Mental health inequality between urban and rural youth under COVID-19 from survey data from China.

Background: While health inequality has been the focus of past scholarly discussions, COVID-19's outbreak and spread have provided a new arena for discussing health inequality, particularly in the context of urban-rural disparities in China. This paper explores the impact of COVID-19 on urban-rural health inequality, and the roles played by socioeconomic status and social capital. Methods: A cross-sectional observational collected data on demographics, mental health, socioeconomic status, and social capital. An online survey was administered from August 27 to August 30, 2020, and, 1936 valid samples were received. Mental health was measured using the Brief Symptom Inventory (BSI-18). This study applied the ordinary least squares regression (OLS) model, and data analysis was performed using STATA. Results: There were 1936 participants, with an equal distribution of genders. Multiple regression analysis showed that the mental health levels of rural youth were superior to those of urban youth (p = 0.049), especially when the epidemic was not severe (p = 0.013). Socioeconomic status had a significant positive promotion effect on mental health (p = 0.008), but the interaction effect between socioeconomic status and the urban-rural divide indicated that the promotion effect of socioeconomic status on the mental health of urban youth was greater than that of rural youth (p = 0.04). Social capital had a significant positive promotion effect on mental health (p = 0.000), and the interaction effect indicated that this promoting effect did not differ between urban and rural areas (p > 0.05).

Health impact assessment of the surface water pollution in China.

China suffers from severe surface water pollution. Health impact assessment could provide a novel and quantifiable metric for the health burden attributed to surface water pollution. This study establishes a health impact assessment method for surface water pollution based on classic frameworks, integrating the multi-pollutant city water quality index (CWQI), informative epidemiological findings, and benchmark public health information. A relative risk level assignment approach is proposed based on the CWQI, innovatively addressing the challenge in surface water-human exposure risk assessment. A case study assesses the surface water pollution-related health impact in 336 Chinese cities. The results show (1) between 2015 and 2022, total health impact decreased from 3980.42 thousand disability-adjusted life years (DALYs) (95 % Confidence Interval: 3242.67-4339.29) to 3260.10 thousand DALYs (95 % CI: 2475.88-3641.35), measured by total cancer. (2) The annual average health impacts of oesophageal, stomach, colorectal, gallbladder, and pancreatic cancers added up to 2621.20 thousand DALYs (95 % CI: 2095.58-3091.10), revealing the significant health impact of surface water pollution on digestive cancer. (3) In 2022, health impacts in the Beijing-Tianjin-Hebei and surroundings, the Yangtze River Delta, and the middle reaches of the Yangtze River added up to 1893.06 thousand DALYs (95 % CI: 1471.82-2097.88), showing a regional aggregating trend. (4) Surface water pollution control has been the primary driving factor to health impact improvement, contributing -3.49 % to the health impact change from 2015 to 2022. It is the first city-level health impact map for China's surface water pollution. The methods and findings will support the water management policymaking in China and other countries suffering from water pollution.

Occurrence and seasonal variations of organophosphate flame retardants in air and dust from college microenvironments at Qingdao, China: Implications for student's exposure and risk assessment.

Organophosphate flame retardants (OPFRs) are widely used as alternatives to brominated flame retardants in a variety of consumer products and their consumption has continuously increased in recent years. However, their concentrations and human exposures in indoor microenvironments, particularly in a university environment, have received limited attention. In this study, the concentrations and seasonal variations of 15 OPFRs were assessed in typical microenvironments of two universities, including dormitories, offices, public microenvironments (PMEs: classroom, dining hall, gymnasium and library), and laboratories on the northern coast of China. Analysis of the OPFRs in both air and dust samples indicated widespread distribution in college campuses. The average concentration of ∑15OPFRs in the winter (12,774.4 ng/g and 5.3 ng/m3 for dust and air, respectively) was higher than in the summer (2460.4 ng/g and 4.6 ng/m3 for dust and air, respectively). The dust and air samples collected from PMEs and laboratories exhibited higher concentrations of OPFRs, followed by offices and dormitories. An equilibrium was reached between dust and air in all collected microenvironments. The daily intakes of OPFRs were significantly lower than the reference dose. Dust ingestion was the primary intake pathway in the winter, while inhalation and dust ingestion were the main intake pathways in the summer. The non-carcinogenic hazard quotients fell within the range of 10-7-10-3 in both the summer and winter, which are below the theoretical risk threshold. For the carcinogenic risk, the LCR values ranged from 10-10 to 10-8, indicating no elevated carcinogenic risk due to TnBP, TCEP, and TDCP in indoor dust and air.

