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This study examines tuberculosis (TB) incidence among students in Jilin Province, China, focusing on spatial, temporal, and demographic dynamics in areas of social inequality. Variation in incidence rate of TB was analyzed using the joinpoint regression method. Spatial analyses techniques included the global and local Moran indices and Getis-Ord Gi* analysis. Demographic changes in new cases were analyzed descriptively, and the Geodetector method measured the influence of risk factors on student TB incidence. The analysis revealed a declining trend in TB cases, particularly among male students. TB incidence showed geographical heterogeneity, with lower rates in underdeveloped rural areas compared to urban regions. Significant spatial correlations were observed, with high-high clusters forming in central Jilin Province. Hotspots of student TB transmission were primarily concentrated in the southwestern and central regions from 2008 to 2018. Socio-economic factors exhibited nonlinear enhancement effects on incidence rates, with a dominant bifactor effect. High-risk zones were predominantly located in urban centers, with university and high school students showing higher incidences than other educational stages. The study revealed economic determinants as being especially important in affecting TB incidence among students, with these factors having nonlinear interacting effects on student TB incidence. [ABSTRACT FROM AUTHOR]

Background: To evaluate the cost-effectiveness of Tislelizumab vs Sorafenib as the first-line treatment of unresectable hepatocellular carcinoma (HCC) from the perspective of the Chinese health service system. Methods: A lifetime partitioned survival model (PSM) was developed to cost-effectively analyze Tislelizumab vs Sorafenib as the first-line treatment of unresectable HCC. The clinical and safety data were derived from a recently randomized clinical trial (RATIONALE-301). Utilities were collected from the published literature. Costs were obtained from an open-access database (http://www.yaozh.com) and previous studies. The model cycle was 21 days, according to the RATIONALE-301 study, and the simulation period was patients' lifetime. Long-term direct medical costs and quality-adjusted life-years (QALYs) were determined. The incremental cost-effectiveness ratio (ICER) was used as the evaluation index. one-way sensitivity analysis (OSWA) and probabilistic sensitivity analysis (PSA) were used to analyze the uncertainty of parameters and to adjust and verify the stability of the baseline results. Results: The Tislelizumab group generated a cost of $39,746.34 and brought health benefits to 2.146 QALYs, while the cost and utility of the Sorafenib group were $26750.95 and 1.578 QALYs, respectively. The Tislelizumab group increased QALYs by 0.568, the incremental cost was $12995.39, and the ICER was $22869.64/QALY, lower than the willingness to pay threshold (WTP). OSWA results showed that the utility of progressed disease (PD), cost of Camrelizumab, and cost of Tislelizumab were the main factors affecting the ICER. PSA results showed that, within 1000 times the Monte Carlo simulation, the cost of the Tislelizumab group was lower than three times the per capita gross domestic product (GDP) of China ($37653/QALY). The cost-effectiveness acceptability curves (CEAC) revealed that when WTP was no less than $12251.00, the Tislelizumab group was the dominant scheme, and the economic advantage grew with an increasing WTP. When WTP ≥ $19000.00, the Tislelizumab group became the absolute economic advantage. Conclusion: Under the current economic conditions in China, the Tislelizumab therapeutic scheme is more cost-effective than the Sorafenib therapeutic scheme for treating patients with unresectable HCC. [ABSTRACT FROM AUTHOR]

Institutions have an important impact on corporate outward foreign direct investment, while differences in environmental regulations play a significant role in international capital flows based on the pollution haven hypothesis (PHH). This study examines the effect of green insurance, an institutional innovation tool designed to diversify and transfer environmental risks, on the decisions of firms regarding their overseas investment. Using a quasi-natural experiment of green insurance in 2007, this paper investigates the relationship between green insurance and corporate outward foreign direct investment and then further examines the effects of marketization and the Belt and Road Initiative (BRI) on this relationship. The results show that green insurance significantly reduces corporate outward foreign direct investment. Furthermore, the effect of green insurance on corporate outward foreign direct investment is stronger in regions with higher marketization and is weaker when investing in BRI countries. These findings suggest that green insurance is playing a gradually important role in influencing corporate overseas investment decisions. This study contributes to the research on the effects of institutions on corporate outward foreign direct investment while also broadening the research perspective of the PHH. [ABSTRACT FROM AUTHOR]

