An energy efficiency assessment of Yttrium-aluminum-garnet laser in vitro.

To study the effect range of the Nd:YAG laser through various levels of cloudy medium for targets with varying grayscale values in vitro. The coated paper cards with grayscale values of 0, 50, 100, and 150 were used as the laser's targets, which were struck straightly with varying energies using three burst modes (single pulse, double pulse, and triple pulse). Six filters (transmittances of 40, 50, 60, 70, 80, and 90) were applied to simulate various levels of cloudy refractive medium. Image J software was used to measure the diameters and regions of the laser spots. The ranges of the Nd:YAG laser spots increased with energy in the same burst mode (P < 0.05). Under the same amount of energy, the ranges of the Nd:YAG laser spot increased with the grayscale value of the targets (P < 0.05). The greater the transmittance of the filters employed, the larger the range of the Nd: YAG laser spots produced. Assuming that the total pulse energy is identical, the effect ranges of multi-pulse burst modes were significantly larger than those of single-pulse burst mode (P < 0.05). The effect range of a Nd:YAG laser grows with increasing energy and the target's grayscale value. A cloudy refractive medium has a negative impact on the effect range of the Nd: YAG laser. The single pulse mode has the narrowest and safest efficiency range.

Economic and healthcare resource utilization assessments of PET imaging in Coronary Artery Disease diagnosis: a systematic review and discussion of opportunities for future economic evaluations.

AIMS: This systematic literature review (SLR) consolidated economic and healthcare resource utilization (HCRU) evidence for positron emission tomography (PET) and single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) to inform future economic evaluations. MATERIALS AND METHODS: An electronic search was conducted in MEDLINE, Embase, and Cochrane databases from 2012-2022. Economic and HCRU studies in adults who underwent PET- or SPECT-MPI for coronary artery disease (CAD) diagnosis were eligible. A qualitative methodological assessment of existing economic evaluations, HCRU, and downstream cardiac outcomes was completed. Exploratory meta-analyses of clinical outcomes were performed. RESULTS: The search yielded 13,439 results, with 71 records included. Economic evaluations and comparative clinical trials were limited in number and outcome types (HCRU, downstream cardiac outcomes, and diagnostic performance) assessed. No studies included all outcome types and only one economic evaluation linked diagnostic performance to HCRU. The meta-analyses of comparative studies demonstrated significantly higher rates of early- and late-invasive coronary angiography and revascularization for PET- compared to SPECT-MPI; however, the rate of repeat testing was lower with PET-MPI. The rate of acute myocardial infarction was lower, albeit non-significant with PET- vs. SPECT-MPI. LIMITATIONS AND CONCLUSIONS: This SLR identified economic and HCRU evaluations following PET- and SPECT-MPI for CAD diagnosis and determined that existing studies do not capture all pertinent outcome parameters or link diagnostic performance to downstream HCRU and cardiac outcomes, thus, resulting in simplified assessments of CAD burden. A limitation of this work relates to heterogeneity in study designs, patient populations, and follow-up times of existing studies. Resultingly, it was challenging to pool data in meta-analyses. Overall, this work provides a foundation for the development of comprehensive economic models for PET- and SPECT-MPI in CAD diagnosis, which should link diagnostic outcomes to HCRU and downstream cardiac events to capture the full CAD scope.

Pricing decision and channel selection of fresh agricultural products dual-channel supply chain based on blockchain.

