Risk assessment model based on nucleotide metabolism-related genes highlights SLC27A2 as a potential therapeutic target in breast cancer.

PURPOSE: Breast cancer (BC) is the most prevalent malignant tumor worldwide among women, with the highest incidence rate. The mechanisms underlying nucleotide metabolism on biological functions in BC remain incompletely elucidated. MATERIALS AND METHODS: We harnessed differentially expressed nucleotide metabolism-related genes from The Cancer Genome Atlas-BRCA, constructing a prognostic risk model through univariate Cox regression and LASSO regression analyses. A validation set and the GSE7390 dataset were used to validate the risk model. Clinical relevance, survival and prognosis, immune infiltration, functional enrichment, and drug sensitivity analyses were conducted. RESULTS: Our findings identified four signature genes (DCTPP1, IFNG, SLC27A2, and MYH3) as nucleotide metabolism-related prognostic genes. Subsequently, patients were stratified into high- and low-risk groups, revealing the risk model's independence as a prognostic factor. Nomogram calibration underscored superior prediction accuracy. Gene Set Variation Analysis (GSVA) uncovered activated pathways in low-risk cohorts and mobilized pathways in high-risk cohorts. Distinctions in immune cells were noted between risk cohorts. Subsequent experiments validated that reducing SLC27A2 expression in BC cell lines or using the SLC27A2 inhibitor, Lipofermata, effectively inhibited tumor growth. CONCLUSIONS: We pinpointed four nucleotide metabolism-related prognostic genes, demonstrating promising accuracy as a risk prediction tool for patients with BC. SLC27A2 appears to be a potential therapeutic target for BC among these genes.

Content of medicine prescription and clinical practice training for haematology advanced practice nurses in China: A modified Delphi study.

AIM: To explore the scope and form of prescriptions for blood and hematopoietic drugs that future advanced practice nurses (APNs) in the Department of Haematology and to establish a medicine prescription training content in China. BACKGROUND: Because the increasing number of doctors cannot meet the increasing demand for medical care with the population growth, many countries have begun to explore the medical team structure and practice areas, among which nurse prescribing rights have been the most effective. However, China's higher nursing education system still lacks education and training on nurse prescription. DESIGN: On the basis of literature research and semi-structured interviews, a set of nursing prescription content, education, training and practice system suitable for Chinese nurses was jointly created. METHODS: Two rounds of expert consultation between 23 haematology nursing experts and clinical experts determined the training content of blood system drugs and medicine prescriptions. Additionally, on the basis of the 23 experts，13 experts engaged in clinical and education, teaching and training experts were involved. Two rounds of expert consultation with 36 experts identified a general clinical practice training program for advanced practice nurses in China. RESULTS: Regarding contents and forms of hematopoietic drugs, the study concluded that advanced practice nurses in haematology department can prescribe anti-anemia drugs, anti-coagulant drugs and anti-thrombotic drugs in 2 categories and 16 drugs. Of these, four kinds of drugs should be prescribed in the form of protocol prescription. One kind of drug should be prescribed in the form of extended prescription and 11 drugs should be prescribed in the form of independent/extended or agreed/extended prescription. Regarding training content, the study obtained the training content of nurses' medicine prescriptions in eight clinical circumstances and the medicine prescription training content for common diseases of the blood system. The required specifications and the medicine prescription decision skills of nurses were sorted out according to different prescription types. CONCLUSIONS: The degrees of expert authority were both higher in consultations. Moreover, the results after consultation were reliable. It was recommended that haematology APNs could prescribe anti-anaemic drugs and anti-coagulation and anti-thrombotic drugs. Furthermore, most drugs should be prescribed in the form of independent/extended or agreed/extended prescriptions. The establishment of a medicine prescription training content for haematology APNs is expected to provide a reference for clinical practice education and training for drug prescriptive authority applicants for blood and hematopoietic system nurses in China.

The safety and feasibility assessment of overlap esophagojejunostomy with self-pulling and latter transection technique in totally laparoscopic total gastrectomy.

