On the urban resource and environment carrying capacity in China: A sustainable development paradigm.

As urbanization progresses, the number of resource and environmental problems that impede sustainable growth in cities is increasing. The urban resource and environment carrying capacity (URECC) serves as a crucial indicator for understanding the interaction between human activities and urban resource and environmental systems, guiding the practice of sustainable urban development. Thus, accurately comprehending and analyzing the URECC and coordinating the balanced growth of the economy and the URECC is essential to ensure cities' sustainable development. In this research, we combine DMSP/OLS and NPP/VIIRS night-time light data to assess the economic growth of Chinese cities using panel data for 282 prefecture-level cities in China from 2007 to 2019. The findings reveal the following outcomes: (1) Economic growth significantly contributes to the enhancement of the URECC, and the economic expansion of neighboring areas also promotes the URECC within the region. Economic growth can indirectly improve the URECC by fostering internet development, industrial upgrading, technological progress, opening up opportunities, and educational advancements. (2) The results from the threshold regression analysis suggest that as the level of internet development improves, the influence of economic growth on the URECC is initially constrained and then facilitated. Similarly, as financial development improves, the effect of economic growth on the URECC is initially constrained and subsequently promoted, with the promotion effect gradually increasing. (3) The relationship between economic expansion and the URECC varies across regions with different geographic locations, administrative levels, scales, and resource endowments.

Decomposing socioeconomic inequalities in dental caries among Chinese adults: findings from the 4th national oral health survey.

OBJECTIVE: This cross-sectional study aimed to investigate socioeconomic inequalities in dental caries among adults (35 years and older) in China and explore the contributions of various factors to these inequalities. METHODS: This study included 10,983 adults (3,674 aged 35-44 years, 3,769 aged 55-64 years and 3,540 aged 65-74 years) who participated in the 4th National Oral Health Survey (2015-2016) in China. Dental caries status was evaluated by the decayed, missing and filled teeth (DMFT) index. Concentration indices (CIs) were applied to quantify the different degrees of socioeconomic-related inequality in DMFT, decayed teeth with crown or root caries (DT), missing teeth due to caries or other reasons (MT), and filled teeth without any primary or secondary caries (FT) among adults of different age groups. Decomposition analyses were conducted to identify the determinants and their associations with inequalities in DMFT. RESULTS: The significant negative CI indicated that DMFT for the total sample were concentrated among socioeconomically disadvantaged adults (CI = - 0.06; 95% confidence interval [CI], - 0.073 to - 0.047). The CIs for DMFT for adults aged 55-64 and 65-74 years were - 0.038 (95% CI, - 0.057 to - 0.018) and - 0.039 (95% CI, - 0.056 to - 0.023), respectively, while the CI for DMFT for adults aged 35-44 years was not statistically significant (CI = - 0.002; 95% CI, - 0.022 to 0.018). The concentration indices of DT were negative and concentrated in disadvantaged populations, while FT showed pro-rich inequalities in all age groups. Decomposition analyses showed that age, education level, toothbrushing frequency, income and type of insurance contributed substantially to socioeconomic inequalities, accounting for 47.9%, 29.9%, 24.5%,19.1%, and 15.3%, respectively. CONCLUSION: Dental caries was disproportionately concentrated among socioeconomically disadvantaged adults in China. The results of these decomposition analyses are informative for policy-makers attempting to develop targeted health policy recommendations to reduce dental caries inequalities in China.

Identifying the nexus among environmental performance, digital finance, and green innovation: New evidence from prefecture-level cities in China.

Globally, nations are increasingly focusing on green innovation in their environmental protection efforts as part of sustainable development, and digital finance is playing a vital role in enhancing green innovation. Employing annual data from 220 prefecture-level cities between 2011 and 2019, we empirically analyze the connections among environmental performance, digital finance, and green innovation via the Karavias panel unit root test with structural breaks, the Gregory-Hansen structural break cointegration test and pooled mean group (PMG) estimation. The following four points are the key conclusions: (1) The results support cointegration links between these variables when structural breaks are considered. (2) The PMG estimation outcomes indicate that green innovation and digital finance may have a favorable long-term effect on environmental performance. (3) For better environmental performance and more green innovation, the level of digitalization of digital finance is crucial. (4) The potential of digital finance and green innovation to improve environmental performance has not been fully realized in the western region of China.

