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Counter-empathy may have more serious negative effects on women than on men. Sixty-four female Chinese university students participated in this study. Based on the counter-empathy model in a competitive setting, we examined how forgiveness affects counter-empathy. We manipulated the degree of participants' forgiveness toward their opponents by changing the type of information they received from their opponents. We also measured counter-empathy through self-reported pleasantness caused by opponents' facial expressions (smiles or frowns). We found that forgiveness can effectively alleviate women's counter-empathy, restraining their emotional experience from being inconsistent with the offender and enhancing their empathic concern toward the offender. We preliminarily explored how forgiveness works on counter-empathy and provided insight into the use of forgiveness to maintain global women's emotional health. [ABSTRACT FROM AUTHOR]

This study aims to comprehensively assess how dietary risk factors have influenced the prevalence of Type 2 Diabetes Mellitus (T2DM) in China from 1990 to 2021. The study seeks to provide robust data and scientific evidence essential for formulating effective preventive and control strategies to combat T2DM in China. This cross-sectional study conducted secondary analyses using data from the Global Burden of Disease 2021 (GBD 2021) to assess the burden of T2DM in China attributable to dietary risks. The study analyzed age-adjusted metrics related to T2DM, including death counts, Disability-Adjusted Life Years (DALYs), and Age-Standardized Rates (ASRs), using GBD 2021 data, stratified by age and sex. Additionally, Estimated Annual Percentage Changes (EAPCs) were employed to track trends over time. In 2021, the results show that 21.43 % of T2DM-related deaths and 23.51 % of DALYs were attributable to dietary risk factors, notably a diet low in whole grains and high in red and processed meats. Over the period from 1990 to 2021, there has been an increasing trend in the EAPCs of death rates and DALYs associated with dietary risks in China, suggesting a substantial impact of dietary factors on the burden of T2DM in the country. This study highlights the urgent need for targeted public health interventions to promote dietary changes and reduce the burden of T2DM in China. [ABSTRACT FROM AUTHOR]

This paper explores the challenges of China's reservoir resettlement, analysing the causes from various perspectives and their connection to existing policies. It highlights the transition from a focus on economic growth to prioritizing social welfare and environmental protection. The study reveals that while China's resettlement policies generally meet World Bank OP 4.12 standards, complexities remain in balancing development with the rights of resettled people. This research provides valuable insights for countries lacking effective resettlement frameworks and contributes to the advancement of SDG 3: Good health and well-being and SDG 10: Reduced inequalities, emphasizing the need for continued improvements. [ABSTRACT FROM AUTHOR]

Objective: Uterine cancer (UC) is one of the prevalent malignancies in the female reproductive system. Estimating the burden trends of UC is crucial for developing effective prevention strategies at the national level. However, there has been no comprehensive analysis of the UC burden in China. We focused on the evaluation of the burden trends of UC in China over the past 32 years to provide a 15-year projection, comparing it with global levels. Methods: Data on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) were extracted from Global Burden of Disease (GBD) 2021 to describe the burden of UC in China. Joinpoint regression analysis was employed to describe the temporal trends of UC in China and globally over the past 32 years. A Bayesian age-period-cohort model was utilized to predict the trends of UC in the next 15 years. Spearman correlation analysis was used to compare the relationship between ASIR, ASPR, ASMR, ASDR, and SDI in UC in China and globally. Changes in ASMR and ASDR in UC caused by high BMI in China and globally from 1990 to 2021 were explored. Results: In 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR) of UC in China were 6.65, 46.52, 1.24, and 37.86 (per 100,000 population) respectively. Compared to 1990, the ASMR and ASDR decreased by 48.63% and 48.15% respectively, while the ASIR and ASPR increased by 17.79% and 37.67% respectively. Globally, the burden of UC followed a similar trend in China, with increasing ASIR and ASPR, and decreasing ASMR and ASDR, although the magnitude of increase and decrease was smaller than in China. Joinpoint regression analysis results showed an overall upward trend in ASIR and ASPR for both China and global UC, while an overall downward trend was observed in ASMR and ASDR. Age-specific analysis revealed that during the period from 1990 to 2021, the age groups with the highest incidence, prevalence, mortality, and DALYs for UC in China generally occurred at earlier ages compared to the global pattern. It is projected that over the next 15 years, the burden of UC in China will continue to increase at a higher rate than the global level. Spearman correlation analysis showed that ASIR and ASPR of UC in China and the world were significantly positively correlated with SDI (p < 0.05), and ASMR and ASDR were significantly negatively correlated with SDI (p < 0.001). High BMI is a risk factor affecting the mortality rate and DALYs of UC in both China and globally, with the increase in ASMR and ASDR due to high BMI being greater in China than globally. Conclusion: The incidence and prevalence burden of UC among Chinese and global women have shown an increasing trend over the past 32 years, while the mortality and DALYs have decreased. The projected burden of UC in China is anticipated to continue rising at a higher rate than the global level over the next 15 years. Given the large population in China, the government needs to strengthen screening and prevention strategies to mitigate the burden of UC. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is a life-threatening condition that increasingly damages cerebral tissue over time and can lead to serious post-effects, including depression, which can hinder a patient's recovery from stroke and reduce quality of life. This paper aims to analyze the global research landscape of post-stroke depression (PSD) between the years 1900 to 2024 using bibliometric analysis. Methods: The data used in this analysis was collected from the Web of Science Core Collection (WoSCC). An advanced search was performed using the keywords, "stroke" and "depression," on July 8th, 2024. From the Web of Science, bibliometric data was then extracted and analyzed in VOSviewer through four categories: countries, number of publications, keywords, and journals. Results: The bibliometric analysis resulted in 2,289 publications from the year 1900 to 2024. A gradual increase in the number of publications on post-stroke depression over the study period was observed. China was found to be the leading country for publications and funding on PSD, with the United States following in second. The top keywords included: "stroke," "depression," and "poststroke depression." The Journal of Stroke had the highest number of publications on depression in post-stroke patients. Conclusion: This study provides an overview of the current trends in articles published on PSD. Depression is an important topic to be considered in post-stroke patients due to its negative effects on post-stroke recovery and reduced quality of life, necessitating a call to attention and support for future research in this field. With continued research efforts led by the United States and China, improved treatments for patients with post-stroke depression can be implemented. [ABSTRACT FROM AUTHOR]

The discourse surrounding China's influence in the Middle East and North Africa tends to oscillate between extremes, in some instances portraying China as a burgeoning hegemon poised to displace America's regional primacy, while in others describing its influence as insufficient to effect meaningful change. China has made significant inroads in the region through diplomacy, trade, investment and infrastructure projects, enhancing its economic presence and raising Beijing's profile in regional geopolitics. However, examining the nature of interdependence between China and Middle Eastern nations reveals that China's capabilities, while increasingly formidable, are tempered by equally formidable constraints. Mutual dependencies, regional dynamics, limited hard power, domestic priorities, geography and the agency of regional states all modulate the extent to which China can exercise influence and impose its will. While Beijing's strategy of gradually shifting asymmetries in China's favour certainly warrants scrutiny, undue alarmism and complacency alike could increase the likelihood of faulty assessments and misguided policymaking. [ABSTRACT FROM AUTHOR]