Cost-Effective Cathode Interlayer Material for Scalable Organic Photovoltaic Cells.

Organic photovoltaic (OPV) cells have demonstrated remarkable success on the laboratory scale. However, the lack of cathode interlayer materials for large-scale production still limits their practical application. Here, we rationally designed and synthesized a cathode interlayer, named NDI-Ph. Benefiting from their well-modulated work function and self-doping effect, NDI-Ph-based binary OPV cells achieve an excellent power conversion efficiency (PCE) of 19.1%. NDI-Ph can be easily synthesized on a 100 g scale with a low cost of 1.96 $ g-1 using low-cost raw materials and a simple postprocessing method. In addition, the insensitivity to the film thickness of NDI-Ph enables it to maintain a high PCE at various coating speeds and solution concentrations, demonstrating excellent adaptability for high-throughput OPV cell manufacturing. As a result, a module with 21.9 cm2 active area achieves a remarkable PCEactive of 15.8%, underscoring the prospects of NDI-Ph in the large-scale production of OPV cells.

Completely Non-Fused Low-Cost Acceptor Enables Organic Photovoltaic Cells with 17 % Efficiency.

To meet the industrial requirements of organic photovoltaic (OPV) cells, it is imperative to accelerate the development of cost-effective materials. Thiophene-benzene-thiophene central unit-based acceptors possess the advantage of low synthetic cost, while their power conversion efficiency (PCE) is relatively low. Here, by incorporating a para-substituted benzene unit and 1st-position branched alkoxy chains with large steric hindrance, a completely non-fused non-fullerene acceptor, TBT-26, was designed and synthesized. The narrow band gap of 1.38 eV ensures the effective utilization of sunlight. The favorable phase separation morphology of TBT-26-based blend film facilitates the efficient exciton dissociation and charge transport in corresponding OPV cell. Therefore, the TBT-26-based small-area cell achieves an impressive PCE of 17.0 %, which is the highest value of completely non-fused OPV cells. Additionally, we successfully demonstrated the scalability of this design by fabricating a 28.8 cm2 module with a high PCE of 14.3 %. Overall, our work provides a practical molecular design strategy for developing high-performance and low-cost acceptors, paving the way for industrial applications of OPV technology.

Characterizing the water resource-environment-ecology system harmony in Chinese cities using integrated datasets: A Beautiful China perspective assessment.

Integrated management and synergistic improvement of the water system is a topic of widespread concern. This study innovatively integrates three functions of quality assessment, synergy evaluation, and driving influence determination to establish a systematic framework assessing water system harmony. A case study of 336 Chinese cities is further performed by combining multi-scale and multi-source datasets. The results show China's water system quality has improved from 2015 to 2022. Development in the water resource, environment, and ecology subsystems have been differentiated, with 0.05 %, 4.33 %, and -1.64 % changes, respectively. The degradation of water ecology and the weak synergy with the other two subsystems have limited China's water system harmony. Water environment improvement played a contributive role in improving the water system quality. The contribution structure of water resources, environment, and ecology has shifted towards equilibrium in recent years. We found and highlighted the north-south differentiation of water system harmony in Chinese cities. The Beijing-Tianjin-Hebei and its surroundings, the Yangtze River Delta, and the middle reaches of the Yangtze River are identified as priority regions for water system harmony improvement. The primary contribution of this study is to propose an assessing concept of water resource-environment-ecology system harmony, establish well-structured assessment methods, and integrate the multiple data sources. The novel methods and findings, including the indicator system, application of data mining and decomposing methods, and the city-level water system harmony map, deconstruct and quantify the complex and diverse water system, supporting clearer and more efficient water management policymaking.

How changes in landscape patterns affect the carbon emission: a case study in the Chengdu-Chongqing Economic Circle, China.

