Impact of water level management on organic carbon availability and nitrogen transformations in wetland sediments.

The impact of water level management via water retention on benthic carbon and nitrogen fluxes was studied in a wetland of the Seine estuary. Carbon and inorganic nitrogen fluxes at the sediment-water interface were determined during periods of intermittent and permanent immersion along a lateral gradient. In addition to fluxes, nitrate reduction rates, quantity and quality of both sedimentary and dissolved organic carbon, and organic matter lability via external enzymatic activities were analyzed. During both periods, the sediments subject to water level management facilitated nitrogen removal, with potential NO3- fluxes averaging -109 ± 31 nmol NO3- cm-2 h-1 under permanent immersion and -34 ± 13 nmol NO3- cm-2 h-1 under intermittent immersion. During permanent immersion, more water retention favors a higher input of dissolved organic matter including fresh and labile compounds, which most likely explained the significantly higher NO3- influxes. Intermittent immersion resulted in a lower quantity of retained dissolved organic matter, which likely explains the low N fluxes. The results of this study indicate the implementation of water retention strategies can markedly enhance NO3- removal by increasing the availability of organic matter. This underscores the importance of considering water-level management of wetlands to sustain the ecological functions of these valuable ecosystems, which are often the first barriers against environmental disturbance.

Joint association of daily rest periods and sleep duration with sick leave: a one-year prospective cohort study of daytime employees in Japan.

Daily rest period (DRP) refers to the interval between the end of one workday and the start of the next. This study examined the joint association of DRP and sleep duration with subsequent sick leave among Japanese daytime employees. Participants (n=5,593) were measured for DRP and sleep duration at baseline and for sick leave at 1-year follow-up. They were categorized into 10 groups based on their DRP and daily sleep duration. Logistic regression analyses for individuals experiencing sick leave for longer than a month showed that the combination of short DRP (<11 h) and sleep duration (<6 h) had a higher odds ratio (4.981, 95% confidence interval [CI] = 1.126-22.046) than the reference group. Furthermore, the combination of short DRP and normal sleep duration had a higher odds ratio (8.152, 95% CI = 1.801-36.902) than the reference group. Short DRP was associated with subsequent long sick leave.

Does China's national volume-based drug procurement policy promote or hinder pharmaceutical innovation?

Introduction: The national volume-based drug procurement policy initiated in China since 2018 represents a significant reform in China's pharmaceutical distribution system. It has largely squeezed out the price bubble of low-end generic drugs, making competition in the pharmaceutical sales segment more intense and transparent. This policy intervenes in the distribution link of the pharmaceutical industry by intensifying market competition, thereby enhancing the innovation willingness and R&D capabilities of pharmaceutical companies. Methods: Taking the national volume-based drug procurement policy as the policy shock, we used the multi-period difference-in-difference method to study the impact of the policy on innovation input, innovation output quantity and innovation output quality of listed pharmaceutical companies and its impact mechanism. Results: We found that the volume-based policy can significantly promote the pharmaceutical companies' innovation input and the innovation output quality, but significantly reduced the innovation output quantity. For innovative and generic drug companies, this policy has limited impact on innovative drug companies, but force generic drug companies to pay more attention to cost control and market positioning, and the quality and cost-effectiveness of R&D output to ensure competitiveness in the market. For bid-winning and non-winning companies, the policy has a greater innovation incentive for non-winning companies than winning companies, by imposing greater survival pressure on non-winning companies, forcing them to increase R&D investment intensity and adopt the innovation strategy of preferring quality to quantity. Discussion: The results show that the national volume-based drug procurement policy should be expanded to lower drug prices and lighten the medical burden on patients, with enhanced quality and safety supervision. Additionally, it suggests cautious application of such policies to innovative and high-end generic drugs to encourage continued pharmaceutical innovation and industry advancement.

Changes in skeletal muscle function during chemotherapy and related factors in patients with acute leukemia.

