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BACKGROUND: In Chinese healthcare settings, drug selection decisions are predominantly influenced by the Pharmacy & Therapeutics Committee (PTC). This study evaluates two recently introduced potassium-competitive acid blockers, vonoprazan (VPZ) and tegoprazan (TPZ), utilizing the Evidence and Value: Impact on DEcisionMaking (EVIDEM) framework. METHODS: The study employed the 10th edition of EVIDEM, which includes a core model with five domains and 13 criteria. Two independent expert panels were involved: the PTC expert panel, tasked with assigning weights using a 5-point scale, defining scoring indicators, examining the evidence matrix, scoring, and decision-making; and the evidence matrix expert panel, responsible for conducting a systematic literature review, creating the evidence matrix, and evaluating the value contributions of VPZ and TPZ. RESULTS: The analysis estimated the value contributions of VPZ and TPZ to be 0.59 and 0.54, respectively. The domain of 'economic consequences of intervention' showed the most significant variation in value contribution between the two drugs, followed by 'comparative outcomes of intervention' and 'type of benefit of intervention'. CONCLUSION: Employing the EVIDEM framework, VPZ's value contribution was found to be marginally superior to that of TPZ. The EVIDEM framework demonstrates potential for broader application in Chinese medical institutions.
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Refluxo Gastroesofágico , Inibidores da Bomba de Prótons , Pirróis , Sulfonamidas , Sulfonamidas/uso terapêutico , Pirróis/uso terapêutico , Humanos , Inibidores da Bomba de Prótons/uso terapêutico , China , Refluxo Gastroesofágico/tratamento farmacológico , Técnicas de Apoio para a Decisão , Análise Custo-BenefícioRESUMO
BACKGROUND: Preliminary evidence of the content validity of the simplified Chinese version of 'Picture My Participation' (PMP-C; Simplified) items and reliability of the subscale attendance for the effectiveness of the use with children and youth in mainland China has been collected. However, evidence of construct validity for the instrument is not yet available. AIM: To explore the construct validity of the attendance scale in PMP-C (Simplified). METHODS: A cross-sectional study using convenience sampling was conducted using PMP-C (Simplified) with a picture-supported interview for 290 children and youths aged 5-21 with and without ID in urban and rural areas of mainland China. Exploratory factor analysis (EFA) was performed using the principal component analysis (PCA) to analyse the resulting data. RESULTS: The EFA extracted five factors with eigenvalues greater than one and the cumulative contribution rate of factors accounted for 51.62% of the variance. All items had factor loadings above 0.50. The five subcomponents included: organised activities, social activities, taking care of others, family life activities and personal care and development activities. CONCLUSION: The results of the factor analysis support the construct validity of the PMP-C (Simplified) attendance scale. It provides further psychometric evidence that PMP-C (Simplified) is a sound measure to assess participation for children and youths in mainland China.
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Psicometria , Humanos , Masculino , Estudos Transversais , Feminino , China , Criança , Adolescente , Reprodutibilidade dos Testes , Adulto Jovem , Análise Fatorial , Inquéritos e Questionários , Pré-Escolar , Participação Social , Terapia OcupacionalRESUMO
To reduce the high burden of disease caused by air pollution, the World Health Organization (WHO) released new Air Quality Guidelines (AQG) on September 22, 2021. In this study, the daily fine particulate matter (PM2.5) and surface ozone (O3) data of 618 cities around the world is collected from 2019 to 2022. Based on the new AQG, the number of attainment days for daily average concentrations of PM2.5 (≤ 15 µg m-3) and O3 (≤ 100 µg m-3) is approximately 10% and 90%, respectively. China and India exhibit a decreasing trend in the number of highly polluted days (> 75 µg m-3) for PM. Every year over 68% and 27% of cities in the world are exposed to harmful PM2.5 (> 35 µg m-3) and O3 (> 100 µg m-3) pollution, respectively. Combined with the United Nations Sustainable Development Goals (SDGs), it is found that more than 35% of the world's cities face PM2.5-O3 compound pollution. Furthermore, the exposure risks in these cities (China, India, etc.) are mainly categorized as "High Risk", "Risk", and "Stabilization". In contrast, economically developed cities are mainly categorized as "High Safety", "Safety", and "Deep Stabilization." These findings indicate that global implementation of the WHO's new AQG will minimize the inequitable exposure risk from air pollution.