The construction of low-carbon cities is an optimal means to balance the competing interests of economic growth and carbon emission reduction. This study focuses on the optimization of land use patterns with a low carbon orientation, taking the Chengdu-Chongqing Economic Circle (CCEC), the fourth-largest economic growth pole in China, as an example. The panel data regression analysis is carried out to identify the dynamic correlations between the landscape changes and the carbon emission induced by land use and land cover change (LICE) of each city, each year, for the last 20 years. The results show that the CCEC has witnessed a 142.85% increase in carbon emissions during the period studied, with the growth of built-up land contributing 94% of total carbon emissions from 2000 to 2020. By constructing the panel regression model, this study finds that the intensity of carbon emissions increases significantly as the urban built-up land area and the agglomeration of artificial structures increase. The conversion of cropland, which dominates the landscape pattern, to built-up land has led to further fragmentation of the landscape pattern and a reduction in LPI, thus increasing carbon emissions. And a more complex regional landscape pattern will have a positive impact on carbon emission reduction. Based on the above findings, suggestions are articulated for carbon emission reduction.

Deletion of the mitochondrial calcium uniporter in adipose tissue promotes energy expenditure and alleviates diet-induced obesity.

OBJECTIVE: Studies have shown a correlation between obesity and mitochondrial calcium homeostasis, yet it is unclear whether and how Mcu regulates adipocyte lipid deposition. This study aims to provide new potential target for the treatment of obesity and related metabolic diseases, and to explore the function of Mcu in adipose tissue. METHODS: We firstly investigated the role of mitoxantrone, an Mcu inhibitor, in the regulation of glucose and lipid metabolism in mouse adipocytes (3T3-L1 cells). Secondly, C57BL/6J mice were used as a research model to investigate the effects of Mcu inhibitors on fat accumulation and glucose metabolism in mice on a high-fat diet (HFD), and by using CRISPR/Cas9 technology, adipose tissue-specific Mcu knockdown mice (Mcufl/+ AKO) and Mcu knockout of mice (Mcufl/fl AKO) were obtained, to further investigate the direct effects of Mcu on fat deposition, glucose tolerance and insulin sensitivity in mice on a high-fat diet. RESULTS: We found the Mcu inhibitor reduced adipocytes lipid accumulation and adipose tissues mass in mice fed an HFD. Both Mcufl/+ AKO mice and Mcufl/fl AKO mice were resistant to HFD-induced obesity, compared to control mice. Mice with Mcufl/fl AKO showed improved glucose tolerance and insulin sensitivity as well as reduced hepatic lipid accumulation. Mechanistically, inhibition of Mcu promoted mitochondrial biogenesis and adipocyte browning, increase energy expenditure and alleviates diet-induced obesity. CONCLUSIONS: Our study demonstrates a link between adipocyte lipid accumulation and mCa2+ levels, suggesting that adipose-specific Mcu deficiency alleviates HFD-induced obesity and ameliorates metabolic disorders such as insulin resistance and hepatic steatosis. These effects may be achieved by increasing mitochondrial biosynthesis, promoting white fat browning and enhancing energy metabolism.

Assessing urban park equity in Chaoyang District, Beijing using online review data.

Urban parks are essential components of urban ecosystems, providing vital ecological resources for city residents. However, the rapid expansion of high-density urban areas has led to an unequal distribution of park resources, raising growing concerns about spatial equity. To address these challenges, we employed an improved Gaussian two-step floating catchment area (2SFCA) method, considering park quality variations and integrating sentiment scores from park reviews to calculate a comprehensive park accessibility index, accounting for both supply and demand dynamics among park users. The results demonstrate the significance of park management, as users prioritise convenience and cleanliness of public facilities. Recreational quality significantly influences park distribution equity, with areas near Beijing's initial greenbelt zone showing improved accessibility (IA). Nonetheless, our analysis exposes disparities in urban park resource allocation within the Chaoyang District, indicating relative inequity. Spatial supply and demand mismatches, especially in the northwest and southeast, are evident. To enhance park layout equity, we recommend strategies like identifying and repurposing underused spaces, establishing pocket parks and micro-green areas, and improving recreational facilities. It is crucial to address the needs of vulnerable groups such as older residents and children. These insights stress the importance of ensuring fair urban park access to enhance the well-being of all city residents.

Assessment of the relationship between plasma fibrinogen-to-albumin ratio and slow coronary flow phenomenon in patients without obstructive coronary artery disease.