INTRODUCTION: Skeletal muscle function is an important prognostically relevant indicator in patients with acute leukemia (AL), but skeletal dysfunction during chemotherapy is not well understood. This study aimed to investigate the factors that influence changes in skeletal muscle function from before the start of chemotherapy to before allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: This was a retrospective cohort study that included 90 patients with AL who underwent chemotherapy before transplantation to perform allo-HSCT (men, 67.3%; median age, 53 years). The outcome measure was defined as changes in skeletal muscle function from before chemotherapy to before allo-HSCT, and was assessed by measuring the psoas muscle index (PMI) as skeletal muscle quantity and computed tomography values (CTV) as skeletal muscle quality using a computed tomography scanner. We examined the differences in PMI and CTV before chemotherapy and allo-HSCT, and the factors associated with changes in PMI. RESULT: The mean PMI for before chemotherapy and allo-HSCT were 4.6 ± 1.4 cm2/m2 and 4.0 ± 1.3 cm2/m2 and significant differences were observed (p < 0.001). However, the mean CTV before chemotherapy and allo-HSCT were 47.3 ± 4.5 HU and 47.4 ± 5.0 HU, respectively, and no significant differences were found (p = 0.798). In stepwise multiple regression analysis, age and sex were identified as factors related to changes in PMI (age, p = 0.019; sex, p = 0.001). CONCLUSION: We found that skeletal muscle quantity decreased during chemotherapy in patients with AL and was influenced by male sex and older age. TRIAL REGISTRATION NUMBER:   TRIAL REGISTRATION NUMBER: 34-096(11,243). Date of registration: September 11, 2023.

Factors affecting age at menopause and their relationship with ovarian reserve: a comprehensive review.

OBJECTIVE: The aim of this article was to discuss all the factors affecting the age at menopause and their correlation with ovarian reserve. MATERIALS AND METHODS: A narrative review of original articles was performed using PubMed until December 2023. The following keywords were used to generate the list of citations: 'menopause', 'ovarian reserve' 'oocytes quality and quantity', 'ovarian ageing'. RESULTS: Menopause is the final step in the process of ovarian ageing and is influenced by the oocyte pool at birth. Conditions that accelerate follicle depletion during the reproductive lifespan lead to premature ovarian insufficiency (POI) and premature ovarian failure (POF), while a higher ovarian reserve is associated with a delayed time to menopause. Reproductive history, sociodemographic, lifestyle and iatrogenic factors may impact ovarian reserve and the age at menopause. CONCLUSIONS: Some factors affecting the age at menopause are modifiable and the risks of early menopause may be preventable. We hypothesise that by addressing these modifiable factors we may also preserve ovarian reserve. However, further interventional studies are needed to evaluate the effects of the described strategies on ovarian reserve.

The age of menopause is determined by the process of follicle depletion, which leads to a decrease in the quantity and quality of oocytes. Various factors such as demographics, menstrual patterns, reproductive history, family history, genetics, and lifestyle choices appear to influence the age at which natural menopause occurs. Some of these factors can be modified. Considering the relationship between ovarian reserve and the age of natural menopause, is it possible to intervene on these modifiable factors to preserve ovarian reserve?

Thermal Dehydrogenation Impact on Positive Bias Stability of Amorphous InSnZnO Thin-Film Transistors.

Recently, the growing demand for amorphous oxide semiconductor thin-film transistors (AOS TFTs) with high mobility and good stability to implement ultrahigh-resolution displays has made tracking the role of hydrogen in oxide semiconductor films increasingly important. Hydrogen is an essential element that contributes significantly to the field effect mobility and bias stability characteristics of AOS TFTs. However, because hydrogen is the lightest atom and has high reactivity to metal and oxide materials, elucidating its impact on AOS thin films has been challenging. Therefore, in this study, we propose controlling the hydrogen quantities in amorphous InSnZnO (a-ITZO) thin films through thermal dehydrogenation to precisely reveal the hydrogen influences on the electrical characteristics of a-ITZO TFTs. The as-deposited device containing 15.69 × 1015 atoms/cm2 of hydrogen exhibited a relatively low saturation mobility of 18.1 cm2/V·s and poor positive bias stress stability. However, depending on the extent of thermal dehydrogenation, not only did the hydrogen quantity and interface defect density (DIT) decrease but also the conductivity and surface energy increased due to the rise in oxygen vacancies and hydroxyl groups in a-ITZO thin films. As a result, the a-ITZO TFT with a hydrogen amount of 4.828 × 1015 atoms/cm2 showed that the saturation mobility improved up to 36.8 cm2/V·s, and positive bias stress stability was remarkably enhanced. Hence, we report the ability to manage the hydrogen quantity with thermal dehydrogenation and demonstrate that high-performance a-ITZO TFTs can be realized when an appropriate hydrogen concentration is achieved.

