The role of financial innovation in carbon intensity reduction: perspectives from energy structure transition and fiscal policies.

Carbon emissions are important factors causing global warming, which requires global efforts to deal with. In this paper, we investigate the mechanism of financial innovation on reducing carbon emissions in China by constructing a financial innovation development index with factors of green finance as well as fintech development. Empirical results show that financial innovation contributes to reduce carbon intensity by promoting energy structure transition as well as public fiscal expenditure on energy conservation and environmental protection. Moreover, heterogeneity exists in the effect of financial innovation on carbon emission reduction. Financial innovation has a significant role in reducing carbon intensity in eastern regions, but has a relatively small influence on central and western regions. Furthermore, financial innovation has a lag effect on reducing carbon intensity.

Exploring the relationship between regional tourism development and land use efficiency: A case study of Guangxi Zhuang Autonomous Region, China.

The utilization efficiency of land resources is an essential embodiment of economic development, social development, and ecological development and is a critical core to measure how to maximize the efficiency of land resources under limited conditions. The land is an important content and essential carrier of the research of tourism development level. This paper selects Panel Data from 2010 to 2019 to research the Guangxi regional tourism development. The entropy weight method and stochastic frontier production function (SFA) model were used to evaluate the development level of urban-rural tourism and the utilization efficiency of land resources in Guangxi. This paper uses the Panel Vector Autoregression (PVAR) model to analyze the internal relationship between urban-rural tourism development. The results show that: (1) Guangxi has a good level of tourism development and a high land use efficiency. (2) There is a reciprocal causation relationship between the regional tourism development level and land use efficiency in Guangxi, with significant levels of 0.005 and 0.034 respectively, indicating high credibility. This indicates that there is a mutual promotion and interaction between the two, which rely on and drive each other, promoting the joint sustainability of tourism development and land use efficiency. (3) . The tourism development level is greatly influenced by itself, with impact values all above 0.99. At the same time, land use also has a significant self-impact, with impact values all above 0.87. Their internal optimization system is solid and endogenous impetus is robust, which can drive their development. Establishing an effective strategy for developing and protecting land use is beneficial to promote the long-term effectiveness of sustainable tourism development, enhancing high-quality development of the tourism economy and improving people's living standards and quality.

Investigation on the budget of peroxyacetyl nitrate (PAN) in the Yangtze River Delta: Unravelling local photochemistry and regional impact.

Peroxyacetyl nitrate (PAN) is a significant indicator of atmospheric photochemical pollution, which can influence the regional distribution of ozone (O3) and hydroxyl radical (OH) through long-range transport. However, investigations of PAN incorporating comprehensive measurement and explicit modeling analysis are limited, hindering complete understandings of its temporal behavior, sources, and impacts on photochemistry. Here we conducted a 1-year continuous observation of PAN and relative atmospheric species in Nanjing located in Yangtze River Delta (YRD). The annual mean concentration of PAN was 0.62 ± 0.49 ppbv and showed a bimodal monthly variation, peaking in April-June and November-January, respectively. This pattern is different from the typical pattern of photochemistry, suggesting important contributions of other non-photochemical processes. We further analyzed the PAN budget using an observation-based model, by which, PAN from local photochemical production and regional source could be decoupled. Our results revealed that local photochemical production of PAN is the sole contributor to PAN in summer, whereas about half of the total PAN concentration is attributed to regional source in winter. Although the formation of PAN can suppress the atmospheric oxidation capacity by consuming the peroxyacetyl radical and nitrogen dioxide (NO2), our analyses suggested this effect is minor at our station (-3.2 ± 1.1 % in summer and - 7.2 ± 2.8 % in winter for O3 formation). However, it has the potential to enhance O3 and OH formation by 14.16 % and 5.93 %, if transported to cleaner environments with air pollutants halved. Overall, our study highlights the importance of both local photochemistry and regional process in PAN budget and provides a useful evaluation on the impact of PAN on atmospheric oxidation capacity.

Gender Disparities in Patients' Decisions about the Management of Myocardial Infarction in East Chinese Province.

