Examining the relationship between international digital trade, green technology innovation and environmental sustainability in top emerging economics.

Ensuring preserving a sustainable environment is a crucial concern for individuals worldwide. In previous research, CO2 emissions have been used to measure environmental deterioration. However, in this study, we have expanded the scope to include carbon emissions and several other gases. This comprehensive measure is referred to as the ecological footprint (EFP). More significant international digital trade (IDT) has the potential to achieve several positive results, including reducing EFP (economic frictions and barriers), stimulating economic growth, and minimizing trade risk and volatility. These benefits can be realized by implementing structural reforms in significant production and development sectors. Green technology innovation (GTI) has the potential to make substantial progress in ecological quality and energy efficiency. Nevertheless, previous studies still need to adequately prioritize examining rising economies in terms of international trade diversification and GTI. This study examined the effects of IDT, GTI, and renewable energy consumption (REC) on EFP in BRICST countries. The study utilized data from the period between 1995 and 2022. The cross-sectionally augmented autoregressive distributed lag (CS-ARDL) model demonstrates that EFP negatively correlates with trade diversification, REC, and GTI in the long and short term. These countries have demonstrated a significant presence of eco-friendly products in their trade portfolios, and their manufacturing processes are shifting towards GTI. The objective is to enhance the REC sources and minimize EFP from consumption. Conversely, the increasing economic growth within this economic group has a compounding impact on the environment's decline since it amplifies the carbon emissions from increased consumption. To reduce the EFP level, the paper suggests increasing investment in GTI, promoting worldwide digital trade, and embracing renewable energy sources.

Burden of psoriasis in young adults worldwide from the global burden of disease study 2019.

Background: To determine the global burden of psoriasis in young adults, i.e., those aged 15-49, from 1990 to 2019 and predict trends in this burden for 2020 to 2030. Methods: Age-standardized disease burden indicators and their estimated annual percentage changes were assessed and used to compare the estimated burden between regions. In addition, generalized additive models were used to predict the burden in this population from 2020 to 2030. Results: From 1990 to 2019, the overall burden of psoriasis in young adults worldwide trended downward, as the age-standardized incidence rate and the age-standardized disability-adjusted life year rate decreased. From 1990 to 2019, there were gender differences in the burden of psoriasis between regions with different Socio-demographic index. Specifically, there was a smaller increase in the burden in young men than in young women in middle- and low-middle-Socio-demographic index areas. In 2019, Western Europe, Australasia, and Southern Latin America had the highest age-standardized incidence rate of psoriasis in young adults, whereas age-standardized disability-adjusted life year rates of psoriasis in young adults were highest in high-income North America. In 2019, the psoriasis burden in young adults was the highest in high-Socio-demographic index areas and the lowest in low-Socio-demographic index regions. We predict that from 2020 to 2030, the incidence rate and disability-adjusted life year rate of psoriasis in all age groups of young adults will continue to decline, but the burden in those aged 30-39 will increase. Conclusion: From 1990 to 2019, the overall burden of psoriasis in each age group trended downward in this period. We predict that from 2020 to 2030, the burden of psoriasis in those aged 30-39 will increase.

Calculation of carbon emission efficiency in China and analysis of influencing factors.

Carbon emissions have risen in line with China's economic expansion. The key to sustainable development is finding a way to strike a balance between economic expansion and environmental protection, so improving carbon emission efficiency is vital. This paper uses provincial data from 2010 to 2020 to account for total carbon emissions using the emission factor method and obtains carbon emission efficiency data on this basis. A dynamic spatial Durbin model is then used to empirically test the possible influencing factors. The results show that, firstly, the growth rate of total carbon emissions is generally in line with the growth rate of GDP, indicating that there is no 'decoupling' in the economic system. Second, regional carbon emissions and carbon emission efficiency are not necessarily related. Thirdly, there is a clear spatial effect on carbon emission efficiency. The eastern region has the highest carbon emission efficiency, the western region has the lowest, and the northeastern and central regions have little difference in carbon emission efficiency. Further spatial and temporal migration analysis reveals that five provinces have made the migration between 2010 and 2020. Fourthly, in the short term, the direct and indirect effects of the factors affecting carbon emission efficiency are insignificant, but in the long term, most of the factors have significant direct and indirect effects on carbon emission efficiency. Finally, based on the above research findings, this paper makes policy recommendations.

