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1.
PLoS One ; 19(4): e0301537, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38626059

RESUMO

As the world's largest electricity-consuming country, China faces the challenge of energy conservation and environmental pollution. Therefore, it is imperative that China takes decisive action to address these issues. Based on the panel data of 30 provinces (cities, districts) in China from 2011 to 2020, we use the entropy method to measure the air pollution index in different provinces, construct two fixed effects models, panel quantile model, and spatial Durbin model to empirically analyze the impact of electricity consumption on air pollution in China's provincial regions. The experimental results show that: (1) Electricity consumption has a significant positive impact on the provincial air pollution index in China and the higher the index is, the more serious the air pollution is. When the electricity consumption increases 1%, the air pollution index will increase of by 0.0649% as accompanied. (2) Through comparison of different times, we found that the degree of increase in air pollution index caused by electricity consumption would be reduced due to the improvement of environmental protection efforts. From the perspective of different geographical locations, the electricity consumption in the southeast side of the "Hu Line" has exacerbated the impact on air pollution index. (3) According to the panel quantile regression results, the marginal effect of electricity consumption on air pollution is positive. With the increase of quantiles, the impact of electricity consumption on air pollution is increasing. (4) Spatial effect analysis shows that electricity consumption has a significant positive spatial spillover effect on air pollution index. The increase in electricity consumption not only increases the air pollution index in the local region, but also leads to an increase in the air pollution index in surrounding areas. These findings contribute to the governance of air pollution and the promotion of sustainable economic, environmental and energy development.


Assuntos
Poluição do Ar , Poluição do Ar/análise , Poluição Ambiental/análise , China , Cidades , Conservação dos Recursos Naturais , Desenvolvimento Econômico
2.
Assessment ; : 10731911231199424, 2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37837333

RESUMO

The Affective Reactivity Index (ARI) is one of the most studied scales for assessing youth irritability, but little is known about its measurement performance in community populations. This study applied item response theory (IRT), network analysis, and classical test theory (CTT) to examine the psychometric properties of the ARI in a sample of n = 395 community-based children (Mage = 13.44, SD = 2.51) and n = 403 parents. In this sample, the ARI demonstrated good reliability, as well as convergent and concurrent validity. The one-factor structure was supported by both confirmatory factor analysis (CFA) and network analysis. IRT analysis revealed that the ARI effectively distinguished between various levels of irritability within the community population. Network analysis identified "Loses temper easily,""Gets angry frequently," and "Often loses temper" are central aspects of irritability. The findings support the ARI as a brief, reliable, and valid instrument to assess irritability in community children and adolescents.

3.
Front Public Health ; 11: 1092018, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37601175

RESUMO

Introduction: Assessing the likelihood of engaging in high-risk sexual behavior can assist in delivering tailored educational interventions. The objective of this study was to identify the most effective algorithm and assess high-risk sexual behaviors within the last six months through the utilization of machine-learning models. Methods: The survey conducted in the Longhua District CDC, Shenzhen, involved 2023 participants who were employees of 16 different factories. The data was collected through questionnaires administered between October 2019 and November 2019. We evaluated the model's overall predictive classification performance using the area under the curve (AUC) of the receiver operating characteristic (ROC) curve. All analyses were performed using the open-source Python version 3.9.12. Results: About a quarter of the factory workers had engaged in risky sexual behavior in the past 6 months. Most of them were Han Chinese (84.53%), hukou in foreign provinces (85.12%), or rural areas (83.19%), with junior high school education (55.37%), personal monthly income between RMB3,000 (US$417.54) and RMB4,999 (US$695.76; 64.71%), and were workers (80.67%). The random forest model (RF) outperformed all other models in assessing risky sexual behavior in the past 6 months and provided acceptable performance (accuracy 78%; sensitivity 11%; specificity 98%; PPV 63%; ROC 84%). Discussion: Machine learning has aided in evaluating risky sexual behavior within the last six months. Our assessment models can be integrated into government or public health departments to guide sexual health promotion and follow-up services.