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Fairness plays a crucial role in children's social life and has garnered considerable attention. However, previous research and theories primarily examined the development of children's fairness behaviors in the conflict between self-interest motivation and fairness-complying motivation, neglecting the influence of advantage-seeking motivation. Moreover, despite the well-established role of gain/loss frame in human decision-making, it remains largely unclear whether the framing effect modulates fairness behaviors in children. It was hypothesized that children would exhibit advantage-seeking motivation resulting in more selfish behaviors in the loss context. To examine the hypothesis, we combined an adapted dictator game and computational modeling to investigate various motivations underlying fairness behaviors of children in both loss and gain contexts and to explore the developmental directions by contrasting children and adults. In addition, the current design enabled the dissociation between fairness knowledge and behaviors by asking participants to decide for themselves (the first-party role) or for others (the third-party role). This study recruited a total of 34 children (9-10 years, Mage = 9.82, SDage = 0.38, 16 females) and 31 college students (Mage = 19.81, SDage = 1.40, 17 females). The behavioral results indicated that children behaved more selfishly in first-party and more fairly in third-party than adults, without any significant framing effects. The computational results revealed that both children and adults exhibited aversion to advantageous and disadvantageous inequity in third-party. However, they showed distinct preferences for advantageous inequity in first-party, with advantage-seeking preferences among children and aversion to advantageous inequity among adults. These findings contribute to a deeper understanding of children's social preferences and their developmental directions.
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Introduction: Depression is the leading cause of disability worldwide and has become a health issue of global concern. Based on the "System of Health Accounts 2011" (SHA 2011) for patients with depression, this paper studies the changes in the current curative expenditure (CCE) of outpatient depression in Liaoning Province, China, and provides policy recommendations. Method: A stratified multistage random sample of 56,994 patients with depression included from 1,227 healthcare facilities in Liaoning Province were included. The significance of differences in variables within groups was analyzed by univariate analysis (including descriptive statistics analysis, Mann-Whitney U test and Kruskal-Wallis H test), and factors influencing depression outpatient CCE were analyzed by multiple linear regression analysis and constructing structural equation models (SEM). Results: The CCE of outpatient depression was ranging from CNY 75.57 million to CNY 100.53 million in 2015-2020, with the highest of CNY 100.53 million in 2018, CNY 103.28 million in 2019. Medical expenditures are mainly concentrated in general hospitals and provincial healthcare institutions, accounting for about 90% of all provincial scope expenditures. The multiple regression results show that provincial healthcare institutions, purchase of drug, select medical treatment for depression, general hospitals and urban employees' health insurance are the main influencing factors for depression outpatient CCE. The results of SEM show that insurance status negative impact outpatient expenditure. Conclusion: Health insurance is an important factor in equitable access to healthcare resources for patients, and medication expenditure is the influential factor affecting the high expenditure of outpatient clinics. It is of great importance to reduce the medical burden of patients by increasing the coverage of medical insurance, increasing the proportion of bills that are eligible for reimbursement, and improving the system by guaranteeing the supply of psychotropic medication.
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Rising surface ozone (O3) levels in China are increasingly emphasizing the potential threats to public health, ecological balance, and economic sustainability. Using a 1 km × 1 km dataset of O3 concentrations, this research employs subpopulation demographic data combined with a population-weighted quality model. Its aim is to evaluate quantitatively the differences in O3 exposure among various subpopulations within China, both at a provincial and urban cluster level. Additionally, an exposure disparity indicator was devised to establish unambiguous exposure risks among significant urban agglomerations at varying O3 concentration levels. The findings reveal that as of 2018, the population-weighted average concentration of O3 for all subgroups has experienced a significant uptick, surpassing the average O3 concentration (118 µg/m3). Notably, the middle-aged demographic exhibited the highest O3 exposure level at 135.7 µg/m3, which is significantly elevated compared to other age brackets. Concurrently, there exists a prominent positive correlation between educational attainment and O3 exposure levels, with the medium-income bracket showing the greatest susceptibility to O3 exposure risks. From an industrial vantage point, the secondary sector demographic is the most adversely impacted by O3 exposure. In terms of urban-rural structure, urban groups in all regions had higher levels of exposure to O3 than rural areas, with North and East China having the most significant levels of exposure. These findings not only emphasize the intricate interplay between public health and environmental justice but further highlight the indispensability of segmented subgroup strategies in environmental health risk assessment. Moreover, this research furnishes invaluable scientific groundwork for crafting targeted public health interventions and sustainable air quality management policies.