Chaos single photon LIDAR and the ranging performance analysis based on Monte Carlo simulation.

With the advent of serial production lidars, single photon lidar faces an increasingly severe threat of crosstalk. In this paper, we first propose the concept of Chaos Single Photon (CSP) lidar and establish the theoretical model. In CSP lidar system, chaos laser replaces pulsed laser, and the physical random sequence generated by a Geiger mode avalanche photodiode (GM-APD) responding to chaos laser substitutes the traditional pseudo-random sequence. The mean density of '1' code of the CSP lidar system can exceed 10 million counts per second (Mcps) with a dead time immunity. The theoretical models of detection probability and false alarm rate are derived and demonstrated based on Poisson distribution. The bit error rate (BER) is introduced into the CSP lidar system for evaluating the range walk error intuitively. Additionally, the simulation results indicate that the CSP lidar system has a robust anti-crosstalk capability. Compared with the traditional pseudo-random single photon (PRSP) lidar system, the CSP lidar system not only overcomes range ambiguity but also has a signal to noise rate (SNR) of 60 times, reaching 10000 when the mean echo photoelectron number is 10 per nanosecond. Benefited from large-scale arrays and extremely high sensitivity properties of GM-APDs, we are looking forward to the applications of the CSP lidar in weak signal detection, remote mapping, autonomous driving, etc.

Income-related inequality and decomposition of edentulism among aged people in China.

BACKGROUND: The aim of this study was to assess the income-related inequality of edentulism among the aged in China and identify the contributing factors. METHODS: A secondary analysis of data from the 4th National Oral Health Epidemiology Survey in China was conducted, and 65-74 years old were selected for the analysis of income-related inequality of edentulism. The concentration curve, Concentration index (CI) and Erreygers-corrected concentration index (EI) were used to represent inequality and its degree qualitatively and quantitatively, respectively. A decomposition method based on probit model was employed to determine the contributors of inequality, including demographic factors, income status, oral health-related knowledge, attitude and practices and self-perceived general health status. RESULTS: In China, aged people with edentulism were concentrated in the poor. The CI was - 0.2337 (95% CIs: - 0.3503, - 0.1170). The EI was - 0.0413 (95% CIs: - 0.0619, - 0.0207). The decomposition results showed that income (75.02%) and oral health-related knowledge, attitude and practices (15.52%) were the main contributors to the inequality. CONCLUSION: This study showed that pro-poor inequality among the elderly with edentulism existed in China. Corresponding policies against the contributors could be considered to promote the health equality of the elders.

Burden of cardiovascular disease from 1990 to 2017 in Henan Province, China.

BACKGROUND: Cardiovascular diseases (CVDs) are the leading causes of death in China. Little is known about the CVD burden and risk factors in Henan Province, China. OBJECTIVE: To analyze the CVD burden and main risk factors between 1990 and 2017 in the Henan Province in China. METHODS: The methodological framework and analytical strategies adopted in the Global Burden of Disease Study 2017 were used. RESULTS: (1) Age-standardized mortality rate attributed to CVDs increased from 355.0 per 100,000 persons in 1990 to 364.1 per 100,000 persons in 2017 in Henan. (2) Age-standardized disability adjusted life years (DALYs) rate fell by 3.9% from 1990 to 2017. However, the number of DALYs attributed to CVDs increased by 75.9% from 4.2 million person-years in 1990 to 7.3 million person-years in 2017. (3) The age-standardized years lived with disability (YLDs) rate increased by 27.5% from 1990 to 2017. However, years of life lost (YLLs) rate decreased by 6.7% from 1990 to 2017. The contribution of YLLs to the DALYs decreased from 91.4% in 1990 to 89.2% in 2017. (4) Stroke (52.3%) and ischemic heart diseases (38.8%) accounted for 91.1% of total CVDs DALYs among adults in 2017. (5) Dietary factors such as high intake of sodium, alcohol use and low intake of fruits, high systolic blood pressure, and tobacco use were the top risk factors for CVDs, and the estimated population attributable fraction in 2017 was 69.4%, 56.7% and 25.2%, respectively. CONCLUSIONS: The absolute burden of CVDs in Henan is still high, although age-standardized DALYs declined between 1990 and 2017. The prevention and control of stroke and ischemic heart diseases should focus on a few modifiable risk factors which mainly contributed to the burden of CVDs, such as dietary factors, high systolic blood pressure, and tobacco use.

