Bioequivalence and Safety Assessment of 2 Formulations of Low-Dose Metformin Hydrochloride under Fasting Conditions in Healthy Chinese Participants: A Randomized Phase 1 Clinical Trial.

The incidence of type 2 diabetes is high, and the existing metformin hydrochloride (MH) tablets of 250 mg cannot meet the demands of the Chinese drug market. This study aimed to evaluate the bioequivalence and safety of generic formulations of MH tablets (test formulation [T], 250 mg/tablet) and innovative products (reference formulation [R], 250 mg/tablet) under fasting conditions. This was an open-label, single-dose, 2-period, 2-sequence crossover, single-center, randomized phase I clinical trial. T and R were considered bioequivalent if the adjusted geometric mean ratios (GMRs) and 90% confidence intervals of the area under the curve (AUC) and maximum concentration (Cmax ) were within the range of 0.8-1.25. Thirty-five participants completed the trial. The T/R adjusted GMRs (95.7% for Cmax , 98.7% for AUC0→t , 98.8% for AUC0→∞ ) were within the acceptable bioequivalence range of 80%-125%. No serious adverse events or suspected or unexpected serious adverse reactions occurred during this trial. The study findings confirmed that generic MH is a well-tolerated and bioequivalent alternative to innovative products under fasting conditions in healthy Chinese participants. (www.chinadrugtrials.org.cn; registration no. CTR20190356).

The application of demographic characteristics of Ectropis grisescens (Lepidoptera: Geometridae) in pest risk assessment of IPM.

Ectropis grisescens Warren is one of the most important pests of tea plants. In this study, data on the development, survival, and fecundity of E. grisescens were collected at 15, 22, and 32 °C and analyzed by using the age-stage, two-sex life table. At 15 °C, the duration of the preadult period of E. grisescens was significantly prolonged (81.06 days), with high mortality (69.0%), and the proportion of emerged female adults was extremely low (7.0%). At 32 °C, the preadult period was significantly shortened (29.12 days), with high preadult mortality (74.0%), and a low proportion of emerged female adults (15.0%). At 22 °C, with low preadult mortality (24.0%), and a high proportion of emerged female adults (26.0%). The overall effects of the shorter preadult duration, higher preadult survival rate, higher proportion of emerged female adults, higher fecundity (F = 350.88 eggs/♀), and higher net reproductive rate (R0 = 91.23 offspring/individual) at 22 °C resulted in the highest values of the intrinsic rate of increase (r = 0.1054 days-1) and finite rate of increase (λ = 1.1112 days-1). Computer simulation showed that E. grisescens populations can increase much faster at 22 °C than at 15 and 32 °C. The weighted population size and cumulative weighted insect-days provided the dynamics necessary for estimating the damage potential of E. grisescens in devising economical pest management programs. Our results demonstrate that populations of E. grisescens were able to develop at a broad range of temperatures and adapt to the high temperatures. These finding can be utilized to improve the management of E. grisescens.

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.

Spectral-domain optical coherence tomography combined with electroretinography in the assessment of conbercept for neovascular age-related macular degeneration: a preliminary study.

Objective: To observe the effect of three consecutive intravitreal injections of conbercept in the treatment of neovascular age-related macular degeneration (nAMD), to investigate the correlation between retinal anatomy and retinal function by spectral-domain optical coherence tomography (SD-OCT) and electroretinography (ERG), to evaluate the short-term clinical efficacy of conbercept in the treatment of nAMD, and to explore the value of ERG as a predictor of treatment efficacy. Method: A retrospective investigation was conducted on 36 patients (36 eyes) treated with intravitreal injections of conbercept at 0.5 mg a month for three consecutive courses. Data collected included the best corrected visual acuity (BCVA), central retinal thickness (CRT), retinal pigment epithelium (RPE) elevation volume in 1 mm-diameter (1RV), 3 mm-diameter (3RV), and 6 mm-diameter circles around the fovea (6RV), amplitude density and latency of the P1 wave in the multifocal electroretinography (mf-ERG) R1 ring and amplitude and latency in full-field electroretinography (ff-ERG) at baseline and monthly. The paired t test was used to compare the difference between pre- and posttreatment. Pearson correlation analysis was used to analyze the correlation between macular retinal structure and function. The difference was significant when p < 0.05. Results: At 12 weeks, the BCVA, CRT, 1RV, 3RV, 6RV, the P1 wave amplitude density of the mf-ERG R1 ring and the ff-ERG amplitude parameters were all significantly improved (p < 0.001). The BCVA in logMAR was positively correlated with CRT; 1RV, 3RV, and 6RV were negatively correlated with the amplitude density and latency of the mf-ERG R1 ring P1 wave. There were no severe ocular or systemic complications during the follow-up period. Conclusion: Conbercept is useful for the short-term treatment of nAMD. It can safely improve the visual acuity of affected eyes and restore the structure and function of the retina. ERG could serve as an objective indicator of function for evaluating the efficacy of and determining the need for retreatment during nAMD treatment.