Protein and fat intake impact on growth of primary school girls in Kerman, Iran.

The school age period is characterized by significant physical and intellectual growth, necessitating the monitoring of macronutrient intake and its impact on weight and height. The objective of this study is to investigate the association between the quality and quantity of protein and fat consumption with anthropometric indices in primary school girls in Kerman. This cross-sectional analysis was conducted on primary school girls aged 6-12 (n 330) from ten schools in Kerman, Iran. A validated and reliable dish-based 185-item food frequency questionnaire was used. We calculated the amount of proteins and fats as the percentage of daily calories and grams per day. Plant-based and animal-based proteins were used to assess the protein quality. To assess the fat quality, we considered trans fatty acids (TFA), cholesterol, vegetable oils, solid vegetable oils, animal oils, omega-6 Polyunsaturated fatty acids (PUFAs), omega-3 PUFA, and (PUFAs + Monounsaturated fatty acids (MUFAs))/Saturated fatty acids (SFAs), PUFAs/SFA, and (MUFA + PUFA)/(SFA + TFA). There was a significant positive association between height-for-age z-score (HAZ) and plant protein (p < 0.001) and vegetable oils (p = 0.038) after adjustment. In higher tertiles of animal protein, weight-for-age z-score (WAZ) (p = 0.024) were significantly higher. A significant positive association was observed between omega-3 PUFA and mid-upper arm circumference (MUAC) (p = 0.039) and BMI-for-age z-score (BAZ) (p = 0.016). Our study emphasizes the importance of monitoring protein and fat intake in primary school girls for optimal growth. Positive associations were found between plant-based protein, vegetable oils and HAZ, as well as animal protein and WAZ, highlighting the impact of protein quality on growth indicators.

A Quantity-Dependent Nonlinear Model of Sodium Cromoglycate Suppression on Beta-Conglycinin Transport.

Understanding the transport mechanism is crucial for developing inhibitors that block allergen absorption and transport and prevent allergic reactions. However, the process of how beta-conglycinin, the primary allergen in soybeans, crosses the intestinal mucosal barrier remains unclear. The present study indicated that the transport of beta-conglycinin hydrolysates by IPEC-J2 monolayers occurred in a time- and quantity-dependent manner. The beta-conglycinin hydrolysates were absorbed into the cytoplasm of IPEC-J2 monolayers, while none were detected in the intercellular spaces. Furthermore, inhibitors such as methyl-beta-cyclodextrin (MßCD) and chlorpromazine (CPZ) significantly suppressed the absorption and transport of beta-conglycinin hydrolysates. Of particular interest, sodium cromoglycate (SCG) exhibited a quantity-dependent nonlinear suppression model on the absorption and transport of beta-conglycinin hydrolysates. In conclusion, beta-conglycinin crossed the IPEC-J2 monolayers through a transcellular pathway, involving both clathrin-mediated and caveolae-dependent endocytosis mechanisms. SCG suppressed the absorption and transport of beta-conglycinin hydrolysates by the IPEC-J2 monolayers by a quantity-dependent nonlinear model via clathrin-mediated and caveolae-dependent endocytosis. These findings provide promising targets for both the prevention and treatment of soybean allergies.

Differential Toxicity of Arsenic in Daphnia pulex Under Phosphorus and Food Limitation.