The application of blockchain can effectively improve the efficiency of fresh agricultural product circulation and consumer trust, but it can also increase investment costs. In this context, this paper introduces parameters such as blockchain unit variable cost, the level of blockchain technology investment, and consumer channel preference in two dual-channel supply chain systems dominated by fresh agricultural product manufacturers: online direct sales and distribution. It compares and analyzes pricing and channel selection strategies in both cases of not using and using blockchain. The research shows that when blockchain is used, manufacturer profits are higher in the direct sales model than in the distribution model. Traditional retailers' profits are lower in the direct sales model than in the distribution model. Total supply chain profits are higher in the direct sales model than in the distribution model, and they exhibit an inverted "U" shape as the level of blockchain investment increases. In the online direct sales model, if the blockchain technology unit variable cost is within a certain threshold range, manufacturer profits, traditional retailer profits, and total supply chain profits are all higher than when blockchain technology is not used. In the online distribution model, when the blockchain variable cost and blockchain usage level meet certain conditions, manufacturers, traditional retailers, and online distributors all have higher profits when using blockchain technology than when not using it. This study provides theoretical guidance for the practical application of blockchain technology in dual-channel fresh agricultural product supply chains.

Microwave deicing properties and carbon emissions assessment of asphalt mixtures containing steel slag towards resource conservation and waste reuse.

A large amount of solid waste, such as steel slag (SS), is generated annually. At the same time, the shortage of road construction materials is becoming a concern. In this study, to recycle and reuse SS as a substitute for natural aggregates to achieve resource conservation and sustainable development of roads were conducted. First, the electromagnetic performance of SS was explored to evaluate its wave-absorbing properties. Next, the effect of different SS contents on heating properties, surface temperature, heating uniformity, and ice melting time (IMT) were investigated. Finally, the carbon emissions assessment (CEA) of conventional asphalt mixture (CAM) and steel slag asphalt mixture (SSAM) was compared. Results indicated that SS has ferromagnetic behavior and higher electromagnetic parameters, showing better wave-absorbing properties than limestone. There were three stages during microwave heating (MH): ice melting, moisture emitting, and stabilization. In addition, heating uniformity tends to be poor with the increase of SS, and samples with 100 % content of SS have the highest standard deviation of 21.04 °C and 20.77 °C after 270 s at -10 °C and - 20 °C. Samples containing 50 % SS have the best microwave deicing properties, which can reduce the IMT by 28.57 % to 46.18 % at different initial freezing temperatures and ice thickness compared to CAM. Furthermore, CEA revealed that CAM and SSAM's carbon emissions over road construction's life cycle are similar (around 27,000 kg) and originate mainly from the mixing and raw material extraction phases. However, SSAM leads to better environmental and economic benefits and provides an exemplary resource conservation and waste reuse solution.

Using the Standing and Walking Assessment Tool at Discharge Predicts Community Outdoor Walking Capacity in Persons With Traumatic Spinal Cord Injury.

OBJECTIVE: The Standing and Walking Assessment Tool (SWAT) standardizes the timing and content of walking assessments during inpatient rehabilitation by combining 12 stages ranging from lowest to highest function (0, 0.5, 1A, 1B, 1C, 2A, 2B, 2C, 3A, 3B, 3C, and 4) with 5 standard measures: the Berg Balance Scale, the modified Timed "Up & Go" test, the Activities-specific Balance Confidence Scale, the modified 6-Minute Walk Test, and the 10-Meter Walk Test (10MWT). This study aimed to determine if the SWAT at rehabilitation discharge could predict outdoor walking capacity 1-year after discharge in people with traumatic spinal cord injury. METHODS: This retrospective study used data obtained from the Rick Hansen Spinal Cord Injury Registry from 2014 to 2020. Community outdoor walking capacity was measured using the Spinal Cord Independence Measure III (SCIM III) outdoor mobility score obtained 12 (±4) months after discharge. Of 206 study participants, 90 were community nonwalkers (ie, SCIM III score 0-3), 41 were community walkers with aids (ie, SCIM III score 4-6), and 75 were independent community walkers (ie, SCIM III score 7-8). Bivariate, multivariable regression, and an area under the receiver operating characteristic curve analyses were performed. RESULTS: At rehabilitation discharge, 3 significant SWAT associations were confirmed: 0-3A with community nonwalkers, 3B/higher with community walkers with and without an aid, and 4 with independent community walkers. Moreover, at discharge, a higher (Berg Balance Scale, Activities-specific Balance Confidence Scale), faster (modified Timed "Up & Go," 10MWT), or further (10MWT) SWAT measure was significantly associated with independent community walking. Multivariable analysis indicated that all SWAT measures, except the 10MWT were significant predictors of independent community walking. Furthermore, the Activities-Specific Balance Confidence Scale had the highest area under the receiver operating characteristic score (0.91), demonstrating an excellent ability to distinguish community walkers with aids from independent community walkers. CONCLUSION: The SWAT stage and measures at discharge can predict community outdoor walking capacity in persons with traumatic spinal cord injury. Notably, a patient's confidence in performing activities plays an important part in achieving walking ability in the community. IMPACT: The discharge SWAT is useful to optimize discharge planning.