Background: Out of the 21 neglected tropical diseases (NTDs) listed by the World Health Organization, 15 affect the People's Republic of China. Despite significant achievements in controlling NTDs, comprehensive assessments of the disease burden based on actual case data and detailed information on spatial and temporal dynamics are still lacking. This study aims to assess the disease burden and spatial–temporal distribution of NTDs in China from 2005 to 2020, to provide a reference for the formulation of national health agendas in line with the global health agenda, and guide resource allocation. Methods: The number of cases and deaths of major NTDs in China from 2005 to 2020 were downloaded from the China Public Health Science Data Center (https://www.phsciencedata.cn/Share/index.jsp) of the Chinese Center for Disease Control and Prevention and relevant literatures. Simplified formulas for disability-adjusted life years (DALYs) helped estimate the years of life lost (YLLs), years lived with disability (YLDs), and total DALYs. Spatial autocorrelation analysis of the average NTDs burden data for the years 2005 to 2020 was evaluated using Moran's I statistic. Results: China's overall NTDs burden decreased significantly, from 245,444.53 DALYs in 2005 to 18,984.34 DALYs in 2020, marking a reduction of 92.27%. In 2005, the DALYs caused by schistosomiasis and rabies represent a substantial proportion of the total disease burden, accounting for 65.37% and 34.43% respectively. In 2015, Hunan and Sichuan provinces had the highest diversity of NTDs, with 9 and 8 number of different NTDs reported respectively. And the highest disease burden was observed in Sichuan (242,683.46 DALYs), Xizang Zizhiqu (178,318.99 DALYs) and Guangdong (154,228.31 DALYs). The "high-high" clustering areas of NTDs were mainly in China's central and southern regions, as identified by spatial autocorrelation analysis. Conclusions: China has made unremitting efforts in the prevention and control of NTDs, and the disease burden of major NTDs in China has decreased significantly. Using the One Health concept to guide disease prevention and control in the field to effectively save medical resources and achieve precise intervention. [ABSTRACT FROM AUTHOR]

Zooming in on the European Union's international identity, this paper argues that maturation, and the achievement of a solid international identity, may result from a process in which different identity traits are integrated, even strategically incorporated. It frames this hybridisation argument in terms of Dragon Power Europe and proceeds in two steps. In a first step, the paper develops an integrated analytical framework for studying the European Union's international identity by comparing the Normative Power Europe and Market Power Europe conceptualisations along three dimensions, namely drivers, actions and impact. In a second step, the paper demonstrates the framework's empirical value through an exploration of the European Union's functioning in relation to health information standardisation, investigating the logics behind the inclusion of a new chapter on diagnoses and syndromes associated with Traditional (Chinese) Medicine in the eleventh revision of the World Health Organization's International Classification of Diseases in 2019. The involvement of the European Union and its member states in this specific case of health (information) standardisation shows initial but compelling evidence of NPE-MPE dynamics shaping the EU's international functioning, in particular its drivers, actions and impact. [ABSTRACT FROM AUTHOR]

Background & Aims: Diabetes and related metabolic syndromes represent a significant global health challenge, with the global burden of diabetes increasing considerably since 1990. In this article, we examined the trend of publications in Endocrinology, Diabetes and Metabolism between 1996 and 2021, focusing on Asian countries. Methods: We obtained and used the data from the Scopus database from the SCImago website (https://www.scimagojr.com/), on 1 April 2023, related to the subspecialty of Endocrinology, Diabetes and Metabolism for country rankings between 1996 and 2021. We did not include any data related to other medical specialties or other fields. Results: There has been a steady rise in global publications on these subspecialties over the past decade, with the number of publications from Asian countries increasing significantly. Western Europe recorded the highest number of publications, followed by North America and Asia. The COVID-19 pandemic also contributed to a surge in publications in this field. In Asian countries, China and India have notably increased their global contribution to publications, with China emerging as the top Asian nation in 2021. Conclusion: Our findings provide valuable insights into the research output from various countries and the productivity trends in Diabetes, Endocrinology and Metabolism-related research. [ABSTRACT FROM AUTHOR]

Rationale: This study presents the first comprehensive analysis and mapping of scientific research on point‐of‐care testing (POCT) in infectious diseases, filling a gap in understanding the evolving landscape of this field. The identification of research themes and global contributions offers valuable insights. Aims and Objectives: This manuscript aims to analyse and map scientific research on POCT in the context of infectious diseases. Methods: The study employed a comprehensive search strategy using terms related to POCT and infectious diseases. The search was conducted on the Scopus database, refining results based on inclusion and exclusion criteria. The dataset of 1719 research articles was then subjected to descriptive analysis and mapping using VOSviewer. Results: The research findings indicate an exponential growth in POCT‐related publications, with 46.8% published post the COVID‐19 pandemic. Plos One journal led in publication frequency, and Biosensors and Bioelectronics received the highest citations per article. North America and Western Europe dominated contributions, with notable participation from China, South Africa, and India. The research landscape revealed the following research themes: detection technologies, human immunodeficiency virus (HIV)/sexually transmitted infection (STI) diagnosis, antibiotic optimisation, and schistosomiasis. Clinical trials focused on antibiotic prescribing, HIV, STIs, and specific infections. The findings suggest a shifting landscape towards POCT, emphasising the need for future planning and investment in healthcare systems. The research identifies areas for future exploration, such as the impact of POCT on antibiotic prescribing and its role in combating infectious diseases in low‐ and middle‐income countries. Conclusion: Implementation of POCT has the potential to revolutionise infectious disease management, improve patient outcomes, and reduce the global burden of diseases. Better public awareness, healthcare team management, and planning for POCT at entry points are crucial for societal benefit. Results demonstrated the evolving role of POCT in infectious disease management and prevention. [ABSTRACT FROM AUTHOR]

Advanced therapy medicinal products (ATMPs) are rapidly evolving to offer new treatment options. The scientific, technical, and clinical complexities subject drug regulatory authorizes to regulatory challenges. To advance the regulatory capacity for ATMPs, the National Medical Products Administration in China made changes to the drug regulatory system and developed regulatory science with the goal of addressing patient needs and encouraging innovation. This study aimed to systematically identify the regulatory evidence on ATMPs in China under the guidance of an overarching framework from the World Health Organization Global Benchmarking Tool. It was found that China's administrative authorities at all levels have issued a number of policy documents to promote the development of ATMPs, covering biopharmaceutical products research and development (n = 14), biopharmaceutical industry development (n = 9), high-quality development of medical institutions (n = 1), specific development plans/projects (n = 6) and specific regional development (n = 4). The legal and regulatory framework of ATMPs in China has been established and is subject to continuous adjustment in various aspects including regulations (n = 3), departmental rules or administrative normative documents (n = 22), and technical guidance (n = 15). As the regulatory reform continues, the drug review processes have been revised, and various technical standards have been launched, which aim to establish a regulatory approach that oversees the full life-cycle development of ATMPs in the country. The limited number of investigational new drug applications and approved ATMPs suggests a lag remains between the translation of advanced therapeutic technologies into clinically available medical products. To accelerate the translational research of ATMP in countries such as China, developing and adopting real-world evidence generated from clinical use in designated healthcare facilities to support scientific decision-making in ATMP regulation is warranted. The enhancement of regulatory capacity building and multi-stakeholder collaborations should also be encouraged to facilitate the timely evaluation of promising ATMPs to meet more patient needs. [ABSTRACT FROM AUTHOR]

Background Understanding the burden of cervical cancer (CC) in young women aged 15–44 years old are essential for formulating effective preventive strategies. Methods Utilizing the Global Burden of Disease 2019 Study, we estimated incidence, disability-adjusted life-years (DALYs), years of life lost (YLLs) and years lived with disability (YLDs) due to CC among young women from 1990 to 2019. Additionally, we evaluated the temporal trends using estimated annual percentage changes (EAPCs) during this period. We conducted a decomposition analysis to assess the absolute contributions of three components: population growth, population age structure and epidemiologic changes. Results Globally, there were 187 609.22 incident cases of CC worldwide, resulting in 2621 917.39 DALYs in 2019. From1990 to 2019, the age-standardized rates were decline, only the age-standardized YLDs rate (EAPC = 0.02; 95% CI: −0.02 to 0.05) showed a stable trend. The largest increase in age-standardized incidence rate (ASIR) and age-standardized YLDs rate observed in the high-middle social demographic index (SDI) quintiles. Population growth and age structure changes were associated with substantial changes in cases of CC, especially in South Asia and East Asia. Conclusions Globally, the burden of CC in young women continues to increase, as measured by the absolute number. As populations are growing and age structure changes were associated with substantial changes in cases of CC, governments will face increasing demand for treatment, and support services for CC, especially in South Asia and East Asia. [ABSTRACT FROM AUTHOR]