BACKGROUND: This study presented an innovative technique in totally laparoscopic total gastrectomy (TLTG) for overlap esophagojejunostomy (E-J), termed self-pulling and latter transection (SPLT) (overlap SPLT). It evaluated the effectiveness and short-term outcomes of this novel method through a comparative analysis with the established functional end-to-end (FETE) E-J incorporating SPLT. METHODS: From September 2018 to September 2023, this study enrolled 68 patients with gastric cancer who underwent TLTG with overlap SPLT anastomosis and 120 patients who underwent TLTG with FETE SPLT anastomosis. Clinicopathologic characteristics and surgical and postoperative outcomes data for overlap SPLT cases were gathered and retrospectively compared with those from FETE SPLT TLTG to evaluate the effectiveness and clinical safety. RESULTS: The duration of anastomosis for overlap SPLT was 25.3 ± 7.4 minutes, significantly longer than that for the FETE SPLT (18.1 ± 4.0 minutes, P = .031). Perioperatively, 1 anastomosis-related complication occurred in each group, but this did not constitute a statistically significant difference (P = .682). No statistically significant differences were found between the 2 groups in terms of operative time, postoperative hospital stay, operative cost, surgical margins, or number of lymph nodes removed. Postoperative morbidity rates were similar between the groups (4.4% vs 5.8%, P = .676). CONCLUSION: The overlap SPLT technique is regarded as a safe and feasible method for anastomosis. There were no apparent differences in complications between overlap SPLT and FETE SPLT, but overlap SPLT costed 1 additional stapler cartridge and required a longer duration.

Cervical cancer incidence, mortality, and burden in China: a time-trend analysis and comparison with England and India based on the global burden of disease study 2019.

Background: Cervical cancer is the fourth highest incidence of malignancy in the world and a common cause of cancer death in women. We assessed the trends of incidence and mortality and disability-adjusted life year (DALY) in China, England and India from 1990 to 2030. Method: Data were obtained from the Global Burden of Disease (GBD) database. We collected the number and rate of incidence, death and DALY from 1990 to 2019 and calculated the estimated annual percentage change (EAPC). Further analysis was carried out by ages and years. We also collected attributable risk factors to cervical cancer. Finally, we utilized the Bayesian Age-Period-Cohort (BAPC) model to forecast trends in the rate of age-standardized incidence (ASIR) and age-standardized death (ASDR) the for the next decade. Result: Globally, the incidence of cervical cancer cases increased from 335,641.56 in 1990 to 565,540.89 in 2019. In 2019, the ASIR and ASDR of cervical cancer were higher than those of India but lower than those of England. Furthermore, unsafe sex and smoking emerge as prominent risk factors for cervical cancer. Over the next decade, ASIR and ASDR are expected to decline in China and England, while India's ASIR is still on an upward trend and ASDR is on a downward trend. Conclusion: The epidemiological data of cervical cancer in these three countries reflects the influence of different stages of development and healthcare systems. Trends over the next decade suggest that China and India still face a huge burden of cervical cancer. When England has made significant progress, China and India need to take more measures to improve the prevention and control of cervical cancer.

Geographic information system-based multi-criteria decision-making analysis for investment assessment of wind-photovoltaic-shared energy storage power stations: a case study of Shanxi Province.

As the center of the development of power industry, wind-photovoltaic (PV)-shared energy storage project is the key tool for achieving energy transformation. This research seeks to construct a feasible model for investment appraisal of wind-PV-shared energy storage power stations by combining geographic information system (GIS) and multi-criteria decision-making (MCDM) method. Firstly, a comprehensive criteria system is established from the perspectives of orography, economy, resources, climate, and society, and the evaluation data is described using probabilistic linguistic term sets (PLTSs). Then, to avoid the weight deviation produced by the single weighting approach, a comprehensive weighting model including the best-worst method (BWM) and entropy weight method is provided to calculate the weights of criteria. Next, expert weights are calculated based on trust analysis. Finally, alternatives are ranked by the improved gained and lost dominance score (GLDS) method. To verify the validity of the model, an empirical investigation is carried out in Shanxi Province. The results show that the economy is the primary factor influencing the investment decision. Among all the projects approved by the government, alternative F4 located in Yanzhuang Town, Yuanping City is the best investment object. Furthermore, to illustrate the stability of the result, triple sensitivity analysis and comparative analysis are conducted in Shanxi Province. This study expands the application scope of GIS and MCDM method by first providing support for government and investors to identify optimal investment targets.

Quantitative ultrasound image assessment of the optic nerve subarachnoid space during 90-day head-down tilt bed rest.