How does haze pollution affect green technology innovation? A tale of the government economic and environmental target constraints.

Numerous studies have revealed that developing green technology innovation is extremely important for minimizing haze pollution. However, limited by serious endogenous problems, research rarely focuses on the effect of haze pollution on green technology innovation. Based on a two-stage sequential game model including both production and government departments, this paper mathematically deduced the effect of haze pollution on green technology innovation. Then China's central heating policy is considered a natural experiment in our study to verify whether haze pollution is the key factor affecting the development of green technology innovation. The result that haze pollution significantly inhibits green technology innovation is confirmed, and this negative impact is mainly concentrated on substantive green technology innovation. Robustness tests have been performed, and the conclusion is still valid. Moreover, we find that government behavior can significantly affect their relationship. Specifically, the government's economic growth target will increase the haze pollution's ability to block the development of green technology innovation. However, if the government has a clear environmental target, their negative relationship will weaken. Based on the findings, targeted policy insights are presented in this paper.

Risk assessment and identification of factors influencing the historical concentrations of microcystin in Lake Taihu, China.

Understanding the history of microcystins (MCs) pollution in large lakes can help inform future lake management. We collected sediment cores from Lake Taihu to: investigate the long-term record of MCs (MC-LR, MC-YR, and MC-RR), explore the main environmental drivers of MCs, and assess their public health and ecological risks. Results showed that MCs content in all cores increased over time. The core from north Taihu had the highest MC concentrations, with an average total MCs (sum of MC-LR, MC-YR, and MC-RR = TMCs) content of (74.31±328.55) ng/g. The core from eastern Taihu showed the lowest average TMCs content of (2.91±3.95) ng/g. PCA showed that sediment MCs at the three sites were positively correlated with sediment chlorophyll-a. MC-LR and MC-YR in northern and western Taihu negatively correlated with both the sediment total organic carbon/sediment total nitrogen ratio (STOC/STN) and water nitrate (NO3--N) concentration, but three MC congeners at eastern Taihu showed positive correlations with water orthophosphate (PO43--P), NO3--N, and STOC/STN. Generalized additive model analysis at each site revealed that NO3--N was the main TMCs driver in northern and western Taihu where phytoplankton dominated, whereas PO43--P was the main TMCs driver in eastern Taihu where macrophytes dominated. At the whole lake scale, total phosphorus (TP) and PO43--P were the most important environmental drivers influencing MCs; TP explained 47.4%, 44.2%, and 47.6% while orthophosphate explained 34.8%, 31.2%, and 34.7% of the deviance on TMCs, MC-LR, and MC-YR, respectively. NO3--N also showed a strong effect on MCs variation, especially on MC-YR. Risk assessment showed that both ecological and public health risk has increased in recent years. We conclude that while control of phosphorus and nitrogen input should be a major focus for future lake management, lake zone-specific management strategies may also be important.

The underlying drivers of energy efficiency: a spatial econometric analysis.

It is theoretical and practical to investigate the causes and effects of energy efficiency. However, few empirical studies have been conducted to examine the potential underlying drivers of energy efficiency from a spatial perspective. In light of this, we combined the data envelopment analysis and spatial econometric analysis to explore the driving factors of energy efficiency. The results show that China's energy efficiency shows significant characteristics of regional disparity and spatial agglomeration; that is, high energy efficiency has presented a benefit agglomeration, while low energy efficiency has presented a disadvantage agglomeration. The empirical results indicate that technological progress, trade openness, and foreign direct investment have effectively improved energy efficiency, while energy structure and industrial structure adversely affect energy efficiency. Furthermore, technological progress, trade openness, energy structure, foreign direct investment, and industrial structure exert different influences on energy efficiency, but their potential underlying mechanisms vary essentially across regions. Thus, using a spatial econometric model allowing for spatial dependence in analyzing drivers of energy efficiency is urgent and necessary for promulgating energy policies.