Proteome profiling of hippocampus reveals the neuroprotective effect of mild hypothermia on global cerebral ischemia-reperfusion injury in rats.

Cerebral ischemia is one of the leading causes of disability and mortality worldwide. Blood reperfusion of ischemic cerebral tissue may cause cerebral ischemia-reperfusion (IR) injury. In this study, a rat model of global cerebral I/R injury was established via Pulsinelli's four-vessel occlusion (4-VO) method. The liquid chromatography-tandem mass spectrometry (LC-MS/MS) and bioinformatics analysis were employed to examine the ipsilateral hippocampus proteome profiles of rats with/without MH (32 °C) treatment after IR injury. Totally 2 122 proteins were identified, among which 153 proteins were significantly changed associated with MH (n = 7 per group, fold change-1.5, p < 0.05). GO annotation of the differentially expressed proteins (DEPs) revealed that cellular oxidant detoxification, response to zinc ions, aging, oxygen transport, negative regulation of catalytic activity, response to hypoxia, regulation of protein phosphorylation, and cellular response to vascular endothelial growth factor stimulus were significantly enriched with MH treatment. The KEGG analysis indicated that metabolic pathways, thermogenesis, pathways of neurodegeneration, chemical carcinogenesis-reactive oxygen species, fluid shear stress and atherosclerosis, and protein processing in endoplasmic reticulum were significantly enriched with MH treatment. Importantly, changes in 16 DEPs were reversed by MH treatment. Among them, VCAM-1, S100A8, CaMKK2 and MKK7 were verified as potential markers associated with MH neuroprotection by Western blot analysis. This study is one of the first to investigate the neuroprotective effects of MH on the hippocampal proteome of experimental models of cerebral IR injury. These DEPs may be involved in the most fundamental molecular mechanisms of MH neuroprotection, and provide a scientific foundation for further promotion of reparative strategies in cerebral IR injury.

The allocation and fairness of health human resources in Chinese maternal and child health care institutions: a nationwide longitudinal study.

BACKGROUND: In response to an aging population, the Chinese government implemented the three-child policy in 2021 based on the comprehensive two-child policy. With the implementation of the new birth policy, people's maternal and child health (MCH) needs will also increase. The allocation and fairness of MCH human resources directly affect people's access to MCH services. The purpose of this study is to analyze the allocation of health human resources in Chinese maternal and child health care institutions, evaluate the fairness of the allocation, to provide a reference for the rational allocation of MCH human resources. METHODS: The data of health technicians, licensed (assistant) physicians, and registered nurses in maternal and child health care institutions nationwide from 2016 to 2020 were included. The health resource density index (HRDI) is used to evaluate the allocation level of MCH human resources. The Gini coefficient (G) and Theil index (T) are used to evaluate the fairness of the allocation of MCH human resources from the perspectives of population and geographic area. RESULTS: From 2016 to 2020, the average annual growth rate of the number of health technicians, licensed (assistant) physicians, and registered nurses in Chinese maternal and child health care institutions was 7.53, 6.88, and 9.12%, respectively. The Gini coefficient (G) of the three types of MCH human resources allocated by population were all below 0.23, and the Gini coefficient (G) allocated by geographical area were all above 0.65. The Theil index (T) of the three types of MCH human resources allocated by population was all lower than 0.06, and the Theil index (T) allocated by geographical area was all higher than 0.53. In addition, the three types of MCH human resources allocated by population and geographic area contributed more than 84% of the Theil index within the group (Tintra) to the Theil index (T). CONCLUSIONS: China's MCH human resources were fair in terms of population allocation, but unfair in terms of geographical area allocation. In the future, more attention should be paid to the geographical accessibility of MCH human resources, and the allocation of resources should comprehensively consider the two factors of serving the population and geographical area.

[Assessment Value of Short-Term Prognosis of Six Predictive Models for Patients with Acute-on-Chronic Liver Failure Treated with Artificial Liver Support System].

