Influencing factors of hospitalization cost of hypertension patients in traditional Chinese medicine hospitals.

Objectives: This study aimed to analyze the influencing factors of hospitalization cost of hypertensive patients in TCM (traditional Chinese medicine, TCM) hospitals, which can provide a scientific basis for hospitals to control the hospitalization cost of hypertension. Methods: In this study, 3,595 hospitalized patients with a primary diagnosis of tertiary hypertension in Tianshui City Hospital of TCM, Gansu Province, China, from January 2017 to June 2022, were used as research subjects. Using univariate analysis to identify the relevant variables of hospitalization cost, followed by incorporating the statistically significant variables of univariate analysis as independent variables in multiple linear regression analysis, and establishing the path model based on the results of the multiple linear regression finally, to explore the factors influencing hospitalization cost comprehensively. Results: The results showed that hospitalization cost of hypertension patients were mainly influenced by length of stay, age, admission pathways, payment methods of medical insurance, and visit times, with length of stay being the most critical factor. Conclusion: The Chinese government should actively exert the characteristics and advantages of TCM in the treatment of chronic diseases such as hypertension, consistently optimize the treatment plans of TCM, effectively reduce the length of stay and steadily improve the health literacy level of patients, to alleviate the illnesses pain and reduce the economic burden of patients.

Cost-Effectiveness Analysis of Fluocinolone Acetonide Intravitreal (FAI) Implant for Chronic Noninfectious Uveitis Affecting the Posterior Segment of the Eye (NIU-PS) in China.

INTRODUCTION: Chronic non-infectious uveitis affecting the posterior segment (NIU-PS), which can be recurrent and persistent for numerous years, mainly affects people of working age and significantly increases the risk of visual impairment. This study aimed to investigate the cost-effectiveness of fluocinolone acetonide intravitreal (FAI) implant in the treatment of patients with chronic NIU-PS from the Chinese healthcare perspective. METHODS: A Markov model with a 2-week cycle was constructed from the perspective of the Chinese healthcare system over a lifetime time horizon. The model consists of four health states: on-treatment, treatment failure, blindness, and death. The outcomes for effectiveness were based on the Chinese real-world study (RWS). Utilities and mortality rates were derived from published literature and standard sources. Costs were determined from the MENET website, prices of medical service items at local providers, published literature, and expert surveys. Outcomes were measured in quality-adjusted life years (QALYs). Sensitivity analyses were performed to account for the impact of uncertainty. RESULTS: It was estimated that in the base case, the FAI implant provided 0.43 incremental QALYs compared with the limited current practice (LCP) at an additional cost of $7503.72 (¥50,575.05), resulting in an incremental cost-effectiveness ratio (ICER) of $17,373.49 (¥117,097.33) per QALY gained. Parameters related to utility emerged as the primary influencers on the outcomes. In probabilistic sensitivity analysis (PSA), considering the willingness-to-pay (WTP) threshold of $19,072 (¥128,547) and $38,145 (¥257,094), the FAI implant had 67.70% and 99.50% probability of being cost-effective, respectively. As demonstrated in the scenario analysis, if the FAI implant aligns its price reduction with the average rate from the 2023 negotiation of the National Reimbursement Drug List (NRDL), it would result in lower costs and represent an absolute advantage. CONCLUSIONS: The FAI implant, which can effectively reduce the recurrence rate and maintain the incremental costs within the WTP limit, is likely to be cost-effective in treating chronic NIU-PS in China.

Low-cost pyrolysis of biomass-derived nitrogen-doped porous carbon: Chlorella vulgaris replaces melamine as a nitrogen source.

