Global, regional and national burden of Glaucoma: an update analysis from the Global Burden of Disease Study 2019.

PURPOSE: As the epidemiological and burden trends of glaucoma are changing, it is extremely necessary to re-investigate geographical differences and trends. Here we use data from the 2019 Global burden of Disease, which aims to report the prevalence and disability-adjusted life years of glaucoma injury to assess the latest epidemiological models and trends from 1990 to 2019. METHOD: Annual case numbers, age-standardized rates of prevalence, DALYs, and their estimated annual percentage changes (EAPCs) for glaucoma between 1990 and 2019 were derived from the GBD 2019 study. The relationship between glaucoma disease burden and social demographic index (SDI) was also investigated in this study. RESULTS: In 2019, there were 7.47 million prevalent cases and 0.75 million DALYs cases, which increased by 92.53% and 69.23% compared with 1990 respectively. The global age-standardized rate of prevalence (ASPR) and age-standardized rate of DALYs (ASDR) decreased during 1990-2019 (EAPC = - 0.55 and - 1, respectively). In 2019, the highest ASPR and ASDR of Glaucoma were all observed in Mali, whereas the lowest occurred in Taiwan (Province of China). In terms of gender, males were more likely to suffer from glaucoma than females, especially the elderly. CONCLUSIONS: The global prevalence and DALYs of glaucoma had an absolute increase during the past 30 years. The disease burden caused by glaucoma is closely related to socioeconomic level, age, gender, and other factors, and these findings provide a basis for policymakers from the perspective of social management.

Service Quality and Residents' Preferences for Facilitated Self-Service Fundus Disease Screening: Cross-Sectional Study.

BACKGROUND: Fundus photography is the most important examination in eye disease screening. A facilitated self-service eye screening pattern based on the fully automatic fundus camera was developed in 2022 in Shanghai, China; it may help solve the problem of insufficient human resources in primary health care institutions. However, the service quality and residents' preference for this new pattern are unclear. OBJECTIVE: This study aimed to compare the service quality and residents' preferences between facilitated self-service eye screening and traditional manual screening and to explore the relationships between the screening service's quality and residents' preferences. METHODS: We conducted a cross-sectional study in Shanghai, China. Residents who underwent facilitated self-service fundus disease screening at one of the screening sites were assigned to the exposure group; those who were screened with a traditional fundus camera operated by an optometrist at an adjacent site comprised the control group. The primary outcome was the screening service quality, including effectiveness (image quality and screening efficiency), physiological discomfort, safety, convenience, and trustworthiness. The secondary outcome was the participants' preferences. Differences in service quality and the participants' preferences between the 2 groups were compared using chi-square tests separately. Subgroup analyses for exploring the relationships between the screening service's quality and residents' preference were conducted using generalized logit models. RESULTS: A total of 358 residents enrolled; among them, 176 (49.16%) were included in the exposure group and the remaining 182 (50.84%) in the control group. Residents' basic characteristics were balanced between the 2 groups. There was no significant difference in service quality between the 2 groups (image quality pass rate: P=.79; average screening time: P=.57; no physiological discomfort rate: P=.92; safety rate: P=.78; convenience rate: P=.95; trustworthiness rate: P=.20). However, the proportion of participants who were willing to use the same technology for their next screening was significantly lower in the exposure group than in the control group (P<.001). Subgroup analyses suggest that distrust in the facilitated self-service eye screening might increase the probability of refusal to undergo screening (P=.02). CONCLUSIONS: This study confirms that the facilitated self-service fundus disease screening pattern could achieve good service quality. However, it was difficult to reverse residents' preferences for manual screening in a short period, especially when the original manual service was already excellent. Therefore, the digital transformation of health care must be cautious. We suggest that attention be paid to the residents' individual needs. More efficient man-machine collaboration and personalized health management solutions based on large language models are both needed.

[Energy-saving and Emission Reduction Path for Road Traffic in Key Coastal Cities of Guangdong, Fujian and Zhejiang].

