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

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

Development and preliminary evaluation of the Comprehensive Health Self-Assessment Questionnaire (CHSAQ) for individuals in the Chinese People Liberation Army.

OBJECTIVE: There is currently no widely accepted multidimensional health assessment questionnaire for individuals in the Chinese People Liberation Army (PLA). This study developed a multidimensional health survey questionnaire (Comprehensive Health Self-Assessment Questionnaire, CHSAQ) suitable for personnel in the PLA and conducted a preliminary examination of its reliability, validity, and discriminative ability. METHODS: After 183 items from 32 dimensions were selected to form the initial version of the CHSAQ, three groups of soldiers were selected from May 2022 to April 2023 and completed three survey rounds (with 183, 131, and 55 valid items). The items were screened based on classic test theory. After screening, the final questionnaire entries were formed, the structure of the questionnaire was explored through exploratory factor analysis and confirmatory factor analysis, and its reliability, structural validity, and discriminative ability were evaluated. RESULTS: The final questionnaire consisted of 8 dimensions and 55 items on job satisfaction, anxiety and depression, daily activities, physical function, the otolaryngology system, the integumentary system, sleep disorders, and the visual system. The total cumulative variance contribution rate was 64.648% according to exploratory factor analysis. According to the confirmatory factor analysis, the normed fit index (NFI) was 0.880, and the comparison fit index (CFI) was 0.893 (close to 0.90). The Cronbach's α coefficient of the total questionnaire was 0.970, the split half reliability coefficient was 0.937, and the retest reliability coefficient was 0.902. The results are presented as different pairwise comparisons. CONCLUSION: Our study developed a self-report questionnaire for evaluating the comprehensive health status of personnel in the PLA in accordance with the standard procedure for questionnaire development. Our findings also showed that the CHSAQ for individuals in the PLA has good reliability and structural validity.

Assessment of long-term safety and efficacy of dupilumab in children with asthma (LIBERTY ASTHMA EXCURSION): an open-label extension study.

BACKGROUND: Dupilumab efficacy and safety in children aged 6-11 years with uncontrolled, moderate-to-severe asthma were shown in the VOYAGE study-a 52-week, multinational, multicentre, phase 3 randomised, double-blind, placebo-controlled trial. We aimed to evaluate the long-term safety and efficacy of dupilumab in children with moderate-to-severe asthma who previously participated in the VOYAGE study. METHODS: 365 of 408 children with moderate-to-severe asthma from VOYAGE enrolled in EXCURSION, a 52 week, open-label extension study conducted at 70 centres across 17 countries. 240 children continued with add-on dupilumab (dosed according to bodyweight: 100 mg for those weighing ≤30 kg and 200 mg for those weighing more than 30 kg at EXCURSION baseline) once every 2 weeks administered by subcutaneous injection (dupilumab/dupilumab group) and 125 children on placebo during VOYAGE initiated dupilumab (100 or 200 mg, according to bodyweight), once every 2 weeks administered by subcutaneous injection (placebo/dupilumab group). Following a protocol amendment, for a subset of children weighing 30 kg or less, the dose was changed to 300 mg once every 4 weeks. The primary endpoint for the open-label extension study was the number and proportion of patients with any treatment-emergent adverse event (TEAE) during the 52-week study period in the overall population (defined as children aged 6-11 years old with moderate-to-severe asthma who previously completed VOYAGE). Statistical analyses were descriptive. This study is registered with ClinicalTrials.gov (NCT03560466; EXCURSION). FINDINGS: Children who completed VOYAGE were eligible to enrol in EXCURSION between June 21, 2018 and Aug 18, 2020. During EXCURSION, the safety profile and proportion of patients reporting TEAEs were consistent with those observed during the parent study (VOYAGE). In the overall population, 232 (63·6%) of 365 patients experienced at least one TEAE (dupilumab/dupilumab: 147 [61·3%]; placebo/dupilumab: 85 [68·0%]). The most frequently reported TEAEs were nasopharyngitis, pharyngitis, and upper respiratory tract infections. INTERPRETATION: In EXCURSION, long-term treatment with dupilumab was well tolerated with an acceptable safety profile. FUNDING: Sanofi and Regeneron Pharmaceuticals.

Opioid and Non-Opioid Pharmacotherapy Use for Pain Management Among Privately Insured Pediatric Patients With Cancer in the United States.