Background: Previous studies showed that there are gender disparities in various respects of acute myocardial infarction (AMI), including risk factors, symptoms, and outcomes. However, few of them noticed the gender disparities in patients' decision about the management of AMI, which might also be associated with the outcome. Aims: To identify gender disparities in patients' decisions about the management of myocardial infarction. Methods: In this cohort study, the critical time points including the time of symptom onset, visiting hospital, diagnosis of AMI, consent to coronary angiography (CAG), beginning of CAG, and balloon dilation were recorded. Medication and major adverse cardiac event (MACE) within 6 months were also recorded. Results: Female patients took more time from symptom onset to visiting hospital (P = 0.001), from diagnosis of AMI to consent to CAG (P < 0.05), and from door to needle/balloon than male (P < 0.05). Less female patients accepted CAG (P < 0.05) and coronary intervention/bypass grafting (P < 0.05). Less female patients kept good inherence to antiplatelet therapy (P < 0.05) and statins (P < 0.05) than male, more female preferred traditional Chinese medicine (TCM) than male patient (P < 0.05), and most of them had MACE within 6 months (P < 0.05). Patients' good adherence to antiplatelet therapy and statins and accepting coronary intervention/bypass grafting were associated with a reduced risk of MACE. Conclusion: Female patients were more reluctant to make decisions about emergency management of AMI and tended to choose conservative treatment. More female patients preferred TCM than evidence-based medicine. Their reluctance about the critical management of AMI and poor adherence to evidence-based medicine were associated with an elevated risk of MACE.

Green production efficiency of China's hog breeding industry: Spatial divergence and its driving factors.

This paper analyzes the green production efficiency (GPE) and spatial divergence of the hog breeding industry, with the aim of providing a foundation for the rational layout of hog breeding and promoting the industry's high-quality development. The paper uses the SBM model to estimate GPE in 29 provinces, cities, and districts of China from 2006 to 2019. Furthermore, it analyzes the spatial divergence of GPE and its driving factors using divergence indexes and the Geodetector. The results show that China's GPE of the hog breeding industry increased from 0.409 to 0.496 between 2006 and 2019. The highest efficiency occurred during the I-period, while the lowest efficiency was observed during the II-period. The highest efficiency was in the key development region, and the lowest efficiency was in the potential growth region. The spatial divergence of GPE in the hog breeding industry expanded, with labor input, non-point source pollution, resource endowment, and environmental load bearing being the main driving factors for the expansion in each period. The potential growth region had the largest spatial divergence, mainly affected by resource endowment. In contrast, the constrained development region had the smallest spatial divergence, mainly affected by resource endowment and pollutant emissions. The spatial divergence of moderate and key development regions was considerable, mainly affected by environmental investment, environmental load bearing, and pollutant emissions. Therefore, the key to improving the GPE of the hog breeding industry is to promote the adoption of advanced technology, such as labor-saving, material-saving, and emission reduction technologies. Moreover, several actions should be taken to reduce the spatial divergence among different regions, such as integrated breeding, clean standards, large-scale breeding, and high-end boutique.

Assessment of dysfunctional tunneled hemodialysis catheters and outcome of endovascular salvage techniques: a simple solution to a complex problem.

Objective: The aim of this study was to evaluate the causes of the dysfunctional tunneled cuffed catheters (TCCs) using multi-spiral computed tomography venography (MSCTV), and to analyze the outcomes of endovascular salvage techniques. Material and methods: This retrospective review data from 27 patients who experienced TCC dysfunction between July 1, 2016 and January 31, 2021 was conducted. Patients' demographic data, clinical signs and symptoms, and imaging data were collected from interventional radiology database. Results: MSCTV showed a range of abnormalities in the hemodialysis (HD) patients, including central venous occlusion (n = 4), fibrin sheath formation (n = 3), malposition of the catheter tips (n = 4), central venous perforation (n = 1), thrombus formation (n = 12), regular catheter exchange without determined lesions (n = 3). Interventional catheter salvage procedures were performed, such as catheter exchange, balloon disruption of a fibrin sheath, angioplasty for central vein stenosis, and stent deployment. The technical success rate for catheter insertions was 100%, and no procedure-related severe complications were observed. The 30-day catheter patency for all assessable catheters was 85.2%. Conclusion: The use of MSCTV showed abnormal findings in almost 88.9% of cases concerning dysfunctional TCC. In this study, the examined appropriate endovascular techniques were found to be safe and technically successful, with a low incidence of procedure-related complications.