BACKGROUND: Prior studies have suggested that the chronic inflammatory response has an important role in the pathophysiology of slow coronary flow phenomenon (SCFP). However, data are scarce regarding the role of plasma fibrinogen-to-albumin ratio (PFAR) in patients having SCFP without obstructive coronary artery disease (CAD). In this study, we investigated the relationship between PFAR and the presence of SCFP in patients without obstructive CAD. METHODS: From January 2021 to January 2023, we consecutively recruited 1085 patients without obstructive CAD according to the diagnostic and exclusion criteria. In total, SCFP was diagnosed in 70 patients. A 1:2 age-matched case-control study was then conducted using comparators without SCFP. Ultimately, this study enrolled 70 patients with angiographically normal coronary arteries and SCFP, along with 140 comparators with angiographically normal coronary arteries and normal coronary flow. Plasma fibrinogen and albumin levels were measured, and the PFAR was then calculated for each patient. RESULTS: PFARs were significantly greater in the SCFP group than in the comparators with normal coronary flow (82.8 ± 15.4 vs 73.1 ± 19.5, p < 0.001). PFAR increased with increasing numbers of vessels affected by SCFP. Multivariate logistic regression analysis showed that PFAR was an independent predictor of SCFP (odds ratio: 1.818, p = 0.015). Receiver operating characteristic (ROC) curve analysis indicated that PFAR showed a better predictive value of SCFP than fibrinogen or albumin, although not significantly (p > 0.05). CONCLUSION: PFAR is an independent predictor of SCFP in patients without obstructive CAD. PAFR could improve the predictive value of SFCP than albumin or fibrinogen alone, but not significantly.

An eHealth Program for Insomnia in Children With Neurodevelopmental Disorders (Better Nights, Better Days): Protocol for an Economic Evaluation of a Randomized Controlled Trial.

BACKGROUND: Children with neurodevelopmental disorders have a high risk of sleep disturbances, with insomnia being the most common sleep disorder (ie, chronic and frequent difficulties with going and staying asleep). Insomnia adversely affects the well-being of these children and their caregivers. Pediatric sleep experts recommend behavioral interventions as the first-line treatment option for children. Better Nights, Better Days for Children with Neurodevelopmental Disorders (BNBD-NDD) is a 5-session eHealth behavioral intervention delivered to parents to improve outcomes (eg, Pediatric Quality of Life Inventory [PedsQL]) for their children (ages 4-12 years) with insomnia and who have a diagnosis of mild to moderate attention-deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, or fetal alcohol spectrum disorder. If cost-effective, BNBD-NDD can be a scalable intervention that provides value to an underserved population. OBJECTIVE: This protocol outlines an economic evaluation conducted alongside the BNBD-NDD randomized controlled trial (RCT) that aims to assess its costs, efficacy, and cost-effectiveness compared to usual care. METHODS: The BNBD-NDD RCT evaluates the impacts of the intervention on children's sleep and quality of life, as well as parents' daytime functioning and psychosocial health. Parent participants were randomized to the BNBD-NDD treatment or to usual care. The economic evaluation assesses outcomes at baseline and 8 months later, which include the PedsQL as the primary measure. Quality of life outcomes facilitate the comparison of competing interventions across different populations and medical conditions. Cost items include the BNBD-NDD intervention and parent-reported usage of private and publicly funded resources for their children's insomnia. The economic evaluation involves a reference case cost-effectiveness analysis to examine the incremental cost of BNBD-NDD per units gained in the PedsQL from the family payer perspective and a cost-consequence analysis from a societal perspective. These analyses will be conducted over an 8-month time horizon. RESULTS: Research funding was obtained from the Kids Brain Health Network in 2015. Ethics were approved by the IWK Health Research Ethics Board and the University of Calgary Conjoint Health Research Ethics Board in January 2019 and June 2022, respectively. The BNBD-NDD RCT data collection commenced in June 2019 and ended in April 2022. The RCT data are currently being analyzed, and data relevant to the economic analysis will be analyzed concurrently. CONCLUSIONS: To our knowledge, this will be the first economic evaluation of an eHealth intervention for insomnia in children with neurodevelopmental disorders. This evaluation's findings can inform users and stakeholders regarding the costs and benefits of BNBD-NDD. TRIAL REGISTRATION: ClinicalTrial.gov NCT02694003; https://clinicaltrials.gov/study/NCT02694003. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46735.

