Reporting Children’s Development below the Test Floor: Looking Back and Forth to Describe Individual Strengths and Needs

The test floor effects seen in standardised tests lead to a standardised score of 1 or less with a flat profile that hides a child’s individual strengths and needs. The Griffiths III community of practitioners requested advice on the reporting of children’s development below the floor of the test, so that individual strengths and needs can be described. This paper reports the third phase of research following an earlier Scoping Review and a wider literature review. To confirm quality control, Phase 3 was conducted in a retrospective manner using the same methodology as the earlier phases but in a reverse direction. Peer reviewer comments and key elements from the Scoping Review and keywords from the publications were tabulated. Data analysis included a change of perspective to that of the child and their individual rights with respect to the literature themes already described in Phase 2. These confirmed that there is little specific guidance in the literature, but that computational advances for homogeneous populations and especially disaggregated data offer some solutions. A greater balance between broad biopsychosocial models and standardised models of assessment should be sought by practitioners together with the use of disaggregated data to highlight issues that pertain to individual subsets of results. This will ensure that the child’s right for their individual strengths and needs to be described together with a plan for management, may be met.

Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.

New development in risk assessment of genotoxic carcinogens in foods

The no-observed-effect level (NOEL) in a study of carcinogenicity for compounds that are both genotoxic and carcinogenic represents the limit of detection in that bioassay, rather than an estimate of a possible threshold. Therefore, for those genotoxic and carcinogenic contaminants (e.g. acrylamides, PAHs, etc.) in foods it is not possible to develop health-based guidance values (e.g. ADI or PTWI) using the traditional NOEL and safety/uncertainty factors.

Restricting factors of the development of SEA in China

＂Environmental Impact Assessment Law of P. R. China＂ was promulgated on Oct. 28^th, 2002 and has been put into effect on Sep 1^th, 2003. This paper puts forward some important factors which restrict the development of Strategic Environmental Assessment according to the preliminary practices of SEA in China. These restricting factors are： （1） potential resistance from some departments; （2） poor cooperation between different departments; （3） limited availability of information resources （4） lack of well-developed SEA methods; （5） difficulties in public participation. The primary thought to solve these problems were proposed at policy and technique level.

Balance,Rationality and Developmental Perspective Are the Key to Assess Sino-African Ties

A senior fellow at Brookings recently published an article titles as'Setting the Record Straight on China’s Engagement in Africa',pointing out the actual share of Chinese investment in Africa as well as its impact on the continent.David Dollar,the research fellow,explained that Chinese investment represents less than 5%of the total volume of foreign investment in Africa,defying accusations that China is buying up the continent with an overwhelming

Quantifying the impacts of COVID-19 on Sustainable Development Goals using machine learning models

The COvID-19 pandemic has posed severe threats to global sustainable development.However,a comprehensive quantitative assessment of the impacts of COVID-19 on Sustainable Development Goals(SDGs)is still lacking.This research quantified the post-COVID-19 SDG progress from 2020 to 2024 using projected GDP growth and population and machine learning models including support vector machine,random forest,and extreme gradient boosting.The results show that the overall SDG performance declined by 7.7%in 2020 at the global scale,with 12 socioeconomic SDG performance decreasing by 3.0%-22.3%and 4 environmental SDG performance increasing by 1.6%-9.2%.By 2024,the progress of 12 SDGs will lag behind for one to eight years compared to their pre-COVID-19 trajectories,while extra time will be gained for 4 environment-related SDGs.Furthermore,the pandemic will cause more impacts on countries in emerging markets and developing economies than those on advanced economies,and the latter will recover more quickly to be closer to their pre-covID-19 trajectories by 2024.Post-COVID-19 economic recovery should emphasize in areas that can help decouple economic growth from negative environmental impacts.The results can help government and non-state stakeholders identify critical areas for targeted policy to resume and speed up the progress to achieve SDGs by 2030.

Tacrolimus and mycophenolate mofetil as second-line treatment in autoimmune hepatitis:Is the evidence of sufficient quality to develop recommendations?