Objective: To apply 6 predictive models on acute-on-chronic liver failure (ACLF) patients treated with artificial liver support system (ALSS), and to compare their assessment values for the short-term prognosis of patients. Methods: A total of 258 ACLF patients who underwent ALSS therapy between January 2018 and December 2019 were selected from the ALSS clinical database established by West China Hospital, Sichuan University, and their clinical data and 90-day prognosis information were collected. Cox proportional hazards model was used to estimate the association between the six predictive models, including Chinese Group on the Study of Severe Hepatitis B-ACLF (COSSH ACLF), European Association for the Study of the Liver--Chronic Liver Failure-Consortium (CLIF-C) ACLF, CLIF-C Organ Failure (OF), Asian Pacific Association for the Study of the Liver (APASL) ACLF Research Consortium (AARC) ACLF, Model for End-Stage Liver Disease (MELD) and Simplified MELD (sMELD), and 90-day mortality, which included death or receiving liver transplantation. The area under the receiver operating characteristic (ROC) curve ( AUC), Harrell's C-index and Brier scores were calculated and compared to evaluate the predictive power. Results: A total of 258 ACLF patients were enrolled. Of these patients, who had a mean age of (46.2±11.7) years old, 37 (14.3%) patients were female, 202 (78.3%) patients had a diagnosis of liver cirrhosis, and 107 (41.5%) patients died during the 90-day follow-up period. The six predictive models all yielded higher scores for patients who died than those for patients who survived (all P<0.001). The six predictive models were all independent risk factors for the short-term prognosis of ACLF patients treated with ALSS (all adjusted hazard ratio [HR]>1, all P<0.001). The AUC (0.806, 95% confidence interval [CI]: 0.753-0.853) and Harrell's C-index (0.772, 95% CI: 0.727-0.816) of COSSH ACLF were much higher than those of the five other predictive models (all AUCs<0.750, P<0.01; all Harrell's C-indices<0.750, P<0.001). The Brier score of COSSH ACLF was 0.18 (95% CI: 0.15-0.20). The 90-day mortality of patients defined as having low risk, moderate risk, and high risk according to the risk stratification of COSSH ACLF were 22.2%, 56.3%, and 90.2%, respectively. Conclusion: The COSSH ACLF could more accurately predict short-term prognosis in ACLF patients who received ALSS therapy, and could facilitate clinical decision-making.

Rare disease curative care expenditure-financing scheme-health provider-beneficiary group analysis: an empirical study in Sichuan Province, China.

BACKGROUND: Rare diseases impose a heavy economic burden on patients' families and society worldwide. This study used the samples from Sichuan Province in China to estimate the curative care expenditure (CCE) of ten rare diseases, for supporting the prioritization of rare disease health policies. METHODS: Multi-stage cluster sampling method was adopted to investigate 9714 rare disease patients from 1556 medical institutions in Sichuan Province. Based on the System of Health Accounts 2011, this study estimated the total CCE of 10 rare diseases, financing schemes, and their allocation among different medical institutions and groups of people. RESULTS: In 2018, the total CCE of the ten rare diseases was $19.00 million, the three costliest rare diseases were Hemophilia ($4.38 million), Young-onset Parkinson's disease ($2.96 million), and Systemic Sclerosis ($2.45 million). Household out-of-pocket expenditure (86.00% for outpatients, 41.60% for inpatients) and social health insurance (7.85% for outpatients; 39.58% for inpatients) were the main sources of financing CCE. The out-of-pocket expenditures for patients with Young-onset Parkinson's disease, Congenital Scoliosis, and Autoimmune Encephalitis accounted for more than 60% of the total CCE. More than 80% of the rare disease CCE was incurred in general hospitals. The 40-59 age group accounted for the highest CCE (38.70%) while men spent slightly more (55.37%) than women (44.64%). CONCLUSIONS: As rare disease treatment is costly and household out-of-pocket expenditure is high, we suggest taking steps to include rare disease drugs in the National Reimbursement Drug List and scientifically re-design insurance coverage. It is also necessary to explore a multi-tiered healthcare security system to pay for the CCE of rare diseases and reduce the economic burden on patients.

Perturbative Quantum Monte Carlo Method for Nuclear Physics.

