[Clinical comprehensive evaluation of Shexiang Tongxin Dropping Pills].

Based on literature and questionnaire research, related evidence and related data on Shexiang Tongxin Dropping Pills were collected in terms of safety, effectiveness, economy, innovation, suitability, and accessibility. In addition, multi-criteria decision analysis(MCDA) model was used to comprehensively evaluate the clinical value of Shexiang Tongxin Dropping Pills. Quality control was carried out strictly based on evidence-based medicine evaluation. Shexiang Tongxin Dropping Pills were recommended for stable fatigue angina of coronary heart disease with Qi deficiency and blood stasis by guidelines and experts. The conventional treatment of western medicine adds Shexiang Tongxin Dropping Pills to reduce the frequency of angina attacks, shorten the duration, improve exercise tolerance, and improve the quality of life and Chinese symptoms, and the effectiveness is rated as grade A. Adverse reactions are mostly general adverse reactions, and no serious adverse reactions have been reported, consistent with the known risks listed in the instruction for adverse events, contraindications, and precautions. The safety is rated as grade A, and the daily cost is 7.74 yuan. The cost-effectiveness shows that it is a treatment regimen with pharmacoeconomic advantages, and the economic performance is rated as grade A. According to specialist research, Shexiang Tongxin Dropping Pills have good clinical innovation and service innovation, and innovation is rated as grade A. There are no special storage conditions, medicinal material ingredients, or other restrictions, and the clinical use meets the specifications of the medication guidelines. The suitability is rated as grade A. The price level, availability, and affordability of drugs are generally good, and the accessibility is rated as grade A. The clinical value of Shexiang Tongxin Dropping Pills is great.

The role of digital transformation in supply chain efficiency and economic output.

From the perspective of sustainable supply chain management (SSCM), this research looks at the key elements influencing how small- and medium-sized companies (SMEs) move toward a circular economy (CE). This research aims to understand the elements that influence SMEs to embrace CE principles and determine the real-world applications of SSCM practices. This research gathered and analyzed data from diverse European SMEs working inside CE networks using a mixed-method approach. We received answers from several of these firms using a survey form sent and emailed to them. The replies were then assessed using an independent t test to account for any biases. We used confirmatory factor analysis (CFA) for the validity assessment, compound consistency, and corrected-item-total association measures to validate the model's validity and reliability. According to our research, SMEs are influenced significantly by societal pressures, green economic incentives, and environmental dedication when deciding whether to adopt CE practices. Our study further emphasizes the importance of SSCM for SMEs' successful transition to a CE model, especially regarding resource and waste management efficiency. This work contributes to the corpus of research on the topic by providing empirical support for the function of SSCM in easing the transition towards CE in the setting of SMEs. The results might serve as a reference for managers and policymakers as they create plans to encourage SMEs to embrace CE practices and to emphasize the advantages of such a change on the economic, social, and environmental fronts. Putting a particular emphasis on the vital roles that public pressure, green financial incentives, and ecological dedication play, this research provides insights into the complex interactions between SSCM and CE transition in SMEs. Further study is needed to examine how these determinants could fluctuate across various industries and geographies.

Poverty alleviation and health services for the poor in China: evidence from national health service surveys in 2013 and 2018.

BACKGROUND: China has made intensive efforts to eliminate extreme poverty by 2020. This paper aims to evaluate the changes in health service needs, utilization, and medical expenses for poor people during the poverty alleviation period. METHODS: The study used data from national health services surveys in 2013 and 2018. The poor people were identified and certified by the local government. Health service needs, utilization, medical expenses, and reimbursement rates were analyzed and compared between 2013 and 2018, between the poor and the non-poor groups. RESULTS: People living in poverty were usually elderly, illiterate, and unemployed. The poor people had a significantly higher two-week morbidity rate and a higher prevalence of chorionic non-communicable diseases than the non-poor group. For both the poor and non-poor, health service needs increased between 2013 and 2018. Accordingly, the poor people had more use of outpatient and inpatient services. The annual inpatient admission rates were 20.8% and 13.1% for the poor and non-poor, respectively, in 2018. The average medical expenses per inpatient admission were much lower for the poor than for the non-poor. Out-of-pocket (OOP) payment share decreased from 41.9% to 2013 to 31.9% in 2018 for the poor, while for the non-poor, the OOP rate was much higher (45.4%) and had no significant changes between the two surveys. The reduction in the OOP share occurred mostly in rural areas. CONCLUSIONS: Poverty alleviation in China may have positive effect in improving poor people's access to health services, and reducing their financial burden due to illness and health service utilization.