BACKGROUND: This study examined the trends and patterns of opioid and non-opioid pharmacotherapy use among a large national sample of privately insured pediatric patients with cancer in the United States. MATERIALS AND METHODS: We identified pediatric (aged < 21) patients diagnosed with central nervous system (CNS), lymphoma, gonadal, leukemia, or bone cancer from MarketScan data 2005-2019. We examined the proportion of patients who filled a prescription for the following 5 types of pharmacotherapy: opioid, anticonvulsant, non-steroidal anti-inflammatory drug (NSAID), antidepressant, and muscle relaxant during active cancer treatment. We assessed the trends and patterns in pharmacotherapy using multivariable logistic regressions. RESULTS: Among 4174 patients included, 2979 (71%) had an opioid prescription; 746 (18%), 384 (9%), 202 (5%), and 169 (4%) had anticonvulsant, NSAID, antidepressant and muscle relaxant prescriptions, respectively. Multivariable logistic regression showed a nonlinear trend in the use of opioids among pediatric patients with cancer over time such that use slightly increased until 2012 (OR of 1.40 [95% CI, 1.12-1.73] for 2012 vs. 2006) but then decreased thereafter (OR of 0.51 [0.37-0.68] for 2018 vs. 2012). The use of anticonvulsants, NSAIDs, and muscle relaxants increased significantly linearly over time (all P < .005). CONCLUSION: There has been a downward trend in the use of opioids in recent years among pediatric patients with cancer and an upward trend in the use of non-opioid pharmacotherapy for pain management potentially as an alternative to opioids.

Assessment of tolerance limits of petroleum residues in soil organic matter: sorption of dichlorobenzene by soil.

Soil organic matter can protect plants and microorganisms from toxic substances. Beyond the tolerance limit, the toxicity of petroleum pollution to soil organisms may increase rapidly with the increase of petroleum content. However, the method for evaluating the petroleum tolerance limit of soil organic matter (SOM) is still lacking. In this study, the petroleum saturation limit in SOM was first evaluated by the sorption coefficient (Kd) of 1,2-dichlorobenzene (DCB) from water to soils containing different petroleum levels. The sorption isotherm of dichlorobenzene in several petroleum-contaminated soils with different organic matter content and the microbial toxicity test of several petroleum-contaminated soils were determined. It is found that when the petroleum content is about 5% of the soil organic matter content, the sorption of petroleum to organic matter reached saturation limit. When organic matter reaches petroleum saturation limit, the sorption coefficient of DCB by soil particles increased linearly with the increase of petroleum content (R2 > 0.991). The results provided important insights into the understanding the fate of petroleum pollutants in soil and the analysis of soil toxicity.

Coating CoFe2O4 shell on Fe particles to increase the utilization efficiencies of Fe and peroxymonosulfate for low-cost Fenton-like reactions.

Bimetallic composites (Fe@CoFe2O4) with zero-valent Fe as the core encapsulated by CoFe2O4 layers are synthesized by a coprecipitation-calcination method, which are applied to activate PMS for the degradation of bisphenol A (BPA). Enhanced activity of Fe@CoFe2O4 is achieved with very fast degradation rate (kobs = 0.5737 min-1). In the fixed-bed reactor, the catalyst lifetime (tul) of Fe@CoFe2O4 is determined to be 22 h compared to 11 h of Fe, and the deactivation rate constant (kd) for Fe@CoFe2O4 is 0.0083 mg·L-1·h-1, only ∼1/10 of Fe (0.0731). The XPS results indicate that the core-shell structure of Fe@CoFe2O4 could promote the redox cycles of Co3+/Co2+ and Fe3+/Fe2+. It is proved that the coating of CoFe2O4 shell on Fe0 can protect the Fe0 core from being oxidized by PMS to form passivation layer. The electrons of Fe0 can therefore be used effectively for activating PMS to produce ROSs via the CoFe2O4 shell. This modification method of Fe0 would decrease the cost of PMS based wastewater remediation greatly, thus should have great potential on an industrial scale.

Risk assessment and source apportionment of heavy metals pollution from atmospheric deposition in Nanjing, China.