Assuntos
Comportamentos de Risco à Saúde , Aprendizado de Máquina , Categorias de Trabalhadores , Comportamento Sexual , Humanos , Algoritmos , Povo Asiático , China , Instalações Industriais e de Manufatura , Categorias de Trabalhadores/psicologia , Comportamento Sexual/psicologia , Saúde Sexual
4.
Child Abuse Negl ; 137: 106041, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36682192

RESUMO

BACKGROUND: Covid-19 pandemic jeopardized family well-being at the population level internationally. Pandemic-related job/financial difficulties in parents have a spillover effect on their child's well-being and issues of child maltreatment. OBJECTIVE: The current review sought to systematically summarize and analyze this pandemic-related spillover effect. PARTICIPANTS AND SETTINGS: In the home setting, participants involved 11,100 adolescents, 9144 parents/caregivers, and another 7927 parent-children dyads. METHODS: An extensive literature search in 13 electronic databases was conducted. A total 21 eligible papers published from 2020 to 2022 were included for further thematic analysis. RESULTS: A significant positive relationship between the pandemic-related spillover effect from parental job or financial issues to child maltreatment and child's mental/behavioral issues was established. The internal mechanisms demonstrated that this relationship was intermediated or moderated by the interactions of parental mental health issues, parenting practice, and family relationships. Families with particular factors may be more vulnerable and sensitive to the spillover effect during the pandemic. The work-from-home arrangement was found as positively related to enhanced parenting warmth and parent-child relationship in some cases who had relatively high familial social-economic status. CONCLUSIONS: Findings of current review provided the evidences from empirical data. During the Covid-19 pandemic, spillover effect from parental job/financial issues significantly influenced the child well-being and family functioning. Future efforts for intervention/service design should be made to enhance familial protective factors and support those families with vulnerable factors.


Assuntos
COVID-19 , Maus-Tratos Infantis , Adolescente , Criança , Humanos , Pandemias , Saúde da Criança , Pais/psicologia , Poder Familiar/psicologia , Maus-Tratos Infantis/psicologia
5.
Assessment ; 30(5): 1499-1513, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-35762827

RESUMO

Executive functions (EFs) are essential for daily living activities but decline with age. Convenient assessment and timely intervention have particular significance for older adults. However, the traditional laboratory tasks of EFs are typically monotonous and inconvenient. The current study aimed to develop an interesting and convenient supplementary tool to assess EFs for older adults. According to the theory of EFs, we developed a serious game, FISHERMAN, to assess EFs. The game includes three subgames, Cautious Fisherman, Agile Fisherman, and Wise Fisherman, targeting core components of inhibition, shifting, and working memory, respectively. The current study aims to verify the reliability and validity of the game. One hundred and eight healthy older adults participated in this study and were tested through the FISHERMAN game and a battery of cognitive tests. The results show that the FISHERMAN game has high internal consistency reliability and good construct validity as well as criterion-related validity, suggesting that the game design is valid and can be used in EFs assessment for older adults. Future studies are warranted to establish the norm of the FISHERMAN game in older adults and investigate whether the FISHERMAN game can be generalized to other populations.


Assuntos
Função Executiva , Memória de Curto Prazo , Humanos , Idoso , Função Executiva/fisiologia , Reprodutibilidade dos Testes , Memória de Curto Prazo/fisiologia , Testes Neuropsicológicos , Atividades Cotidianas
6.
Med Phys ; 50(2): 867-878, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36196039

RESUMO

BACKGROUND: Hyperpolarized (HP) 129 Xe multiple b-values diffusion-weighted magnetic resonance imaging (DW-MRI) has been widely used for quantifying pulmonary microstructural morphometry. However, the technique requires long acquisition times, making it hard to apply in patients with severe pulmonary diseases, who cannot sustain long breath holds. PURPOSE: To develop and evaluate the technique of variable-sampling-ratio compressed sensing (VCS) patterns for accelerating HP 129 Xe multiple b-values DW-MRI in humans. METHODS: Optimal variable sampling ratios and corresponding k-space undersampling patterns for each b-value were obtained by retrospective simulations based on the fully sampled (FS) DW-MRI dataset acquired from six young healthy volunteers. Then, the FS datasets were retrospectively undersampled using both VCS patterns and conventional compressed sensing (CS) pattern with a similar average acceleration factor. The quality of reconstructed images with retrospective VCS (rVCS) and CS (rCS) datasets were quantified using mean absolute error (MAE) and structural similarity (SSIM). Pulmonary morphometric parameters were also evaluated between rVCS and FS datasets. In addition, prospective VCS multiple b-values 129 Xe DW-MRI datasets were acquired from 14 cigarette smokers and 13 age-matched healthy volunteers. The differences of lung morphological parameters obtained with the proposed method were compared between the groups using independent samples t-test. Pearson correlation coefficient was also utilized for evaluating the correlation of the pulmonary physiological parameters obtained with VCS DW-MRI and pulmonary function tests. RESULTS: Lower MAE and higher SSIM values were found in the reconstructed images with rVCS measurement when compared to those using conventional rCS measurement. The details and quality of the images obtained with rVCS and FS measurements were found to be comparable. The mean values of the morphological parameters derived from rVCS and FS datasets showed no significant differences (p > 0.05), and the mean differences of measured acinar duct radius, mean linear intercept, surface-to-volume ratio, and apparent diffusion coefficient with cylinder model were -0.87%, -2.42%, 2.04%, and -0.50%, respectively. By using the VCS technique, significant differences were delineated between the pulmonary morphometric parameters of healthy volunteers and cigarette smokers (p < 0.001), while the acquisition time was reduced by four times. CONCLUSION: A fourfold reduction in acquisition time was achieved using the proposed VCS method while preserving good image quality. Our preliminary results demonstrated that the proposed method can be used for evaluating pulmonary injuries caused by cigarette smoking and may prove to be helpful in diagnosing lung diseases in clinical practice.


