Health Systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

Tracking direct and indirect impact on technology and policy of transformative research via ego citation network

Purpose:The disseminating of academic knowledge to nonacademic audiences partly relies on the transition of subsequent citing papers.This study aims to investigate direct and indirect impact on technology and policy originating from transformative research based on ego citation network.Design/methodology/approach:Key Nobel Prize-winning publications(NPs)in fields of gene engineering and astrophysics are regarded as a proxy for transformative research.In this contribution,we introduce a network-structural indicator of citing patents to measure technological impact of a target article and use policy citations as a preliminary tool for policy impact.Findings:The results show that the impact on technology and policy of NPs are higher than that of their subsequent citation generations in gene engineering but not in astrophysics.Research limitations:The selection of Nobel Prizes is not balanced and the database used in this study,Dimensions,suffers from incompleteness and inaccuracy of citation links.Practical implications:Our findings provide useful clues to better understand the characteristics of transformative research in technological and policy impact.Originality/value:This study proposes a new framework to explore the direct and indirect impact on technology and policy originating from transformative research.

Climate change,ambient air pollution,and students'mental health

The impact of global climate change and air pollution on mental health has become a crucial public health issue.Increased public awareness of health,advancements in medical diagnosis and treatment,the way media outlets report environmental changes and the variation in social resources affect psychological responses and adaptation methods to climate change and air pollution.In the context of climate change,extreme weather events seriously disrupt people's living environments,and unstable educational environments lead to an increase in mental health issues for students.Air pollution affects students'mental health by increasing the incidence of diseases while decreasing contact with nature,leading to problems such as anxiety,depression,and decreased cognitive function.We call for joint efforts to reduce pollutant emissions at the source,improve energy structures,strengthen environmental monitoring and governance,increase attention to the mental health issues of students,and help student groups build resilience;by establishing public policies,enhancing social support and adjusting lifestyles and habits,we can help students cope with the constantly changing environment and maintain a good level of mental health.Through these comprehensive measures,we can more effectively address the challenges of global climate change and air pollution and promote the achievement of the United Nations Sustainable Development Goals.

Impact of Plastic Waste on the Human Health in Low-Income Countries: A Systematic Review

Background: Plastic pollution is the accumulation of waste composed of plastic and its derivatives all over the environment. Whether in the form of visible garbage or microparticles, as it slowly degrades, plastic pollution poses significant threats to terrestrial and aquatic habitats and the wildlife that call them home, whether through ingestion, entanglement or exposure to the chemicals contained in the material. Unfortunately, there is a lack of documentation on the impact of plastic waste on human health in low- and middle-income countries (LMICs). Methods: We searched five electronic databases (PubMed, Embase, Global Health, CINAHL and Web of Science) and gray literature, following the preferred reporting elements for systematic reviews and meta-analyses (PRISMA), for the impact of plastic waste on human health in developing countries. We included quantitative and qualitative studies written in English and French. We assessed the quality of the included articles using the Mixed Methods Appraisal tool (MMAT). Results: A total of 3779 articles were initially identified by searching electronic databases. After eliminating duplicates, 3167 articles were reviewed based on title and abstract, and 26 were selected for full-text review. Only three articles were retained. The three articles dealt with practices likely to lead to oral exposure to plastic chemicals in human health, as well as the level of awareness of participants concerning the possible impact of plastic on human health, namely, the use of plastic baby bottles, the use of microwaves to cook food and reheat precooked food, the use of plastic bottles to store water in the refrigerator, water purifier containers with plastic bodies and plastic lunch boxes, the reuse of plastic bags and the inadequacy of treatment facilities. Conclusion: Plastic waste poses different risks to human health at every stage of its life cycle. Hence, strategies must be adopted to raise public awareness of the dangers of plastic waste to their health. Trial registration: The review protocol is registered in the PROSPERO international prospective register of systematic reviews (ID = CRD42023409087).

Opportunities and Challenges of College Mental Health Education from the Perspective of Big Data

This paper explores the opportunities and challenges of college mental health education from the perspective of big data.Firstly,through literature review,the importance of mental health education and the current issues are elucidated.Then,from the perspective of big data,the potential opportunities of big data in college mental health education are analyzed,including data-driven personalized education,real-time monitoring and warning systems,and interdisciplinary research and collaboration.At the same time,the challenges faced by college mental health education under the perspective of big data are also pointed out,such as data privacy and security issues,insufficient data analysis and interpretation capabilities,and inadequate technical facilities and talent support.Lastly,the research content of this paper is summarized,and directions and suggestions for future research are proposed.