Porous carbon generated from biomass has a rich pore structure, is inexpensive, and has a lot of promise for use as a carbon material for energy storage devices. In this work, nitrogen-doped porous carbon was prepared by co-pyrolysis using bagasse as the precursor and chlorella as the nitrogen source. ZnCl2 acts as both an activator and a nitrogen fixer during activation to generate pores and reduce nitrogen loss. The thermal weight loss experiments showed that the pyrolysis temperatures of bagasse and chlorella overlap, which created the possibility for the synthesis of nitrogen-rich biochar. The optimum sample (ZBC@C-5) possessed a surface area of 1508 m2g-1 with abundant nitrogen-containing functional groups. ZBC@C-5 in the three-electrode system exhibited 244.1F/g at 0.5A/g, which was extremely close to ZBC@M made with melamine as the nitrogen source. This provides new opportunities for the use of low-cost nitrogen sources. Furthermore, the devices exhibit better voltage retention (39%) and capacitance retention (96.3%). The goal of this research is to find a low cost, and effective method for creating nitrogen-doped porous carbon materials with better electrochemical performance for highly valuable applications using bagasse and chlorella.

Source analysis and health risk assessment of polycyclic aromatic hydrocarbon (PAHs) in total suspended particulate matter (TSP) from Bengbu, China.

The polycyclic aromatic hydrocarbon (PAH) concentrations in total suspended particulate matter (TSP) samples collected from October, 2021 to September, 2022 were analyzed to clarify the pollution characteristics and sources of 16 PAHs in the atmospheric TSP in Bengbu City. The ρ(PAHs) concentrations ranged from 1.71 to 43.85 ng/m3 and higher concentrations were detected in winter, followed by spring, autumn, and summer. The positive matrix factorization analysis revealed that, in spring and summer, PAH pollution was caused mainly by industrial emissions, gasoline and diesel fuel combustion, whereas in autumn and winter, it was coal, biomass and natural gas combustion. The cluster and potential source factor analyses showed that long-range transport was a significant factor. During spring, autumn, and winter, the northern and northwestern regions had a significant impact, whereas the coastal area south of Bengbu had the greatest influence in summer. The health risk assessment revealed that the annual total carcinogenic equivalent concentration values for PAHs varied from 0.0159 to 7.437 ng/m3, which was classified as moderate. Furthermore, the annual incremental lifetime cancer risk values ranged from 1.431 × 10-4 to 3.671 × 10-3 for adults and from 6.823 × 10-5 to 1.749 × 10-3 for children, which were higher than the standard.

A rapid and low-cost platform for detection of bacterial based on microchamber PCR microfluidic chip.

Polymerase chain reaction (PCR) has been considered as the gold standard for detecting nucleic acids. The simple PCR system is of great significance for medical applications in remote areas, especially for the developing countries. Herein, we proposed a low-cost self-assembled platform for microchamber PCR. The working principle is rotating the chamber PCR microfluidic chip between two heaters with fixed temperature to solve the problem of low temperature variation rate. The system consists of two temperature controllers, a screw slide rail, a chamber array microfluidic chip and a self-built software. Such a system can be constructed at a cost of about US$60. The micro chamber PCR can be finished by rotating the microfluidic chip between two heaters with fixed temperature. Results demonstrated that the sensitivity of the temperature controller is 0.1℃. The relative error of the duration for the microfluidic chip was 0.02 s. Finally, we successfully finished amplification of the target gene of Porphyromonas gingivalis in the chamber PCR microfluidic chip within 35 min and on-site detection of its PCR products by fluorescence. The chip consisted of 3200 cylindrical chambers. The volume of reagent in each volume is as low as 0.628 nL. This work provides an effective method to reduce the amplification time required for micro chamber PCR.

Systematic Assessment of Chinese Medicine Compounds for Mitigating Anthracycline-Induced Cardiotoxicity.

