Does an antihypertensive diet cost more? Analysis from the Chinese Heart-Healthy diet trial.

OBJECTIVE: To determine whether the Chinese heart-healthy diet (Sichuan cuisine version) (CHH diet-SC) was more expensive than the conventional Sichuan diet and explore the food groups and nutrients that mainly affected the cost of CHH diet-SC. DESIGN: Cost analysis of 4-week intervention diets in the Sichuan center representing southwestern China in the CHH diet study. SETTING: A multicentre, parallel-group, single-blind, randomised feeding trial evaluating the efficacy of lowering blood pressure with the cuisine-based CHH diet. PARTICIPANTS: Totally, fifty-three participants with hypertension aged 25-75 years in the Sichuan center were randomised into the control group (n 26) or the CHH diet-SC group (n 27). RESULTS: The CHH diet-SC was more expensive than the control diet (¥27·87 ± 2·41 v. ¥25·18 ± 2·79 equals $3·90 ± 0·34 v. $3·52 ± 0·39, P < 0·001), and the incremental cost-effectiveness ratio for a 1-mm Hg systolic blood pressure reduction was ¥9·12 ($1·28). Intakes and the cost of seafood, dairy products, fruits, soybeans and nuts, whole grains and mixed beans were higher for the CHH diet-SC than for the control diet (P < 0·001). Intakes of vitamin B1, vitamin B6, vitamin C, Mg and phosphorus were positively correlated with the cost (P < 0·05). CONCLUSIONS: The CHH diet-SC costs more than the conventional Sichuan diet, partly due to the high cost of specific food groups. Positive correlations between the intakes of vitamin B1, vitamin B6, vitamin C, Mg, phosphorus and the dietary cost could be a direction to adjust the composition within the food groups to reduce the cost of the CHH diet-SC.

Risk assessment of honeybee larvae exposure to pyrethroid insecticides in beebread and honey.

Honeybee is an essential pollinator to crops, evaluation to the risk assessment of honeybee larvae exposure to pesticides residue in the bee bread and honey is an important strategy to protect the bee colony due to the mixture of these two matrices is main food for 3-day-old honeybee larvae. In this study, a continuous survey to the residue of five pyrethroid insecticides in bee bread and honey between 2018 and 2020 from 17 major cultivation provinces which can be determined as Northeast, Northwest, Eastern, Central, Southwest, and Southern of China, there was at least one type II pyrethroid insecticide was detected in 54.7 % of the bee bread samples and 43.4 % of the honey. Then, we assayed the acute toxicity of type II pyrethroid insecticides based on the detection results, the LD50 value was 0.2201 µg/larva (beta-cyhalothrin), 0.4507 µg/larva (bifenthrin), 2.0840 µg/larva (fenvalerate), 0.0530 µg/larva (deltamethrin), and 0.1640 µg/larva (beta-cypermethrin), respectively. Finally, the hazard quotient was calculated as larval oral ranged from 0.046 × 10-3 to 2.128 × 10-3. Together, these empirical findings provide further insight into the accurate contamination of honey bee colonies caused by chemical pesticides, which can be used as a valuable guidance for the beekeeping industry and pesticide regulation.

Digestion dynamics of acetamiprid during royal jelly formation and exposure risk assessment to honeybee larva based on processing factor.

Previous studies to the exposure effects of acetamiprid on honeybees were based on the analysis of bee pollen and honey sacs from field trials or of beebread and honey in the hive, which overestimate or underestimate the risk of exposure to pesticide residues. It was believed that the processing factor (PF) is an important variable to determine the final pesticide residue during royal jelly formation and the actual risk to honeybee larva. Hence, a QuEChERS method to determine acetamiprid contents in honeybee samples was established in this study. Then, the PFs for acetamiprid in beebread fermentation, honey brewing, and royal jelly formation were determined to be 0.85, 0.76, and 0.16, respectively. The PF for royal jelly formation was 0.04 when acetamiprid was detected in beebread alone, and it was 0.12 when acetamiprid was only detected in honey. Finally, the predicted exposure concentration of acetamiprid in royal jelly was calculated to be 2.05 µg/kg using the PF without significant difference with the 90th percentile value (3.64 µg/kg) in the actual sample. However, the value was 16.62 µg/kg without considering the PF. This study establishes a methodology for the correct evaluation of the risk to bee larva of acetamiprid residues in bee pollen and honey sac contents and the residual levels in royal jelly.