Towards Innovative Research Approaches to Investigating the Role of Emotional Variables in Promoting Language Teachers’ and Learners’ Mental Health

The adequacy of language education largely depends on the favorable and unfavorable emotions that teachers and students experience throughout the education process.Simply said,emotional factors play a key role in improving the quality of language teaching and learning.Furthermore,these emotional factors also promote the well-being of language teachers and learners and place them in a suitable mental condition.In view of the favorable impact of emotional factors on the mental health of language teachers and learners,many educational scholars around the world have studied these factors,their background,and their pedagogical consequences.Nonetheless,the majority of previous studies have employed traditional research methods in assessing these variables and their influences on language teachers’and learners’mental health.Because of the complex and dynamic quality of emotional factors,traditional research approaches often fail to evaluate these factors and their dynamic,non-linear connections with teachers’and learners’mental health and well-being.Accordingly,some novel research approaches are required to measure the dynamicity and complexity of emotional factors in language education settings.To address this call,the current state-of-the-art conceptual article seeks to provide new insights for investigating emotional factors and their potential impact on language teachers’and learners’mental states.This study also intends to offer a comprehensive list of emerging methods that take into account the complex and dynamic nature of emotional variables.Finally,the study outlines the potential implications of this review for educational researchers.

Use of Research Evidence in Policy and Decision-Making: Views, Attitudes and Practices of Health Policy Makers in Lusaka Province of Zambia

Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations: There is need for more sensitization and ca-pacity building among the decision and policy makers on the importance of using research evidence in decision and policy making process as incorporation of relevant high-quality research evidence into the health policy making pro-cess is a key strategy for improving health systems.

Biology of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and the humoral immunoresponse:a systematic review of evidence to support global policy-level actions and research

Background Both population-level epidemiological data and individual-level biological data are needed to control the coronavirus disease 2019(COVID-19)pandemic.Population-level data are widely available and efforts to combat COVID-19 have generated proliferate data on the biology and immunoresponse to the causative pathogen,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).However,there remains a paucity of systemized data on this subject.Objective In this review,we attempt to extract systemized data on the biology and immuno-response to SARS-CoV-2 from the most up-to-date peer-reviewed studies.We will focus on the biology of the virus and immunological variations that are key for determining long-term immunity,transmission potential,and prognosis.Data Sources and Methods Peer-reviewed articles were sourced from the PubMed database and by snowballing search of selected publications.Search terms included:“Novel Coronavirus”OR“COVID-19”OR“SARS-CoV-2”OR“2019-nCoV”AND“Immunity”OR“Immune Response”OR“Antibody Response”OR“Immunologic Response”.Studies published from December 31,2019 to December 31,2020 were included.To ensure validity,papers in pre-print were excluded.Results Of 2889 identified papers,36 were included.Evidence from these studies suggests early seroconversion in patients infected with SARS-CoV-2.Antibody titers appear to markedly increase two weeks after infection,followed by a plateau.A more robust immune response is seen in patients with severe COVID-19 as opposed to mild or asymptomatic presentations.This trend persists with regard to the length of antibody maintenance.However,overall immunity appears to wane within two to three months post-infection.Conclusion Findings of this study indicate that immune responses to SARS-CoV-2 follow the general pattern of viral infection.Immunity generated through natural infection appears to be short,suggesting a need for long-term efforts to control the pandemic.Antibody testing will be essential to gauge the epidemic and inform decision-making on effective strategies for treatment and prevention.Further research is needed to illustrate immunoglobulin-specific roles and neutralizing antibody activity.