Integrating ecosystem services modeling into effectiveness assessment of national protected areas in a typical arid region in China.

Protected areas (PAs) are essential for biodiversity conservation and for the delivery of ecosystem services (ESs). However, little is known about their effectiveness in providing ESs and contribution to species richness, especially in arid regions. Effectiveness evaluation is fundamental to understanding the extent of management enhancement required to fulfill conservation targets. In this study, we analyzed the supply of six ESs (water yield, nutrient retention, soil retention, sand fixation, carbon storage, and biodiversity richness) by landscapes in China's arid region of Xinjiang Uygur Autonomous Region (hereafter Xinjiang). The aim was to identify distribution of ESs hotspots and the extent of hotspots located within or outside national PAs. The results showed significant spatial heterogeneity and coverage differences in six types of ESs hotspots. Hotspots coverage of six ESs on average accounted for 10.45 % of the total area, distributed mainly in mountains and oases covered by vegetation and wetlands. Among these ESs hotspots, over 50 % fell within PAs. This suggested that although PAs delivered moderately well outcomes in preserving ESs and biodiversity in Xinjiang, conservation gaps needed to be addressed. Our study also revealed substantial differences in ESs supplied by different PAs, and serious deficiency existed in some PAs in protecting either biodiversity or key ESs outlined in their conservation objectives. Our study illustrated the priority areas for future conservation expansion and stressed the urgent shift toward broadening the goals of PAs from a dominant focus to ones that encompass multiple ESs for human well-being.

Socioeconomic-related inequality in dental care utilization among preschool children in China.

OBJECTIVES: This study aimed to investigate socioeconomic-related inequality in dental care service utilization in the past 12 months among Chinese preschool children and to explore the contribution of various factors to this inequality. METHOD: A total of 40 305 children aged 3-5 years from 372 kindergartens who participated in the Fourth National Oral Health Survey in China were included in the final analysis. The method of data weighting in complex sampling was adopted to make the samples more representative. Erreygers-corrected concentration index (EI) was used to measure socioeconomic-related inequality in dental care service utilization. The horizontal inequality index (HI) was employed to analyse horizontal inequality. Decomposition analyses were conducted to explore the contributions of income level, need variables (dmft, caregiver-evaluated oral health status and toothache experience) and nonneed variables (caregiver education level, residential location, age, and sex) to the inequality of health service utilization. RESULT: The utilization of oral health services within the past 12 months among the high-, middle- and low-income groups was 17.4% (95% CI: 15.6-19.3), 13.6% (95% CI: 12.2-15.1) and 9.4% (95% CI: 8.1-11.0) respectively. The concentration curve was below the line of equality, and the EI and HI were 0.072 and 0.078, respectively, indicating that dental care utilization in children aged 3-5 years was concentrated in those who were better off. The contribution of the need variables to socioeconomic-related inequality in dental services was minimal, and most dental care utilization inequality could be explained by household income, caregiver education attainment and urban-rural disparities, accounting for 32.0%, 49.4% and 20.4% respectively. CONCLUSION: This study reveals the existence of pro-rich inequality in dental care utilization among preschool children in China. The decomposition analysis suggests that income, caregiver education background and urban-rural disparities are the main factors contributing to this outcome. Equity-oriented policies and programmes are needed to achieve equitable dental care utilization.

The burden of oral cancer in China, 1990-2017: an analysis for the Global Burden of Disease, Injuries, and Risk Factors Study 2017.