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Poluentes Atmosféricos , Poluição do Ar , Ozônio , Pessoa de Meia-Idade , Humanos , Exposição Ambiental/análise , Monitoramento Ambiental , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Ozônio/análise , China , Material ParticuladoRESUMO
In recent years, the pattern of air pollution in China has changed profoundly, and PM2.5 and surface ozone (O3) have become the main air pollutants affecting the air quality of cities and regions in China. The synergistic control of the two has become the key to the sustainable improvement of air quality in China. In this study, we investigated and analyzed the spatial and temporal distribution patterns, exposure health risks, key drivers, and sustainable characteristics of PM2.5 and O3 concentrations in China from 2013 to 2022 at the national and city cluster scales by combining methodological models such as spatial statistics, trend analysis, exposure-response function, Hurst index, and multi-scale geographically weighted regression (MGWR) model. Ultimately, a synergistic management system for PM2.5 and O3 pollution was proposed. The results showed that: (1) The PM2.5 concentration decreased at a rate of 1.45 µg/m3 per year (p < 0.05), while the O3 concentration increased at a rate of 2.54 µg/m3 per year (p < 0.05). The trends of the two concentrations showed significant differences in spatial distribution. (2) Population exposure risks to pollutants showed an increasing trend, with PM2.5 and O3 increasing by 55.1 % and 42.7 %, respectively. The annual deaths associated with exposure to PM2.5 and O3 demonstrated a decreasing and inverted U-shaped trend, respectively, with annual average deaths of 1.312 million and 98,000. Significant regional disparities in health risks from these pollutants were influenced by socio-economic factors such as industrial activities and population density. In the future, it is expected that more than half of China's regions will be exposed to rising risks of PM2.5 and O3 population exposure. (3) Key drivers of regional exacerbation in PM2.5 and O3 levels include the number of industrial enterprises above designated size (NSIE) and population agglomeration (PA), while the disposable income of urban residents (URDI), technological innovation (TI), and government attention level (GAL) emerged as primary factors in controlling pollution hotspots, ranked in order of influence from greatest to least as TI > GAL > URDI. Overall, this study sheds light on the current status of air pollution and health risk sustainability in China and enhances the understanding of future air pollution dynamics in China. The results of the study may help to develop effective targeted control measures to synergize the management of PM2.5 and O3 in different regions.
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Poluentes Atmosféricos , Poluição do Ar , Material Particulado/análise , Poluentes Atmosféricos/análise , China , Cidades , Monitoramento AmbientalRESUMO
Social egg freezing is an emerging topic in China, where single women currently face restrictions in accessing this service at medical facilities. Administrative regulations prohibit single women from accessing all forms of assisted reproductive technologies. Both the first lawsuit filed by a single woman seeking to freeze her eggs and a legislative proposal aiming to protect single women's rights to access assisted reproductive technologies were denied. This has sparked controversy and discussion about the reproductive rights of single women and the legitimacy of their access to medical and technical assistance. Laws and family planning policies related to women's reproductive rights in China have undergone dramatic changes in recent years, owing to shifts in population growth trends and societal attitudes toward marriage and childbirth, subsequently leading to a notable enhancement in women's reproductive autonomy. Meanwhile, factors such as marital status and career considerations have led to a delay in childbearing, triggering a growing need and advocacy for fertility preservation among single women. In China, the pursuit of social egg freezing by single women comes into conflict with the strict regulatory restrictions on assisted reproductive technologies. This study delves into the profound impacts of demographic changes, marital trends, fertility culture, and other social factors on female fertility in China. It also discusses the legislative issues and medical-social ethical concerns associated with the application of social egg freezing for single women. Additionally, this study offers regulatory suggestions aimed at enhancing women's reproductive health and autonomy, as well as the avoidance of potential ethical risks.