Heavy metals (HMs) are the toxic pollutants in urban environment, and their sources are complex. Dust might be a good carrier of HMs into ecosystem and human. In this study, 48 dust samples were collected in Nanjing, an industrial city and transportation hub in the Yangtze River Delta, China. The concentrations, spatial distribution, sources and risks of heavy metals (Cr, Ni, Cu, Zn, Cd and Pb) in dust were determined and analyzed. The results showed that although the health risks of some HMs had decreased, Cr, Zn, and Cd had high concentrations and high risks on ecosystem/human. And thus, the total risks of the target HMs were higher than the threshold of non-risks. Especially, children may face the highest possible risks due to the frequent hand-oral ingestion when children play. The hot spot regions of the HMs were mainly in the industrial district in the north, urban, and rural region in south, relating with the industrial, traffic, and agricultural sources, respectively. The analysis for the risks of individual sources further confirmed these sources should be further controlled. The results in this study will provide information on the priority of HMs' monitoring and source management.

Macro tax incentives and corporate sustainable innovation: Evidence from Chinese Enterprises.

Innovation has become the driving force behind China's economy's sustainable growth. Due to the efficient transmission of taxation leverage, preferential tax policies are frequently used to stimulate innovation. Therefore, the incentive effect of preferential tax policies on sustainable innovation has gradually become the focus of attention. This paper takes the 2016-2019 China A-share listed high-tech enterprises as a sample, calculates tax incentive intensity with the aid of B-index, and studies the incentive effect of preferential tax policies on the sustainability of corporate innovation. This study shows that: (1) Tax incentive intensity has a positive incentive effect on corporate sustainable innovation. (2) The R&D expenses plus deduction policy and the preferential tax rate policy can significantly enhance corporate sustainable innovation, but there is a substitution effect between them. (3) Based on the heterogeneity of institutional environment and enterprise characteristics, the incentive effect of tax preferential policies is more obvious in enterprises which are non-state-owned and in areas with low government intervention and sound legal system. However, the incentive effect of different types of preferential policies differs in the size of the enterprise. This study will provide reference for the improvement of preferential tax policy system and the optimization of innovation policy environment.

Causality assessment of circulating Vitamin D level on venous thromboembolism: A Mendelian randomization study.

BACKGROUND AND AIMS: The associations of vitamin D level with venous thromboembolism (VTE) reported in observational studies, whereas these causal associations were uncertain in European population. Therefore, we used Mendelian randomization (MR) method to explore the causal associations between 25-hydroxyvitamin D (25(OH)D) concentrations and the risk of VTE and its subtypes [including deep vein thrombosis (DVT) and pulmonary embolism (PE)]. METHODS AND RESULTS: We used three kinds of genetic instruments to proxy the exposure of 25(OH)D, including genetic variants significantly associated with 25(OH)D, expression quantitative trait loci of 25(OH)D target genes, and genetic variants within or nearby 25(OH)D target genes. MR analyses did not provide any evidence for the associations of 25(OH)D levels with VTE and its subtypes (p > 0.05). The summary-data-based MR (SMR) analyses indicated that elevated expression of VDR was associated with decreased risk of VTE (OR = 0.81; 95% CI, 0.65-0.998; p = 0.047) and PE (OR = 0.67; 95% CI, 0.50-0.91; p = 0.011), and expression of AMDHD1 was associated with PE (OR = 0.93; 95% CI, 0.88-0.99; p = 0.027). MR analysis provided a significant causal effect of 25(OH)D level mediated by gene AMDHD1 on PE risk (OR = 0.09; 95% CI, 0.01-0.60; p = 0.012). CONCLUSION: Our MR analysis did not support causal association of 25(OH)D level with the risk of VTE and its subtypes. In addition, the expression of VDR and AMDHD1 involved in vitamin D metabolism showed a strong association with VTE or PE and might represent targets for these conditions.

Design of a Low-Cost, Self-Adaptive and MRI-Compatible Cardiac Gating System.

OBJECTIVE: Cardiac gating, synchronizing medical scans with cardiac activity, is widely used to make quantitative measurements of physiological events and to obtain high-quality scans free of pulsatile artefacts. This can provide important information for disease diagnosis, targeted control of medical microrobots, etc. The current work proposes a low-cost, self-adaptive, MRI-compatible cardiac gating system. METHOD: The system and its processing algorithm, based on the monitoring and analysis of blood pressure waveforms, are proposed. The system is tested in an in vitro experiment and two living pigs using four-dimensional (4D) flow magnetic resonance imaging (MRI) and two-dimensional phase-contrast (2D-PC) sequences. RESULTS: in vitro and in vivo experiments reveal that the proposed system can provide stable cardiac synchronicity, has good MRI compatibility, and can cope with the fringe magnetic field of the MRI scanner, radiofrequency signals during image acquisition, and heart rate changes. High-resolution 4D flow imaging is successfully acquired both in vivo and in vitro. The difference between the 2D and 4D measurements is ≤ 21%. The incidence of false triggers is 0% in all tests, which is unattainable for other known cardiac gating methods. CONCLUSION: The system has good MRI compatibility and can provide a stable and accurate trigger signal based on pressure waveform. It opens the door to applications where the previous gating methods were difficult to implement or not applicable.