Unexpected capacity-building experiences of multicultural, multilingual participants in a public health initiative.

AIMS: This study of a levy-voter funded public health initiative program (1) identifies capacity-building concerns, (2) summarizes those concerns at the community-based organization (CBO) level, and (3) documents the desired CBO capacity-building outcome. PARTICIPANTS: Nineteen participants from nine CBOs were included, representing 95% of participants (19/20) and 90% of CBOs (9/10) from the initiative's program population. METHODS: Interviews were conducted. A focus group validated data. Demographic surveys were completed. METHODOLOGY AND ANALYSIS: Data were analyzed using demographic and inductive content analyses. Fifteen capacity-building unexpected concerns were identified. Participants from eight out of nine (88.8%) CBOs shared at least ten concerns. Seven CBO capacity-building outcomes were identified. RESULTS: Capacity-building providers helped participants mitigate the Initiative's capacity-building testing of the National Implementation Research Network (NIRN) model. Participants' NIRN processes were Western and mainstream. Participants wanted community-designed processes and the funder to understand CBO clients' backgrounds, cultures, and languages. The contract money did not match the needed capacity-building processes, time, and workload. DISCUSSION: The funder's pre-selected the NIRN Western majority approach did not fit. Participants wanted to lead. Capacity-building only for home-based program development was less desired. Social justice leadership could have made a difference.

Cost-sharing and horizontal compensation scheme of regional sulfur dioxide treatment: Evidence from China.

Establishing a reasonable cost-sharing and compensation mechanism for air pollution control is a prerequisite for realizing inter-regional cooperative treatment. Taking inter-provincial sulfur dioxide (SO2) emissions in China from 2005 to 2019 as the research object, this paper proposes a data-driven approach to establish a cost-sharing index system of regional SO2 treatment in four dimensions and construct a cost-sharing and compensation scheme using the entropy-TOPSIS method. The results revealed that there are significant spatial and temporal differences in the treatment cost of SO2 emission, and the total SO2 treatment costs at the national level increased first and then decreased during the study period, meanwhile, the regional SO2 treatment costs are much higher in the less economically developed regions such as the central and western regions than in economically developed eastern coastal regions. The design of the cost-sharing and compensation mechanism of SO2 treatment should consider the regional differences in abatement capacity, abatement potential, abatement responsibility, and development demands. The economically developed regions should share higher treatment costs according to their historical cumulative abatement responsibilities, and provide economic compensation and technical support to the less economically developed regions. Specifically, the marginal abatement cost in the more economically developed eastern region is much higher than that in the less economically developed central and western areas due to their large abatement responsibility and strong reduction capacity but insufficient abatement potential, so the eastern regions can transfer part of their abatement responsibility to the central and western regions using economic compensation. Reasonable cost sharing and horizontal compensation can help promote regional cooperation and synergistic management in air pollution abatement. Finally, corresponding policy recommendations are given to provide a decision basis for cross-regional cooperation in air pollution control.

Dealkylation in Fluid Catalytic Cracking Condition for Efficient Conversion of Heavy Aromatics to Benzene-Toluene-Xylene.

