Current curative expenditure of non-communicable diseases changed in Dalian, China from 2017 to 2019: a study based on 'System of Health Accounts 2011'.

OBJECTIVES: To analyse the current curative expenditure (CCE) of NCDs in China from 2017 to 2019. DESIGN: A cross-sectional study. Medical institutions were collected by multistage stratified random sampling from 2017 to 2019. SETTING: Dalian, China PARTICIPANTS: 408 institutions and 8 104 233 valid items were included in the study. NCDs patients were selected according to International Classification of Diseases-10. PRIMARY AND SECONDARY OUTCOME MEASURES: CCE for NCDs was measured based on the System of Health Accounts 2011. Influenced factors were analysed by linear regression. All analyses and calculations were performed by STATA V.15.0. RESULTS: The CCE of NCDs was ¥14.929 billion in 2017, ¥16.377 billion in 2018 and ¥18.055 billion in 2019, which accounted for more than 65% of total expenditure spent each year. More than 60% came from public financing. The proportion of family health financing continued to decline, reaching 31.16% in 2019. The expenditures were mainly in general hospitals, above 70%. Elderly patients account for the majority. Diseases of the circulatory system, diseases of the digestive system and neoplasms were the main NCDs. Year, age, gender, length of stay, surgery, insurance and institution level affected hospitalisation expenses. CONCLUSIONS: NCDs are the main CCE of diseases in China, and their resources are not allocated reasonably. To reduce the CCE of NCDs, the government needs to optimise resource allocation and rationalise institutional flows and functions.

Power Batteries Health Monitoring: A Magnetic Imaging Method Based on Magnetoelectric Sensors.

With the popularity of electric vehicles, the ever-increasing demand for high-capacity batteries highlights the need for monitoring the health status of batteries. In this article, we proposed a magnetic imaging technique (MIT) to investigate the health status of power batteries nondestructively. This technique is based on a magnetic sensor array, which consists of a 16-channel high-performance magnetoelectric sensor, and the noise equivalent magnetic induction (NEB) of each channel reaches 3-5 pT/Hz1/2@10 Hz. The distribution of the magnetic field is imaged by scanning the magnetic field variation of different positions on the surface. Therefore, the areas of magnetic anomalies are identified by distinguishing different magnetic field abnormal results. and it may be possible to classify the battery failure, so as to put forward suggestions on the use of the battery. This magnetic imaging method expands the application field of this high-performance magnetoelectric sensor and contributes to the battery's safety monitoring. Meanwhile, it may also act as an important role in other nondestructive testing fields.

Assessment of Medical Expenditure for Patients With Breast Cancer in China: Evidence From Current Curative Expenditure by System of Health Accounts 2011.

OBJECTIVES: The incidence and mortality of breast cancer have been increasing in China and bring heavy economic burdens to patients, families, and society. This study aimed to analyze the structure and influencing factors of inpatient expenditures of patients with breast cancer and put forward suggestions for insurance management. METHODS: A multistage stratified random sampling method was used to investigate 379 medical institutions and 7366 pieces of inpatient records of patients with breast cancer in Dalian in 2018. Under the framework of "System of Health Accounts 2011," the current curative expenditure (CCE) and its distribution were calculated. The relationships between hospitalization expenditure and factors were analyzed by multiple stepwise regression and structural equation modeling. RESULTS: The CCE of patients with breast cancer in Dalian in 2018 was ¥273.38 million, accounting for 10.66% of the total expenditure on cancer. The majority of the CCE flowed to large general hospitals. The CCE was concentrated in patients aged 40 to 69 years (23.46%). The hospitalization expenditure correlated positively with length of stay, surgery, and drug expenses (rs = 0.586-0.754, P < .01) and negatively associated with age (rs = -0.074, P < .01). The length of stay mediated the relationship between surgery and hospitalization expenses for patients with breast cancer. The factors that affected the hospitalization expenditure were the drug expenses, surgery, length of stay, insurance status, and institution level. CONCLUSIONS: The cost control for CCE of breast cancer inpatient treatment is crucial in China. Promoting hierarchical diagnosis and treatment, reducing the length of stay, and improving medical insurance depth would be effective measures to reduce the financial burden of patients.

