Association between digital engagement and urban-rural disparities in Chinese women's depressive symptoms: A national-level cross-sectional study.

Objectives: This study aims to investigate the impact of digital engagement on urban-rural disparities in depressive symptoms among Chinese women. Methods: Using a dataset from the China Family Panel Studies (CFPS) wave 2020, this study analyzes the impact of digital engagement on the urban-rural disparity in women's depressive symptoms using multiple linear regression and recentered influence function (RIF) models. Furthermore, the extent to which digital engagement affects the urban-rural disparity in women's depressive symptoms was calculated using the RIF decomposition method. Results: Analysis showed that rural women had significantly higher levels of depressive symptoms compared to urban women; digital engagement significantly reduced women's depressive symptoms levels and mitigated the urban-rural disparity for women with moderate to high levels of depressive symptoms, and the mitigating effect was stronger for the highly depressed sample, but still widened the urban-rural disparity in women's depressive symptoms overall. In addition, the results of the RIF decomposition showed that digital engagement explained 28.28% of the urban-rural disparity in women's depressive symptoms. Conclusion: There is a significant disparity in depressive symptoms levels between urban and rural women in China. Digital engagement reduces women's depressive symptoms, but it also widens the depressive symptoms disparity between urban and rural women overall. Digital engagement is potentially positive for reducing women's depressive symptoms.

Accumulation and risk assessment of mercury in soil as influenced by mercury mining/smelting in Tongren, Southwest China.

To investigate the influence of mercury (Hg) mining/smelting on the surrounding soil environment, ninety soil samples were collected around Hg mining/smelting areas in Tongren city, Guizhou Province, Southwest China. The total mercury (THg), methylmercury (MeHg), bioavailability and fractions of Hg in the soil and their potential risk were evaluated. The results showed that Hg mining/smelting significantly increased the soil pH and decreased the soil organic matter content (p < 0.05). The THg content in the surrounding soil was much higher than that at the control site, with almost all the samples exceeding the national standard in China (3.4 mg/kg, GB15618-2018). Similarly, the concentrations of MeHg (0.09-2.74 µg/kg) and bioavailable Hg (0.64-62.94 µg/kg) in these soil samples were also significantly higher than those in the control site. However, the MeHg/THg ratio was significantly lower in mining/smelting influenced soils (0.01-0.68%) than in control soils (0.60-3.72%). Fraction analysis revealed that residual (RES-Hg) and organic matter-bounded (OM-Hg) Hg accounted for more than 50% of the THg. Ecological risk assessment revealed that the potential ecological risk for most of the Hg mining/smelting-influenced soils (30.16 ≤ Er ≤ 2280.02) were higher than those at the control site (15.12 ≤ Er ≤ 27.1). In addition, these Hg mining/smelting-influenced soils posed acceptable noncarcinogenic risks to adults (except for two soil samples), with hazard indices (HIs) ranging from 0.04 to 1.11 and a mean HI of 0.44. However, children suffer serious noncarcinogenic risks, with HIs ranging from 0.34 to 7.43 and a mean HI of 3.10.

Comparative analysis of preoperative chemoradiotherapy and upfront surgery in the treatment of upper-half rectal cancer: oncological benefits, surgical outcomes, and cost implications.