While first order perturbation theory is routinely used in quantum Monte Carlo (QMC) calculations, higher-order terms present significant numerical challenges. We present a new approach for computing perturbative corrections in projection QMC calculations. We demonstrate the method by computing nuclear ground state energies up to second order for a realistic chiral interaction. We calculate the binding energies of several light nuclei up to ^{16}O by expanding the Hamiltonian around the Wigner SU(4) limit and find good agreement with data. In contrast to the natural ordering of the perturbative series, we find remarkably large second-order energy corrections. This occurs because the perturbing interactions break the symmetries of the unperturbed Hamiltonian. Our method is free from the sign problem and can be applied to QMC calculations for many-body systems in nuclear physics, condensed matter physics, ultracold atoms, and quantum chemistry.

Predicting the Failure Risk of Internal Fixation Devices in Chinese Patients Undergoing Spinal Internal Fixation Surgery: Development and Assessment of a New Predictive Nomogram.

The current study is aimed at developing and validating a nomogram of the risk of failure of internal fixation devices in Chinese patients undergoing spinal internal fixation. We collected data from a total of 1139 patients admitted for spinal internal fixation surgery at the First Affiliated Hospital of Guangxi Medical University from May 2012 to February 2019. Of these, 1050 patients were included in the spinal internal fixation group and 89 patients in the spinal internal fixation device failure group. Patients were divided into training and validation tests. The risk assessment of the failure of the spinal internal fixation device used 14 characteristics. In the training test, the feature selection of the failure model of the spinal internal fixation device was optimized using the least absolute shrinkage and selection operator (LASSO) regression model. Based on the characteristics selected in the LASSO regression model, multivariate logistic regression analysis was used for constructing the model. Identification, calibration, and clinical usefulness of predictive models were assessed using C-index, calibration curve, and decision curve analysis. A validation test was used to validate the constructed model. In the training test, the risk prediction nomogram included gender, age, presence or absence of scoliosis, and unilateral or bilateral fixation. The model demonstrated moderate predictive power with a C-index of 0.722 (95% confidence interval: 0.644-0.800) and the area under the curve (AUC) of 0.722. Decision curve analysis depicted that the failure risk nomogram was clinically useful when the probability threshold for internal fixation device failure was 3%. The C-index of the validation test was 0.761. This novel nomogram of failure risk for spinal instrumentation includes gender, age, presence or absence of scoliosis, and unilateral or bilateral fixation. It can be used for evaluating the risk of instrumentation failure in patients undergoing spinal instrumentation surgery.

Top management team faultlines, green technology innovation and firm financial performance.

Focusing on green technology innovation, the paper researches its motivation and implementation results from the perspective of internal corporate management. The impact of top manager team faultlines on green technology innovation and the moderating role of environmental information disclosure in the relationship between green technology innovation and financial performance are discussed. Using listed manufacturing corporate data obtained from China Stock Market & Accounting Research database, the hypotheses are tested. It is found that there is an inverted U-shaped relationship between task-related faultline and green technology innovation, while bio-demographic faultline has no significant influence on green technology innovation. In addition, both green technology innovation and environmental information disclosure have positive effects on financial performance, while the moderating effect of environmental information disclosure on innovation-performance doesn't exist. Combined with the research results, the practical implications for policy makers and managers and future research avenue are proposed.

Influence of Environmental Management on Green Process Innovation: Comparison of Multiple Mediating Effects Based on Routine Replication.

Although green process technology is vital to sustainable development, few articles focus on how to implement it from the perspective of firms. This article tries to answer this question. Being set as an antecedent of green process innovation, the influence of environmental management is analyzed and the influential path is elaborated. Hypotheses are tested by means of multivariate regression analysis and bootstrap method. The results show that environmental management is conducive to firms' green process innovation, and the influence is through zero-order routine replication and higher-order routine replication. The mediating effect played by the interaction between the two is stronger than that of the individual. Implications are given to academia and practitioners.

Social support, social network and salt-reduction behaviours in children: a substudy of the School-EduSalt trial.