Prevalence, predictors, and management for balloon uncrossable or undilatable lesions in patients undergoing percutaneous coronary intervention with in-stent restenosis chronic total occlusion.

Background: Percutaneous coronary intervention for in-stent restenosis (ISR) chronic total occlusion (CTO) has been a great challenge. There are occasions when the balloon is uncrossable or undilatable (BUs) even though the guidewire has passed, leading to failure of the procedure. Few studies have focused on the incidence, predictors, and management of BUs during ISR-CTO intervention. Methods: Patients with ISR-CTO were recruited consecutively between January 2017 and January 2022 and divided into two groups based on the presence of BUs. The clinical data of the two groups (BUs group and non-BUs group) were retrospectively analyzed and compared to explore the predictors and clinical management strategies of BUs. Results: A total of 218 patients with ISR-CTO were included in this study, 23.9% (52/218) of whom had BUs. The percentage of ostial stents, stent length, CTO length, the presence of proximal cap ambiguity, moderate to severe calcification, moderate to severe tortuosity, and J-CTO score were higher in the BUs group than in the non-BUs group (p < 0.05). The technical success rate and the procedural success rate were lower in the BUs group than in the non-BUs group (p < 0.05). Multivariable logistic regression analysis showed that ostial stents (OR: 2.011, 95% CI: 1.112-3.921, p = 0.031), the presence of moderate to severe calcification (OR: 3.383, 95% CI: 1.628-5.921, p = 0.024) and moderate to severe tortuosity (OR: 4.816, 95% CI: 2.038-7.772, p = 0.033) were independent predictors of BUs. Conclusion: The initial rate of BUs in ISR-CTO was 23.9%. Ostial stents, presence of moderate to severe calcification, and moderate to severe tortuosity were independent predictors of BUs.

Assessing the Beautiful China Initiative from an environmental perspective: indicators, goals, and provincial performance.

The Beautiful China Initiative (BCI) is part of China's national strategy for implementing the long-term goals of building an ecological civilization and promoting sustainable development. However, currently, there is no goal-oriented, comparable, and standardized indicator framework for monitoring the performance of the BCI. Here, we established the BCI from an environmental perspective (BCIE) index comprising 40 indicators and targets in eight fields and used a systematic approach to measure the distance and progress towards the goal of building a "Beautiful China" by 2035 at the national and subnational levels. Our analyses indicate that the BCIE index score (range: [0, 1]) was 0.757 at the national level and 0.628-0.869 at the provincial level in 2020. Between 2015 and 2020, the BCIE index scores of all provinces improved; however, large spatio-temporal variations were evident. Provinces with better BCIE performances exhibited relatively balanced scores across different sectors and cities. Our study revealed that the BCIE index scores at the city level surpassed provincial administrative boundaries, resulting in a wider range of aggregation. By focusing on the strategic arrangement of BCI, this study provides an effective index system and evaluation method for dynamic monitoring and phased evaluations at all levels of government in China.

Assessment of a novel variation in DHODH gene causing Miller syndrome: The first report in Chinese population.

BACKGROUND: Miller syndrome is a rare type of postaxial acrofacial dysostosis caused by biallelic mutations in the DHODH gene, which is characterized mainly by craniofacial malformations of micrognathia, orofacial clefts, cup-shaped ears, and malar hypoplasia, combined with postaxial limb deformities like the absence of fifth digits. METHODS: In this study, a prenatal case with multiple orofacial-limb abnormities was enrolled, and a thorough clinical and imaging examination was performed. Subsequently, genetic detection with karyotyping, chromosomal microarray analysis (CMA) and whole-exome sequencing (WES) was carried out. In vitro splicing analysis was also conducted to clarify the impact of one novel variant. RESULTS: The affected fetus displayed typical manifestations of Miller syndrome, and WES identified a diagnostic compound heterozygous variation in DHODH, consisting of two variants: exon(1-3)del and c.819 + 5G > A. We conducted a further in vitro validation with minigene system, and the result indicated that the c.819 + 5G > A variant would lead to an exon skipping in mRNA splicing. CONCLUSIONS: These findings provided with the first exonic deletion and first splice site variant in DHODH, which expanded the mutation spectrum of Miller syndrome and offered reliable evidence for genetic counseling to the affected family.