Based on the characteristics of typical C9 + aromatics in naphtha fractions, the effects of key process parameters and heavy aromatic composition on product distribution of fluid catalytic cracking (FCC) of heavy aromatics (HAs) were investigated. The results show that catalysts with large pore size and strong acid sites are favorable for the conversion of HAs to benzene-toluene-xylene (BTX) at higher reaction temperatures and moderate catalyst-oil ratios (C/O). With a Y zeolite-based catalyst which was hydrothermally pretreated for 4 h, the conversion of Feed 1 at 600 °C and C/O of 10 may reach 64.93%. Meanwhile, the yield and selectivity of BTX are 34.80 and 53.61%, respectively. The proportion of BTX can be adjusted within a certain range. The HAs from different sources show high conversion and good BTX selectivity, which provides strong support for the technological development of HAs to light aromatics in FCC operation.

Business credit network characteristics and impact on green economy efficiency: Evidence from the Greater Bay Area around Hangzhou Bay of China.

In regions where the development of formal finance is relatively lagging behind, commercial credit has partially replaced the role of formal finance and facilitated the development of the private economy and even the country, thus making commercial credit an important entry point for understanding and promoting sustainable economic development. Taking the Hangzhou Bay Greater Bay Area as a case study, based on the City Business Credit Environment Index (CEI) from 2015 to 2019, we examine the characteristics of business credit networks using social network analysis and discuss the impact of business credit on urban green economy efficiency heterogeneity by drawing on spatial econometrics. The study confirms that the structure of business credit networks in the Hangzhou Bay Greater Bay Area tends to be dense, the network density and number of connections show growth, the spatial network structure is taking shape, and the strength of spatial connections among cities has increased. Hangzhou, Shaoxing, Jiaxing and Shanghai are at the centre of the network and play a radiation-driven role. The business credit network in the Hangzhou Bay Greater Bay Area is characterised by self-stability and has evolved from a multi-centre to a single centre. Business credit is negatively correlated with the efficiency of the green economy in the Hangzhou Bay Area, which is a departure from the Chinese "financial development paradox". In terms of heterogeneity, the relationship remains consistent for port cities and open coastal cities in general, while the effect is less pronounced for cities above sub-provincial level. The study concludes that, with the high-quality economic development of the Hangzhou Bay Greater Bay Area, the Chinese "financial development paradox" does not exist in the region at this stage, which also highlights the need to accelerate the construction of a Chinese-style modernisation theory and practice system.

Health belief model and social media engagement: A cross-national study of health promotion strategies against COVID-19 in 2020.

Background: Using the Health Belief Model (HBM), this study analyzed tweets related to COVID-19 published by national health departments of the United States, the South Korea, the United Kingdom, Japan, Germany, and India to explore their differences in (1) the health measures against COVID-19, (2) the health promotion strategies, (3) the social media engagements that those measures and strategies have triggered. Method: We conducted a content analysis with 1,200 randomly selected COVID-19-related tweets from six national health departments' Twitter accounts from 1 January 2020 to 31 December 2020. We coded the six HBM constructs and 21 sub-themes of the HBM constructs for each tweet. Results: Results showed that all six HBM constructs were used in the full sample. The most commonly used HBM construct was cues to action, followed by susceptibility, benefits, self-efficacy, severity, and barriers. All the HBM constructs were positively related to Twitter engagement variables except barriers. Further analysis illustrated that people from the six countries responded differently to the HBM constructs and the HBM sub-themes. Twitter users in Germany, India, the U.S., and Japan positively reacted to the clear directions of "what to do against COVID-19" (cues to action), while Twitter users in the U.S. and Japan were also eager to know the justifications for such directions (benefits); people in South Korea and the U.K. were mainly seeking a diagnosis of the severity and susceptibility of COVID-19, instead of health measures, of COVID-19 in the year 2020. Conclusions: This study showed the use of HBM constructs is generally effective in inducing Twitter engagement. The further comparison illustrated a homogenization in the promotion strategies that the health departments implemented and the health measures they promoted, yet responses to such promotions varied across nations. This study broadened the scope of HBM applications from predicting health behaviors in surveys to guiding the design of health promotion messages online.