The value of neoadjuvant chemoradiotherapy (CRT) is not absolutely clear for upper-half (> 7-15 cm) rectal cancer. This study aimed to compare the efficacy and safety of radical surgery with preoperative CRT vs. upfront surgery (US) in Chinese patients with stage II and III upper-half rectal cancer. A total of 809 patients with locally advanced upper-half rectal cancer between 2017 and 2021 were enrolled retrospectively (280 treated with CRT and 529 treated with US). Through 1:1 propensity score matching, the CRT (172 patients) and US (172 patients) groups were compared for short-term postoperative results and long-term oncological and functional outcomes. In the entire cohort, patients in the CRT group had a younger age, lower distance from the anal verge (DAV), and higher rates of cT4 stage, cN2 stage, mrCRM positivity, EMVI positivity, CEA elevation, and CA-199 elevation than those in the US group. The 5-year disease-free survival (DFS) was lower in the CRT group than in the US group (76% vs. 84%, p = 0.022), while the 5-year overall survival (OS) was comparable between the two groups (85% and 88%, p = 0.084). The distant metastasis rate was higher in the CRT group than in the US group (12.5% vs. 7.8%, p = 0.028), though the local recurrence rate was similar between the two groups (1.1% and 1.3%, p = 1.000). After performing PSM, the 5-year OS (86% vs. 88% p = 0.312), the 5-year DFS (79% vs. 80%, p = 0.435), the local recurrence rate (1.2% vs. 1.7%, p = 1.000), and the distant metastasis rate (11.0% vs. 9.3%, p = 0.593) were comparable between the two groups. Notable pathological downstaging was observed in the CRT group, with a pathological complete response (PCR) rate of 14.5%. In addition, patients in the CRT group had a lower proportion of pT3 (61.6% vs. 77.9%, p < 0.001), pN + (pN1, 15.1% vs. 30.2%, pN2, 9.3% vs. 20.3%, p < 0.001), stage III (24.4% vs. 50.6%, p < 0.001), perineural invasion (19.8% vs. 32.0%, p = 0.014), and lymphovascular invasion (9.3% vs. 25.6%, p < 0.001) than those in the US group. Postoperative complications and long-term functional results were similar, yet there was a trend toward a higher conversion to laparotomy rate (5 (2.9%) vs. 0 (0.0%), p = 0.061) and higher rates of robotic surgery (11.6% vs. 4.7%, p < 0.001), open surgery (7.0% vs. 0.6%, p < 0.001), diverting stoma (47.1% vs. 25.6%, p < 0.001), and surgery costs (1473.6 ± 106.5 vs. 1140.3 ± 54.3$, p = 0.006) in the CRT group. In addition, EMVI (OR = 2.516, p = 0.001) was the only independent risk factor associated with poor response to CRT, and in subgroup analysis of EMVI + , CRT group patients presented a lower 5-year DFS (72.9% vs. 80.5%, p = 0.025) compared to US group patients. CRT prior to surgery has no additional oncological benefits over US in the treatment of upper-half rectal cancer. In contrast, CRT is associated with increased rates of conversion to laparotomy, stoma creation and higher surgery costs. Surgeons tend to favor robotic surgery in the treatment of complex cases such as radiated upper-half rectal cancers. Notably, EMVI + patients with upper-half rectal cancer should be encouraged to undergo upfront surgery, as preoperative CRT may not provide benefits and may lead to delayed treatment effects.

Challenges in the Management of Children and Adolescents With Epilepsy in China During the COVID-19 Pandemic: An Online Survey-Based Study.

INTRODUCTION: To investigate the challenges in the management of children and adolescents with epilepsy in China during the coronavirus disease (COVID-19) pandemic. METHODS: We conducted a cross-sectional survey among 845 patients with epilepsy using an online-based questionnaire. The questionnaire focused on sociodemographic characteristics, epilepsy-related conditions, health care access, COVID-19 vaccination, and the mental health of caregivers. Depression was assessed using Patient Health Questionnaire-9. RESULTS: During the pandemic, 24.73% of the patients had increased seizures. The majority of patients (68.89%) experienced difficulty obtaining antiseizure medications. In addition, 94.79% of the patients had difficulty consulting a doctor. A total of 52.78% of the patients selected telemedicine services, and most found these services to be helpful. Moreover, 76.11% of the patients failed to complete the COVID-19 vaccination. More than half of the caregivers had anxiety and depressive symptoms. The risk factors for depression comprised irregularity in taking antiseizure medications, difficulty in obtaining antiseizure medications, and failure to consult a doctor on time. CONCLUSIONS: The COVID-19 pandemic presented a great challenge in the management of children and adolescents with epilepsy in China. The findings highlight the importance of improving health care systems and medication management and the mental health of their caregivers.

Stability and ecological risk assessment of nickel (Ni) in phytoremediation-derived biochar.