Assuntos
Imagem de Difusão por Ressonância Magnética , Doença Pulmonar Obstrutiva Crônica , Humanos , Imagem de Difusão por Ressonância Magnética/métodos , Estudos Retrospectivos , Doença Pulmonar Obstrutiva Crônica/patologia , Estudos Prospectivos , Isótopos de Xenônio , Pulmão/fisiologia , Imageamento por Ressonância Magnética/métodos
7.
Epidemiol Psychiatr Sci ; 31: e33, 2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35535764

RESUMO

AIMS: Autism spectrum disorder (ASD) is a neurodevelopmental condition, with symptoms appearing in the early developmental period. Little is known about its current burden at the global, regional and national levels. This systematic analysis aims to summarise the latest magnitudes and temporal trends of ASD burden, which is essential to facilitate more detailed development of prevention and intervention strategies. METHODS: The data on ASD incidence, prevalence, disability-adjusted life years (DALYs) in 204 countries and territories between 1990 and 2019 came from the Global Burden of Disease Study 2019. The average annual percentage change was calculated to quantify the secular trends in age-standardised rates (ASRs) of ASD burden by region, sex and age. RESULTS: In 2019, there were an estimated 60.38 × 104 [95% uncertainty interval (UI) 50.17-72.01] incident cases of ASD, 283.25 × 105 (95% UI 235.01-338.11) prevalent cases and 43.07 × 105 (95% UI 28.22-62.32) DALYs globally. The ASR of incidence slightly increased by around 0.06% annually over the past three decades, while the ASRs of prevalence and DALYs both remained stable over the past three decades. In 2019, the highest burden of ASD was observed in high-income regions, especially in high-income North America, high-income Asia Pacific and Western Europe, where a significant growth in ASRs was also observed. The ASR of ASD burden in males was around three times that of females, but the gender difference was shrunk with the pronounced increase among females. Of note, among the population aged over 65 years, the burden of ASD presented increasing trends globally. CONCLUSIONS: The global burden of ASD continues to increase and remains a major mental health concern. These substantial heterogeneities in ASD burden worldwide highlight the need for making suitable mental-related policies and providing special social and health services.


Assuntos
Transtorno do Espectro Autista , Carga Global da Doença , Idoso , Transtorno do Espectro Autista/epidemiologia , Feminino , Humanos , Incidência , Masculino , Prevalência , Anos de Vida Ajustados por Qualidade de Vida
8.
Neoplasia ; 24(1): 12-21, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34872041