BACKGROUND The standard management of autoimmune hepatitis(AIH)is based on corticosteroids,alone or in combination with azathioprine.Second-line treatments are needed for patients who have refractory disease.However,high-quality data on the alternative management of AIH are scarce.AIM To evaluate the efficacy and safety of tacrolimus and mycophenolate mofetil(MMF)and the quality of evidence by using the Grading of Recommendations Assessment,Development and Evaluation approach(GRADE).METHODS A systematic review and meta-analysis of the available data were performed.We calculated pooled event rates for three outcome measures:Biochemical remission,adverse events,and mortality,with their corresponding 95%confidence intervals(CI).RESULTS The pooled biochemical remission rate was 68.9%(95%CI:60.4-76.2)for tacrolimus,and 59.6%(95%CI:54.8-64.2)for MMF,and rates of adverse events were 25.5%(95%CI:12.4-45.3)for tacrolimus and 24.1%(95%CI:15.4-35.7)for MMF.The pooled mortality rate was estimated at 11.5%(95%CI:7.1-18.1)for tacrolimus and 9.01%(95%CI:6.2-12.8)for MMF.Pooled biochemical remission rates for tacrolimus and MMF in patients with intolerance to standard therapy were 56.6%(CI:43.4-56.6)vs 73.5%(CI:58.1-84.7),and among non-responders were 59.1%(CI:48.7-68.8)vs 40.8%(CI:32.3-50.0),respectively.Moreover,the overall quality assessments using GRADE proved to be very low for all our outcomes in both treatment groups.CONCLUSION Tacrolimus and MMF are in practice considered effective for patients with AIH who are non-responders or intolerant to first-line treatment,but we found no high-quality evidence to support this statement.

Chinese medicine formulas for nonalcoholic fatty liver disease: Overview of systematic reviews

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)affects more than one-quarter of the global population.Due to the lack of approved chemical agents,many patients seek treatment from traditional Chinese medicine(TCM)formulas.A variety of systematic reviews have been published regarding the effectiveness and safety of TCM formulas for NAFLD.AIM To critically appraise available systematic reviews and sort out the high-quality evidence on TCM formulas for the management of NAFLD.METHODS Seven databases were systematically searched from their inception to 28 February 2020.The search terms included“non-alcoholic fatty liver disease,”“Chinese medicines,”“systematic review,”and their synonyms.Systematic reviews involving TCM formulas alone or in combination with conventional medications were included.The methodological quality and risk of bias of eligible systematic reviews were evaluated by using A Measure Tool to Assess Systematic Reviews 2(AMSTAR 2)and Risk of Bias in Systematic Review(ROBIS).The quality of outcomes was assessed by the Grading of Recommendations Assessment,Development and Evaluation(GRADE)system.RESULTS Seven systematic reviews were ultimately included.All systematic reviews were conducted based on randomized controlled trials and published in the last decade.According to the AMSTAR 2 tool,one systematic review was judged as having a moderate confidence level,whereas the other studies were rated as having a low or extremely low level of confidence.The ROBIS tool showed that the included systematic reviews all had a high risk of bias due to insufficient consideration of identified concerns.According to the GRADE system,only two outcomes were determined as high quality;namely,TCM formulas with the HuoXueHuaYu principle were better than conventional medications in ultrasound improvement,and TCM formulas were superior to antioxidants in alanine aminotransferase normalization.Other outcomes were downgraded to lower levels,mainly because of heterogeneity among studies,not meeting optimal information sample size,and inclusion of excessive numbers of small sample studies.Nevertheless,the evidence quality of extracted outcomes should be further downgraded when applying to clinical practice due to indirectness.CONCLUSION The quality of available systematic reviews was not satisfactory.Researchers should avoid repeatedly conducting systematic reviews in this area and focus on designing rigorous randomized controlled trials to support TCM formula applications.

A Protocol for Developing a Clinical Practice Guideline for Therapeutic Drug Monitoring of Vancomycin

This study aimed to develop a guideline for therapeutic drug monitoring（TDM） of vancomycin. We adopted the new guideline definition from the Institute of Medicine（IOM）, adhered closely to the six domains of the Appraisal of Guidelines for Research ＆ Evaluation Ⅱ（AGREE Ⅱ）, and made recommendations based on systematic reviews. We established a Guideline Steering Group and a Guideline Development Group, formulated 12 questions in the form of Population, Intervention, Comparison, Outcome（PICO） and completed a literature search. As far as we know, we will develop the first evidenced-based guideline for vancomycin TDM under the framework of the Grade of Recommendations Assessment, Development and Evaluation（GRADE）.

Green Barriers： Obstacle or Stimulation ？

Most viewpoints in China consider green barrier is one kind of non-tariff barriers imposed by developed countries and is unfair to developing countries. Different from these, this paper points out that green barriers, evolving from the background of sustainable development theory and the principle of environment protection, have positive effect on ideology, international institutional arrangement and innovation stimulation. Demonstrating the rationality of green barriers, the paper puts forward that green barriers should be regarded as the stimulation for technology innovation and industrial restructure rather than obstacles. The best way to surmount the green barriers for Chinese government and enterprises is to implement circular economy and clean production so as to achieve the harmony of trade, environment and economic development.