The on-going anthropogenic degradation of freshwater habitats has drastically altered the environmental supply of both nutrients and common pollutants. Most organisms living in these altered habitats experience interactive effects of various stressors that can initiate adjustments at multiple levels impacting their fitness. Hence, studies measuring response to a single environmental parameter fail to capture the complexities of the status quo. We tested both the individual and the interactive effect of arsenic (As) exposure, food quantity, and dietary phosphorus (P)-supply on six life-history traits (Juvenile Growth Rate; Adult Growth Rate; Age and Size at Maturity, Lifespan, and Fecundity) as surrogates for organismal fitness in the keystone aquatic grazer Daphnia pulex. We also tested the effect of food quantity and P-supply on somatic As accumulation in Daphnia. Our results indicated an influence of P-supply on neonatal growth and an influence of As and food quantity on growth and maintenance later in life. Maturation was strongly influenced by all three variables, with no reproduction observed in the presence of two or more environmental stressors. We found a strong interaction between As and dietary P, with increased P-supply intensifing the toxicity effect of As. No such effects were seen between As and food quantity, indicating a differential role of quantity versus quality on As toxicity. We found a nominal effect of diet on somatic As accumulation. The results from the present study emphasize the importance of considering such interactions between co-occurring environmental stressors and the dietary status of organisms, to better predict and manage impacts and risks associated with common environmental toxicants in highly vulnerable ecosystems. Environ Toxicol Chem 2024;00:1-13. © 2024 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC.

Exploring the potential of genetic analysis in historical blood spots for patients with iodine-deficient goiter and thyroid carcinomas in Switzerland and Germany (1929-1989).

Iodine deficiency-induced goiter continues to be a global public health concern, with varying manifestations based on geography, patient's age, and sex. To gain insights into clinical occurrences, a retrospective study analyzed medical records from patients with iodine deficiency-induced goiter or thyroid cancer who underwent surgery at the Community Hospital in Riehen, Switzerland, between 1929 and 1989. Despite today's adequate iodine supplementation, a significant risk for iodine-independent goiter remains in Switzerland, suggesting that genetic factors, among others, might be involved. Thus, a pilot study exploring the feasibility of genetic analysis of blood spots from these medical records was conducted to investigate and enhance the understanding of goiter development, potentially identify genetic variations, and explore the influence of dietary habits and other environmental stimuli on the disease.Blood prints from goiter patients' enlarged organs were collected per decade from medical records. These prints had been made by pressing, drawing, or tracing (i.e., pressed and drawn) the removed organs onto paper sheets. DNA analysis revealed that its yields varied more between the prints than between years. A considerable proportion of the samples exhibited substantial DNA degradation unrelated to sample collection time and DNA mixtures of different contributors. Thus, each goiter imprint must be individually evaluated and cannot be used to predict the success rate of genetic analysis in general. Collecting a large sample or the entire blood ablation for genetic analysis is recommended to mitigate potential insufficient DNA quantities. Researchers should also consider degradation and external biological compounds' impact on the genetic analysis of interest, with the dominant contributor anticipated to originate from the patient's blood.

Analyzing the relative importance of habitat quantity and quality for boosting pollinator populations in agricultural landscapes.

To increase pollinator populations, international policy targets minimum levels of seminatural habitat cover, but it is unknown whether improving the quality of existing habitats could bring similar benefits without the need of reducing cropland area. Using data we collected in 26 Italian agricultural landscapes during the entire flying season, we explored the relative importance of habitat quantity (seminatural habitat cover) and quality (flower availability) on pollinator densities in seminatural habitats. We obtained transect-based counts and estimated the effect of habitat quantity (proportion of seminatural habitat) and quality (flower cover and richness) on wild bee and hoverfly densities. We used the relationships revealed in the data to simulate pollinator population sizes in landscapes with varying habitat quantity and quality. Wild bee densities were only related to flower availability, whereas hoverfly densities were additionally related to seminatural habitat cover. We found that in complex agricultural landscapes (above 15% seminatural habitat cover), improving habitat quality increased pollinator populations more effectively than increasing habitat quantity. However, increasing habitat quantity was by far the most effective approach for boosting pollinator populations in simple landscapes.