Does Environmental Regulation Promote the Infrastructure Investment Efficiency? Analysis Based on the Spatial Effects.

Infrastructure investment plays a key role in steady economic growth. Investment in infrastructure is gradually increasing; however, large-scale infrastructure investment is also associated with efficiency problems and environmental problems, which need to be carefully examined. The entropy weight method and the Super-SBM model are implemented to measure environmental regulation and infrastructure investment efficiency, respectively; and the spatial Durbin model is applied to analyze the influence mechanism and spatial effects of environmental regulation on infrastructure investment efficiency. The results show that spatial agglomeration characteristics exist in both environmental regulation and infrastructure investment efficiency. Besides, environmental regulation can promote infrastructure investment efficiency in general, but it develops an inverted U-shaped relationship as the intensity increases. Lastly, the spillover effects of environmental regulation on infrastructure investment efficiency present a U-shaped relationship. The conclusion is that both environmental regulation and infrastructure investment efficiency in China increased from 2008 to 2020. Besides, moderate environmental regulation is beneficial to infrastructure investment efficiency and restrains spatial spillover, but strict environmental regulation appears to be the opposite. This research expands the literature on environmental regulation and production efficiency and provides a reference basis for formulating effective policies to improve infrastructure investment efficiency from the perspective of the ecological environment.

Indistinct assessment of the quality of traditional Chinese medicine in precision medicine exampling as safflower.

The quality of traditional Chinese medicine (TCM) guarantees its clinical efficacy. Although advanced analytical techniques and methods can accurately determine the content of chemical components in TCM, it is difficult to accurately determine its clinical efficacy. In addition, the current analytical methods and technologies are complex and have difficulty meeting the requirements of a rapid, accurate and convenient determination of TCM quality. In this study, we first propose the concept of "indistinct" evaluation of the quality of TCM, that is, combining biological potency with character evaluation, quantifying the character evaluation, and preparing the safflower quality grade evaluation card based on the character analysis, which provides research ideas and methods for the rapid and accurate evaluation of the quality of TCM. We determined the biological potency of different batches of safflower based on the in vitro antiplatelet aggregation model and divided the safflower samples into two grades based on the biological potency. We further collected the color information of different grades of safflower samples, quantified the color information of different grades of safflower, drew a quality grade evaluation card for the rapid judgment of safflower quality grade and verified its accuracy by pharmacodynamic evaluation. To further analyze the differences in the material basis of different grades of safflower, the LC-MS method was used to simultaneously determine the contents of 19 chemical components, such as myricetin, in different grades of safflower samples to analyze the differences in the material basis of different grades of safflower. The result shows that the different grades of safflower exhibited significant differences in color. The pharmacodynamic results show that the quality evaluation card prepared based on color information can accurately evaluate quality, and the effect of first-class safflower is significantly better than that of second-class safflower. The chemical analysis results of different grades of safflower show that there are also significant differences between them, among which hypericin, 6-hydroxyapin-6-O-glucose-7-O-glucuronide, 6-hydroxykaempferol-3,6-O-diglucoside-7-O-glucuronic acid glycoside, 6-hydroxykaempferol-3,6,7-tri-O-glucoside and hydroxysafflower yellow A exhibit significant differences, which may be the main differentiating components of different grades of safflower. This study preliminarily confirmed that the "indistinct" evaluation of the quality of TCM based on character analysis is accurate and scientific, and the quality evaluation card prepared can accurately judge the quality of TCM, providing a reference for the rapid application of TCM character evaluation.

Spatial connection network characteristics and development trend forecast of natural gas industry's sustainable development resilience in China.

