A Comparison of Quality of Life, Cosmesis and Cost-Utility of Open Surgery, Vacuum-Assisted Breast Biopsy and High Intensity Focused Ultrasound for Breast Fibroadenoma.

RATIONALE AND OBJECTIVES: To compare the quality of life (QOL), cosmesis and cost-utility of open surgery (OS), vacuum-assisted breast biopsy (VABB) and high intensity focused ultrasound (HIFU) for fibroadenoma (FA). MATERIALS AND METHODS: A total of 162 patients with 267 FAs were enrolled. Baseline characteristics and treatment information were recorded. Patients were followed up at 3-, 6- and 12-month post-treatment. QOL was evaluated by health survey. Breast cosmesis was evaluated by self-rating survey and Harvard Scale. A decision-analytic model was established and incremental cost was calculated for cost-utility analysis. RESULTS: For QOL evaluation, there was no difference of physical component summary (PCS) score in three groups (P > 0.05), while the mental component summary (MCS) score was significantly higher in HIFU group than the other two groups at 3- and 6-month post-treatment (P < 0.05). The proportion of patients satisfied with breast cosmesis was significantly higher in HIFU group (96.49%) than in VABB group (54.90%) and OS group (49.99%) (P < 0.05). By Harvard Scale, 27.78%, 78.42% and 100.00% of patients were rated as excellent and good in OS group, VABB group and HIFU group, respectively (P < 0.05). To acquire a quality-adjusted life year (QALY), cost of OS, VABB and HIFU was 1034.31 USD, 1776.96 USD and 1277.67 USD, respectively. When compared to OS, incremental cost analysis showed HIFU was cost-effective, while VABB was not. CONCLUSION: OS, VABB and HIFU were all effective and safe for FA, but among these three treatments, HIFU had the best QOL improvement, breast cosmesis and cost-effectiveness.

Multifunctional bimetallic MOF with oxygen vacancy synthesized by microplasma for rapid total antioxidant capacity assessment in agricultural products.

The assessment of total antioxidant capacity (TAC) is crucial for evaluating overall antioxidant potential, predicting the risk of chronic diseases, guiding dietary and nutritional interventions, and studying the effectiveness of antioxidants. However, achieving rapid TAC assessment with high sensitivity and stability remains a challenge. In this study, Ce/Fe-MOF with abundant oxygen vacancies was synthesized using microplasma for TAC determination. The microplasma synthesis method was rapid (30 min) and cost-effective. The presence of oxygen vacancies and the collaboration between iron and cerium in Ce/Fe-MOF not only enhanced the catalyst's efficiency but also conferred multiple enzyme-like properties: peroxidase-like, oxidase-like, and superoxide dismutase mimetic activities. Consequently, a simple colorimetric assay was established for TAC determination in vegetables and fruits, featuring a short analysis time of 15 min, a good linear range of 5-60 µM, a low detection limit of 1.3 µM and a good recovery of 91 %-107 %. This method holds promise for rapid TAC assessment in agricultural products.

Impacts of the zero mark-up policy on hospitalization expenses of T2DM and cholecystolithiasis inpatients in SC province, western China: an interrupted time series analysis.

Background: Since 2009, a series of ambitious health system reforms have been launched in China, including the zero mark-up drug policy (ZMDP); the policy was intended to reduce substantial medicine expenses for patients by abolishing the 15% mark-up on drugs. This study aims to evaluate the impacts of ZMDP on medical expenditures from the perspective of disease burden disparities in western China. Method: Two typical diseases including Type 2 diabetes mellitus (T2DM) in internal medicine and cholecystolithiasis (CS) in surgery were selected from medical records in a large tertiary level-A hospital in SC Province. The monthly average medical expenses of patients from May 2015 to August 2018 were extracted to construct an interrupted time series (ITS) model to evaluate the impact of policy implementation on the economic burden. Results: A total of 5,764 cases were enrolled in our study. The medicine expenses for T2DM patients maintained a negative trend both before and after the intervention of ZMDP. It had declined by 74.3 CNY (P < 0.001) per month on average in the pre-policy period and subsequently dropped to 704.4 CNY (P = 0.028) immediately after the policy. The level change of hospitalization expenses was insignificant (P = 0.197), with a reduction of 677.7 CNY after the policy, while the post-policy long-term trend was significantly increased by 97.7 CNY (P = 0.035) per month contrasted with the pre-policy period. In addition, the anesthesia expenses of T2DM patients had a significant increase in the level under the impact of the policy. In comparison, the medicine expenses of CS patients significantly decreased by 1,014.2 CNY (P < 0.001) after the policy, while the total hospitalization expenses had no significant change in level and slope under the influence of ZMDP. Furthermore, the expenses of surgery and anesthesia for CS patients significantly increased by 320.9 CNY and 331.4 CNY immediately after the policy intervention. Conclusion: Our study indicated that the ZMDP has been an effective intervention to reduce the excessive medicine expenses for both researched medical and surgical diseases, but failed to show any long-term advantage. Moreover, the policy has no significant impact on relieving the overall hospitalization burden for either condition.