Studies in medicine, bioscience, psychology, sociology, and public health have provided various contextual, individual, and vaccine‐specific explanations for vaccine uptake. However, one significant yet often ignored fact is that vaccination could be viewed as a site of citizen‐state interaction in implementing public vaccination policy. This begs the questions: What barriers create administrative burdens in vaccination? How do the experiences of administrative burdens (i.e., the learning, psychological, and compliance costs in citizen‐state interactions) shape the public's willingness to vaccinate? According to theoretical insights drawn from the extant literature on administrative burden and vaccine uptake, this study uses a conjoint experiment design based on a representative sample of China to reveal the role of administrative burdens in shaping the public's willingness to vaccinate against the monkeypox outbreak, a 'Public Health Emergency of International Concern' from July 2022 to May 2023. The experimental results suggest that multiple salient barriers have distinct effects on the respondents' learning, psychological, and compliance costs, thus significantly influencing their vaccine uptake. These findings have important implications for both future research and efforts to promote mass immunization programs. [ABSTRACT FROM AUTHOR]

The coronavirus disease-19 crisis has challenged the legitimacy of the World Health Organization as an actor in global health governance and provided the opportunity for China to emerge as a partner of developing countries in facing global pandemics. In this respect, South East Asia represents an emblematic region for testing the legitimacy of the international organisation vis-a-vis the emerging power. This article adopts a sociological interpretation of legitimacy and provides an empirical analysis of the discursive and non-discursive practices in South East Asian countries concerning support to – and criticism against – the World Health Organization–led initiative COVAX. It provides a variegated and dynamic picture of perceptions of the international organisation in the region. Our results partly call into question representations of the weakening of the legitimacy of the World Health Organization in favour of China's leading role. Finally, the article recognises the need to analyse legitimacy of the World Health Organization in connection both with the broader geopolitical positioning of governments receiving the Organization's aid and with the levels of trust in the government of the public in competing partners in dealing with global pandemics. [ABSTRACT FROM AUTHOR]

Background: Dental caries in young children is a difficult global oral health problem. In the last decade, China has put a great deal of effort into reducing the prevalence of dental caries. This study, which is part of the China Population Chronic Disease and Nutrition Surveillance 2021, aimed to investigate the prevalence of dental caries among children aged 5 in Shanghai, China, and its associated factors. Methods: A total of 1281 children aged 5 years from 6 districts in Shanghai were selected by a stratified sampling method. The survey consisted of an oral health questionnaire and an oral health examination. The questionnaire included questions on oral health knowledge, attitudes, and behaviours. The oral health examination used WHO standards. After screening, the data were input and analysed. Chi-square tests and logistic regression analyses were used to study the relevant factors affecting dental caries. Results: The prevalence of dental caries among 1281 children was 51.0%, the dmft index score was 2.46, the Significant Caries Index (SiC) score was 6.39, and the SiC10 score was 10.35. Dental caries experience was related to the frequency of sweet drink consumption, the age of starting tooth brushing, eating habits after brushing, whether the children had received an oral examination provided by the government (p < 0.05), and the mother's education level but was not related to sex, the use of fluoride toothpaste, the frequency of brushing, whether the parents assisted brushing, or the frequency of flossing (p > 0.05). Logistic regression analysis showed that the region of residence, eating after brushing and the age of starting brushing were associated with dental caries. Conclusions: Dental caries remained prevalent among 5-year-old children in Shanghai, China. Prevention strategies that target the associated factors including region of residence, eating after brushing, and the age of starting brushing should be considered. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore the spatial and temporal characteristics of emerging airborne viral infectious diseases outbreaks worldwide. Subject and methods: We conducted a systematic literature review on outbreaks of emerging airborne viral infectious diseases and calculated outbreak number and intensity at the country level. Fisher's exact test was used to compare the viral infectious diseases outbreaks in different income-level regions. To identify the major airborne viral infectious diseases outbreaks, we ranked and extracted the leading viral infectious diseases in outbreak number and intensity in each country by year. Results: A total of 2505 outbreaks were reported from 1873 to 2021 across 2010 studies. There were 47 countries (47/130, 36.15%) with more frequent emerging airborne viral infectious disease outbreaks (more than nine outbreaks), and these countries mainly distributed in high-income regions (22/47 countries, 46.81%, p < 0.05), especially in Western Europe (14/47 countries, 29.79%, p < 0.05). The number of overall outbreaks was more in the United States and China than in other countries in different years. Outbreaks of measles and influenza are always frequent and intense. Highly pathogenic human coronaviruses infection caused short-term pandemics during which their outbreak number and intensity exceeded other viruses. Rift valley fever outbreaks in the human population are spreading outside of Africa through the flow of goods and travelers. Conclusion: Countries in high-income regions reported more emerging airborne viral infectious diseases outbreaks, especially in the Western European region, the United States, and China. It is urgent to strengthen collaborative surveillance of emerging airborne viruses, cross-border flow of goods and travelers, and ecological environment to avoid the spread of viral infectious diseases outbreaks worldwide. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) causes high levels of global mortality. There is a global need to develop new antimicrobials to replace those whose efficacy is being eroded, but limited incentive for companies to engage in R&D, and a limited pipeline of new drugs. There is a recognised need for policies in the form of 'push' and 'pull' incentives to support this R&D. This article discusses China, a country with a rapidly emerging pharmaceuticals and biotech (P&B) sector, and a history of using coordinated innovation and industrial policy for strategic and developmental ends. We investigate the extent to which 'government guidance funds' (GGFs), strategic industrial financing vehicles (a 'push' mechanism), support the development of antimicrobials as part of China's 'mission-driven' approach to innovation and industrial policy. GGFs are potentially globally significant, having raised approximately US$ 872 billion to 2020. Results: GGFs have a substantial role in P&B, but almost no role in developing new antimicrobials, despite this being a priority in the country's AMR National Action Plan. There are multiple constraints on GGFs' ability to function as part of a mission-driven approach to innovation at present, linked to their business model and the absence of standard markets for antimicrobials (or other effective 'pull' mechanisms), their unclear 'social' mandate, and limited technical capacity. However, GGFs are highly responsive to changing policy demands and can be used strategically by government in response to changing needs. Conclusions: Despite the very limited role of GGFs in developing new antimicrobials, their responsiveness to policy means they are likely to play a larger role as P&B becomes an increasingly important component of China's innovation and industrial strategy. However, for GGFs to effectively play that role, there is a need for reforms to their governance model, an increase in technical and managerial capacity, and supporting ('pull') incentives, particularly for pharmaceuticals such as antimicrobials for which there is strong social need, but a limited market. Given GGFs' scale and strategic importance, they deserve further research as China's P&B sector becomes increasingly globally important, and as the Chinese government commits to a larger role in global health. [ABSTRACT FROM AUTHOR]

Radon-222 (222Rn) is a global indoor health issue. A total of 74 points were measured in the woodland and grassland with the RAD7 device on the Hongxiang Campus of the University of South China. The results showed that the 222Rn flux (RF) was 39.0 ± 30.3 mBq m−2 s−1 and 39.7 ± 29.3 mBq m−2 s−1 in the woodland and grassland, respectively. The value of RF map was lower than 50 mBq m−2 s−1 in most campus areas. The results serve as essential reference data for future 222Rn risk-health assessment and management strategies on the campus. [ABSTRACT FROM AUTHOR]

Outdoor air pollution, particularly volatile organic compounds (VOCs), significantly contributes to the global health burden. Previous analyses of VOC exposure have typically focused on regional and national scales, thereby limiting global health burden assessments. In this study, we utilized a global chemistry-climate model to simulate VOC distributions and estimate related cancer risks from 2000 to 2019. Our findings indicated a 10.2% rise in global VOC emissions during this period, with substantial increases in Sub-Saharan Africa, the Rest of Asia, and China, but decreases in the U.S. and Europe due to reductions in the transportation and residential sectors. Carcinogenic VOCs such as benzene, formaldehyde, and acetaldehyde contributed to a lifetime cancer burden affecting 0.60 [95% confidence interval (95CI): 0.40–0.81] to 0.85 [95CI: 0.56–1.14] million individuals globally. We projected that between 36.4% and 39.7% of the global population was exposed to harmful VOC levels, with the highest exposure rates found in China (82.8–84.3%) and considerably lower exposure in Europe (1.7–5.8%). Open agricultural burning in less-developed regions amplified VOC-induced cancer burdens. Significant disparities in cancer burdens between high-income and low-to-middle-income countries were identified throughout the study period, primarily due to unequal population growth and VOC emissions. These findings underscore health disparities among different income nations and emphasize the persistent need to address the environmental injustice related to air pollution exposure. [ABSTRACT FROM AUTHOR]