OBJECTIVES: Healthy behaviour changes, such as reducing salt intake, are important to prevent lifestyle-related diseases. Social environment is a major challenge to achieve such behaviours, but the explicit mechanisms remain largely unknown. We investigated whether social networks of children were associated with their behaviours to reduce salt intake. DESIGN: An ancillary study of a school-based cluster randomised controlled trial to reduce salt intake in children and their families (School-EduSalt), in which salt intake of children was significantly reduced by 25%. SETTING: 14 primary schools in urban Changzhi, northern China. PARTICIPANTS: 603 children aged 10-12 years in the intervention arm. PRIMARY AND SECONDARY OUTCOME MEASURES: We developed a score assessing salt-reduction behaviours (SRB score) of children based on self-administered questionnaires. The SRB score was validated by the changes in salt intake measured by 24-hour urine collection in a random sample of 135 children. A 1-unit increase in SRB score was associated with a 0.31 g/day greater reduction in salt intake during the trial (95% CI 0.06 to 0.57, p=0.016). RESULTS: Children from families with more family members not supporting salt reduction had significantly lower SRB scores (p<0.0001). Children from a class with a smaller size and from a class with more friendship connections, as well as children having more friends within the class all showed higher SRB scores (all p<0.05). Children whose school teachers attended the intervention programme more frequently also had higher SRB scores (p=0.043). CONCLUSION: Social networks were associated with the behaviours to reduce salt intake in children. Future salt-reduction programmes may benefit from strategies that actively engage families and teachers, and strategies that enhance interconnectivity among peers. TRIAL REGISTRATION NUMBER: NCT01821144; post-results.

Chinese medical students' agreement with and fulfillment of the Physician Charter.

BACKGROUND: Although it has been nearly 15 years since the Medical Professionalism in the New Millennium: A Physician Charter (the Physician Charter) was proposed to reaffirm medical professionalism in response to the new challenges in healthcare delivery in the new century, the manner in which Chinese medical students agree with and fulfill the principles and responsibilities of professionalism defined in the Physician Charter still remains unknown. METHODS: In March 2016, 748 fifth-year medical students from China Medical University (CMU) participated in a survey in which they indicated their rate of agreement with and manner of fulfillment of the principles and responsibilities defined in the Physician Charter using a 10-point Likert scale. The data were then analyzed by t-tests, exploratory factor analysis, and multiple linear regressions. RESULTS: The total score of agreement with the Physician Charter was significantly higher than that of fulfillment (p < 0.001). The largest difference between agreement and fulfillment scores were with the principle of social justice (P3), commitments to improving access to care (R6), and a just distribution of finite resources (R7). Exploratory factor analysis distinguished two principles - primacy of patient welfare (P1) and patient autonomy (P2) - from the others in terms of the gap between agreement and fulfillment. This is partially because the proportion of students who rated agreement lower than fulfillment of P1 or P2 was much higher than it was for any other principle or responsibility. Additionally, multiple linear regressions show that students who are enrolled in a five-year program or who was registered as a rural resident (i.e. holding a rural Hukou) had significantly higher scores of agreement, but not fulfillment. CONCLUSIONS: Chinese medical students endorsed the Physician Charter and its core values of medical professionalism, although they felt difficult to fulfill in practice. Medical educators and the health authority should act together to support and foster professional values.

Cognitive functioning transitions, health expectancies, and inequalities among elderly people in China: A nationwide longitudinal study.

OBJECTIVE: In China, cognitive impairment has become a huge challenge owing to the rapid aging process. We investigate cognitive health expectancy and potential factors leading to inequalities of cognitive health for Chinese older people. METHODS: The study included 19 943 participants aged 65 to 95 at the first observation in Chinese Longitudinal Healthy Longevity Survey collected during 2002-2014. Cognitive impairment was categorized into none, mild, and severe by the score of cMMSE. Multistate models based on continuous-time Markov process were applied to calculate cognitive health expectancies and estimate hazard ratio from no impairment to impairment for potential factors. RESULTS: Urban women and men aged 65 were expected to spend 31.18% and 19.82% of their remaining 17.46 and 15.45 years with cognitive impairment; meanwhile, rural women and men aged 65 were expected to spend 35.31% and 21.39% of their remaining 16.73 and 14.87 years with cognitive impairment. Women achieving lower educational attainment (HR1-6 years  = 0.78, 95% CI, 0.71-0.87; HR7+ years  = 0.59, 95% CI, 0.49-0.70) than men and rural residents having less access to medical service (HR = 0.79, 95% CI, 0.68-0.92) and doing less regular exercise (HR = 0.87, 95% CI, 0.80-0.96) than urban people caused the differences of cognitive health for genders and regions. CONCLUSIONS: Women and rural people experience less cognitive health expectancies compared with their counterparts, respectively. Chinese government should pay more attention to rural women and make efforts to reduce the inequalities of cognitive health by increasing opportunities of education for women and improving access to medical service and healthy lifestyle for rural people.