Background: Anthracycline chemotherapy is highly effective in treating various cancers but is associated with significant cardiotoxicity. Chinese herbal compounds have shown promise in mitigating this adverse effect, warranting systematic evaluation for clinical applicability. Objective: This study seeks to systematically assess the effectiveness of Chinese herbal compounds in managing anthracycline-induced cardiotoxicity via meta-analysis. The objective is to establish an evidence-based framework for their clinical use in preventing and treating this condition. Methods: This study employed a systematic review and meta-analysis design. A comprehensive search strategy was implemented across multiple databases, including CNKI, VIP, PubMed, Embase, and the Cochrane Library, to identify relevant randomized controlled trials (RCTs). Data collection involved extracting information on the efficacy of Chinese herbal compounds in treating anthracycline-induced cardiotoxicity. The primary outcome measures included left ventricular ejection fraction (LVEF), serum levels of cardiac troponin I (cTnI), creatine kinase-MB (CK-MB), creatine kinase (CK), and ST-T abnormality. The risk of bias in these studies was assessed following Cochrane Handbook guidelines. Meta-analysis of outcome indicators was conducted utilizing RevMan 5.4. Results: A total of 10 RCTs involving 748 patients met the inclusion criteria. Findings indicate that Chinese herbal compounds significantly enhance left ventricular ejection fraction (LVEF) while reducing serum levels of cTnI, CK-MB, and CK. Additionally, the compounds demonstrate a significant improvement in ST-T abnormality. Conclusions: Chinese herbal compounds exhibit promising potential in ameliorating anthracycline-induced cardiotoxicity. These findings underscore the potential utility of Chinese herbal medicine as an adjunctive therapy in managing this condition. Further research is warranted to explain the underlying mechanisms and optimize their clinical application.

Disparities in mortality risk after diagnosis of hematological malignancies in 185 countries: A global data analysis.

This study was to report proxy measures for mortality risk in patients with hematological malignancies across 185 countries globally and explore its association with their socioeconomic status and treatment. The incidence, mortality, and 5-year prevalence data were extracted from the GLOBOCAN database. The data regarding the human development index (HDI), gross national income (GNI), vulnerability index, and concordance with cancer Essential Medicines List (EML) were obtained from open-source reports. The ratio of mortality to 5-year-prevalence (MPR) and that of mortality to incidence (MIR) were calculated and age-standardized using Segi's world standard population. Finally, the possible associations were assessed using Pearson correlation analyses. In 2020, the global incidence, mortality, and 5-year prevalence of HMs were 1,278,362, 711,840, and 3,616,685, respectively. Global age-standardized MPR and MIR were 0.15 and 0.44, respectively; they varied significantly among 6 regions, 185 countries, 4 HM types, and 4 HDI groups worldwide. Older populations always had higher ratios. The correlation of MPRs and MIRs with HDI, GNI, and concordance with cancer EML was negative, whereas it was positive with the vulnerability index (lower was better). Increasing access to cancer drugs in resource-limited regions with a focus on vulnerable children may aid in reducing HM-related mortality risk.

Corrigendum: Comparison of cardiac function between single left ventricle and tricuspid atresia: assessment using echocardiography combined with computational fluid dynamics.

[This corrects the article DOI: 10.3389/fped.2023.1159342.].

Mono+ algorithm assessment of the diagnostic value of dual-energy CT for high-risk factors for colorectal cancer: a preliminary study.

Background: Risk factors for colorectal cancer (CRC) affect the way patients are subsequently treated and their prognosis. Dual-energy computerized tomography (DECT) is an advanced imaging technique that enables the quantitative evaluation of lesions. This study aimed to evaluate the quality of DECT images based on the Mono+ algorithm in CRC, and based on this, to assess the value of DECT in the diagnosis of CRC risk factors. Methods: This prospective study was performed from 2021 to 2023. A dual-phase DECT protocol was established for consecutive patients with primary CRC. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), overall image quality, lesion delineation, and image noise of the dual-phase DECT images were assessed. Next, the optimal energy-level image was selected to analyze the iodine concentration (IC), normalized iodine concentration (NIC), effective atomic number, electron density, dual-energy index (DEI), and slope of the energy spectrum curve within the tumor for the high- and low-risk CRC groups. A multifactor binary logistic regression analysis was used to construct a differential diagnostic regression model for high- and low-risk CRC, receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to assess the diagnostic value of the model. Results: A total of 74 patients were enrolled in this study, of whom 41 had high-risk factors and 33 had low-risk factors. The SNR and CNR were best at 40 keV virtual monoenergetic imaging (VMI) based on the Mono+ algorithm (VMI+) (SNR 8.79±1.27, P<0.001; CNR 14.89±1.77, P=0.027). The overall image quality and lesion contours were best at 60 keV VMI+ and 40 keV VMI+, respectively (P=0.001). Among all the DECT parameters, the arterial phase (AP)-IC, NIC, DEI, energy spectrum curve, and venous phase-NIC differed significantly between the two groups. The AP-IC was the optimal DECT parameter for predicting high- and low-risk CRC with AUC, sensitivity, specificity, and cut-off values of 0.96, 97.06%, 87.80%, and 2.94, respectively, and the 95% confidence interval (CI) of the AUC was 0.88-0.99. Integrating the clinical factors and DECT parameters, the AUC, sensitivity, specificity, and predictive accuracy of the model were 0.99, 100.00%, 92.68%, and 94.67%, respectively, and the 95% CI of the AUC was 0.93-1.00. Conclusions: The DECT parameters based on 40 keV noise-optimized VMI+ reconstruction images depicted the CRC tumors best, and the clinical DECT model may have significant implications for the preoperative prediction of high-risk factors in CRC patients.

