PI3K-AKT/mTOR Signaling in Psychiatric Disorders: A Valuable Target to Stimulate or Suppress?

Economic development and increased stress have considerably increased the prevalence of psychiatric disorders in recent years, which rank as some of the most prevalent diseases globally. Several factors, including chronic social stress, genetic inheritance, and autogenous diseases, lead to the development and progression of psychiatric disorders. Clinical treatments for psychiatric disorders include psychotherapy, chemotherapy, and electric shock therapy. Although various achievements have been made researching psychiatric disorders, the pathogenesis of these diseases has not been fully understood yet, and serious adverse effects and resistance to antipsychotics are major obstacles to treating patients with psychiatric disorders. Recent studies have shown that the mammalian target of rapamycin (mTOR) is a central signaling hub that functions in nerve growth, synapse formation, and plasticity. The PI3K-AKT/mTOR pathway is a critical target for mediating the rapid antidepressant effects of these pharmacological agents in clinical and preclinical research. Abnormal PI3K-AKT/mTOR signaling is closely associated with the pathogenesis of several neurodevelopmental disorders. In this review, we focused on the role of mTOR signaling and the related aberrant neurogenesis in psychiatric disorders. Elucidating the neurobiology of the PI3K-AKT/mTOR signaling pathway in psychiatric disorders and its actions in response to antidepressants will help us better understand brain development and quickly identify new therapeutic targets for the treatment of these mental illnesses.

Comprehensive quality assessment of peppermint oils and commercial products: An integrated approach involving conventional and chiral GC/MS coupled with chemometrics.

Peppermint essential oil (EO) has a multitude of applications, such as a fragrance in cosmetics, personal care and industrial products, or as a flavoring ingredient in food and beverages. Despite its popularity and economic significance, peppermint EO is often adulterated to reduce production costs and to increase profits. Although the ISO standard for peppermint EO exists, detecting sophisticated forms of adulteration remains challenging.The current study used conventional and chiral GC/MS analysis of volatiles compounds, and chemometric techniques to evaluate an extensive set of authentic peppermint EO (n = 22) and commercial products (n = 36) purported to contain peppermint EO. Specifically, thirty-six terpenoids were examined in each sample and compared with the ISO standard. Fifty-three percent of the selected commercial products did not meet the ISO specifications and the ratio between menthone/isomenthone was proven to be a good indicator for authentication and adulteration detection. Chiral GC/MS was further employed to measure eight terpenoids: α-pinene, ß-pinene, limonene, menthol, menthone, isomenthone, pulegone, and menthyl acetate. The enantiomeric compositions of 27 commercial products were above or below the norm measured from authentic peppermint EOs. Of the 27 samples, eight met the ISO standard. A sample class prediction (SCP) model based on partial least squares-discriminant analysis (PLS-DA) of conventional GC/MS data was constructed using authentic peppermint EOs and cornmint EOs. The model can distinguish the most common types of peppermint EOs (US, India, and US/India blend) and cornmint EOs sold in the US market. After construction, the SCP model was then used to analyze commercial samples. One sample, which passed both ISO specification and chiral analysis, was identified as outlier by the SCP model. Overall, the applicability of combining both conventional and chiral GC/MS along with chemometric tools has been successfully demonstrated to address the overall quality of peppermint EOs in commerce and may help combat sophisticated adulteration.

Disentangling age, gender, and racial/ethnic disparities in multiple myeloma burden: a modeling study.

Multiple myeloma (MM) is a hematological malignancy that is consistently preceded by an asymptomatic condition, monoclonal gammopathy of undetermined significance (MGUS). Disparities by age, gender, and race/ethnicity in both MGUS and MM are well-established. However, it remains unclear whether these disparities can be explained by increased incidence of MGUS and/or accelerated progression from MGUS to MM. Here, we fit a mathematical model to nationally representative data from the United States and showed that the difference in MM incidence can be explained by an increased incidence of MGUS among male and non-Hispanic Black populations. We did not find evidence showing differences in the rate of progression from MGUS to MM by either gender or race/ethnicity. Our results suggest that screening for MGUS among high-risk groups (e.g., non-Hispanic Black men) may hold promise as a strategy to reduce the burden and MM health disparities.