Minimal research exists on polychlorinated biphenyl (PCB) exposure from traditional Chinese medicines (TCMs), despite their significant contributions to domestic and international health protection. This study is the first to investigate the levels, profiles, and health risks of PCB residue in Pheretima, a typical TCM produced from earthworm. Seventy-seven Pheretima samples from different regions of China were analyzed for 45 PCB congeners. PCBs were found in all samples exhibiting species-dependent discrepancies. ∑45PCBs was ranging from 0.532 to 25.2 µg/kg (mean 4.46 µg/kg), with CB-11 being the most abundant congener contributing 71.8% ± 10.8% to ∑45PCBs, followed by CB-47, which were all non-Aroclor congeners called unintentionally produced PCBs (UP-PCBs). The average estimated daily intake of ∑45PCBs, ∑7ID-PCBs (indicative polychlorinated biphenyls), and CB-11 were 0.71, 0.04, and 0.51 ng/kg bw/d, respectively. The ∑HQ of PCBs in Pheretima samples was 2.97 × 10−4–2.46 × 10−2 (mean 2.77 × 10−3, 95th 4.21 × 10−3), while the ∑RQ ranged from 1.19 × 10−8 to 2.88 × 10−6 (mean 4.87 × 10−7, 95th 2.31 × 10−6). These findings indicate that Pheretima ingestion does not pose significant non-carcinogenic risks. However, certain individual samples exhibit an acceptable level of potential risks, particularly when considering that PCBs are recognized as endocrine disruptors and classified as probable carcinogens. These results contribute to the safety evaluation of traditional medicines and suggest the potential use of Pheretima as a bioindicator for PCB pollution. It is advisable to monitor UP-PCBs as indicator congeners and gather additional toxicological data. [ABSTRACT FROM AUTHOR]

Background: Blindness and vision loss (BVL) is a major global health issue affecting older adults, but its burden in transition countries has received limited attention. Therefore, we aimed to assess the trends in the burden of BVL among older adults between 1990 and 2019 across Brazil, Russia, India, China, and South Africa (BRICS), and predict the burden by 2040. Methods: Data on BVL and its related causes were obtained from the Global Burden of Disease 2019 study. We investigated the temporal trends by calculating the average annual percentage change using joinpoint regression analysis. Subsequently, we performed Bayesian age‐period‐cohort modeling to estimate the burden of BVL and its related causes by 2040. Results: Most BRICS countries experienced a significant decline (p < 0.05) in age‐standardized prevalence rates, and the decreasing trends tend to continue. However, by 2040, the number of BVL cases is expected to increase by approximately 50% across BRICS, with an estimated approximately 192, 170, 25, 17, and 7 million cases in China, India, Russia, Brazil, and South Africa, respectively. The related ranks of BVL causes are also estimated to change in the future, particularly in India. Conclusions: The different burdens and trends of BVL across BRICS reflected the different stages of population health transition. Effective eye disease prevention requires appropriate public health interventions. Developing effective health policies and services for older adults is urgently needed in BRICS countries. [ABSTRACT FROM AUTHOR]

Introduction: Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low‐ and middle‐income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV. Design: An explanatory sequential mixed‐methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data. Methods: The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In‐depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research. Results: The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV‐related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti‐domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first‐line support requirements even without formal education or training on IPV) were identified. Conclusions: Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening. Clinical Relevance: The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector. [ABSTRACT FROM AUTHOR]

In December 2019, an outbreak of a respiratory disease called the coronavirus disease 2019 (COVID-19) caused by a new coronavirus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Wuhan, China. The SARS-CoV-2, an encapsulated positive-stranded RNA virus, spread worldwide with disastrous consequences for people's health, economies, and quality of life. The disease has had far-reaching impacts on society, including economic disruption, school closures, and increased stress and anxiety. It has also highlighted disparities in healthcare access and outcomes, with marginalized communities disproportionately affected by the SARS-CoV-2. The symptoms of COVID-19 range from mild to severe. There is presently no effective cure. Nevertheless, significant progress has been made in developing COVID-19 vaccine for different therapeutic targets. For instance, scientists developed multifold vaccine candidates shortly after the COVID-19 outbreak after Pfizer and AstraZeneca discovered the initial COVID-19 vaccines. These vaccines reduce disease spread, severity, and mortality. The addition of rapid diagnostics to microscopy for COVID-19 diagnosis has proven crucial. Our review provides a thorough overview of the historical development of COVID-19 and molecular and biochemical characterization of the SARS-CoV-2. We highlight the potential contributions from insect and plant sources as anti-SARS-CoV-2 and present directions for future research. [ABSTRACT FROM AUTHOR]

Suicide is a serious public health problem for adolescents. Based on the framework of ideation-to-action, it is important to examine the factors associated with the translation from suicide ideation to suicide attempt. The present study aimed to investigate the risk factors of suicide attempts among adolescents with suicide ideation in low-income and middle-income countries (LMICs). We analyzed data of students aged 12–18 years who participated in the 2009–2013 Global School-based Health Surveys (GSHS) in 39 LMICs. The Chi-square test was used to compare the prevalence of suicide attempts among participants with suicide ideation, the multilevel logistic regression model was used to identify significant factors associated with suicide attempts among suicide ideators. Among 22,655 adolescents with suicide ideation, 55.1% of them reported having made a suicide attempt in the past year. Loneliness, anxiety, alcohol use, and drug use were risk factors for suicide attempts among suicide ideators. Strategies should be implemented to reduce the likelihood of adolescents acting on their suicidal thoughts, such as community psychological crisis line, school-based mental health and skills training programs, and family support for adolescents with psychological problems. [ABSTRACT FROM AUTHOR]

As we approach the deadline for achieving the United Nations’ 17 Sustainable Development Goals (SDGs), which is less than a decade away, it is crucial for researchers and research institutions at both national and international levels to conduct rigorous scientific assessments of the progress made towards these goals. The assessment is of utmost importance as it will provide valuable insights and information to political leaders and other stakeholders, guiding their actions and efforts towards successfully attaining the SDGs by the year 2030. This study aimed at providing vivid descriptions of the SDG 2 – zero hunger-related research endeavour. It employed bibliometric analysis and geographical patterns of SDG 2-related publications extracted from Scopus database from 2015 to 2023. A total of 397 documents were extracted where Sustainability journal ranked 1st among the journal outlets of zero hunger-related publications. The publication of zero hunger-related documents grew from 1.5% in 2016 to 29.7% in 2022. Food and Agriculture Organisation (FAO) and Chinese Academy of Sciences were the top 2 institutions publishing zero hunger-related documents while the lead article was published by Journal of Cleaner Production with 128 citations. The funding sponsors of SDG 2-related publications were dominated by sponsors from developed countries (such as China, Belgium, United States, and United Kingdom) while no funding sponsors from developing countries were among the top 10. The United States and United Kingdom were the two most productive countries while only one African country (South Africa) made the list of top 10 countries publishing zero hunger-related documents. This study provided political leaders and key stakeholders with in-depth understanding of the SDG 2-related research activities and highlighted research funding and collaboration gaps facing the developing nations. [ABSTRACT FROM AUTHOR]

