than the control group (18.20 kg). The percentage of excess-GWG in the intervention group (31.42%) was also significantly lower than the control (57.57%). Findings from our pilot study suggest that diet recommendation basting on REE may improve management of GWG in obese/overweight women.

[Research on artificial substitutes of rare and endangered animal medicinal materials and industrialization].

Rare and endangered animal medicine, a kind of important Chinese medicine, plays an irreplaceable role in the prevention and treatment of serious acute and chronic diseases and major diseases. Due to resource limitation and depletion and the increasing demand, rare and endangered medicinal animal resources have been drastically reduced or even extinct, which threatens the inheritance of traditional Chinese medicine, the integrity of clinical medicine, and the development of the traditional Chinese medicine industry. For the protection and sustainable utilization of Chinese medicinal resources, artificial substitutes came into being. However, there is still a lack of systematic research on the pharmacological effects and clinical applications of artificial substitutes and whether they can completely replace the original medicinal materials in clinical practice. Therefore, this study focuses on the status quo of rare and endangered animal medicinal materials and their artificial substitutes that have been marketed. To be specific, the two were compared and whether the artificial substitutes can completely replace the original medicinal materials was analyzed. In addition, constructive suggestions on the industrialization of artificial substitutes were put forward, which was expected to promote the sustainable development of Chinese medicinal resources.

[History and application of foreign medicinal resources serving healthcare industry].

Foreign medicinal resources have always been an important part of Chinese medicine and have made great contributions to the development of the Chinese medical and health industry. Since the opening of the Silk Road in the Han Dynasty, foreign medicinal resources have been introduced for different purposes, some of which have become Chinese medicine in clinical practice and are still in use today.Today, foreign medicinal resources also serve the Big Health industry in China. They are introduced and applied to the fields in the Big Health industry, such as food, cosmetics, health products, decoction pieces, and daily chemical products. With the integration and development of the "Healthy China" initiative, more foreign resources will enter the Big Health industry. This paper retrospectedthe history of foreign medicinal resources serving the ancient medical and health industry, reviewedits current development under the Big Health industry, summarizedthe experience of foreign medicinal resources serving the ancient medical and health industry, as well as the development and problems of new foreign medicinal resources, and put forward some suggestions to provide ideas for the development and application of foreign medicinal resources under the Big Health industry.

Effects of the Health-Awareness-Strengthening Lifestyle Program in a Randomized Trial of Young Adults with an At-Risk Mental State.

BACKGROUND: Increasing health awareness in health promotion is considered as one of the less stigmatized interventions for improving help-seeking behaviors and total well-being. This study aimed to explore the short-term and long-term effectiveness of the health-awareness-strengthening lifestyle (HASL) program on Taiwanese young adults with at-risk mental state. METHODS: A pre- and post-test randomized trial was conducted on 92 young adults with at-risk mental state. The HASL program was provided to the experimental group as intervention, and it was only provided to the control group passively by request after the post-test for ethical reasons. The program was conducted once every six weeks, 60-90 min per session, for a total of three times. Mental health risk, anxiety level, health promotion lifestyles, quality of life, physiological index, and physical exercises were assessed one week before and after the program for both groups and followed up to 6 and 12 months for experimental group only. RESULTS: Compared to the control group, those in the experimental group showed significant improvements regarding anxiety level, health promotion lifestyles, and quality of life one week after participating in the program. Furthermore, the experimental group also showed an additional long-term positive effect on mental risk, physical exercises, and physical health after the follow-ups. CONCLUSIONS: The outcomes highlighted the interventions of the HASL program leading to more positive health effects on young adults with at-risk mental state. The implementation of similar clinical service is recommended for young adults with at-risk mental state.

A preliminary study on the effectiveness of a stress management program for healthcare-related undergraduates with at-risk mental state.

PURPOSE: This study aimed to examine the effects of a stress management program on stress perception and coping strategies for healthcare-related undergraduates with at-risk mental state (ARMS). DESIGN AND METHODS: A randomized experimental design with pretest and posttest was used. Of the 2812 students screened, 65 were identified as having ARMS, 52 enrolled in the study, and 49 (75%) completed the study. FINDINGS: Significance was found for subjects with schizotypal traits in emotion expression and problem-avoidance coping strategies. Subjects with trait anxiety improved significantly in interpersonal deficits after the program. PRACTICE IMPLICATIONS: Students with different trait risks reported benefits in different stress-coping strategies from the program.

Effectiveness of Levoamlodipine Maleate for Hypertension Compared with Amlodipine Besylate: a Pragmatic Comparative Effectiveness Study.