BACKGROUND: Oral cancer is among the most common malignant tumors worldwide, and it has become an increasingly important public health problem in China. This study systematically assesses the current state of oral cancer in China from 1990 to 2017, providing new information and perspectives for oral health researchers and public health policy makers. METHODS: Based on the Global Burden of Disease, Injuries, and Risk Factors Study 2017 (GBD 2017), we evaluated the incidence rates, mortality and disability-adjusted life year (DALY) rates for oral cancer in China and their changing trends between 1990 and 2017, making comparisons by gender and age. We also assessed the DALY rates associated with oral cancer at the provincial level for 33 provinces and their trends over time. RESULTS: From 1990 to 2017, the number of new cases and the age-standardized incidence rate for oral cancer in China increased by 280.0% and 79.7%, respectively; the number of deaths and the age-standardized mortality rose by 196.8% and 29.0%, respectively; and the number of DALYs and the age-standardized DALY rate increased by 149.1% and 21.0%, respectively. The incidence rates for oral cancer rose after 30 years of age and peaked at 65-69 years; the mortality for oral cancer rose after 50 years of age and peaked at 65-69 years; and the DALY rates for oral cancer rose after 45 years of age and peaked at 65-69 years. The incidence rates, mortality and DALY rates for oral cancer in males were significantly higher than those in females and showed an upward trend, while there was a decrease or no significant change in females. The DALY rates increased in 21 provinces and decreased in 12 provinces, with the largest growth in Henan Province and the largest decline in Hong Kong Province. CONCLUSIONS: The burden of oral cancer in China continues to increase continuously. More prevention, control and intervention measures should be taken and increased attention paid to common risk factors is essential for the prevention of oral cancer.

Measuring and decomposing socioeconomic-related inequality in the use of oral health services among Chinese adults.

OBJECTIVES: This study aimed to measure socioeconomic-related inequality and horizontal inequity in the use of oral health services and decompose this inequality among adults of different age groups in China. METHODS: In total, 10 973 adults (3669 aged 35-44 years, 3767 aged 55-64 years and 3537 aged 65-74 years) who participated in the 4th National Oral Health Survey (2015-2016) in China were included. Concentration curves and the Erreygers-corrected concentration index (EI) were employed to measure socioeconomic-related inequality in the use of oral health services. Then, inequity in this utilization was measured by the horizontal inequity index (HI). Furthermore, decomposition analyses were conducted for the three groups to explain the contributions of income level, need factors (ie self-assessed oral health and evaluated oral health status), other factors (ie sex, residential location, educational attainment level and type of basic insurance) and a residual term to overall inequality in oral health service utilization. RESULTS: The significant positive EI and HI values indicated that pro-rich inequality and inequity in oral health service utilization exist among Chinese adults. Income and type of basic medical insurance contributed the most to socioeconomic-related inequality in the use of oral health services among adults aged 55-64 and 65-74 years. However, the main driving factors of socioeconomic inequality among adults aged 35-44 years in dental care use included income, educational achievement, type of basic medical insurance and residential location. The need variables accounted for a very small proportion of overall socioeconomic-related inequality in oral health service use in all three groups. CONCLUSIONS: Oral healthcare service utilization was disproportionately concentrated among better-off Chinese adults. The primary determinants of inequality in dental care use in different age groups provide information for policymakers to create more targeted policies to achieve equity in the oral healthcare system in China.

Patient-centred and economic effectiveness of a decision aid for patients with age-related cataract in China: study protocol of a randomised controlled trial.