[Heavy Metal Concentration, Source, and Pollution Assessment in Topsoil of Chuzhou City].

In order to understand the pollution level and ecological risk of heavy metals in topsoil of Chuzhou City, a total of 4360 soil samples in Chuzhou City were collected, and the concentrations of eight heavy metals including Cr, Zn, Pb, Cu, Ni, Cd, As, and Hg were measured. Correlation analysis, cluster analysis, and principal component analysis were used to analyze the sources of the heavy metals, and the enrichment factor index, single-factor pollution index, pollution load index, geo-accumulation index method, and potential ecological risk index were selected to assess the environmental risk of the eight heavy metals in the topsoil. The results showed that the average values of Cr, Zn, Pb, Cu, Ni, Cd, As, and Hg contents in the surface soil of Chuzhou City were higher than the background value of that in the soil of Yangtze-Huaihe River Basin of Anhui, and Cd, Ni, As, and Hg were significantly different in space and influenced by external disturbance. The eight types of heavy metals could be divided into four categories based on correlation analysis, cluster analysis, and principal component analysis. Cr, Zn, Cu, and Ni were from natural background sources; As and Hg mainly came from sources of industrial and agricultural pollution; Pb mainly came from the sources of transportation pollution and industrial and agricultural pollution; and Cd came from the sources of transportation pollution, natural background, and industrial and agricultural pollution. The overall pollution degree of Chuzhou City was low, and the ecological risk level was at a slight level based on the pollution load index and the potential ecological risk index; however, the ecological risk of Cd and Hg was generally serious, and these two heavy metals should be taken as the objects of priority control. The results provided a scientific basis for soil safety utilization and classification control in Chuzhou City.

A comprehensive clinical evaluation of first-line drugs for ALK-positive advanced non-small cell lung cancer.

Background: Anaplastic lymphoma kinase-tyrosine kinase inhibitors (ALK-TKIs) are mainly used in the treatment of ALK-positive advanced non-small cell lung cancer (NSCLC), but a comprehensive clinical evaluation of ALK-TKIs is lacking. Hence, a comparison of ALK-TKIs for first-line treatment of ALK-positive advanced NSCLC is essential to provide rational drug use and a basis for improving national policies and systems. Methods: According to the Guideline for the Administration of Clinical Comprehensive Evaluation of Drugs (2021) and the Technical Guideline for the Clinical Comprehensive Evaluation of Antitumor Drugs (2022), a comprehensive clinical evaluation index system of first-line treatment drugs for ALK-positive advanced NSCLC was established by literature review and expert interviews. We conducted a systematic literature review, meta-analysis, and other relevant data analyses, combined with an indicator system, to establish a quantitative and qualitative integration analysis for each indicator and each dimension of crizotinib, ceritinib, alectinib, ensartinib, brigatinib, and lorlatinib. Results: The comprehensive clinical evaluation results of all dimensions were as follows: in terms of safety, alectinib had a lower incidence of grade 3 and above adverse reactions; for effectiveness, alectinib, brigatinib, ensartinib, and lorlatinib showed better clinical efficacy, and alectinib and brigatinib have been recommended by several clinical guidelines; in terms of economy, second-generation ALK-TKIs have more cost-utility advantages, and both alectinib and ceritinib have been recommended by the UK and Canadian Health Technology Assessment (HTA) agencies; for suitability, accessibility, and innovation, alectinib has a higher degree of physician recommendations and patient compliance. Except for brigatinib and lorlatinib, all other ALK-TKIs have been admitted to the medical insurance directory; the accessibility of crizotinib, ceritinib, and alectinib is good, meeting the needs of patients. Second- and third-generation ALK-TKIs have higher blood-brain barrier permeability, stronger inhibition ability, and innovation than first-generation ALK-TKIs. Conclusions: Compared with other ALK-TKIs, alectinib performs better across six dimensions and has a higher comprehensive clinical value. The results provide better drug choice and rational use for patients with ALK-positive advanced NSCLC.

High cardiorespiratory disease burden following a fracture among adults with intellectual disabilities.