Simple Summary: In the treatment of colorectal cancer, classic chemotherapy drugs such as 5-fluorouracil, capecitabine, irinotecan, oxaliplatin, trifluridine, and tipiracil have played a crucial role. Through the analysis of the top 100 most influential articles, we examined the evolution in research and current relevance, confirming the continued significance of this group of drugs despite the emergence of new treatments. The research reveals global collaboration among institutions, countries (primarily the United States, China, and Europe), and researchers, with three main themes driving the study: pharmacogenetics, new pharmaceutical formulations, and the use of adjuvants. In the landscape of colorectal cancer treatment, classical chemotherapeutic agents such as 5-fluorouracil, capecitabine, irinotecan, oxaliplatin, trifluridine, and tipiracil have historically played a pivotal role. This study presents a comprehensive bibliometric analysis of the top 100 most influential articles focusing on these classic chemotherapy drugs in the management of colorectal cancer. With this, we shed light on their current importance, despite the emergence of new therapeutic targets and treatments in the field of oncology. Systematically evaluating research outputs, this analysis reveals a prevalence of co-authorship among institutions, countries (led by the United States, China, and Europe), and researchers highlighting the global and collaborative nature of efforts in research, utilization, and development of these drugs. Three thematic axes lead the research: pharmacogenetics, the development of new pharmaceutical forms, and the use of adjuvants. This research serves as a foundation for future endeavors, aiding researchers, clinicians, and policymakers in making informed decisions about the direction of research and development in the dynamic field of colorectal cancer therapy. [ABSTRACT FROM AUTHOR]

Background: A shortage of qualified nurses and their low level of educational qualifications hinders the development of global health services. Studies have proven the role of nursing education in addressing these problems. However, no related studies have focused on senior high school students in China. This study aimed to explore senior high school students' intentions to learn nursing and identify the factors influencing their decision-making processes. Methods: An anonymous questionnaire was distributed to 8050 senior high school students, which included questions regarding their demographic characteristics, obtaining nursing specialty information, cognition of the nursing occupation and the impact of the COVID-19 on the nursing profession. Descriptive calculation, the chi-square test and logistic regression were used for the analysis. Results: Only 0.73% of the participants had a clear intention to study nursing. Academic performance and family support were significant predictors of students' intentions to pursue nursing education. Students' interest in nursing specialties was associated with their choice. There was a positive correlation between cognition of nursing occupation and students' choice of nursing. Students' experience of the COVID-19 pandemic also had a positive impact on their nursing career choice. Conclusion: This survey to some extent reflects the problem of nurses shortage in China. In addition, these findings may also provide a new perspective for predictors of nursing shortage and potential interventions. [ABSTRACT FROM AUTHOR]

The article investigates how the COVID-19 pandemic around the world is represented by the New York Times (NYT) and China Daily (CD), newspapers from two countries with long-standing political tension. The data consists of 2572 reports that are classified into three groups: reports on COVID-19 in the US, reports on COVID-19 in China, and reports on COVID-19 in other countries/regions. The reports are analyzed in terms of their discursive news values. Analysis results show that NYT represents the pandemic in the US, and CD represents the pandemic in China as the least negative, the least impactful and with the most personal accounts. NYT represents the pandemic in China, and CD represents the pandemic in the US as the most negative, the most impactful, the most severe, and the least positive and proximate. The selection and representation of other countries/regions reflect a differentiated coverage of the "Others" by both NYT and CD. The study lends support to a previous hypothesis that domestic crises tend to be presented as less negative than those in other countries, and invites contemplation on the influence of nationalism and political antagonism on the news media in times of global health crises. [ABSTRACT FROM AUTHOR]

Objectives: More people with dementia live in low‐ and middle‐income countries (LMICs) than in high‐income countries, but best‐practice care recommendations are often based on studies from high‐income countries. We aimed to map the available evidence on dementia interventions in LMICs. Methods: We systematically mapped available evidence on interventions that aimed to improve the lives of people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs (registered on PROSPERO: CRD42018106206). We included randomised controlled trials (RCTs) published between 2008 and 2018. We searched 11 electronic academic and grey literature databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, World Health Organization Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODEM Toolkit) and examined the number and characteristics of RCTs according to intervention type. We used the Cochrane risk of bias 2.0 tool to assess the risk of bias. Results: We included 340 RCTs with 29,882 (median, 68) participants, published 2008–2018. Over two‐thirds of the studies were conducted in China (n = 237, 69.7%). Ten LMICs accounted for 95.9% of included RCTs. The largest category of interventions was Traditional Chinese Medicine (n = 149, 43.8%), followed by Western medicine pharmaceuticals (n = 109, 32.1%), supplements (n = 43, 12.6%), and structured therapeutic psychosocial interventions (n = 37, 10.9%). Overall risk of bias was judged to be high for 201 RCTs (59.1%), moderate for 136 (40.0%), and low for 3 (0.9%). Conclusions: Evidence‐generation on interventions for people with dementia or MCI and/or their carers in LMICs is concentrated in just a few countries, with no RCTs reported in the vast majority of LMICs. The body of evidence is skewed towards selected interventions and overall subject to high risk of bias. There is a need for a more coordinated approach to robust evidence‐generation for LMICs. Key points: While the majority of people with dementia reside in low‐ and middle‐income countries (LMICs), it is not known what types of interventions have been studied in these settings and how effective they are.We conducted the first comprehensive mapping study of interventions for people with dementia or mild cognitive impairment (MCI) and/or their carers in LMICs.This high‐level overview of dementia intervention research in LMICs identified the following gaps: dementia intervention research is highly concentrated in just a few LMICs, and skewed towards Traditional Chinese Medicine, Western pharmaceuticals, and supplements, with comparatively little evidence generated on interventions for carers.Lack of robust and locally relevant evidence on effective interventions presents a substantial challenge to designing evidence‐based treatment and care systems that help people with dementia or MCI and their carers to live better lives. [ABSTRACT FROM AUTHOR]

Background: This study aimed to describe the trends in incidence, mortality, and burden of tracheal, bronchial and lung (TBL) cancer in Asia from 2010 through 2019 and compare with global and other continental data. Methods: We collected TBL cancer data from the 2019 Global Burden of Disease (GBD) study from 2010 to 2019 in 49 countries and territories in Asia. For all locations, annual case data and age‐standardized rates (ASRs) were used to investigate the incidence, prevalence, mortality, and disability‐adjusted life‐years (DALYs) of TBL from 2010 to 2019. The relative difference (%) between years was used to show comparative variations of ASRs for the indicators studied. Results: In 2019, more than 55% of TBL cancer cases and deaths occurred in Asian countries. A total of 57% of lung cancer patients lived in Asia and almost 60% of the global burden of lung cancer was imposed on Asian countries. From 2010 to 2019, incidences, deaths, prevalence cases, and DALYs number of TBL cancer increased over 1.34‐, 1.31‐, 1.31‐, and 1.26‐fold, in Asia. During this period, the age‐standardized incidence rate (ASIR), the age‐standardized death rate (ASDR), the age‐standardized prevalence rate (ASPR), and the age‐standardized DALYs rate (DALYs ASR) of TBL cancer decreased by 1, 3, 4, and 4%, respectively. While at the same time, the decreasing trend of these rates globally and in America and in Europe happened faster. In 2019, age‐specific incidence, death, prevalence, and DALY cases of TBL cancer were peaking at 65–74, 70–74, 65–69, and 65–69 years, respectively. In 2019, the highest ASIR, ASDR, and DALYs ASR of TBL cancer was observed in East Asia countries and the highest ASPR in high‐income Asia Pacific countries. Central Asia and high‐income Asia Pacific countries experienced a decreasing trend in ASIR and ASDR, and the South Asia countries experienced the highest increasing trend from 2010 to 2019. ASPR only decreased in Central Asia, and DALYs ASR only increased in South Asia. In 2019, among high sociodemographic index (SDI) Asian countries, Brunei Darussalam had the highest ASIR, ASDR, and DALYs ASR and the Republic of Korea had the highest ASPR. Among high‐middle SDIs, Turkey and Georgia; among middle SDIs, China and Armenia; among low‐middle SDIs, Mongolia and the Democratic People's Republic of Korea had the highest ASIR, ASDR, ASPR, and DALY ASR of TBL cancer. Among low SDI Asian countries, Pakistan had the highest ASIR, ASDR, ASPR, and DALY ASR of TBL cancer. Conclusion: Most of the global burden of lung cancer occurs in Asian countries, and the decreasing trend of incidence, death, prevalence, and burden of this cancer in these countries is slower than in other regions. Therefore, the implementation of necessary measures in order to reduce the process of this cancer is considered urgent. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) represents a complex group of metabolic disorders. As MetS poses a significant challenge to global public health, predicting the occurrence of MetS and the development of related risk factors is important. In this study, we conducted a predictive analysis of MetS based on machine learning algorithms using datasets of 15,661 individuals. Five consecutive years of medical examination records were provided by Nanfang Hospital, Southern Medical University, China. The specific risk factors used included WC, WHR, TG, HDL-C, BMI, FGLU, etc. We proposed a feature construction method using the examination records over the past four consecutive years, combining the differences between the annual value and the normal limits of each risk factor and the year-to-year variation. The results showed that the feature set, which contained the original features of the inspection record and new features proposed in this study yielded the highest AUC of 0.944, implying that the new features could help identify risk factors for MetS and provide more targeted diagnostic advice for physicians. [ABSTRACT FROM AUTHOR]