Adebrelimab plus chemotherapy vs. chemotherapy for treatment of extensive-stage small-cell lung cancer from the US and Chinese healthcare sector perspectives: a cost-effectiveness analysis to inform drug pricing.

Purpose: The aim of this study was to evaluate the cost-effectiveness of a recently approved first-line therapy (adebrelimab plus chemotherapy vs. chemotherapy alone) for patients with extensive-stage small-cell lung cancer (ES-SCLC) in the US and China, and to estimate the reasonable range of adebrelimab price from the decision-makers. Methods: Several partitioned survival models were built to compare the cost and effectiveness of adebrelimab plus chemotherapy vs. chemotherapy alone over a 10-year time horizon. Clinical efficacy and safety data were extracted from the CAPSTONE-1 trial. Costs and utilities were obtained from previously published studies. Sensitivity, scenario and subgroup analyses were performed to explore the uncertainty of the model outcomes. Price simulation was conducted at three thresholds of willingness-to-pay (WTP), including WTP of $100,000 in the US and of $37,422 in China, 0.5WTP of $50,000 in the US and of $18,711 in China, and 1.5WTP of 150,000 in the US and of $56,133 in China. Findings: Base-case analysis at $1382.82/600 mg of adebrelimab price indicated that adebrelimab plus chemotherapy would be cost-effective in the US at the WTP threshold of $100,000, but not in China at the WTP threshold of $37,422. If PAP was taken into account, the regimen would be cost-effective in China at the given WTP. The results of price simulation indicated that adebrelimab plus chemotherapy was completely favored in the US if adebrelimab price was less than $8894.98/600 mg (total quality-adjusted life years [QALYs] were calculated with progression-based utility [PB-utility]) or $8912.51/600 mg (total QALYs were calculated with time-to-death utility [TTD-utility]) at the WTP threshold of $100,000; if adebrelimab price was reduced by at least $202.03/600 mg (total QALYs were calculated with PB-utility) or $103.06/600 mg (total QALYs were calculated with TTD-utility), the regimen was also cost-effective in China without PAP at the WTP threshold of $37,422. The above results were stable in the sensitivity analyses. Subgroup analysis found that the subgroup with better survival benefits tended to have a higher probability of cost-effectiveness, which was also associated with adebrelimab price. Implications: First-line adebrelimab plus chemotherapy represented a dominant treatment strategy comparing with chemotherapy alone in the US and also did in China with PAP at $1382.82/600 mg of adebrelimab price. Decision-makers could benefit from pricing strategy provided by this study in making optimal decisions. More evidences were needed to verify and improve the results.

Bioinspired "cage traps" for closed-loop lead management of perovskite solar cells under real-world contamination assessment.

Despite the remarkable progress made in perovskite solar cells, great concerns regarding potential Pb contamination risk and environmental vulnerability risks associated with perovskite solar cells pose a significant obstacle to their real-world commercialization. In this study, we took inspiration from the ensnaring prey behavior of spiders and chemical components in spider web to strategically implant a multifunctional mesoporous amino-grafted-carbon net into perovskite solar cells, creating a biomimetic cage traps that could effectively mitigate Pb leakage and shield the external invasion under extreme weather conditions. The synergistic Pb capturing mechanism in terms of chemical chelation and physical adsorption is in-depth explored. Additionally, the Pb contamination assessment of end-of-life perovskite solar cells in the real-world ecosystem, including Yellow River water and soil, is proposed. The sustainable closed-loop Pb management process is also successfully established involving four critical steps: Pb precipitation, Pb adsorption, Pb desorption, and Pb recycling. Our findings provide inspiring insights for promoting green and sustainable industrialization of perovskite solar cells.

Economic evaluation of bailing capsules for patients with diabetic nephropathy in China.