Bioinformatic analysis and validation of cardiac hypertrophy-related genes.

In this study, we have screened genes involved in myocardial hypertrophy (MH) using a mice model for compensatory stress overload (transverse aortic constriction, TAC) and bioinformatics. Microarrays were downloaded, and according to the Venn diagram, three groups of data intersections were obtained. Gene function was analyzed by Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG), whereas protein-protein interactions (PPI) were analyzed using the STRING database. A mouse aortic arch ligation model was established to verify and screen the expression of hub genes. A total of 53 (DEGs) and 32 PPI genes were screened out. GO analysis showed DEGs mainly involved in cytokine and peptide inhibitor activity. KEGG analysis focused on ECM receptor interaction and osteoclast differentiation. Expedia co-expression gene network analysis showed that Serpina3n, Cdkn1a, Fos, Col5a2, Fn1 and Timp1 participated in the occurrence and development of MH. RT-qPCR verified that all the other 9 hub genes except Lox were highly expressed in TAC mice. This study lays a foundation for further study on the molecular mechanism of MH and for screening of molecular markers.

Prognostic Assessment of Oxidative Stress-Related Genes in Colorectal Cancer and New Insights into Tumor Immunity.

Oxidative stress is crucial to the biology of tumors. Oxidative stress' potential predictive significance in colorectal cancer (CRC) has not been studied; nevertheless here, we developed a forecasting model based on oxidative stress to forecast the result of CRC survival and enhance clinical judgment. The training set was chosen from the transcriptomes of 177 CRC patients in GSE17536. For validation, 65 samples of colon cancer from GSE29621 were utilized. For the purpose of choosing prognostic genes, the expression of oxidative stress-related genes (OXEGs) was found. Prognostic risk models were built using multivariate Cox regression analysis, univariate Cox regression analysis, and LASSO regression analysis. The outcomes of the western blot and transcriptome sequencing tests were finally confirmed. ATF4, CARS2, CRP, GPX1, IL1B, MAPK8, MRPL44, MTFMT, NOS1, OSGIN2, SOD2, AARS2, and FOXO3 were among the 14 OXEGs used to build prognostic characteristics. Patients with CRC were categorized into low-risk and high-risk groups according on their median risk scores. Cox regression analysis using single and multiple variables revealed that OXEG-related signals were independent risk factors for CRC. Additionally, the validation outcomes from western blotting and transcriptome sequencing demonstrated that OXEGs were differently expressed. Using 14 OXEGs, our work creates a predictive signature that may be applied to the creation of new prognostic models and the identification of possible medication candidates for the treatment of CRC.

Multi-period uncertain portfolio selection model with prospect utility function.

In this paper, we discuss a multi-period portfolio optimization problem based on uncertainty theory and prospect theory. We propose an uncertain multi-period portfolio selection model, in which the return utility and risk of investment are measured by prospect theory utility function and uncertain semivariance. More realistically, the influence of transaction costs and bankruptcy of investor are also considered. Moreover, to solve the portfolio model, this paper designs a new artificial bee colony algorithm by combining sine cosine search method. Finally, a numerical experiment is presented to demonstrate the proposed model and the effectiveness of the designed algorithm.

Incorporating Near-Pseudocapacitance Insertion Ni/Co-Based Hexacyanoferrate and Low-Cost Metallic Zn for Aqueous K-Ion Batteries.