Report on Cardiovascular Health and Diseases in China 2022:an Updated Summary

In the past 30 years,the accessibility and quality index of medical care have made remarkable progress in China,ranking the first among middle-income countries.Many cardiovascular technologies are at or near the world's leading level,and significant progress has been achieved in China solving the problem of“treatment difficulty”of cardiovascular diseases(CVD).However,due to the prevalence of unhealthy lifestyles among Chinese residents,a huge population with CVD risk factors,accelerated population aging,and other reasons,the incidence and mortality rate of CVD are still increasing,and the turning point of the decline in disease burden has not appeared yet in China.In terms of proportions of disease mortality among urban and rural residents,CVD still ranks the first.In 2020,CVD accounted for 48.00%and 45.86%of the causes of death in rural and urban areas,respectively;two out of every five deaths were due to CVD.It is estimated that the number of current CVD patients in China is around 330 million,including 13 million stroke,11.39 million coronary heart disease,8.9 million heart failure,5 million pulmonary heart disease,4.87 million atrial fibrillation,2.5 million rheumatic heart disease,2 million congenital heart disease,45.3 million peripheral artery disease,and 245 million hypertension cases.China has entered a new stage of transformation from high-speed development to high-quality development,and the prevention and control of CVD in China should also shift from previous emphasis on scale growth to strategies focusing more on strategic and key technological development in order to curb the trend of increasing incidence and mortality rates of CVD.

Exploring the Prevalence and Contributing Factors of Depression among Sickle Cell Anemia Patients in Saudi Arabia’s Jazan Region

Sickle Cell Anemia(SCA)is a prevalent genetic condition in Saudi Arabia,particularly in the Jazan region.The study’s purpose was to assess the prevalence of de-pression among individuals with SCA in this area and to identify the factors associated with this condition.The study involved 391 adult participants,all patients in the hematology center of Prince Mohammed bin Nasser Hospital(PMNH).Data was collected through an anonymous interview questionnaire–the Arabic version of the Patient Health Questionnaire-9(PHQ-9)–between March–May 2022.The questionnaire covered socio-demographic information and variables related to the participant’s SCA history,such as pain levels,frequency of pain,hospitalization duration,and frequency of blood transfusions.These variables underwent Chi-square and One-way ANOVA testing,followed by multivariate regression.The study found a 42%prevalence of depression among the SCA patients.Factors significantly linked with heightened depression levels included being widowed or divorced,experiencing frequent and severe pain,and longer duration of hospital stays.An educational level of at least a bachelor’s degree was also a significant factor.The study reveals a high prevalence of depression among SCA patients in the Jazan region.It underscores the need for policymakers to educate both physicians and patients about the importance of mental health in SCA management.The study also highlights the need for more research into the specific causes and effects of depressive symptoms in SCA patients to inform the creation of effective management plans.

Patient-centric periodontal research:A pioneering application of patient-reported outcome measures

Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient.In this context,patient-centric periodontal research(PCPR)is an approach that considers the patient´s feedback concerning their functional status,experience,clinical outcomes,and accessibility to their treatments.It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief,cultural background,and social and economic factors.However,literature has shown that the incorporation of“patient-centric outcome”components considerably enhances the validity and applicability of research findings.Variations in the results of different studies might be due to the use of different and non-standardized assessment tools.To overcome this problem,this editorial enlists various reliable tools available in the literature.In conclusion,we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy.

The Defects and Future Research Direction of the Auditof the Policy Implementation Effect 2 China

近年来,政策执行效果审计在中国逐渐引起了关注.论文首先介绍了政策执行效果审计的内涵和研究的意义,在此基础上简要阐述了政策执行效果审计的发展现状,并指出了其缺陷,最后提出了未来的研究应重点关注建立政策执行效果审计理论框架体系、完善政策执行效果审计评价指标体系、探索对政策本身的评价以及将政策执行效果审计与新兴互联网工程及信息技术结合起来等几个方面.

Lessons for Epidemic Emergency Policy: A Scoping Review of Ebola and COVID-19 Pandemics in Africa

Ebola Virus Disease (EVD) outbreaks in Central and West Africa 2013-2020 were the deadliest, most intense and most widely spread. On top of this, the novel Corona Virus Disease 2019 (COVID-19) has given us all a new experience. It is imperative to draw lessons to prepare for future disease outbreaks. This was a scoping review, a method that allows the assessment of emerging evidence. The objectives of the review were to 1) describe the manifestation of the epidemics;2) elaborate on the social and economic effects;3) characterize the responses;and 4) draw lessons. The findings show that Ebola risk is permanent and even increasing. The next COVID-19 epidemic is around the corner. For Africa, the situation has been made worse by poverty and fragility of institutions. Africa’s incapacity to manufacture its own vaccines, medicines, diagnostics and protective wear has been detrimental in the management of epidemics. The need for personal and home hygiene has been emphatically brought to attention. The trust in the government and other agencies is the cornerstone in the management of emergencies. The use of armed soldiers should be discouraged, for they scare people from seeking help. It is much better to use trusted local leaders instead of strangers during pandemic emergencies. Understanding the local politics without getting involved in them is essential. It is critical to understand community and individual perception of the risk of the disease in question. Often neglected is the psycho-social aspect, which should be planned early. The science of response measures ought to be explained simply and transparently, as part of risk communication. Emergency funds should be raised, and made easy and quick to disburse. Mechanisms of sharing health technologies and knowledge need to be devised under the UN. People centeredness ought to guide the conduct of trans-border movements and all transactions during pandemics.

