Establishment of Reference Range for Serum Concentration of Vitamin A and Vitamin E in Southern Sichuan Area of China.

OBJECTIVE: To establish the reference range of serum concentration of vitamin A (VA) and vitamin E (VE) in Southern Sichuan area of China. METHODS: From August 1, 2021, to May 31, 2023, 9482 blood tablets were received for the screening of VA and VE. The information was divided into four different age groups: ≤1 year old, 1< to ≤6 years, 6< to ≤17 years, and 17< to ≤59 years. In each age group, the four seasons were further subdivided into spring, summer, autumn, and winter, as well as male and female genders. The serum concentration of VA and VE was detected by liquid chromatography-tandem mass spectrometry (HPLC-MS), and the reference range was established for verification. RESULTS: The concentration of VA and VE in 9482 cases showed skewed distribution. When comparing between different age groups, the serum concentration of VA and VE was statistically significant (p < 0.05). While comparing different seasons, the serum VA levels in different seasons were significantly different (p < 0.05) except in summer and autumn. There was statistical significance in VE level in different seasons (p < 0.05). And while comparing different genders, there was no statistical significance in VA concentration levels (p > 0.05). The VE concentration levels were statistically significant (p < 0.05). The established reference range was established and verified, and the results were in accordance with the standard. CONCLUSION: The reference range of VA and VE should be set according to different ages, different seasons, and different genders.

Prevalence rate of primary osteoporosis in China: a meta-analysis.

BACKGROUND: Primary osteoporosis (POP) is recognized as a "silent disease" and often ignored. This meta-analysis aimed to determine the prevalence of POP in the Chinese population over the past 20 years to raise awareness of the disease's epidemiology, which is hoped to help prevent and treat the condition better. METHODS: Eight English and three Chinese language databases were searched systematically from January 2002 to December 2023. Relevant data were analysed using Stata 16.0. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. A funnel plot was further drawn in combination with Egger and Begg tests to determine publication bias. RESULTS: A total of 45 studies (241,813 participants) were included. The meta-analysis revealed that the overall prevalence of POP in the Chinese population was 18.2% (95% CI: 14.7-21.7%), showing a positive correlation with age. Specifically, prevalence rates were 23.4% (18.3-28.5%) in women and 11.5% (9.1-13.9%) in men. A notable increase was observed within the span of 20 years (16.9% before 2010 and 20.3% in 2011-2020). Notably, regional variations were observed, with southern China reporting a lower prevalence of 16.4% compared to 20.2% in northern China. Meta-regression suggested that sample size significantly influenced the estimation of point prevalence (P = 0.037). CONCLUSIONS: Over the past two decades, there has been an increase in the prevalence of POP within the Chinese population. The growing prevalence of older individuals and women further highlights the urgency for tailored disease prevention and control measures.

First identification of Cytauxzoon manul in Eurasian lynx (Lynx lynx) in northwestern China.

BACKGROUND: Multiple species of the genera Cytauxzoon and Hepatozoon can infect wild felines, but the diversity of these and other apicomplexan parasites in Eurasian lynx is scarcely known. The aim of this study was to detect Cytauxzoon and Hepatozoon species with molecular methods in Eurasian lynxes and their ticks in northwestern China. METHODS: DNA was extracted from the heart, liver, spleen, lung, and kidney samples of three Eurasian lynxes as well as from their five ixodid ticks. These DNA samples were screened with polymerase chain reactions (PCRs) for Cytauxzoon with the partial cytochrome b gene (CytB), cytochrome c oxidase subunit I gene (COI), and small subunit ribosomal RNA gene (18S rRNA), and Hepatozoon with three different fragments of small subunit ribosomal RNA gene (18S rRNA). PCR products were sequenced, aligned, and phylogenetically analyzed. RESULTS: One adult female of Eurasian lynx (#1, adult female) was co-infected with Cytauxzoon manul and Hepatozoon felis genotype I, while an adult male lynx (#2) was infected with C. manul. Interestingly, H. felis genotype I was both detected in a male cub (#3) and two out of five infesting Hyalomma asiaticum ticks. CONCLUSIONS: For the first time, Cytauxzoon manul is reported here from Eurasian lynx. In addition, H. felis has not been known to occur in this host species in China and Central Asia. Thus, the findings of this study extend our knowledge on the geographical distribution and host range of these haemoprotozoan parasites. Moreover, this is also the first evidence of C. manul and H. felis co-infection in Eurasian lynx.