Background: Diabetic nephropathy is a major microvascular complication and the main cause of end-stage renal disease in diabetic patients. The therapeutic effects of Bailing capsules for diabetic nephropathy have already been demonstrated; however, the cost-effectiveness of Bailing capsules remains controversial. This study aimed to evaluate the cost-effectiveness of Bailing capsules combined with Western medicine compared with Western medicine alone in diabetic nephropathy from a Chinese healthcare system perspective. Methods: A Markov model was established to simulate the disease process of patients over a 20-year period. Clinical efficacy data were obtained from a meta-analysis, and transition probability was estimated based on microsimulation. Direct costs and utility values were collected from the Chinese Drug Bidding Database (https://www.shuju.menet.com.cn) and published literature. The incremental cost-effectiveness ratio (ICER) was measured, and one-way and probabilistic sensitivity analyses were performed to observe model stability. Results: A total of 34 randomized controlled trials involving 3,444 patients with diabetic nephropathy were selected for the meta-analysis. Compared to Western medicine alone, the addition of Bailing capsules resulted in an increase of 0.39 quality-adjusted life-years (QALYs) and additional costs of Chinese Yuan (CNY) 24,721, yielding an ICER of CNY 63,001 per QALY gained. The ICER was lower than the threshold of willingness-to-pay of CNY 80,976 (The GDP per Capita in China). The reliability and stability of the results were confirmed by the sensitivity analysis. Conclusion: We found that Bailing capsules may be a cost-effective treatment choice for patients with diabetic nephropathy in the Chinese population.

Integration of green economy concepts for sustainable biosurfactant production - A review.

The link between increasing global population, food demand, industrialization, and agricultural waste is strong. Decomposing by-products from food cycles can introduce harmful toxic heavy metals, active degrading microbes, and enzymes to the environment. Additionally, high greenhouse gas emissions from the decomposing wastes contribute to global change and a high carbon economy. The bioeconomy and circular economy of biosurfactant production utilize these cheap feedstocks and promote waste to valuable product initiatives. Waste reduction, reuse, and recycling in an integrating green economy bioprocess ensure the sustainability of novel, cost-effective, safe, and renewable health-grade biosurfactants. This work reviews green economy concepts integration with sustainable biosurfactant production and its application in health-related industries. Benefits from recent advances in the production, characterization, and health-wise classification of biosurfactants were further discussed, including its limitations, techno-economic assessment, market evaluations, possible roadblocks, and future directions.

A polyketide synthase from Verticillium dahliae modulates melanin biosynthesis and hyphal growth to promote virulence.

BACKGROUND: During the disease cycle, plant pathogenic fungi exhibit a morphological transition between hyphal growth (the phase of active infection) and the production of long-term survival structures that remain dormant during "overwintering." Verticillium dahliae is a major plant pathogen that produces heavily melanized microsclerotia (MS) that survive in the soil for 14 or more years. These MS are multicellular structures produced during the necrotrophic phase of the disease cycle. Polyketide synthases (PKSs) are responsible for catalyzing production of many secondary metabolites including melanin. While MS contribute to long-term survival, hyphal growth is key for infection and virulence, but the signaling mechanisms by which the pathogen maintains hyphal growth are unclear. RESULTS: We analyzed the VdPKSs that contain at least one conserved domain potentially involved in secondary metabolism (SM), and screened the effect of VdPKS deletions in the virulent strain AT13. Among the five VdPKSs whose deletion affected virulence on cotton, we found that VdPKS9 acted epistatically to the VdPKS1-associated melanin pathway to promote hyphal growth. The decreased hyphal growth in VdPKS9 mutants was accompanied by the up-regulation of melanin biosynthesis and MS formation. Overexpression of VdPKS9 transformed melanized hyphal-type (MH-type) into the albinistic hyaline hyphal-type (AH-type), and VdPKS9 was upregulated in the AH-type population, which also exhibited higher virulence than the MH-type. CONCLUSIONS: We show that VdPKS9 is a powerful negative regulator of both melanin biosynthesis and MS formation in V. dahliae. These findings provide insight into the mechanism of how plant pathogens promote their virulence by the maintenance of vegetative hyphal growth during infection and colonization of plant hosts, and may provide novel targets for the control of melanin-producing filamentous fungi.

Clinical and economic analysis of Gastrodin injection for dizziness or vertigo: a retrospective cohort study based on electronic health records in China.

