[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.

A news-based climate policy uncertainty index for China.

Climate policies can have a significant impact on the economy. However, these policies have often been associated with uncertainty. Quantitative assessment of the socioeconomic impact of climate policy uncertainty is equally or perhaps more important than looking at the policies themselves. Using a deep learning algorithm-the MacBERT model-this study constructed indices of Chinese climate policy uncertainty (CCPU) at the national, provincial and city levels for the first time. The CCPU indices are based on the text mining of news published by a set of major newspapers in China. A clear upward trend was found in the indices, demonstrating increasing policy uncertainties in China in addressing climate change. There is also evidence of clear regional heterogeneity in subnational indices. The CCPU dataset can provide a useful source of information for government actors, academics and investors in understanding the dynamics of climate policies in China. These indices can also be used to investigate the empirical relationship between climate policy uncertainty and other socioeconomic factors in China.

Cost-of-illness of gastroenteritis caused by rotavirus in Chinese children less than 5 years.

Acute gastroenteritis (AGE) caused by rotavirus (RV) remains a public health issue in China. To accelerate the mass rotavirus vaccination, it is important to inform the policy maker, and the public of the economic burden caused by rotavirus infection. A meta-analysis was conducted applying standardized algorithms. Articles published before January 1, 2023, in English and Chinese were searched through PubMed, CNKI, and WanFang Data. Studies with cost analysis of RV AGE were included. A random-effects model was applied to synthesize the total cost of RV AGE from the societal perspective. A prospective survey aimed to measure the cost of RV AGE was conducted in 2021 and 2022 in Shaoxing city, Zhejiang province, that can represent the developed region. The cost data was applied as deviation indicator, in comparison with the pooled estimate generated from meta-analysis. Totally 286 articles were identified, and eventually 12 studies were included. The pooled total social cost of RV AGE was US$282.1 (95%CI: US$213.4-350.7). The pooled private cost of RV AGE was US$206.4 (95%CI: US$155.2-257.5). RV AGE hospitalized and RV AGE incurred in developed regions caused remarkable higher burden (US$631.2 [95%CI: US$512.6-749.8], and US$333.6 [95%CI: US$234.1-433.2] respectively), compared to RV AGE treated at outpatient, and incurred in less developed regions. Our study demonstrates that RV AGE causes a significant economic burden in China. Given the promising effectiveness and highly cost-effective, introduction of rotavirus vaccines in national immunization programs could substantially reduce the economic burden in China.

Assessment of Surgical Efficacy in Total Hysterectomy for Managing Massive Cervical Tumors: A Study of 7 Cases.

Objective: This study aims to evaluate the efficacy and safety of total hysterectomy in the surgical management of rare cervical giant tumors and improve patient outcomes. It summarizes the experience in diagnosing and treating clinical cervical giant tumors, focusing on improving the surgical techniques for these cases. Methods: We conducted a retrospective analysis of seven patients who underwent total hysterectomy for rare cervical giant tumors between January 2020 and June 2022 at our hospital. Among these cases, four were diagnosed as super cervical giant tumors, while two were identified as cervical giant sarcomas. The clinical data of these patients were documented and analyzed. The study evaluated the efficacy and safety of total hysterectomy, focusing on minimizing damage to surrounding organs, reducing intraoperative bleeding, and preventing iatrogenic dissemination in patients with cervical giant sarcomas. Results: Total abdominal hysterectomy was successfully performed in all seven cases. During the surgical procedures, we encountered one case of ureteral injury and two cases of significant bleeding, with a bleeding volume of 800ml. Fortunately, all patients recovered well after surgery. Conclusions: This analysis highlights the challenges and successful outcomes of total hysterectomy in the treatment of rare cervical giant tumors. It underscores the importance of careful surgical techniques to minimize complications and promote patient recovery. While ureteral injuries and bleeding were encountered, our patients eventually had positive postoperative outcomes.

Correction: Chua et al. Cost-Effectiveness Analysis of HPV Extended versus Partial Genotyping for Cervical Cancer Screening in Singapore. Cancers 2023, 15, 1812.