RESUMO

This study aimed to estimate the latest magnitudes and temporal trends of melanoma burden at the national, regional, and global levels. The data on melanoma incidence, deaths, and disability-adjusted life-years (DALYs) in 204 countries and territories between 1990 and 2019 came from the Global Burden of Disease 2019 Study. Estimated annual percentage change (EAPC) was calculated to depict the temporal trends and Spearman rank correlation was used to analyze the influential factors of EAPC. From 1990 to 2019, the incident cases of melanoma increased by 170% to 289,950, death increased by 90% to 62,840, and DALYs increased by 67% to 1,707,800 globally. The age-standardized incidence rate (ASIR) of melanoma increased globally by an average of 1.13 [95% confidence interval (CI): 0.93-1.32], while the age-standardized rates of death and DALYs both declined with the EAPC of -0.27 (95% CI: -0.36 to -0.19) and -0.49 (95% CI: -0.57 to -0.41). In 2019, the highest burden of melanoma was observed in Australasia, followed by high-income North America and Europe regions, which all presented an incremental growth in ASIR. The positive association between the EAPC in ASIR and socio-demographic index (SDI) in 2019 (ρ = 0.600, P < 0.001) suggested that countries with higher SDI have experienced a more rapid increase in ASIR of melanoma. In conclusion, the burden of melanoma is increasing globally but differed greatly across the world. Notably, the high burden areas are facing a continuing increase in incidence, which implies more targeted strategies should be taken for reducing the increasing melanoma burden.


Assuntos
Melanoma/epidemiologia , Bases de Dados Factuais , Feminino , Geografia Médica , Carga Global da Doença/história , Carga Global da Doença/tendências , Saúde Global , História do Século XX , História do Século XXI , Humanos , Incidência , Masculino , Melanoma/história , Vigilância da População , Fatores de Risco , Análise Espaço-Temporal
9.
Artigo em Inglês | MEDLINE | ID: mdl-34890839

RESUMO

Large-scale genome-wide association studies (GWAS) and expression quantitative trait loci (eQTLs) studies have identified multiple noncoding variants associated with genetic diseases by affecting gene expression. However, pinpointing causal variants effectively and efficiently remains a serious challenge. Here, we developed CARMEN, a novel algorithm to identify functional noncoding expression-modulating variants. Multiple evaluations demonstrated CARMEN's superior performance over state-of-the-art tools. Applying CARMEN to GWAS and eQTLs datasets further pinpoints several causal variants other than reported lead single-nucleotide polymorphisms (SNPs). CARMEN scales well with the massive datasets and is available online as a web server at http://carmen.gao-lab.org.

10.
EBioMedicine ; 74: 103649, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34814051

RESUMO

BACKGROUND: Shotgun metagenomics has been used clinically for diagnosing infectious diseases. However, most technical assessments have been limited to individual sets of reference standards, experimental workflows, and laboratories. METHODS: A reference panel and performance metrics were designed and used to examine the performance of shotgun metagenomics at 17 laboratories in a coordinated collaborative study. We comprehensively assessed the reliability, key performance determinants, reproducibility, and quantitative potential. FINDINGS: Assay performance varied significantly across sites and microbial classes, with a read depth of 20 millions as a generally cost-efficient assay setting. Results of mapped reads by shotgun metagenomics could indicate relative and intra-site (but not absolute or inter-site) microbial abundance. INTERPRETATION: Assay performance was significantly impacted by the microbial type, the host context, and read depth, which emphasizes the importance of these factors when designing reference reagents and benchmarking studies. Across sites, workflows and platforms, false positive reporting and considerable site/library effects were common challenges to the assay's accuracy and quantifiability. Our study also suggested that laboratory-developed shotgun metagenomics tests for pathogen detection should aim to detect microbes at 500 CFU/mL (or copies/mL) in a clinically relevant host context (10^5 human cells/mL) within a 24h turn-around time, and with an efficient read depth of 20M. FUNDING: This work was supported by National Science and Technology Major Project of China (2018ZX10102001).


Assuntos
Bactérias/isolamento & purificação , Doenças Transmissíveis/diagnóstico , Fungos/isolamento & purificação , Metagenômica/instrumentação , Metagenômica/métodos , Bactérias/classificação , Bactérias/genética , Benchmarking , China , Fungos/classificação , Fungos/genética , Células HeLa , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Laboratórios , Metagenômica/normas , Reprodutibilidade dos Testes , Análise de Sequência de DNA , Fluxo de Trabalho
11.
Epidemiol Psychiatr Sci ; 30: e36, 2021 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-33955350