Improper treatment of heavy metal-enriched biomass generated after phytoremediation might cause secondary pollution in soil and water. At present, the pyrolysis process is an effective method for the treatment of phytoremediation residue. In this study, Ni-enriched biomass was prepared using hydroponics method and further pyrolyzed at different temperatures (300-700 °C). At low pyrolysis temperatures (below 500 °C), carbonate precipitation was the main reason of Ni stabilization in biochar. Nevertheless, the formed phosphate and aluminosilicate were important factors for immobilizing Ni in biochar at high pyrolysis temperatures (above 500 °C). Moreover, the oxidizable (F3) and residual (F4) components of Ni in biochar increased with increasing pyrolysis temperature, which indicated that higher pyrolysis temperature could effectively reduce the bioavailability of Ni in biochar. The results of deionized water, acidification, oxidation, and toxic characteristic leaching procedure (TCLP) experiments showed that pyrolysis temperature was the dominant factor for Ni stabilization in biochar. The ecological risk assessments further proved that pyrolyzed Ni-enriched biochar could reduce the environmental toxicity and potential ecological risks of Ni. In the soil simulated experiment, the soil microenvironment gradually promoted the transformation of Ni in BCNiX from bioavailable fraction to stable fraction. Overall, this study would expose more reasonable reference for the long-term storage of phytoremediation residues.

Smartphone-based versus traditional face-to-face collaborative care for community-dwelling older adults living with dementia in China: protocol for an implementation science-based sequential multiple assignment randomised trial.

INTRODUCTION: The high costs of institutional care and the burdensome demands of home care are challenging for families of adults with dementia. The collaborative care model (CCM) provides a potential solution to these challenges. Leveraging advancements in mobile technologies, smartphone-based management could offer a feasible means of providing collaborative care in a community setting. Therefore, this study aims to establish a CCM for home-cared older adults with dementia to determine the best strategy to deliver collaborative care, including both the channel and frequency of delivery. METHODS AND ANALYSIS: This study will be conducted in the communities of Chengdu city, Sichuan province, China. It is designed under the framework of implementation science. In the first stage, intervention strategies for community-dwelling older adults with dementia and their caregivers will be developed using Delphi methods and focus group interviews. The second stage will involve designing a sequential multiple assignment randomised trial to compare the effectiveness of face-to-face intervention versus a WeChat mini program-based intervention. This comparison will involve 358 pairs of older adults with dementia and their caregivers, with the frequency of intervention also assessed. Follow-up evaluations will be implemented at the 6th, 12th and 18th months post-intervention initiation. Primary outcomes encompass the proportion of patients demonstrating an improvement in quality of life and the proportion of caregivers exhibiting a reduction in caregiver burden. Analysis will be based on the intention-to-treat principle, and the generalised estimating equation approach will be used. Incremental cost-effectiveness ratios will be used to evaluate the cost-effectiveness of different delivery methods and frequencies. ETHICS AND DISSEMINATION: This study has received approval from the Ethics Committee of West China Fourth Hospital/School of Public Health, Sichuan University (Gwll2022004). Informed consent will be obtained for all participants. The findings of the study will be disseminated through peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER: ChiCTR2200057945.

A fully-automatic semi-supervised deep learning model for difficult airway assessment.