Relations between maternal parenting styles and callous-unemotional behavior in Chinese children: A longitudinal study.

BACKGROUND: Previous studies on maternal parenting styles and children's callous-unemotional behavior (CU behavior) have focused on the West, and few studies have examined the longitudinal relationship between maternal parenting styles and CU behavior using Chinese preschoolers as subjects. OBJECTIVE: Through a 1.5-year longitudinal lens, this study probed the relations between maternal parenting styles and CU behavior in the Chinese cultural setting. PARTICIPANTS: Participants were N = 492 Chinese young children (Mage = 52.44 months, SD = 5.00, 48 % girls). METHODS: At Time 1 (T1), mothers reported their use of authoritative parenting styles (i.e., warmth, reasoning, and autonomy), authoritarian parenting styles (i.e., physical coercion, verbal hostility, and nonreasoning) and children's CU behavior. At Time 2 (T2; approximately 1.5 years later), mothers again reported the above variables. RESULTS: Cross-lagged models indicated that maternal warmth, reasoning, autonomy, and nonreasoning at T1 predicted CU behavior at T2. However, not only did maternal physical coercion and verbal hostility at T1 predict CU behavior at T2, but CU behavior at T1 also predicted maternal physical coercion and verbal hostility at T2. Additionally, there were no gender differences in the relationship between dimensions of maternal parenting styles and CU behavior. CONCLUSIONS: It underscores the influence of authoritative parenting in potentially mitigating CU behavior, while authoritarian approaches may exacerbate CU behavior. The absence of gender differences suggests these dynamics are broadly applicable across genders. These findings have significant implications for parenting strategies aimed at addressing CU behavior in children, emphasizing the need for warmth, reasoning, and autonomy in parenting practices.

Tuberculosis infection among close contacts of pulmonary tuberculosis patients in China:a population-based, multicentered study.

OBJECTIVES: Limited information is currently available on the prevalence of and risk factors for tuberculosis infection (TBI) among close contacts of pulmonary TB (PTB) patients in China. In this study, we estimated the burden of TBI among close contacts using QuantiFERON-TB Gold In-Tube (QFT) and identified factors associated with TB transmission among this high-risk population. METHODS: Between January 1 2018 and August 31 2020, we identified laboratory-confirmed PTB patients from a population-based, multicentered, cluster-randomized control trial for tuberculosis preventive treatment (TPT). Close contacts of these patients were identified, interviewed and tested using QFT. We estimated TBI prevalence and calculated odds ratios (ORs) and 95% confidence intervals (CIs) for TBI risk factors. RESULTS: A total of 3,138 index cases and 8,117 close contacts were identified. Of these contacts, 36 contacts had PTB (prevalence of 443.51 cases/100,000 population). Among the remaining 7,986 close-contacts, 3,124 (39.12%) had a positive QFT result. QFT positivity was significantly associated with older age [adjusted OR: 1.77 (95% CI 1.27-2.47), 2.20 (95% CI 1.59-3.05) and 2.74 (95% CI 1.96-3.82) for the age groups of "35-44", "45-54" and "55-64" respectively, compared with the age group "5-14"], longer contact duration (adjusted OR 1.44; 95% CI 1.22-1.69), and sharing bedroom (adjusted OR 1.39; 95% CI 1.18-1.65). CONCLUSIONS: Our findings indicate a high TBI burden among the close contacts of PTB. The results also highlighted that contacts tracing and investigation for TBI are necessary and beneficial, particularly for those who are older, have longer contact duration - including sharing a bedroom.

How housing burden damages residents' health: evidence from Chinese cities.

