Costs of chronic obstructive pulmonary disease in urban areas of China: a cross-sectional study in four cities

PURPOSE: The economic burden of COPD has not been well studied in China. This study investigated the total costs caused by COPD and the influencing factors for the high economic burden in urban areas of China. PATIENTS AND METHODS: A cross-sectional study was carried out among 678 COPD patients in four cities in China in 2011. The average annual direct medical costs (DMCs), direct nonmedical costs (DNMCs), and indirect costs (ICs) on COPD were measured by median and mean (± standard deviation). Logistic regression model was used to explore factors related to high total costs on COPD. RESULTS: The median annual DMCs, DNMCs, and ICs per COPD patient were RMB 5565 Yuan (US$862), 0 Yuan (US$ 0), and 0 Yuan (US$0), respectively, and the mean annual DMCs, DNMCs, and ICs per COPD patient were RMB 11968 (±22422) Yuan [US$ 1853 (±3472)], 539 (±2092) Yuan [US$83 (±324)], and 2087 (±8110) Yuan [US$ 323 (±1256)], respectively. The annual DMCs, DNMCs, and ICs for diagnosed COPD patients were RMB 195.70 billion Yuan (US$30.30 billion), 8.78 billion Yuan (US$ 1.36 billion), and 34.10 billion Yuan (US$ 5.28 billion), respectively, in China. Hospitalization accounted for 56.7% of the total costs. High economic burden was significantly related to age, acute exacerbations, and disease severity in COPD patients. CONCLUSION: COPD posed a heavy economic burden in China. Measures to delay the disease progression and to reduce the risks of acute exacerbation and hospitalization will help substantially lower the costs for COPD care

Bridging resilience and sustainability:a reconciled framework for navigating social-ecological systems

Maintaining the resilience and sustainability of social-ecological systems (SESs) is widely acknowledged as a pivotal governance objective. However, the tendency to analyze these aspects separately raises concerns regarding potential inherent trade-offs between them, wherein bolstering one may impede the other. Addressing this, we present a reconciled framework to elucidate the relationship between resilience and sustainability. Our framework highlights that the fundamental linkages between humans and nature, which involve the acquisition of resources from the natural environment and the discharge of waste resulting from human production activities, as well as the feedback mechanisms from the natural environment in response to human activities, are the primary determinants of SESs’ resilience and sustainability. Sustainability necessitates these linkages staying within environmental boundaries while meeting socio-economic goals, whereas resilience means that these links can resist disruption and recover swiftly if disrupted by internal or external factors. Using the Yellow River Basin in China as a case study, we demonstrate how our framework can analyze SES evolution and drivers. Overall, our analysis underscores the importance of circumventing the trade-off between resilience and sustainability while fostering synergies, which could yield critical insights for the refinement of governance approaches of SESs.</p

Network structure of emotional and behavioral problems, loneliness, and suicidal thoughts in adolescents at the school closure and reopening stage in China

BACKGROUND: Public restriction and school closure policies during the pandemic may have long-term effects on adolescents' mental health, and adolescents' feelings and needs may change as the pandemic progresses. This study was conducted to explore the network structure and differences in emotional and behavioral problems (EBPs), loneliness, and suicidal thoughts in adolescents during different pandemic periods in China. METHODS: Based on two cross-sectional studies conducted in Taizhou, China, during school closure (April 16 to May 14, 2020) and reopening (May 25 to July 10, 2021) using online questionnaire, a total of 14,726 adolescents (school closure: 6,587, school reopening: 8,139) were recruited. EBPs were evaluated based on the student version of the Strengths and Difficulties Questionnaire (SDQ). Loneliness and suicidal thoughts were measured by item 20 and item 9 of the Chinese version of the Children's Depression Inventory (CDI), respectively. Network analysis was used to estimate the network connections and properties between EBPs, loneliness, and suicidal thoughts. RESULTS: The prevalence of psychosocial problems significantly increased at the school reopening compared with the school closure: EBPs: 36.8% vs. 31.6%; loneliness: 40.3% vs. 33.9%; suicidal thoughts: 40.8% vs. 15.4%. Suicidal thoughts showed the closest connections with being unhappy and lonely. Being bullied was strongly connected with conduct problems of lying and stealing. The links between hyperactivity symptoms and the other domains of EBPs were stronger after the school reopened. Being unhappy and showing the hyperactivity symptoms of "nonpersistent, distractible, and fidgety" presented high network and bridge (increasing transference from one symptom domain to another) centrality. Loneliness showed high expected influence and bridge centrality. CONCLUSIONS: This study highlighted the high prevalence of EBPs, loneliness, and suicidal thoughts in Chinese adolescents. It also presented the network structure of these psychological problems over different pandemic stages. It is recommended that psychological support should be provided for adolescents, especially focusing on the central and bridge symptoms highlighted in this study