Production of sustainable biofuels from microalgae with CO2 bio-sequestration and life cycle assessment.

Due to anthropogenic emissions, there is an increase in the concentration of carbon dioxide (CO2) in the atmosphere. Microalgae are versatile, universal, and photosynthetic microorganisms present in nature. Biological CO2 sequestration using microalgae is a novel concept in CO2 mitigation strategies. In the current review, the difference between carbon capture and storage (CCS), carbon capture utilization and storage (CCUS), and carbon capture and utilization (CCU) is clarified. The current status of CO2 sequestration techniques is discussed, including various methods and a comparative analysis of abiotic and biotic sequestration. Particular focus is given to sequestration methods associated with microalgae, including advantages of CO2 bio-sequestration using microalgae, a summary of microalgae species that tolerate high CO2 concentrations, biochemistry of microalgal CO2 biofixation, and elements influencing the microalgal CO2 sequestration. In addition, this review highlights and summarizes the research efforts made on the production of various biofuels using microalgae. Notably, Chlorella sp. is found to be the most beneficial microalgae, with a sizeable hydrogen (H2) generation capability ranging from 6.1 to 31.2 mL H2/g microalgae, as well as the species of C. salina, C. fusca, Parachlorella kessleri, C. homosphaera, C. vacuolate, C. pyrenoidosa, C. sorokiniana, C. lewinii, and C. protothecoides. Lastly, the technical feasibility and life cycle analysis are analyzed. This comprehensive review will pave the way for promoting more aggressive research on microalgae-based CO2 sequestration.

Cold spells linked with respiratory disease hospitalization, length of hospital stay, and hospital expenses: Exploring cumulative and harvesting effects.

BACKGROUND: Previous studies have revealed the relationship between cold spells and morbidity and mortality due to respiratory diseases, while the detrimental effects of cold spells on the length of hospital stay and hospitalization expenses remain largely unknown. METHODS: We collected hospitalization data for respiratory diseases in 11 cities of Shanxi, China during 2017-2019. In each case, exposure to meteorological variables and air pollution was estimated by the bilinear interpolation approach and inverse distance weighting method, respectively, and then averaged at the city level. Cold spells were defined as the daily mean temperature below the 10th, 7.5th, or 5th percentiles for at least 2 to 5 consecutive days. We applied distributed lag non-linear models combined with generalized additive models to assess cumulative effects and harvesting effects. RESULTS: There were significant associations between cold spells and hospital admissions, length of hospital stay, and hospital expenses for respiratory diseases. Compared with the non-cold spell period, the overall (lag 0-21) cumulative risk of hospitalization for total respiratory diseases was 1.232 (95 % CI: 1.090, 1.394) on cold spell days, and the increased length of hospital stay and hospitalization expenses were 112.793 (95 % CI: 10.755, 214.830) days and 127.568 (95 % CI: 40.513, 214.624) thousand Chinese yuan. The overall cumulative risks of cold spells on total respiratory diseases and pneumonia were statistically significant. We further observed harvesting effects in the associations between cold spells and hospital admission, length of hospital stay, and hospitalization expenses for respiratory diseases. CONCLUSIONS: Cumulative cold-spell exposure for up to three weeks is associated with hospitalization, length of hospital stay, and hospital expenses for respiratory diseases. The observed harmful effects of cold spells on respiratory diseases can be partly attributable to harvesting effects.

Associations of Ambient NO2 with Daily Hospitalization, Hospitalization Expenditure and Length of Hospital Stay of Cause-Specific Respiratory Diseases - Shanxi, China, 2017-2019.