The elevation in the optic nerve sheath (ONS) pressure (ONSP) due to microgravity-induced headward fluid shift is the primary hypothesized contributor to SANS. This longitudinal study aims to quantify the axial plane of the optic nerve subarachnoid space area (ONSSA), which is filled with cerebrospinal fluid (CSF) and expands with elevated ONSP during and after head-down tilt (HDT) bed rest (BR). 36 healthy male volunteers (72 eyes) underwent a 90-day strict 6° HDT BR. Without obtaining the pre-HDT data, measurements were performed on days 30, 60, and 90 during HDT and at 6 recovery time points extended to 180-days (R + 180) in a supine position. Portable B-scan ultrasound was performed using the 12 MHz linear array probe binocularly. The measurements of the ONS and the calculation of the ONSSA were performed with ImageJ 1.51 analysis software by two experienced observers in a masked manner. Compared to R + 180, the ONSSA on HDT30, HDT60, and HDT90 exhibited a consistently significant distention of 0.44 mm2 (95% CI: 0.13 to 0.76 mm2, P = 0.001), 0.45 mm2 (95% CI: 0.15 to 0.75 mm2, P = 0.001), and 0.46 mm2 (95% CI: 0.15 to 0.76 mm2, P < 0.001), respectively, and recovered immediately after HDT on R + 2. Such small changes in the ONSSA were below the lateral resolution limit of ultrasound (0.4 mm) and may not be clinically relevant, possibly due to ONS hysteresis causing persistent ONS distension. Future research can explore advanced quantitative portable ultrasound-based techniques and establish comparisons containing the pre-HDT measurements to deepen our understanding of SANS.

Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods.

Sleep disturbances are highly prevalent during the COVID-19 pandemic, especially among older adults. We aimed to evaluate sleep heath during COVID-19 pandemic and assess the differences among geographical regions and pandemic periods. We searched three databases (PubMed, Embase, Web of Science) to find articles up to March 12, 2023. We included observational studies that reported the prevalence of sleep disturbances among adults aged 60 years or older in any setting. Two researchers independently reviewed the literature and retrieved the data. We used Der Simonian-Laird random effects meta-analyses to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. A total of 64 studies with 181,224 older adults during the pandemic were included. The prevalence of poor sleep quality, short sleep duration, long sleep duration, and insomnia symptoms were 47.12% (95% CI: 25.97%, 68.27%), 40.81% (95% CI: 18.49%, 63.12%), 31.61% (95% CI: 24.83%, 38.38%), and 21.15% (95% CI: 15.30%, 27.00%), respectively. The prevalence of sleep problems reported by self-constructed items was 26.97% (95% CI: 20.73%, 33.22%). When compared to America (64.13%), Europe (20.23%) and the Western Pacific (21.31%) showed a lower prevalence of sleep problems (all P < 0.0001). The prevalence of worsened sleep problems was 27.88% (95% CI: 11.94%, 43.82%). Compared to 2020 (15.14%), it increased to 47.42% in 2021 (P < 0.05). Eight studies on sleep disturbances among 672 older COVID-19 patients were included. The prevalence of sleep problems and insomnia symptoms among older COVID-19 patients were 41.58% (95% CI: 21.97%, 61.20%) and 41.56% (95% CI: 28.11%, 58.02%), respectively. A significant burden related to poor sleep has been observed among older adults worldwide over the past three years, with variations across different regions and time periods. It is important to make more efforts in prevention and intervention to identify the risk factors, treatment, and rehabilitation of sleep disturbances for healthy aging.

Evaluating the cost utility of estradiol plus dydrogesterone for the treatment of menopausal women in China.

AIM: Evaluate the cost utility of menopausal hormone therapy for women in China. MATERIALS AND METHODS: A bespoke Markov cost utility model was developed to evaluate a cohort of symptomatic perimenopausal women (>45 years) with intact uterus in China in accordance with China's Pharmacoeconomic guideline. Short (5-year) and long (10-year) treatment durations were evaluated over a lifetime model time horizon with 12-month cycle duration. Societal and healthcare payer perspectives were evaluated in the context of a primary care provider/prescriber, outpatient setting with inpatient care for patients with chronic conditions. Disease risk and mortality parameters were derived from focused literature searches, and China Diagnosis-related Group cost data was included. Comprehensive scenario, univariate and probabilistic sensitivity analysis were undertaken along with independent validation. This is the first model to include MHT-related disease risks. RESULTS: According to base case results, the total cost for MHT was 22,516$ (150,106¥) and total quality adjusted life years 12.32 versus total cost of no MHT 30,824$ (205,495¥) and total quality adjusted life years 11.16 resulting in a dominant incremental cost effectiveness ratio of -7,184$ (-47,898¥) per QALY. Results hold true over a range of univariate deterministic sensitivity and scenario analyses. Probabilistic analysis showed a 91% probability of being cost effective at a willingness to pay threshold of three times Gross Domestic Product per capita in China. CONCLUSION: Contingent on the structure and assumptions of the model, combination of estradiol plus dydrogesterone MHT is potentially cost saving in symptomatic women over the age of 45 years in China.