RESUMO

AIMS: Anxiety disorders are widespread across the world. A systematic understanding of the disease burden, temporal trend and risk factors of anxiety disorders provides the essential foundation for targeted public policies on mental health at the national, regional, and global levels. METHODS: The estimation of anxiety disorders in the Global Burden of Disease Study 2019 using systematic review was conducted to describe incidence, prevalence and disability-adjusted life years (DALYs) in 204 countries and regions from 1990 to 2019. We calculated the estimated annual percentage change (EAPC) to quantify the temporal trends in anxiety disorders burden by sex, region and age over the past 30 years and analysed the impact of epidemiological and demographic changes on anxiety disorders. RESULTS: Globally, 45.82 [95% uncertainty interval (UI): 37.14, 55.62] million incident cases of anxiety disorders, 301.39 million (95% UI: 252.63, 356.00) prevalent cases and 28.68 (95% UI: 19.86, 39.32) million DALYs were estimated in 2019. Although the overall age-standardised burden rate of anxiety disorders remained stable over the past three decades, the latest absolute number of anxiety disorders increased by 50% from 1990. We observed huge disparities in both age-standardised burden rate and changing trend of anxiety disorders in sex, country and age. In 2019, 7.07% of the global DALYs due to anxiety disorders were attributable to bullying victimisation, mainly among the population aged 5-39 years, and the proportion increased in almost all countries and territories compared with 1990. CONCLUSION: Anxiety disorder is still the most common mental illness in the world and has a striking impact on the global burden of disease. Controlling potential risk factors, such as bullying, establishing effective mental health knowledge dissemination and diversifying intervention strategies adapted to specific characteristics will reduce the burden of anxiety disorders.


Assuntos
Carga Global da Doença , Saúde Global , Adolescente , Adulto , Transtornos de Ansiedade/epidemiologia , Criança , Pré-Escolar , Humanos , Incidência , Anos de Vida Ajustados por Qualidade de Vida , Adulto Jovem
12.
Stem Cells Transl Med ; 10(5): 647-659, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33399273

RESUMO

For patients with angiitis-induced critical limb ischemia (AICLI), cell transplantation, such as purified CD34+ cells (PCCs) and peripheral blood mononuclear cells (PBMNCs), is gradually being used as a promising treatment. This was the first randomized single-blinded noninferiority trial (number: NCT02089828) specifically designed to evaluate the therapeutic efficacies of the transplantation of PCCs vs those of PBMNCs for the treatment of AICLI. We aimed to compare the mid-term safety and efficacy between the two groups and determine their respective advantages. From April 2014 to September 2019, 50 patients with AICLI were equally allocated to the two groups, except for 1 lost patient, 1 amputee, and 1 patient who died of heart disease. The other 47 patients completed the 36-month follow-up. The endpoints were as follows: major amputation-free survival and total amputation-free survival at 6 months, which were 96.0% and 84.0% in the PBMNCs group and 96.0% and 72.0% in the PCCs group, respectively. These rates remained stable at 12, 24, and 36 months. The PCCs group had a significant higher probability of rest pain relief than the PBMNCs group, whereas earlier significant improvements in the Rutherford classification were observed in the PBMNCs group. Accordingly, PCCs would be preferred for patients with significant pain, whereas PBMNCs may be a good option for patients with two or more critically ischemic limbs. Concerning cost-effectiveness, PCCs are not more cost-effective than PBMNCs. These outcomes require verification from long-term trials involving larger numbers of patients.


Assuntos
Leucócitos Mononucleares , Vasculite , Isquemia Crônica Crítica de Membro , Análise Custo-Benefício , Humanos , Isquemia/terapia , Dor , Resultado do Tratamento
13.
Pest Manag Sci ; 76(7): 2525-2536, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32077584

RESUMO

BACKGROUND: Phytophthora capsici is a destructive plant oomycete pathogen that could lead to devastating losses in food production. Fungicide application is the main way to control plant disease caused by P. capsici. SYP-14288, a novel fungicide with a unique mode of action, could be used to control a broad range of plant diseases. Here, the potential for SYP-14288 resistance in P. capsici and the resistance mechanism involved were evaluated. RESULTS: Baseline sensitivities of 133 isolates to SYP-14288 were determined and found to conform to a unimodal curve with a mean half-maximal effective concentration (EC50 ) of 0.625 µg mL-1 . In total, 21 stable SYP-14288-resistant mutants were generated by fungicide adaptation in three sensitive isolates. The fitness of all the mutants was found to be lower than that of the parental isolates. Otherwise, downregulation of various ATPases may confer different resistance levels in P. capsici. Finally, multiple biochemical studies strongly suggest that both ATP content and electric potential were reduced in SYP-14288-resistant mutants, and as a compensatory mechanism, respiration was facilitated to make up for the energy defect in mutants. CONCLUSION: The low fitness of SYP-14288-resistant mutants suggests that the resistance risk of P. capsici to SYP-14288 is low. Resistance may be led by a permeability change in the mitochondrial inner membrane in SYP-14288-resistant isolates, and lower ATP consumption lifestyles may be key to the SYP-14288 resistance generated in P. capsici. The current study could benefit the registration and application of the novel fungicide SYP-14288. © 2020 Society of Chemical Industry.