Risk Assessment of Heavy Metal Pollution in Farmland Soils at the Northern Foot of the Qinling Mountains, China.

To provide scientific basis for the prevention and control of heavy metal pollution, a field investigation, sample collection and analysis of the heavy metal content in farmland soils at the northern foot of the Qinling Mountains were conducted. Based on the comparative analysis of the single pollution index method, the Nemerow comprehensive pollution index method, the geological accumulation index method, the potential ecological hazard index method, and the geological accumulation index method were used to comprehensively analyze and evaluate the risk of soil heavy metal pollution. The results showed that the heavy metal pollution of farmland soil at the northern foot of the Qinling Mountains was severe, among which Hg and Cr pollution was relatively obvious. Taking the soil screening values of agricultural land as the standard, the quantity of element Hg in agricultural soils at the northern foot of the Qinling Mountains was higher than the relevant screening value. In the two sample sites investigated, the intensity of the heavy metal accumulation index in Baoqizhai Village was Hg > Cr > Cu > As > Pb, and in Dayangyu Village it was Cr > Cu > As > Pb. Among them, in Baoqizhai Village it shows the heavy pollution caused by Hg (Igeo= 3.42) and the light pollution caused by Cr (Igeo < 1) in the two areas. Hg is mostly affected by mining activities and its atmospheric subsidence. At the same time, Cr is mainly derived from the weathering of rock parent material and is also affected by anthropogenic factors to a certain extent. The accumulation of heavy metals in the farmland soil around the northern foot of the Qinling Mountains was relatively high, posing a threat to the surrounding soil environment. Therefore, it is urgent to control farmland soil environmental pollution.

Assessment for the associations of twenty-three metal(loid)s exposures with early cardiovascular damage among Chinese urban adults with five statistical methods: Insight into assessing health effect of multipollutant exposure.

The topic of cardiovascular hazards from multiple metal (loid)s exposures has attracted widespread attention. Here, we measured concentrations of twenty-three urinary metal (loid)s and mean platelet volume (MPV), an early cardiovascular damage biomarker, for 3396 Chinese adults. We aimed to comprehensively assess the associations of single metal (loid) and multiple metal (loid)s (as a mixture) with MPV by combined use of five statistical methods, including general linear models, Bayesian kernel machine regression (BKMR), weight quartile sum (WQS) regression, quantile g-computation (QGC), and adaptive elastic network regression (AENR). And based on that, we hope to provide insight into assessing the health effect of multipollutant exposure. After adjustment for potential covariates, at least three methods jointly suggested that of twenty-three metal (loid)s, iron, arsenic, and antimony were positively while aluminum, tungsten, and thallium were inversely associated with MPV. The environmental risk score of metal (loid)s construed by AENR was significantly positively associated with MPV, while the association between overall twenty-three metal (loid)s mixture and MPV was neutralized to be insignificant in QGC and BKMR. Conclusively, single metal (loid) may be inversely (iron, arsenic, and antimony) and positively (aluminum, tungsten, and thallium) associated with early cardiovascular damage, while the association of overall twenty-three metal (loid)s mixture with MPV was insignificant when concurrent exposures exist. It is crucial to select appropriate statistical methods based on study purpose and principles/characteristics of statistical methods, and combined employment of multimethod is insightfully suggested when assessing health effects of multipollutant exposure.

The global burden of disease attributable to high fasting plasma glucose in 204 countries and territories, 1990-2019: An updated analysis for the Global Burden of Disease Study 2019.