What is already known about this topic?: Numerous epidemiological studies have documented the association between ambient nitrogen dioxide (NO2) and mortality and morbidity of respiratory diseases, however, research on the effect of NO2 on the length of hospital stay (LOS) and hospitalization expenditure is limited. What is added by this report?: This study collected the respiratory hospitalization, hospital expenditure, and LOS for respiratory diseases from 2017-2019 in Shanxi, China, and comprehensively evaluated the association between ambient NO2 exposure and respiratory hospitalization, expenditure, and LOS. What are the implications for public health practice?: This study provides evidence on the association between ambient NO2 and respiratory burden, suggesting that continuously reducing the NO2 concentrations could prevent respiratory disease-associated hospital admissions and decrease the relative burden in Shanxi Province and other similar regions.

Global burden of chronic obstructive pulmonary disease attributable to ambient particulate matter pollution and household air pollution from solid fuels from 1990 to 2019.

We aimed to estimate the spatiotemporal trends in the global burden of chronic obstructive pulmonary disease (COPD) attributable to both household air pollution from solid fuels (HAP) and ambient particulate matter (APM) from 1990 to 2019 and compared the possible differences between the burdens attributable to APM and HAP. The number of deaths, disability-adjusted life-years (DALYs), and years of life lost (YLLs) of COPD attributable to HAP from solid fuels and APM during 1990-2019 were extracted from the Global Burden of Diseases Study 2019. The proportion of YLLs in DALYs and average YLLs per COPD death were also calculated. Subgroup analyses by sex, age, and socio-demographic index (SDI) were conducted. The estimated annual percentage change (EAPC) was used to assess the temporal trend of age-standardized rate of mortality (ASMR) and DALYs (ASDR). Over the past 30 years, we observed a clear downward trend in COPD deaths attributable to HAP and an upward trend by 97.61% in COPD deaths attributable to APM. The global COPD burden attributable to APM in 2019 was higher than those due to HAP, except in low-SDI regions. For both HAP and APM, YLLs continued to predominate in DALYs of COPD, with an average YLLs per death of more than 10 years in different regions. The ASMR was higher in males and lower in high-SDI regions. The ASMR and ASDR attributable to HAP decreased globally in all age groups during 1990-2019, while those attributable to APM increased among people older than 80 years and in regions with lower SDI. Our study reveals an increasing trend in APM-attributable COPD burden over the past three decades. Comparatively, the global burden due to HAP decreased markedly, but it was still pronounced in low-SDI regions. Continued efforts on PM mitigation are needed for COPD prevention.

Fuzzy Cluster-based Group-wise Point Set Registration with Quality Assessment.

This article studies group-wise point set registration and makes the following contributions: "FuzzyGReg", which is a new fuzzy cluster-based method to register multiple point sets jointly, and "FuzzyQA", which is the associated quality assessment to check registration accuracy automatically. Given a group of point sets, FuzzyGReg creates a model of fuzzy clusters and equally treats all the point sets as the elements of the fuzzy clusters. Then, the group-wise registration is turned into a fuzzy clustering problem. To resolve this problem, FuzzyGReg applies a fuzzy clustering algorithm to identify the parameters of the fuzzy clusters while jointly transforming all the point sets to achieve an alignment. Next, based on the identified fuzzy clusters, FuzzyQA calculates the spatial properties of the transformed point sets and then checks the alignment accuracy by comparing the similarity degrees of the spatial properties of the point sets. When a local misalignment is detected, a local re-alignment is performed to improve accuracy. The proposed method is cost-efficient and convenient to be implemented. In addition, it provides reliable quality assessments in the absence of ground truth and user intervention. In the experiments, different point sets are used to test the proposed method and make comparisons with state-of-the-art registration techniques. The experimental results demonstrate the effectiveness of our method. The code is available at https://gitsvn-nt.oru.se/qianfang.liao/FuzzyGRegWithQA.

Ambient sulfur dioxide and hospital expenditures and length of hospital stay for respiratory diseases: A multicity study in China.