BACKGROUND: Adults with intellectual disabilities have a greater risk for fragility fractures that begin to accumulate early in the adult lifespan, which may contribute to accelerated health declines. The objective was to determine if fragility fractures were associated with an increased 2-year rate of cardiorespiratory diseases among adults with intellectual disabilities. METHOD: This retrospective cohort study used nationwide administrative claims data from 01/01/2011-12/31/2016 from the Medicare fee-for-service database. 2-year incidence of cardiorespiratory diseases were compared between adults ≥18 years old with intellectual disabilities with (n = 6183) vs. without (n = 67,842) an incident fragility fracture after confounder adjustment using Cox regression. RESULTS: Fracture at the vertebral column, hip, non-proximal femur, tibia/fibula, and multiple sites had an elevated hazard ratio (HR) compared to those with no fracture for pneumonia, respiratory failure, heart failure, and cerebrovascular disease (HR range, 1.15-2.09, all P < 0.05), while humerus and radius/ulna fracture were associated with an elevated HR for congestive heart failure and cerebrovascular disease (HR range, 1.38-1.72, all P < 0.05). CONCLUSIONS: Fragility fractures were associated with an increased incidence of cardiorespiratory diseases among adults with intellectual disabilities.

Preliminary assessment of cardiotoxicity in chimeric antigen receptor T cell therapy: a systematic review and meta-analysis.

As a novel anticancer therapy, chimeric antigen receptor T (CAR T) cell therapy may lead to cardiotoxic reactions. However, the exact incidence remains unclear. Our study aimed to preliminarily assess the prevalence of cardiotoxicity after CAR T cell treatment using a systematic review and meta-analysis. PubMed, Embase, Web of Science, and Cochrane databases were searched for potentially relevant studies. All types of relevant clinical studies were screened and assessed for risk bias. In most instances, random-effect models were used for data analysis, and heterogeneity between studies was evaluated. Standard quality assessment tools were used to assess quality. The study was registered with PROSPERO (CRD42022304611). Eight eligible studies comprising 3567 patients, including seven observational studies and one controlled study, were identified. The incidence of cardiovascular events was 16.7% [95% confidence interval (CI) 0.138-0.200, P < 0.01)]. Arrhythmia was the most common disorder, with an incidence of 6.5% (95% CI 0.029-0.115, P < 0.01). The occurrence of cardiotoxicity was associated with cytokine release syndrome (CRS), with a prevalence of 18.7% (95% CI 0.107-0.315, P < 0.01). Moreover, such adverse reactions were more common when CRS > 2 (OR = 0.07, 95% CI 0.02-0.29, P < 0.01). The risk of cardiotoxicity was not notably higher in patients receiving CAR T cell therapy than in those receiving traditional anticancer treatment. However, sufficient attention should be paid to this. And further evidence from large-scale clinical trials are needed.

CAS Array: design and assessment of a genotyping array for Chinese biobanking.

Background: Chronic diseases are becoming a critical challenge to the aging Chinese population. Biobanks with extensive genomic and environmental data offer opportunities to elucidate the complex gene-environment interactions underlying their aetiology. Genome-wide genotyping array remains an efficient approach for large-scale genomic data collection. However, most commercial arrays have reduced performance for biobanking in the Chinese population. Materials and methods: Deep whole-genome sequencing data from 2 641 Chinese individuals were used as a reference to develop the CAS array, a custom-designed genotyping array for precision medicine. Evaluation of the array was performed by comparing data from 384 individuals assayed both by the array and whole-genome sequencing. Validation of its mitochondrial copy number estimating capacity was conducted by examining its association with established covariates among 10 162 Chinese elderly. Results: The CAS Array adopts the proven Axiom technology and is restricted to 652 429 single-nucleotide polymorphism (SNP) markers. Its call rate of 99.79% and concordance rate of 99.89% are both higher than for commercial arrays. Its imputation-based genome coverage reached 98.3% for common SNPs and 63.0% for low-frequency SNPs, both comparable to commercial arrays with larger SNP capacity. After validating its mitochondrial copy number estimates, we developed a publicly available software tool to facilitate the array utility. Conclusion: Based on recent advances in genomic science, we designed and implemented a high-throughput and low-cost genotyping array. It is more cost-effective than commercial arrays for large-scale Chinese biobanking.

Noninvasive assessment of myocardial work during left ventricular isovolumic relaxation in patients with diastolic dysfunction.