Background: Hand, foot, and mouth disease (HFMD) is a global infectious disease; particularly, it has a high disease burden in China. This study was aimed to explore the temporal and spatial distribution of the disease by analyzing its epidemiological characteristics, and to calculate the early warning signals of HFMD by using a logistic differential equation (LDE) model. Methods: This study included datasets of HFMD cases reported in seven regions in Mainland China. The early warning time (week) was calculated using the LDE model with the key parameters estimated by fitting with the data. Two key time points, "epidemic acceleration week (EAW)" and "recommended warning week (RWW)", were calculated to show the early warning time. Results: The mean annual incidence of HFMD cases per 100,000 per year was 218, 360, 223, 124, and 359 in Hunan Province, Shenzhen City, Xiamen City, Chuxiong Prefecture, Yunxiao County across the southern regions, respectively and 60 and 34 in Jilin Province and Longde County across the northern regions, respectively. The LDE model fitted well with the reported data (R2 > 0.65, P < 0.001). Distinct temporal patterns were found across geographical regions: two early warning signals emerged in spring and autumn every year across southern regions while one early warning signals in summer every year across northern regions. Conclusions: The disease burden of HFMD in China is still high, with more cases occurring in the southern regions. The early warning of HFMD across the seven regions is heterogeneous. In the northern regions, it has a high incidence during summer and peaks in June every year; in the southern regions, it has two waves every year with the first wave during spring spreading faster than the second wave during autumn. Our findings can help predict and prepare for active periods of HFMD. Author summary: Hand, foot, and mouth disease (HFMD), a global infectious disease, has a high disease burden in China. This study aimed to explore the temporal and spatial distribution of the disease by analyzing its epidemiological characteristics and to calculate the early warning signals of HFMD by using a logistic differential equation (LDE) model. Our findings showed that 1) the HFMD disease burden in China remained high and HFMD incidence in the southern region was higher than that in the northern region; and 2) the HFMD early warnings times across China were heterogeneous. One high incidence period occurred in the northern regions during summer, peaking in June every year, while in the southern regions two waves emerged every year. Over the southern regions, the disease appeared to spread faster in the spring wave than in the autumn wave. These results provide important information for public health authorities such as the Centers for Disease Control and Prevention staff to predict and prepare for the onset of the high active periods of HFMD, especially by indicating the heterogeneous warning times of HFMD outbreak across different geographical regions in Mainland China. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate whether and how policy uncertainty affect corporate environmental information disclosure. Design/methodology/approach: This study conducts a difference-in-difference estimation and systematically investigates the relationship between policy uncertainty and corporate environmental information disclosure. The baseline regression results are robust to a series of robustness and endogeneity tests. Findings: The authors show that firms located in cities with stronger policy uncertainty disclose less information on environmental issues. Furthermore, this negative relationship is stronger in the Midwest and in pre-industrial regions and for stated-owned firms and firms in highly polluting industries. Practical implications: This study argues that policy uncertainty reduce the corporate disclosure of environmental information. Therefore, the results provide evidence on how to better emphasize the importance of green gross domestic product in the performance appraisal system for officials. Social implications: This study confirms that corporate environmental disclosure is a response to public pressure. The results encourage the government and the public to increase corporate awareness of environmental protection. Originality/value: This study contributes to the literature in the following ways. First, the authors provide a new perspective to study the relationship between policy uncertainty and corporate finance. Second, it contributes to the literature on corporate environmental information disclosure by linking policy uncertainty with firms' disclosure of environmental information. Third, this study is a serious attempt to solve the problem of endogeneity between policy uncertainty and corporate environmental information disclosure. [ABSTRACT FROM AUTHOR]

Background: The transmission features and the feasibility of containing shigellosis remain unclear among a population-based study in China.Methods: A population-based Susceptible - Exposed - Infectious / Asymptomatic - Recovered (SEIAR) model was built including decreasing the infectious period (DIP) or isolation of shigellosis cases. We analyzed the distribution of the reported shigellosis cases in Hubei Province, China from January 2005 to December 2017, and divided the time series into several stages according to the heterogeneity of reported incidence during the period. In each stage, an epidemic season was selected for the modelling and assessing the effectiveness of DIP and case isolation.Results: A total of 130,770 shigellosis cases were reported in Hubei Province. The median of Reff was 1.13 (range: 0.86-1.21), 1.10 (range: 0.91-1.13), 1.09 (range: 0.92-1.92), and 1.03 (range: 0.94-1.22) in 2005-2006 season, 2010-2011 season, 2013-2014 season, and 2016-2017 season, respectively. The reported incidence decreased significantly (trend χ2 = 8260.41, P <  0.001) among four stages. The incidence of shigellosis decreased sharply when DIP implemented in three scenarios (γ = 0.1, 0.1429, 0.3333) and when proportion of case isolation increased.Conclusions: Year heterogeneity of reported shigellosis incidence exists in Hubei Province. It is feasible to contain the transmission by implementing DIP and case isolation. [ABSTRACT FROM AUTHOR]