Head to Head Comparison of Two Point-of-care Platelet Function Tests Used for Assessment of On-clopidogrel Platelet Reactivity in Chinese Acute Myocardial Infarction Patients Undergoing Percutaneous Coronary Intervention.

BACKGROUND: Platelet function tests are widely used in clinical practice to guide personalized antiplatelet therapy. In China, the thromboelastography (TEG) test has been well accepted in clinics, whereas VerifyNow, mainly used for scientific research, has not been used in routine clinical practice. The aim of the current study was to compare these two point-of-care platelet function tests and to analyze the consistency between the two tests for evaluating on-clopidogrel platelet reactivity in Chinese acute myocardial infarction patients undergoing percutaneous coronary intervention (PCI). METHODS: A total of 184 patients admitted to Fuwai Hospital between August 2014 and May 2015 were enrolled in the study. On-clopidogrel platelet reactivity was assessed 3 days after PCI by TEG and VerifyNow using adenosine diphosphate as an agonist. Based on the previous reports, an inhibition of platelet aggregation (IPA) <30% for TEG or a P2Y12 reaction unit (PRU) >230 for VerifyNow was defined as high on-clopidogrel platelet reactivity (HPR). An IPA >70% or a PRU <178 was defined as low on-clopidogrel platelet reactivity (LPR). Correlation and agreement between the two methods were analyzed using the Spearman correlation coefficient (r) and kappa value (κ), respectively. RESULTS: Our results showed that VerifyNow and TEG had a moderate but significant correlation in evaluating platelet reactivity (r = -0.511). A significant although poor agreement (κ = 0.225) in identifying HPR and a significantly moderate agreement in identifying LPR (κ = 0.412) were observed between TEG and VerifyNow. By using TEG as the reference for comparison, the cutoff values of VerifyNow for the Chinese patients in this study were identified as PRU >205 for HPR and PRU <169 for LPR. CONCLUSIONS: By comparing VerifyNow to TEG which has been widely used in clinics, VerifyNow could be an attractive alternative to TEG for monitoring on-clopidogrel platelet reactivity in Chinese patients.

Salt sales survey: a simplified, cost-effective method to evaluate population salt reduction programs--a cluster-randomized trial.

Twenty-four-hour urine collection, as a gold standard method of measuring salt intake, is costly and resource consuming, which limits its use in monitoring population salt reduction programs. Our study aimed to determine whether a salt sales survey could serve as an alternative method. This was a substudy of China Rural Health Initiative-Sodium Reduction Study (CRHI-SRS), in which 120 villages were randomly allocated (1:1:2) into a price subsidy+health education (PS+HE) group, a HE-only group or a control group. Salt substitutes (SS) were supplied to shops in the intervention groups; 24-h urine was collected from 2567 randomly selected adults at the end of the trial to evaluate the effects of the intervention. Ten villages were randomly selected from each group (that is, 30 villages in total), and 166 shops from these villages were invited to participate in the monthly salt sales survey. The results showed that during the intervention period, mean monthly sales of SS per shop were 38.0 kg for the PS+HE group, 19.2 kg for the HE only and 2.2 kg for the control group (P<0.05), which was consistent with the results from the 24-h urine sodium and potassium data. The intervention effects of CRHI-SRS on sodium and potassium intake estimated from SS sales were 101% and 114%, respectively, of those observed from the 24-h urine data. Furthermore, the salt sales survey cost only 14% of the cost of the 24-h urine method and had greater statistical power. The results indicate that a salt sales survey could serve as a simple, sensitive and cost-effective method to evaluate community-based salt reduction programs in which salt is mainly added by the consumers.

[The cost effectiveness analysis of minimally invasive surgery and conservative treatment in elderly osteoporotic spinal fracture].