Análisis de la importancia relativa de la cantidad y calidad del hábitat para incrementar las poblaciones de polinizadores en los paisajes agrícolas Resumen Las políticas internacionales buscan que existan niveles mínimos de cobertura seminatural del hábitat para incrementar las poblaciones de polinizadores y se desconoce si mejorar la calidad de los hábitats existentes podría brindar beneficios similares sin tener que reducir el área de cultivo. Usamos datos recolectados en 26 paisajes agrícolas de Italia durante la temporada de vuelo para analizar la importancia relativa de la cantidad (cobertura de hábitat seminatural) y calidad (disponibilidad de flores) del hábitat para la densidad de polinizadores en los hábitats seminaturales. Obtuvimos conteos basados en transectos y estimamos el efecto de la cantidad (proporción del hábitat seminatural) y calidad (riqueza y cobertura de flores) del hábitat sobre la densidad de las abejas silvestres y los sírfidos. Usamos la relación revelada por los datos para simular el tamaño poblacional de los polinizadores en los paisajes con diferente calidad y cantidad de hábitat. La densidad de las abejas silvestres sólo se relacionó con la disponibilidad de flores cuando la densidad de sírfidos se relacionó con la cobertura del hábitat seminatural. Descubrimos que en los paisajes agrícolas complejos (por encima del 15% de cobertura de hábitat seminatural) cuya calidad mejoraba, las poblaciones de polinizadores incrementaban de manera más eficiente que cuando se mejoraba la cantidad. Sin embargo, incrementar la cantidad del hábitat fue por mucho la estrategia más efectiva para acrecentar las poblaciones de polinizadores en paisajes simples.

Rapid evolutionary tuning of endospore quantity versus quality trade-off via a phase-variable contingency locus.

The UV resistance of bacterial endospores is an important quality supporting their survival in inhospitable environments and therefore constitutes an essential driver of the ecological success of spore-forming bacteria. Nevertheless, the variability and evolvability of this trait are poorly understood. In this study, directed evolution and genetics approaches revealed that the Bacillus cereus pdaA gene (encoding the endospore-specific peptidoglycan-N-acetylmuramic acid deacetylase) serves as a contingency locus in which the expansion and contraction of short tandem repeats can readily compromise (PdaAOFF) or restore (PdaAON) the pdaA open reading frame. Compared with B. cereus populations in the PdaAON state, populations in the PdaAOFF state produced a lower yield of viable endospores but endowed them with vastly increased UV resistance. Moreover, selection pressures based on either quantity (i.e., yield of viable endospores) or quality (i.e., UV resistance of viable endospores) aspects could readily shift populations between PdaAON and PdaAOFF states, respectively. Bioinformatic analysis also revealed that pdaA homologs within the Bacillus and Clostridium genera are often equipped with several short tandem repeat regions, suggesting a wider implementation of the pdaA-mediated phase variability in other sporeformers as well. These results for the first time reveal (1) pdaA as a phase-variable contingency locus in the adaptive evolution of endospore properties and (2) bet-hedging between what appears to be a quantity versus quality trade-off in endospore crops.

Dynamic efficiency of tradable license system with time-flexible quantities.

Tradable license system (TLS) is a fundamental policy instrument for environmental management or resource development. We construct a muti-periods dynamic model with respect to a general TLS with three time-flexible quantity mechanisms: fixed quantity, solely banking, and banking and borrowing, in which the firm maximizes its discounted net benefits over the horizon by selecting an optimal license usage by license trading across agents or transferring across periods. The dynamic efficiency performance and price dynamics in TLS are respectively examined. The decentralized equilibrium in TLS with fixed quantity cannot achieve benefit-maximum unless initial license allocation is efficient. The decentralized behaviors in TLS with solely banking lead to benefit-maximum and price dynamics follows the Hotelling rule, if and only if the cumulative initial license allocation in each period is not less than the optimum, while TLS with banking and borrowing can achieve the optimal outcome and price dynamics follows Hotelling rule regardless of the initial allocation. The findings highlight the synergistic effects between the initial allocation of licenses and time-flexible quantity mechanisms in TLS design.

Quantity, Duration, Adherence, and Reasons for Dietary Supplement Use among Adults: Results from NHANES 2011-2018.