AIMS: High fasting plasma glucose (HFPG) is an independent risk factor for several adverse health outcomes and has become a serious public health problem. We aimed to evaluate the spatial pattern and temporal trend of disease burden attributed to HFPG from 1990 to 2019 using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. MATERIALS AND METHODS: Using data from GBD 2019, we estimated the numbers and age-standardized rates of deaths and disability-adjusted life years (DALYs) attributed to HFPG by calendar year, age, gender, country, region, Socio-demographic Index (SDI), and specific causes. The joinpoint regression analysis was used to assess the temporal trends of deaths and DALYs from 1990 to 2019. RESULTS: In 2019, globally, the numbers of deaths and DALYs attributable to HFPG were approximately 6.50 million and 172.07 million, respectively, with age-standardized rates of 83.00 per 100,000 people and 2104.26 per 100,000 people, respectively. From 1990 to 2019, the global numbers of deaths and DALYs attributed to HFPG have over doubled. The age-standardized rate of DALYs showed an increasing trend, particularly in males and in regions with middle SDI or below. The leading causes of the global disease burden attributable to HFPG in 2019 were diabetes mellitus, ischaemic heart disease, stroke, and chronic kidney disease. CONCLUSIONS: HFPG is an important contributor to increasing the global and regional disease burden. Necessary measures should be taken to curb the growing burden attributed to HFPG, particularly in males and in regions with middle SDI or below.

The impact of network positions in scientific collaboration on pharmaceutical firms' technological innovation performance: Moderating roles of scientific collaboration strength and patent stock.

Scientific knowledge is an underlying basis for technological innovation in the pharmaceutical industry. Collaboration is the main way to participate in the creation of scientific knowledge for pharmaceutical firms. Will network positions in scientific collaboration affect their technological innovation performance? Moreover, what factors moderate the firms' scientific collaboration network positions and technological innovation link? Using a dataset based on 194 Chinese publicly traded pharmaceutical companies, this paper constructs the dynamic scientific collaboration networks among 1,826 organizations by analyzing 4,092 papers included in CNKI and Web of Science databases. Then we probe the impact and boundaries of positions in the scientific collaboration network of pharmaceutical firms on their technological innovation performance through the negative binomial modeling approach. Our study confirms that degree centrality has an inverted U-shaped impact on pharmaceutical firms' technological innovation performance, while structural holes benefit it. Moreover, this article identifies that the strength of scientific collaboration positively moderates the U-shaped relationship between degree centrality and technological innovation of pharmaceutical firms, the matching of high patent stock and high structural holes can promote their technological innovation performance. The results deepen the present understanding of scientific collaboration in the pharmaceutical industry and offer new insights into the formulation of pharmaceutical firms' scientific collaboration strategies.

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.

A comprehensive assessment of upgrading technologies of wastewater treatment plants in Taihu Lake Basin.

To meet the increasingly stringent discharge standards of wastewater treatment plants (WWTPs) in the Taihu Lake Basin, the Chinese government successively established the National Special Water Project Program to develop new technologies to retrofit and upgrade existing wastewater treatment processes during the 11th, 12th, and 13th Five-Year Plans. However, there is a lack of systematic sorting of the existing research outcomes, and thus hinders the application and promotion of the upgrade technologies. Based on the outcomes of the National Special Water Project and a field survey, this research analyzed the current status of wastewater treatment in the Taihu Lake Basin and systematically integrated the retrofitting measures of WWTPs in terms of achieving the Grade IA of the national standard and local stricter discharge standards (DB 32/1072-2018 and DB 33/2169-2018). In particular, the boundary conditions, design parameters, specific recommendations of the technologies, and some typical engineering cases were provided accordingly. Finally, this study discussed the future development directions of WWTPs during the upgrade process from the perspective of carbon neutrality and digitalization. The present work will hopefully assist in retrofitting and constructing WWTPs to achieve the stricter effluent discharge criteria and help optimize the design and construction of WWTPs in the best way.

First use of triply labelled water analysis for energy expenditure measurements in mice.