Background: Currently, China is steadily pursuing high-quality development and promoting common prosperity, for which residents' health is a precondition. However, high housing-price-to-income ratios and rent-to-income ratios have already triggered many social problems and have substantially affected people's work and life. It is of practical significance to examine the relationship between housing burden and residents' health. Methods: Combining city-level housing price-to-income ratio data and residents' health data from the China Family Panel Studies, this study employs a binary logit model to investigate the impact and mechanism of housing burden on residents' physical and psychological health. Results: Overall, a 1% increase in the housing-price-to-income ratio leads to a 1.2% decrease in physical health and a 1.9% decrease in psychological health. In terms of different psychological state indicators, a 1% increase in the housing price-to-income ratio leads to a 1.1% increase in depression, 1.1% increase in nervousness, 1.4% increase in relentlessness, 1.4% increase in hopelessness, 1.0% increase in a sense of incapability, and 1.4% increase in meaninglessness. According to mechanistic analyses, a 1% increase in the housing-price-to-income ratio leads to increases of 0.6 and 0.7% in the smoking rate and late sleep rate, respectively, while it leads to a 0.9% decrease in the noon nap rate. Conclusion: A growing housing burden significantly negatively impacts both the physical and psychological health of residents and increases the possibility of negative emotions. Further investigation revealed that the housing burden damages residents' health by increasing their likelihood of smoking and sleeping late and decreasing their likelihood of taking a nap at noon, while exercise alleviates the negative impacts of the housing burden on residents' physical and psychological health. Finally, we also find that housing burdens' impacts on physical and psychological health differ significantly in terms of gender, age, and educational attainment. From the perspective of improving livelihoods, governments should consider the relationship between housing burdens and residents' health when formulating livelihood policies. Location-specific and targeted policies should be followed. Additionally, efforts should be made to promote exercise among citizens.

Real-world drug treatment models of novel targeted drugs in Chinese patients with gynecological cancer from 2017 to 2021: A cross-sectional analysis.

Objective: The significance of novel anti-tumor pharmaceuticals in the treatment of gynecological tumors is growing, but there is no consensus regarding the optimal drug delivery strategy for gynecological tumors. This study seeks to investigate the treatment models of novel anti-tumor drugs in patients with gynecological cancer in China over the past five years, with a particular emphasis on the trend and rationality of their use. Method: We conducted a cross-sectional analysis of data from a China Medical Association-supervised hospital prescription analysis cooperation initiative. The data was derived from prescriptions written for patients diagnosed with cancer between January 2017 and December 2021. The required information for patients was extracted. Our study included 2308 patients that were diagnosed as gynecological tumors which were treated with novel antineoplastic targeted drugs. Patients were categorized by age and region. Then, the selection, application, and indications of the most essential treatment pharmaceuticals were investigated. We evaluated anti-tumor prescription information based on the recommended drug labeling protocol and the most recent domestic and international guidelines.Excel 2013 and SPSS (version 25; SPSS Inc., Chicago, IL, United States) were utilized to conduct statistical analysis.In addition，we also used Sankey diagram to evalute the relation between novel antineoplastic targeted drugs and corresponding diagnoses. Result: The top three cities for the 2308 patients included in this study were Guangzhou (28.51%), Hangzhou (21.79%), and Beijing (20.06%). In the past five years, the average age of medication patients was 55.61-year-old, with 37.86% of women aged of 51-60. Each patient's primary treatment regimens were statistically analyzed, yielding a total of 16 single-drug and combination-drug primary treatment regimens. Bevacizumab, Olaparib, Trastuzumab, Apatinib, and Arotinib were the top five treatment strategies. The maximum proportion, up to 0.74%, was attributed to the combination of human epidermal growth factor receptor-2 inhibitor (HER2i), including Trastuzumab and Parostuzumab. Vascular endothelial growth factor receptor inhibitor (VEGFRi), including Bevacizumab and Apatinib was the most frequently prescribed medication for outpatients in major cities across the country. According to the 5-year change in time, poly adenosine diphosphate ribose polymerase inhibitor (PARPi) rated first in terms of usage, with Olaparib ranking first with the highest concentration of 33.44% and Niraparib ranking second overall with the fastest growth in 2021. The quantity of VEGFRi variants utilized was the greatest, and their proportion of total usage increased annually. The top five drugs by total drug costs were Bevacizumab, Carelizumab, Olaparib, Trastuzumab, and Apatinib. However, the top five drugs by per capita drug cost were Olaparib + Bevacizumab, Bevacizumab + Sidilimab, Arrotinib + Olaparib, Olaparib, and Patuzumab + Trastuzumab. Conclusion: The incidence rate of gynecological tumor patients rises with age, and the cost of drug treatment has risen annually over the past five years, which is also related to the rising incidence rate of tumors in recent years. Bevacizumab rates first in the drug treatment scheme for the application of novel anti-tumor targeted drugs, which may be related to the widespread use of VEGFRi drugs in gynecological and reproductive tumors. Breast cancer and adenocarcinoma are at the top of the female cancer incidence spectrum, which may explain why HER2i multi-drug combination regimen rates highest among multi-drug combination regimens. Future research may concentrate on how novel anti-tumor targeted drugs can minimize the economic burden and maximize the benefits of patient treatment for patients with gynecological cancer.