Dietary supplement use is common among US adults. We aimed to investigate the quantity, duration, adherence, and reasons for supplement use in individuals who take supplements. Data from 2011 to 2018 from the National Health and Nutrition Examination Survey (NHANES) dataset were analyzed. Four cycles of data were combined to estimate these outcomes. Results are presented as overall group and by subgroups. All analyses were weighted to be nationally representative. The Taylor Series Linearization approach was used to generate variance estimates. A total of 12,529 participants were included. Over 70% of these individuals reported taking more than one unit of dietary supplements daily. Notably, approximately 40% had been taking supplements for more than five years and about 67% were highly adherent to at least one supplement. However, only 26.9% of these supplements were taken following a doctor's recommendation. The primary reasons for dietary supplements intake included improving overall health (37.2%), maintaining health (34.7%), bone health (21.4%), and diet supplementation (20.3%). Our findings indicate that most participants proactively used multiple dietary supplements focused on self-managed health and prevention, with substantial dedication to long-term use and high adherence. Healthcare professionals should play a more active role in guiding such behaviors to optimize the health outcomes of dietary supplement users across the United States.

Factors of children's allocation behavior: peer relationship and resource quantity as the main determinants.

This study investigated the resource allocation of Chinese sixth-graders and the role of peer relationship in different resource conditions (N = 132, Mage = 11. 35 years, SD = 0.60). We designed the resource quantity as a between-group variable, with one group participating in a resource-limited experiment and another group in a resource-abundant experiment. Both groups of children allocated token resources to three types of peers relationships: good friends, disliked individuals, and strangers. Based on our experimental hypotheses, we presupposed three experimental outcomes: selfish allocation, equal allocation, and altruistic allocation. To analyze the data, we employed multivariate unordered regression analysis and performed two rounds of regression analyses using both selfish and altruistic allocations as reference categories to enhance the statistical power of regression model. Our results reveal that the resource quantity had a significant hindering effect on children's allocation behaviors, as the amount of available resources for allocation increased, so did their willingness to allocate selfishly. It was also found that an increase in resources led to a decrease in the proportion of children allocating equally. Nonetheless, the results still revealed generalized peer relationship preferences: children tended to allocate more resources to friends than to individuals they disliked. But when faced with disliked individuals, they were relatively more likely to allocate equally. Finally, we observed the proportion of equal allocation and discussed the similar impact of inequality aversion, different allocation contexts, and children's theory of mind on equitable allocation among sixth-graders.

Spermatogonial quantity in prepubertal boys undergoing fertility preservation is comparable between haematological and non-haematological cancers.

Fertility restoration potential of immature testicular tissue (ITT) depends on the number of spermatogonial cells in the retrieved tissue prior to cryopreservation in oncofertility programme. There are limited data on the association between type of malignancy and testicular germ cell population. Hence, this study is aimed to investigate the spermatogonial and Sertoli cell population in ITT retrieved from 14 pre-pubertal boys who opted for fertility preservation. Histopathological and immunochemical analysis of seminiferous tubules from haematological (N = 7) and non-haematological (N = 7) malignant patients revealed 3.43 ± 2.92 and 1.71 ± 1.81 spermatogonia per tubular cross section (S/T), respectively. The Sertoli cell number was comparable between haematological and non-haematological group (18.42 ± 3.78 and 22.03 ± 10.43). Spermatogonial quantity in ITT did not vary significantly between haematological and non-haematological cancers. This observation, though preliminary, would contribute to the limited literature on paediatric male oncofertility.

Unit one is intrusive.

The SI brochure's treatment of quantities that it regards as dimensionless, with the associated unit one, requires certain physical quantities to be regarded as simply numbers. The resulting formal system erases the nature of these quantities and excludes them from important benefits that quantity calculus provides over numerical value calculations, namely, that accidental confusion of different units and different kinds of quantities is sometimes prevented. I propose a better treatment that entails removing from the SI brochure those prescriptions that conflict with common practices in the treatment of dimensionless quantities, especially the definition and use of non-SI dimensionless units that are distinguished by kind.