The rapid development of society and economy has resulted in a substantial increase in energy consumption, consequently exacerbating pollution issues. Current research predominantly focuses on energy-saving and emission reduction in road transportation within individual cities or the three major economic regions of China:the Yangtze River Delta, the Pearl River Delta, and the Beijing-Tianjin-Hebei Region. However, there is a dearth of studies addressing the southeastern coastal economic region. Located at the heart of China's southeastern coastal economic development, the provinces of Guangdong, Fujian, and Zhejiang unavoidably face challenges associated with energy consumption and emissions while pursuing economic growth. To address these challenges, this study employed a LEAP model to construct various scenarios for road transportation in the key coastal cities of Guangdong, Fujian, and Zhejiang from 2015 to 2035. These scenarios included a baseline scenario (BAU), an existing policy scenario (EPS), and an improved policy scenario (MPS). The MPS and EPS encompassed vehicle structure optimization (VSO), improved fuel economy (IFE), and reduced annual average mileage (RDM). By simulating and evaluating these scenarios, the energy-saving and emission reduction potentials of road transportation in the key coastal cities were assessed. The results indicated that, in the primary scenario, the MPS exhibited the most significant improvements in energy-saving, carbon reduction, and pollutant reduction effects. By 2035, the MPS achieved a remarkable 75% energy-saving rate compared to that in the baseline scenario, accompanied by reductions of 68%, 59%, 66%, 70%, and 64% in CO2, CO, NOx, PM2.5, and SO2 emissions, respectively. In the secondary scenario, the improved scenario of enhancing fuel economy achieved a notable 30% reduction in energy consumption. Additionally, the scenarios involving vehicle structure adjustment (yielding reductions of 36%, 30%, 36%, 26%, and 40%) and annual average mileage reduction (resulting in reductions of 37%, 37%, 36%, 37%, and 36%) demonstrated significant reductions in CO2, CO, NOx, PM2.5, and SO2 emissions.

[Pollution Characteristics, Source, and Health Risk Assessment of Metal Elements in PM2.5 Between Winter and Spring in Zhengzhou].

A total of 18 metal elements in ambient PM2.5 in Zhengzhou were continuously determined using an online heavy metal observation instrument in January and April, 2021, and the changes in element concentrations were analyzed. Metal elements were traced via enrichment factors, positive matrix factorization (PMF), and a characteristic radar chart. The US EPA health risk assessment model was used to assess the health risks of heavy metals, and the backward trajectory method and the concentration-weighted trajectory (CWT) method were used to evaluate the potential source regions of health risks. The results showed that the element concentrations were higher in spring, and the sum of Fe, Ca, Si, and Al concentrations accounted for 89.8% and 87.5% of the total element concentrations in winter and spring, respectively. Cd was enriched significantly, which was related to human activities. The concentrations of Pb, Se, Zn, Ni, Sb, and K in winter and Cr, Ni, Fe, Mn, V, Ba, Ca, K, Si, and Al in spring increased with the increasing pollution level. The results of PMF and the characteristic radar chart showed that the main sources of metal elements in winter and spring were industry, crust, motor vehicles, and mixed combustion, with industry and mixed combustion pollution occurring more often in winter and crust pollution occurring more often in spring. Significant non-carcinogenic risks existed in both winter and spring with more severe health risks in winter, and Mn caused significant non-carcinogenic risks. The health risks in winter were mainly influenced by Zhengzhou and surrounding cities and long-distance transport in the northwest, and the health risks in spring were mainly influenced by Zhengzhou and surrounding cities.

[Characterization of Metal Elements in Atmospheric PM2.5 and Health Risk Assessment in Heze in Winter from 2017 to 2018].