Antibiotic governance and use on commercial and smallholder farms in eastern China

IntroductionChina is one of the largest consumers of agricultural antibiotics in the world. While the Chinese government has been tightening its regulations to control antimicrobial resistance (AMR) from animal sources in recent years, the extent of antimicrobial oversight and the practices of antibiotic use in animal agriculture in China has not yet been explored. This study describes the practices of antimicrobial management in eastern China and current scenarios of antibiotic use in commercial farms and smallholder backyard farming.Methods33 semi-structured interviews were conducted with government agriculture officials, veterinary drug sellers, farmers and smallholders in two contrasting areas of rural Zhejiang and Jiangsu provinces, China. Interview transcripts were analyzed in NVivo12 using a thematic approach.ResultsFindings revealed that although the governance of antibiotic use has made progress, especially in controlling irrational antibiotic use in commercial farms, smallholders are under-regulated due to a lack of resources and assumptions about their marginal role as food safety governance targets. We also found that smallholders resort to human antibiotics for the treatment of backyard animals because of economic constraints and lack of access to professional veterinary services.DiscussionMore attention needs to be devoted to the local structural needs of farmers to reduce antibiotic misuse. Considering the extensive links of AMR exposure under the One Health framework, efforts to integrate smallholders in antibiotic governance are required to address the AMR burden systematically in China.</jats:sec

Two new species of freshwater goby (Teleostei, Gobiidae) from the Upper Youshui River, Chongqing, China

Two previously unknown species of Rhinogobius have been discovered in the streams of the Upper Youshui River, within the Yuan River Basin, Xiushan County, Chongqing, China. These new species are named as Rhinogobius sudoccidentalis and Rhinogobius lithopolychroma. Phylogenetic analysis based on mitochondrial genomes revealed that R. sudoccidentalis is genetically closest to R. reticulatus, while R. lithopolychroma shares the greatest genetic similarity with R. leavelli. Morphological distinctions allow for the clear differentiation of these species. Rhinogobius sudoccidentalis sp. nov. is characterized by having VI–VII rays in the first dorsal fin and I, 8–9 rays in the second dorsal fin. The longitudinal scale series typically consists of 22–24 scales, while the transverse scale series comprises 7–8 scales. Notably, the predorsal scale series is absent and the total vertebrae count is 12+17=29. Rhinogobius lithopolychroma sp. nov. can be distinguished from other species by the presence of 13–15 rays on the pectoral fin. Its longitudinal scale series ranges from 30 to 33 scales, with no scales in the predorsal area. The total vertebral count is 30, with 12 precaudal and 18 caudal vertebrae. The head and body of this species are light gray with irregular orange markings on the cheeks and opercle. Through morphological and molecular analyses, it has been confirmed that R. lithopolychroma and R. sudoccidentalis represent novel species within the Rhinogobius genus

ShapeMatcher: Self-Supervised Joint Shape Canonicalization, Segmentation, Retrieval and Deformation