The authors wish to revise two words in Table 1 row 3, and the first paragraph of Section 2 [...].

[Translocation, Accumulation, and Comprehensive Risk Assessment of Heavy Metals in Soil-Crop Systems in an Old Industrial City, Shizuishan, Ningxia, Northwest China].

In order to explore the environmental geochemistry characteristics of heavy metals (HMs) in soil-crop systems in an old industrial city, the concentration and fraction of HMs in the paddy, wheat, and maize root soil and their seeds were detected and analyzed. Subsequently, statistical methods, risk assessment coding (RAC), the bio-enrichment coefficient factor (BCF), influence index of comprehensive quality (IICQ), and ArcGIS spatial interpolation were used to conduct the translocation, accumulation, and comprehensive risk assessment of HMs in soil-crop systems. The results showed that the average concentrations of As, Cd, Cr, Cu, Hg, Ni, Pb, and Zn in root soil were ranked respectively as follows:12.56, 0.19, 63.48, 23.52, 0.038, 28.86, 21.68, and 69.47 mg·kg-1. HMs in root soil were accumulated to some extent in comparison with the soil background value in Ningxia, especially Cd and Hg, but did not exceed the soil environmental pollution screening value (GB 14618-2018). The average concentrations of the eight aforementioned elements in supporting crop seeds were 0.0149, 0.0112, 0.075, 6.7, 0.0015, 0.67, 0.0427, and 20.48 mg·kg-1 in turn. The over-limit ratio of As, Pb, and Cr in crop seeds was 4%, 3%, and 1%, respectively, relative to the national food safety standards (GB 2762-2017), whereas the other five elements were within the allowable range. In comparison to those in paddy and wheat, HMs hardly tended to translocate to maize seeds from root soil. According to the results of IICQ in soil-crop systems, the cultivated soil was in the state of slight sub-contamination regionally, and only 10% of sampling points showed slight (sub-)contamination-submoderate contamination, where we could replant maize to reduce HMs contamination risk.

A critical application of different methods for the vulnerability assessment of shallow aquifers in Zhengzhou City.

Groundwater vulnerability can partially reflect the possibility of groundwater contamination, which is crucial for ensuring human health and a good ecological environment. The current study seeks to assess the groundwater vulnerability of Zhengzhou City by adopting an amended version of the traditional DRASTIC model, i.e., the DRASTICL model, which incorporates land use type indicators. More specifically, the AHP-DRASTICL, entropy-DRASTICL, and AE-DRASTICL models were established by optimizing weights using the analytic hierarchy process (AHP) and entropy weight method. The evaluation results for these five models were divided into five levels: very low, low, medium, high, and very high. Using Spearman's rank correlation coefficient, the nitrate concentration was used to verify the groundwater vulnerability assessment results. The AE-DRASTICL model was found to perform the best, with a Spearman correlation coefficient of 0.78. However, the AHP and entropy weight method effectively improved the accuracy of vulnerability assessment results, making it more suitable for the study area. This study provides important insights to inform the design of strategies to protect groundwater in Zhengzhou.

Combined assessment of health hazard and odour impact of soils at a contaminated site: a case study on a defunct pharmaceuticals factory in China.

Surveys and assessments of contaminated sites primarily focus on hazardous pollutants in the soil with less attention paid to odorants. This makes the management of contaminated sites difficult. In this study, hazardous and odorous pollutants in the soil were assessed for a large site that was previously used for production of pharmaceuticals to determine the degree and characteristics of soil contamination at pharmaceutical production sites, for undertaking rational remediation measures. The main hazardous pollutants at the study site were triethylamine, n-butyric acid, benzo(a)pyrene (BaP), N-nitrosodimethylamine (NDMA), dibenzo(a,h)anthracene (DBA), total petroleum hydrocarbons (C10-C40) (TPH), and 1,2-dichloroethane; TEA, BA, and isovaleric acid (IC) were the main odorants. As the type and distribution of hazardous and odorous pollutants differ, it is necessary to separately assess the impact of these pollutants at a contaminated site. Soils in the surface layer pose significant non-carcinogenic (HI = 68.30) and carcinogenic risks (RT = 3.56E-5), whereas those in the lower layer only pose non-carcinogenic risks (HI > 7.43). Odorants were found at considerable concentrations both in the surface and lower layers, with the maximum concentrations being 29,309.91 and 41.27, respectively. The findings of this study should improve our understanding of soil contamination at former pharmaceutical production sites and should inform the assessment of the risks posed by contaminated sites, with problems associated with odour, and possible remediation strategies.