Large Steric Hindrance Enhanced Molecular Planarity for Low-Cost Non-Fused Electron Acceptors.

Designing efficient non-fused ring electron acceptors is of great importance in decreasing the material cost of organic photovoltaic cells (OPVs). It is a challenge to construct a planar molecular skeleton in non-fused molecules as there are many torsions between adjacent units. Here, we design two non-fused electron acceptors based on bithieno[3,2-b]thiophene units as core structures and study the impact of steric hindrance of substituents on molecular planarity. We use 2,4,6-triisopropylphenyl and 4-hexylphenyl groups to prepare ATTP-1 and ATTP-2, respectively. Our results suggest that the enhanced steric hindrance is beneficial for obtaining a more planar molecular configuration, which significantly increases the optical absorption and charge transport properties. The power conversion efficiency (PCE) of PBDB-TF:ATTP-1 combination (11.3%) is superior to that of PBDB-TF:ATTP-2 combination (3.7%). In addition, an impressive PCE of 10.7% is recorded in ATTP-1-based devices when a low-cost polythiophene donor PDCBT is used, which is an outstanding value in OPVs fabricated by non-fused donor/acceptor combinations. Our work demonstrates that modulation of the steric hindrance effect is of great significance to control the molecular planarity and thus obtain excellent photovoltaic performance of low-cost non-fused electron acceptors.

Indicators, Goals, and Assessment of the Water Sustainability in China: A Provincial and City-Level Study.

The United Nations and scholars called for more attention and efforts for cleaner water and water sustainability. This study established a water sustainability evaluating method framework, including indicators, goals, and methods and performs provincial and city-level assessments as case studies. The framework involves six fields, surface water quality, marine environmental quality, water-soil-agriculture, water infrastructure, water conservation, aquatic ecology, water-efficient use, and pollutant emission reduction. The methods innovatively integrate multi fields and concerns of water sustainability while providing a goal-oriented evaluation and implementing the United Nations' call for the refinement and clarification of SDGs. China's overall water sustainability was evaluated as 0.821 in 2021, and have performed well in surface water quality, sea quality, water conservation, and aquatic ecology fields while performing poorly in the water-soil-agriculture field. The overall strategy, policy, and action for water sustainability could be developed based on the evaluation. The water sustainability evaluation presented the regional and field/indicator differentiations. It is necessary to implement regionally classified policies and differentiated management for sustainable water development. The correlation analysis with socioeconomic factors implies the complicated and intimate interaction between socioeconomic development and water sustainability while revealing that development stages and the inherent conditions of natural ecology and water sources bring about the differentiations. A comprehensive evaluation of water sustainability may be three-dimensional, involving water quality and ecology, development related to water, and water resources and utilization.

Can the Sci-Tech Innovation Increase the China's Green Brands Value?-Evidence from Threshold Effect and Spatial Dubin Model.

Based on the perspective of the innovation value chain, sci-tech innovation is divided into two stages: R&D and achievement transformation. This paper uses panel data from 25 provinces in China as the sample. We utilize a two-way fixed effect model, spatial Dubin model, and panel threshold model to discuss the impact of two-stage innovation efficiency on the value of the green brand, the spatial effect of this impact, and the threshold role of intellectual property protection in the process. The results indicate that: (1) the two stages of innovation efficiency have a positive impact on the value of green brands, and the effect of the eastern region is significantly better than that of the central and western regions. (2) The spatial spillover effect of the two stages of regional innovation efficiency on the value of green brands is evident, especially in the eastern region. (3) The innovation value chain has a pronounced spillover effect. (4) The single threshold effect of intellectual property protection is significant. When the threshold is crossed, the positive impact of the two stages of innovation efficiency on the value of green brands is significantly enhanced. (5) The influence of economic development level, openness, market size, and marketization degree on the value of green brands shows remarkable regional differences. In conclusion, this study contributes to understanding green brands' growth and provides important implications for developing independent brands in various regions of China.

Systematic literature review of health economic models developed for multiple myeloma to support future analyses.