Background: Difficult airway conditions represent a substantial challenge for clinicians. Predicting such conditions is essential for subsequent treatment planning, but the reported diagnostic accuracies are still quite low. To overcome these challenges, we developed a rapid, non-invasive, cost-effective, and highly-accurate deep-learning approach to identify difficult airway conditions through photographic image analysis. Methods: For each of 1000 patients scheduled for elective surgery under general anesthesia, images were captured from 9 specific and different viewpoints. The collected image set was divided into training and testing subsets in the ratio of 8:2. We used a semi-supervised deep-learning method to train and test an AI model for difficult airway prediction. Results: We trained our semi-supervised deep-learning model using only 30% of the labeled training samples (with the remaining 70% used without labels). We evaluated the model performance using metrics of accuracy, sensitivity, specificity, F1-score, and the area under the ROC curve (AUC). The numerical values of these four metrics were found to be 90.00%, 89.58%, 90.13%, 81.13%, and 0.9435, respectively. For a fully-supervised learning scheme (with 100% of the labeled training samples used for model training), the corresponding values were 90.50%, 91.67%, 90.13%, 82.25%, and 0.9457, respectively. When three professional anesthesiologists conducted comprehensive evaluation, the corresponding results were 91.00%, 91.67%, 90.79%, 83.26%, and 0.9497, respectively. It can be seen that the semi-supervised deep learning model trained by us with only 30% labeled samples can achieve a comparable effect with the fully supervised learning model, but the sample labeling cost is smaller. Our method can achieve a good balance between performance and cost. At the same time, the results of the semi-supervised model trained with only 30% labeled samples were very close to the performance of human experts. Conclusions: To the best of our knowledge, our study is the first one to apply a semi-supervised deep-learning method in order to identify the difficulties of both mask ventilation and intubation. Our AI-based image analysis system can be used as an effective tool to identify patients with difficult airway conditions. Clinical trial registration: ChiCTR2100049879 (URL: http://www.chictr.org.cn).

Spatial Distribution and Risk Assessment of Heavy Metal(oid)s Contamination in Topsoil around a Lead and Zinc Smelter in Henan Province, Central China.

A total of 137 farmland soil samples were collected around a lead/zinc smelter within 64 km2. The concentration, spatial distribution, and potential source of nine heavy metal(oid)s (As, Cd, Co, Cr, Cu, Ni, Pb, V, and Zn) in soils and their potential ecological risk were investigated in detail. The results showed that the average concentrations of Cd, Pb, Cr and Zn in these soils were higher than their background value in Henan Province, and the average content of Cd was 2.83 times of the risk screening values in the national standard of China (GB 15618-2018). According to the distribution of different heavy metal(oid)s in soils, Cd and Pb in soil decrease gradually with the increase of distance from the smelter to the surrounding area. This indicates that the Pb and Cd originate from smelters via airborne practices according to the typical air pollution diffusion model. The distribution of Zn, Cu, and As were similar to Cd and Pb. However, Ni, V, Cr, and Co were mainly affected by soil parent materials. The potential ecological risk of Cd was higher than those of other elements, and the risk grade of the other eight elements was mainly low. The polluted soils with significantly high and high potential ecological risk covered 93.84% of all the studied regions. This should be of serious concern to government. The results of a principal component analysis (PCA) and cluster analysis (CA) show that Pb, Cd, Zn, Cu, and As were the elements mainly stemmed from smelter and other types of plants, with a contribution rate of 60.08%, while Co, Cr, Ni, and V are mainly caused by nature, with a contribution rate of 26.26%.

Error simulation of atmospheric scattered radiance and its influence on slant visibility based on the SBDART model and Monte Carlo method.

Atmospheric scattered radiance is an important factor affecting slant visibility measurement in the daytime. This paper explores atmospheric scattered radiance errors and their influence on slant visibility measurements. Considering the difficulty in error synthesis of the radiative transfer equation, an error simulation scheme based on the Monte Carlo method is proposed. An error simulation and error analysis for atmospheric scattered radiance was carried out based on the Santa Barbara DISTORT atmospheric radiative transfer (SBDART) model and the Monte Carlo method. The error in aerosol parameters including the single-scattering albedo (SSA), the asymmetry factor, and the aerosol optical depth (AOD), was simulated by a random number and random error under different normal distributions, and the error influence of aerosol parameters on the error in the solar irradiance and 33-layer atmosphere scattered radiance is discussed in detail. The maximum relative deviations of the output scattered radiance at a certain slant direction are 5.98%, 1.47%, and 2.35%, when SSA, the asymmetry factor, and the AOD obey the normal distribution of (0, 5). The error sensitivity analysis also confirms that the SSA is the most sensitive factor affecting atmospheric scattered radiance and the total solar irradiance. Then, according to the error synthesis theory, we investigated the error transfer effect of three error sources related to the atmosphere based on the contrast ratio between the object and the background. The simulation results show that the error in the contrast ratio caused by solar irradiance and scattered radiance is lower than 6.2% and 2.84%, indicating the main role in contributing to the error transfer of slant visibility. Further, the comprehensive process of the error transfer in slant visibility measurements was demonstrated by a set of lidar experiments and the SBDART model. The results provide a reliable theoretical basis for the measurement of atmospheric scattered radiance and slant visibility, which is of great significance to improve the measurement accuracy of slant visibility.