Menopausal hormone therapy is publicly funded in many countries to alleviate symptoms of menopause; however, uptake has been comparatively slow in China. This has implications for the estimated 168 million menopausal-aged women. This analysis is the first to evaluate the cost effectiveness of menopausal hormone therapy in China using best practice principles and incorporating longer term disease risks. Menopausal hormone therapy is potentially cost saving in the context of China.

Association of Catastrophic Health Expenditure With the Risk of Depression in Chinese Adults: Population-Based Cohort Study.

BACKGROUND: Depression is one of the most common mental illnesses, and it may have a lasting effect on one's whole life. As a form of financial hardship, catastrophic health expenditure (CHE) may be associated with depression. However, current evidence about the relationship between CHE and the risk of depression is insufficient. OBJECTIVE: This study aimed to explore the relationship between CHE and the risk of depression among Chinese adults. METHODS: In this study, we used 3 waves of the China Family Panel Studies (CFPS) from 2012, 2016, and 2018. The CFPS are a nationally representative study covering 25 of 31 provinces in Chinese mainland and representing nearly 94.5% of the total population. We selected eligible household heads as participants, divided them into 2 groups by CHE events at baseline (exposed group: with CHE; unexposed group: without CHE), and followed them up. Households with CHE were defined as having out-of-pocket medical expenditures exceeding 40% of the total household nonfood expenditure, and people with depression were identified by the 8-item Centre for Epidemiological Studies Depression Scale (CES-D). We first described the baseline characteristics and used logistical regression to estimate their effects on CHE events. Then, we used Cox proportional hazard models to estimate adjusted hazard ratios and 95% CIs of depression among participants with CHE compared with those without CHE. Finally, we analyzed the subgroup difference in the association between CHE and depression. RESULTS: Of a total of 13,315 households, 9629 were eligible for analysis. Among them, 6824 (70.9%) were men. The mean age was 50.15 (SD 12.84) years. Only 987 (10.3%) participants had no medical insurance. The prevalence of CHE at baseline was 12.9% (1393/9629). Participants with a higher family economic level (adjusted odds ratio [aOR] 1.15, 95% CI 1.02-1.31) and with the highest socioeconomic development level (aOR 1.18, 95% CI 1.04-1.34) had a higher prevalence of CHE than reference groups. During a median of 71 (IQR 69-72) person-months of follow-up, the depression incidence of participants with CHE (1.41 per 1000 person-months) was higher than those without CHE (0.73 per 1000 person-months). Multivariable models revealed that the adjusted hazard ratio for the incidence of depression in participants with CHE was 1.33 (95% CI 1.08-1.64), and this association appeared to be greater in participants without outpatient services (for interaction, P=.048). CONCLUSIONS: CHE was significantly associated with increased risk of depression among Chinese adults. Concentrated work should be done to monitor CHE, and more efforts to ensure financial protection need to be made to prevent depression, especially for people with high health care needs.

Catastrophic health expenditure and the risk of depression among middle-aged and old people in China: a national population-based longitudinal study.