BACKGROUND: Dizziness and vertigo are common clinical symptoms. Gastrodin injection has shown clinical effects on dizziness or vertigo. However, little is known about the effectiveness and costs of combining Gastrodin injection with conventional treatment on dizziness or vertigo in daily practice. This study aimed to analyze the clinical and economic effects of Gastrodin injection for patients with dizziness or vertigo in comparison to Extract of Ginkgo Biloba Leaves injection in real-world practice. METHODS: Data was collected from the Hospital Information System of 131 hospitals across China from January to December 2018. Patients whose primary discharge diagnosis was dizziness or vertigo according to ICD-10 diagnostic coding were included and divided into two samples: sample of dizziness or vertigo; sample of dizziness or vertigo, with the complication of cerebral infarction. Comparative analysis of the medical cost per hospitalization, hospitalization duration, effective rates, and cure rates between the group of Gastrodin injection and the group of Extract of Ginkgo Biloba Leaves injection was conducted. Propensity Score Matching was used to control potential confounding factors. RESULTS: In the sample of dizziness or vertigo, although there was no significant differences on hospitalization duration (P = 0.080), the group of Gastrodin injection was significantly better than the group of Extract of Ginkgo Biloba Leaves injection (P < 0.001) in terms of treatment effect and the per capita hospitalization cost. In the sample of dizziness or vertigo, with the complication of cerebral infarction, there was no significant difference (P = 0.371) in terms of hospitalization duration, but the group of Gastrodin injection was significantly better than the group of Extract of Ginkgo Biloba Leaves injection (P = 0.009) in terms of treatment effect, and significant difference regarding the per capita hospitalization cost (P < 0.001). CONCLUSIONS: Gastrodin injection showed advantages for inpatients with dizziness or vertigo compared with Extract of Ginkgo Biloba Leaves injection. Future studies using prospective pragmatic controlled trials can test and explore more about the effects of Gastrodin injections on dizziness or vertigo.

Impact of house price growth on mental health: Evidence from China.

BACKGROUND: Housing boom has raised global attention in the past two decades. A number of studies attempted to analyse the effect of house price increase. However, little is known about the health consequence as a result of housing boom, likely due to the scarcity of the data. The objective of this paper is to investigate the relationship between housing affordability and mental health as a result of house price increase. METHODS: Based on a panel dataset of 32 Chinese cities from January 2013 to December 2017, we used a fixed effect model adjusting for per capita disposable income to estimate the impact of house price growth rate on mental health, and applied the Instrumental Variable (IV) method to address the endogeneity problem. RESULTS: From both Ordinary Least Squares (OLS) and IV estimations, the results suggested that a one standard deviation increase in house price increase rate in the past three months is associated with a 0.443 standard deviation increase in people consulting with doctors about their mental disorders in the city. This effect does not vary by gender, but was more pronounced in residents older than 40 years. CONCLUSION: These results revealed the potential negative consequences in people's mental health due to house price increase, necessitate appropriate policy responses.

Effects of Artificial Islands Construction on the Spatial Distribution and Risk Assessment of Heavy Metals in the Surface Sediments from a Semi-closed Bay (Longkou Bay), China.

Artificial islands construction can significantly influence the spatial distribution of heavy metals in inshore sediments. In this study, the distribution and contamination of heavy metals (Cd, Co, Cr, Cu, Ni, Pb, Zn, As and Hg) in inshore sediments of the Longkou Bay and artificial island adjacent areas were investigated in 2013 and 2014, respectively. Results showed that the contents of heavy metals increased in the Longkou Bay and decreased in the west of the artificial island in 2014 compared with 2013. The contamination and potential eco-risk of heavy metals in the sediments were higher in 2014 than those in 2013. Cd and Hg showed a high potential eco-risk in LK02, and other metals were in the lower level. The results indicated that after the construction of artificial islands in the Longkou Bay, the contamination and eco-risk of heavy metals in the sediments markedly increased in the Longkou Bay.

Clinical and Economic Evaluation of Salvianolate Injection for Coronary Heart Disease: A Retrospective Study Based on National Health Insurance Data in China.