Application of homocysteine as a non-invasive and effort-free measurements for risk assessment of patients with pulmonary hypertension.

BACKGROUND: Current guideline-recommended multiparameters used to assess the risk levels of pulmonary arterial hypertension (PAH) are invasive hemodynamic measurements or effort-dependent exercise tests. Serum natriuretic peptide is only one kind of effort-free biomarker that has been adopted for risk assessment. This study aimed to investigate the application of homocysteine as a non-invasive and effort-free measurement for the risk assessment of patients with PAH. METHODS: Samples of 50 patients diagnosed with PAH via right heart catheterization were obtained, and the patients were divided into low-, intermediate- and high-risk groups for further analysis. Additionally, serum N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) and homocysteine levels of monocrotaline (MCT)-induced PAH rats were analyzed at each week with progressed severity of PAH, and they were sacrificed on day 28 with pathology being assessed. RESULTS: Hyperhomocysteinemia was an independent predictor (odds ratio [OR]: 1.256; 95% confidence interval [CI]: 1.002-1.574) and showed a linear correlation with NT-proBNP. Hyperhomocysteinemia could discriminate between low/intermediate and high-risk levels in PAH with a cut-off value in 12 µmol/L. Moreover, the elevated homocysteine levels by weeks in MCT rats also demonstrated the association between homocysteine and the severity of PAH. CONCLUSIONS: Homocysteine can be a non-invasive and effort-free risk assessment for patients with pulmonary hypertension. Homocysteine level had a linear correlation with NT-proBNP level, and patients with hyperhomocysteinemia had a higher risk level, higher NT-proBNP level, and decreased lower diffusing capacity for carbon monoxide. The correlation between homocysteine level and PAH severity was also demonstrated in MCT rats.

Does human capital matter for energy consumption in China? Evidence from 30 Chinese provinces.

The impact of human capital on energy consumption is an important economic and environmental issue, especially in a country like China with a strong energy demand and continuously improving education levels. This study uses panel data from 30 provinces in China from 2000 to 2020 to explore the impact of human capital on energy consumption. Empirical research shows that human capital can not only reduce local energy consumption but also reduce energy consumption in surrounding areas, through structural, technological, and knowledge spillover effects. The impact of human capital on energy consumption exhibits a U-shaped curve, decreasing first and then increasing, when economic growth reaches a threshold level. As industrial structure and urbanization develop, the impact of human capital on energy consumption increases. This study inform policy by demonstrating the energy conservation and emission reduction effects of human capital and provide insights for investors and policymakers.

Degree of persistence of energy mix diversification of the US states: fresh evidence using LM unit root tests with sharp or smooth breaks and cross-sectional dependence.

Diversification of energy mix is related to the heterogeneity of contributions of energy sources in the energy consumption basket of nations. Its persistent degree reveals the efficiency of energy-related policies or shocks to diversify the contributions of energy sources in the energy mix. For the first time, the current study measures the diversification level of energy mix of the USA and its 51 states and examines its stochastic behavior to analyze its degree of persistence. To this end, we calculated the diversification of energy mix using Herfindahl-Hirschman index over the period 1960-2020. Then, we applied two novel versions of LM unit root tests that can incorporate sharp or smooth breaks and common factors (to control for cross-sectional dependence) to quantify the stochastic behavior of time series of Herfindahl-Hirschman index. Our results indicate (i) the energy mix of most of the US states diversified over the period. (ii) Most parts of diversification of energy mix occurred from mid of the 1970s to first half of the 1990s. (iii) Sharp breaks of deterministic part (intercept and slope of the linear trend) of Herfindahl-Hirschman indexes occurred coinciding with oil prices shocks in two decades 1970 and 1980. (iv) The Herfindahl-Hirschman index of most of states display stationary behavior, which indicate the pro-diversification policies, e.g., which are implemented to develop renewable energy sources, have transitory effects and policymakers should implement long-horizon policies to achieve their targeted level of diversification.