Sound Touch Elastography for Noninvasive Assessment of Liver Stiffness in Patients With Chronic Heart Failure.

Heart failure (HF) can damage various organs, including the liver, a phenomenon known as "cardiohepatic syndrome." The latter is characterized by liver congestion and hepatic artery hypoperfusion, which can lead to liver damage. In this study, we aimed to assess liver damage quantitatively in chronic HF (CHF) with sound touch elastography (STE). A total of 150 subjects were enrolled, including HF with reduced ejection fraction (HFrEF) groups (left ventricular ejection fraction ≤40%, n = 45), HF with mildly reduced ejection fraction (HFmrEF) groups (left ventricular ejection fraction between 41% and 49%, n = 40), and right-sided HF (RHF) groups (n = 25); normal groups (n = 40). Liver stiffness measurement (LSM) was performed in all subjects by STE. The other hepatic parameters were also measured. The LSM was 5.4 ± 1.1 kPa in normal subjects and increased slightly to 5.9 ± 0.7 kPa in patients with HFmrEF. However, the HFrEF and RHF groups had significantly higher LSMs of 8.4 ± 2.0 kPa and 10.3 ± 2.7 kPa, respectively. The LSM of HFrEF was significantly higher than that of HFmrEF, whereas the increase in LSM in patients with RHF was significant relative to HFmrEF and HFrEF. In addition, the other parameters showed abnormal values in only RHF and HFrEF. In conclusion, STE is a useful clinical technique for the noninvasive evaluation of liver stiffness associated with CHF, which could help patients with CHF manage their treatment regimens.

CYP4CS5-mediated thiamethoxam and clothianidin resistance is accompanied by fitness cost in the whitefly Bemisia tabaci.

BACKGROUND: Understanding the trade-offs between insecticide resistance and the associated fitness is of particular importance to sustainable pest control. One of the most devastating pest worldwide, the whitefly Bemisia tabaci, has developed resistance to various insecticides, especially the neonicotinoid group. Although neonicotinoid resistance often is conferred by P450s-mediated metabolic resistance, the relationship between such resistance and the associated fitness phenotype remains largely elusive. By gene cloning, quantitative reverse transcription (qRT)-PCR, RNA interference (RNAi), transgenic Drosophila melanogaster, metabolism capacity in vitro and 'two sex-age stage' life table study, this study aims to explore the molecular role of a P450 gene CYP4CS5 in neonicotinoid resistance and to investigate whether such resistance mechanism carries fitness costs in the whitefly. RESULTS: Our bioassay tests showed that a total of 13 field-collected populations of B. tabaci MED biotype displayed low-to-moderate resistance to thiamethoxam and clothianidin. Compared to the laboratory susceptible strain, we then found that an important P450 CYP4CS5 was remarkably upregulated in the field resistant populations. Such overexpression of CYP4CS5 had a good match with the resistance level among the whitefly samples. Further exposure to the two neonicotinoids resulted in an increase in CYP4CS5 expression. These results implicate that overexpression of CYP4CS5 is closely correlated with thiamethoxam and clothianidin resistance. RNAi knockdown of CYP4CS5 increased mortality of the resistant and susceptible populations after treatment with thiamethoxam and clothianidin in bioassay, but obtained an opposite result when using a transgenic line of D. melanogaster expressing CYP4CS5. Metabolic assays in vitro revealed that CYP4CS5 exhibited certain capacity of metabolizing thiamethoxam and clothianidin. These in vivo and in vitro assays indicate an essential role of CYP4CS5 in conferring thiamethoxam and clothianidin resistance in whitefly. Additionally, our life-table analysis demonstrate that the field resistant whitefly exhibited a prolonged development time, shortened longevity and reduced fecundity compared to the susceptible, suggesting an existing fitness cost as a result of the resistance. CONCLUSION: Collectively, in addition to the important role of CYP4CS5 in conferring thiamethoxam and clothianidin resistance, this resistance mechanism is associated with fitness costs in the whitefly. These findings not only contribute to the development of neonicotinoids resistance management strategies, but also provide a new target for sustainable whitefly control. © 2023 Society of Chemical Industry.