When income meets faith: the development and application of the Chinese generation Z unconventional religious orientation scale.

This study seeks to analyze the psychological construction of Unconventional Religious Orientations and their association with individual income level satisfaction within Generation Z. Generation Z, individuals born between 1995 and 2010, grew up in a socio-cultural context marked by digitization and globalization. This study identifies three key dimensions of Unconventional Religious Orientations: religious spiritual dependence, religious instrumental tendencies, and religious uniqueness identity. By combining rootedness theory, semi-structured interviews, and literature review, we constructed and refined a set of relevant scales. Using exploratory and validation factor analyses (EFA and CFA), we verified the structural validity of the scale. The results of the analyses revealed significant negative correlations between satisfaction with income level and all dimensions of Unconventional Religious Orientation for Generation Z, suggesting that Unconventional Religious Orientation tends to diminish as income satisfaction increases. In addition, the significant positive correlations between these dimensions of religious inclination imply that they may share certain underlying factors in their psychological structure. This study not only successfully developed a set of psychometric instruments for Unconventional Religious Orientations, but also provided a new psychological perspective for understanding the dynamic interaction between economic satisfaction and religious psychological attitudes in Generation Z.

Clinical characteristics and risk factors in patients with SARS-CoV-2 Omicron variant infection complicated with cardiovascular diseases.

Objective: To investigate the clinical characteristics and risk factors of patients with SARS-CoV-2 Omicron variant infection complicated with cardiovascular diseases. Methods: A retrospective analysis of general clinical data was conducted on patients with SARS-CoV-2 omicron infection complicated with hypertension, coronary heart disease, and heart failure admitted to one hospital in Guangdong Province from December 1, 2022, to February 28, 2023. Clinical symptoms, laboratory tests, imaging examinations, treatment, and clinical outcomes were collected. Multivariate logistic regression analysis was used to analyze the risk factors for mortality in patients with SARS-CoV-2 Omicron variant infection complicated with cardiovascular diseases. ROC curves were drawn to evaluate the predictive value of CRP, D-dimer, and CK-MB in predicting the risk of death. Results: A total of 364 confirmed cases were included, divided into the asymptomatic group, mild to moderate group, and severe to critically ill group based on the symptoms of COVID-19. There were 216 males (59.34%) and 148 females (40.66%), with a median age of 75 years. The differences between the three groups in terms of sex and age were statistically significant (p < 0.05). The top three underlying diseases were hypertension (288 cases, 79.12%), coronary heart disease (100 cases, 27.47%), and diabetes (84 cases, 23.08%). The differences in unvaccinated and triple-vaccinated patients among the three groups were statistically significant (p < 0.05). The common respiratory symptoms were cough in 237 cases (65.11%) and sputum production in 199 cases (54.67%). In terms of laboratory tests, there were statistically significant differences in neutrophils, lymphocytes, red blood cells, C-reactive protein, D-dimer, aspartate aminotransferase, and creatinine among the three groups (p < 0.05). In imaging examinations, there were statistically significant differences among the three groups in terms of unilateral pulmonary inflammation, bilateral pulmonary inflammation, and bilateral pleural effusion (p < 0.05). There were statistically significant differences among the three groups in terms of antibiotic treatment, steroid treatment, oxygen therapy, nasal cannula oxygen inhalation therapy, non-invasive ventilation, and tracheal intubation ventilation (p < 0.05). Regarding clinical outcomes, there were statistically significant differences among the three groups in terms of mortality (p < 0.05). Multivariate logistic regression analysis showed that CRP (OR = 1.012, 95% CI = 1.004-1.019) and D-dimer (OR = 1.117, 95% CI = 1.021-1.224) were independent risk factors for patient mortality. The predictive value of CRP, D-dimer, and CK-MB for the risk of death was assessed. D-dimer had the highest sensitivity (95.8%) in predicting patient mortality risk, while CRP had the highest specificity (84.4%). Conclusion: For patients with COVID-19 and concomitant cardiovascular diseases without contraindications, early administration of COVID-19 vaccines and booster shots can effectively reduce the mortality rate of severe cases. Monitoring biomarkers such as CRP, D-dimer, and CK-MB and promptly providing appropriate care can help mitigate the risk of mortality in patients.