Assessment of Brown and Beige Adipose Tissue Activation in Mice Using PET/CT Imaging.

In response to cold induction, brown adipose tissues (BAT) and emerged brown-like adipocytes (beige adipocytes) in subcutaneous white adipose tissues (WAT browning/beiging) are activated. Thermogenesis is increased during glucose and fatty acid uptake and metabolism in adult humans and mice. This activation of BAT or WAT beiging to generate heat helps to counteract diet-induced obesity. This protocol applies the glucose analog radiotracer 18F-fluorodeoxyglucose (FDG), coupled with positron emission tomography and computed tomography (PET/CT) scanning to evaluate cold-induced thermogenesis in the active BAT (interscapular region) and browned/beiged WAT (subcutaneous adipose region) in mice. The PET/CT scanning technique not only can quantify cold-induced glucose uptake in well-known BAT and beige-fat depots but also helps to visualize the anatomical location of novel uncharacterized mouse BAT and beige fat where cold-induced glucose uptake is high. Histological analysis is further employed to validate signals of delineated anatomical regions in PET/CT images as bona fide mouse BAT or beiged WAT fat depots.

Chemical Characterization and Quality Assessment of Copaiba Oil-Resin Using GC/MS and SFC/MS.

In recent years, the popularity of copaiba oil-resin has increased worldwide due to its medicinal value and wide applications in industry. Despite its popularity, the oil has not been standardized by industry or regulatory agencies. Product adulteration in order to maximize profits has become a problem. To address these issues, the current study describes the chemical and chemometric characterization of forty copaiba oil-resin samples by GC/MS. The results demonstrated, with the exception of commercial samples, that all sample groups contained six characteristic compounds (ß-caryophyllene, α-copaene, trans-α-bergamotene, α-humulene, γ-muurolene, and ß-bisabolene) in varying concentrations. Furthermore, compositional patterns were observed in individual groups which corresponded to sample origin. Within the commercial group, two samples did not contain or contained only one of the characteristic compounds. Principal component analysis (PCA) revealed distinct groups which largely corresponded to sample origin. Moreover, commercial samples were detected by PCA as outliers, and formed a group far removed from the other samples. These samples were further subjected to analysis using a SFC/MS method. Product adulteration with soybean oil was clearly detected, with each individual triglyceride in soybean oil being unambiguously identified. By combining these analytical techniques, the overall quality of copaiba oil-resin can be assessed.

Challenges with the discovery of RNA-based therapeutics for flaviviruses.

INTRODUCTION: Flaviviruses are emerging or reemerging pathogens that have caused several outbreaks throughout the world and pose serious threats on human health and economic development. RNA-based therapeutics are developing rapidly, and hold promise in the fight against flaviviruses. However, to develop efficient and safe therapeutics for flaviviruses, many challenges remain unsolved. AREAS COVERED: In this review, the authors briefly introduced the biology of flaviviruses and the current advances in RNA-based therapeutics for them. Furthermore, the authors list the challenges and possible solutions in this area. Finally, the authors give their opinion on the development and future of RNA-based therapeutics for flaviviruses. EXPERT OPINION: With the rapid development of structural biology, the crystal structures of flavivirus proteins may lay the foundation for future rational drug design. Studies regarding the interactions between the flavivirus and the host will also be invaluable to inhibitor design. Researchers should maintain the current momentum to bring about safe and effective anti-flavivirus drugs to licensure through joint efforts of academia, government, and industry.

Cadmium mobility and health risk assessment in the soil-rice-human system using in vitro biaccessibility and in vivo bioavailability assay: Two year field experiment.