Do the academician independent directors promote green innovation in enterprises?

Using the manually collated data on the employment of academicians as independent directors by Shanghai and Shenzhen A-share listed firms from 2010 to 2020, the role and impact mechanism of academician independent directors on enterprise green innovation were empirically analyzed. The research shows that the academician independent directors promote green innovation of enterprises by alleviating corporate financing constraints, increasing corporate R&D investment, and alleviating managerial myopia, and their role in promoting green invention patents is greater than that of green utility model patents. The academician independent directors will improve the green innovation level of enterprises in non-heavy polluting industries and enterprises in the eastern region, and the nature of property rights and the degree of marketization will strengthen their role in promoting green innovation.

Enhanced degradation of tetracycline under natural sunlight through the synergistic effect of Ag3PO4/MIL-101(Fe) photocatalysis and Fenton catalysis: Mechanism, pathway, and toxicity assessment.

Here, we show that the adverse environmental and health effects of tetracycline (TC) can be efficiently reduced by encapsulating Ag3PO4 into MIL-101(Fe) to construct a Ag3PO4/MIL-101(Fe) heterojunction composite through advanced oxidation processes, such as Fenton catalysis, photocatalysis, and photo-Fenton catalysis. Notably, the reaction can be driven by natural sunlight and does not require any artificial energy source. Remarkably, the optimal degradation of TC can be achieved under different compositions of the composite system through photocatalysis and photo-Fenton catalysis. For photo-Fenton catalysis, the maximum degradation rate of TC (2.5730 min-1) is achieved when the mass ratio of MIL-101(Fe) to Ag3PO4 in the composite is 5:1, which is 31.65- and 3.12-fold of that in the Ag3PO4 + PDS + Sunlight and MIL-101(Fe) + PDS+ Sunlight catalyst systems, respectively. Moreover, the internal conversion of matrix during photocatalysis and Fenton catalysis processes inhibits the photocorrosion of Ag3PO4 and improves the reusability of the composite. Furthermore, it is found that both radical and non-radical species participate in the TC degradation. Besides, the degradation products and catalytic mechanism of Ag3PO4 and Ag3PO4/MIL-101(Fe) systems are explored. The toxicity evaluation results suggest that the intermediates produced during Ag3PO4/MIL-101(Fe) catalysis have a lower biotoxicity than those produced during Ag3PO4 catalysis. Overall, this work provides an effective strategy to inhibit the inherent photocorrosion of Ag3PO4 and establishes an efficient catalytic system for the treatment of organic-contaminated wastewater under natural sunlight conditions.

Comprehensive Assessment of ERα, PR, Ki67, P53 to Predict the Risk of Lymph Node Metastasis in Low-Risk Endometrial Cancer.

PURPOSE: According to international guidelines, selective lymph node dissection can be performed on patients with early-stage endometrial cancer. However, some patients at early stage have already occurred lymph node metastasis at the time of diagnosis. This study was aimed to find a method to predict the risk of lymph node metastasis in this part of patient. METHODS: We collected data from 571 patients as training cohort and 351 patients as validation cohort for this study. Then we performed univariate and multivariate analyses to confirm the correlation of frequently used factors and lymph node metastasis. Combined analysis of four commonly indicators (ERα, PR, P53 and Ki67) from pathological parameter sources was mainly carried out, and the combined ratio is defined as (ERα + PR)/(Ki67 + P53). Then the accuracy of the combined ratio and other factors in prediction were compared by AUC value. Also, the optimal truncation value was searched. Finally, patients followed up for more than two years were divided into groups by the threshold value, and their difference in survival was explored. RESULTS: This study showed that CA125, grade, LVSI, ERα, PR, P53, Ki67 have statistical significance (P-value <0.05). The AUC value of combined ratio is 0.876, which is the best. The best cutoff value of combined ratio is 1.38. CONCLUSION: The combined ratio cutoff value of 1.38 in this study can be used for prediction of risk of lymph node metastasis in early-stage endometrial cancer patients and provide a reference for therapeutic planning.