AIMS: To estimate the association of catastrophic health expenditure (CHE) with the risk of depression in middle-aged and old people in China. METHODS: We used data of 2011, 2013, 2015 and 2018 from the China Health and Retirement Longitudinal Study, which covered 150 counties of 28 provinces in China. CHE was calculated as out-of-pocket health expenditure exceeding 40% of a household's capacity to pay. Depression was measured by a 10-item Centre for Epidemiological Studies Depression Scale. We evaluated CHE prevalence and applied Cox proportional hazard models to estimate adjusted hazard ratios (aHRs) and 95% confident intervals (CIs) for the risk of depression among participants with CHE after controlling potential confounders, compared with those without CHE. RESULTS: Among 5765 households included in this study, CHE prevalence at baseline was 19.24%. The depression incidence of participants with CHE (8.00 per 1000 person-month) was higher than that of those without CHE (6.81 per 1000 person-month). After controlling confounders, participants with CHE had a 13% higher risk (aHR = 1.13, 95% CI: 1.02-1.26) of depression than those without CHE. In subgroup analysis, the association of CHE with depression was significant in males and in people with chronic diseases, of younger age, living in rural areas and of lowest family economic level (all P < 0.05). CONCLUSIONS: Nearly one of five middle-aged and old people in China incurred CHE, and CHE was associated with the risk of depression. Concerted efforts should be made to monitor CHE and related depression episode. Moreover, timely interventions about CHE and depression need to be implemented and strengthened among middle-aged and old people.

COVID-19 Vaccination Coverage among 42,565 Adults Amid the Spread of Omicron Variant in Beijing, China.

Vaccines against coronavirus disease 2019 (COVID-19) have been in use for over two years, but studies that reflect real-world vaccination coverage and demographic determinants are lacking. Using a multistage stratified random cluster sampling method, we planned to directly explore vaccination coverage and the demographic determinants of different doses of COVID-19 vaccines in Beijing, especially in older populations. All 348 community health service centers in 16 districts were involved. We performed multivariable logistic regression analyses to identify demographic determinants of different coverage rates via adjusted odds ratios (aORs) and 95% CIs. Of the 42,565 eligible participants, the total vaccination coverage rates for ≥1 dose, ≥2 doses, ≥3 doses, and 4 doses were 93.3%, 91.6%, 84.9%, and 13.0%, respectively, but decreased to 88.1%, 85.1%, 76.2%, and 3.8% in the older population. Among all participants, younger (aOR = 1.77, 95% CI: 1.60-1.95), male (aOR = 1.15, 95% CI: 1.06-1.23), and better-educated residents (high school and technical secondary school aOR = 1.58, 95% CI: 1.43-1.74; bachelor's degree aOR = 1.53, 95% CI: 1.37-1.70) were more likely to be fully vaccinated. People who lived in rural areas (aOR = 1.45, 95% CI: 1.31-1.60) and held the new rural cooperative health insurance (aOR = 1.37, 95% CI: 1.20-1.57) established a higher rate of full vaccination coverage. No history of chronic disease was positively associated with a higher coverage rate (aOR = 1.81, 95% CI: 1.66-1.97). Occupation also affected vaccination coverage. Demographic factors influencing the rate of vaccination with at least one or three doses were consistent with the results above. Results remained robust in a sensitivity analysis. Given the highly transmissible variants and declining antibody titers, accelerating the promotion of booster vaccination coverage, especially in high-risk groups such as the elderly, is a top priority. For all vaccine-preventable diseases, rapidly clarifying vaccine-hesitant populations, clearing barriers, and establishing a better immune barrier can effectively safeguard people's lives and property and coordinate economic development with epidemic prevention and control.

Associations among socioeconomic status, multimorbidity of non-communicable diseases, and the risk of household catastrophic health expenditure in China: a population-based cohort study.

BACKGROUND: Multimorbidity of non-communicable diseases (NCDs) is increasingly prevalent among older adults around the world, leading a higher risk of household catastrophic health expenditure (CHE). As current powerful evidence was insufficient, we aimed to estimate the association between multimorbidity of NCDs and the risk of CHE in China. METHODS: We designed a cohort study using data investigated in 2011-2018 from the China Health and Retirement Longitudinal Study, which is a nationally-representative study covering 150 counties of 28 provinces in China. We used mean ± standard deviation (SD) and frequencies and percentages to describe baseline characteristics. Person χ2 test was employed to compare the differences of baseline characteristics between households with and without multimorbidity. Lorenz curve and concentration index were used to measure the socioeconomic inequalities of CHE incidence. Cox proportional hazards models were applied to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the association between multimorbidity and CHE. RESULTS: Among 17,708 participants, 17,182 individuals were included for the descriptive analysis of the prevalence of multimorbidity in 2011, and 13,299 individuals (8029 households) met inclusion criteria and were included in the final analysis with a median of 83 (interquartile range: 25-84) person-months of follow-up. 45.1% (7752/17,182) individuals and 56.9% (4571/8029) households had multimorbidity at baseline. Participants with higher family economic level (aOR = 0.91, 95% CI: 0.86-0.97) had lower multimorbidity prevalence than those with lowest family economic level. 82.1% of participants with multimorbidity did not make use of outpatient care. The CHE incidence was more concentrated among participants with higher socioeconomic status (SES) with a concentration index of 0.059. The risk of CHE was 19% (aHR = 1.19, 95% CI: 1.16-1.22) higher for each additional NCD. CONCLUSIONS: Approximately half of middle-aged and older adults in China had multimorbidity, causing a 19% higher risk of CHE for each additional NCD. Early interventions for preventing multimorbidity among people with low SES could be intensified to protect older adults from financial hardship. In addition, concerted efforts are needed to increase patients' rational healthcare utilization and strengthen current medical security for people with high SES to reduce economic disparities in CHE.