The doubly labelled water (DLW) method is widely used to determine energy expenditure. In this work, we demonstrate the addition of the third stable isotope, 17O, to turn it into triply labelled water (TLW), using the three isotopes measurement of optical spectrometry. We performed TLW (2H, 18O and17O) measurements for the analysis of the CO2 production (rCO2) of mice on different diets for the first time. Triply highly enriched water was injected into mice, and the isotope enrichments of the distilled blood samples of one initial and two finals were measured by an off-axis integrated cavity output spectroscopy instrument. We evaluated the impact of different calculation protocols and the values of evaporative water loss fraction. We found that the dilution space and turnover rates of 17O and 18O were equal for the same mice group, and that values of rCO2 calculated based on 18O-2H, or on 17O-2H agreed very well. This increases the reliability and redundancy of the measurements and it lowers the uncertainty in the calculated rCO2 to 3% when taking the average of two DLW methods. However, the TLW method overestimated the rCO2 compared to the indirect calorimetry measurements that we also performed, much more for the mice on a high-fat diet than for low-fat. We hypothesize an extra loss or exchange mechanism with a high fractionation for 2H to explain this difference.

Evolving Patterns of Nutritional Deficiencies Burden in Low- and Middle-Income Countries: Findings from the 2019 Global Burden of Disease Study.

Low- and middle-income countries (LMICs) suffered the most from nutritional deficiencies (NDs). Although decades of efforts have reduced it, little is known about the changing trajectory of ND burden in LMICs. By extracting data of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019, we calculated indicators of incidence and disability-adjusted life years (DALYs) to measure the burden of NDs and its main subcategories in LMICs, including protein-energy malnutrition, iodine deficiency, vitamin A deficiency, dietary iron deficiency, and other nutritional deficiencies by sex, age and spatial patterns. In LMICs, ND incidence still increased in the age group 15+ born before 2005, especially in males. The effort of reducing the DALYs of NDs has generated a strong decline in per age group. In the main subcategories of NDs, protein-energy malnutrition incidence in males age 45+ born before 1970 still increased. Despite vitamin A deficiency incidence and dietary iron deficiency, DALYs strongly experienced decreases over three decades while still remaining at the heaviest level in 2019, especially in females and children under 5 years. The top largest tendency estimates occurred in Mali' females and Bhutan' males. Zimbabwe was the only country with increased DALYs rate tendency in both sexes.

How does financial development alleviate pollutant emissions in China? A spatial regression analysis.

Assessing the environmental effects of financial development has an important theoretical and practical reference for the government to achieve the goal of sustainable development. Financial development is affected dramatically by the real economy and typically shows nonlinear characteristics. This study aims to investigate the nonlinearity between financial development and pollutant emissions while considering the various stages of financial development among regions. Also, the spatial transmission mechanism between financial development and pollutant emissions is analyzed theoretically. Industrial sulfur dioxide ([Formula: see text]) and solid waste (SW) emissions are used to quantify pollutant emissions in China. The results show a positive spatial spillover effect on pollutant emissions across various regions. Moreover, a region's pollutant emissions can be influenced by the financial development of its surrounding regions, suggesting that financial development reduces [Formula: see text] emissions in a particular region, but it significantly increases [Formula: see text] emissions in surrounding regions, indicating a strong spillover effect. However, financial development significantly decreases SW emissions of a particular region but does not exert a significant impact on its surrounding regions, implying a weak spillover effect. Our results reveal that whereas the relationship of financial development with [Formula: see text] and SW emissions shows a significant U-shaped pattern, that of economic growth exhibit a significant inverted U-shaped pattern. The investigation can help in designing appropriate environmental policies for promoting financial development.

The impact of semi-urbanization on carbon emissions: a spatial econometric perspective.

Whether semi-urbanization can effectively help reduce carbon emissions has become increasingly attractive to scholars and policymakers. To the knowledge of the authors, there are no empirical studies that were conducted to explore the impact of semi-urbanization on carbon emissions from a spatial perspective. By employing panel data for the years between 2000 and 2014 of 30 Chinese provinces, this paper examines the relationship between semi-urbanization and carbon emissions by using a spatial regression method. Also, the spatial transmission mechanisms between semi-urbanization and carbon emissions are analyzed. Empirical results indicate a positive spatial spillover effect on carbon emissions across various regions. Simultaneously, we find that semi-urbanization not only facilitates emission reduction in a particular region, but also significantly reduces the carbon emissions in surrounding regions, ultimately implying a significant and negative total effect. Moreover, semi-urbanization has decreased carbon emissions, that is, for every 1% increase in semi-urbanization, the carbon emissions will decrease by 0.803%. Furthermore, semi-urbanization, industrial structure, technological progress, human capital, and energy consumption show spillover impacts on carbon emissions, yet their impact mechanisms vary substantially across various regions. Based on these findings, we suggest several related policy implications for mitigating carbon emissions and promoting semi-urbanization in China.