A self-learning Monte Carlo tree search algorithm for robot path planning.

This paper proposes a self-learning Monte Carlo tree search algorithm (SL-MCTS), which has the ability to continuously improve its problem-solving ability in single-player scenarios. SL-MCTS combines the MCTS algorithm with a two-branch neural network (PV-Network). The MCTS architecture can balance the search for exploration and exploitation. PV-Network replaces the rollout process of MCTS and predicts the promising search direction and the value of nodes, which increases the MCTS convergence speed and search efficiency. The paper proposes an effective method to assess the trajectory of the current model during the self-learning process by comparing the performance of the current model with that of its best-performing historical model. Additionally, this method can encourage SL-MCTS to generate optimal solutions during the self-learning process. We evaluate the performance of SL-MCTS on the robot path planning scenario. The experimental results show that the performance of SL-MCTS is far superior to the traditional MCTS and single-player MCTS algorithms in terms of path quality and time consumption, especially its time consumption is half less than that of the traditional MCTS algorithms. SL-MCTS also performs comparably to other iterative-based search algorithms designed specifically for path planning tasks.

Multidimensional evaluation method and application based on life cycle carbon efficiency considering carbon emission, cost, and function.

Low carbon research has currently become the most discussed environmental issue. Current comprehensive evaluation methods for low carbon consider carbon emission, cost, process parameters, and resource utilization, but the realization of low carbon may lead to cost fluctuations and functional changes and lack consideration of product functional requirements. Hence, this paper developed a multidimensional evaluation method for low-carbon research based on the association among three dimensions, namely, carbon emission, cost, and function. This multidimensional evaluation method was named life cycle carbon efficiency (LCCE), which is defined as the ratio between the value in the life cycle and the carbon emissions generated. The LCCE model was established, and then carbon emission calculation, cost assessment, and function quantification of the life cycle were performed according to the three dimensions. Case study and sensitivity analysis verified the feasibility of the proposed method. The method had comprehensive and accurate evaluation results, which provided theoretical support and optimized the low-carbon design.

Budget Impact Analysis of Adopting a One-Step Nucleic Acid Amplification Testing (NAAT) Alone Diagnostic Pathway for Clostridioides difficile in Japan Compared to a Two-Step Algorithm with Glutamate Dehydrogenase/Toxin Followed by NAAT.

Clostridioides difficile infection (CDI) is a major healthcare-associated infection that leads to a significant health economic burden in Japan. Using a decision tree model, we evaluated the budget impact of adopting a one-step nucleic acid amplification test (NAAT) alone pathway compared to a two-step diagnostic algorithm with glutamate dehydrogenase (GDH) and toxin antigen, followed by NAAT. The analysis was conducted from the government payer's perspective for 100,000 symptomatic, hospitalized adults requiring a CDI diagnostic test. One-way sensitivity analysis was conducted for all data inputs. The NAAT alone strategy costed JPY 225,886,360 (USD 2,424,714) more, but was more effective, resulting in 1749 more patients accurately diagnosed and 91 fewer deaths compared to the two-step algorithm. Additionally, the NAAT alone pathway costed JPY 26,146 (USD 281) less per true positive CDI diagnosed. The total budget impact, and cost per CDI diagnosed was most sensitive to GDH sensitivity in one-way sensitivity analysis, where a lower GDH sensitivity resulted in greater cost savings with the NAAT alone pathway. Findings from this budget impact analysis can guide the adoption of a NAAT alone pathway for CDI diagnosis in Japan.