Evaluation of Enterprise Green Mine Construction Based on DPSIR Model.

As a new mode of mining development, green mine optimizes the development and utilization of mineral resources with a minimum of the environmental impact, and how to objectively evaluate the construction level of the green mine has become the key to promote green mine construction and it has also been an important path to achieve sustainable development of mineral resources. The evaluation system and methods of green mine construction, however, are not perfect at present as the existing green mine evaluation mostly adopts the index scoring accumulation method, with which the internal relations between the indicators are ignored, and the subjective influence it causes is too large. Based on the framework model of driving forces, pressure, state, impact and response, an indicator system is constructed in this paper to express the internal relationship between indicators more intuitively. Combined with subjective and objective combination weighting method to determine the index weight, TOPSIS and coupling coordination degree models are introduced to quantitatively evaluate the spatio-temporal evolution process of green mine construction and the coupling coordination between subsystems, analyze and obtain the main obstacle factors affecting the green mine construction of enterprises, and provide suggestions and countermeasures for the improvement of green mine construction of enterprises. The applicability of the model is verified by an actual case study of a mine in China. The model enriches the connotation of green mines, making the evaluation process and results fairer and more reliable, thus providing an effective way to promote the sustainable development of mines.

Unlocking the effects and optimization path of financial support for improvement in environmental quality and rural revitalization development: an empirical analysis based on provincial data of Shaanxi province.

This study establishes an economic financial support model for the improvement of environmental quality through the development rural revitalization based on the extended Cobb-Douglas production function. Using statistical data from Shaanxi Province, China, from 2004 to 2019, a vector autoregressive (VAR) model is used to empirically analyze the development effect of financial support for rural revitalization and to give the focus points and optimization paths for financial support for environmental quality, rural revitalization and sustainable development. The research results show that financial support plays an active and long-term role in improving environmental quality and promoting rural revitalization and sustainable development. Specifically, the effect of financial instruments in supporting rural revitalization and sustainable development is continuous. In the insurance system, increasing the scale of agricultural insurance support and expanding the coverage of agricultural insurance are key to improving environmental quality and promoting rural revitalization and sustainable development. Therefore, financial policy makers should improve the targeting of financial instruments to provide the right guidance for improving the quality of rural environment and enhancing rural economy, so as to ultimately realize rural revitalization in China.

Impact of human capital on the green economy: empirical evidence from 30 Chinese provinces.

In China, exploring the relationship between human capital and green economy in the context of economic transformation can promote the construction of an ecological civilization and high-quality economic development. This paper is dedicated to assessing the impact of human capital stock, human capital structure, and the difference between the two on China's green economy. Using the super-efficiency slack-based measure (SBM) model, this paper evaluated the green total factor productivity (GTFP) of 30 Chinese provinces to assess the greenness of its economy and analyzed its spatiotemporal evolution from 2000 to 2017. A spatial error model (SEM) was established to explore the impact of human capital on green economy. The results show that (1) the GTFP of China increased continuously from 0.219 to 0.457, showing a regional spatial differentiation of "eastern region > central region > western region." The spatial gaps of the green economy in the east-west and north-south directions are narrowing. (2) Moran's I index and Moran's I scatter plot indicate a significant spatial correlation between human capital and China's green economy. The local spatial correlation between human capital and green economy is mainly characterized by "high-high" and "low-low" types of agglomeration. (3) The effects of human capital stock and human capital structure on green economy were both positive, with coefficients of 0.0005 and 0.1601, respectively, but the effects of human capital structure were not significant. (4) The results of regional regression show that the difference between the human capital impact coefficients on green economy in the eastern and midwestern regions is small. The impact of human capital stock and human capital structure on green economy is consistent with the national level results. It can be preliminarily concluded that the development of China's green economy relied more on improving the human capital stock than on the improvement of the human capital structure. This study further enriches the literature on the green economy and provides information that can support government policy-making.

