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Background: The relative contributions of genetic and environmental factors versus unavoidable stochastic risk factors to the variation in cancer risk among tissues have become a widely-discussed topic. Some claim that the stochastic effects of DNA replication are mainly responsible, others believe that cancer risk is heavily affected by environmental and hereditary factors. Some of these studies made evidence from the correlation analysis between the lifetime number of stem cell divisions within each tissue and tissue-specific lifetime cancer risk. However, they did not consider the measurement error in the estimated number of stem cell divisions, which is caused by the exposure to different levels of genetic and environmental factors. This will obscure the authentic contribution of environmental or inherited factors.Methods: In this study, we proposed two distinct modeling strategies, which integrate the measurement error model with the prevailing model of carcinogenesis to quantitatively evaluate the contribution of hereditary and environmental factors to cancer development. Then, we applied the proposed strategies to cancer data from 423 registries in 68 different countries (global-wide), 125 registries across China (national-wide of China), and 139 counties in Shandong province (Shandong provincial, China), respectively.Results: The results suggest that the contribution of genetic and environmental factors is at least 92% to the variation in cancer risk among 17 tissues. Moreover, mutations occurring in progenitor cells and differentiated cells are less likely to be accumulated enough for cancer to occur, and the carcinogenesis is more likely to originate from stem cells. Except for medulloblastoma, the contribution of genetic and environmental factors to the risk of other 16 organ-specific cancers are all more than 60%.Conclusions: This work provides additional evidence that genetic and environmental factors play leading roles in cancer development. Therefore, the identification of modifiable environmental and hereditary risk factors for each cancer is highly recommended, and primary prevention in early life-course should be the major focus of cancer prevention. [ABSTRACT FROM AUTHOR]

At present, the proportion of individual financial investors in China is relatively high, the phenomenon of noisy trading is frequent, and the market system risk caused by the polarization of investor sentiment cannot be ignored. Therefore, exploring the polarization of investor sentiment under the influence of sudden financial events is of great practical significance for alleviating abnormal fluctuations in financial markets and building a long-term and stable market mechanism. Based on the B–A scale-free network and J–A model, this paper combines the multi-agent system and the DSSW model to construct a polarization model of investor sentiment. Through simulation tests and empirical tests, it is concluded that the polarization of investor sentiment stems from the herd effect and exclusion effect of investor behavior, and that increasing the coefficient of destabilization ε and reducing the effect interval threshold D 1 and D 2 will aggravate the polarization of investor sentiment in the equilibrium state, while increasing the effect parameter α and β will not affect the polarization of investor sentiment in the equilibrium state, but will accelerate the number of interactions required to reach the equilibrium state. Finally, this paper puts forward targeted policy recommendations to provide references for responding to unexpected financial events. [ABSTRACT FROM AUTHOR]

Background: With the effective prevention and control of COVID‐19 in China, the number of cured cases has increased significantly. Further monitoring of the disease prognosis and effective control of the "relapse" of the epidemic has become the next focus of work. This study analysed the clinical prognosis of discharged COVID‐19 patients by monitoring their SAR‐CoV‐2 nucleic acid status, which provided a theoretical basis for medical institutions to formulate discharge standards and follow‐up management for COVID‐19 patients. Methods: We included 13 discharged COVID‐19 patients who were quarantined for 4 weeks at home. The patient's daily clinical signs were recorded and sputum and faecal specimens were regularly sent for detection of SARS‐CoV‐2 nucleic acid. Results: The time between initial symptoms and meeting discharge criteria was 18 to 44 days with an average of 25 ± 6 days. The faecal samples of two patients still tested positive after meeting the discharge criteria and the sputum samples of four patients returned positive 5 to 14 days after discharge. The rate of the recurring positive test result in samples from the respiratory system was 31% (4/13). Conclusion: Under the present discharge criteria, the high presence of SARS‐CoV‐2 nucleic acid in faecal and respiratory samples of discharged COVID‐19 patients indicates potential infectivity. Therefore, we suggest that faecal virus nucleic acid should be tested as a routine monitoring index for COVID‐19 and a negative result be added to the criteria. Simultaneously, we should strengthen the regular follow‐up of discharged patients with continuous monitoring of the recurrence of viral nucleic acid. Highlights: The positive rate of SARS‐CoV‐2 nucleic acid in faeces and respiratory tract of discharged COVID‐19 patients both were high, which indicate potential infectivity. [ABSTRACT FROM AUTHOR]

Background: Controlling unobserved confounding still remains a great challenge in observational studies, and a series of strict assumptions of the existing methods usually may be violated in practice. Therefore, it is urgent to put forward a novel method.Methods: We are interested in the causal effect of an exposure on the outcome, which is always confounded by unobserved confounding. We show that, the causal effect of an exposure on a continuous or categorical outcome is nonparametrically identified through only two independent or correlated available confounders satisfying a non-linear condition on the exposure. Asymptotic theory and variance estimators are developed for each case. We also discuss an extension for more than two binary confounders.Results: The simulations show better estimation performance by our approach in contrast to the traditional regression approach adjusting for observed confounders. A real application is separately applied to assess the effects of Body Mass Index (BMI) on Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Fasting Blood Glucose (FBG), Triglyceride (TG), Total Cholesterol (TC), High Density Lipoprotein (HDL) and Low Density Lipoprotein (LDL) with individuals in Shandong Province, China. Our results suggest that SBP increased 1.60 (95% CI: 0.99-2.93) mmol/L with per 1- kg/m2 higher BMI and DBP increased 0.37 (95% CI: 0.03-0.76) mmol/L with per 1- kg/m2 higher BMI. Moreover, 1- kg/m2 increase in BMI was causally associated with a 1.61 (95% CI: 0.96-2.97) mmol/L increase in TC, a 1.66 (95% CI: 0.91-55.30) mmol/L increase in TG and a 2.01 (95% CI: 1.09-4.31) mmol/L increase in LDL. However, BMI was not causally associated with HDL with effect value - 0.20 (95% CI: - 1.71-1.44). And, the effect value of FBG per 1- kg/m2 higher BMI was 0.56 (95% CI: - 0.24-2.18).Conclusions: We propose a novel method to control unobserved confounders through double binary confounders satisfying a non-linear condition on the exposure which is easy to access. [ABSTRACT FROM AUTHOR]