OBJECTIVE: To evaluate the cost effectiveness of conservative treatment, percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)for elderly osteoporotic vertebral compression fracture(OVCF). METHODS: The clinical data of 152 patients with osteoporotic vertebral compression fractures, collected in the orthopedic department of 309th Hospital of PLA from October 2013 to July 2014, was retrospectively analyzed. According to the therapeutic methods, the patients who met the inclusion criteria were divided into conservative treatment group (51 cases), percutaneous vertebroplasty group (50 cases) and percutaneous kyphoplasty group(51 cases). The average medical cost (C) in hospital period and 1 year after discharging, and the treatment effect (E) according to standard of "cure" (VAS score less than or equal to 2) or "improvement" (VAS score was 3 to 8) was recorded. Then the C/E value indicated the cost effectiveness in different standards. RESULTS: The average hospitalization days of the PVP and PKP group was 3 to 5 days with an average of(3.4±0.6) days. The conservative group was 12 to 15 days with an average of (14.0±0.6) days. During the hospitalization period, the cost effectiveness of the conservative group, PVP group and PKP group were RMB 1 253.88, 935.75, 983.99 yuan, respectively, according to the standard of "cure". The PVP group was superior to the PKP group and the latter was superior to the conservative group. If "improvement" was used as the standard of evaluation, the results were RMB 97.80, 449.16, 501.84 yuan, respectively, suggesting that the conservative group was better than the PVP group and the latter was better than the PKP group. After hospital discharge, the cost effectiveness of the conservative group, PVP group and PKP group were RMB 3 834.05, 1 878.41 and 1 916.11 yuan, respectively, according to the standard of "cure". The PVP group was superior to the PKP group and the latter exceeded the conservative group. CONCLUSIONS: The study showed that the PVP was the best choice at the evaluation criterion of "cure", while taking "improvement" as the evaluation criterion, the conservative treatment was the best one. Either way, the PVP was the best choice after hospital discharge.

A school-based education programme to reduce salt intake in children and their families (School-EduSalt): protocol of a cluster randomised controlled trial.

INTRODUCTION: The current salt intake is very high for children as well as adults in China. A reduction in salt intake is one of the most cost-effective measures to curb the rapidly growing disease burden attributed to blood pressure and cardiovascular disease in the Chinese population. A lower salt diet starting from childhood has the potential to prevent the development of such conditions. The School-EduSalt (School-based Education Programme to Reduce Salt) study aims to determine whether an education programme targeted at school children can lower salt intake in children and their families. METHODS AND ANALYSIS: The study is designed as a cluster randomised controlled trial. The location is Changzhi, Shanxi province in northern China. The study population will consist of 28 primary schools with 280 children aged ≈11 years and 560 adult family members. Children in the intervention group will be educated on how to reduce salt intake. They will then be empowered to deliver the salt reduction message home to their families. In particular, children need to persuade the person who does the cooking to reduce the amount of salt used during food preparations. The duration of the intervention is one school term (≈4.5 months). The primary outcome is the difference between the intervention and the control group in the change in 24 h urinary sodium and the secondary outcome is the difference between the intervention and control group in the change of blood pressure. An economic evaluation will be undertaken to assess cost-effectiveness. ETHICS AND DISSEMINATION: The study has been approved by The Queen Mary Research Ethics Committee (QMREC2012/81) and Peking University Health Science Centre IRB (IRB00001052-12072). Study findings will be disseminated widely through conference presentations and peer-reviewed publications. PROTOCOL REGISTRATION: Protocol Registered on ClinicalTrials.gov NCT01821144.

COmplex-Model-Based Estimation of thermal noise for fMRI data in the presence of artifacts.

Due to the presence of artifacts induced by fast-imaging acquisition in functional magnetic resonance imaging (fMRI) studies, it is very difficult to estimate the variance of thermal noise by traditional methods in magnitude images. Moreover, the existence of incidental phase fluctuations impairs the validity of currently available solutions based on complex datasets. In this article, a time-domain model is proposed to generalize the analysis of complex datasets for nonbrain regions by incorporating artifacts and phase fluctuations. Based on this model, a novel estimation schema has been developed to find an appropriate set of voxels in nonbrain regions according to their levels of artifact and phase fluctuation. In addition, noise intensity from these voxels is estimated. The whole schema is named COmplex-Model-Based Estimation (COMBE). Theoretical and experimental results demonstrate that the proposed COMBE method provides a better estimation of thermal noise in fMRI studies compared with previously proposed methods and suggest that the new method can adapt to a broader range of applications, such as functional connectivity studies, evaluation of sequence designs and reconstruction schemas.