Bioaccessibility and reliable human health risk assessment of heavy metals in typical abandoned industrial sites of southeastern China.

Heavy metal pollution caused by a large number of abandoned industrial sites cannot be underestimated, but its human health risks have not been accurately assessed. This study investigated the pollution of heavy metals in soils of the typical abandoned industrial sites in southeastern China. Based on the bioaccessibility of different heavy metals (Pb, Ni, Cu, Zn, Cd, Cr) in the industrial soils, the human health risks were accurately evaluated, and the controlling factors were quantitatively assessed. The results showed that the heavy metals in each typical abandoned industrial sites had a high degree of spatial heterogeneity. Among them, Cd was the most susceptible to relevant discrete input from external factors such as human activities, followed by Zn, Pb, Cr, Ni and Cu. The bioaccessible concentration of heavy metals by the physiological-based extraction test (PBET) had a good correlation (R2 = 0.58 ∼ 0.86) with its bioavailable concentration by diethylenetriaminepentaacetic acid (DTPA) extraction. The regression model based on soil parameters had great potential to predict the bioaccessibility of heavy metals in abandoned industrial sites (R2 = 0.49 ∼ 0.95). The total concentration of heavy metals, Fe, soil texture and pH were the controlling factors of the metal bioaccessibility. Compared with the total concentration, the hazard index (HI) and carcinogenic risk (CR) values calculated based on gastrointestinal bioaccessibility were decreased by 39.0∼77.9% and 68.2∼79.9% in adults, and 45.3∼88.0% and 73.9∼83.5% in children, respectively. This work provides a feasible theoretical basis for reliable assessment of the human health risks of heavy metals in the abandoned industrial sites in the future.

Which Students With Disabilities are Placed Primarily Outside of U.S. Elementary School General Education Classrooms?

Students with disabilities (SWD) who are Black or Hispanic have been reported to be more likely to be placed primarily outside of general education classrooms while attending U.S. schools. Federal law and regulation require monitoring of special education placement based on race or ethnicity. Yet, whether and to what extent racial or ethnic disparities in placement are explained by bias or by other explanatory factors is currently unclear. We evaluated for racial and ethnic bias in special education placement by analyzing longitudinal data from two independent samples of SWD (N values range 590-1,130) attending U.S. elementary schools. We statistically controlled for plausibly exogenous sociodemographic, academic, and behavioral risk factors measured in kindergarten in analyses of the students as they attended first, third, and fifth grades between the 1999-2000 and 2015-2016 school years. Of the resulting 12 Black or Hispanic grade-year-specific tests, 11 (i.e., 92%) indicated that controls for kindergarten explanatory factors-particularly significant academic difficulties-fully explained the risk initially attributable to race or ethnicity. We observed little evidence that bias explains racial or ethnic disparities in special education placement in U.S. elementary schools.

Disparities in Family-Centered Care Among US Children and Youth with Special Healthcare Needs.

Cross-sectional analyses of 4 nationally representative samples indicate disparities in family-centered care occur among US children and youth with special healthcare needs by race and ethnicity, family income and composition, insurance coverage, and healthcare setting. Measured confounds including children's health and impairment severity do not explain the disparities.

Sociodemographic Disparities in Attention-Deficit/Hyperactivity Disorder Overdiagnosis and Overtreatment During Elementary School.