Humans are mainly exposed to cadmium (Cd) due to the rice consumption, however there exist considerable differences across rice cultivars in terms of Cd absorption and accumulation in the grains, and subsequent release after digestion (bioaccessibility), as well as uptake by Caco-2 cells of humans (bioavailability). This study comprised of field and lab simulation trials where in the field, firstly 39 mid-rice cultivars were screened for their phytoremediation potential coupled with safe production in relation to uptake and translocation of Cd. Lower Cd concentrations (˂0.2 mg kg-1) in polished rice of 74 % cultivars were ascribed to the increased root to straw translocation indicating that straw may acquire higher accumulation of Cd. Furthermore, the ionomic profile demonstrated that the spatial distribution of metals in different rice organs corresponds to the plant growth morphology. In the second year, in vitro-in vivo assay model was employed to assess the bioaccessibility and bioavailability of Cd in polished rice and to further estimate the daily Cd intake by humans through rice grains. The results of bioaccessibility and bioavailability assays and daily estimated Cd intake presented the corresponding values of 39.02-59.76 %, 8.69-24.26 %, and 0.0185-0.9713 µg kg-1 body weight day-1, respectively. There exists a strong connection between total Cd and bioaccessible Cd to humans (R2 = 0.94, P < 0.01). Polynomial fitting (R2 = 0.91, P < 0.01) showed a better statistically significant correlation between total Cd contents and bioavailable levels, suggesting that in vitro-in vivo assays should be considered in future studies. The results of field experiments and in vitro-in vivo assays recommended the Tianyouhuazhan (MR-29), Heliangyou1hao (MR-17), and Yongyou15 (MR-1) as suitable mid-rice cultivars for the phytoremediation of slightly Cd contaminated soils coupled with rice agro-production due to their high nutritional value and low total and bioavailable Cd for human.

Revisit economic growth and CO2 emission nexus in G7 countries: mixed frequency VAR model.

Applying a mixed frequency vector autoregressive (MF-VAR) approach, we examine relationships between CO2 emissions and economic growth from 1970Q1 to 2019Q4 among G7 countries. We incorporate primary energy consumption as a control variable, to avoid any bias from an omitted variable. Our empirical results, using forecast error variance decomposition and a Granger causality check, suggest that MF-VAR exhibits better explanatory ability over the more commonly used VAR model employing single frequency data. Results from LF-VAR exhibit a feedback loop connecting economic expansion and emissions of CO2 with one-way Granger causality from primary energy consumption to growth of the economies studied. MF-VAR model results also indicate that, in G7 countries, economic expansion exhibits a one-way causal link to CO2 emissions in Canada, UK, and US cases. Interestingly, MF-VAR shows feedback between economic expansion and primary energy use in Germany, while LF-VAR quantifies the link from economic growth to CO2 emissions in Canada and from CO2 to economic growth in the UK. Results raise implications for the G7 samples' policymakers.

The correlation between economic fluctuation, workforce employment and health expenditure in the BRICS countries.

In this paper, we use the Fourier ARDL method (data from 2000 to 2019) to examine whether there is a correlation between economic fluctuation, health expenditure, and employment rate among BRICS countries. Fourier ARDL's model, the same as Bootstrap ARDL model, is to test the long-term cointegration relationship of variables; when there is cointegration, it will test whether there is a causal relationship. When there is no cointegration, short-term Granger causality between variables is tested. Our study shows that, in the long-term, whether South Africa takes economic fluctuation, employment rate or health expenditure as the dependent variable, there is a cointegration relationship with the other two independent variables, but the causal relationship is not significant. In short-term Granger causality tests, the effects of economic fluctuation in Brazil, China, and South Africa on health expenditure lag significantly by one period. Economic fluctuation in Brazil, India and China had a negative effect on employment rate, while South Africa had a positive effect. Health expenditure in Russia and India has a negative effect on employment rate, while China has a positive effect. Employment rates in China and South Africa have a significant positive effect on economic fluctuation, while Russia has a negative effect. India's employment rate has a negative effect on health expenditure, while South Africa's has a positive effect. In short-term causality tests, different countries will exhibit different phenomena. Except for economic fluctuation, where health spending is positive, everything else is negatively correlated, and all of them are positive in South Africa. Finally, we make policy recommendations for the BRICS countries on economic fluctuation, employment rates, and health expenditure.