OBJECTIVE: The study aimed to conduct clinical and economic evaluation of salvianolate injection for patients with coronary heart disease (CHD) in comparison to Danhong injection and alprostadil injection. METHOD: This was a retrospective study using National Health Insurance Data about inpatients diagnosed with CHD in China in 2015 who met the inclusion criteria. The recruited patients were divided into two samples: surgery and non-surgery. The exposed group received salvianolate injection, while the control group received either alprostadil injection or Danhong injection. The medical cost per hospitalization, hospitalization duration, and the rehospitalization rates were used as outcome indicators. Heterogeneity was processed according to disease stratification. Propensity score matching and multivariate analysis were used for statistical analysis to control potential confounding factors. RESULTS: The hospitalization duration of salvianolate injection group was significantly (P < 0.05) shorter than that of Danhong injection group in the non-surgery sample. The hospitalization duration of salvianolate injection group was significantly (P < 0.05) shorter than those of alprostadil injection group in both surgery and non-surgery samples. In the non-surgery sample, the medical cost per hospitalization of salvianolate injection group was significantly (P < 0.05) lower than that of alprostadil injection group. However, there were no statistical differences of rehospitalization rates in salvianolate injection group versus alprostadil injection group or salvianolate injection group versus Danhong injection group in both surgery and non-surgery samples. CONCLUSION: Salvianolate injection showed advantages in reducing hospitalization duration for inpatients with CHD when comparing with alprostadil injection and Danhong injection. The results of this real-world study can help to inform clinical practice for CHD patients.

[Pollution Characteristics and Exposure Risk Assessment of Perfluoroalkyl Substances in Road Dust, Chengdu].

To study the pollution characteristics and exposure health risk of perfluoroalkyl substances (PFASs) in road dust, 12 PFASs were analyzed by ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) in this study. PFAS concentrations in road dust ranged from 0.95 to 111 ng·g-1, with an average concentration of (25.6±37.2) ng·g-1, suggesting large spatial differences between PFASs in road dust. PFAS concentrations on the main roads were significantly higher than on minor roads, and the minor roads downtown displayed higher concentration levels than suburban minor roads. Perfluorobutanoic acid (PFBA) was the predominant compound in Section 1 of Jie-fang Road, Jin-niu-ba Road and Shui-nian-he Road, while perfluroroocantanoic acid (PFOA, 24.8%) and perfluorooctane sulfonate (PFOS, 24.1%) were the main PFASs on other roads, indicating different sources of PFASs in these areas. The total daily dose of PFASs in road dust for children and adults were 0.168 ng·(kg·d)-1 and 0.028 ng·(kg·d)-1, respectively, suggesting higher exposure risk for children than adults. Therefore, more attention should be paid to children's health risk assessment. Daily doses of PFOA and PFOS in road dust for Chengdu residents were lower than the maximum daily intakes recommended by the European Authority, indicating that there was no immediate health risk to local residents.

Cost-Effectiveness Analysis of Xiyanping Injection (Andrographolide Sulfonate) for Treatment of Adult Community Acquired Pneumonia: A Retrospective, Propensity Score-Matched Cohort Study.

Xiyanping injection (andrographolide sulfonate) has shown clinical effects on community acquired pneumonia. However, there is little known about the effectiveness and costs of combining Xiyanping injection with conventional treatment on adult community acquired pneumonia in daily practice. The aim of this study was to evaluate the cost-effectiveness of combining Xiyanping injection with conventional treatment for treatment of adult community acquired pneumonia by comparing with conventional treatment from a societal perspective. Using retrospective cohort method, this study demonstrates that Xiyanping injection combined with conventional treatment is superior to conventional treatment for patients using cephalosporins and antibiotics under the effectiveness index of length of hospital stay and is more cost-effective.

Discharge against medical advice from hospitalizations for substance use disorders: The potential impact of the Affordable Care Act.