Distribution of Aspergillus species and risk factors for aspergillosis in mainland China: a systematic review.

Background: Aspergillus, a widespread fungus in the natural environment, poses a significant threat to human health by entering the human body via the airways and causing a disease called aspergillosis. This study comprehensively analyzed data on aspergillosis in published articles from mainland China to investigate the prevalence of Aspergillus, and risk factors, mortality rate, and underlying condition associated with aspergillosis. Methods: Published articles were retrieved from Google Scholar, PubMed, and Science Direct online search engines. In the 101 analyzed studies, 3558 Aspergillus isolates were meticulously collected and classified. GraphPad Prism 8 was used to statistically examine the epidemiology and clinical characteristics of aspergillosis. Results: Aspergillus fumigatus was prominently reported (n = 2679, 75.14%), followed by A. flavus (n = 437, 12.25%), A. niger (n = 219, 6.14%), and A. terreus (n = 119, 3.33%). Of a total of 9810 patients, 7513 probable cases accounted for the highest number, followed by confirmed cases (n = 1956) and possible cases (n = 341). In patients, cough emerged as the most common complaint (n = 1819, 18.54%), followed by asthma (n = 1029, 10.48%) and fever (1024, 10.44%). Of total studies, invasive pulmonary aspergillosis (IPA) was reported in 47 (45.53%) studies, exhibiting an increased prevalence in Beijing (n = 12, 25.53%), Guangdong (n = 7, 14.89%), and Shanghai (n = 6, 12.76%). Chronic pulmonary aspergillosis (CPA) was reported in 14 (13.86%) studies. Among the total of 14 studies, the occurrence of CPA was 5 (35.71%) in Beijing and 3 (21.42%) in Shanghai. Allergic bronchopulmonary aspergillosis (ABPA), was reported at a lower frequency (n = 8, 7.92%), Guangdong recorded a relatively high number (n = 3, 37.5%), followed by Beijing (n = 2, 25.0%), and Shanghai (n = 1, 12.5%). Percentage of death reported: IPA had the highest rate (n = 447, 68.87%), followed by CPA (n = 181, 27.88%) and ABPA (n = 14, 2.15%). Among the aspergillosis patients, 6220 had underlying conditions, including chronic lung disease (n = 3765, 60.53%), previous tuberculosis (n = 416, 6.68%), and organ transplant or organ failure (n = 648, 10.41%). Aspergillosis was also found in patients using corticosteroid therapy (n = 622, 10.0%). Conclusion: This review sheds light on the prevalence patterns of Aspergillus species, risk factors of aspergillosis, and gaps in surveillance that could be helpful for the control and treatment of aspergillosis and guide the researchers in future studies. Registration: This systematic review was prospectively registered on PROSPERO: Registration ID CRD42023476870.

Epidemiology and distribution of 207 rare diseases in China: A systematic literature review.