Atmospheric PM2.5 samples were collected in Heze, Shandong Province, from a total of three sampling sites at Heze College, Huarun Pharmacy, and a wastewater treatment plant between October 15, 2017 and January 31, 2018, to determine the concentrations of 21 metal elements in PM2.5 using inductively coupled plasma mass spectrometry (ICP-MS). The degree of elemental enrichment was also discussed, the health risks and potential heavy metal ecological risks were assessed. The results showed that ρ (PM2.5) ranged from 26.7 to 284.1 µg·m-3 at the three sampling sites during the sampling period, and the concentration values did not differ significantly, all of which were at high pollution levels. The highest concentrations of K were found in the three sampling sites, accounting for 31.03%, 39.47%, and 38.43% of the total, respectively, mainly due to the high contribution of biomass burning in autumn and winter in Heze, a large agricultural city. The highest concentrations of Zn, 89.70, 84.21, and 67.68 ng·m-3, were found in the trace elements at the three sampling sites, respectively. The enrichment factor results showed that the enrichment factor values of Zn, Pb, Sn, Sb, Cd, and Se were higher than 100, among which the enrichment factors of Cd and Se were higher than 2 000 and 4 000, respectively, which were significantly influenced by anthropogenic activities and might have been related to industrial production, metal smelting, road sources, and coal combustion emissions. The health risk results showed that there was some potential non-carcinogenic risk (HQ>0.1 for children and adults) for As and a combined potential non-carcinogenic risk (HI>0.1) and some potential carcinogenic risk (CRT>1×10-6) for both children and adults at the three sampling sites. There was a more significant carcinogenic risk (CRT>1×10-4) for adults at the wastewater treatment plant, and the slightly higher carcinogenic risk for adults than that for children may have been related to the longer outdoor activity and higher PM2.5 exposure for adults. The elements with the highest potential ecological risk values were Cd, As, and Pb, with Cd exhibiting a very high potential ecological risk that should be taken seriously. All three sampling sites showed a very high combined potential ecological risk, with the intensity spatially expressed as Heze College>Huarun Pharmacy>wastewater treatment plant.

Availability, price, and affordability of anti-hepatitis B virus drugs: a cross-sectional study in China.

BACKGROUND: The global prevalence of hepatitis B virus (HBV) has presented a persistent challenge for public health prevention and treatment. However, studies that assess the public's access to anti-HBV drugs are absent. AIM: To examine the availability, pricing, and affordability of anti-HBV drugs in Jiangsu province, China and provide recommendations for improvement. METHOD: An enhanced methodology developed by the World Health Organization (WHO) and Health Action International was applied in a cross-sectional study that included 1026 healthcare facilities distributed in 13 prefectural-level cities in Jiangsu province. RESULTS: Since almost all drugs had an availability of less than 30%, the accessibility of anti-HBV drugs was notably low. Primary healthcare facilities had the lowest availability, reporting 1.4% for Original Brands (OBs) and 1.7% for lowest-priced generics (LPGs). Furthermore, the northern Jiangsu region recorded the lowest availability at 0.7%. LPGs demonstrated higher availability than OBs, with median availability probabilities of 2.6% and 1.4%, respectively. The drugs listed on the WHO Essential Medicines List exhibited higher availability than those on other lists. The median price ratios for OBs, LPGs, and volume-based purchasing drugs were 0.83, 0.50, and 0.27, respectively, less than 1.5 times the international reference price. Despite favorable pricing, affordability rate was 23% for urban residents and 0% for rural residents, which was discouraging. CONCLUSION: Low availability and affordability of anti-HBV drugs were observed. Policy recommendations should emphasize the improvement of LPG availability by incentivizing priority prescribing. Healthcare subsidies should be provided more effectively and equitably.

Carbon tax vs. carbon trading in China: which is better for promoting sustainable development of remanufacturing companies?

To accelerate achieving carbon neutrality, the promotion of low-carbon development in the manufacturing industry has been facilitated by the government's implementation of policies such as carbon taxation and carbon emissions trading. These measures have been put in place to reduce carbon emissions and enhance sustainability within the manufacturing sector. Remanufacturing is an important direction for the low-carbon transformation of enterprises, and improving remanufactured product quality is crucial to the sustainability of remanufacturing enterprises. To elucidate the influence of policies aimed at reducing carbon emissions on the quality of remanufactured products, we developed a game model involving three key players: the original equipment manufacturer (OEM), the remanufacturer (IR), and retailers. This model was constructed based on the heterogeneous consumer demand for both new and remanufactured products. The study delved into the effects of various governmental policies aimed at reducing carbon emissions on the quality-related decisions made by remanufacturing enterprises. Our primary focus was on the implementation of two specific policies: a high-level carbon taxation policy and a carbon trading policy characterized by elevated carbon pricing. These policies create a favorable environment for remanufacturers (IR) to enhance the quality of their products. The sales of remanufactured products are influenced by the purchasing preferences of consumers, and carbon reduction policies can be effective in reducing the total environmental impact of manufacturing. Carbon trading policy is most conducive to environmental protection and achieves a win-win situation for economic and environmental benefits for OEMs and IRs when the carbon tax per unit is compared with the carbon trading price. Hence, this situation is favorable for the sustainable growth of existing remanufacturing businesses. Consequently, the government's requirement for subsidies to enhance the quality of remanufactured products and boost the competitiveness of IRs in the market becomes less pronounced.