Objectively recognizing and improving the sustainable development resilience of China's natural gas industry will help achieve the low-carbon transformation goal of China's energy system. Taking 31 Chinese provinces as the research area, this paper measures the sustainable development resilience (SDR) of China's natural gas industry based on the Drive-Pressure-State-Impact-Response (DPSIR) model and entropy method, and integrates the gravity correction model and social network analysis methods to identify the spatial linkages and network patterns among core regions, and further explores the development trend of the SDR of China's natural gas industry using grey model (GM(1,1)) moderated by a variable-weight buffer operator. The results show that: (1) There are significant regional differences in the SDR of the natural gas industry across Chinese provinces. The SDR is a high priority in Shanghai, Shaanxi, Sichuan, Xinjiang, Guangdong and Shandong, while it is low major in Tibet, Yunnan, Guangxi, Guizhou and Ningxia. (2) The spatial connection network density is low in China's natural gas industry, and the network correlation between provinces is poor. In detail, Jiangsu, Guangdong and Shandong are the core of the entire network and the connection lines between provinces are mainly basic in the whole region with poor connection strength, but there is a trend for the better. (3) The changing trend is significantly different in the SDR of Chinese provinces, and the prediction results show a trend of "polarization" in the SDR index of the provinces in the resource endowment area.

Assessment of oral health status and related factors in adolescents aged 12-15 years in the Gansu Province of China: a cross-sectional survey.

BACKGROUND: The national oral epidemiological survey conducted every decade has become an indispensable means of detecting changes in oral disease patterns. This study was undertaken to investigate the oral health status and related factors in 12-15-year-old students in Gansu, China. METHODS: According to the methodology adopted by the Fourth National Oral Health Survey, a multi-stage, stratified, random sampling method was used to select 3871 adolescents aged 12-15 years from four regions of Gansu Province for oral examination and questionnaire survey. Caries experience was measured using the Decayed, Missing, and Filled Teeth (DMFT) index; and periodontal health examination included gingival bleeding, calculus, periodontal pockets and attachment loss. The questionnaire included questions regarding sociodemographic characteristics, and oral health knowledge and behaviors. SPSS20.0 software was used for statistical analysis of the survey data. RESULTS: The mean DMFT index was 0.83 ± 1.42. The prevalence of caries experience was 38.6%, filling rate was 1.6%, and pit and fissure sealing rate was 0.5%. Logistic regression analysis showed that female sex, rural district, older age, non-only child, frequency of dental visits, and toothache experience were the risk factors for caries experience, with OR ranging between 1.280 and 3.831 (p < 0.05). Prevalence of healthy periodontium was 29.8%. Female sex, rural district, and younger age were found to be the protective factors for healthy periodontium, with OR ranging between 1.178 and 1.414 (p < 0.05). CONCLUSIONS: Adolescents in Gansu Province had high prevalence of caries experience along with low filling rate, and low prevalence of healthy periodontium. Therefore, it is necessary to vigorously strengthen oral health education, disease prevention and control programs in the province. This would help improve the oral health-related quality of life of these individuals.

Reliability and validity of the simplified Chinese version of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator.

PURPOSE: This study aimed to translate and culturally adapt the immune checkpoint modulator (ICM) subscale of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM) scale and to validate the FACT-ICM scale in Chinese cancer patients receiving immune checkpoint inhibitors (ICIs) treatment. METHODS: In total, 354 cancer patients treated with ICIs were included in our cross-sectional study including 2 phases. Firstly, the ICM subscale was translated and culturally adapted by standardized procedures. Then the FACT-ICM scale was validated, which included item analysis, content validity, floor and ceiling effects, internal consistency reliability, test-retest reliability, construct validity, convergent/divergent validity, and known-group validity. RESULTS: The content validity indexes at the item and scale level of the ICM subscale were greater than 0.8. No floor and ceiling effects were found. The Cronbach's α and McDonald's omega coefficients of the simplified Chinese version of the FACT-ICM scale were 0.935 and 0.936, and the intraclass correlation coefficient was 0.833 (95% confidence interval: 0.574-0.940). Confirmatory factor analysis confirmed the 5-subscale structure of the simplified Chinese version of the FACT-ICM scale (χ2/df = 2.144, RMSEA = 0.057, SRMR = 0.072, and CFI = 0.848). Convergent and divergent validity further supported the construct validity of the simplified Chinese version of the FACT-ICM scale. The known-group validity of the simplified Chinese version of the FACT-ICM scale was confirmed in patients with different physical statuses. CONCLUSIONS: The simplified Chinese version of the FACT-ICM scale is a valid and reliable instrument and can be used in clinical practice and research on cancer patients receiving ICIs treatment.