PURPOSE: Antihypertensive treatment is the most important method to reduce the risk of cardiovascular events in hypertensive patients. However, there is scant evidence of the benefits of levoamlodipine maleate for antihypertensive treatment using a head-to-head comparison in the real-world. This study aims to examine the effectiveness of levoamlodipine maleate used to treat outpatients with primary hypertension compared with amlodipine besylate in a real-world setting. METHODS: This was a pragmatic comparative effectiveness study carried out at 110 centers across China in outpatients with primary hypertension treated with levoamlodipine maleate or amlodipine besylate, with 24 months of follow-up. The primary outcomes used for evaluating the effectiveness were composite major cardiovascular and cerebrovascular events (MACCE), adverse reactions, and cost-effectiveness. RESULTS: Among the included 10,031 patients, there were 482 MACCE, 223 (4.4%) in the levoamlodipine maleate group (n = 5018) and 259 (5.2%) in the amlodipine besylate group (n = 5013) (adjusted hazard ratio = 0.90, 95%CI: 0.75-1.08, P = 0.252). The levoamlodipine maleate group had lower overall incidences of any adverse reactions (6.0% vs. 8.4%, P < 0.001), lower extremity edema (1.1% vs. 3.0%, P < 0.001) and headache (0.7% vs. 1.1%, P = 0.045). There was a nearly 100% chance of the levoamlodipine maleate being cost-effective at a willingness to pay threshold of 150,000 Yuan per quality-adjusted life years (QALYs) gained, resulting in more QALYs (incremental QALYs: 0.00392) and cost savings (saving 2725 Yuan or 28.8% reduction in overall costs) per patient. CONCLUSION: In conclusion, levoamlodipine maleate could reduce cost by 29% with a similar MACCE incidence rate and lower occurrence of adverse reactions (especially edema and headache) compared with amlodipine besylate. TRIAL REGISTRATION: Clinicaltrials.gov NCT01844570 registered at May 1, 2013.

Daily Temperature and Bacillary Dysentery: Estimated Effects, Attributable Risks, and Future Disease Burden in 316 Chinese Cities.

BACKGROUND: Bacillary dysentery (BD) remains a significant public health issue, especially in developing countries. Evidence assessing the risk of BD from temperature is limited, particularly from national studies including multiple locations with different climatic characteristics. OBJECTIVES: We estimated the effect of temperature on BD across China, assessed heterogeneity and attributable risks across cities and regions, and projected the future risk of BD under climate change. METHODS: Daily BD surveillance and meteorological data over 2014-2016 were collected from the Chinese Center for Disease Control and Prevention and the China Meteorology Administration, respectively. A two-stage statistical model was used to estimate city-specific temperature-BD relationships that were pooled to derive regional and national estimates. The risk of BD attributable to temperature was estimated, and the future burden of BD attributable to temperature was projected under different climate change scenarios. RESULTS: A positive linear relationship for the pooled effect was estimated at the national level. Subgroup analyses indicate that the estimated effect of temperature on BD was similar by age (≤5y or >5y) and gender. At baseline, estimated attributable risks for BD due to average daily mean temperatures above the 50th percentile were highest for the Inner Mongolia (16%), Northeast China (14%), and Northern China (13%). Most of the individual cities in the same regions and most of the cities in the Northwest, Southern, and Southwest regions, had high attributable risks (≥5%). The Northern, Northeast, Inner Mongolia, Northwest, and Southern China regions were identified as high risk for future BD, with estimated increases by the 2090s compared with baseline of 20% (95% confidence interval: 11%, 27%), 15% (6%, 20%), 15% (-1%, 22%), 12% (1%, 19%), and 11% (5%, 15%), respectively, under Representative Concentration Pathway 8.5. CONCLUSIONS: The positive association between temperature and BD in different climatic regions of China, and the projection for increased risk due to climate change, support efforts to mitigate future risks. https://doi.org/10.1289/EHP5779.

Multiple conceptions of resource rationality.

Resource rationality holds great promise as a unifying principle across theories in neuroscience, cognitive science, and economics. The target article clearly lays out this potential for unification. However, resource-rational models are more diverse and less easily unified than might appear from the target article. Here, we explore some of that diversity.

Bayesian Decision Models: A Primer.

To understand decision-making behavior in simple, controlled environments, Bayesian models are often useful. First, optimal behavior is always Bayesian. Second, even when behavior deviates from optimality, the Bayesian approach offers candidate models to account for suboptimalities. Third, a realist interpretation of Bayesian models opens the door to studying the neural representation of uncertainty. In this tutorial, we review the principles of Bayesian models of decision making and then focus on five case studies with exercises. We conclude with reflections and future directions.