AN ASSESSMENT FOR SUSTAINABLE DEVELOPING CAPABILITY OF INTEGRATED AGRICULTURAL REGIONALIZATION IN CHINA

Based on the provincial units evaluation, this paper makes an assessment forsustainable developing capability of the integrated agricultural regionalization in China. At first,an index system of agricultural sustainable development in China is built up, which includes 5supporting subsystems of agricultural resources, agricultural development, environment andecosystem, rural society, sciences-education and management. We selected 95 factors on provinciallevel as basic indexes. Second, a relative assets/debt assessing method is used to gain relative netassets values (relative superiority) of every provincial unit, which are as supporting data forassessment. We also overlaid the Administrative Divisions Map of China and the Map of IntegratedAgricultural Regionalization of China by Geography Information System (GIS) to gain the area unitsof assessment. Third, according to the relative coherence principle of regionalizaticn, we transformadministration units to natural units through homogenizing all provincial relative net assetsvalues in every agricultural assessing unit. After making order and grade, we complete thesustainable developing capability assessment to integrated agricultural regionalization in China.The assessing outcome shows that the total sustainable agricultural developing capability of Chinais not high. Only about 1 /3 in number or in area has reached the level of agricultural sustainabledevelopment. The relative net assets values exists a reducing trend from East China to West China.It needs a long period and great efforts to realize sustainable agricultural development over allChina. Finally, there is a discussion to the study method.

The sustainable development of innovative cities in China： Comprehensive assessment and future configuration

Innovative cities not only constitute an important basis for innovation activities, but also play a strategically critical role in constructing an innovative country, producing new forms of urban development, and fostering urban sustainable development. Currently, China is marching toward the goal of establishing an innovative country by 2020, but in the start-up phase of this process of innovative city construction, the fundamental transition from factor-driven development to innovation-driven development is not being realized. As a result,a wide gap currently exists between China＇s innovative cities and the advanced innovative cities in developed countries. This paper argues that this necessary transition is being constrained by a series of bottlenecks in investment, income, techniques, contributions, and talents. The article takes 287 prefecture-level cities as its object of comprehensive assessment, developing a comprehensive assessment system for innovative cities and devising innovative monitoring system software in order to evaluate the current situation in China＇s innovative city construction. The analysis addresses four key aspects – namely,independent innovation, industrial innovation, living environmental innovation, and institutional innovation – as well as the spatial heterogeneity of the innovative city construction process. The results demonstrate that the level of innovation in Chinese cities is low, and the paper warns that building an innovation-oriented country will, as a consequence,be difficult. Some 87.8% of the cities studied maintained comprehensive levels of innovation that were lower than the national average. The level of comprehensive innovation in a city was found to have close and positive correlation with economic development. The level of the eastern region of China was, in particular, found to be significantly higher than that of the central and western regions. The levels of urban independent innovation, industrial innovation,environmental innovation, and institutional innovation showed consistent spatial heterogeneity, as did the comprehensive level of innovation in cities. In the future, the authors suggest, China should speed up the construction process in accordance with the basic principles of ＂independent innovation, breakthroughs in key fields, market-oriented, regional interaction, talent-supported,＂ with the purpose of building up Beijing, Shenzhen, Shanghai,and Guangzhou as global innovation centers; and Nanjing, Suzhou, Xiamen, Hangzhou, Wuxi,Xi＇an, Wuhan, Shenyang, Dalian, Tianjin, Changsha, Qingdao, Chengdu, Changchun, Hefei,and Chongqing as national innovation centers, by 2020. Through this process, China will finally build a national urban innovation network that includes 4 global innovative cities, 16 national innovative cities, 30 regional innovative cities, 55 local innovative cities, and 182innovation-driven development cities, thereby contributing to the establishment of an innovative country by 2020.

Life cycle assessment of low impact development technologies combined with conventional centralized water systems for the City of Atlanta, Georgia

Low-impact development （LID） technologies, such as bioretention areas, rooftop rainwater harvesting, a_nd xeris_caping can co_ntrol stormwater runoff, supply non-potable water, and landscape open space.TillS study examines a hybrid system （HS） that combines LID technologies with a centralized water system to lessen the burden on a conventional system （CS）. CS is defined as the stormwater collection and water supply infrastructure, and the conventional landscaping choices in the City of Atlanta. The study scope is limited to five single-family residential zones （SFZs）, classified R-1 through R-5, and four multi-family residential zones （MFZs）, classified RG-2 through RG-5. Population density increases from 0.4 （R-1） to 62.2 （RG-5） persons per 1,000 m2. We performed a life cycle assessment （LCA） comparison of CS and HS using TRACI 2.1 to simulate impacts on the ecosystem, human health, and natural resources. We quantified the impact of freshwater consumption using the freshwater ecosystem impact （FEI） indicator. Test results indicate that HS has a higher LCA single score than CS in zones with a low population density; however, the difference becomes negligible as population density increases. Incorporating LID in SFZs and MFZs can reduce potable water use by an average of 50%. and 25%,respectively.; however, water savings are negligible in zones with high population density （i.e., RG-5） due to the diminished surface area per capitaavailable for LID technoogies. The results demonstrate that LID technologies effectively reduce outdoor water demand and therefore would be a good choice to decrease the water consumption impact in the City of Atlanta.