Nicotinamide mononucleotide alleviates endotoxin-induced acute lung injury by modulating macrophage polarization via the SIRT1/NF-κB pathway.

CONTEXT: Sepsis-induced acute lung injury (ALI) is a severe condition with limited effective therapeutics; nicotinamide mononucleotide (NMN) has been reported to exert anti-inflammatory activities. OBJECTIVE: This study explores the potential mechanisms by which NMN ameliorates sepsis-induced ALI in vivo and in vitro. MATERIALS AND METHODS: Cultured MH-S cells and a murine model were used to evaluate the effect of NMN on sepsis-induced ALI. MH-S cells were stimulated with LPS (1 µg/mL) and NMN (500 µM) for 12 h grouping as control, LPS, and LPS + NMN. Cell viability, apoptotic status, and M1/2 macrophage-related markers were detected. The mice were pretreated intraperitoneally with NMN (500 mg/kg) and/or EX-527 (5 mg/kg) 1 h before LPS injection and randomized into 7 groups (n = 8): control, LPS, LPS + NMN, NMN, LPS + NMN + EX-527 (a SIRT1 inhibitor), LPS + EX-527, and EX-527. After 12 h, lung histopathology, W/D ratio, MPO activity, NAD+ and ATP levels, M1/2 macrophage-related markers, and expression of the SIRT1/NF-κB pathway were detected. RESULTS: In MH-S cells, NMN significantly decreased the apoptotic rate from 12.25% to 5.74%. In septic mice, NMN improved the typical pathologic findings in lungs and reduced W/D ratio and MPO activity, but increased NAD+ and ATP levels. Additionally, NMN suppressed M1 but promoted M2 polarization, and upregulated the expression of SIRT1, with inhibition of NF-κB-p65 acetylation and phosphorylation. Furthermore, inhibition of SIRT1 reversed the effects of NMN-induced M2 macrophage polarization. CONCLUSIONS: NMN protects against sepsis-induced ALI by promoting M2 macrophage polarization via the SIRT1/NF-κB pathway, it might be an effective strategy for preventing or treating sepsis-induced ALI.

A study of the economic growth effects of market integration: An examination of 27 cities in the Yangtze River Delta city cluster.

The city cluster of the Yangtze River Delta is a highly dynamic and competitive economic region in China. The integration of the market across the 27 cities is crucial in driving economic growth in the area. This paper aims to provide policymakers with recommendations on promoting regional integration, enhancing the structure, and improving overall performance. By utilizing the benefits and resources of each community more effectively, greater economic gains can be achieved. The findings of this study can also be applied to other Chinese towns or business areas. Market integration is a necessary foundation for regional integration, as it enables the seamless movement of goods and factors throughout the region while simultaneously reducing entry barriers and supporting the creation of a unified market. Unfortunately, the "vassal economy" model has impeded the region's economic growth. The integration of regional markets is crucial for economic growth. However, it is equally important to create industrial clusters with central towns as their hubs. The Yangtze River Delta urban agglomeration is a prime example of one of six world-class city clusters demonstrating how market integration can result in high-quality economic progress. The paper's primary discoveries are threefold: firstly, there has been a progressive elevation in the level of market integration among the 27 cities within the Yangtze River Delta city cluster, characterized by increasingly intimate connections concerning trade, investment, and population mobility. Secondly, this heightened market integration exerts a catalytic impact on the real economic growth of the Yangtze River Delta city cluster, particularly concerning regional industrial restructuring, transformation, and upgrading. Finally, market integration is poised to expedite the industrial division of labor and synergistic development between the cities, thus promoting a concentration of advanced manufacturing and new industries in the central cities and furthering the development of profitable industries in the central individual cities.