The limited availability of cathode materials with high specific capacity and significant cycling stability for aqueous K-ion batteries (AKIBs) hinder their further development owing to the large radius of K+ (1.38 Å). Prussian blue and its analogs with a three-dimensional frame structure possessing special energy storage mechanism are promising candidates as cathode materials for AKIBs. In this study, K0.2 Ni0.68 Co0.77 Fe(CN)6 ⋅ 1.8H2 O (KNCHCF) was prepared as a cathode material for AKIBs. Both the electrochemical activity of Co ions and the near-pseudocapacitance intercalation of KNCHCF enhance K+ storage. Therefore, KNCHCF exhibits a superior capacity maintenance rate of 86 % after 1000 cycles at a high current density of 3.0 A g-1 . The storage mechanism of K+ in AKIBs was revealed through ex situ X-ray diffraction, ex situ Fourier transform infrared spectroscopy, and ex situ X-ray photoelectron spectroscopy measurements. Moreover, the assembled K-Zn hybrid battery showed good cycling stability with 93.1 % capacity maintenance at 0.1 A g-1 after 50 cycles and a high energy density of 96.81 W h kg-1 . Hence, KNCHCF may be a potential material for the development of AKIBs.

Optimization Model of Financial Market Portfolio Using Artificial Fish Swarm Model and Uniform Distribution.

The central issue in finance is how to select a portfolio in the financial market. The traditional artificial fish swarm algorithm (AFSA) is optimized in this paper, and the improved AFSA is used to solve the portfolio model. This model generates a uniform distribution operator using uniform distribution and combines it with the basic fish swarm algorithm. Uniform variation occurs when the variance of the optimal value of continuous convergence is within the allowable error. In this manner, the fish can escape the trap of the local extremum, obtaining the global optimal state. To validate the feasibility of improving AFSA, this paper conducts simulation experiments on portfolio problems using MATLAB tools. Experiments show that this model has an accuracy of 93.56 percent, which is 8.43 percent higher than that of the NSGA-II model and 3.76 percent higher than that of the multiobjective optimization model. The experiment shows that the algorithm in this paper can solve these types of problems well and that, using this model, the optimal portfolio investment decision scheme satisfying investors can be obtained. The optimized AFSA presented in this paper can serve as an important reference for investment portfolios and has a wide range of application possibilities in the investment market.

A Study of Carbon Emission Efficiency in Chinese Provinces Based on a Three-Stage SBM-Undesirable Model and an LSTM Model.

As a major carbon-emitting country, there is an urgent need for China to reduce carbon emissions. Studying the carbon emission efficiency of each province helps us to learn about the characteristics and evolution of regional carbon emissions, which is important for proposing effective and targeted measures to achieve the carbon peaking and carbon neutrality goals. This paper measures the carbon emission efficiency of 30 Chinese provinces from 2006 to 2019 based on a three-stage SBM-undesirable model and explores external drivers using stochastic frontier models. The results of the SBM-undesirable model show that the inter-provincial carbon emission efficiency is unevenly distributed and shows a big difference. From the results of the stochastic frontier model analysis, external drivers such as the intensity of finance in environmental protection, the level of economic development, the industrial structure, the level of urbanization, the degree of openness and the level of science as well as technology innovation all have an impact on the emission efficiency. In terms of LSTM model prediction, the model shows an excellent fitting effect, which provides a possible path for carbon emission efficiency prediction. Finally, based on the empirical results and the actual situation of each province in China, this paper proposes relevant feasible suggestions.

Digital finance and migrant workers' urban integration: The mediation effect of the gender-earning gap.

Introduction: In the context of the wide application of digital finance, whether digital finance promotes or inhibits migrant workers' urban integration is an important issue. Methods: Based on microdata from the Chinese Social Survey (CSS) in 2019, we examined the mediation effects of inclusive digital finance on migrant workers' urban integration. Results: The empirical results showed that digital finance promotes migrant workers' integration into urban life and has positive effects. When the digital finance index increases by 1 unit, the urban integration of migrant workers also increases by 0.599 units. The usage depth and digitization degree of digital finance are positively correlated with the assimilation process of urban migrant workers, with coefficients of 0.690 and 1.282, respectively. Using the intermediary effect model, it was found that the development of digital finance promotes migrant workers' integration into urban society by narrowing the gender gap in income. One unit of digital finance increases the income of female migrant workers by 144.4% points greater than that of male migrant workers. It significantly improves the ability of female migrant workers to obtain wealth and promotes their integration into cities and family migration. Discussion: It is necessary to strengthen the promotion and utilization of digital finance to enhance its positive impact on the assimilation process of urban migrant workers by strengthening the construction of digital financial infrastructure, improving supporting policies related to the development of digital finance and improving the financial literacy of migrant workers, especially female migrant workers.