Effectiveness and usability of the system for assessment and intervention of frailty for community-dwelling pre-frail older adults: A pilot study.

Background: Effective multicomponent interventions in the community targeted at preventing frailty in at-risk older adults can promote healthy ageing. However, there is a lack of studies exploring the effectiveness of technology-enabled autonomous multi-domain community-based interventions for frailty. We developed a novel end-to-end System for Assessment and Intervention of Frailty (SAIF) with exercise, nutrition, and polypharmacy components. This pilot study aimed to explore SAIF's effectiveness in improving frailty status, physical performance and strength, and its usability in pre-frail older adults. Materials and methods: This is a single arm 8-week pilot study in 20 community-dwelling older adults who were pre-frail, defined using the Clinical Frailty Scale (CFS) as CFS 3 + (CFS 3 and FRAIL positive) or CFS 4. For outcomes, we assessed frailty status using the modified Fried Frailty Phenotype (FFP) and CFS; physical performance using Short Physical Performance Battery (SPPB); and Hand Grip Strength (HGS) at baseline and 8-week. User experience was explored using the System Usability Scale (SUS), interest-enjoyment subscale of the Intrinsic Motivation Inventory and open-ended questions. We analyzed effectiveness using repeated-measures tests on pre-post scores, and usability using a convergent mixed-method approach via thematic analysis of open-ended responses and descriptive statistics of usability/interest-enjoyment scales. Results: Sixteen participants (71.8 ± 5.5 years) completed the 8-week study. There was a significant improvement in FFP score (-0.5, p < 0.05, effect size, r = 0.43), but not CFS (-1.0, p = 0.10, r = 0.29). Five (31.3%) improved in frailty status for both FFP and CFS. SPPB (+1.0, p < 0.05, r = 0.42) and HGS (+3.5, p < 0.05, r = 0.45) showed significant improvements. Three themes were identified: "Difficulty in module navigation" (barriers for SAIF interaction); "User engagement by gamification" (facilitators that encourage participation); and "Perceived benefits to physical health" (subjective improvements in physical well-being), which corroborated with SUS (68/100) and interest-enjoyment (3.9/5.0) scores. Taken together, user experience results cohere with the Senior Technology Acceptance and Adoption Model. Conclusion: Our pilot study provides preliminary evidence of the effectiveness of SAIF in improving frailty status, physical performance and strength of pre-frail older adults, and offers user experience insights to plan the follow-up large-scale randomized controlled trial.

Quality assessment and Q-markers discovery of Tongsaimai tablet by integrating serum pharmacochemistry and network pharmacology for anti-atherosclerosis benefit.