Assuntos
Phytophthora , Trifosfato de Adenosina , Fungicidas Industriais , Mitocôndrias , Doenças das Plantas
14.
Artigo em Inglês | MEDLINE | ID: mdl-32012836

RESUMO

Tourism and transportation have extremely complex interactions. Tourism developments have expanded demand and stimulated transportation development, which has consequently affected the environment of cities striving towards low-carbon sustainable development. Therefore, there has been an increased research focus on the coordinated binary development of the tourism and transportation industries to ensure sustainable low-carbon cities. To this end also this paper first developed a comprehensive evaluation index system with three subsystems, seven aspects, and 31 indicators. Then, entropy weight and gray correlation were combined to determine the index weights and a physics coupling concept employed to build a tourism, transportation and low-carbon city (TTLC) coupling coordination degree model, which was then applied to quantitatively analyze the coupling and evolutionary trends in Chongqing's TTLC efforts from 2008 to 2017. It was found that the overall coupling coordination was volatile and rising, and that industry scale, industry performance, and energy consumption had the most significant impact on the coupled systems, indicating that these key factors must be considered in macro decision-making. In general, it was shown that the combination of the coupling coordination degree model and entropy weight gray correlation was able to effectively evaluate dynamic coupling relationships.


Assuntos
Carbono , Desenvolvimento Sustentável , Meios de Transporte , China , Cidades
15.
Front Pharmacol ; 11: 572569, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33536905

RESUMO

Background and Purpose: The availability of oncology biosimilars is deemed as a fundamental strategy to achieve sustainable health care. However, there is scarce systematic evidence on economic effectiveness of cancer biosimilars. We aimed to synthesize evidence from pharmacoeconomic evaluation of oncology biosimilars globally, provide essential data and methodological reference for involved stakeholders. Materials and Methods: This systematic review was conducted in PubMed, embase, the Cochrane library, CRD, ISPOR and NICE utill December 31, 2019. Information on basic characteristics, evaluation methodology and results were extracted. Quality of included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards Checklist. Results: For 17 studies identified (13 from Europe and four from United States), the overall quality was generally acceptable. A total of seven biological molecules involved with filgrastim, EPOETIN α, and trastuzumab leading the three. The mostly common evaluation perspective was payer, but the time horizon varied greatly. There were ten studies which adopted cost minimization analysis to evaluate efficiency while seven studies adopted budget impact analysis to address affordability, with cost ratio and cost saving being its corresponding primary endpoint. Although the comparability of included studies was limited and specific results were largely affected by uptake and price discount rates of the oncology biosimilar, the comprehensive results consistently favored its promotion. Conclusion: Globally, the economic evaluation of cancer biosimilars is in its initial phase. However, limited evidence from developed countries consistently supported both cost-effectiveness of efficiency and affordability of oncology biosimilars, while they were largely affected by uptake and price discount rate.