Analyzing China's provincial environmental emissions and its influencing factors: a spatial analysis.

In-depth analyses of the spatial heterogeneity in environmental emissions and the causes of differences are of great importance to provide a reference for reduction policies. However, a spatial analysis of the specific mechanisms of China's environmental emissions is rarely scarce. Using the province-level data of 30 provinces in China over 2005-2017, this paper constructs a spatial Durbin model (SDM) to empirically address the existence and spatial mechanisms of environmental emissions. The results show that: first, China's environmental emissions show significant characteristics of spatial dependence and clustering from global and local perspectives, indicating the existence of spatial autocorrelation in environmental emissions across regions. Second, both per capita GDP and urbanization have positive impacts on environmental emissions, but the impact of environmental regulation is not significant. Third, urbanization not only directly influences environmental emissions, but also indirectly influences environmental emissions. These analyses provide comprehensive policy implications for government and policymakers to promote environmental quality.

Prevalence of early childhood caries in three regions of China: A cross-sectional study.

BACKGROUND: The burden of early childhood caries (ECC) in different regions of China with different levels of economic development has been of interest to policymakers and public health workers. AIM: To investigate regional differences in ECC prevalence in China and to identify associated risk factors. METHODS: A total of 11 612 three- to five-year-old children from three geographic regions of China were included in this cross-sectional study. The dmft index was assessed for each child. A questionnaire regarding children's dietary habits, oral health behaviors, parents' socioeconomic status, and attitudes toward oral health was administered. Odds ratios and 95% confidence intervals were calculated to evaluate associated factors. RESULTS: Caries prevalence in the Eastern, Central and Northwestern regions of China was 63.4% (95% CI: 61.4%-64.5%), 59.4% (95% CI: 58.6%-61.7%), and 59.0% (95% CI: 58.5%-61.6%), respectively. Children from the Northwestern (OR = 0.83, 95% CI: 0.75-0.92) and Central (OR = 0.83, CI: 0.75-0.92) regions of China had a lower risk of experiencing ECC. Dietary habits and parents' specific oral health knowledge and attitudes were associated with ECC. CONCLUSIONS: Differences in ECC prevalence were found in the three regions of China. Multiple factors were associated with ECC. Overall, the burden of ECC was heavy in the examined regions.

Global, regional, and national burden of kidney, bladder, and prostate cancers and their attributable risk factors, 1990-2019.

BACKGROUND: The burden of kidney, bladder, and prostate cancers has changed in recent decades. This study aims to investigate the global and regional burden of, and attributable risk factors for genitourinary cancers during the past 30 years. METHODS: We extracted data of kidney, bladder, and prostate cancers from the Global Burden of Disease 2019 database, including incidence, mortality, disability-adjusted life-years (DALYs), and attributable risk factors from 1990 to 2019. Estimated annual percentage changes (EAPC) were calculated to assess the changes in age-standardized incidence rate, age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR). The associations between cancers burden and socio-demographic index (SDI) were also analyzed. RESULTS: Compared with 1990, the global incident cases in 2019 were higher by 154.78%, 123.34%, and 169.11% for kidney, bladder, and prostate cancers, respectively. During the 30-year study period, there was a downward trend in ASMR and ASDR for bladder cancer (EAPC = - 0.68 and - 0.83, respectively) and prostate cancer (EAPC = - 0.75 and - 0.71, respectively), but an upward trend for kidney cancer (EAPC = 0.35 and 0.12, respectively). Regions and countries with higher SDI had higher incidence, mortality, and DALYs for all three types of cancers. The burden of bladder and prostate cancers was mainly distributed among older men, whereas the burden of kidney cancer increased among middle-aged men. Smoking related mortality and DALYs decreased, but high body mass index (BMI) and high fasting plasma glucose (FPG) related mortality and DALYs increased among kidney, bladder, and prostate cancers during the study period. CONCLUSIONS: Kidney, bladder, and prostate cancers remain major global public health challenges, but with distinct trend for different disease entity across different regions and socioeconomic status. More proactive intervention strategies, at both the administrative and academic levels, based on the dynamic changes, are needed.