A Cost-Driven Method for Deep-Learning-Based Hardware Trojan Detection.

The Cyber-Physical System and even the Metaverse will become the second space in which human beings live. While bringing convenience to human beings, it also brings many security threats. These threats may come from software or hardware. There has been a lot of research on managing malware, and there are many mature commercial products, such as antivirus software, firewalls, etc. In stark contrast, the research community on governing malicious hardware is still in its infancy. Chips are the core component of hardware, and hardware Trojans are the primary and complex security issue faced by chips. Detection of hardware Trojans is the first step for dealing with malicious circuits. Due to the limitation of the golden chip and the computational consumption, the existing traditional detection methods are not applicable to very large-scale integration. The performances of traditional machine-learning-based methods depend on the accuracy of the multi-feature representation, and most of the methods may lead to instability because of the difficulty of extracting features manually. In this paper, employing deep learning, a multiscale detection model for automatic feature extraction is proposed. The model is called MHTtext and provides two strategies to balance the accuracy and computational consumption. After selecting a strategy according to the actual situations and requirements, the MHTtext generates the corresponding path sentences from the netlist and employs TextCNN for identification. Further, it can also obtain non-repeated hardware Trojan component information to improve its stability performance. Moreover, a new evaluation metric is established to intuitively measure the model's effectiveness and balance: the stabilization efficiency index (SEI). In the experimental results for the benchmark netlists, the average accuracy (ACC) in the TextCNN of the global strategy is as high as 99.26%, and one of its stabilization efficiency index values ranks first with a score of 71.21 in all comparison classifiers. The local strategy also achieved an excellent effect, according to the SEI. The results show that the proposed MHTtext model has high stability, flexibility, and accuracy, in general.

Food aflatoxin exposure assessment in Sichuan Province, China.

Aflatoxins (AFs) are frequent contaminants in crops worldwide and can cause adverse health effects in exposed humans. Since foods AFs (AFB1, AFB2, AFG1, AFG2) contamination in Sichuan Province are unexplored, we conducted a study to assess AFs exposure in the population. In total, 318 samples, including grains, red chilli, red chilli powder, and vegetable protein beverages, were collected from 13 cities of Sichuan Province, China, in 2022. AFs were detected in all types of foods except for wheat flour, the highest incidence was found in red chilli powder (75.0%). The concentrations of AFtot (the total aflatoxins) ranged between ND (not detected) and 54.20 µg kg-1. It was observed that the AFs profile was dominated by AFB1. The AFB1 content ranged from ND to 52.60 µg kg-1 across food types. According to EU maximum limits (ML) of AFs, 2.8% of samples exceeded the AFtot limits. For AFB1, 0.4% and 4.3% of samples exceeded the China and EU limits, respectively. In this study, packaging types and sampling sites were selected as parameters influence food aflatoxin contamination. Nevertheless, there was no significant difference between different samples. According to exposure assessment and risk characterization, AFtot daily exposure was shown to be 0.263 and 283.936 ng kg-1 bw for the lower and upper exposure. The MOE value derived from consumption grains and red chilli pepper products were generally bellow 10 000, and liver cancer cases based on these two foods consumption could range from < 0.001 to 0.16 cases per year/10 000 persons.

A retrospective study of the accuracy of Invisalign Progress Assessment with clear aligners.