16.
J Matern Fetal Neonatal Med ; 33(13): 2241-2245, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30415592

RESUMO

Background: Hypertensive disorders of pregnancy are major causes of maternal mortality and morbidity, and postpartum hypertensive complications have significant implications on maternal health and public health care system. Antepartum community care programs for hypertension are in place at major centers of Canada, however, such a program for postpartum are usually lacking, and could be a cost-effective solution to reduce postpartum hypertensive complications.Objectives: To assess the proportion of women who present to the emergency department (ED) or outpatient clinics for postpartum hypertensive (PPHTN) complications up to 6 weeks postpartum, among pregnancies complicated by antenatal hypertensive disorders in Calgary, Canada. Secondary objectives were to identify risk factors for PPHTN complications, and to perform a cost-benefit analysis to support postpartum community care program (PCCP) as a way to decrease ED and clinic visits for PPHTN complications, and thus has a favorable economic impact on the public health care system.Study design: Retrospective cohort study using administrative databases, followed by chart review of ED visits to confirm diagnoses and estimate cost of visits and admissions. The participants were women followed by the Calgary Antenatal Community Care Program (ACCP) for hypertensive disorders, from 2014 to 2015, inclusive. The primary outcome was ED or clinic visit associated with an outpatient database record of hypertensive disorder diagnosis, within 42 days postpartum.Results: Among 319 deliveries included in the study, 30 women (9.4, 95%CI: 6.2-12.6%) visited ED or clinics for PPHTN. We identified multiple antihypertensive medication uses and abnormal postpartum gestational hypertension labs as risk factors for ED visit among these women. We estimate a CAD$152 per antenatal hypertensive patient cost benefit for PCCP.Conclusion: The proposed PCCP appears to have an economic benefit to health care system with a decrease in ED and clinic visits. Further studies with greater sample size could strengthen the findings in this study.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Hipertensão Induzida pela Gravidez/terapia , Alberta/epidemiologia , Anti-Hipertensivos/uso terapêutico , Análise Custo-Benefício , Bases de Dados Factuais , Feminino , Humanos , Hipertensão Induzida pela Gravidez/tratamento farmacológico , Hipertensão Induzida pela Gravidez/economia , Hipertensão Induzida pela Gravidez/epidemiologia , Período Pós-Parto , Gravidez , Estudos Retrospectivos
17.
BMC Health Serv Res ; 18(1): 873, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458780

RESUMO

BACKGROUND: The development of assisted reproduction techniques (ART) has resulted in rapid advances in the treatment of infertility. However, a systematic assessment of ART and its processes and outcomes in China has never been carried out. The goal of this study was to assess the features of ART status from 2012 to 2016 in clinics and in vitro fertilization (IVF) laboratories in Liaoning, the largest IVF province in the northeast of China. METHODS: Data from Jan 1, 2012 to Dec 31, 2016 was retrieved from the assisted reproductive certificate registry of Liaoning province. We extracted data from: i) fresh and thawed cycles; ii) donor sperm and donor egg cycles; iii) intrauterine insemination with husband semen and donor semen (AIH and AID). RESULTS: We showed that: (i) there has been a significant increase in the number of IVF fresh and thawed cycles, and the proportion of cases of primary infertility and secondary infertility has decreased and increased, respectively; (ii) standard long GnRH agonist was the major ovarian stimulation protocol. During the observation period, increasing trends in the use of GnRH antagonists, mild stimulation, and natural cycles were observed; (iii) significant differences in the number of cycles, number of retrieved oocytes, fertilization rates, implantation rates, and sex ratio were noticed between conventional IVF and intracytoplasmic sperm injection; (iv) significant differences in age at treatment for infertility, number of cycles, and ectopic pregnancy rates were noticed between donor sperm cycles and donor egg cycles; (v) significant differences in number of thawed cycles, number of thawed embryos, embryo recovery rates, implantation rates, and clinical pregnancy rates were noticed between day 3 and day 5 embryos; (vi) significant differences in age at treatment for infertility, number of cycles, clinical pregnancy rates, ectopic pregnancy rates, and live birth ratio were noticed between AIH and AID. CONCLUSIONS: ART in Liaoning province has undergone substantial development from 2012 to 2016 in clinics and IVF laboratories. This presentation of detailed ART data will provide researchers, policy makers, and potential ART users a rich source of information about IVF characteristics in the northeast of China.


Assuntos
Resultado da Gravidez , Técnicas de Reprodução Assistida/tendências , China , Feminino , Fertilização in vitro/tendências , Humanos , Infertilidade Feminina/terapia , Infertilidade Masculina/terapia , Masculino , Indução da Ovulação/tendências , Gravidez , Taxa de Gravidez/tendências , Sistema de Registros , Estudos Retrospectivos , Injeções de Esperma Intracitoplásmicas/tendências
18.
Vaccine ; 36(19): 2657-2665, 2018 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-29606519