BACKGROUND: This study aims to investigate the value of myocardial work (MW) parameters during the isovolumic relaxation (IVR) period in patients with left ventricular diastolic dysfunction (LVDD). METHODS: This study prospectively recruited 448 patients with risks for LVDD and 95 healthy subjects. An additional 42 patients with invasive measurements of left ventricular (LV) diastolic function were prospectively included. The MW parameters during IVR were noninvasively measured using EchoPAC. RESULTS: The total myocardial work during IVR (MWIVR), myocardial constructive work during IVR (MCWIVR), myocardial wasted work during IVR (MWWIVR), and myocardial work efficiency during IVR (MWEIVR) of these patients were 122.5 ± 60.1 mmHg%, 85.7 ± 47.8 mmHg%, 36.7 ± 30.6 mmHg%, and 69.4 ± 17.8%, respectively. The MW during IVR was significantly different between patients and healthy subjects. For patients, MWEIVR and MCWIVR were significantly correlated with the LV E/e' ratio and left atrial volume index, MWEIVR exhibited a significant correlation with the maximal rate of decrease in LV pressure (dp/dt per min) and tau, and the MWEIVR corrected by IVRT also exhibited a significant correlation with tau. CONCLUSIONS: MW during IVR significantly changes in patients with risks for LVDD, and is correlated to LV conventional diastolic indices, including dp/dt min and tau. Noninvasive MW during IVR may be a promising tool to evaluate the LV diastolic function.

Whether ambulatory electroencephalogram and visual tracking system could be the new strategy for pain assessment?

The human pain experience is a complex multi-faceted symptom. Effective pain management begins with a comprehensive assessment. However, a plethora of existing assessment tools for pain assessment focus more on self-report of pain intensity but lack of multi-dimensional impersonal assessment. These unidimensional scales, which capture self-reported levels of pain intensity, not only underestimate the complexity of the pain experience, but also lack stability and objectivity in their own assessments of pain intensity. Therefore, we propose a hypothesis that using scientific and technological means, such as visual tracking and surveillance system, ambulatory electroencephalogram and other techniques, combined with psychological assessment pictures and existing scales, to comprehensively evaluate pain may provide a new method for more effective clinical treatment of pain, especially chronic severe pain.

Microplastics contamination associated with low-value domestic source organic solid waste: A review.

Waste activated sludge and food waste are two typical important domestic low-value organic solid wastes (LOSW). LOSW contains significant organic matter and water content resulting in the transboundary transfer of liquid-solid-gas and other multi-mediums, such that the complexity of microplastics (MPs) migration should be of greater concern. This article provides a review of the literature focusing on the separation and extraction methods of MPs from LOSW. The occurrence and source of MPs are discussed, and the output and impact of MPs on LOSW heat and biological treatments are summarized. The fate and co-effects of MPs and other pollutants in landfills and soils are reviewed. This review highlights the migration and transformation of MPs in domestic source LOSW, and future perspectives focused on the development of a unified extraction and analysis protocol. The objective of this review is to promote the technological development of decontamination of MPs in LOSW by sufficient understanding of the fate of MPs, their interaction with coexisting pollutants and the development of targeted preventive research strategies.

Post-fracture rehabilitation pathways and association with mortality among adults with cerebral palsy.

OBJECTIVE: Rehabilitation may mitigate the high mortality rates and health declines post-fracture for adults with cerebral palsy, but this is understudied. The objectives were to characterize the post-fracture rehabilitation pathways and identify their association with 1-year survival among adults with cerebral palsy. METHODS: A retrospective cohort study of adults with cerebral palsy with a fragility fracture with continuous health plan enrollment ≥1-year prior to and ≥1 day after their fracture date was performed using a random 20% Medicare fee-for-service dataset. Participants were categorized as a home discharge or inpatient rehabilitation admission post-fracture. For the home discharge cohort, weekly exposure to outpatient physical/occupational therapy (PT/OT) was examined up to 6-month post-fracture. Cox regression examined the association between time-varying PT/OTuse within 6-month post-fracture and mortality from 30 days to 1-year post-fracture before and after adjusting for confounders (e.g. medical complexity). RESULTS: Of 3598 adults with cerebral palsy with an incident fragility fracture, 74% were discharged home without inpatient rehabilitation; they were younger, but more medically complex compared to the 26% admitted to inpatient rehabilitation. Among the home discharge cohort (n = 2662), 43.1% initiated PT/OTwithin 6-month post-fracture, and cumulative PT/OTexposure post-fracture was associated with improved survival; for example, per 3 weeks of PT/OTexposure, the adjusted mortality rate was 40% lower (95% confidence interval (CI) = 0.41-0.89). CONCLUSIONS: Most adults with cerebral palsy with a fragility fracture were discharged home rather than to inpatient rehabilitation, and only 43.1% of that group initiated outpatient PT/OTwithin 6 months post-fracture. Receiving outpatient PT/OTwas associated with improved 1-year survival.