Cost-Utility Analysis of Dapagliflozin Versus Saxagliptin Treatment as Monotherapy or Combination Therapy as Add-on to Metformin for Treating Type 2 Diabetes Mellitus.

OBJECTIVE: To assess the long-term cost effectiveness of dapagliflozin (DAPA) and saxagliptin (SAXA) separately or together in patients with type 2 diabetes mellitus (T2DM) inadequately controlled by metformin (MET). METHODS: Five head-to-head randomised controlled trials of the efficacy of DAPA and SAXA in type 2 diabetes mellitus (T2DM) patients were found by searching PubMed, Embase and Cochrane from inception to October 2019. The lifetime disease progression and long-term effectiveness of therapy in patients were projected by the United Kingdom Prospective Diabetes Study Outcome Model 2 (UKPDS OM2) in three T2DM therapeutic groups: DAPA + SAXA, DAPA and SAXA. Each group used DAPA and/or SAXA as an add-on therapy to MET. The study took the perspective of Chinese healthcare service providers. Univariate, scenario and probabilistic sensitivity analyses were performed. RESULTS: The quality-adjusted life-years (QALYs) value of the DAPA + SAXA, SAXA and DAPA groups were 11.28, 11.26 and 11.45 years, respectively. The total costs were US$27,954.84, US$23,254.46 and US$25,608.49, respectively. DAPA was dominant over DAPA + SAXA. The DAPA + SAXA group presented an estimated QALY gain of 0.02 and a total cost increase of US$4700.39 over the SAXA group, with an incremental cost of US$217,530.10 per QALY. Compared with the SAXA group, the DAPA group had a QALY gain of 0.19 years and a total cost increase of US$2354.04, for an incremental cost of US$12,191.97 per QALY. The pharmacoeconomic results were robust to univariate, scenario and probabilistic sensitivity analyses. CONCLUSIONS: Compared with DAPA + SAXA or SAXA, DAPA appears to be a cost-effective therapy as add-on to MET for Chinese patients whose T2DM is insufficiently controlled by MET.

Reduction in NO(x) emission trends over China: regional and seasonal variations.

We analyzed satellite observations of nitrogen dioxide (NO2) columns by the Ozone Monitoring Instrument (OMI) over China from 2005 to 2010 in order to estimate the top-down anthropogenic nitrogen oxides (NOx) emission trends. Since NOx emissions were affected by the economic slowdown in 2009, we removed one year of abnormal data in the analysis. The estimated average emission trend is 4.01 ± 1.39% yr(-1), which is slower than the trend of 5.8-10.8% yr(-1) reported for previous years. We find large regional, seasonal, and urban-rural variations in emission trends. The average NOx emission trend of 3.47 ± 1.07% yr(-1) in warm season (June-September) is less than the trend of 5.03 ± 1.92% yr(-1) in cool season (October-May). The regional annual emission trends decrease from 4.76 ± 1.61% yr(-1) in North China Plain to 3.11 ± 0.98% yr(-1) in Yangtze River Delta and further down to -4.39 ± 1.81% yr(-1) in Pearl River Delta. The annual emission trends of the four largest megacities, Shanghai, Beijing, Guangzhou, and Shenzhen are -0.76 ± 0.29%, 0.69 ± 0.27%, -4.46 ± 1.22%, and -7.18 ± 2.88% yr(-1), considerably lower than the regional averages or surrounding rural regions. These results appear to suggest that a number of factors, including emission control measures of thermal power plants, increased hydro-power usage, vehicle emission regulations, and closure or migration of high-emission industries, have significantly reduced or even reversed the increasing trend of NOx emissions in more economically developed megacities and southern coastal regions, but their effects are not as significant in other major cities or less economically developed regions.

A novel approach to DNA copy number data segmentation.