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To understand the status of heavy metals in soils of typical industrial and mining towns and quantitatively analyze the potential sources, the contents of seven heavy metals (Cd, As, Pb, Cr, Cu, Ni, and Zn) in 150 surface soils in Xuanhua District, Zhangjiakou City, Hebei Province were collected and examined. The geoaccumulation index and potential ecological risk index methods were used to evaluate the heavy metal pollution status and potential ecological risk. Principal component analysis (PCA) and the positive matrix factorization (PMF) model were used to comprehensively analyze the pollution sources of seven heavy metals, and geostatistics was used to identify the high contribution areas of potential sources. The results revealed that:â the average values of heavy metals in the study area ranged from 0.23-103.34 mg·kg-1, among which the average contents of Cd, Pb, Cu, and Zn were higher than the soil background value of Hebei Province. â¡ The results of the geoaccumulation and potential ecological risk indices demonstrated that the degree of pollution of the seven heavy metals was in the following order:Cd>Pb>Cu>Zn>Ni>As>Cr, the content of Cd in 16% sites was above a moderate pollution level, and the potential ecological risk of heavy metals in more than 95% sites was at a light risk level. ⢠The main sources of accumulation of the seven heavy metals in the study area were combined sources of industry and traffic, natural sources, and agricultural sources, with their contribution rates of 33.1%, 48.7%, and 18.2%, respectively. Among them, Cd, Pb, Cu, and Zn were primarily affected by the combined sources of industry and transportation; Cr, Ni, and As were mainly affected by natural sources, whereas Cd and some As were affected by agricultural sources. The organic combination of PCA, PMF model, and geostatistical methods confirmed the results of each analysis, which increased the reliability of the analytical results of heavy metal sources.
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OBJECTS: Dementia has physical, social and economic impacts, causing considerable distress for people with age-related cognitive impairment (PWACI) and their caregivers. Electronic health (e-health) interventions can provide convenient education to improve the coping competence of caregivers and have become an important approach to supporting them. Understanding the economic evidence of e-health interventions will facilitate the decision making and implementation of integrating e-health into routine health services. The present review aimed to appraise economic evidence related to e-health interventions for PWACI and their caregivers. METHODS: We systematically searched multiple cross-disciplinary databases from inception to February 28, 2023. Two reviewers independently selected the trials, assessed the quality, and checked the data. A descriptive-analytical narrative method was used to analyze the review findings. RESULTS: Thirteen studies were analyzed, including 12 randomized controlled trials and one quasi-experimental study. All included studies were conducted in developed countries. The included studies reported limited economic information. There were six cost-effectiveness analysis, five cost-consequence analysis and one partial economic evaluation. The included studies were heterogeneous, and varied in quality. The results demonstrated that e-health multicomponent interventions can reduce the cost of health service utilization in short term (10-104 weeks). CONCLUSIONS: Few studies calculated the incremental cost-effectiveness ratio to evaluate the cost-effectiveness of e-health interventions. Preliminary evidence indicates that e-health interventions can reduce the cost of health service utilization in the short term, but the cost-effectiveness of e-health interventions hasn't been identified. More robust evidence is needed to clarify the value of e-health interventions for PWACI and their caregivers.
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Cuidadores , Disfunção Cognitiva , Humanos , Análise Custo-Benefício , Análise de Custo-Efetividade , Disfunção Cognitiva/terapia , EletrônicaRESUMO
Biochar-derived dissolved organic matter (DOM) contains toxic substances that are first released into the soil after biochar application. However, the ecological risks of biochar-derived DOM on soil invertebrate earthworms are unclear. Therefore, this study investigated the ecological risks and toxic mechanisms of sewage sludge biochar (SSB)-derived DOM on the earthworm Eisenia fetida (E. fetida) via microcosm experiments. DOM exposure induced earthworm death, growth inhibition, and cocoon decline. Moreover, DOM, especially the 10% DOM300 (derived from SSB prepared at 300 °C) treatments, disrupted the antioxidant defense response and lysosomal stability in earthworms. Integrated biomarker response v2 (IBRv2) analysis was performed to assess the comprehensive toxicity of DOM in E. fetida, and the results revealed that DOM300 might exert more hazardous effects on earthworms than DOM500 (prepared at 500 °C) and DOM700 (prepared at 700 °C), as revealed by increases in the IBRv2 value of 3.48-18.21. Transcriptome analysis revealed that 10% DOM300 exposure significantly disrupted carbohydrate and protein digestion and absorption and induced endocrine disorder. Interestingly, 10% DOM300 exposure also significantly downregulated the expression of genes involved in signaling pathways, e.g., the P13K-AKT, cGMP-PKG, and ErbB signaling pathways, which are related to cell growth, survival, and metabolism, suggesting that DOM300 might induce neurotoxicity in E. fetida. Altogether, these results may contribute to a better understanding of the toxicity and defense mechanisms of biochar-derived DOM on earthworms, especially during long-term applications, and thus provide guidelines for using biochar as a soil amendment.