OBJECTIVES: To explore whether the Affordable Care Act (ACA) enactment is associated with changes in the proportion of discharge against medical advice (DAMA) among hospitalizations due to substance use disorders (SUDs). METHODS: Data were drawn from the 2012-2015 National Inpatient Samples. The sample comprised hospitalizations with a principal diagnosis of SUD (i.e., SUD-involved hospitalization) for patients aged 18-64 years (unweighted N = 287,629). Interrupted time series analyses were conducted to evaluate the effect of the ACA on monthly proportions of DAMA among SUD-involved hospitalizations. RESULTS: Overall, approximately 11% of SUD-involved hospitalizations were DAMA. DAMA was most frequently found among hospitalizations for primary opioid use disorder (pre-ACA: 16.4%; post-ACA: 17.2%). Despite the increase in the Medicaid coverage after ACA enactment, there was no significant change in the proportion of DAMA before and after ACA periods across various demographic groups and clinical conditions. Time series analyses also indicated no significant trend effect on the proportion of DAMA during the pre- and post-ACA months. CONCLUSIONS: As many as 1 in 10 SUD-involved hospitalizations were considered as DAMA. Concerted efforts are needed to enhance insurance benefits for SUDs and patients' knowledge of SUD treatment benefits in order to increase SUD treatment engagement and completion and to reduce DAMA, especially for substance-using patients with Medicaid or opioid use disorder.

Assessment of radio frequency heating on composition, microstructure, flowability and rehydration characteristics of milk powder

Abstract Radio frequency heating (RFH) provides higher efficiency and more uniform heating zone compared with conventional method. The aim of present work is to evaluate the effect of RFH (at 90 °C for 5 or 10 min) on the changes in composition (protein oxidation and fat distribution), microstructure, flow characteristic and rehydration property of infant milk powder. The results indicate that the concentration of protein dityrosine was slightly enhanced, more free fat appeared on powder surfaces (> 50% increase), and porosity in powder matrix as tested by SEM was increased after RFH treatment. For powder flowability, raw sample had low cohesiveness (specific energy = 4.39 mJ/g), and RFH provided better flowability and decreased compressibility. Moreover, RFH had some negative impacts on wettability and solubility of powder particles with contact angle increase at least 5% and solubility decrease of 2%~4%, indicating worse rehydration abilities. Guggenheim-Anderson-de Boer (GAB) model was applied to fit moisture vapor sorption isotherms, and longer RFH duration leading to higher c values (about 63% increase at 10 min). In addition, the RFH initiated browning reaction as CIE a* values increased from -1.8 to -1.3.

Spatial variation and toxicity assessment for heavy metals in sediments of intertidal zone in a typical subtropical estuary (Min River) of China.

Sediment samples were collected in five marshes (C1, Phragmites australis marsh; C2, P. australis and Cyperus malaccensis marsh; C3, C. malaccensis marsh; C4, Spartina alterniflora marsh; and C5, Cyperus compressus marsh) respectively along two typical transects (T1 and T2) extending from the vegetated marsh to the mudflat in a typical subtropical estuary (Min River) of China in July 2015 to investigate the spatial variation and toxicity of heavy metals (Pb, Cr, Cu, Zn, and Ni) in intertidal zone. Results showed that the concentrations of heavy metal in surface sediments of the two transects were in the order of Zn > Cr > Pb > Cu > Ni and slightly decreased from the land to the sea except for Pb and Zn. The levels of the five metals at C5 marsh were generally the lowest, while those of Pb, Cr, and Zn at C2 marsh were the highest. The vertical variations of Pb, Cr, and Zn concentrations in profiles differed among marshes or transects, and in most cases, there was no evidence of sediment organic matter (SOM) contributing to the sorption of significant amount of metals in sediments along the two transects, while grain composition was a primary factor controlling the spatial variations of metals. Both the vertical distributions of Cu and Ni levels among marshes or transects showed little fluctuation, which could be better explained by the effects of sulfur on the solubility and mobility of the two metals in profiles. Heavy metal levels in sediments of the Min River estuary were much higher compared with most estuaries in Asia, Europe, Africa, and South America. The sediments in intertidal zone of the Min River estuary were moderately polluted by the five metals, and particularly, Ni was identified as heavy metal of primary concern. Both Ni and Pb in sediments of the intertidal zone showed high potential toxicity and high contributions to the sum of the toxic units (ΣTUs). In future, the metal pollutions in intertidal zone of the Min River estuary might be more serious, and in the next step, there will be long-term potential consequences for endangered animals or migrant birds if measures are not taken to rehabilitate the sediments resulting from metal pollutions.

Sex Differences in Cannabis Use Disorder Diagnosis Involved Hospitalizations in the United States.