[Assessing the Lead Accumulation Risks of Wheat Grain by Developing a Source-Specific Accumulation Risk Assessment Model].

Characterizing the lead (Pb) transfer in the "source-soil-wheat" chain is of great importance for the prevention and control of the Pb accumulation risk in wheat grain harvested from the croplands of China. In this study, we used the Jiyuan City, northern China, as a case study to investigate the influence of contamination sources and soil factors on the accumulation of Pb in wheat grain. A site-specific source risk assessment model (SRAM), coupling the positive matrix factorization model, Freundlich-type function, and the Monte Carlo simulation method, was developed to estimate the risk of Pb accumulation in wheat grain harvested from different scenarios. Based on the results of the spatial analysis, the effectiveness and potential risk of the control measures applied in the study area was also evaluated. Atmospheric deposition and phosphate fertilizer application were identified as major sources contributing to 29.0% of the Pb accumulations in wheat grain. Soil pH and cation-exchange capacity (CEC) were the primary causative factors affecting the Pb accumulation in wheat grain. Cropping wheat in the high Pb continuation risk areas (western and northwestern areas) of Jiyuan City caused a 10.5% likelihood of Pb to accumulate above the China food standard limit of 0.2 mg·kg-1 (DW). This risk was significantly decreased to 2.39% when the CEC levels of affected soils was improved to 20 cmol·kg-1 and above.

Lifestyle and Social Factors Exacerbated on the Prevalence of Mood Disorders and Functional Dyspepsia Among Neonatal Nurses in China.

Background: Nursing is a high-stress occupation that can have an impact on mental health, particularly for neonatal nurses. Job-related stress factors and work-related behaviors have played a critical role in nurses' mental health. This study aimed to explore the prevalence of mood disorders and the impact of social factors, lifestyle on mood disorders among neonatal nurses. Methods: A total of 260 participants comprising neonatal nurses and nurses who work in neonatal intensive care units (NICU) were recruited. Data were collected using a validated generalized anxiety disorder questionnaire, patient health questionnaire-9, Pittsburgh sleep quality index, and social factors and lifestyle assessments. Results: In total, 49.23% of neonatal nurses exhibited mood disorders, particularly a combination of depression and anxiety. Female, poor interpersonal relationships and unhappy marital status, preference for smoking, alcohol, irregular diet, and poor sleep were common in neonatology nurses who exhibited mood disorders; preference for coffee and tea were lower in neonatology nurses without mood disorders (all P < 0.05). Interpersonal relationships, marital status, irregular diet, and poor sleep were independent factors associated with mood disorders among neonatal nurses (all P < 0.05). Mood disorders presented as functional dyspepsia (FD) among 50.78% of the participants (P < 0.05). Poor sleep and preference for smoking were common among neonatal nurses who had FD with mood disorders (all P < 0.05). Furthermore, the preference for sugary beverages was lower in participants with FD and mood disorders (P < 0.05). Poor sleep was independently associated with FD with mood disorders in neonatology nurses (P < 0.05). Conclusion: Prevalence of anxiety and depression was higher among neonatal nurses. Furthermore, most cases of mood disorders presented as FD. Thus, social factors and lifestyle have an impact on mood disorders which can manifest through somatic symptoms.

Assessment of breast lesions by the Kaiser score for differential diagnosis on MRI: the added value of ADC and machine learning modeling.