DNA copy number (DCN) is the number of copies of DNA at a region of a genome. The alterations of DCN are highly associated with the development of different tumors. Recently, microarray technologies are being employed to detect DCN changes at many loci at the same time in tumor samples. The resulting DCN data are often very noisy, and the tumor sample is often contaminated by normal cells. The goal of computational analysis of array-based DCN data is to infer the underlying DCNs from raw DCN data. Previous methods for this task do not model the tumor/normal cell mixture ratio explicitly and they cannot output segments with DCN annotations. We developed a novel model-based method using the minimum description length (MDL) principle for DCN data segmentation. Our new method can output underlying DCN for each chromosomal segment, and at the same time, infer the underlying tumor proportion in the test samples. Empirical results show that our method achieves better accuracies on average as compared to three previous methods, namely Circular Binary Segmentation, Hidden Markov Model and Ultrasome.

Assessment of secondary organic carbon in the Southeastern United States: a review.

Organic carbon (OC) is one of the major components of ambient PM2.5 (particulate matter [PM] < or = 2.5 microm in aerodynamic diameter) and a significant portion of OC is from secondary organic aerosol (SOA) formation in the southeastern United States. Various approaches (based on measurement and modeling results) are applied to estimate secondary organic carbon (SOC) and its origins in the region. SOC estimates by various methods are consistent as to clear seasonal variation (i.e., relatively higher SOC in summer) and little spatial variability (i.e., a regional characteristic of SOC). However, there are differences as to the origins of SOC. SOA organic tracer and emission-based modeling studies indicate that the biogenic origin of SOC is dominant in the Southeast, showing that biogenic-origin SOC accounts for 90% of SOC in summer and more than 70% even in other seasons. However, results from other studies suggest that the anthropogenic origin of SOC is dominant, significant amounts of anthropogenic-origin SOC, or important roles of anthropogenic pollutants for SOA formation, especially at urban areas, as strong correlations between water-soluble OC (an indicator of SOC) and anthropogenic pollutants, considerable amounts of fossil water-soluble OC, and significant contributions of fossil SOC (37-52% in summer months, 70-73% in winter months) are observed. Therefore, more studies are needed to reconcile the differences in the source attribution of SOC measurements.

East China plains: a "basin" of ozone pollution.

Economic growth and associated pollution emissions in China are concentrated over three connected plains to the east In this work, we analyze an episode of highly elevated ozone over East China on June 9-14, 2004, using a 3-D chemical transport model. During this episode, the East China plains were under a high-pressure system, which suppressed the ventilation of pollutants from the boundary layer. Simulated ozone concentrations over a major fraction of East China reached high levels, all the way down to the Pearl River Delta region in the southern border. The convergence of pollutant emissions and population over the vast stretch of the geographically flat plains of East China makes the region susceptible to high-ozone exposure. During this episode, the high-03 region extended over an area >1 million km2, which hosts a population of >800 million people. Model results indicate that controlling anthropogenic NOx emissions effectively reduces the area with high-ozone exposure.

Assessment of biomass burning emissions and their impacts on urban and regional PM2.5: a Georgia case study.

Biomass burning is a major and growing contributor to particulate matter with an aerodynamic diameter less than 2.5 microm (PM2.5). Such impacts (especially individual impacts from each burning source) are quantified using the Community Multiscale Air Quality (CMAQ) Model, a chemical transport model (CTM). Given the sensitivity of CTM results to uncertain emission inputs, simulations were conducted using three biomass burning inventories. Shortcomings in the burning emissions were also evaluated by comparing simulations with observations and results from a receptor model. Model performance improved significantly with the updated emissions and speciation profiles based on recent measurements for biomass burning: mean fractional bias is reduced from 22% to 4% for elemental carbon and from 18% to 12% for organic matter; mean fractional error is reduced from 59% to 50% for elemental carbon and from 55% to 49% for organic matter. Quantified impacts of biomass burning on PM2.5 during January, March, May, and July 2002 are 3.0, 5.1, 0.8, and 0.3 microg m(-3) domainwide on average, with more than 80% of such impacts being from primary emissions. Impacts of prescribed burning dominate biomass burning impacts, contributing about 55% and 80% of PM2.5 in January and March, respectively, followed by land clearing and agriculture field burning. Significant impacts of wildfires in May and residential wood combustion in fireplaces and woodstoves in January are also found.