Purpose: β-elemene and cisplatin combined chemotherapy currently is one of the most important settings available for lung cancer therapy in China. However, the clinical outcome is limited by their pharmacokinetic drawbacks. On the other hand, most of nanomedicines have failed in clinical development due to the huge differences between heterogeneous clinical tumor tissues and homogenous cell-derived xenografts. In this work, we fabricated a β-elemene and cisplatin co-loaded liposomal system to effectively treat lung cancer. Method: In vitro cytotoxicity of co-loaded liposomes was studied by MTT, trypan and Hoechst/PI staining, and western blot in A549, A549/DDP, and LCC cells. In vivo antitumor efficacy was evaluated in cell-derived and clinically relevant patient-derived xenografts. Results: Co-loaded liposomes were more cytotoxic to cancer cells, especially than the combination of single-loaded liposomes, benefiting from their simultaneous drug internalization and release. As a result, they exhibited desirable therapeutic outcome in both cell-derived and patient-derived xenografts. Conclusion: β-elemene and cisplatin co-loaded liposomes are a clinically promising candidate for effective lung cancer therapy. [ABSTRACT FROM AUTHOR]

Background: In resource-limited settings where laboratory capacity is limited and response strategy is non-specific, delayed or inappropriate intervention against outbreaks of Norovirus (NoV) are common. Here we report interventions of two norovirus outbreaks, which highlight the importance of evidence-based modeling and assessment to identify infection sources and formulate effective response strategies.Methods: Spatiotemporal scanning, mathematical and random walk modeling predicted the modes of transmission in the two incidents, which were supported by laboratory results and intervention outcomes.Results: Simulation results indicated that contaminated water was 14 to 500 fold more infectious than infected individuals. Asymptomatic individuals were not effective transmitters. School closure for up to a week still could not contain the outbreak unless the duration was extended to 10 or more days. The total attack rates (TARs) for waterborne NoV outbreaks reported in China (n = 3, median = 4.37) were significantly (p < 0.05) lower than worldwide (n = 14, median = 41.34). The low TARs are likely due to the high number of the affected population.Conclusions: We found that school closure alone could not contain Norovirus outbreaks. Overlooked personal hygiene may serve as a hotbed for infectious disease transmission. Our results reveal that evidence-based investigations can facilitate timely interventions of Norovirus transmission. [ABSTRACT FROM AUTHOR]