Assessment of early dental arch growth modification with removable maxillary expansion by cone-beam computed tomography and lateral cephalometric radiographs: a retrospective study.

BACKGROUND: This study evaluated the skeletal and dental changes of patients brought by early removable maxillary expansion (ERME) treatment to explore the clinical treatment effect of ERME on early dental arch growth modification. METHODS: Subject children aged 6-10 years with a maxillary transverse deficiency received ERME treatment, cone-beam computed tomography (CBCT) and lateral cephalometric radiographs were measured before and after treatment, and statistical differences in the measured items were evaluated with corresponding statistical methods to explore the skeletal and dental changes. RESULTS: After ERME treatment, there was a statistical increase in the maxillary basal bone arch width, nasal cavity width, maxillary alveolar bone arch width, and maxillary dental arch width. A buccal inclination of the maxillary alveolar bone and a buccal inclination and buccal movement in the alveolar bone of maxillary first molars were found. The maxillary skeletal expansion was statistically greater than the dental expansion. Increases in the mandibular alveolar bone arch width and dental arch width happened after treatment. A decrease in angle ANB and an increase in Ptm-A, U1-SN, U1-PP, L1-MP, and L6-MP were found after treatment. No statistical changes in the growth pattern-related measured items were observed. CONCLUSIONS: ERME could expand the maxillary basal bone arch width, nasal cavity width, maxillary alveolar bone arch width, and maxillary dental arch width. The maxillary skeletal expansion was greater than the dental expansion. Secondary increases in the mandibular alveolar bone and dental arch widths would happen after ERME. ERME would result in a mandibular advancement, a labial inclination of maxillary anterior teeth, and an increase of maxillary sagittal length, and would not change the patient's growth pattern. TRIAL REGISTRATION: This study was approved by the Institutional Review Board of the West China Hospital of Stomatology, Sichuan University. (WCHSIRB-D-2020-446).

Revisiting Assessment of Computational Methods for Hi-C Data Analysis.

The performances of algorithms for Hi-C data preprocessing, the identification of topologically associating domains, and the detection of chromatin interactions and promoter-enhancer interactions have been mostly evaluated using semi-quantitative or synthetic data approaches, without utilizing the most recent methods, since 2017. In this study, we comprehensively evaluated 24 popular state-of-the-art methods for the complete end-to-end pipeline of Hi-C data analysis, using manually curated or experimentally validated benchmark datasets, including a CRISPR dataset for promoter-enhancer interaction validation. Our results indicate that, although no single method exhibited superior performance in all situations, HiC-Pro, DomainCaller, and Fit-Hi-C2 showed relatively balanced performances of most evaluation metrics for preprocessing, topologically associating domain identification, and chromatin interaction/promoter-enhancer interaction detection, respectively. The comprehensive comparison presented in this manuscript provides a reference for researchers to choose Hi-C analysis tools that best suit their needs.

Construction of a multi-classified decision tree model for identifying malignant pleural effusion and tuberculous pleural effusion.