BACKGROUND: Ambient sulfur dioxide (SO2) has been associated with morbidity and mortality of respiratory diseases, however, its effect on length of hospital stays (LOS) and cost for these diagnoses remain unclear. METHODS: We collected hospital admission information for respiratory diseases from all 11 cities in the Shanxi Province of China during 2017-2019. We assessed individual-level exposure by using an inverse distance weighting approach based on geocoded residential addresses. A generalized additive model was built to delineate city-specific effects of SO2 on hospitalization, hospital expenditure, and length of hospital stay for respiratory diseases. The overall effects were obtained by random-effects meta-analysis. We further estimated the respiratory burden attributable to SO2 by comparing different reference concentrations. RESULTS: We observed significant effects of SO2 exposure on respiratory diseases. At the provincial level, each 10 µg/m3 increase in SO2 on lag03 was associated with a 0.63% (95% CI: 0.14-0.11) increase in hospital admission, an increase of 4.56 days (95% CI: 1.16-7.95) of hospital stay, and 3647.97 renminbi (RMB, Chinese money) (95% CI: 1091.05-6204.90) in hospital cost. We estimated about 6.13 (95% CI: 1.33-11.10) thousand hospital admissions, 65.77 million RMB (95% CI: 19.67-111.87) in hospital expenditure, and 82.13 (95% CI: 20.87-143.40) thousand days of hospital stay could have potentially been avoided had the daily SO2 concentrations been reduced to WHO's reference concentration (40 µg/m3). Variable values in correspondence with this reference concentration could reduce the hospital cost and LOS of each case by 52.67 RMB (95% CI: 15.75-89.59) and 0.07 days (95% CI: 0.02-0.117). CONCLUSION: This study provides evidence that short-term ambient SO2 exposure is an important risk factor of respiratory diseases, indicating that continually tightening policies to reduce SO2 levels could effectively reduce respiratory disease burden in Shanxi Province.

Economic Policy Uncertainty, Environmental Regulation, and Green Innovation-An Empirical Study Based on Chinese High-Tech Enterprises.

As the continuous changes in environmental regulations have a non-negligible impact on the innovation activities of micro subjects, and economic policy uncertainty has become one of the important influencing factors to be considered in the development of enterprises. Therefore, based on the panel data of Chinese high-tech enterprises from 2012-2017, this paper explores the impact of heterogeneous environmental regulations on firms' green innovation from the perspective of economic policy uncertainty as a moderating variable. The empirical results show that, first, market-incentivized environmental regulation instruments have an inverted U-shaped relationship with innovation output, while voluntary environmental regulation produces a significant positive impact. Second, the U-shaped relationship between market-based environmental regulation and innovation output becomes more pronounced when economic policy uncertainty is high. However, it plays a negative moderating role in regulating the relationship between voluntary-based environmental regulation and innovation output. This paper not only illustrates the process of technological innovation by revealing the intrinsic mechanism of environmental regulation on firm innovation, but also provides insights for government in environmental governance from the perspective of economic policy uncertainty as well.

Health-Related and Economic Burden Among Family Caregivers of Patients with Acute Myeloid Leukemia or Hematological Malignancies.

INTRODUCTION: Acute myeloid leukemia (AML) is associated with lower survival and greater unmet need compared with some other hematologic malignancies (HMs). Despite differences in acuteness between AML and other HMs, the burden of family caregivers (FCs) of patients with these malignancies offer similar patient experiences. A targeted literature review was conducted to explore FC burden of patients with AML and HM with and without hematopoietic stem cell transplant (HSCT). Instruments to measure and interventions to address FC burden were identified. METHODS: Studies on economic burden and compromised health-related quality of life (HRQoL) associated with FC burden, family affairs, and childcare from 1 January 2010 to 30  June 2019 were identified through database and hand searches. Published English articles on randomized controlled trials or standardized qualitative or quantitative observational studies were included. FCs were those in close familial proximity to the patient (i.e., spouse, parents, children, relatives, other family members, significant others). RESULTS: Seventy-one publications were identified (AML, n = 3; HM, n = 29; HSCT, n = 39). Predominant burden categories included humanistic (n = 33), economic (n = 17), and interventions (n = 22); one study was classified as humanistic and economic. FCs lack sufficient resources to manage stressors and experience negative psychological, behavioral, and physiological effects. FCs of patients with HMs reported post-traumatic stress disorder, significant sleep problems, moderate-to-poor HRQoL, and negative impacts on family relationships. Instruments designed to measure caregiver burden were generic and symptom-specific. Educational, expressional, and self-adjustment interventions were used to improve FC burden. CONCLUSION: Findings indicate a need for additional research, public health approaches to support FCs, and effective interventions to address FC burden. Minimizing FC burden and improving quality of life may reduce the overall healthcare service use and allow FCs to more effectively fulfill caregiver tasks. Support systems to alleviate caregiver burden may create reinforced integrators, thus positively affecting quality of life and possibly the outcomes of patients.