Epidemiological data on rare diseases in China are currently limited. The objective of this study was to provide a comprehensive understanding of the prevalence and incidence of rare diseases by systematically analyzing the available epidemiological data. We conducted a comprehensive search of English and Chinese databases, the Incidence and Prevalence Database, the Chinese Rare Disease Guideline, and the Taiwan Health Promotion Administration from 2010 to 2023. We identified the top diseases and regions based on epidemiological data and present the maximum, minimum, and median prevalence and incidence values in tables and forest plots. 1,264 prevalence and incidence data were retrieved from 277 studies, guidelines and official websites, covering 110 rare diseases (53.1%) and 32 regions (94.1%). In terms of geographical regions, incidence or prevalence data were available for 32 regions (94.1%), excluding Tibet Hui Autonomous Region and Macao Special Administrative Region. In terms of rate, 60 and 77 out of 207 diseases (29.0% and 37.2%) had available incidence and prevalence data, respectively. Eight diseases had an incidence rate equal to or greater than that of 1,000 patients per million. The present study provides a comprehensive epidemiological analysis and valuable insights into the prevalence and incidence of rare diseases in China. Our findings underscore the pressing need for sustained drug research and medical support for individuals and families impacted by rare diseases.

Effectiveness of instant versus text messaging intervention on antiretroviral therapy adherence among men who have sex with men living with HIV.

Objective: This study aimed to compare the effectiveness of instant versus text messaging intervention (TMI) on antiretroviral therapy (ART) adherence among men who have sex with men (MSM) living with HIV. Methods: This study was conducted in an infectious disease hospital of Jinan, China from October 2020 to June 2021, using non-randomized concurrent controlled design to compare the effectiveness of instant messaging intervention (IMI) versus TMI. The intervention strategies (health messaging, medication reminder, and peer education) and contents were consistent between the two groups, and the difference was service delivery method and type of information. The primary outcome was the proportion of achieving optimal ART adherence, defined as never missing any doses and delayed any doses more than 1 hour. Results: A total of 217 participants (including 72 in TMI group and 145 in IMI group) were included in the study. The proportion of achieving optimal adherence was higher in IMI group than TMI group at the first follow-up (90.2% versus 77.6%, p = 0.021) and second follow-up (86.5% versus 76.6%, p = 0.083). The effect of IMI versus TMI on improving ART adherence was found not to be statistically significant (risk ratio (RR) = 1.93, 95% confidence interval (CI): 0.95-3.94) in complete-case analysis. However, when excluding participants who did not adhere to the interventions, a significant improvement was observed (RR = 2.77, 95%CI: 1.21-6.38). More participants in IMI group expressed highly rated satisfaction to the intervention services than those in TMI group (67.3% versus 50.0%). Conclusions: The IMI demonstrated superior efficacy over TMI in improving ART adherence and satisfaction with intervention services. It is suggested that future digital health interventions targeting ART adherence should prioritize instant messaging with multimedia information in areas with Internet access. Trial registration: The study was registered at the Chinese Clinical Trial Register (ChiCTR), with number [ChiCTR2000041282].

The response rules to maintain social stability facing the climate change in ming dynasty.

Studying the mechanisms by which climate change interacted with human societies during the historical period can provide historical insights and cultural roots for climate policy building in the region. In this study, we constructed Stability-Robustness-Resilience Model (SSR model) and used the TOPSIS method (Technique for Order Preference by Similarity to Ideal Solution) and the entropy weight method to assess the change processes of robustness, resilience, and stability of Ming's society in response to climate threats. We have also compared three extreme droughts that occurred in different periods of social robustness-resilience combinations by using the SRR model. The results are as follows. (1) The stability of the Ming society was high in YongLe - HongZhi period (1402-1505 CE), when both social robustness and resilience were higher than the average level of Ming Dynasty (0.5611 for the former and 0.4215 for the latter), but there was a significant decline in social stability in TianShun period (1457-1464 CE). In ZhengDe - ChongZhen period (1506-1644 CE), the stability of Ming society gradually decreased, and it rebounded shortly in the LongQing-WanLi period (1506-1620 CE). (2) The high stability benefited from higher socio-economic levels, better government finance levels, larger national food reserves, safer social environments (high robustness), and higher levels of ruling class governance and risk response (high resilience); whereas insecure social environment induced by war, declining socio-economic levels and government finance levels were the main reasons for the decline in society's stability. (3)The ChengHua and WanLi droughts both happened at a time with high social robustness, so although their meteorological anomalies were severe, their impact on society was small. While the JiaJing drought happened at a time with low social robustness and resilience, so although the meteorological anomaly was relatively weak, it resulted in a more severe social consequence than the other two events.