OBJECTIVE: Pleural effusion (PE) is a common clinical complication associated with various disorders. We aimed to utilize laboratory variables and their corresponding ratios in serum and PE for the differential diagnosis of multiple types of PE based on a decision tree (DT) algorithm. METHODS: A total of 1435 untreated patients with PE admitted to The First Affiliated Hospital of Ningbo University were enrolled. The demographic and laboratory variables were collected and compared. The receiver operating characteristic curve was used to select important variables for diagnosing malignant pleural effusion (MPE) or tuberculous pleural effusion (TPE) and included in the DT model. The data were divided into the training set and the test set at a ratio of 7:3. The training data was used to develop the DT model, and the test data was for evaluating the model. Independent data was collected as external validation. RESULTS: Three PE indicators (carcinoembryonic antigen, adenosine deaminase [ADA], and total protein), two serum indicators (neuron-specific enolase and cytokeratin 19 fragments), and two ratios [high-sensitivity C-reactive protein (hsCRP)/ PE lymphocyte and hsCRP/PE ADA] were used to construct the DT model. The area under the curve (AUC), sensitivity, and specificity for diagnosing MPE were 0.963, 84.0%, 91.6% in the training set, 0.976, 84.1%, 88.6% in the test set, and 0.955,83.3%, 86.7% in the external validation set. The AUC, sensitivity, and specificity of diagnosing TPE were 0.898, 86.8%, 92.3% in the training set, 0.888, 88.8%, 92.7% in the test set, and 0.778, 84.8%, 94.3% in the external validation set. CONCLUSION: The DT model showed good diagnostic efficacy and could be applied for the differential diagnosis of MPE and TPE in clinical settings.

Improving food security and farmland carbon sequestration in China through enhanced rock weathering: Field evidence and potential assessment in different humid regions.

Enhanced rock weathering (ERW) in farmland is an emerging carbon dioxide removal technology with crushed silicate rocks for soil improvement. However, due to climatic variability and field data limitations, uncertainties remain regarding the influence of ERW on food security and soil carbon pools in temperate regions. This study focused to evaluate the crop productivity and carbon sequestration potential of farmland ERW in China by conducting field monitoring in different humid regions and ERW performance model. Additionally, the contribution of climate, soil, and management factors to ERW-mediated yield and carbon sequestration changes was explored using random forest and correlation networks. Field monitoring indicated that farmland ERW significantly improved crop yield in humid region (13.5 ± 5.2 %), along with notable improvements in soil pH and available nutrients. Precipitation (10.4-16.7 %) and soil pH (9.7-16.8 %) had the highest contribution on ERW mediated yield and carbon sequestration changes, but the contribution of management factors (24-26.2 %), especially N input (2.7-7.0 %), should not be disregarded. The model evaluation demonstrated that the carbon sequestration rate of farmland ERW in China can reach 0.28-0.40 Gt yr-1, thereby presenting an opportunity to expand and accelerate the nationally determined contributions of China. The mean sequestration cost of farmland ERW was 633 ± 161 CNY ¥ t-CO2-1, which was an attractive sequestration price considering the positive benefits of rock powder on soil pH and nutrients. Deploying ERW in acidified and mineral nutrient deficient regions was able to serve as an alternative to lime and part chemical fertilizers to improve yield and maximize agricultural sustainability and resource co-benefits. Farmland ERW also has the potential to resource silicate waste to assist traditional, difficult-to-decarbonize industries to reduce carbon emissions. As a result, a comprehensive assessment of existing artificial silicate waste materials could further expand the application of farmland ERW.

Comprehensive assessment of resources for prevention and control of chronic and non-communicable diseases in China: a cross-sectional study.