OBJECTIVES: The study examined sex differences in trend and clinical characteristics of cannabis use disorder (CUD) diagnosis involved hospitalizations among adult patients. METHODS: We analyzed hospitalization data from the 2007-2011 Nationwide Inpatient Samples for patients aged 18-64 years (N = 15,114,930). Descriptive statistics were used to characterize demographic variables and to compare the proportions of CUD diagnosis and comorbid patterns between male and female hospitalizations. Logistic regressions were performed to examine the association of sex and other demographic variables with CUD diagnosis. RESULTS: During the study period, 3.3% of male and 1.5% of female hospitalizations had any-listed CUD diagnoses, and both sexes presented an upward trend in the number, rate, and proportion of CUD diagnosis. Among hospitalizations for patients aged 18-25 years, about 1 in 10 males and 1 in 20 females included a CUD diagnosis, and this proportion decreased with age strata. Mental disorders accounted for the highest proportion of CUD involved inpatient hospitalizations, and female CUD involved hospitalizations included a higher proportion of mental disorders that required hospitalized care compared with male hospitalizations (41% vs 36%). In each sex group, younger age, black race, lower household income, large metropolitan residence, non-private insurance, substance use diagnosis, and mental disorders were associated with elevated odds of having CUD diagnosis. CONCLUSION: The large sample of clinical hospitalization data suggest an increased trend in CUD diagnosis and sex differences in several comorbidities with CUD-involved hospital admissions. Prevention and treatment for CUD should consider sex differences in clinical comorbidities.

The Association of Gasoline Prices With Hospital Utilization and Costs for Motorcycle and Nonmotorcycle Motor Vehicle Injuries in the United States.

OBJECTIVES: This study examined the association between gasoline prices and hospitalizations for motorcycle and nonmotorcycle motor vehicle crash (MVC) injuries. METHODS: Data on inpatient hospitalizations were obtained from the 2001 to 2010 Nationwide Inpatient Sample. Panel feasible generalized least squares models were used to estimate the effects of monthly inflation-adjusted gasoline prices on hospitalization rates for MVC injuries and to predict the impact of increasing gasoline taxes. RESULTS: On the basis of the available data, a $1.00 increase in the gasoline tax was associated with an estimated 8348 fewer annual hospitalizations for nonmotorcycle MVC injuries, and reduced hospital costs by $143 million. However, the increase in the gasoline tax was also associated with an estimated 3574 more annual hospitalizations for motorcycle crash injuries, and extended hospital costs by $73 million. CONCLUSIONS: This analysis of some existing data suggest that the increased utilization and costs of hospitalization from motorcycle crash injuries associated with an increase in the price of gasoline are likely to substantially offset reductions in nonmotorcycle MVC injuries. A policy decision to increase the gasoline tax could improve traffic safety if the increased tax is paired with public health interventions to improve motorcycle safety.

Use of information technology for medication management in residential care facilities: correlates of facility characteristics.

The effectiveness of information technology in resolving medication problems has been well documented. Long-term care settings such as residential care facilities (RCFs) may see the benefits of using such technologies in addressing the problem of medication errors among their resident population, who are usually older and have numerous chronic conditions. The aim of this study was two-fold: to examine the extent of use of Electronic Medication Management (EMM) in RCFs and to analyze the organizational factors associated with the use of EMM functionalities in RCFs. Data on RCFs were obtained from the 2010 National Survey of Residential Care Facilities. The association between facility, director and staff, and resident characteristics of RCFs and adoption of four EMM functionalities was assessed through multivariate logistic regression. The four EMM functionalities included were maintaining lists of medications, ordering for prescriptions, maintaining active medication allergy lists, and warning of drug interactions or contraindications. About 12% of the RCFs adopted all four EMM functionalities. Additionally, maintaining lists of medications had the highest adoption rate (34.5%), followed by maintaining active medication allergy lists (31.6%), ordering for prescriptions (19.7%), and warning of drug interactions or contraindications (17.9%). Facility size and ownership status were significantly associated with adoption of all four EMM functionalities. Medicaid certification status, facility director's age, education and license status, and the use of personal care aides in the RCF were significantly associated with the adoption of some of the EMM functionalities. EMM is expected to improve the quality of care and patient safety in long-term care facilities including RCFs. The extent of adoption of the four EMM functionalities is relatively low in RCFs. Some RCFs may strategize to use these functionalities to cater to the increasing demands from the market and also to provide better quality of care.