Comments by opponents on the British Medical Association’s guidance on non-therapeutic male circumcision of children seem one-sided and may undermine public health

The British Medical Association(BMA)guidance on non-therapeutic circumcision(NTMC)of male children is limited to ethical,legal and religious issues.Here we evaluate criticisms of the BMA’s guidance by Lempert et al.While their arguments promoting autonomy and consent might be superficially appealing,their claim of high procedural risks and negligible benefits seem one-sided and contrast with high quality evidence of low risk and lifelong benefits.Extensive literature reviews by the American Academy of Pediatrics and the United States Centers for Disease Control and Prevention in developing evidence-based policies,as well as risk-benefit analyses,have found that the medical benefits of infant NTMC greatly exceed the risks,and there is no reduction in sexual function and pleasure.The BMA’s failure to consider the medical benefits of early childhood NTMC may partly explain why this prophylactic intervention is discouraged in the United Kingdom.The consequence is higher prevalence of preventable infections,adverse medical conditions,suffering and net costs to the UK’s National Health Service for treatment of these.Many of the issues and contradictions in the BMA guidance identified by Lempert et al stem from the BMA’s guidance not being sufficiently evidence-based.Indeed,that document called for a review by others of the medical issues surrounding NTMC.While societal factors apply,ultimately,NTMC can only be justified rationally on scientific,evidence-based grounds.Parents are entitled to an accurate presentation of the medical evidence so that they can make an informed decision.Their decision either for or against NTMC should then be respected.

Study on the demand for public health professional after the COVID-19 epidemic in Zhejiang Province, China: A survey based on human-machine collaboration

To understand the needs of public health institutions in Zhejiang Province,China for public health personnel,and provide basis for training public health personnel.Methods:512 public health institutions in Zhejiang Province were randomly selected from different levels and regions,and the number of ublic health professional and the demand for professional ability were investigated by questionnaire.Results:The preventive medicine personnel in public health institutions in Zhejiang Province are insufficient;There is a certain disjunction or dislocation between the abilities and needs of public health professional;The way of continuing education for public health professional is single and the opportunities are few.Conclusion:Zhejiang Province should appropriately expand the enrollment of preventive medicine majors,especially high-level preventive medicine talents,deepen the education and teaching reform of preventive medicine majors,and strengthen the continuing education and training of public health professional to meet the needs of public health services after the COVID-19 epidemic.

Perceptions of climate change in China:The research and policy connection

Global climate change has evolved from a scientific problem into an economic and political problem oI worlOwloe rater- est. National perspectives play a crucial role in addressing climate change. Mutual understanding of perspectives is nec- essary to result in rational policies and a consensus among stakeholders with divergent interests. Conceptual frameworks for understanding the problem of climate change in China, the largest developing country and the largest greenhouse gas emitter, are of great significance to national and international efforts to address the problems of climate change. Chinese perceptions of climate change as a sustainable development problem have recently been in tension with an emerging Western perspective that frames climate change as a security issue. This paper explores Chinese perceptions of climate change as expressed in recent governmental policy statements, public opinion surveys, and academic scholarship with a focus on publications in Chinese-language journals, often unfamiliar in the West. It looks at the relationship between Chinese research and policy and finds that the Chinese policy frame of climate change as a sustainable development problem draws from the body of domestic research and is reflective of the perspectives and multidisciplinary approach of Chinese researchers in areas of climate change.

Performance of the health system in China and Asia as measured by responsiveness

Objectives: To examine differences in health system responsiveness across different sectors in China and to compare to other Asian countries. Methods: The World Health Survey was implemented in a nationally representative sample in China and 10 additional Asian countries from 2002-2003. Face-to-face interviews were conducted to gather health care utilization and health systems responsiveness data. Results: Overall health system responsiveness in China was better for the inpatient than the outpatient health system. Differences were seen by domain, with prompt attention and respectful treatment performing better than the other domains. Differences in responsiveness were seen by socio- demographic characteristics, with women and younger respondents rating inpatient systems, whereas men and higher educated respondents rated outpatient systems, more responsive. Conclusions: As populations age, health care systems will come under more pressures – responsiveness can be used by governments to guide policy and system improvement efforts when resources are limited. In China, reforms might prioritize outpatient system responsiveness.