OBJECTIVES: To evaluate the diagnostic performance of Kaiser score (KS) adjusted with the apparent diffusion coefficient (ADC) (KS+) and machine learning (ML) modeling. METHODS: A dataset of 402 malignant and 257 benign lesions was identified. Two radiologists assigned the KS. If a lesion with KS > 4 had ADC > 1.4 × 10-3 mm2/s, the KS was reduced by 4 to become KS+. In order to consider the full spectrum of ADC as a continuous variable, the KS and ADC values were used to train diagnostic models using 5 ML algorithms. The performance was evaluated using the ROC analysis, compared by the DeLong test. The sensitivity, specificity, and accuracy achieved using the threshold of KS > 4, KS+ > 4, and ADC ≤ 1.4 × 10-3 mm2/s were obtained and compared by the McNemar test. RESULTS: The ROC curves of KS, KS+, and all ML models had comparable AUC in the range of 0.883-0.921, significantly higher than that of ADC (0.837, p < 0.0001). The KS had sensitivity = 97.3% and specificity = 59.1%; and the KS+ had sensitivity = 95.5% with significantly improved specificity to 68.5% (p < 0.0001). However, when setting at the same sensitivity of 97.3%, KS+ could not improve specificity. In ML analysis, the logistic regression model had the best performance. At sensitivity = 97.3% and specificity = 65.3%, i.e., compared to KS, 16 false-positives may be avoided without affecting true cancer diagnosis (p = 0.0015). CONCLUSION: Using dichotomized ADC to modify KS to KS+ can improve specificity, but at the price of lowered sensitivity. Machine learning algorithms may be applied to consider the ADC as a continuous variable to build more accurate diagnostic models. KEY POINTS: • When using ADC to modify the Kaiser score to KS+, the diagnostic specificity according to the results of two independent readers was improved by 9.4-9.7%, at the price of slightly degraded sensitivity by 1.5-1.8%, and overall had improved accuracy by 2.6-2.9%. • When the KS and the continuous ADC values were combined to train models by machine learning algorithms, the diagnostic specificity achieved by the logistic regression model could be significantly improved from 59.1 to 65.3% (p = 0.0015), while maintaining at the high sensitivity of KS = 97.3%, and thus, the results demonstrated the potential of ML modeling to further evaluate the contribution of ADC. • When setting the sensitivity at the same levels, the modified KS+ and the original KS have comparable specificity; therefore, KS+ with consideration of ADC may not offer much practical help, and the original KS without ADC remains as an excellent robust diagnostic method.

[Ecological risk assessment of contaminated soil using improved "Weight of Evidence"approach:A case study of electroplating site in Jingjiang, Jiangsu, China]. / 基于改进的"证据-权重法"评估污染土壤生态风险:以江苏靖江某电镀场地为例.

Ecological risk assessment of soil in contaminated sites provides the scientific basis for accurately developing soil quality standards, confirming remediation targets, and making safe use of contaminated soil. It thus is a critical mean to protect soil health and safety. "Weight-of-Evidence" (WoE) has been widely used in ecological risk assessment due to its systematic, integrated and scientific properties. However, most current WoE approaches are poor in objectivity and comparability because they rely too much on expertise scoring in weighing and the difficulty to collect complete evidence bodies with quantitative and comprehensive information. Focusing on those issues above, we developed an improved framework of WoE approach for ecological risk assessment of contaminated site soil based on the "Four-Step" framework of EPA coupled with the concept of hierarchy. Assessment methods and procedures for each tier were unified. Weights were weighed quantitatively through multiple criteria decision analysis. The relative independence among bodies of evidence was assured by the pre-establishment of hierarchy. The "site specific" was stressed based on matrix trails and field investigation. Finally, a case study in an electroplating site in Jingjiang was conducted to verify the approach. Results of the case study suggested that the approach was practical and that the assessment results were objective, scientific, and accurate.

Systemic assessment of the chiral insecticide pyriproxyfen in a citrus nectar source system: Stereoselective degradation, biological effect and exposure risk.