An integrated simulation-optimization approach for combined allocation of water quantity and quality under multiple uncertainties.

Multiple uncertainties such as water quality processes, streamflow randomness affected by climate change, indicators' interrelation, and socio-economic development have brought significant risks in managing water quantity and quality (WQQ) for river basins. This research developed an integrated simulation-optimization modeling approach (ISMA) to tackle multiple uncertainties simultaneously. This approach combined water quality analysis simulation programming, Markov-Chain, generalized likelihood uncertainty estimation, and interval two-stage left-hand-side chance-constrained joint-probabilistic programming into an integration nonlinear modeling framework. A case study of multiple water intake projects in the Downstream and Delta of Dongjiang River Basin was used to demonstrate the proposed model. Results reveal that ISMA helps predict the trend of water quality changes and quantitatively analyze the interaction between WQQ. As the joint probability level increases, under strict water quality scenario system benefits would increase [3.23, 5.90] × 109 Yuan, comprehensive water scarcity based on quantity and quality would decrease [782.24, 945.82] × 106 m3, with an increase in water allocation and a decrease in pollutant generation. Compared to the deterministic and water quantity model, it allocates water efficiently and quantifies more economic losses and water scarcity. Therefore, this research has significant implications for improving water quality in basins, balancing the benefits and risks of water quality violations, and stabilizing socio-economic development.

Analysis and discussion on the pharmaceutical centralized procurement implementation - a case study of a large provincial hospital in China.

Unaffordable medical treatment and inflated drug prices have become a challenging issue for lawmakers worldwide. To reduce the financial burden and standardize the pharmaceutical market, the Chinese government has issued several detailed regulations, including the measures of drug recruitment and procurement in one and volume purchasing to not only ensure the high quality of approved drugs but also lower the cost of the production and sell procedure. In this work, to have a thorough overview of the enforcement of these regulations, we attempted to critically analyze the data of our hospital's centralized procurement of drugs from 2019 to 2022. We identified some concerns, such as the difficulty in determining the "quantity" of drug procurement, out-of-stock of collectively procured drugs, difficulty in managing the preallocation of associated funds, incomplete centralized procurement systems, etc. Therefore, it is essential to promote a multidimensional strategy, including the combination of the medical insurance reform and drug centralized procurement policies, strict controlling of the forecast quantity of drugs to ensure stable drug supply, improvement of the relevant policies for retaining the surplus of centralized procurement drug medical insurance funds, secureness of the drug procurement system platform, and available reference and guidance for subsequent centralized quantity procurement of drugs.

Psoriasis and Sleep Disturbance: A US Population-Based Study Using the NHANES Database.

INTRODUCTION: Psoriasis, a chronic inflammatory skin condition, affects approximately 3.0% of the US population, with patients often experiencing significant sleep disturbances. These disturbances include a higher prevalence of conditions such as obstructive sleep apnea, restless leg syndrome, and insomnia. Given the additional risks for cardiovascular disease, metabolic disorders, and depression linked to both poor sleep and psoriasis, addressing sleep issues in this patient group is critical. METHODS: The study utilized National Health and Nutrition Examination Survey (NHANES) data, focusing on individuals aged ≥ 20 years who provided information on psoriasis status and sleep. Multistage stratified survey methodology was applied, with multivariable logistic regression models used to examine the association between psoriasis and sleep issues, adjusting for factors such as age, gender, and health history. RESULTS: Psoriasis diagnosis was significantly associated with trouble sleeping (adjusted odds ratio [aOR] 1.88; 95% confidence interval [CI] 1.44-2.45). There was no significant association between psoriasis and sleep quantity. Older age, female gender, and a history of sleep disorders were predictors of trouble sleeping among psoriasis patients. CONCLUSIONS: Psoriasis is significantly associated with sleep disturbances, independent of sleep duration. This underscores the need for clinical screening focusing on sleep quality rather than quantity in psoriasis patients to effectively identify and treat sleep-related comorbidities. Further research using objective sleep measures is warranted to guide clinical management and improve patient quality of life.