Biliary colic in the emergency department: A state-wide analysis of one-year costs and clinical outcomes.

Importance: Approximately 335,000 cases of biliary colic present to US emergency departments (EDs) annually, and most patients without complications are discharged from the ED. It is unknown what are the subsequent surgery rates, subsequent complications of biliary disease, ED revisits, repeat hospitalizations and cost; and, how does the ED disposition decision (admission versus discharge) affect long-term outcomes. Objective: To determine whether there is a difference in one-year surgery rates, complications of biliary disease, ED revisits, repeat hospitalizations, and cost in ED patients with uncomplicated biliary colic who are admitted to the hospital versus those that are discharged from the ED. Design setting and participants: A retrospective observational study was conducted using records collected from the Maryland Healthcare Cost and Utilization Project (HCUP) in the Ambulatory Surgery, the Inpatient, and the ED setting between 2016 and 2018. After applying inclusion criteria, 7036 ED patients with uncomplicated biliary colic were followed for one year after their index ED visit for repeat healthcare utilization across multiple settings. A multivariable logistic regression study was performed to asses for risk factors for surgery allocation and hospital admission. Medicare Relative Value Units (RVUs) and HCUP Cost-Charge Ratio files were used to estimate direct costs. Exposures: Episodes of biliary colic were ascertained using ICD-10 codes at the index ED visit. Main outcomes and measures: The primary outcome was the one-year surgery rate, defined as a cholecystectomy. Secondary outcomes included the rate of new acute cholecystitis or other related complications, ED revisits, hospital admission and costs. Associations with hospital admission and surgeries were measured using adjusted odds ratios (ORs) with 95 % CIs. Results: Of the 7036 patients analyzed, 793 (11.3 %) were admitted and 6243 (88.7 %) were discharged on their initial ED visit. When comparing the groups who were initially admitted versus discharged, we observed similar one-year cholecystectomy rates (42 % versus 43 %, mean difference 0.5 %, 95 % CI -3.1 %-4.2 %; P < 0.001), lower rates of new cholecystitis occurrences (18 % versus 41 %, mean difference 23 %, 95 % CI, 20 %-26 %; P < 0.001), lower rates of ED revisits (96 vs 198 per 1000 patients, mean difference 102, 95 % CI, 74-130; P < 0.001) and higher costs ($9880 versus $1832, mean difference 8048, 95 % CI, 7478-8618; P < 0.001). Initial ED hospital admission was associated with increased age (adjusted odds ratio [aOR], 1.44; 95 % CI, 1.35-1.53; P < 0.001), obesity (aOR, 1.38; 95 % CI, 1.32-1.44; P < 0.001), ischemic heart disease (aOR, 1.39; 95 % CI, 1.30-1.48; P < 0.001), mood disorders (aOR, 1.18; 95 % CI, 1.13-1.24; P < 0.001), alcohol-related disorders (aOR, 1.20; 95 % CI, 1.12-1.27; P < 0.001), hyperlipidemia (aOR, 1.16; 95 % CI, 1.09-1.23; P < 0.001), hypertension (aOR, 1.15; 95 % CI, 1.08-1.21; P < 0.001), and nicotine dependence (aOR, 1.09; 95 % CI, 1.03-1.15; P = 0.003) but not associated with race (P > 0.9), ethnicity (P > 0.9), or income-stratified zip code (aOR, 1.04; 95 % CI, 0.98-1.09; P = 0.17). Conclusions and relevance: In our analysis of ED patients with uncomplicated biliary colic from a single state, the majority of patients do not receive a cholecystectomy within one year and hospital admission at the initial visit was not associated with an overall change in rates of cholecystectomy but was associated with increased costs. These findings inform our understanding of the long-term outcomes and are important considerations when communicating care options with ED patients with biliary colic.

Cost-Effectiveness Analysis of HPV Extended versus Partial Genotyping for Cervical Cancer Screening in Singapore.