Attention-deficit/hyperactivity disorder (ADHD) overdiagnosis and overtreatment unnecessarily exposes children to potential harm and contributes to provider and community skepticism toward those with moderate or severe symptoms and significant impairments, resulting in less supportive care. Yet, which sociodemographic groups of children are overdiagnosed and overtreated for ADHD is poorly understood. We conducted descriptive and logistic regression analyses of a population-based subsample of 1,070 U.S. elementary schoolchildren who had displayed above-average levels of independently assessed behavioral, academic, or executive functioning the year prior to their initial ADHD diagnoses and who did not have prior diagnostic histories. Among these children, (a) 27% of White children versus 19% of non-White children were later diagnosed with ADHD and (b) 20% of White children versus 14% of non-White children were later using medication. In adjusted analyses, White children are more likely to later be diagnosed (odds ratio [OR] range = 1.70-2.62) and using medication (OR range = 1.70-2.37) among those whose prior behavioral, academic, and executive functioning suggested that they were unlikely to have ADHD.

Cost-effective Bi2WO6 for efficient degradation of rhodamine B and tetracycline.

The morphology-controlled synthesis of nanostructured photocatalysts by an environmentally friendly and low-cost method provides a feasible way to realize practical applications of photocatalysts. Herein, Bi2WO6 (BWO) nanophotocatalysts with mulberry shape, sheet-like, and round-cake morphologies have been successfully synthesized through a highly facile solvothermal process by simply adjusting the solvothermal temperature or utilizing selective addition of ethylene glycol as an orientation agent without using strong acids and bases and/or hazardous chemicals. The ratio of ethylene glycol and glacial acetic acid can affect the morphology and oxygen vacancy content of BWO, thereby influencing the photocatalytic performance. The photocatalytic activity of the as-prepared samples was evaluated by degradation of rhodamine B (RhB) and tetracycline under visible-light irradiation. The results indicated that all the BWO samples exhibited morphology-associated photocatalytic activity, and the sheet-like structure of BWO obtained via solvothermal treatment at 120 °C with ethylene glycol and glacial acetic acid ratio of 1:3 achieved the maximum specific surface area and possessed abundant oxygen vacancies, exhibiting outstanding photocatalytic activity for degradation of RhB and tetracycline. The degradation rate of RhB reached 100% within 20 min. To the best of our knowledge, this value is one of the most remarkable values for pristine BWO photocatalysts. Radical capture experiments demonstrated that hydroxyl radicals (·OH) play major roles compared with electrons (e-) and holes (h+) in the photocatalytic degradation process. A possible mechanism for the photocatalytic degradation of pollutants was proposed to better understand the reaction process. We believe that the more economical, efficient and greener methodology can provide guidance to develop highly efficient photocatalysts with favourable morphology and structure. Supplementary Information: The online version contains supplementary material available at 10.1007/s10854-022-09654-z.

Assessment of Cd Pollution in Paddy Soil-Rice System in Silver Mining-Affected Areas: Pollution Status, Transformation and Health Risk Assessment.

Mining activities are one of the main contamination sources of Cd in soil. However, the information about the influence of silver mining on Cd pollution in soil in mining-affected areas is limited. In the present study, sixteen paired soil and rice grain samples were collected from the farmland along the Luxi River nearby a silver mine in Yingtan City, Jiangxi Province, China. The total, bioavailable, and fraction of Cd in soil and Cd content in rice grain were determined by inductively coupled plasma mass spectrometry. The transformation of Cd in the soil-rice system and potential health risk via consumption of these rice grains were also estimated. The results showed that Cd concentration in these paddy soils ranged from 0.21 to 0.48 mg/kg, with the mean Cd concentration (0.36 mg/kg) exceeded the national limitation of China (0.3 mg/kg, GB 15618-2018). Fortunately, all these contaminated paddy soils were just slightly polluted, with the highest single-factor pollution index value of 1.59. The DTPA- and CaCl2-extractable Cd in these paddy soils ranged from 0.16 to 0.22 mg/kg and 0.06 to 0.11 mg/kg, respectively, and the acid-soluble Cd occupied 40.40% to 52.04% of the total Cd, which was the highest among different fractions. The concentration of Cd in rice grain ranged from 0.03 to 0.39 mg/kg, and the mean Cd concentration in rice grain (0.16 mg/kg) was within the national limitation of China (0.2 mg/kg, GB 2762-2017). The bioaccumulation factor of Cd in rice grain ranged from 0.09 to 1.18, and its correlation with various indicators was nonsignificant (p < 0.05). Health risk assessment indicated that the noncarcinogenic risk for local rice consumers was within the acceptable range, but the carcinogenic risk (CR) was ranging from 1.24 × 10-2 to 1.09 × 10-3 and higher than the acceptable range (1.0 × 10-4), indicating that the local rice consumers suffered serious risk for carcinogenic diseases. The results of the present study can provide reference for safety production of rice in silver mining-affected areas.