Endocrine therapy initiation and overall survival outcomes with omission of radiation therapy in older Medicare patients with early-stage hormone-receptor-positive breast cancer.

BACKGROUND: Guidelines allow for the omission of radiotherapy in older women with early-stage, hormone-receptor-positive breast cancer, given that the patients receive adequate endocrine therapy (ET). However, the initiation of ET and survival outcomes after forgoing radiation therapy among these patients have not been well-studied. METHODS: We identified patients aged 70 to 90 years old newly diagnosed in 2010-2015 with early-stage, hormone receptor positive, and human epidermal growth factor receptor 2 (HER2) negative (HR+/Her2-) breast cancer who received lumpectomy and omitted radiation therapy using the SEER-Medicare database. We examined the initiation of ET and the utilization patterns of ET using a multivariable logistic regression. We further examined the overall survival outcomes using Kaplan-Meier estimation and Cox proportional hazard model with inverse probability weighting. RESULTS: Of the 2618 patients, 808 (30.9%) received no ET. The multivariable logistic regression showed that more recent years had better ET initiation (2013-2015 vs. 2010-2012: OR = 1.39, 95% CI:[1.16, 1.66]), while older patients (81-90 vs. 70-80: OR = 0.45, 95% CI:[0.38, 0.54]) were less likely to receive ET. Both the Kaplan-Meier estimation (log-rank p-value<0.0001) and the Cox proportional hazard model with inverse probability weighting (HR = 0.76, 95% CI:[0.58, 0.99]) showed that receiving ET was associated with better overall survival. CONCLUSION: This population-based study suggests that a sizable proportion of patients who omitted radiation did not receive endocrine therapy and receiving endocrine therapy was beneficial among these patients. Although ET initiation has improved in more recent years, certain patient groups were still especially susceptible to no endocrine therapy.

Ball-milling as effective and economical process for biodiesel production under Kraft lignin activated carbon stabilized potassium carbonate.

Biodiesel is a typical renewable energy and the previous transesterification processes for biodiesel production mainly focus on thermocatalytic methods. In this paper, the ball-milling process was investigated into the biodiesel production under Kraft lignin activated carbon stabilized K2CO3. Biodiesel yield increased to 66 % after only 5 min and reached 100 % within 25 min under optimal ball-milling conditions (0.5 g of the catalyst; methanol/oil molar ratio 18:1; 195 g of ball-mill beads; 1400 rpm; 25 °C). The power demand between the thermocatalytic method and the ball-milling method was also compared. Based on the computation, the ball-milling method has lower power demand than the traditional method (38 vs 201 kWh·mol-1). Therefore, the ball-milling method is an effective and economical process for biodiesel production.

Source-oriented ecological risk assessment of heavy metals in sediments of West Taihu Lake, China.

The geographical location of West Taihu Lake determines that it is the entrance of the whole Taihu Lake, and the intensive industries around it pose a great threat to the ecology of Taihu Lake. We innovatively combined Pb isotope ratio analysis with ecological risk assessment index to quantify the source-oriented ecological risk of heavy metals (HMs) in the sediments of West Taihu Lake. In this study, the representative HMs Zn, Pb, Cr, and Cd in the surface (0-2 cm) sediments of West Tai Lake were determined, and the ecological risk assessment of HM sources was carried out based on the Pb isotope ratio and ecological risk index. The results showed that HMs were significantly enriched in the south and the west of the study area. The average geo-accumulation index (Igeo) of Pb was unpolluted, Cr and Zn were between unpolluted and moderately polluted, and Cd was moderately polluted. The average ecological risk index (Ei) of Pb, Cr, and Zn was low, and only Cd reached a considerable risk (ECd = 120.7), which accounted for 89.8% of the comprehensive ecological risk index (RI). However, the RI in the whole study area (RI = 134.4) still indicated low risk. There was a significant correlation between Pb and other HMs (P < 0.05). The IsoSource analysis showed that the order of contribution rate was fossil fuels (48.0%) > industrial sources (35.8%) > natural sources (14.9%) > agricultural sources (1.3%). The HM pollution caused by fossil fuel combustion and industrial activities reaches a moderate ecological risk, whereas natural sources and agricultural sources pose a low risk. Overall, the main sources of HM pollution are anthropogenic, which pose moderate ecological risk to the study area and should be paid more attention to.

Lateral approach is a more aesthetical option for radical resection of BSCC: assessment of its surgical, oncological, functional, and aesthetic outcomes.