Spatial spillover effects of skilled migration on innovation in China.

Despite the importance of interregional skilled migration to regional development, few studies have explored its spatial spillover effects and their changes over time. Thus, employing the Spatial Durbin Model, we investigate the presence of regional spillovers of skilled migration at both national and sub-national levels in China. Especially, we focus on the regional difference and change in the spatial spillover. Although our results confirm positive spillover effects at the national level due to the strong mobility characteristic of skilled migrants, developed regions benefit more from spillovers of skilled migration than developing regions, and such effects are divergent in different regions over time. Our findings also indicate that changes in spatial spillovers among regions are closely associated with the mobility of economic factors in geography. Theoretically, by considering the spatial effects of skilled migration on the innovation output of recipient regions, we extend the labour economics literature into geographical economic agglomeration, especially innovation economic geography. Methodologically, we examine the spatial effects at both national and sub-national levels, and capture the spatial externalities; we also apply Maximum Likelihood estimation to assess the endogeneity issues to understand the mechanisms of spillover change over time. The study can be of significance for municipalities in the policy-making of attracting talents and promoting regional innovation.

Medical insurance benefits and health inequality: evidence from rural China.

Alleviating health inequality among different income groups has become a significant policy goal in China to promote common prosperity. Based on the data from the China Health and Retirement Longitudinal Study (CHARLS) covering the period from 2013 to 2018, this study empirically examines the impact of Integrated Medical Insurance System (URRBMI) on the health and health inequality of older adult rural residents. The following conclusions are drawn: First, URRBMI have elevated the level of medical security, reduced the frailty index of rural residents, and improved the health status of rural residents. Second, China exhibits "pro-rich" health inequality, and URRBMI exacerbates health inequality among rural residents with different incomes. This result remains robust when replacing the frailty index with different health modules. Third, the analysis of influencing mechanisms indicates that the URRBMI exacerbate inequality in the utilization of medical services among rural residents, resulting in a phenomenon of "subsidizing the rich by the poor" and intensifying health inequality. Fourth, in terms of heterogeneity, URRBMI have significantly widened health inequality among the older adult and in regions with a higher proportion of multiple-tiered medical insurance schemes. Finally, it is suggested that China consider establishing a medical financing and benefit assurance system that is related to income and age and separately construct a unified public medical insurance system for the older adult population.

Predictors of parental acceptance to live attenuated influenza vaccine for children.

To determine the influencing factors of Chinese parents' intention and behavior for children to receive live attenuated influenza vaccine during the 2022-2023 influenza season. A theoretical model was developed and included seven constructs, and structural equation modeling was used to test 11 hypotheses. From October 2022 to December 2023, a survey was conducted across 38 medical institutions in four Chinese cities and their subordinate districts, counties, and rural areas. Parents who accompanied their children for vaccinations were selected through a randomization process based on their child's medical card numbers. Measures were taken to minimize method bias, including a diverse geographical representation and random sampling. The survey resulted in the collection of 936 valid responses, exceeding the recommended sample size for structural equation model analysis and providing robust statistical inferences. During the study period, 936 respondents were included in the study. Perceived ease of use was verified to be a predictor of perceived usefulness and perceived value. Perceived usefulness was verified as a predictor of perceived value and behavioral intention. Knowledge was a significant antecedent of perceived value and risk perception of influenza disease. Risk perception of influenza disease was proved to be a significant predictor of perceived value and self-reported vaccination behavior. Perceived value significantly affected behavioral intention, and behavioral intention significantly affected self-reported vaccination behavior. Six demographic variables significantly moderate the theoretical models. The low vaccination coverage of live attenuated influenza vaccine (LAIV) among children in China suggests a need for a deeper understanding of the factors that influence vaccination rates. Particularly, effective strategies are necessary from policymakers and practitioners to elevate childhood LAIV coverage.