The objective of this study was to detective the accuracy of model superimposition and automatic analysis for upper and lower dentition width in Invisalign Progress Assessment during the process of clear aligners. 19 cases were included in this study. Pre-treatment dental cast (T0) and post-treatment dental cast after staged treatment (T1) were available for three-dimensional model superimposition. Subsequently, movements of maxillary teeth in the horizontal plane (cross-section) after staged treatment and width of upper and lower dentition were measured by three-dimensional model superimposition in the real world and Invisalign Progress Assessment separately. Consequently, the data collected from these two methods were compared. In Invisalign Progress Assessment, movements of maxillary teeth in the horizontal plane after staged treatment was 2.31 (1.59,3.22) [median (upper quartile, lower quartile)] millimeter (mm), while in three-dimensional model superimposition, the result was 1.79 (1.21,3.03) mm. The difference between the two groups is significant (P < 0.05). Intercanine width upper, intermolar width upper, intercanine width lower, and intermolar width lower were 36.55 ± 2.76 mm, 56.98 ± 2.62 mm, 28.16 ± 1.85 mm, 53.21 ± 2.72 mm separately in Invisalign Progress Assessment and were 36.48 ± 2.78 mm, 56.89 ± 2.58 mm, 28.05 ± 1.85 mm, 53.16 ± 2.64 mm separately in three-dimensional model analysis, which was no significant difference among these groups (P > 0.05). The data from Invisalign Progress Assessment was not in parallel with what was achieved from model superimposition with palate as a reference completely. The accuracy of model superimposition in Invisalign Progress Assessment needs further investigation, whereas the accuracy of model analysis in Invisalign Progress Assessment was accurate. Thereby, results from Invisalign Progress Assessment should be interpreted with caution by the orthodontist in the clinic.

Impact of energy depletion, human development, and income distribution on natural resource sustainability.

Constant exploitation of natural resources has resulted from the industrialization and urbanization of society. One of the possible causes of the COVID-19 pandemic is an ecological disturbance caused by excessive resource exploitation. Countries worldwide have taken precautionary measures to limit the spread of this disease because of its highly infectious nature: lockdowns, quarantines, curfews, etc. This paper explores the impacts of energy depletion and the human development index on natural resources, considering the roles of CO2 emissions and economic growth in China from 1971 to 2019. We apply advanced economic modeling using the Phillips-Ouliaris test for integration, Gaussian identity mixed-effects Generalized Linear Model, and Robust GEE population-averaged model for long-run estimates. Results explain that CO2 emissions and economic growth devalue natural resources, while the human development index and energy depletion increase them. Depletion of natural resources occurs due to overexploitation and overuse of natural resources, as well as unsustainable planning and waste. In the case of natural resources that man uses to make other resources, such as dams, roads, sports complexes, etc., these are considered human-made resources. It is, therefore, essential to develop human resources as a part of the natural resource development process. Research limitations and future directions are discussed.

Deep learning assessment of syllable affiliation of intervocalic consonants.

In English, a sentence like "He made out our intentions." could be misperceived as "He may doubt our intentions." because the coda /d/ sounds like it has become the onset of the next syllable. The nature and occurrence condition of this resyllabification phenomenon are unclear, however. Previous empirical studies mainly relied on listener judgment, limited acoustic evidence, such as voice onset time, or average formant values to determine the occurrence of resyllabification. This study tested the hypothesis that resyllabification is a coarticulatory reorganisation that realigns the coda consonant with the vowel of the next syllable. Deep learning in conjunction with dynamic time warping (DTW) was used to assess syllable affiliation of intervocalic consonants. The results suggest that convolutional neural network- and recurrent neural network-based models can detect cases of resyllabification using Mel-frequency spectrograms. DTW analysis shows that neural network inferred resyllabified sequences are acoustically more similar to their onset counterparts than their canonical productions. A binary classifier further suggests that, similar to the genuine onsets, the inferred resyllabified coda consonants are coarticulated with the following vowel. These results are interpreted with an account of resyllabification as a speech-rate-dependent coarticulatory reorganisation mechanism in speech.

Artificial Intelligence in Community-Based Diabetic Retinopathy Telemedicine Screening in Urban China: Cost-effectiveness and Cost-Utility Analyses With Real-world Data.