AIMS: The goal of this study was to review the economic evaluations of health technologies in multiple myeloma (MM) and provide guidance and recommendations for future health economic analyses. MATERIALS AND METHODS: A systemic literature review (SLR) was conducted on original economic assessment studies and structured review papers focusing on the studies in MM. The search was limited to English language papers published from 1 January 2000 onwards. Publications not applying any type of modelling methodology to describe disease progression and patient pathways over a specific time horizon were excluded. RESULTS: A total of 2,643 publications were initially identified, of which 148 were eligible to be included in the full-text review phase. From these, 49 publications were included in the final analysis. Most published health economic analyses supported by models came from high-income countries. Evaluations from middle-income countries were rarely published. Diagnostic technologies were rarely modelled and integrated care had not been modelled. Very few models investigated MM treatments from a societal perspective and there was a relative lack of evaluations regarding minimal residual disease (MRD). LIMITATIONS: Limitations of the publications included differences between trial populations and modelled populations, justification of methods, lack of confounder analyses, and small trial populations. Limitations of our study included the infeasibility of comparing MM economic evaluations due to the significant variance in modelled therapeutic lines and indications, and the relative scarcity of published economic evaluations from non-high-income countries. CONCLUSIONS: As published economic models lacked many of the elements of the complex and heterogeneous patient pathways in MM and they focused on single decision problems, a thorough, open-source economic whole disease modelling framework is needed to assess the economic value of a wide range of technologies across countries with various income levels with a more detailed view on MM, by including patient-centric and societal aspects.

A Depression-Risk Mental Pattern Identified by Hidden Markov Model in Undergraduates.

Few studies have examined depression risk screening approaches. Universal depression screening in youth typically focuses on directly measuring the current distress and impairment by several kinds of depression rating scales. However, as many people have stigmatizing attitudes to individuals with depression, youths with depression were in fear of being known, and embarrassment held them back from reporting their depression symptoms. Thus, the present study aimed to identify the best, most easy access screening approach for indirectly predicting depression risks in undergraduates. Here, the depression score was ranked and viewed as the different stages in the development of depression; then, we used a Hidden Markov Model (HMM) approach to identify depression risks. Participants included 1247 undergraduates (female = 720, mean age = 19.86 years (std =1.31), from 17 to 25) who independently completed inventories for depressive symptoms, emotion regulation, subjective well-being (life satisfaction, negative and positive affect), and coping styles (positive and negative). Our findings indicated that the risk pattern (state 1) and the health pattern (state 2) showed distinct different rating results in emotional regulation, subjective well-being, and coping style. Screening for prospective risk of depression can be better accomplished by HMM incorporating subjective well-being, emotion regulation, and coping style. This study discussed the implications for future research and evidence-based decision-making for depression screening initiatives.

Tracking short-term health impacts attributed to ambient PM2.5 and ozone pollution in Chinese cities: an assessment integrates daily population.

Joint and synergistic control of PM2.5 and ozone pollution is an urgent need in China and a global-widely concerned issue. Health impact assessment could provide a comprehensive perspective for PM2.5-ozone coordinated control strategies. For a detailed understanding of the seasonality and regionality of the health impacts attributed to PM2.5 and ozone in China, this study extended the classic health impact function by daily population and assessed the short-term (daily) health impacts in 335 Chinese cities in 2021. Population migration indexes from Baidu were introduced to estimate the cities' daily population. Using this method, we quantitatively investigated the influence of population on short-term health impact assessment and identified which was significant in the Pearl River Delta (PRD) region and other populous cities. Although the annual sums of PM2.5- and ozone-related daily health impacts were close for all Chinese cities, the PM2.5-related health impact was equivalent to 333.96% and 32.07% of that ozone-related, during the cold and warm periods. The correlation and local spatial association analysis found significant city-specific and city-cluster associations of daily health impacts during the warm period and in Beijing-Tianjin-Hebei and surrounding regions (BTHS) and the Yangtze River Delta (YRD). Policymakers could promote period- and pollutant-targeted control actions for the major city groups, especially the BTHS, YRD, and PRD. Our methods and findings investigated the various influences of the population on short-term health impact assessment and proposed the PM2.5-ozone collaborative control idea for key regions and city groups.