INTRODUCTION: The need for cataract surgery is on the rise due to our ageing population and high demands for greater visual functioning. Although the majority of patients want to participate in a shared decision-making process, no decision aid has been available to improve the quality of decision. The present study aims to determine whether a decision aid increases informed decision about cataract surgery. METHODS AND ANALYSIS: A parallel randomised controlled trial (772 participants) will be conducted. The decision aid will be implemented among patients with any age-related cataract in Yuexiu District, which is socioeconomically representative of a major metropolitan region in Southern China. Participants will be randomly assigned to receive either a patient decision aid or a traditional booklet, and they will complete three surveys: (1) baseline assessment before the intervention (time point (T)1), 2 weeks (T2) and 1 year (T3) after the intervention. The control group receives a traditional booklet with standard general information developed by the National Eye Institute to help patients understand cataract, whereas the intervention group receives a patient decision aid that includes not only the standard general information, but also the quantitative risk information on the possible outcomes of cataract surgery as well as value clarification exercise. The primary study outcome is the informed decision, the percentage of patients who have adequate knowledge and demonstrate consistency between attitudes and intentions. Secondary outcomes include perceived importance of cataract surgery benefits/harms, decision conflict and confidence, anticipated regret and booklet utilisation and acceptability at 2 weeks, and surgical rates and a cost-utility estimate of the decision aid at 1 year. ETHICS AND DISSEMINATION: Ethics approval was obtained from the Ethics Committee of Zhongshan Ophthalmic Center (reference number: 2019KYPJ090). Results will be published in peer-reviewed journals and presented at scientific meetings for academic audiences. TRIAL REGISTRATION NUMBER: NCT03992807.

Utilization of dental services and associated factors among preschool children in China.

BACKGROUND: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen's behavioural model to explore influencing factors, thereby providing a reference for future policy making. METHODS: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child's parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization. RESULTS: The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6-19.4%) among 5-year-old children. "No dental diseases" (71.3%) and "dental disease was not severe" (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor's degree or higher (OR: 2.29, 95%CI: 1.97-2.67, p < 0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p < 0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18-1.65, p < 0.001),think their child have worse or bad oral health (OR: 3.54, 95%CI: 2.84-4.40, p < 0.001), and children who often have toothaches (OR: 9.72, 95%CI: 7.81-12.09, p < 0.001) were more likely to go to the dentist in the past year. CONCLUSION: The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.

Factors associated with oral health service utilization among adults and older adults in China, 2015-2016.

OBJECTIVES: To explore the factors associated with utilization of oral health services among Chinese adults and older adults according to the Andersen Behavior Model. METHODS: Data from the 4th National Oral Health Survey (2015-2016) in China were used. A total of 7206 people (3669 adults aged 35-44 years and 3537 older adults aged 65-74 years) were included in our analysis. Oral health service utilization in the past 12 months was the outcome variable. Explanatory variables were selected according to the Andersen Behavior Model. Descriptive statistics and bivariate associations (chi-square tests) were analysed, followed by hierarchical Poisson regression models, which were conducted to determine the factors associated with oral health service utilization. RESULTS: In total, 21.4% (95% CI: 19.4%-23.7%) of adults (35-44 years old) and 20.7% (95% CI: 18.6%-22.9%) of older adults (65-74 years old) utilized oral health services in the past 12 months. Nearly 80% of adults (78.7%, 95% CI: 74.0%-82.7%) and more than 90% of older adults (93.7%, 95% CI: 91.0%-95.6%) visited a dentist for treatment. Adults aged 35-44 years old who were female (IRR: 1.15, 95% CI: 1.00-1.33, P = .047), had good oral health knowledge and attitudes (IRR: 1.30, 95% CI: 1.06-1.59, P = .011), perceived their oral health status as fair (IRR:1.51, 95% CI:1.24-1.85, P < .001) or poor/very poor (IRR:2.52, 95% CI:2.01-3.18, P < .001) and had a decayed, missing and filled teeth (DMFT) index >0 (IRR: 1.52, 95% CI: 1.11-2.09, P = .009) were more likely to report dental visits in the past 12 months. Older adults who utilized oral health services tended to be female (IRR: 1.32, 95% CI: 1.09-1.59, P = .004); to be covered by Urban Resident Basic Medical Insurance (URBMI) (IRR: 1.56, 95% CI: 1.18-2.05, P = .002), Urban Employee Basic Medical Insurance (UEBMI) (IRR: 1.69, 95% CI: 1.32-2.16, P < .001) or government medical insurance (GMI) (IRR: 1.03, 95% CI:1.01-2.16, P = .044); to have a high education level (IRR: 1.37, 95% CI: 1.08-1.74, P = .010); to have an income level in the 2nd tertile (IRR: 1.44, 95% CI: 1.13-1.84, P = .003) or 3rd tertile (IRR:1.52, 95% CI:1.18-1.95, P = .001); and to perceive their oral health status as poor or very poor (IRR: 1.53, 95% CI: 1.21-1.95, P = .001). CONCLUSIONS: Sex and self-perceived oral health status were associated with oral health utilization among Chinese population. Additionally, for older adults, education level, household income and insurance coverage were determinants of dental service use. These findings can aid in creating more targeted policies to increase the use of dental services by Chinese adults.