BACKGROUND: Community-based telemedicine screening for diabetic retinopathy (DR) has been highly recommended worldwide. However, evidence from low- and middle-income countries (LMICs) on the choice between artificial intelligence (AI)-based and manual grading-based telemedicine screening is inadequate for policy making. OBJECTIVE: The aim of this study was to test whether the AI model is more worthwhile than manual grading in community-based telemedicine screening for DR in the context of labor costs in urban China. METHODS: We conducted cost-effectiveness and cost-utility analyses by using decision-analytic Markov models with 30 one-year cycles from a societal perspective to compare the cost, effectiveness, and utility of 2 scenarios in telemedicine screening for DR: manual grading and an AI model. Sensitivity analyses were performed. Real-world data were obtained mainly from the Shanghai Digital Eye Disease Screening Program. The main outcomes were the incremental cost-effectiveness ratio (ICER) and the incremental cost-utility ratio (ICUR). The ICUR thresholds were set as 1 and 3 times the local gross domestic product per capita. RESULTS: The total expected costs for a 65-year-old resident were US $3182.50 and US $3265.40, while the total expected years without blindness were 9.80 years and 9.83 years, and the utilities were 6.748 quality-adjusted life years (QALYs) and 6.753 QALYs in the AI model and manual grading, respectively. The ICER for the AI-assisted model was US $2553.39 per year without blindness, and the ICUR was US $15,216.96 per QALY, which indicated that AI-assisted model was not cost-effective. The sensitivity analysis suggested that if there is an increase in compliance with referrals after the adoption of AI by 7.5%, an increase in on-site screening costs in manual grading by 50%, or a decrease in on-site screening costs in the AI model by 50%, then the AI model could be the dominant strategy. CONCLUSIONS: Our study may provide a reference for policy making in planning community-based telemedicine screening for DR in LMICs. Our findings indicate that unless the referral compliance of patients with suspected DR increases, the adoption of the AI model may not improve the value of telemedicine screening compared to that of manual grading in LMICs. The main reason is that in the context of the low labor costs in LMICs, the direct health care costs saved by replacing manual grading with AI are less, and the screening effectiveness (QALYs and years without blindness) decreases. Our study suggests that the magnitude of the value generated by this technology replacement depends primarily on 2 aspects. The first is the extent of direct health care costs reduced by AI, and the second is the change in health care service utilization caused by AI. Therefore, our research can also provide analytical ideas for other health care sectors in their decision to use AI.

Assessment of the spatiotemporal water quality variations in the Middle Route of China's South-to-North Water Diversion Project by multivariate analysis.

As an important drinking water source for North China, the Middle Route of China's South-to-North Water Diversion Project (MRP) must provide high-quality water to maintain the health and safety of more than 60 million people. However, different water transfer operation modes may affect the water quality status, and the spatiotemporal characteristics of water quality in the MRP, with high water transfer volumes, remain poorly understood. In this study, the differences in water quality in the MRP between the initial stage (Nov. 2015 to Oct. 2017, low transfer volumes) and the current stage (Nov. 2017 to Oct. 2020, high transfer volumes) were compared, and the spatiotemporal water quality variations in the current stage were evaluated using multivariate statistical methods. For this purpose, approximately 12,528 observations, including the datasets of 12 water quality parameters collected from 29 monitoring sites, were used. The results showed that the water quality status improved significantly during the current stage. Based on principal component analysis (PCA), physical parameters (natural), nutrients, organic matter and microbes (anthropogenic), and heavy metals (natural and anthropogenic) were the key factors influencing water quality variations. Based on hierarchical cluster analysis, 12 months were classified into two groups: the high-flow period (HFP, Jun.-Oct.) and the low-flow period (LFP, Nov.-May). Additionally, 29 sampling sites were grouped into three sections: the Henan section (HN; S1-S16), Hebei section (HB; S17-S24), and Tianjin-Beijing section (TB; S25-S29). From the perspective of water quality regulation, the total nitrogen concentration and permanganate index in the HB and TB sections of the MRP should be considered throughout the year, and the faecal coliform concentrations in these two sections should also be considered during the HFP. The results of this study could be helpful for local administrations to understand and control pollution and better protect the quality of water in the MRP.

Do different types of carbon mitigation regulations have heterogeneous effects on innovation quality?