OBJECTIVE: This study aims to comprehensively evaluate the resources for prevention and control of chronic and non-communicable diseases (NCDs) in China to provide a reference basis for optimising the resource allocation for prevention and control of NCDs. METHODS: China Chronic Disease and Risk Factor Surveillance sites and National Demonstration Areas for Integrated Chronic and Non-communicable Disease Prevention and Control (NCDDA) were selected as investigation objects. In December 2021, the district (or county) resource allocation for NCD prevention and control was investigated through the NCDDA management information system. According to the index system of NCD prevention and control, 31 indicators of 6 dimensions were collected, and the weighted technique for order preference by similarity to an ideal solution, weighted rank-sum ratio and fuzzy comprehensive evaluation methods were used for comprehensive evaluation of resources for prevention and control of NCDs. RESULTS: The 653 districts (or counties) in this study cover 22.96% of China's districts (or counties). The top three weights were full-time staff for NCD prevention and control (0.1066), the amount of funds for NCD prevention and control (0.0967), and the coverage rate of districts (or counties) establishing chronic obstructive pulmonary disease surveillance information system (0.0886). The comprehensive evaluation results for the resources for prevention and control of NCDs by the three methods were basically the same. The results of fuzzy comprehensive evaluation showed that the resource allocation in urban areas (0.9268) was better than that in rural areas (0.3257), the one in eastern region (0.9016) was better than that in central (0.3844) and western regions (0.3868), and the one in NCDDA (0.9625) was better than that in non-NCDDA (0.2901). CONCLUSION: The resources in China for NCD prevention and control differ among different regions, which should be taken into account in future policymaking and resource allocation.

Development of an Automated Composite Ureteroscopic Efficiency Score Through Simulated Ureteroscopic Skills Assessment.

Introduction: Flexible ureteroscopy (fURS) is the most common procedure for treatment of urolithiasis. We previously utilized kinematic evaluations of simulated fURS to demonstrate that certain body movements are associated with efficient ureteroscopic manipulation for complex tasks. In this study, we incorporated computer vision to create an efficiency score using the ureteroscope travel distance (DIST), task time (TIME), spectral arc length (SPARC), and percentage of purposeful wall collisions (COLL). The goal is a simulation-based system that can abstract these automated performance metrics (APMs) to differentiate between novice and expert ureteroscope handling. Methods: A ureteroscopic simulation box was used. Body kinematics, task time, and ureteroscopic movements were analyzed using a motion capture system and video camera. Optical flow computer vision was used to track the ureteroscope. DIST, TIME, and SPARC were automatically calculated. Wall collisions were automatically captured and independently judged by two authors; an algorithm was developed to automatically determine the COLL variable. A mixed-effects model was used to aggregate these variables and distinguish between surgeons' first and final task attempts. Normalized values of these metrics were added to create a composite ureteroscopic efficiency score (CUES). Results: Twelve urologists completed the simulated tasks. The COLL assessment algorithm determined beneficial wall collisions with an accuracy of 77%. Normalized values of TIME, DIST, SPARC, and COLL were combined to create a composite ureteroscopic efficiency score (CUES). Compared with the first attempt, both the second and third attempts showed statistically significant improvements in CUES. The ROC-AUC score reached 0.86, suggesting excellent discrimination between attempts. There was also a statistically significant difference in CUES when comparing resident and attending performance. Conclusions: APMs can be abstracted using computer vision and artificial intelligence; an aggregate composite score (CUES) may be a promising method for evaluation of ureteroscopic efficiency.

Comparison of cardiac function between single left ventricle and tricuspid atresia: assessment using echocardiography combined with computational fluid dynamics.

Patients with single left ventricle (SLV) and tricuspid atresia (TA) have impaired systolic and diastolic function. However, there are few comparative studies among patients with SLV, TA and children without heart disease. The current study includes 15 children in each group. The parameters measured by two-dimensional echocardiography, three-dimensional speckle tracking echocardiography (3DSTE), and vortexes calculated by computational fluid dynamics were compared among these three groups. Twist is best correlated with ejection fraction measured by 3DSTE. Twist, torsion, apical rotation, average radial strain, peak velocity of systolic wave in left lateral wall by tissue Doppler imaging (sL), and myocardial performance index are better in the TA group than those in the SLV group. sL by tissue Doppler imaging in the TA group are even higher than those in the Control group. In patients with SLV, blood flow spreads out in a fan-shaped manner and forms two small vortices. In the TA group, the main vortex is similar to the one in a normal LV chamber, but smaller. The vortex rings during diastolic phase are incomplete in the SLV and TA groups. In summary, patients with SLV or TA have impaired systolic and diastolic function. Patients with SLV had poorer cardiac function than those with TA due to less compensation and more disordered streamline. Twist may be good indicator for LV function.