Urban 3D building morphology and energy consumption: empirical evidence from 53 cities in China.

The impact of building morphology on building energy consumption has been extensively studied. However, research on how 3D building morphology affects energy consumption at a macroscopic scale is lacking. In this study, we measured the mean building height (BH), mean building volume (BV), and mean European nearest neighbor distance (MENN) of the city to quantify the 3D building morphology. We then used a spatial regression model to analyze the quantitative impact of urban 3D building morphology on per capita electricity consumption (PCEC). Results indicate that at the macroscopic scale of the city, the BH and the MENN have a significant positive impact on the PCEC, while the BV has a significant negative impact on the PCEC. Moreover, the inclusion of the 3D building morphology greatly improves the model's ability to explain building energy efficiency, surpassing the impact of traditional economic factors. Considering the 3D building morphology indicators together, buildings with a lower height, a larger volume, and a more compact 3D morphology have greater potential for energy savings and are more conducive to electricity conservation. This study offers valuable insights for the energy-efficient arrangement of buildings.

Cost-effectiveness of brentuximab vedotin compared with conventional chemotherapy for relapsed or refractory classic Hodgkin lymphoma in China.

BACKGROUND: Relapsed or refractory classic Hodgkin lymphoma (RRcHL) associates with poor prognosis and heavy disease burden to patients. This study evaluated the cost-effectiveness of brentuximab vedotin (BV) in comparison to conventional chemotherapy in patients with RRcHL, from a Chinese healthcare perspective. METHODS: The lifetime cost and quality adjusted life years (QALYs) were estimated through a partitioned survival model with three health states (progression free, post progression, and death). Two cohorts for each BV arm and chemotherapy arm were built, representing patients with and without transplant after BV or chemotherapy, respectively. Clinical parameters were retrieved from BV trials and the literature. Resource utilization data were mainly collected from local expert surveys and cost parameters were reflecting local unit prices. Utility values were sourced from the literature. A discount rate of 5% was employed according to the Chinese guideline. A series of deterministic and probabilistic sensitivity analyses were conducted to evaluate the robustness and uncertainty associated with the model. RESULTS: Results of the base case analysis showed that the incremental cost-effectiveness ratio (ICER) for BV versus chemotherapy was $2,867 (¥19,774). The main model driver was the superior progression-free and overall survival benefits of BV. The ICERs were relatively robust in a series of sensitivity analyses, all under a conventional decision threshold (1 time of Chinese per capita GDP). With this conventional threshold, the probability of BV being cost-effective was 100%. CONCLUSIONS: Brentuximab vedotin can be considered a cost-effective treatment versus conventional chemotherapy in treating relapsed or refractory classic Hodgkin lymphoma in China.

Spatiotemporal drivers of Nature's contributions to people: A county-level study.

Nature's contributions to people (NCP) encompass both the beneficial and detrimental effects of living nature on human quality of life, including regulatory, material, and non-material contributions. Globally, vital NCPs have been deteriorating, accelerated by changes in both natural and anthropogenic drivers over recent decades. Despite the often inevitable trade-offs between NCPs due to their spatially and temporally uneven distributions, few studies have quantitatively assessed the impacts of different drivers on the spatial and temporal changes in multiple NCPs and their interrelationships. Here we evaluate the effects of precipitation, temperature, population, gross domestic product, vegetation restoration, and urban expansion on four key regulatory NCPs-habitat maintenance, climate regulation, water quantity regulation, and soil protection-in Nei Mongol at the county level. We observe increasing trends in climate regulation and soil protection from 2000 to 2019, contrasted with declining trends in habitat maintenance and water quantity regulation. We have identified the dominant positive and negative drivers influencing each NCP across individual counties, finding that natural drivers predominantly overpowered anthropogenic drivers. Furthermore, we discover significant spatial disparities in the trade-off or synergy relationships between NCPs across the counties. Our findings illustrate how the impacts of various drivers on NCPs and their interrelationships can be quantitatively evaluated, offering significant potential for application in various spatial scales. With an understanding of trade-offs and scale effects, these insights are expected to support and inform policymaking at both county and provincial levels.