BACKGROUND: The purpose of this study was to introduce a modified lateral approach for combined radical resection of buccal squamous cell carcinoma (BSCC) and evaluate its surgical, oncological, functional, and aesthetic outcomes in comparison with the conventional lower-lip splitting approach. METHODS: This single-center study retrospectively reviewed 80 patients with BSCC, of which 37 underwent the lateral approach and 43 underwent the conventional approach. Surgical, functional, oncological, and aesthetic evaluations, as well as follow-ups, were recorded and compared. RESULTS: Compared to the conventional approach group, the lateral approach group had a longer surgical time (P = 0.000), but there was no significant difference in other surgical and oncological parameters. Moreover, the scar in the head and neck had a significantly discreet appearance in the lateral approach group, whose satisfaction was better than those in the conventional approach group (P = 0.000). Other oral function parameters, postoperative mouth-opening, and 3-year survival rate were not significantly different between the two groups. CONCLUSION: The lateral approach could provide superior aesthetic results while maintaining equal surgical, functional, and oncological outcomes compared to the conventional approach for radical resection of BSCC.

Accelerating the integration of China into the global development of innovative anticancer drugs.

The aim of this Policy Review was to compare China's overall and synchronous participation in clinical trials for innovative anticancer drugs with that of the USA, the EU, Japan, and South Korea, and to assess changes in the participation rate trends in these five regions. Relevant data from the top 20 international pharmaceutical companies from 2011 to 2021 were systematically collected from the Trialtrove and Pharmaprojects databases. Among the 8260 trials for 954 new anticancer drugs identified, China was involved in 8·8% of the trials and with 20·4% of the drugs being trialled. These participation rates are significantly lower than those for South Korea (14·5% of trials and 36·3% of drugs), Japan (16·1% of trials and 38·7% of drugs), the EU (40·6% of trials and 67·7% of drugs), and the USA (65·7% of trials and 91·2% of drugs; p<0·0001 for all). Similar results were found for the synchronous participation rate, defined as the proportion of drugs or trials at the highest development stage internationally, for the 803 tested drugs, which ranged from 9·0% in China to 87·7% in the USA. China's participation rate in early phase trials (4·4%) and in synchronous trials (5·4%) was even lower, in stark contrast to that of the USA (66·1% for early phase trials and 89·1% for synchronous trials). The fastest growing annual rate of participation in trials was observed in China (15·7%), followed by South Korea (8·2%) and Japan (6·8%); no change was detected in the USA or the EU. This Policy Review shows that Chinese participation in the clinical development of innovative cancer drugs by international pharmaceutical companies has increased over the past decade, but an obvious gap persists in comparison with the USA, the EU, Japan, and South Korea, especially in its synchronous participation and early participation rates.

Soil Quality Assessment in Farmland of a Rapidly Industrializing Area in the Yangtze Delta, China.

The comprehensive quality assessment of farmland soil is critical for agricultural production and soil ecological protection. Currently, there is no systematic method for conducting a comprehensive quality assessment of farmland soil; subsequently, as the most developed economic area in China, the comprehensive quality assessment of farmland soil in the Yangtze River Delta is lacking. We chose the farmland soil of Suzhou city as the research object. The soil fertility index (SFI) and soil environment index (SEI) were calculated with the membership function and Nemerow index. Finally, the comprehensive assessment of soil quality was achieved with the TOPSIS model. The results showed that the average values of soil pH, SOM, TN, AHN, AP, and AK were 6.44 (slightly acidic), 28.17 g/kg (medium), 1.63 g/kg (rich), 118.16 mg/kg (medium), 38.31 mg/kg (rich), and 160.63 mg/kg (rich), respectively. For the concentrations of heavy metals, including Cr, Ni, Cu, Zn, Cd, and Pb, in 122 soil samples, the percentages exceeding the background values of Jiangsu province were 5.74%, 8.20%, 8.20%, 10.66%, 86.07%, and 84.43%, respectively. Cd and Pb were the main heavy metal pollutants on farmlands. The soil samples with SFI values below the medium level (SFI < 0.6) accounted for 44.26%, and samples with SEI values below the medium level (SEI < 0.6) accounted for 13.12%. The values of the soil quality index (SQI) ranged from 0.171 to 0.996, with an average SQI value of 0.586 (very poor-V), and approximately half of the farmland soil quality in Suzhou city needed to be further improved. In a word, this study provides a theoretical basis and scientific support for the quality assessment and rational utilization of farmland soil.