Despite the role of public health interventions in controlling disease transmission and protecting the public during the COVID-19 emergency, the implementation of quarantine restrictions has raised serious ethical concerns, especially in relation to the well-being of vulnerable populations. Drawing on the lived experiences of rural Chinese migrants who are subject to pandemic control, the authors highlight their inadequate capacities to manage the risks associated with the pandemic and adjust to quarantine restrictions. Informed by an ethical discourse of vulnerability, we show that underpinning this group's deficient coping strategies is a range of detrimental social structures and institutions that have developed under the persistent rural–urban divide in China. These structural constraints and pathologies expose rural migrants to serious risks and uncertainties while depriving them of the means and resources necessary to protect their own interests in the process of complying with quarantine restrictions. Understanding the plight of rural Chinese migrants as a structural problem also has implications for the global response to the COVID-19 pandemic. We further suggest a need for state intervention to mitigate structural deficiencies and empower the vulnerable during the COVID-19 era. [ABSTRACT FROM AUTHOR]

This article analyses China's global health governance (GHG) practices and GHG legal infrastructure in the wake of COVID-19. It posits that China has pursued a mix of bilateral and multilateral strategies during the pandemic to promote global cooperation and domestic regulation to shape an effective GHG response. It demarcates China's proactive role in norm-setting to respond to the global health crisis. It first considers China's responses to COVID-19 and its interaction model with multilateral institutions including WHO and GAVI. It then examines China's bilateral health strategies, taking its interactions with African countries as an example, before analysing and comparing existing norms and practices on the 'right to regulate' under the rules of the World Trade Organisation and treaties that China participates in that call for more regulatory recognition. The article then proceeds to examine China's new initiatives in shaping GHG strategy during COVID-19. Finally, it concludes and calls for a coordinated multilateral approach to handle global health crises. [ABSTRACT FROM AUTHOR]

Obesity is a social problem that needs to be carefully considered regarding its causes and consequences. This study examines the impact of human development, unemployment, and globalization on obesity in BRICS (Brazil, Russia, India, China, and South Africa) countries from 1991 to 2016. For this aim, the study uses Fourier causality and cointegration tests, which consider smooth structural breaks. The cointegration test results show that obesity and explanatory variables do not move together in the long run for all countries. According to the causality result of this study, there is a unidirectional causal relationship from obesity to unemployment in China. On the other hand, there is unidirectional causality from obesity to human development and globalization in India. Overall, India can lessen the negative effects of obesity on its population and improve its standing in the global economy if it promotes healthy lifestyles and controls the food and beverage industry. On the other hand, obesity may cause people to become unemployed, so it is recommended that policymakers fight obesity to control unemployment in China. [ABSTRACT FROM AUTHOR]

Background: Transcultural capacity is a key component of consolidated global public health assistance cooperation (GPHAC). The aim of this study is to investigate the transcultural capacity perceptions of public health professionals from China's disease control and prevention system after relative training in order to provide a reference for enhancing transcultural capacity during the practice of GPHAC. Methods: A cross sectional qualitative survey in which self-administrated questionnaire with 5 open ended questions was used. The questionnaire was disseminated on the completion of an online training for China's senior public health professions on transcultural capacity in GPHAC. Descriptive statistics, word frequency analysis and content analysis were used to analyze the questionnaire data. Results: Totally, 45 participants took part in this training, 25 of them voluntarily participated in this survey. The participants demonstrated the need for transcultural competence in public health services and suggested improvement in the course content arising from their wealth of knowledge and practical experience in the field. 96% of the participants considered that the training course was "very necessary" and "meaningful". The most interested topics were "Overview of transcultural adaptation and GPHAC", "Transcultural adaptation and response" and "African culture and health". The contents about "Country-specific analysis on cultural factors in public health", "rapid transcultural adaptation" and "more specific practical experiences in diverse cultural backgrounds" were suggested to be added in future training. The participants considered that transcultural capacity ensured the smooth progress of GPHAC and they both could complement each other, transcultural adaptation was the premise of gaining trust and reaching cooperation, it can be conducive to the health assistance professionals to integrate into local cultural life, facilitating their foreign assistance work to be effective and efficient, and impart experiences well. The participants hoped to put the concept into action. Conclusion: The importance of transcultural competence in GPHAC is becoming a consensus of public health professionals. Enhanced transcultural competence reflected in the attitude of public health as well as other health workers would promote GPHAC and would foster efficient emergency health response management among many countries. [ABSTRACT FROM AUTHOR]

During the outbreak of a disease caused by a pathogen with unknown characteristics, the uncertainty of its progression parameters can be reduced by devising methods that, based on rational assumptions, exploit available information to provide actionable insights. In this study, performed a few (~6) weeks into the outbreak of COVID-19 (caused by SARS-CoV-2), one of the most important disease parameters, the average time-to-recovery, was calculated using data publicly available on the internet (daily reported cases of confirmed infections, deaths, and recoveries), and fed into an algorithm that matches confirmed cases with deaths and recoveries. Unmatched cases were adjusted based on the matched cases calculation. The mean time-to-recovery, calculated from all globally reported cases, was found to be 18.01 days (SD 3.31 days) for the matched cases and 18.29 days (SD 2.73 days) taking into consideration the adjusted unmatched cases as well. The proposed method used limited data and provided experimental results in the same region as clinical studies published several months later. This indicates that the proposed method, combined with expert knowledge and informed calculated assumptions, could provide a meaningful calculated average time-to-recovery figure, which can be used as an evidence-based estimation to support containment and mitigation policy decisions, even at the very early stages of an outbreak. [ABSTRACT FROM AUTHOR]

Gaining wide prominence in the global health arena, scaling-up increases the coverage of health innovations emerging from pilots and experimental projects to a larger scale. However, scaling-up in the health sector should not follow a linear 'pilot-diffusion' pathway in order to better facilitate local adaptation and policy refinement. This paper puts forth 'scaling-up through piloting' as a distinctive pathway for the strategic management of scaling-up in the health sector. It analyses the recent development of provider payment reforms in China, focusing particularly on the ongoing pilot programmes, namely diagnosis-related groups (DRGs) and diagnosis-intervention packet (DIP), that are being piloted in a dual-track fashion since 2020. Data were drawn from extensive documentary analysis and 20 in-depth interviews with key stakeholders, including decision-makers and implementers. This paper finds that scaling-up through piloting helps Chinese policymakers minimize the vast uncertainties associated with complex payment reforms and maximize the local adaptability of provider payment innovations. This pathway has forged a phased implementation process, allowing new payment models to be tested, evaluated, compared and adjusted in a full spectrum of local contexts before national rollout. The phased implementation creates a 'slower is faster' effect, helping reduce long-term negative consequences arising from improperly managed scaling-up in a complex system. Error detection and correction and recalibration of new policy tools can support national-level policy refinement in a more robust and dynamic fashion. Several key factors have been identified as crucial for strategic scaling-up: necessary central steering, a pragmatic piloting design, strong technical capacity and effective policy learning mechanisms [ABSTRACT FROM AUTHOR]