The weakness of the strong: Examining the squeaky-wheel effect of hospital violence in China.

Hospital violence has become a worldwide issue that disturbs health care systems. China is in a particular dilemma between meeting the healthcare demand of 1.39 billion residents and ensuring the safety of 12.3 million health professionals. Drawing on data from an administrative survey, we presented the types and distribution of disruptive behaviors, as well as the summary statistics of 225 medical disputes that took place from 2012 to 2013 in Z city. Logit and OLS regression analyses show that disruptive behaviors, characterized by the number of protest participants and the length of protest, can significantly predict whether the claimant receives compensation and the amount of compensation. All else equal, a one-person increase in the number of participants is associated with 3.94% higher odds of getting compensated, whereas a one-day increase in the length of protest is associated with a 1.03% increase in the odds of receiving compensation. Further analyses show that the link between disruptive behaviors and compensation outcomes is due to the involvement of the state, which tends to press hospitals to pay when substantial violence is present. Chinese government's overwhelming emphasis on social stability gives protestors leverage against hospitals, which can be summarized as "the squeaky wheel gets the grease." Ironically, the sensitivity of Chinese government towards social stability becomes a weakness of its own. Government's active intervention to reach a peace-oriented goal will incentivize patients to resort to violence in pursuit of compensation. This study has implications for understanding the Chinese government's logic of addressing social problems that range from hospital violence, labor disputes, land disputes to demolition compensation and civil petitions.

A comparison of DALYs for periodontal disease in China between 1990 and 2013: insights from the 2013 global burden of disease study.

BACKGROUND: China has undergone a rapid demographic and epidemiological transition with fast ecomonic development since the 1980s. Oral health is becoming a major public health problem as the prevalence of non-communicable diseases has greatly increased. Periodontal disease (PD) and caries are among the most prevalent oral diseases. PD accounts for the majority of tooth loss and increases with age. China's third national epidemiological investigation on oral diseases (2005) revealed that periodontitis affected >50% of the adult population. The Global Burden of Disease Study 2013 (GBD2013) have been used to estimate DALYs for 301 acute and chronic diseases and injuries in 188 countries for 1990-2013. The estimation of burden of PD between 1990 and 2013 will provide a unique perspective for planning interventions and developing public health policies for PD even chronic diseases in China. METHODS: We used the GBD 2013 results for Years of Life Lost (YLLs) and Years Lived with Disability (YLDs) to calculate Disability Adjusted Life Years (DALYs) for PD in China. PD standardized DALYs rate (SDR) per 100,000 persons, the percentage of PD standardized DALYs rate (% PD SDR) in all diseases DALYs, and variance ratio of these two indexes between the years of 1990 and 2013 were compared by province, gender and age groups. RESULTS: Nationwide, compared to 1990, the SDR in 2013 increased slightly from 24.7 to 25.7, while the variance ratio of SDR for provinces in the middle, west and south of China showed a greater variation(4.8-6.2%). The % PD SDR in all disease DALYs increased from 0.06 to 0.11% for all groups. The four highest variance ratios % PD SDR in all diseases DALYs between 1990 and 2013 occurred in the west of China (97, 98.6, 108.4 and 112.8%). The PD SDR changed slightly in the women (20.3 to 21.7), meanwhile the variance ratio of PD SDR and % PD SDR in all diseases DALYs for the women (6.7 and 94.5%) was also higher than for men (2.1 and 60.6%). The highest variance ratio % PD SDR in all oral diseases DALYs occurred between 1990 and 2013 in ages 20 to 24 (50.7%) and 25 to 29 years (50.5%). CONCLUSION: The PD standardized DALYs rate and % PD SDR in all diseases DALYs in China in 2013 has increased from 1990. Especially, the variance ratio of % PD SDR in all disease DALYs among Young population and women, in the west provinces of China have been becoming the highest in all age groups and national wide. Future intervention measurements should include young women of child-bearing age because women's health impacts infant health. Periodontal disease has risk factors in common with a number of other non-communicable diseases (NCD) and conditions, and focusing on the common behavioral and environmental risk factors would be instrumental in the effective prevention of periodontal disease.