Remote Digital Psychiatry for Mobile Mental Health Assessment and Therapy: MindLogger Platform Development Study.

BACKGROUND: Universal access to assessment and treatment of mental health and learning disorders remains a significant and unmet need. There are many people without access to care because of economic, geographic, and cultural barriers, as well as the limited availability of clinical experts who could help advance our understanding and treatment of mental health. OBJECTIVE: This study aims to create an open, configurable software platform to build clinical measures, mobile assessments, tasks, and interventions without programming expertise. Specifically, our primary requirements include an administrator interface for creating and scheduling recurring and customized questionnaires where end users receive and respond to scheduled notifications via an iOS or Android app on a mobile device. Such a platform would help relieve overwhelmed health systems and empower remote and disadvantaged subgroups in need of accurate and effective information, assessment, and care. This platform has the potential to advance scientific research by supporting the collection of data with instruments tailored to specific scientific questions from large, distributed, and diverse populations. METHODS: We searched for products that satisfy these requirements. We designed and developed a new software platform called MindLogger, which exceeds the requirements. To demonstrate the platform's configurability, we built multiple applets (collections of activities) within the MindLogger mobile app and deployed several of them, including a comprehensive set of assessments underway in a large-scale, longitudinal mental health study. RESULTS: Of the hundreds of products we researched, we found 10 that met our primary requirements with 4 that support end-to-end encryption, 2 that enable restricted access to individual users' data, 1 that provides open-source software, and none that satisfy all three. We compared features related to information presentation and data capture capabilities; privacy and security; and access to the product, code, and data. We successfully built MindLogger mobile and web applications, as well as web browser-based tools for building and editing new applets and for administering them to end users. MindLogger has end-to-end encryption, enables restricted access, is open source, and supports a variety of data collection features. One applet is currently collecting data from children and adolescents in our mental health study, and other applets are in different stages of testing and deployment for use in clinical and research settings. CONCLUSIONS: We demonstrated the flexibility and applicability of the MindLogger platform through its deployment in a large-scale, longitudinal, mobile mental health study and by building a variety of other mental health-related applets. With this release, we encourage a broad range of users to apply the MindLogger platform to create and test applets to advance health care and scientific research. We hope that increasing the availability of applets designed to assess and administer interventions will facilitate access to health care in the general population.

Effect of family doctor contract services on patient perceived quality of primary care in southern China.

BACKGROUND: Family doctor contract service is an important service item in China's primary care reform. This research was designed to evaluate the impact of the provision of family doctor contract services on the patient-perceived quality of primary care, and therefore give evidence-based policy suggestions. METHODS: This cross-sectional study of family doctor contract service policy was conducted in three pilot cities in the Pearl River Delta, South China, using a multistage stratified sampling method. The validated Primary Care Assessment Tool-Adult Edition (PCAT-AS) was used to measure the quality of primary care services. PCAT-AS assesses each of the unique characteristics of primary care including first contact, continuity, comprehensiveness, coordination, family-centeredness, community orientation, culture orientation. Data was collected through face-to-face interviews held from July to November, 2015. Covariate analysis and multivariate Linear Regression were adopted to explore the effect of contract on the quality of primary care by controlling for the socio-demographic status and health care service utilization factors. RESULTS: A total of 828 valid questionnaires were collected. Among the interviewees, 453 patients signed the contract (54.7%) and 375 did not (45.3%). Multivariate linear regression showed that contracted patients reported higher scores in dimensions of PCAT total score (ß = - 8.98, P < 0.000), first contact-utilization(ß = - 0.71,P < 0.001), first contact-accessibility(ß = - 1.49, P < 0.001), continuity (ß = 1.27, P < 0.001), coordination (referral) (ß = - 1.42, P < 0.001), comprehensiveness (utilization) (ß = - 1.70, P < 0.001), comprehensiveness (provision) (ß = - 0.99, P < 0.001),family-centeredness(ß = - 0.52, P < 0.01), community orientation(ß = - 1.78, P < 0.001), than un- contracted after controlling socio-demographic and service utilization factors. There were no statistically significant differences in the dimensions of coordination (information system) (ß = - 0.25, P = 0.137) and culture orientation (ß = - 0.264, P = 0.056) between the two both groups. CONCLUSIONS: This study demonstrates that the pilot implementation of family doctor contract services has significantly improved patients' perceived primary care quality in the pilot cities, and could help solve the quality problem of primary care. It needs further promotion across the province.