Background The association between fine particular matter (PM2.5) and frailty is less studied, and the national burden of PM2.5-related frailty in China is unknown. Objective To explore the association between PM2.5 exposure and incident frailty in older adults, and estimate the corresponding disease burden. Design Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014. Setting Twenty-three provinces in China. Subjects A total of 25,047 participants aged ≥65-year-old. Methods Cox proportional hazards models were performed to evaluate the association between PM2.5 and frailty in older adults. A method adapted from the Global Burden of Disease Study was used to calculate the PM2.5-related frailty disease burden. Results A total of 5,733 incidents of frailty were observed during 107,814.8 person-years follow-up. A 10 μg/m3 increment of PM2.5 was associated with a 5.0% increase in the risk of frailty (Hazard Ratio = 1.05, 95% confidence interval = [1.03–1.07]). Monotonic, but non-linear exposure-response, relationships of PM2.5 with risk of frailty were observed, and slopes were steeper at concentrations >50 μg/m³. Considering the interaction between population ageing and mitigation of PM2.5, the PM2.5-related frailty cases were almost unchanged in 2010, 2020 and 2030, with estimations of 664,097, 730,858 and 665,169, respectively. Conclusions This nation-wide prospective cohort study showed a positive association between long-term PM2.5 exposure and frailty incidence. The estimated disease burden indicated that implementing clean air actions may prevent frailty and substantially offset the burden of population ageing worldwide. [ABSTRACT FROM AUTHOR]

This article compares the discursive construction of news values in English news reporting of China Daily and CNN about the COVID-19 vaccine, to reveal how the two media packaged the vaccine and improved the acceptance of the international community towards the vaccines made in the respective countries. Adopting corpus linguistic methods and Discursive news values analysis (DNVA) framework, this study examines news values through keywords, nomination strategies, and photographs. The results show that the two media outlets constructed the news value of Eliteness dominantly through a systematic combination of words and images, albeit in different ways. China Daily prominently consists of references to China's international communications in the production and application of the COVID-19 vaccine, at the same time packaging the COVID-19 vaccine as foreign aid to enhance diplomatic relations as well as protect and promote the order of the international community. In contrast, CNN chiefly demonstrates references to domestic medical experts and the well-known manufacturers of the COVID-19 vaccine, packaging the COVID-19 vaccine as the US' medical/commercial product. The respective ways in which they portray the COVID-19 vaccine have helped to bolster the acceptance of each country's vaccine by the international community. [ABSTRACT FROM AUTHOR]

China has been contributing to new approaches to global governance. The Health Silk Road (HSR), a significant component of the Belt and Road Initiative (BRI), was proposed by China in 2016. This paper claims that HSR is a new institution introduced alongside the existing WHO-led multilateral health system, and its relationship with the existing system can be described as layering. Having explored the new development of HSR during COVID-19, this paper further argues that while HSR has its unique strength in making contributions to global health governance and economic recovery, it faces a prominent issue of securitisation in the context of China-U.S. strategic competition, suspicion of the quality of medical products and sectoral fragmentation. [ABSTRACT FROM AUTHOR]

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Background Understanding the incidence pattern of cutaneous reactions is crucial for promoting COVID-19 vaccination. We aimed to report the global incidence pattern of, and factors associated with common cutaneous reactions related to COVID-19 vaccination in real-world settings. Methods We searched five databases (PubMed, Web of Science, Embase, CNKI, and Wanfang) from inception to May 13, 2022, for studies reporting the incidence of common cutaneous reactions related to COVID-19 vaccines in real-world settings. The outcomes were the systematic skin reactions (rash and urticaria) and the local injection site reactions (pain, swelling, redness, and erythema). We conducted random-effects meta-analyses and explored associated factors using multi-step statistical analyses. Results We included 35 studies and assessed 2549968 participants from 23 countries. The pooled incidence of overall systemic skin reactions was 3.8% (95% confidence interval (CI)=2.4%-5.5%) with short duration (about one week). Specifically, the pooled incidence rates of rash and urticaria were 3.0% (95% CI=2.1%-3.9%) and 1.1% (95% CI=0.7%-1.5%), respectively. For overall local injection site reactions, the pooled incidence was 72.4% (95% CI=65.7%-78.7%) with short duration (1 to 4.5 days). Except for local pain (72.2%, 95% CI=65.3%-78.5%), other localized reactions had low incidence, including swelling (13.3%, 95% CI = 9.5%-17.7%), redness (11.5%, 95% CI=5.7%-19.0%), and erythema (5.8%, 95% CI=0.7%-15.4%). Geographically, different distribution patterns were observed for these reactions. Regarding associated factors, mRNA vaccines showed lower incidence of urticaria (P<0.001). Asia population showed higher incidence of urticaria (P<0.001). We observed lower incidence rates of overall local injection site reactions and pain among inactivated vaccines (P<0.001). We found no significant difference among reactions between the first and the second dose of vaccines. Conclusions We examined the global incidence pattern of common cutaneous reactions related to COVID-19 vaccination and found low incidence and short duration of systemic skin reactions and local injection site reactions (except for pain); discrepancies in these reactions were observed across different vaccine types. The cutaneous side effects related to COVID-19 vaccination do not seem to cause concern. [ABSTRACT FROM AUTHOR]

Background The Equitable Impact Sensitive Tool (EQUIST) was developed to address the limitations of the traditional cost-effectiveness analysis (CEA) in global health, which often overlooked equity considerations. Its primary aim was to create more effective and efficient health systems by explicitly incorporating equity as a key driver in health policy decisions. This was done in response to the recognition that, while CEA helped reduce mortality rates through interventions like childhood vaccinations, it was insufficient in addressing growing inequalities in health, especially in low-and-middle-income countries (LMICs). Methods The development of EQUIST involved a multi-stage process which began in 2011 with the recognition of the need for a more nuanced approach than CEA alone. This led to a proposal for creating a tool that balanced cost-effectiveness with equity. The conceptual framework, developed between March and May 2012, included assessments of intervention efficiency by equity strata, effectiveness, impact, and cost-effectiveness. Key to EQUIST's development was its integration with other data science platforms, notably the Lives Saved Tool and the Marginal Budgeting for Bottlenecks tool, allowing EQUIST to draw on comprehensive data sets and thus enabling a more detailed analysis of health interventions' impacts across different socio-economic strata. Results EQUIST was validated in 2012 through applications in five representative countries, demonstrating its ability to identify more equitable and cost-effective health interventions which targeted vulnerable populations, leading to more lives saved compared to traditional methods. It was then used to develop investment cases for the Global Financing Facility, resulting in significant funding being made available for maternal and child health programmes. Consequently, EQUIST directly influenced the development of national health policies and resource allocations in over 26 African countries. Conclusions EQUIST has proven to be a valuable tool in developing health policies that are both cost-effective and equitable. In the future, it will be further integrated with other tools and expanded in scope to address broader health issues, including adolescent health and human immunodeficiency virus/acquired immunodeficiency syndrome programme planning. Overall, EQUIST represents a paradigm shift in global health economics, emphasising the importance of equity alongside cost-effectiveness in health policy decisions. Its development and implementation have had a tangible impact on health outcomes, particularly in LMICs, where it has been instrumental in reducing maternal and child mortality while addressing health inequities. [ABSTRACT FROM AUTHOR]