Background: The elevated incidence of tuberculosis (TB) outbreaks in schools poses a significant challenge to prevention and control efforts in China. The commonality among most outbreaks is the failure to isolate patients at an early stage. Early isolation of TB cases is crucial for reducing the spread of TB within schools. This study aims to quantify the impact of different isolation proportions and durations on the attack rate of TB in schools. It explored the intervention effects of isolation measures in preventing and controlling TB in school settings. The goal is to provide insights that can serve as a reference for reducing the occurrence of TB outbreaks in schools., Methods: We collected data from 4 school TB outbreaks. Susceptible-Exposed-Infected-Recovered (SEIR) model was used to fit the collected data and calculate transmissibility. Susceptible-Exposed-Infected-Quarantined-Recovered (SEIQR) model was employed to evaluate the effect of isolation. Effective reproduction numbers and cumulative incidence were used to quantify the transmissibility of TB., Results: In the 4 outbreaks, the majority of student cases were distributed in high grades of high school and universities, with a widespread occurrence of significant intervention delays. The median ascending reproduction value for the 4 outbreaks was 18.44 [interquartile range: 15.40-20.11]. Isolating 100% of the patients at the first month could reduce the number of cases by 99.47%, 87.99%, 96.48%, and 99.16%, respectively., Conclusions: This study suggests that high schools and universities may represent significant high-risk environments for TB outbreaks. Early detection and isolation of cases are important strategies that can help reduce the risk of TB outbreaks, with observed case reductions of up to 99.47% when implemented promptly., Competing Interests: Declarations. Ethics approval statement and consent to participate: This study was approved by the Ethics Committee of the School of Medicine, Xiamen University. Consent requirement, either verbal or written, was waived by the ethics Committee of the School of Medicine on the following grounds: (1) only anonymized records were used without the need for direct involvement nor active participation of patients; (2) neither medical intervention nor biological samples were involved; (3) study procedures and results would not affect clinical management of patients in any form. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Background: Tuberculosis (TB) is a chronic infectious disease that harms human health for a long time. TB epidemiological distribution analysis can help governments to control TB in high TB incidence areas. The distribution trend of TB cases varies in different regions. The unbalanced temporal and spatial trends of pulmonary TB (PTB) risk at a fine level in Fujian Province remain unclear., Objective: The purpose was to analyze different distribution characteristics, explore the prevalence of TB in this region, and provide a scientific basis for further guidance of TB control work in Fujian Province, China., Methods: Prefectural-level and county-level notified PTB case data were collected in Fujian Province. A joinpoint regression model was constructed to analyze the unbalanced temporal patterns of PTB notification rates from 2005 to 2021 at prefecture-level city scales. The spatial clustering analysis and spatial autocorrelation analysis were performed to assess the inequality of the locations of PTB cases. Demographical characteristics were explored by the method of descriptive analysis., Results: TB cases reported in Fujian showed an overall downward trend from 2005 to 2021 (in 2005: n=32,728 and in 2021: n=15,155). TB case numbers showed obvious seasonal changes. The majority of TB cases were middle-aged and older adult male patients (45 years and older; n=150,201, 42.6%). Most of the TB cases were farmers (n=166,186, 47.1%), followed by houseworkers and the unemployed (n=48,828, 13.8%) and workers (n=34,482, 9.8%). Etiologically positive TB cases continue to be the main source of TB cases (n=159,702, 45.3%). Spatially, the reported TB cases were mainly distributed in cities in southeastern Fujian, especially at the county level. TB case numbers showed 2 spatial groups; cases within each group shared similar case characteristics. In terms of geographical distribution, TB showed obvious spatial correlation, and local areas showed high aggregation., Conclusions: The TB incidence trend decreased annually in Fujian Province. TB cases distributed commonly in the male population, middle-aged and older people, and farmers. Etiologically positive cases are still the main source of Mycobacterium tuberculosis infection. TB incidence is higher in the cities with a developed economy and large population in the southeast. TB control should be strengthened in these populations and areas, such as via early screening of cases and management of confirmed cases., (© Shanshan Yu, Meirong Zhan, Kangguo Li, Qiuping Chen, Qiao Liu, Laurent Gavotte, Roger Frutos, Tianmu Chen. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org).)

Background: Human immunodeficiency virus (HIV) is a single-stranded RNA virus that can weaken the body's cellular and humoral immunity and is a serious disease without specific drug management and vaccine. This study aimed to evaluate the epidemiologic characteristics and transmissibility of HIV. Methods: Data on HIV follow-up were collected in Nanning City, Guangxi Zhuang Autonomous, China. An HIV transmission dynamics model was built to simulate the transmission of HIV and estimate its transmissibility by comparing the effective reproduction number ( R eff ) at different stages: the rapid growth period from January 2001 to March 2005, slow growth period from April 2005 to April 2011, and the plateau from May 2011 to December 2019 of HIV in Nanning City. Results: High-risk areas of HIV prevalence in Nanning City were mainly concentrated in suburbs. Furthermore, high-risk groups were those of older age, with lower income, and lower education levels. The R eff in each stage (rapid growth, slow growth, and plateau) were 2.74, 1.62, and 1.15, respectively, which suggests the transmissibility of HIV in Nanning City has declined and prevention and control measures have achieved significant results. Conclusion: Over the past 20 years, the HIV incidence in Nanning has remained at a relatively high level, but its development trend has been curbed. Transmissibility was reduced from 2.74 to 1.15. Therefore, the prevention and treatment measures in Nanning City have achieved significant improvement., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Lin, Deng, Rui, Guo, Hu, Chen, Tang, Zhou, Zhao, Lin, Zhu, Yang, Wang, Xu, Liu, Yang, Li, Li, Luo, Liu, Liu, Huang, Yao, Nong, Nong, Wu, Luo, Chen, Frutos, Yang, Li, Cui and Chen.)