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Oligoquetos , Poluentes do Solo , Animais , Matéria Orgânica Dissolvida , Poluentes do Solo/toxicidade , Poluentes do Solo/análise , Solo , EsgotosRESUMO
Polycystic ovary syndrome (PCOS) is a well-recognized, multi-system metabolic disorder affecting fertility. Although various classification methods have been proposed to assess the phenotypic heterogeneity of PCOS, there is currently no reliable phenotype for predicting clinical IVF outcomes. This retrospective study, as a comprehensive phenotypic assessment across all PCOS classifications, aimed to identify dependable phenotypes that can serve as predictors for IVF and pregnancy outcomes. The study included 1313 PCOS patients who received their initial IVF treatment between January 2019 and December 2021. The phenotypes reflect the diverse metabolic and hormonal characteristics in this study. Phenotype A, within the Rotterdam criteria classification, exhibited the highest anti-Müllerian hormone levels (AMH), while phenotype D displayed the lowest Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) values. Both the hyperandrogenism (HA) phenotype within HA-based classification and the overweight phenotype within the body-mass-index-based classification showed increased HOMA-IR and metabolic syndrome (MetS). The MetS phenotype had higher free androgen index and a lower AMH. Notably, the MetS-based classification system demonstrated an independent association of MetS with cumulative live birth, preterm birth, and gestational diabetes mellitus as a contributing risk factor for PCOS patients undergoing IVF (p < 0.05). These findings carry noteworthy implications for advancing clinical management strategies for PCOS.
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Establishing a reasonable cost-sharing and compensation mechanism for air pollution control is a prerequisite for realizing inter-regional cooperative treatment. Taking inter-provincial sulfur dioxide (SO2) emissions in China from 2005 to 2019 as the research object, this paper proposes a data-driven approach to establish a cost-sharing index system of regional SO2 treatment in four dimensions and construct a cost-sharing and compensation scheme using the entropy-TOPSIS method. The results revealed that there are significant spatial and temporal differences in the treatment cost of SO2 emission, and the total SO2 treatment costs at the national level increased first and then decreased during the study period, meanwhile, the regional SO2 treatment costs are much higher in the less economically developed regions such as the central and western regions than in economically developed eastern coastal regions. The design of the cost-sharing and compensation mechanism of SO2 treatment should consider the regional differences in abatement capacity, abatement potential, abatement responsibility, and development demands. The economically developed regions should share higher treatment costs according to their historical cumulative abatement responsibilities, and provide economic compensation and technical support to the less economically developed regions. Specifically, the marginal abatement cost in the more economically developed eastern region is much higher than that in the less economically developed central and western areas due to their large abatement responsibility and strong reduction capacity but insufficient abatement potential, so the eastern regions can transfer part of their abatement responsibility to the central and western regions using economic compensation. Reasonable cost sharing and horizontal compensation can help promote regional cooperation and synergistic management in air pollution abatement. Finally, corresponding policy recommendations are given to provide a decision basis for cross-regional cooperation in air pollution control.
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Objectives: This study aimed to determine the risk factors that affect visual impairment in older adults for developing and evaluating a visual impairment risk prediction model. Methods: In this hospital-based unmatched case-control design study, we enrolled 586 participants (411 in the training set and 175 in the internal test set) from the ophthalmology clinic and physical examination center of a teaching hospital in Liaoning Province, China, from June to December 2020. Visual impairment was defined as best-corrected visual acuity <6/18 (The WHO definition). Possible influencing factors of visual impairment were assessed, including demographic factors, socioeconomic factors, disease and medication factors, and lifestyle. A visual impairment risk prediction model was developed using binary logistic regression analysis. The area under the ROC curve (AUC) was used to evaluate the effectiveness of the proposed prediction model. Results: Six independent influencing factors of visual impairment in older adults were identified: age, systolic blood pressure, physical activity scores, diabetes, self-reported ocular disease history, and education level. A visual impairment risk prediction model for older adults was developed, showing powerful predictive ability in the training set and internal test set with AUCs of 0.87 (95%CI 0.83-0.90) and 0.81 (95%CI 0.74-0.88), respectively. Conclusions: The risk prediction model for visual impairment in older adults had high predictive power. Identifying older adults at risk for developing visual impairment can help healthcare workers to adopt appropriate targeted programs for early education and intervention to prevent or delay visual impairment and prevent injuries due to visual impairment in older adults.