Relationship between internet use intensity and quality of life in chronic patients during the COVID-19 pandemic: The role of physical exercise and health insurance.

The internet use intensity of human has increased substantially during the COVID-19 Pandemic, and it is severely impacting the well-being of chronic patients. This study aimed to explore the underlying mechanism of the relationship between internet use intensity and quality of life in chronic patients, based on the cross-sectional data from China Family Panel Studies (CFPS) during the COVID-19 Pandemic in 2020. The results showed that the internet use intensity had significant positive association with quality of life among chronic patients, and such association has been found in both urban and rural samples. Among the relationship of internet use intensity and quality of life in chronic patients, the mediating effect of physical exercise reached 10.25%. Furthermore, health insurance positively moderated this relationship. There are new insights for policy recommendations and clinical guidance on the role of physical activity and health insurance aimed at improving chronic patients' quality of life. Meanwhile, in both rural and urban governance, public health agencies should promote the "Internet + Healthcare" program to improve health insurance and physical activity literacy, thus providing a higher level of quality of life for patients with chronic diseases during the COVID-19 Pandemic.

Is the Discount Really Favorable? The Effect of Numeracy on Price Magnitude Judgment: Evidence From Electroencephalography.

Attractive price promotion will induce an unreasonable willingness to purchase, especially through shopping. However, it is not clear how numeracy, one of the essential abilities for understanding and applying numbers, influences the process of purchase judgment. In total, 61 participants were recruited to perform a price promotion task using electroencephalography. The results showed that consumers with low numeracy performed worse than their peers with high numeracy at the behavioral level, and they also had lower P3b amplitude and less alpha desynchronization, regardless of price promotion frameworks. These findings provided evidence on the processing of price information and provided further insights into how numeracy impacts price magnitude judgment.

[5-Year Readmission Status and Risk Factors for Senile Dementia Patients: A Study Based on Chengdu Municipal Medical Insurance Database].

Objective: To study the status quo of the readmission of senile dementia patients in Chengdu, and to analyze the primary diagnosis, the economic burden and the influencing factors of readmission. Methods: Dementia inpatients aged 60 and above in Chengdu were the subjects of this study. The subjects were diagnosed with dementia between 2013 and 2017. Their heath insurance coverage was either the basic medical insurance for urban employees in Chengdu or the basic medical insurance for urban and rural residents of Chengdu. The rank sum test and the chi-square test were conducted to analyze the differences in readmission rate and the economic burden of hospitalization among subjects with different characteristics. Logistic regression was done to analyze the factors affecting readmission. Results: The total number of dementia inpatients over the 5-year period was 27881 patients (78820 admissions). The 30-day readmission rate was 25.14% (7011/27881) and the 5-year readmission rate was 45.79% (12767/27881). The primary diagnoses of 12767 readmitted patients mainly included dementia (28.57%), circulatory system diseases (24.26%), and respiratory system diseases (23.71%). The economic burden of hospitalization was higher for readmitted patients than that of patients who were not readmitted ( Z=33.777, P<0.001). The occurrence of readmission was correlated to the following factors, advanced age (compared to that of the 60-65 yr. group, the 70-75 yr. group: odds ratio [ OR]=1.123, 95% confidence interval [ CI]: 1.019-1.237, and the 75-80 yr. group: OR=1.123, 95% CI: 1.108-1.218), participation in the basic medical insurance for urban employees ( OR=1.674, 95% CI: 1.578-1.775), types of dementia (compared to unspecified dementia, Alzheimer's dementia group: OR=1.256, 95% CI: 1.163-1.357, Parkinson's disease dementia group: OR=1.774, 95% CI: 1.658-1.898, and mixed-type dementia group: OR=1.750, 95% CI: 1.457-2.103), disease condition (compared with patients with only dementia, those who have other diseases: OR=0.536，95% CI ：0.493-0.583), length of hospital stay ( OR=1.593, 95% CI: 1.552-1.635), and staying at a lower level hospital (compared to that of tertiary hospitals, secondary hospitals: OR=1.319, 95% CI: 1.248-1.395, primary hospitals: OR=1.744, 95% CI: 1.608-1.891, and other hospitals: OR=1.465, 95% CI: 1.311-1.537). Conclusion: Senile dementia patients have a high 30-day readmission rate, and the readmission entails heavy economic burdens on the patients. For the populations covered by medical insurance, the following features are correlated to the occurrence of readmission: advanced age, coverage by the basic medical insurance for urban employees, Alzheimer's dementia, Parkinson's disease dementia, mixed-type dementia, dementia patients without other comorbidities, extended length of stay, and hospitalization at a lower level hospital. However, further research is needed for better understanding of the specific mechanisms so that readmission of senile dementia patients can be reduced and the economic burden of the disease can be minimized.