Carbon peak and carbon neutralization as a global mission cannot be completed without systematically designed carbon mitigation regulations. In order to achieve the carbon emission reduction as formulated in the Paris Agreement and fulfill the promises made at the United Nations General Assembly, the Chinese government has promulgated various types of regulations to curb carbon emission with the hope of realizing the Porter effect. Selecting low-carbon pilot cities and carbon emission trading schema as the research objects, this study employs a differences-in-differences (DID) model to investigate the effects of carbon mitigation regulations on innovation quality and its heterogeneity. The empirical results reveal that market-based carbon mitigation regulations can significantly achieve the Porter effect and improve innovation quality. Furthermore, the government financial situation and the technical efficiency change have important moderating and mediating effects respectively. It is recommended that a full play of the market be given in China for the Porter effect. The main scientific value of this paper is distinguished the heterogenous effect of different types of environmental regulations, which can enhance the pertinence of environmental regulation.

Subsidizing high-quality remanufactured products for sustainability.

This study aims to analyze the impact of government subsidy policies on the development of remanufacturing enterprises and product quality in the context of carbon peaking and carbon neutrality, to promote the sustainable development of the remanufacturing industry. It establishes a comparative game model for two cases of remanufacturing enterprises respectively producing low-quality and high-quality remanufactured products. In the context of government subsidies for only high-quality remanufactured products, we investigate the effects of government subsidies on remanufactured products' forms, prices, profits, and consumer preferences. The results show that government subsidies for high-quality remanufactured products help not only reduce the quality cost of remanufactured products and lower the wholesale and retail prices but also increase consumer preference for high-quality remanufactured products, enhance the market demand for remanufactured products, and promote scale expansion of the remanufacturing industry. This study provides decision support for governments to formulate subsidy coefficients for remanufacturing enterprises, offers theoretical and methodological support for the decarbonization and scale-up of remanufacturing and reduction of environmental pollution, and has significant practical value for achieving carbon peak and carbon neutralization goals.

Diffusion-weighted imaging-based radiomics in epithelial ovarian tumors: Assessment of histologic subtype.

Background: Epithelial ovarian tumors (EOTs) are a group of heterogeneous neoplasms. It is importance to preoperatively differentiate the histologic subtypes of EOTs. Our study aims to investigate the potential of radiomics signatures based on diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps for categorizing EOTs. Methods: This retrospectively enrolled 146 EOTs patients [34 with borderline EOT(BEOT), 30 with type I and 82 with type II epithelial ovarian cancer (EOC)]. A total of 390 radiomics features were extracted from DWI and ADC maps. Subsequently, the LASSO algorithm was used to reduce the feature dimensions. A radiomics signature was established using multivariable logistic regression method with 3-fold cross-validation and repeated 50 times. Patients with bilateral lesions were included in the validation cohort and a heuristic selection method was established to select the tumor with maximum probability for final consideration. A nomogram incorporating the radiomics signature and clinical characteristics was also developed. Receiver operator characteristic, decision curve analysis (DCA), and net reclassification index (NRI) were applied to compare the diagnostic performance and clinical net benefit of predictive model. Results: For distinguishing BEOT from EOC, the radiomics signature and nomogram showed more favorable discrimination than the clinical model (0.915 vs. 0.852 and 0.954 vs. 0.852, respectively) in the training cohort. In classifying early-stage type I and type II EOC, the radiomics signature exhibited superior diagnostic performance over the clinical model (AUC 0.905 vs. 0.735). The diagnostic efficacy of the nomogram was the same as that of the radiomics model with NRI value of -0.1591 (P = 0.7268). DCA also showed that the radiomics model and combined model had higher net benefits than the clinical model. Conclusion: Radiomics analysis based on DWI, and ADC maps serve as an effective quantitative approach to categorize EOTs.

Global disease burden and trends of leukemia attributable to occupational risk from 1990 to 2019: An observational trend study.