Ecological risk assessment of glyphosate and its possible effect on bacterial community in surface sediments of a typical shallow Lake, northern China.

Glyphosate is a widely used herbicide worldwide and its prevalent presence in aquatic ecosystems poses a threat to living organisms. This study evaluated potential ecological risk of glyphosate to sediment-dwelling organisms and assessed the probable effect of glyphosate on structure and predicated function of sediment-attached bacterial communities from a large shallow lake in northern China based on 16S rRNA high-throughput sequencing. Results suggested that glyphosate showed a medium to high concentration (up to 8.63 mg/kg) and chronic risk to sediment-dwelling organisms (10% samples exhibiting medium to high risk quotient), especially in sites nearby farmland and residential areas in August. Bacterial community identification based on 16S rRNA sequence indicated some species of dominant phylum Proteobacteria and Campilobacterota (e.g., Steroidobacteraceae, Thiobacillus, Gallionellaceae, Sulfurimonadaceae) were stimulated while some species of dominant phylum Actinobacteriota, Acidobacteriota and Firmicutes (e.g., Nocardioidaceae, Microtrichales, Vicinamibacteraceae, Paenisporosarcina) were inhibited by glyphosate accumulation. The stimulating species were related to sulfur-oxidizing, sulfate-, iron-, or nitrate-reducing bacteria; The inhibiting species were related to plant bacterial endophytes, polyphosphate-accumulating organisms (PAOs) and denitrifers. Correspondingly, promoted bacterial metabolic functions of "sulfite respiration", "nitrogen respiration", "aromatic compound degradation" and "nitrification" but suppressed "cellulolysis", "manganese oxidation", "anoxygenic photoautotrophy S oxidizing" and "nitrate denitrification" were predicated on functional annotation of prokaryotic taxa. Although these results could only partly suggest the impacts of glyphosate on the bacterial communities due to the lack of actual results from control experiments, the identified Steroidobacteraceae could be thought as a bioindicator in the future mechanism study for the ecological effect and bioremediation of glyphosate. This work intends to arise the concern about the depletion of biodiversity and bacterial metabolic functions with contribution of glyphosate in part in eutrophic lakes.

Association of Body Mass Index with Risk of Household Catastrophic Health Expenditure in China: A Population-Based Cohort Study.

Catastrophic health expenditure (CHE) is a major obstacle to achieving universal health coverage, and body mass index (BMI) is linked to both health and economy. We aimed to explore the association of BMI with the risk of CHE to provide advice for reducing CHE. We used national cohort data from the China Family Panel Studies, which comprised 33,598 individuals (14,607 households) from 25 provinces between 2010 to 2018. We used multivariate Cox proportional hazard models to estimate adjusted hazard ratios (aHRs) and 95% confident interval (CI) for CHE in participants at underweight, overweight, and obesity, compared with those at normal weight. Restricted cubic splines were employed to model the association of continuous BMI scale with risk of CHE. We found that families with female household heads at underweight had a 42% higher risk of CHE (aHR = 1.42, 95%CI: 1.16-1.75), and those at overweight had a 26% increased risk of CHE (aHR = 1.26, 95%CI: 1.09-1.47), compared with those at normal weight. A weak U-shaped curve for the association of continuous BMI with risk of CHE in female-headed households (p for non-linear = 0.0008) was observed, which was not significant in male-headed households (p for non-linear = 0.8725). In female-headed households, underweight and overweight BMI are connected with a higher risk of CHE. Concerted efforts should be made to keep a normal BMI to prevent CHE.

Spatiotemporal Evolution and Influencing Factors of Carbon Emission Efficiency in the Yellow River Basin of China: Comparative Analysis of Resource and Non-Resource-Based Cities.