RESUMO

BACKGROUND: This study was to investigate parental acceptability of HPV vaccination for their sons and daughters aged 9-13 years under different cost scenarios, and factors associated with parental acceptability at market price. METHODS: Participants were: (1) Chinese speaking parents aged 18-60 years with a Hong Kong ID card; (2) had a son or a daughter aged 9-13 years at the date of the survey; (3) the child had the right to abode in Hong Kong. Random telephone numbers were selected from up-to-date telephone directories of Hong Kong. A total of 300 eligible parents (boys' parents: 162; girls' parents: 138, response rate: 68.9% & 69%) provided verbal informed consent and completed the anonymous telephone interview during March to October 2016. Using parental acceptability of HPV vaccination at market price as the dependent variable, univariate and multiple logistic regression models were fitted. RESULTS: The prevalence of HPV vaccination was very low among boys and girls (0.6% vs. 2.2%, p = 0.242). Among those whose children had not taken up HPV vaccination, the prevalence of parental acceptability of HPV vaccination for the index son and daughter were: 14.9% and 27.4% (market price), and 51.6% and 63.0% (free vaccination). Adjusted for sociodemographic variables, attitudinal variables based on the Health Belief Model were associated with parental acceptability of HPV vaccination for their sons (perception that it was not worthy, perceived cue to action from mass media and perceived self-efficacy) and for their daughters (perceived susceptibility and perceived severity of HPV infection among females, perceived benefit of HPV vaccination and perceived self-efficacy). CONCLUSION: Coverage of HPV vaccination among children aged 9-13 years was very low. Instead of waiting for the free universal vaccination to become available, promotion of self-paid HPV vaccination targeting parents is urgently needed. Different strategies should be applied to boys' and girls' parents.


Assuntos
Vacinas contra Papillomavirus/uso terapêutico , Pais/psicologia , Vacinação/estatística & dados numéricos , Adolescente , Adulto , Criança , China , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Vacinas contra Papillomavirus/economia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fatores Socioeconômicos , Vacinação/psicologia , Cobertura Vacinal/estatística & dados numéricos
19.
Sci Rep ; 7(1): 15698, 2017 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-29146923

RESUMO

We tested the hypotheses that kidney cancer incidence was increasing globally whilst its mortality was reducing; and its incidence was positively correlated with country-specific socioeconomic development. The incidence and mortality figures of each country were projected to 2030. Data on age-standardized incidence/mortality rates were retrieved from the GLOBOCAN in 2012. Temporal patterns were examined for 39 countries from the Cancer Incidence in Five Continents volumes I-X and other national registries. We evaluated the correlation between the incidence/mortality rates and Human Development Index (HDI)/Gross Domestic Product (GDP]). The average annual percent change of its incidence and mortality in the most recent 10 years was obtained from joinpoint regression. The highest incidence rates were observed in Eastern Europe and North America, while its mortality rates were the highest in European countries. Incidence was positively correlated with HDI and GDP per capita. Many countries experienced incidence rise over the most recent 10 years, and a substantial reduction in mortality rates was observed for a significant number of countries, yet increases in mortality rates were observed in Eastern Europe. By 2030, Brazil and Ecuador may have the greatest rise in incidence both in men and women, which requires urgent need for planning healthcare resources.


Assuntos
Internacionalidade , Neoplasias Renais/epidemiologia , Feminino , Humanos , Incidência , Neoplasias Renais/economia , Masculino , Fatores Socioeconômicos , Fatores de Tempo
20.
Med Phys ; 44(8): 4035-4039, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28569992

RESUMO

PURPOSE: This work studies the detective quantum efficiency (DQE) of a-Se-based solid state x-ray detectors for medical imaging applications using ARTEMIS, a Monte Carlo simulation tool for modeling x-ray photon, electron and charged carrier transport in semiconductors with the presence of applied electric field. METHODS: ARTEMIS is used to model the signal formation process in a-Se. The simulation model includes x-ray photon and high-energy electron interactions, and detailed electron-hole pair transport with applied detector bias taking into account drift, diffusion, Coulomb interactions, recombination and trapping. For experimental validation, the DQE performance of prototype a-Se detectors is measured following IEC Testing Standard 62220-1-3. RESULTS: Comparison of simulated and experimental DQE results show reasonable agreement for RQA beam qualities. Experimental validation demonstrated within 5% percentage difference between simulation and experimental DQE results for spatial frequency above 0.25 cycles/mm using uniform applied electric field for RQA beam qualities (RQA5, RQA7 and RQA9). Results include two different prototype detectors with thicknesses of 240 µm and 1 mm. CONCLUSIONS: ARTEMIS can be used to model the DQE of a-Se detectors as a function of x-ray energy, detector thickness, and spatial frequency. The ARTEMIS model can be used to improve understanding of the physics of x-ray interactions in a-Se and in optimization studies for the development of novel medical imaging applications.


Assuntos
Diagnóstico por Imagem/métodos , Método de Monte Carlo , Raios X , Elétrons , Desenho de Equipamento , Selênio , Semicondutores
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