Human papillomavirus (HPV) partial genotyping (PGT) identifies HPV16 and HPV18 individually, alongside 12 other high-risk HPV genotypes (hrHPV) collectively. HPV extended genotyping (XGT) identifies four additional hrHPV individually (HPV31, 45, 51, and 52), and reports the remaining eight in three groups (HPV33|58; 56|59|66; 35|39|68). Quality-adjusted life years (QALY), health care resource use, and costs of XGT were compared to PGT for cervical cancer screening in Singapore using DICE simulation. Women with one of the three hrHPV identified by XGT (HPV35|39|68; 56|59|66; 51), and atypical squamous cells of undetermined significance (ASCUS) on cytology, are recalled for a repeat screening in one year, instead of undergoing an immediate colposcopy with PGT. At the repeat screening, the colposcopy is performed only for persistent same-genotype infections in XGT, while with PGT, all the women with persistent HPV have a colposcopy. Screening 500,122 women, aged 30-69, with XGT, provided an incremental cost-effectiveness ratio (ICER) versus PGT of SGD 16,370/QALY, with 7130 (19.4%) fewer colposcopies, 6027 (7.0%) fewer cytology tests, 9787 (1.6%) fewer clinic consultations, yet 2446 (0.5%) more HPV tests. The XGT ICER remains well below SGD 100,000 in sensitivity analyses, (-SGD 17,736/QALY to SGD 50,474/QALY). XGT is cost-effective compared to PGT, utilizes fewer resources, and provides a risk-based approach as the primary cervical cancer screening method.

Communication of costs and financial burdens between cancer patients and healthcare providers: a qualitative systematic review and meta-synthesis.

OBJECTIVES: The aim of this study was to synthesize qualitative research regarding communication of costs and financial burdens between patients and healthcare providers to provide evidence for the subsequent development of intervention programs. METHODS: Studies published prior to 11 February 2023 were collected from electronic databases, including PubMed/MEDLINE, MEDLINE (Ovid), Web of Science, EMBASE (Ovid), CINAHL (EBSCO), and ProQuest. A checklist for qualitative research drawn from the Joanna Briggs Institute Reviewer's Manual was applied to assess the quality of the included studies. Meta-aggregation was performed to synthesize the findings of the included studies. RESULTS: Four synthesized findings were derived from 15 studies: cost communication offered more benefits than drawbacks, and most patients were willing to engage in cost communication; cost communication has been implemented in clinical practice but continued to face shortcomings and barriers; an expected cost communication should take into account timing, location, personnel, personality, and content; healthcare providers required education, information, tools, standardized processes, and policy and organizational support to increase their ability to deliver cost communication. CONCLUSIONS: Cost communication can help optimize decision-making and reduce the risk of financial difficulties, as has been widely recognized by patients and healthcare providers. However, a complete clinical practice plan to facilitate cost communication has not yet been created.

An automated method for the assessment of the rice grain germination rate.

The germination rate of rice grain is recognized as one of the most significant indicators of seed quality assessment. Currently, grain germination rate is generally determined manually by experienced researchers, which is time-consuming and labor-intensive. In this paper, a new method is proposed for counting the number of grains and germinated grains. In the coarse segmentation process, the k-means clustering algorithm is applied to obtain rough grain-connected regions. We further refine the segmentation results obtained by the k-means algorithm using a one-dimensional Gaussian filter and a fifth-degree polynomial. Next, the optimal single grain area is determined based on the area distribution curve. Accordingly, the number of grains contained in the connected region is equal to the area of the connected region divided by the optimal single grain area. Finally, a novel algorithm is proposed for counting germinated grains. This algorithm is based on the idea that the length of the intersection between the germ and the grain is less than the circumference of the germ. The experimental results show that the mean absolute error of the proposed method for germination rate is 2.7%. And the performance of the proposed method is robust to changes in grain number, grain varieties, scale, illumination, and rotation.

Financial inclusion and energy consumption in China: the roles of economic growth and technological innovation.