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Nitrous acid (HONO) plays a significant role in radical cycling and atmospheric oxidative chemistry. While the source and evolution of HONO in the Yangtze River Delta (YRD) region of China after 2018 remains largely unknown, this work monitored HONO and other air pollutants throughout 2019 at an urban site (Pudong, PD) and a suburban site (Qingpu, QP) in Shanghai. Episodes with high HONO mixing ratios but different PM2.5 levels, namely haze and clean episodes, were chosen for HONO budget analysis. Using an observation-based photochemical box model, relative importance of different sources and sinks of HONO were evaluated. Gas-phase reaction of NO with OH was found to be one of the most important daytime HONO formation sources, especially during the QPhaze period (accounting for 40.3 % of daytime HONO formation). In particular, heterogeneous conversion of NO2 on ground and aerosol surface was found to be the dominant source for nocturnal HONO. Photo-enhanced NO2 conversion on ground surface plays an important role in daytime HONO production (19.4 % in PDhaze vs. 27.6 % in PDclean, and 19.8 % in QPhaze vs. 25.9 % in QPclean). In addition, photo-enhanced NO2 conversion at the aerosol surface during haze episodes made more significant contributions to HONO formation compared to the clean periods (20.9 % in PDhaze vs. 17.1 % in PDclean, and 19.7 % in QPhaze vs. 11.2 % in QPclean). The role of multiphase reactions was found to be increasingly important in HONO generation with enhanced relative humidity (RH) during daytime. Significant unknown HONO source was further analyzed and found to be positively related with photolytic as well as multiphase pathways. Overall, our study sheds light on the budget of HONO in one of the biggest megacities in east China, which would help developing future mitigation strategies for urban HONO and atmospheric oxidation capacity.
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With rapid economic development, an increasing number of people suffer from mental health diseases, which are gradually receiving the attention of society. However, basic data from surveys of mental disorders are limited. Composite influent samples were collected from 26 wastewater treatment plants in 23 major cities in China. The concentrations of the psychoactive drugs diphenhydramine, fluoxetine, doxepin, imipramine, sulpiride, zolpidem, carbamazepine, and flunitrazepam in the wastewater were determined. The detection frequency of diphenhydramine, sulpiride, and carbamazepine was close to 100 %, whereas that of the compounds was lower than 35 %. Carbamazepine had the highest mean consumption (31.1 mg/d/1000 people), followed by diphenhydramine (10.4 mg/d/1000 people) and sulpiride (11.3 mg/d/1000 people). Wastewater-based epidemiology (WBE) estimates of the average use of the three drugs were lower than those from the drug statistics data. Consumption of diphenhydramine in northern China was higher than that in southern China. A correlation analysis of psychotropic and illicit drugs revealed a correlation between sulpiride and heroin use, which may be related to the adverse effects of sulpiride treatment after heroin withdrawal. Psychotropic drug use is associated with both economic and social factors. We found associations between the use of the three drugs and age, occupation, and obesity, which are risk factors for mental disorders. The results showed that the monitoring of psychotropic drug using WBE has a certain reference value for public health care and for improving the understanding of mental disorders.