Spatial distribution and risk assessment of metal(loid)s in marine sediments in the Arctic Ocean and Bering Sea.

Seventy-four surface sediment samples were collected from the Arctic Ocean and Bering Sea to determine the content of metal(loid)s (As, Cu, Cd, Ni, Pb, Zn and Cr). Metal(loid)s content in these sediments varied from 2.36-41.90 mg/kg for As, 8.63-82.28 mg/kg for Cu, 0.14-0.71 mg/kg for Cd, 11.86-100.60 mg/kg for Ni, 8.30-27.58 mg/kg for Pb, 39.93-391.43 mg/kg for Zn, and 40.96-106.49 mg/kg for Cr. The pH and water-soluble organic carbon content had considerable impacts on the content of metal(loid)s in sediment, but the texture of sediment has limited influence on metal(loid)s content in sediment. In addition, the hotspots of most of these metal(loid)s appeared in the Beaufort Sea region. The geoaccumulation index (Igeo) indicated that Cd was the metal with the highest contamination in these sediments, with 55.41% of the sample sites posing moderate pollution. The ecological risk for As, Cu, Ni, Pb, Zn and Cr indicates low ecological risk (100%), while Cd posed moderate risk (35.14%), considerable risk (54.05%) and high risk (10.81%) and attributed more than 76.45% of the total potential ecological risk of these metal(loid)s.

Metal(loid)s Spatial Distribution, Accumulation, and Potential Health Risk Assessment in Soil-Wheat Systems near a Pb/Zn Smelter in Henan Province, Central China.

To understand the influence of Pb/Zn smelter on surrounding environment, 110 soil and 62 wheat grain samples (62 paired samples) were collected nearby a Pb/Zn smelter in Jiaozuo City, Henan Province, China. The content and spatial distribution of metal(loid)s in the soil-wheat system, and the potential health risk via consumption of wheat grains were determined. Results showed that the average content of Pb, Cd, As, Cu, Zn, and Ni in soil were 129.16, 4.28, 17.95, 20.43, 79.36, and 9.42 mg/kg, respectively. The content of Cd in almost all soil samples (99.1%) exceeded the national limitation of China (0.6 mg/kg). Spatial distribution analysis indicated that atmospheric deposition might be the main pollution source of Pb, Cd, As, and Zn in soil. In addition, the average content of Pb, Cd, As, Cu, Zn, and Ni in wheat grain were 0.62, 0.35, 0.10, 3.7, 35.77, and 0.15 mg/kg, respectively, with the average Pb and Cd content exceeding the national limitation of China. The average bioaccumulation factor of these metal(loid)s followed the following order: Zn (0.507) > Cu (0.239) > Cd (0.134) > Ni (0.024) > Pb (0.007) > As (0.006). Health risk assessment indicated that the average noncarcinogenic risk of children (6.78) was much higher than that of adults (2.83), and the carcinogenic risk of almost all wheat grain is higher than the acceptable range, with an average value of 2.43 × 10−2. These results indicated that humans who regularly consume these wheat grains might have a serious risk of noncarcinogenic and carcinogenic diseases.