Comparing the carbon emission efficiency (CEE) of resource and non-resource-based cities in the Yellow River Basin (YRB) can guide their synergistic development and low-carbon transition. This study used the super-efficiency slacks-based measure (super-SBM) model to measure the CEE of cities in the YRB. Kernel density estimation and Theil index decomposition methods were used to explore the spatiotemporal evolutionary patterns, and a panel regression model was established to analyze the influencing factors of CEE. The research results showed that the CEE of the two types of cities have an overall upward trend in time, with a widening regional gap. Resource-based cities mainly displayed the characteristics of decentralized regional agglomeration, while non-resource-based cities mainly showed the characteristics of convergent regional agglomeration. Panel regression results showed that the levels of economic development, indus-trial structure, and population density are significantly positively correlated with CEE in the YRB, while foreign direct investment and resource endowment are significantly negatively correlated with CEE. Except for economic development and industrial structure, there is some variability in the contribution of the remaining influencing factors to the CEE of the resource and non-resource-based cities. The research results suggest developing classification measures for low-carbon transition in the YRB.

The Spatiotemporal Distribution and Drivers of Urban Carbon Emission Efficiency: The Role of Technological Innovation.

Urban agglomerations have become the core areas for carbon reduction in China since they account for around 75% of its total emissions. Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and the Pearl River Delta (PRD), which are its most important poles of regional development and technological innovation, are key to achieving China's carbon peak emissions target. Based on the panel data of these three major urban agglomerations from 2003 to 2017, this study estimated the carbon emission efficiency (CEE) by the super-efficiency slacks-based measure (super-SBM) model and analyzed its spatiotemporal distribution pattern. The Dagum Gini coefficient was used to evaluate the difference in CEE between the three major agglomerations, while panel data models were established to analyze the impact of technological innovation on the three agglomerations. The overall CEE showed an upward trend during the study period, with significant spatial and temporal variations. Additionally, the main source of urban agglomeration difference in CEE evolved from inter-regional net differences to intensity of transvariation. While technological innovations are expected to significantly improve CEE, their effect varies among urban agglomerations. These results provide policymakers with insights on the collaborative planning of urban agglomerations and the low-carbon economy.

Global trends, regional differences and age distribution for the incidence of HIV and tuberculosis co-infection from 1990 to 2019: results from the global burden of disease study 2019.

BACKGROUND: People living with human immunodeficiency virus (HIV) are more likely to develop tuberculosis (TB), and their co-infection (HIV-TB) increases the risk of death. We aimed to describe the global trends, regional differences and age distribution of HIV-TB. METHODS: Annual new cases, age-standardized incidence rates (ASRs) and age-specific incidence rates with 95% uncertainty intervals (UIs) of HIV-infected drug-susceptible tuberculosis (HIV-DS-TB), HIV-infected multidrug-resistant tuberculosis without extensive drug resistance (HIV-MDR-TB) and HIV-infected extensively drug-resistant tuberculosis (HIV-XDR-TB) during 1990-2019 were collected from the Global Burden of Disease Study 2019. To reveal the trends of HIV-TB by region and age, the percentage change of new cases and estimated annual percentage change (EAPC) of ASRs were calculated. RESULTS: The ASR of HIV-XDR-TB increased significantly by an average of 14.77% (95% CI: 11.05%-18.62%) per year during 1990-2019 worldwide, while the ASRs of HIV-DS-TB and HIV-MDR-TB decreased after 2005. HIV-XDR-TB was a great threat to Eastern Europe for the largest number of new cases (792, 95% UI: 487-1167) and the highest ASR (0.34 per 100,000 population, 95% UI: 0.21-0.50). In addition, Oceania had the largest rise in ASRs of HIV-MDR-TB (EAPC = 22.56, 95% CI: 18.62-26.64) and HIV-XDR-TB (EAPC = 32.95, 95% CI: 27.90-38.20) during 1990-2019. Recently, age-specific incidence rates of HIV-XDR-TB increased in all age groups, especially in the 50-69 age groups among high, low-middle and low Socio-Demographic Index regions. Additionally, the proportion of patients aged <15 years was nearly 10% of new cases in sub-Saharan Africa in 2019, which was higher than in other regions. CONCLUSIONS: HIV-infected drug-resistant TB is common in Oceania and Eastern Europe. Moreover, HIV-XDR-TB among elderly people became increasingly prevalent. In the future, the collaboration of management for HIV and TB should be intensified in Oceania and Eastern Europe, and more concerns need to be paid in elderly people.