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Vigilância Epidemiológica Baseada em Águas Residuárias , Poluentes Químicos da Água , Humanos , Cidades , Heroína/análise , Sulpirida/análise , Poluentes Químicos da Água/análise , Águas Residuárias/análise , Psicotrópicos/análise , China/epidemiologia , Carbamazepina/análise , Difenidramina/análiseRESUMO
Background: Public health emergencies have an immense effect on social stability, economic development, and human life. Volunteers played an indispensable role in health monitoring, assistance with daily life, and social network repairing. However, few policies analysis concentrated on the voluntary services involved in public health emergencies. Objectives: This study aims to analyze and summarize the advantages and flaws of the policy documents relating to voluntary services involved in public health emergencies, and put forward the enlightenment on policymaking and optimization. Methods: A three-dimensional analysis framework of "Policy instruments-Participants of voluntary services-Stages of voluntary services" was designed. Policy documents at the national level were retrieved from the official websites of the State Council of the People's Republic of China and its departments as well as the PKULAW Database. NVivo software was applied to analyze the contents of the included policy documents. Gephi software was adopted to conduct a visualized atlas analysis of the cooperative network among policymaking departments. Results: A total of 77 policy documents were included, and most were published in 2020 (n = 40). The Ministry of Civil Affairs (n = 19) and the National Health Commission (n = 18) issued more documents than the other departments. They cooperated more extensively with other departments. In policy documents, supply-side policy instruments were utilized the most (65.4%), followed by demand-side (23.9%). Voluntary organizations in the form of ambiguous sense were most mentioned as service participants (n = 73). In the stages of service delivery, service content mainly involved the prevention and control of public health emergencies (27, 18.9%) and psychological counseling (26, 18.2%). Conclusion: Time distribution of policy documents featured "incubation period-outbreak and continuous evolution period-elimination recovery period." Joint issuing became the dominant form. The internal structure of policy instruments was unbalanced with different priorities, and the overall structure is expected to be optimized to promote voluntary organization management, reinforce external resources, and close the gap between policymaking and policy implementation. Volunteers' competence and voluntary organizations' system needs to be improved, and the contents of voluntary services should be enriched for the preparedness for future public health emergency.
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Emergências , Saúde Pública , China , Humanos , Motivação , PolíticasRESUMO
As the COVID-19 outbreak has an impact on the global economy, there will be interest in how China's financial markets function during the outbreak. To investigate the path of risk contagion in China's financial sub-markets before and after the COVID-19 outbreak, we divided the 2016-2021 period into two phases. Based on the time of the COVID-19 outbreak, we divided the new stage of economic development into pre-epidemic and post-epidemic stages and employed the DCC-GARCH model to investigate the dynamic correlation coefficients among the financial sub-markets in China. Furthermore, we employed complex network theory and the minimum tree model to describe the risk contagion path between two-stage Chinese financial submarkets. Finally, we provided pertinent recommendations for investors and policymakers and conducted a brief discussion based on the findings of the research.
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As aging deepens, early detection of mild cognitive impairment (MCI) is increasingly important to prevent Alzheimer Dementia (AD) and improve the quality of life of older adults. In recent years, a large number of studies focus on the abnormal brain cognitive function of MCI, while ignoring the quantitative evaluation of MCI's mental workload. In this study, we propose a workload index for MCI screening, named EMCI, which is a linear discriminant cumulative estimate of subjects' electroencephalography (EEG) power spectra in α and ß rhythms. Then, we design a matched prototype system to verify the effectiveness of EMCI. The results show that the EMCI is sensitive to changes of subjects' mental workload, and is significantly lower in MCI than in HC (Health control), which may be precisely caused by cognitive dysfunction. The proposed EMCI index can be used for online assessment of mental workload in older adults, which can help achieve quick screening of MCI and provide a critical window for clinical treatment interventions.
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Doença de Alzheimer , Disfunção Cognitiva , Humanos , Idoso , Qualidade de Vida , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Eletroencefalografia/métodos , Doença de Alzheimer/diagnóstico , EncéfaloRESUMO
Lung adenocarcinoma (LUAD) is the most common type of lung cancer. Accurate identification of lymph node (LN) involvement in patients with LUAD is crucial for prognosis and making decisions of the treatment strategy. CT imaging has been used as a tool to identify lymph node involvement. To tackle the shortage of high-quality data and improve the sensitivity of diagnosis, we propose a Cost-Sensitive Uncertainty Hypergraph Learning (CSUHL) model to identify the lymph node based on the CT images. We design a step named "Multi-Uncertainty Measurement" to measure the epistemic and the aleatoric uncertainty, respectively. Given the two types of attentional uncertainty weights, we further propose a cost-sensitive hypergraph learning to boost the sensitivity of diagnosing, targeting task-driven optimization of the clinical scenarios. Extensive qualitative and quantitative experiments on the real clinical dataset demonstrate our method is capable of accurately identifying the lymph node and outperforming state-of-the-art methods across the board.