In this paper, we present ShapeMatcher, a unified self-supervised learning framework for joint shape canonicalization, segmentation, retrieval and deformation. Given a partially-observed object in an arbitrary pose, we first canonicalize the object by extracting point-wise affine-invariant features, disentangling inherent structure of the object with its pose and size. These learned features are then leveraged to predict semantically consistent part segmentation and corresponding part centers. Next, our lightweight retrieval module aggregates the features within each part as its retrieval token and compare all the tokens with source shapes from a pre-established database to identify the most geometrically similar shape. Finally, we deform the retrieved shape in the deformation module to tightly fit the input object by harnessing part center guided neural cage deformation. The key insight of ShapeMaker is the simultaneous training of the four highly-associated processes: canonicalization, segmentation, retrieval, and deformation, leveraging cross-task consistency losses for mutual supervision. Extensive experiments on synthetic datasets PartNet, ComplementMe, and real-world dataset Scan2CAD demonstrate that ShapeMaker surpasses competitors by a large margin.Comment: CVPR202

Patterns and Determinants of Antibiotic Use Behaviors among Rural Community Residents in Eastern China

Inappropriate antibiotic use may lead to antibiotic resistance, which has become a serious global crisis. Addressing suboptimal antibiotic use in the general population can play a significant role in the fight against antimicrobial resistance. This study aims to describe antibiotic use and sources of acquisition, and to identify factors influencing antibiotic access among rural community residents in Eastern China. A cross-sectional survey was conducted from July to August 2020, and 1494 participants from two villages in Eastern China were enrolled. Information was obtained using face-to-face interviews with a structured electronic questionnaire. Chi-squared and multinominal logistic regression analysis were used to explore possible determinants. In total, 1379 participants were eligible for the analysis. In the past 12 months, nearly half the respondents had taken any antibiotic (48.4%), and this proportion varied across marital status and age group. Two thirds of them (59.9%) obtained antibiotics from medical facilities with a prescription when they last took antibiotics, while 17.7% and 22.4% chose retail pharmacies and other sources, respectively. Multinominal analysis found that a higher proportion obtained antibiotics outside medical facilities among those aged 15 to 44 years, unmarried, non-white collar workers, with more years of education, lower annual household income per capita and lower levels of antibiotic knowledge. The antibiotic use behavior of rural community residents in Eastern China remains suboptimal. Antibiotic use and access behaviors need to be further addressed. Effective antibiotic stewardship in non-medical facility sources and training programs targeted for rural Chinese is warranted in future

WGCNA-ML-MR integration: uncovering immune-related genes in prostate cancer

BackgroundProstate cancer is one of the most common tumors in men, with its incidence and mortality rates continuing to rise year by year. Prostate-specific antigen (PSA) is the most commonly used screening indicator, but its lack of specificity leads to overdiagnosis and overtreatment. Therefore, identifying new biomarkers related to prostate cancer is crucial for the early diagnosis and treatment of prostate cancer.MethodsThis study utilized datasets from the Gene Expression Omnibus (GEO) to screen for differentially expressed genes (DEGs) and employed Weighted Gene Co-expression Network Analysis (WGCNA) to identify driver genes highly associated with prostate cancer within the modules. The intersection of differentially expressed genes and driver genes was taken, and Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses were performed. Furthermore, a machine learning algorithm was used to screen for core genes and construct a diagnostic model, which was then validated in an external validation dataset. The correlation between core genes and immune cell infiltration was analyzed, and Mendelian randomization (MR) analysis was conducted to identify biomarkers closely related to prostate cancer.ResultsThis study identified six core biomarkers: SLC14A1, ARHGEF38, NEFH, MSMB, KRT23, and KRT15. MR analysis demonstrated that MSMB may be an important protective factor for prostate cancer. In q-PCR experiments conducted on tumor tissues and adjacent non-cancerous tissues from prostate cancer patients, it was found that: compared to the adjacent non-cancerous tissues, the expression level of ARHGEF38 in prostate cancer tumor tissues significantly increased, while the expression levels of SLC14A1, NEFH, MSMB, KRT23, and KRT15 significantly decreased. To further validate these findings at the protein level, we conducted Western blot analysis, which corroborated the q-PCR results, demonstrating consistent expression patterns for all six biomarkers. IHC results confirmed that ARHGEF38 protein was highly expressed in tumor tissues, while MSMB expression was markedly reduced.ConclusionOur study reveals that SLC14A1, ARHGEF38, NEFH, MSMB, KRT23, and KRT15 are potential diagnostic biomarkers for prostate cancer, among which MSMB may play a protective role in prostate cancer