This paper studies the impact of financial inclusion on energy consumption in China since the new millennium by using provincial data in China from 2000 to 2019. A financial inclusion index is first constructed, and the spatial-temporal evolution of China's financial inclusion and energy consumption are explored. Second, a spatial econometric model is applied to investing their relationship. Third, the mechanism on how financial inclusion may affect energy consumption is investigated through the mediation effect model. Results show that both financial inclusion and energy consumption show signs of polarization in China. Besides, most provinces saw a significant increase in their per capita energy consumption. Further, the relationship between financial inclusion and energy is U-shaped. Lastly, economic growth and technology upgrading mediate the impact of financial inclusion on energy consumption, with the direct effects (II) dominating the mediation effects. Some policy suggestions are also given.

Patients with complicated gallstone disease in the emergency department: clinical impact and cost-effectiveness of emergency department disposition decision.

Objective: The objective of this study was to assess the 1-year outcomes of emergency department (ED) patients with complicated gallstone disease, including surgery rates, initial admission rates, ED revisits, repeat hospitalizations, and cost. Methods: Using 3 linked statewide databases from the Maryland Healthcare Cost and Utilization Project, we identified patients with a primary diagnosis of complicated gallstone disease treated in an ED between 2016 and 2018. We measured the healthcare use and direct costs in the ambulatory surgery, inpatient, and ED settings for 1 year after the initial ED visit. Finally, we performed a multivariate logistic regression analysis comparing initially admitted versus discharged patients. Results: Of the 8751 patients analyzed, 86.8% were admitted to the hospital and 13.2% were discharged on their initial ED visit. Of the admitted patients, 78.7% received a cholecystectomy during the initial hospitalization plus 6.1% at a later date; of the discharged patients, 41.5% received a cholecystectomy. Admitted patients demonstrated lower recurrent gallbladder complications compared with those discharged (7.5% vs 44.5%), fewer ED revisits (4% vs 20.3%), and fewer repeat hospitalizations (4.5% vs 16.7%). Despite this, the 1-year cost in the admitted patients was higher ($9448 vs $2933). Obesity, age, and mood disorders but not race, ethnicity, or zip code were associated with admission at initial ED visit. Conclusions: In our single-state analysis of ED patients with complications of gallstone disease, most patients are admitted on the initial visit and receive a cholecystectomy during that hospitalization. The discharged group had higher rates of 1-year complications, ED revisits, and repeat hospitalizations but lower cost.

[Risk Assessment and Attribution Analysis of "Five Toxic" Heavy Metals in Cultivated Land in Lanzhou].

Heavy metals in cultivated soil may migrate and transform through the food chain to harm the ecological environment and human health. At present, the ecological environment and human health risks of heavy metals in cultivated soil in Lanzhou city remain unclear, which impacts the effective management and control of heavy metals. The potential ecological risk hazard index was used to evaluate the ecological environmental risks of As, Cd, Cr, Hg, and Pb in the surface soil of cultivated land in Lanzhou, and the health risk model proposed by USEPA and the recommended standard were used to evaluate their human health risk. The main factors influencing the spatial differentiation of human health risk were explored by using geographic detectors. The risk of heavy metals to the ecological environment of the cultivated land surface soil in the study area was mainly medium (65.25%), and small portions were low (13.80%) and high (20.95%). The low-risk areas were mainly located in the southeast of Yongdeng County, the middle and north of Yuzhong County, and the southwest of Gaolan County. Moderate risk areas were distributed in three counties and five districts. The high-risk areas were located in the north and southeast of Yongdeng County, the south of Chengguan District, the northeast of Qilihe, the east of Xigu District, and the middle of Yuzhong County. The non-carcinogenic and carcinogenic risks of five types of heavy metal exposure pathways were as follows:oral ingestion>skin contact>respiratory ingestion; generally speaking, children were at higher risk than adults. The non-carcinogenic risk in children was higher than that in adults; however, there was no such risk for local residents, as they were all less than 1. At the same time, the carcinogenic risk of As was greater than 1×10-5 (children 2.04×10-5) and less than 1×10-4 (adults 1.91×10-5), respectively. This indicated an acceptable medium risk to the local residents, and the risk to children was again greater than that to adults. Geographical detector analysis showed that average precipitation during the sampling season had the greatest impact on the spatial differentiation of human health risks of As and Cd, GDP had the greatest impact on the spatial differentiation of human health risks of Cr, and distance from the railway had the greatest impact on the spatial differentiation of human health risks of Hg and Pb. Interaction detection showed that all factors were enhanced by double factors. In addition to leading factors, other factors such as pH, slope, and altitude also enhanced the influence of leading factors on the spatial differentiation of heavy metal risk in cultivated soil.