Incidence and in-hospital mortality of acute aortic dissection in China： analysis of China Health Insurance Research （CHIRA） Data 2011

ObjectiveAcute 大动脉的解剖(AAD ) 是有高早的死亡率的一个灾难的事件，但是迄今为止，在大陆中国的 AAD 的发生上的数据都不是可得到的。这研究试图在中国估计 AAD 的发生并且描绘临床的侧面，这脉管的 event.MethodsWe 的管理和在里面医院结果使用了中国健康保险研究数据( CHIRA 数据) 2011 它从 25 个城市在到 3,335,000 个随机取样的受益人( 1,718,500 个男人和 1,616,500 个女人)的2011年12月31日的1月一日 2011 的经期期间包括所有住院病人医院记录( 300,886 )并且在大陆中国的不同经济地理的区域的县。有尖锐大动脉的解剖的病人根据疾病 10 I71.0 的 th 修订(ICD-10 ) 。AAD 的估计的发生用方程被计算：估计的发生 = 2.0 ×；（ 40%×；医院承认率)+60%×；医院承认 rate.ResultsThe 医院承认率是 2.0/100,000 (65/3,325,000， 95% CI：1.2-2.8 ) 。AAD 的估计的年度发生是 2.8/100,000 (95% CI：1.9-3.6 ) 并且比在女性在男性是更高的(3.7 对 1.5， P <；0.001 ) 。吝啬的年龄是 58.9 ±；13.4 年。在 23 ± 的吝啬的医院停留期间；6 天，全面在里面医院死亡是 13.9%(9/65 ).ConclusionsOur 学习在中国的大陆显示出相对更低然而并非可以忽略的发生和 AAD 的在里面医院死亡。有用汉语的 AAD 的病人的吝啬的年龄比从西方国家由研究报导了的年轻，当到女发生比率的男性类似于另外的研究报导的那些时。

Looking ahead to significant improvements in mining safety and health through innovative research and effective diffusion into the industry

Mining safety and health improvements over the past decades are remarkable by many metrics, and yet the expectation of society, and the goal of the mining industry, is zero harm. If we examine the underlying enablers for the significant gains that have been achieved, the key role that research to help understand the causes of problems and to develop lasting solutions is clear. Many of the remaining challenges have been resistant to solutions by various approaches. Some, such as fatalities and injuries from ground control or powered haulage are prominent year after year. Different approaches are indicated and new solutions will be required if we are to achieve a goal of zero harm. These will originate with research, but into which topics, and what are some of these different approaches? This paper examines the current state of mine safety in the United States and highlights areas of significant opportunity for research that will lead to solutions. The likely direction of research that will enable realization of the ‘‘zero harm'' goal is described in terms of evolutionary and revolutionary approaches. Both are important, but the author's view is that some of the largest gains will be made with trans-disciplinary approaches that break from the past. Topical areas of research are suggested and several research questions are given to illustrate the direction of future research in mining safety and health.

Health-related quality of life in patients that have undergone liver resection:A systematic review and meta-analysis

BACKGROUND Mortality after hepatectomy has decreased,and the quality of various surgical approaches to hepatectomy have been evaluated.Various assessments of quality of life(QOL)after hepatectomy have been developed and investigated in different clinical settings.AIM To conduct a systematic review and meta-analysis to examine two clinical topics:Laparoscopic hepatectomy vs open hepatectomy,and preoperative QOL status vs postoperative QOL status.METHODS A systematic literature search was performed using PubMed and MEDLINE,including the Cochrane Library Central.The following inclusion criteria were set for inclusion in this meta-analysis:(1)Studies comparing preoperative QOL and postoperative QOL;and(2)Studies comparing QOL between laparoscopic hepatectomy and open hepatectomy.RESULTS A total of 8 articles were included in this meta-analysis.QOL was better after laparoscopic hepatectomy than after open hepatectomy.CONCLUSION The outcomes of evaluations of QOL after hepatectomy can depend on the type of questionnaire used,the timing of the assessment,and the etiology of the hepatic disease.