Ambient PM2.5 exposure and hospital cost and length of hospital stay for respiratory diseases in 11 cities in Shanxi Province, China.

BACKGROUND: Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (PM2.5) on hospital cost and length of hospital stay for respiratory diseases in China. METHODS: We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM2.5 using the standards of WHO (25 µg/m3) and China (75 µg/m3) as reference. RESULTS: Each 10 µg/m3 increase in lag03 PM2.5 corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM2.5 exposures using WHO's guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case. CONCLUSION: Significant respiratory burden could be attributable to PM2.5 exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.

Fitting marginalized two-part models to semicontinuous survey data arising from complex samples.

OBJECTIVE: To accurately model semicontinuous data from complex surveys, we extend marginalized two-part models to a design-based inferential framework and provide guidance on incorporating complex sample designs. DATA SOURCES: 2014 Medical Expenditure Panel Survey (MEPS). STUDY DESIGN: We describe the use of pseudo-Maximum Likelihood Estimation and Jackknife Repeated Replication for estimating model parameters and sampling variance, respectively. We illustrate our approach using MEPS, modeling total healthcare expenditures in 2014 as a function of respondents' age and family income. We provide SAS and R code for implementing the extension, assessing model-fit indices, and evaluating the need to incorporate complex sampling features. DATA EXTRACTION METHODS: Data obtained from www.meps.ahrq.gov. PRINCIPLE FINDINGS: A 100 percentage-point increase in family income as a percent of the federal poverty level was associated with a 5%-6% increase in healthcare spending. People over 65 had an increase of 4-5 times compared to those younger. Accounting for complex sampling in the models led to different parameter estimates and wider confidence intervals than the unweighted models. Ignoring complex sampling could lead to inaccurate finite population inference. CONCLUSION: Researchers should account for complex sampling features when analyzing semicontinuous data from surveys.

Redox-active zinc thiolates for low-cost aqueous rechargeable Zn-ion batteries.

Aqueous zinc-ion batteries (AZIBs) are promising candidates for large-scale electrical energy storage due to the inexpensive, safe, and non-toxic nature of zinc. One key area that requires further development is electrode materials that store Zn2+ ions with high reversibility and fast kinetics. To determine the viability of low-cost organosulfur compounds as OEMs for AZIBs, we investigate how structural modification affects electrochemical performance in Zn-thiolate complexes 1 and 2. Remarkably, modification of one thiolate in 1 to sulfide in 2 reduces the voltage hysteresis from 1.04 V to 0.15 V. While 1 exhibits negligible specific capacity due to the formation of insulating DMcT polymers, 2 delivers a capacity of 107 mA h g-1 with a primary discharge plateau at 1.1 V vs. Zn2+/Zn. Spectroscopic studies of 2 suggest a Zn2+ and H+ co-insertion mechanism with Zn2+ as the predominant charge carrier. Capacity fading in Zn-2 cells likely results from the formation of (i) soluble H+ insertion products and (ii) non-redox-active side products. Increasing electrolyte concentration and using a Nafion membrane significantly enhances the stability of 2 by suppressing H+ insertion. Our findings provide insight into the molecular design strategies to reduce the polarization potential and improve the cycling stability of the thiolate/disulfide redox couple in aqueous battery systems.