First-Year College Students' Mental Health in the Post-COVID-19 Era in Guangxi, China: A Study Demands-Resources Model Perspective.

The post-COVID-19 era means that the COVID-19 is basically under control; however, the risk of the pandemic still affects people's work, study, and life, physically and psychologically. In this era, due to the more challenges first-year college students face, more attention should be paid to their mental health. An emerging study demands-resources (SD-R) model can explain the influencing mechanism of college students' mental health. This model suggests that study demands increase the risk of student burnout, which results in mental health problems; meanwhile, study resources reduce student burnout and increase student engagement, thus improving mental health. Based on the SD-R model, this study explores the impacts of time pressure, emotional exhaustion, perceived social support, and student engagement on mental health and provides adequate measures to reduce the risk of mental health problems among first-year students. Time pressure, perceived social support, emotional exhaustion, student engagement, and mental health scales were used to investigate 537 first-year students at three universities in Guangxi, China, of whom 290 (54%) were female, and 247 (46%) were male, and the average age was 18.97 ± 1.01. Results indicated that: (1) Moderate scores on time pressure and emotional exhaustion and slightly-above-the-median scores on perceived social support, student engagement, and mental health were found among first-year students in the post-COVID-19 era. (2) Time pressure had a positive relationship with emotional exhaustion and a negative relationship with mental health. (3) Perceived social support was negatively correlated with emotional exhaustion but positively correlated with student engagement, and thus improved mental health. Results of this study with a sample of first-year college students in China support the hypotheses based on the SD-R model. These findings suggest that increasing perceived social support and student engagement while decreasing time pressure and emotional exhaustion may promote mental health among first-year college students.

Assessment of the Clinical Diagnosis of Onychomycosis by Dermoscopy.

Background: As a common clinical superficial fungal infection, the diagnosis of onychomycosis relies on clinical features, traditional KOH direct microscopy and fungal culture. In recent years, dermoscopy has been widely used in the diagnosis and treatment of infectious diseases and has provided new options for the diagnosis of onychomycosis. Objective: To evaluate the value of dermoscopy in the clinical diagnosis of onychomycosis and to explore the relationship between each clinical subtype and the dermoscopic pattern. Methods: A retrospective study of 114 cases of clinically suspected onychomycosis was conducted to compare the differences between dermoscopy and fungal pathogenic examination (microscopy and culture) in the diagnostic sensitivity of onychomycosis and to analyze the relationship between nine common dermoscopic modalities and clinical subtypes of onychomycosis. Results: Among the 114 proposed patients, 87 nails with positive fluorescent staining microscopy and/or positive fungal cultures were diagnosed as onychomycosis. The sensitivity and specificity of dermatoscopy, using the mycological findings as a reference, were 86.21 and 33.33%, respectively. The incidence of common dermatoscopic patterns in the 87 nails with confirmed onychomycosis was as follows: white flocculation in 76 cases (87.35%), longitudinal nail pattern in 72 cases (82.76%), jagged changes in the distal nail plate in 69 cases (79.31%) and yellow staining in 46 cases (52.87%), these four patterns were more commonly seen in the distal lateral subungual onychomycosis and total dystrophic onychomycosis, but there was no statistical difference in the positive dermatoscopic pattern between these two types (P > 0.05). Conclusion: Dermoscopy can be an important aid in the diagnosis of onychomycosis, especially when fungal microscopy or culture is not appropriate, but this method is still not a substitute for fungal microscopy and culture.