[Source Apportionment and Health Risk Assessment of Polycyclic Aromatic Hydrocarbons in PM2.5 in Changchun City, Autumn of 2017].

In this study, 30 PM2.5 samples were collected from the atmosphere in Changchun City in the autumn of 2017. The concentration and composition characteristics of 17 polycyclic aromatic hydrocarbons (PAHs) in the samples were analyzed by gas chromatography mass spectrometry (GC-MS). The diagnostic ratio and principal component analysis method were used to determine the source of PAHs pollution. The health risk assessment was carried out by both calculating the equivalent carcinogenic concentration of benzo(a)pyrene and the lifetime risk of cancer. Results show that the average PM2.5 concentration in autumn in Changchun is (50.84±12.23) µg·m-3, and the content of organic carbon (OC) and elemental carbon (EC) are (17.07±5.64) µg·m-3 and (1.33±0.75) µg·m-3, respectively, accounting for 37% of the total PM2.5. The total concentration of PAHs is (15.69±5.93) ng·m-3, which was dominated by medium- to high-ring-number PAHs, accounting for 84.26% of total PAHs. The atmospheric PAHs in Changchun mainly originate from motor vehicle exhaust emissions (44.48%) > coal combustion (29.16%) > biomass burning (26.36%), local transportation (gasoline vehicles) emissions being the main source of pollution. The average carcinogenic concentration of benzo(a)pyrene is in the range of 1.55 ng·m-3 and 5.38 ng·m-3, and the average carcinogenic equivalent concentration is (6.44±1.53) ng·m-3, which is generally considered a slight pollution level. The ingestion of PAHs by breathing is the most harmful to the health of adult women, followed by adult males and children, however since the lifetime carcinogenic risk value of the entire population did not exceed 1×10-6, their health risks are considered to be at acceptable levels.

Clinical Characteristics and Allergen Sensitization Patterns of Patients with Local Allergic Rhinitis in Southern China.

BACKGROUND: Local allergic rhinitis (LAR) is characterized by the production of specific IgE (sIgE) in the nasal mucosa without evidence of systemic atopy. The characteristics of LAR in Caucasians have been well documented. LAR is understudied in China, with prevalence, patient demographics, symptomatology, and the allergen sensitization profile being poorly understood. The purpose of this study is to investigate the demographics, characteristics, and allergen sensitization profile of patients with LAR in Southern China. METHODS: A total of 194 patients with rhinitis and 13 healthy subjects were enrolled in the current study. The patients' demographic data, clinical history, and symptoms were recorded. Local and systemic sIgE to a wide panel of specific allergens were measured in the nasal secretion and serum samples. RESULTS: Among the rhinitis patients, 115 were classified as allergic rhinitis (AR; 59.3%), 15 as LAR (7.7%), and 64 as non-AR (33.0%). The demographic characteristics, duration, frequency, and severity of symptoms were similar, although LAR exhibited higher symptom scores for nasal itch. Monosensitization was the predominant pattern of sensitization in both AR (109 out of 115, 95%) and LAR (14 out of 15, 93%). House dust mite was the dominant allergen in AR patients (109 out of 115, 95%), while pollen was the dominant allergen in LAR patients (11 out of 15, 73%). CONCLUSION: The prevalence of LAR patients in Southern China was 7.7%. Pollen was the most common sensitizing allergen for the local LAR patients, which differs from Caucasian studies, in which house dust mite was the dominant sensitizing allergen. Monosensitization was the predominant pattern in both AR and LAR.