BACKGROUND: The limited therapeutic outcomes of atherosclerosis (AS) have allowed, traditional Chinese medicine has been well established as an alternative approach in ameliorating AS and associated clinical syndromes. Clinically, Tongsaimai tablet (TSMT), a commercial Chinese patent medicine approved by CFDA, shows an obvious therapeutic effect on AS treatment. However, its effective mechanism and quality control still need thorough and urgent exploration. METHODS: The mice were orally administered with TSMT and their serum was investigated for the absorbed compounds using serum pharmacochemistry via the UPLC-Q-Exactive Orbitrap/MS analysis was employed to investigate these absorbed compounds in serum of mice orally administrated with TSMT. Based on these absorbed prototype compounds in serum derived from TSMT, a component-target-disease network was constructed using network pharmacology strategy, which elucidated the potential bioactive components, effective targets, and molecular mechanisms of TSMT against AS. Further, the screened compounds from the component-target network were utilized as the quality control (QC) markers, determining multi-component content determination and HPLC fingerprint to assess quality of nine batches of TSMT samples. RESULTS: A total of 164 individual components were identified in TSMT. Among them, 29 prototype compounds were found in serum of mice administrated with TSMT. Based on these candidate prototype components, 34 protein targets and 151 pathways related to AS were predicted, and they might significantly exhibit potential anti-AS mechanisms via synergistic regulations of lipid regulation, shear stress, and anti-inflammation, etc. Five potentially bioactive ingredients in TSMT, including Ferulic acid, Liquiritin, Senkyunolide I, Luteolin and Glycyrrhizic acid in quantity not less than 1.2798, 0.4716, 0.5419, 0.1349, 4.0386 mg/g, respectively, screened from the component-target-pathway network. Thereby, these indicated that these five compounds of TMST which played vital roles in the attenuation of AS could serve as crucial marker compounds for quality control. CONCLUSIONS: Overall, based on the combination of serum pharmacochemistry and network pharmacology, the present study firstly provided a useful strategy to establish a quality assessment approach for TSMT by screening out the potential anti-AS mechanisms and chemical quality markers.

Fiscal Decentralization, Green Technology Innovation, and Regional Air Pollution in China: An Investigation from the Perspective of Intergovernmental Competition.

Fiscal decentralization (FD), as an institutional arrangement for the fiscal division between central and local governments, gives local governments the enthusiasm and autonomy to provide public products and services. With the dominance of environmental governance, how local governments can avoid intergovernmental "race to the bottom" issues through green technology innovation (GTI) is a matter of regional green development and continuous improvement of atmospheric environmental quality. Based on a sample of 30 provinces in China from 2003 to 2018, this paper uses the spatial Durbin model (SDM) to examine the relationship between FD, GTI, and regional air pollution and explores their spatial spillover effect and regional heterogeneity from the perspective of intergovernmental competition. The results indicate that the FD and GTI in various provinces had significant and regionally differentiated inhibitory effects on local air pollution. In Western China, due to the regional competition among local governments in terms of economic development, economic development-oriented fiscal expenditures crowd out environmental governance-oriented fiscal expenditures, which has led to the consequence that FD can intensify local air pollution and has a positive spillover effect, but the demonstration effect of green technological innovation can well moderate the effect of FD on air pollution. FD in the eastern region has played a positive role in promoting regional air quality improvement. However, its green technological innovation has not played a positive role in reducing emissions, and it plays a significant negative regulatory role in the emission reduction effect led by FD. Finally, the article puts forward policy recommendations in terms of a fiscal decentralization system, green technological innovation, and performance evaluation mechanism.

Cumulative risk assessment of dietary exposure to phthalates in pregnant women in Beijing, China.

Diet is an important exposure route for phthalates, such as di-iso-butyl phthalate (DiBP), dibutyl phthalate (DBP), bis(2-ethylhexyl) phthalate (DEHP), and benzyl butyl phthalate (BBP). In this study, we aimed to estimate phthalate exposure in the diet of pregnant women and assess the health risk. A total of 517 pregnant women in the first trimester were recruited, and food frequency questionnaires were collected. A simple distribution assessment method was used to estimate daily exposure, and the hazard index (HI) method was used to assess cumulative risk. The maximum daily dietary exposure to DEHP, DBP, DiBP, and BBP was 5.25, 3.17, 2.59, and 0.58 µg/kg bw/day, respectively, and did not exceed the safety limit values. Cereals and vegetables were the main sources of the estimated daily intake (EDI) of phthalates in the diet. The cumulative risk assessment, based on the European Food Safety Authority tolerable daily intake (TDI) and the US Environmental Protection Agency reference dose (RfD), did not exceed the threshold of 1. DiBP, DBP, and DEHP had higher hazard quotient (HQ) values for cumulative health risk than BBP. In conclusion, a low health risk was posed by the cumulative dietary exposure to phthalates for pregnant women in Beijing.