Background: This study aims to explore the effect of public hospital managers' risk and gain perception on their attitude towards physician dual practice (PDP).Methods: A cross-sectional study enrolling 1513 managers from public hospitals in the East, Middle and West of China was conducted. Generalized linear mixed models (GLMM) were used to identify the determinants of managers' support for PDP.Results: The rate of managers' support for allowing PDP or implementing PDP with restriction, was 94.3% (95% CI: 0.93, 0.95). The mean score of managers' risk perception was 67.7 ± 14.46, and the mean score of managers' gain perception was 24.0 ± 5.56. After controlling for individual and institutional characteristics, the GLMM presented the score for risk perception increased 1 score and the rate of managers' support for PDP decreased by 5% (OR = 0.95, 95% CI: 0.93, 0.97); while the score for gain perception increased 1 score and the rate of managers' support increased by 18% (OR = 1.18, 95% CI: 1.12, 1.24).Conclusions: Our data demonstrate that the majority of Chinese public hospital managers are in favor of allowing or implementing PDP with restrictions. Although gain perception is comparatively weaker than risk perception, a stronger influence in determining public hospital managers' support for PDP is demonstrated. [ABSTRACT FROM AUTHOR]

Objectives For-profit medical institutions were officially allowed to enter the Chinese medical market since 2000, which raised a lot of debate about positioning of for-profit medical institutions. The objective of this study was to compare non-profit and for-profit medical institutions in terms of market scale, medical quality and service efficiency, and to investigate the market potential for for-profit medical institutions in China. Methods Data were collected from multiple sources, including China Health Statistical Yearbook, National Health Services Survey and China Statistical Yearbook. We assessed the performance of the two types of medical institutions from three aspects: market scale, medical quality and service efficiency. Key findings The result showed that for-profit medical institutions increased obviously in the cities of China. Compared with non-profit medical institutions, for-profit medical institutions have less market scale. However, medical quality and service efficiency of for-profit medical institutions are mostly the same as those of non-profit medical institutions. Besides, for-profit medical institutions have great market potential in top medical service market in the coming future. Conclusion For-profit medical institutions have realized great development in China. A quite large potential market still exists for for-profit medical institutions because of the increasing medical service demand and the improving insurance system in China. However, the long-term development of for-profit medical institutions depends on policy design in establishing and implementing fair systems of medical evaluation, technology accreditation and talent assessment. [ABSTRACT FROM AUTHOR]

Proton pump inhibitors (PPIs) are commonly used for gastric acid-related disorders, but their safety profile and risk stratification for high-burden diseases need further investigation. Analyzing over 2 million participants from five prospective cohorts from the US, the UK, and China, we found that PPI use correlated with increased risk of 15 leading global diseases, such as ischemic heart disease, diabetes, respiratory infections, and chronic kidney disease. These associations showed dose-response relationships and consistency across different PPI types. PPI-related absolute risks increased with baseline risks, with approximately 82% of cases occurring in those at the upper 40% of the baseline predicted risk, and only 11.5% of cases occurring in individuals at the lower 50% of the baseline risk. While statistical association does not necessarily imply causation, its potential safety concerns suggest that personalized use of PPIs through risk stratification might guide appropriate decision-making for patients, clinicians, and the public., (© 2024. The Author(s).)

The biotransformation behavior and toxicity of organophosphate esters (OPEs) in rice and rhizosphere microbiomes were comprehensively studied by hydroponic experiments. OPEs with lower hydrophobicity were liable to be translocated acropetally, and rhizosphere microbiome could reduce the uptake and translocation of OPEs in rice tissues. New metabolites were successfully identified in rice and rhizosphere microbiome, including hydrolysis, hydroxylated, methylated, and glutathione-, glucuronide-, and sulfate-conjugated products. Rhizobacteria and plants could cooperate to form a complex ecological interaction web for OPE elimination. Furthermore, active members of the rhizosphere microbiome during OPE degradation were revealed and the metagenomic analysis indicated that most of these active populations contained OPE-degrading genes. The results of metabolomics analyses for phytotoxicity assessment implied that several key function metabolic pathways of the rice plant were found perturbed by metabolites, such as diphenyl phosphate and monophenyl phosphate. In addition, the involved metabolism mechanisms, such as the carbohydrate metabolism, amino acid metabolism and synthesis, and nucleotide metabolism in Escherichia coli , were significantly altered after exposure to the products mixture of OPEs generated by rhizosphere microbiome. This work for the first time gives a comprehensive understanding of the entire metabolism of OPEs in plants and associated microbiome, and provides support for the ongoing risk assessment of emerging contaminants and, most critically, their transformation products.