Assessment of soft and hard tissue characteristics of ridge preservation at molar extraction sites with severe periodontitis: a randomized controlled trial.

BACKGROUND: Changes in alveolar bone dimension after tooth extraction may affect placement of the subsequent implant, resulting in ridge deficiency that can adversely impact long-term implant stability or aesthetics. Alveolar ridge preservation (ARP) was effective in reducing the amount of ridge resorption following tooth extraction. There is sparse evidence regarding the benefit of ARP at periodontally compromised molar extraction sockets. This study will be a randomized trial to assess the soft tissue contour, radiographical, and histological changes of ARP at molar extraction sites in order to compare severe periodontitis cases with natural healing results and determine the most beneficial and least traumatic clinical treatment for such patients. METHODS: This research is designed as a two-group parallel randomized controlled trial. The total number of tooth extraction sites will be 70 after calculation with power analysis. Teeth will be randomly assigned to two groups with the test group conducting ridge preservation and the control group healing naturally. Periodontal examination, cone beam-computed tomography (CBCT) data, and stereolithographic (STL) files obtained by intraoral scanning will be collected through the follow-up period, and bone biopsy samples would be obtained during implant surgery. The primary outcomes are the vertical and horizontal change of alveolar ridge measured on CBCT images, soft tissue contour changes evaluated by superimposing the digital impressions, alterations of mucosa thickness (as measured by superimposing the CBCT data and STL files), histological features of implant sites and periodontal parameter changes. The secondary outcomes are patient-reported post-operative reaction and conditions of simultaneous bone graft or sinus lifting procedures during implantation. DISCUSSION: This study will provide information about hard and soft tissue dimension changes and histomorphology evaluation following ARP and natural healing in periodontally compromised molar sites, which may contribute to complement the missing information of ARP at periodontally compromised molar extraction sockets. TRIAL REGISTRATION: Chinese Clinical Trial Register (ChiCTR) ChiCTR2200056335. Registered on February 4, 2022, Version 1.0.

China's Actions to Achieve Universal Health Coverage for Children.

The United Nations General Assembly adopted the 2030 Sustainable Development Goals (SDGs) in September 2015. Through this, governments have also committed to universal health coverage (UHC) as a development sub-goal within the SDG health field (1-2). In its effort to fully safeguard universal child health, China has established a management system for child healthcare to provide all children with continuous healthcare services starting at birth. Since 1950, China has implemented a system of local physicians who take responsibility for child healthcare services within their areas. Under the three-tier management system at the county, township, and village levels, every newborn is included in the child health management system starting immediately after birth. The urban and rural community-based health facilities in the area provide unified, standardized, and systematic healthcare services. Moreover, since 2009, child health management has been included in the National Essential Public Health Service Program, which mandates that community-based primary health facilities provide free health management services for children 0-6 years old in their area. This has led to equitable and comprehensive coverage of health services for these children. When children enter school at the age of six, they receive an annual routine physical examination at school. In 2020, the national coverage for neonatal visits, the health management rate for children under 3 and the health management rate for children under 7 all surpassed 92%, while the prevalence of stunting among children under 5 continued to decline. In addition, urban-rural disparities in major child health indicators have also narrowed significantly. Moreover, the inoculation rate of children in National Immunization Programme Vaccines has remained over 99% since 2011 (3).

Gap between Willingness and Behaviors: Understanding the Consistency of Farmers' Green Production in Hainan, China.