Background: Leukemia caused by occupational risk is a problem that needs more attention and remains to be solved urgently, especially for acute lymphoid leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphoid leukemia (CLL). However, there is a paucity of literature on this issue. We aimed to assess the global burden and trends of leukemia attributable to occupational risk from 1990 to 2019. Methods: This observational trend study was based on the Global Burden of Disease (GBD) 2019 database, the global deaths, and disability-adjusted life years (DALYs), which were calculated to quantify the changing trend of leukemia attributable to occupational risk, were analyzed by age, year, geographical location, and socio-demographic index (SDI), and the corresponding estimated annual percentage change (EAPC) values were calculated. Results: Global age-standardized DALYs and death rates of leukemia attributable to occupational risk presented significantly decline trends with EAPC [-0.38% (95% CI: -0.58 to -0.18%) for DALYs and -0.30% (95% CI: -0.45 to -0.146%) for death]. However, it was significantly increased in people aged 65-69 years [0.42% (95% CI: 0.30-0.55%) for DALYs and 0.38% (95% CI: 0.26-0.51%) for death]. At the same time, the age-standardized DALYs and death rates of ALL, AML, and CLL were presented a significantly increased trend with EAPCs [0.78% (95% CI: 0.65-0.91%), 0.87% (95% CI: 0.81-0.93%), and 0.66% (95% CI: 0.51-0.81%) for DALYs, respectively, and 0.75% (95% CI: 0.68-0.82%), 0.96% (95% CI: 0.91-1.01%), and 0.55% (95% CI: 0.43-0.68%) for death], respectively. The ALL, AML, and CLL were shown an upward trend in almost all age groups. Conclusion: We observed a substantial reduction in leukemia due to occupational risks between 1990 and 2019. However, the people aged 65-69 years and burdens of ALL, AML, and CLL had a significantly increased trend in almost all age groups. Thus, there remains an urgent need to accelerate efforts to reduce leukemia attributable to occupational risk-related death burden in this population and specific causes.

Quantitative assessment of intracellular/extracellular dimethyl sulfoxide concentrations during freezing with low-temperature confocal Raman micro-spectroscopy.

Although cryopreservation plays an indispensable role in the clinical application of cell therapy, the research on the osmotic behavior of cells during freezing is still at the level of theoretical models, and quantitative experimental data are still lacking. Therefore, the Raman spectra of dimethyl sulfoxide (DMSO) solutions with different standard concentrations (5%-80% v/v) were recorded experimentally to establish a quantitative evaluation method with the intensity ratio of different labeled peaks to the hydrogen bonding peak (as the internal standard) of water molecules in relation to different DMSO concentrations. By using this method, the characteristics of quantitative changes in intra- and extracellular concentrations under three different freezing methods were explored, including direct freezing, ice seeding freezing and vitrification. It was found that the intracellular concentration (@ -50 °C) after the ice seeding (@ -7 °C) freezing (1 °C min-1) method could reach 41.6%-49.2%, significantly higher than that of the direct freezing method (1 °C min-1 to -50 °C) of 32.4%-39.1%. Moreover, it is worth noting that the quantitative values of concentrations (@ -50 °C) of the ice seeding freezing are more consistent with the primary saturation curve of the DMSO solution. Thus, for the first time, it was revealed from the experimental data that the fundamental reason for the improvement of cell survival after ice seeding operation was pre-dehydration, higher concentration and smaller osmotic pressure difference between the inside and outside of the cell. These results also confirmed the validity of the famous two-factor hypothesis and more work will be carried out in depth.

The Effects of Online Social Interactions on Life Satisfaction of Older Chinese Adults: New Insights Based on a Longitudinal Approach.

Population aging and digitalization have become universal phenomena. Over the past two decades, digital inclusion has started to play a crucial role in supporting successful aging. Based on a nationally representative sample of around 5200 older adults in China over the period of 2014-2018, we explore the effects of online social interactions (OSIs) on the life satisfaction of older adults. We find that OSIs can improve the levels of life satisfaction of older Chinese adults. Estimates from fixed effect and cross-lagged structural equation models further suggest that OSIs work by increasing physical activities, healthy time allocation, interpersonal trust, and informal social engagement and reducing loneliness. We also find that OSIs narrow the social inequality in life satisfaction across groups from rural-urban areas and groups with different social statuses. Moreover, a comparison among different online engagements shows that not all online activities positively affect older adults' life satisfaction. Different online activities have varying effects. Our results highlight that public digital interventions focusing on social functions can benefit the lives of older adults.