BACKGROUND: Balancing the safety and efficiency of chiral pesticides can help protect pollinators. We evaluated the stereoselective behavior, bioactivity, toxicity and exposure risk of the chiral insecticide pyriproxyfen in a citrus nectar system. RESULTS: Density functional theory (DFT) and ultra-performance liquid chromatography tandem mass spectroscopy (UPLC-MS/MS) were applied for absolute configuration appraisal and chiral analysis validation, respectively. The recoveries ranged from 72.3% to 100.5% with an relative standard deviation (RSD) ranging from 1.2% to 9.7%. In a field trial, we determined insecticide half-lives in citrus leaves and flowers, which were 7.0 and 8.6 days for R-(+)-pyriproxyfen, and 11.7 and 14.7 days for S-(-)-pyriproxyfen, respectively. We found that the bioactivity of R-(+)-pyriproxyfen was 3.39 and 2.37 times higher than S-(-)-pyriproxyfen against Unaspis yanonensis and Diaphorina citri nymphs, respectively. S-(-)-pyriproxyfen had 3.8 times higher acute toxicity than R-(+)-pyriproxyfen on Apis mellifera L., and its exposure risk was moderate based on the hazard quotient. CONCLUSION: The phenomenon of stereoselective degradation and biological effect demonstrated that the high-risk stereoisomer of S-(-)-pyriproxyfen degraded more slowly than R-(+)-pyriproxyfen, but R-(+)-pyriproxyfen with better efficiency for target. Therefore, an increased duration of R-(+)-pyriproxyfen activity on citrus was beneficial for efficacy. Our results could guide the scientific application and evaluation of chiral pesticides on nectar plants. © 2022 Society of Chemical Industry.

The relationship between health expenditure, CO2 emissions, and economic growth in the BRICS countries-based on the Fourier ARDL model.

In this paper, we use (Yilanci et al. 2020) Fourier autoregressive distributed lag (ARDL) model to study the correlation between health expenditures, CO2 emissions, and GDP fluctuations in BRICS countries from 2000 to 2019. The Fourier ARDL model has the function of bootstrap repeated simulation calculations, so that small samples can also achieve the advantages of finer inspection results. In this paper, we find that in the long term, Brazil and China are countries that both have cointegration relationships in health expenditure, CO2 emissions, and economic growth. With CO2 emissions as the dependent variable and health expenditure and economic growth as independent variables, in the short term, there is a negative causal relationship between India's CO2 emissions and health expenditure; other countries only show the relationship between CO2 emissions, health expenditure, or economic growth one-way relationship. This paper also has some policy suggestions on health expenditures and CO2 emissions in the BRICS countries at the end.

18F-FDG PET/MR Assessment of Pediatric Langerhans Cell Histiocytosis.

INTRODUCTION: Langerhans cell histiocytosis (LCH) is a histiocytic proliferative disease without a well-understood etiology. The aim of our study is to summarize the imaging features of PET/MR in children with LCH and to explore its diagnostic role in LCH. METHODS: Retrospective analysis was performed of the pretreatment PET/MR imaging data of 15 children with LCH. Comparison of ADC values was done between lesions and normal tissues. RESULTS: Of the fifteen patients enrolled, five had single-organ or single-system involvement, and ten had multiple-system involvement. Nine patients had varying degrees of bone destruction and increased FDG uptake, whereas thickening and deviation of the pituitary stalk and disappearance of the normal high-signal intensity of T1WI in the neurohypophysis were observed in the pituitary gland in six of them. Splenomegaly with diffuse increased FDG uptake or a normal spleen with increased FDG uptake was found in four cases, liver in three, multiple lymph node enlargement in three, pulmonary lesions in three, and increased metabolism in medullary cavity in two cases. Additionally, two cases involved the skin. Hypermetabolic nodules were detected in muscle in one case, thyroid involvement in one case, and a mediastinal lesion in one case. CONCLUSION: PET/MR can show well the distribution of the organs, systems, and lesions involved in LCH and is of considerable significance in the systemic evaluation of LCH.

Pandemic Risk Management for Public Health Care Schemes.

The coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2, has caused a large death, a range of serious health problems, and significant economic costs in many countries around the world. This study analyzes statistical characteristics of pandemic disasters using historical records since the Middle Ages. Compared to literature which studies the effect of the COVID- 19 pandemic on the financial market, this paper attempts to find two financial instruments in the financial market to hedge pandemic risks. Two instruments could be useful for public health care schemes to increase their assets or decrease their liabilities during the pandemic period, namely, assets in the form of a biotechnology investment portfolio and liabilities in the form of pandemic bonds. Empirical results show the feasibility of such instruments and the informational efficiency of the U.S. stock market.