Background Bladder cancer (BCa) is one of the most common urological malignancies worldwide. This study examines the global epidemiological profile of BCa incidence and mortality in 2020 and the projected burden to 2040. Methods The estimated number of BCa cases and deaths were extracted from the GLOBOCAN 2020 database. Age-standardised incidence rates (ASIRs) and age-standardised mortality rates (ASMRs) were calculated using the world standard. The predicted BCa incidence and mortality in 2040 was calculated based on demographic projections. Results Globally, approximately 573000 new BCa cases and 213000 deaths occurred in 2020, corresponding to ASIRs and ASMRs of 5.6 and 1.9 per 100000, respectively. The incidence and mortality rates were approximately 4-fold higher in men (9.5 and 3.3 per 100000, respectively) than women (2.4 and 0.9, respectively). Across world regions, incidence rates varied at least 12-fold among men and 8-fold among women, with the highest ASIRs for both men and women detected in Southern Europe (26.5 and 5.8 per 100000, respectively) and Western Europe (21.5 and 5.8, respectively) and the lowest in Middle Africa (2.2) in men and South-Central Asia (0.7) in women. The highest ASMRs for both men and women were found in Northern Africa (9.2 and 1.8 per 100000, respectively). By 2040, the annual number of new BCa cases and deaths will increase to 991000 (72.8% increase from 2020) and 397000 (86.6% increase), respectively. Conclusions Geographical distributions of BCa incidence and mortality uncovered higher risk of BCa incidence in Southern and Western European populations and higher risk of mortality in Northern African populations. Considering the predicted 73% and 87% increase in annual BCa cases and deaths by 2040 globally, respectively, there is an urgent need to develop and accelerate BCa control initiatives for highrisk populations to tackle global BCa burden and narrow its geographical disparities. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyze the moderating effect of managerial discretion on the relationship between cross-border knowledge search and the high-tech firms' innovation quality in a global health emergency and addresses the following issues: the influence mechanism of different types of cross-border knowledge search on the high-tech firms' innovation quality in a global health emergency; and the moderating role of different dimensions of manager discretion on the above relationship. Design/methodology/approach: Based on the firms' strategy selection methods, the authors divided cross-border knowledge search into three aspects, namely, breadth, depth and balance, and analyzed the impact of cross-border knowledge search on the innovation quality of high-tech firms in a global health emergency, taking managerial discretion as the moderating variable, and divided it into position rights, pay rights and operation rights according to the key rights of firms' strategic management. Furthermore, the authors constructed a theoretical model, and for an analysis sample, the authors collected data from Chinese high-tech firms from 2013 to 2021. Findings: The empirical results show that there is an inverted U-shaped relationship between cross-border knowledge search breadth, depth and balance and the innovation quality of high-tech firms. The position rights, pay rights and operation rights of managerial discretion have partially significant moderating effects on the relationship between cross-border knowledge search breadth, depth and balance and the high-tech firms' innovation quality. Originality/value: Considerable literature has grown around the theme of the impact of knowledge search on the firms' innovation quality. Nevertheless, only a few studies draw on the combination of global health emergency, cross-border knowledge search and the innovation quality; in particular, no literature has analyzed the relationship between the three from the managerial discretion perspective. Exploring the above relationships has great theoretical value for enriching and improving knowledge management and innovation management theories and provides a theoretical basis and practical support for high-tech firms to face challenges of a global health emergency and to break through the innovation dilemma. [ABSTRACT FROM AUTHOR]

Circulation of seasonal influenza is the product of complex interplay among multiple drivers, yet characterizing the underlying mechanism remains challenging. Leveraging the diverse seasonality of A(H3N2) virus and abundant climatic space across regions in China, we quantitatively investigated the relative importance of population susceptibility, climatic factors, and antigenic change on the dynamics of influenza A(H3N2) through an integrative modelling framework. Specifically, an absolute humidity driven multiscale transmission model was constructed for the 2013/2014, 2014/2015 and 2016/2017 influenza seasons that were dominated by influenza A(H3N2). We revealed the variable impact of absolute humidity on influenza transmission and differences in the occurring timing and magnitude of antigenic change for those three seasons. Overall, the initial population susceptibility, climatic factors, and antigenic change explained nearly 55% of variations in the dynamics of influenza A(H3N2). Specifically, the additional variation explained by the initial population susceptibility, climatic factors, and antigenic change were at 33%, 26%, and 48%, respectively. The vaccination program alone failed to fully eliminate the summer epidemics of influenza A(H3N2) and non-pharmacological interventions were needed to suppress the summer circulation. The quantitative understanding of the interplay among driving factors on the circulation of influenza A(H3N2) highlights the importance of simultaneous monitoring of fluctuations for related factors, which is crucial for precise and targeted prevention and control of seasonal influenza. Author summary: Seasonal influenza, especially for A(H3N2), has a considerable impact on public health around the world. Until now, quantitatively characterizing the underlying mechanism for the circulation of influenza A(H3N2) remains challenging, especially for countries with diverse seasonal patterns. China is a climatologically diverse country, where the seasonal pattern of influenza A(H3N2) varies across regions. Using multi-source data, the mechanism for the heterogenic transmission patterns of influenza A(H3N2) in China was revealed through an integrative modelling framework. The contributions of population susceptibility, climate factors and antigenic change to the dynamics of influenza A(H3N2) were also quantified. Finally, the effects of interventions on the summer epidemics were tested to help for optimizing the routine influenza immunization campaigns in China. The quantitative understanding of the interplay among driving factors on the circulation of influenza A(H3N2) highlights the importance of simultaneous monitoring of fluctuations for related factors, which is crucial for precise and targeted prevention and control of seasonal influenza. [ABSTRACT FROM AUTHOR]

Background: The Scottish Government introduced a free Baby Box scheme for all new parents in 2017, modelled on the Finnish scheme, to give every baby 'an equal start in life'. There is little evidence that it results in better health outcomes, but there has been limited research into different perspectives and discourses on such schemes. Methods: Four focus groups were conducted with 21 parents in North‐East Scotland. Recordings were transcribed verbatim, anonymized and analysed thematically with NVivo 12 software. Our thematic analysis was both inductive and deductive—remaining open to themes identified by participants themselves but also informed by the social policy literature on universalism and social cohesion. Results: Across all the focus groups, we found a high degree of positivity about the principle of the Baby Box scheme, and for the most part the practical value of the contents. This was remarkably consistent across different communities and backgrounds. There was little evidence of the strongly polarized views present in media reporting. Parents seemed considerably less focused than the media on safety and health outcomes, and more focused on practical, material and social impacts. They reported little in the way of feeling patronized or monitored by the government. Conclusion: Our findings have important implications for future economic evaluations of the baby box. Such evaluations should broaden the valuation space beyond health outcomes to allow for the value of feelings of inclusion, solidarity and being part of a community. Patient or Public Contribution: This small project was designed in response to parent views already collected in the early roll‐out of the Baby Box scheme in Scotland, about their priorities and responses to the scheme. Additional views were sought on the topic guide for the focus groups, and local community groups advised us on recruitment and the best timing and location for the focus groups to be held. The focus groups themselves were conducted as research, but with the intent of ensuring parent views featured more prominently in a debate that has been largely dominated by clinical and public health perspectives. [ABSTRACT FROM AUTHOR]

Global health governance (GHG) was one of COVID-19's earliest victims. Soon after the novel coronavirus escaped China, the World Health Organization (WHO) was marginalized, and the International Health Regulations became practically irrelevant, as nations adopted uncoordinated, ad hoc responses. Existing explanations of GHG's collapse are largely utopian, criticizing states for failing to empower the WHO with sufficient supranational authority. This misunderstands how GHG was supposed to work in the first place and hence mistakenly diagnoses the causes of failure. We argue that COVID-19 exposed the pathologies of an entire, neoliberal approach to global governance: metagovernance and state transformation. In this approach, international organizations are hollowed out and their role shifts to metagovernance—developing and disseminating 'best practice' policies, institutions and rules for states to embed domestically. Such global regimes' efficacy, therefore, depends on states' capacity to enforce global disciplines. However, nation-states are also hollowed out by neoliberal strictures, undermining practical implementation. Consequently, GHG was failing long before COVID-19, leaving the system dependent on ad hoc interventions by dominant states. With the latter also affected by COVID-19, GHG was left in disarray. Reform proposals should therefore focus less on global institutions and rules and more on building domestic capabilities. [ABSTRACT FROM AUTHOR]