The green transformation of production modes plays an essential role in the sustainable development of China's agriculture and the modernization process, but there is often a deviation between farmers' behavior and their willingness regarding green production. This paper analyzed the factors influencing the deviation of farmers' green production behaviors from their willingness, along with their hierarchical logic structure, using the ordered logit model and ISM model with field survey data of 436 households in Hainan Province. The results show that: (1) there are deviations between farmers' green production behavior and willingness; (2) age, number of dependents, peer influence, and social networks aggravate farmers' green production behavior-willingness deviation, while ethnicity, education, land fragmentation, agricultural expenditure, land transfer, neighborhood learning, and green production cognition mitigate the deviation; (3) among the significant influencing factors, farmers' perceptions of green production, peer influence, land transfer, and agricultural expenditure are the direct surface factors, while neighborhood learning, land fragmentation, and number of dependents are the middle indirect factors, and farmers' education, social networks, age, and ethnicity are the deep-rooted factors. This study sheds more light and detail on the understanding of the factors influencing farmers' green production behavior-willingness deviation, and provides more practical and relevant guidance for the agricultural green development in tropical China.

Effectiveness of early essential newborn care implementation in four counties of western China.

BACKGROUND: Neonatal survival is a public health concern globally. However, the regional disparity in neonatal mortality between rural counties of western China and urban areas of eastern provinces remains high. Early essential newborn care (EENC), recommended by World Health Organization, refers to a set of cost-effective interventions to improve neonatal health and development outcomes. In this study, we aimed to explore the effectiveness of EENC implementation in four counties of western China. METHODS: Pre- and post-intervention investigations were conducted in four selected EENC intervention counties and four control counties of four western provinces of China, from June to August 2017 and from December 2020 to April 2021 respectively. A mixed quantitative and qualitative approach was used for data collection and analysis. Data on the coverage of EENC practices were collected via a post-intervention face-to-face questionnaire survey with postpartum mothers before hospital discharge. Hospital-reported data on neonatal health indicators were obtained through mail surveys in both investigations. We also performed semi-structured interviews with policymakers, health staff and postpartum mothers to understand their perceptions about the usefulness of EENC implementation. RESULTS: Overall, 599 mother-newborn pairs in the intervention group and 699 pairs in the control group participated in the post-intervention survey. Controlling for the confounding factor of province, the proportion of newborns receiving EENC interventions was higher in the intervention group than in the control group (P < 0.05). Intervention groups in four provinces had higher coverage of: any skin-to-skin contact (99.50% vs. 49.07%); early breastfeeding initiation (within 60 min of birth) (90.84% vs. 80.35%); no medicine applied to the umbilical cord (98.50% vs. 9.73%); routine eye care (93.16% vs. 8.73%); and vitamin K1 administration (98.33% vs. 88.98%). EENC implementation was associated with decreased risk of neonatal diarrhea (OR: 0.326, 95% CI: 0.123, 0.865) and eye infection (OR: 0.147, 95% CI: 0.045, 0.483). Policymakers, health staff and postpartum mothers expressed satisfaction with the EENC interventions, noting a willingness among staff and policymakers to implement and sustain these interventions; the promotion of these interventions within hospital policy; the positive emotions experienced by postpartum mothers; perceived improvements in health; and improvements in support for health workers. CONCLUSION: EENC-recommended core practices (except kangaroo mother care) have been successfully introduced in pilot hospitals. The efficacy of EENC implementation should be highly recognized to accelerate the progress towards its national roll out.

Income-related inequality and decomposition of edentulism among aged people in China.

BACKGROUND: The aim of this study was to assess the income-related inequality of edentulism among the aged in China and identify the contributing factors. METHODS: A secondary analysis of data from the 4th National Oral Health Epidemiology Survey in China was conducted, and 65-74 years old were selected for the analysis of income-related inequality of edentulism. The concentration curve, Concentration index (CI) and Erreygers-corrected concentration index (EI) were used to represent inequality and its degree qualitatively and quantitatively, respectively. A decomposition method based on probit model was employed to determine the contributors of inequality, including demographic factors, income status, oral health-related knowledge, attitude and practices and self-perceived general health status. RESULTS: In China, aged people with edentulism were concentrated in the poor. The CI was - 0.2337 (95% CIs: - 0.3503, - 0.1170). The EI was - 0.0413 (95% CIs: - 0.0619, - 0.0207). The decomposition results showed that income (75.02%) and oral health-related knowledge, attitude and practices (15.52%) were the main contributors to the inequality. CONCLUSION: This study showed that pro-poor inequality among the elderly with edentulism existed in China. Corresponding policies against the contributors could be considered to promote the health equality of the elders.