Delayed-enhancement magnetic resonance imaging at 3.0T using 0.15mmol/kg of contrast agent for the assessment of chronic myocardial infarction.

OBJECTIVE: A recent international, multicenter, double-blinded, randomized trial shows delayed-enhanced magnetic resonance imaging (DE-MRI) using contrast doses of ≥0.2mmol/kg is effective in the detection and assessment of myocardial infarction (MI), and 0.1mmol/kg is not enough; intermediate doses between 0.1 and 0.2mmol/kg have not been tested. The aim of this study was to prospectively test the performance of DE-MRI using 0.15mmol/kg of contrast agent for the detection of MI. MATERIALS AND METHODS: A total of 31 consecutive patients with chronic MI underwent DE-MRI at 3.0T using both 0.15mmol/kg and 0.2mmol/kg of contrast agent in random order and on separate days. Infarction segment and infarction size were compared on DE-MRI images using a 17-segment model. Bland-Altman analysis was used to analyze correlation and agreement between global infarct sizes. RESULTS: DE-MRI showed enhanced myocardium in all the 31 patients with chronic MI. There was no significant difference between the 0.15mmol/kg and 0.2mmol/kg images in all 31 patients based on the infarction segment (7.87±2.72 vs. 7.81±2.64, respectively; p=0.33). There was no significant difference between the infarction size obtained from 0.15mmol/kg acquisition and that from 0.2mmol/kg acquisition (16.3±7.8% vs. 16.4±7.9%, respectively; p=0.87). A strong correlation between the infarction size obtained from 0.15mmol/kg acquisition and that from 0.2mmol/kg acquisition was indicated through Bland-Altman analysis. CONCLUSION: DE-MRI at 3.0T using 0.15mmol/kg of contrast agent is effective for the assessment of MI.

Performance of Pediatric Risk of Mortality, Pediatric Index of Mortality and PIM2 in term Chinese neonates.

Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM) and PIM2 could be applicable to the subset of term neonates has not been well investigated. The purpose of this study is to access and compare the performance of these scoring systems in predicting mortality probability in term Chinese neonates with critical illness. PRISM, PIM and PIM2 scores were calculated prospectively during a 1-year period on 243 neonates admitted to the neonatal intensive care unit (NICU) in the Children's Hospital of Zhejiang University in China. Of these, 36 neonates (14.81%) died in the NICU, while the mortality rates estimated by PRISM, PIM and PIM2 were 16.19, 14.58 and 11.12%, respectively. The area under the receiver-operating characteristic (ROC) curve [95% confidence intervals (CIs)] were 0.834 (0.767-0.902), 0.851 (0.786-0.916) and 0.854 (0.790-0.918) for PRISM, PIM and PIM2, respectively. The Hosmer-Lemeshow test gave a chi-square of 1.35 (p = 0.930) for PRISM, 1.03 (p = 0.960) for PIM and 4.58 (p = 0.469) for PIM2. The standardized mortality rates (SMRs) (95% CI) using PRISM, PIM and PIM2 were 0.92 (0.79-1.08), 1.02 (0.88-1.20) and 1.33 (1.13-1.62), respectively. Although PRISM, PIM and PIM2 have displayed good discrimination and calibration in the present setting, PIM is considered as the most accurate and appropriate tool for predicting mortality in the studied NICU.