Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns i...Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.展开更多
Rivers are important habitats for wintering waterbirds.However,they are easily influenced by natural and human activities.An important approach for waterbirds to adapt to habitats is adjusting the activity time and en...Rivers are important habitats for wintering waterbirds.However,they are easily influenced by natural and human activities.An important approach for waterbirds to adapt to habitats is adjusting the activity time and energy expenditure allocation of diurnal behavior.The compensatory foraging hypothesis predicts that increased energy expenditure leads to longer foraging time,which in turn increases food intake and helps maintain a constant energy balance.However,it is unclear whether human-disturbed habitats result in increased energy expenditure related to safety or foraging.In this study,the scan sample method was used to observe the diurnal behavior of the wintering Spot-billed Duck(Anas poecilorhyncha) in two rivers in the Xin’an River Basin from October 2021 to March 2022.The allocation of time and energy expenditure for activity in both normal and disturbed environments was calculated.The results showed that foraging accounted for the highest percentage of time and energy expenditure.Additionally,foraging decreased in the disturbed environment than that in the normal environment.Resting behavior showed the opposite trend,while other behaviors were similar in both environments.The total diurnal energy expenditure of ducks in the disturbed environment was greater than that in the normal environment,with decreased foraging and resting time percentage and increased behaviors related to immediate safety(swimming and alert) and comfort.These results oppose the compensatory foraging hypothesis in favor of increased security.The optimal diurnal energy expenditure model included river width and water depth,which had a positive relationship;an increase in either of these two factors resulted in an increase in energy expenditure.This study provides a better understanding of energy allocation strategies underlying the superficial time allocation of wintering waterbirds according to environmental conditions.Exploring these changes can help understand the maximum fitness of wintering waterbirds in response to nature and human influences.展开更多
A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in weste...A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in western China,identifies the three pillars(absorptive capacity,adaptive capacity,and transformative capacity)contribution to resilience,and then establishes the estimated Resilience Capacity Index(RCI)linked with food security and dietary diversity supported by the multiple indicator multiple cause(MIMIC)model.Results show that,despite geographical heterogeneity,the RCI consistently increased from 2015 to 2021.Households with a higher RCI inheriting better capacity to deal with risk and shocks are significantly and positively correlated with increasing food expenditure and diversifying food choices.It can be because resilient households will allocate more money to food expenditure instead of saving for livelihood uncertainty.Thus,policymakers can provide more incentives for rural households to adopt more dynamic and effective risk management strategies.This,in turn,could yield positive spillover effects by preventing human capital loss associated with dietary-related chronic diseases and mortality.展开更多
Green technology innovation is an important driving force and source to promote my country’s high-quality development,and it is the core path to achieve sustainable development.This paper uses my country’s provincia...Green technology innovation is an important driving force and source to promote my country’s high-quality development,and it is the core path to achieve sustainable development.This paper uses my country’s provincial panel data from 2016 to 2019 to study the impact mechanism of R&D investment on green technology innovation,and introduces the level of digitization,using the panel threshold model to discuss its role in the impact mechanism of R&D investment on green technology innovation.The study found that when the level of digitalization in a region is low,increasing R&D investment does not necessarily improve the ability of green technology innovation;when the level of digitalization is relatively high,R&D investment has a positive role in promoting green technology innovation.Therefore,it is necessary to improve policies to encourage enterprises to increase investment in research and development;at the same time,it is necessary to promote the coordinated development of digital foundation,digital investment,digital literacy,digital economy and digital application,and promote the deep integration of digitalization and green technology innovation.展开更多
Climate change is an alarming global challenge, particularly affecting the least developed countries (LDCs) including Liberia. These countries, located in regions prone to unpredictable temperature and precipitation c...Climate change is an alarming global challenge, particularly affecting the least developed countries (LDCs) including Liberia. These countries, located in regions prone to unpredictable temperature and precipitation changes, are facing significant challenges, particularly in climate-sensitive sectors such as mining and agriculture. LDCs need more resilience to adverse climate shocks but have limited capacity for adaptation compared to other developed and developing nations. This paper examines Liberia’s susceptibility to climate change as a least developed country, focusing on its exposure, sensitivity, and adaptive capacity. It provides an overview of LDCs and outlines the global distribution of carbon dioxide emissions. The paper also evaluates specific challenges that amplify Liberia’s vulnerability and constrain sustainable adaptation, providing insight into climate change’s existing and potential effects. The paper emphasizes the urgency of addressing climate impacts on Liberia and calls for concerted local and international efforts for effective and sustainable mitigation efforts. It provides recommendations for policy decisions and calls for further research on climate change mitigation and adaptation.展开更多
Objective To study the threshold effect of export trade on internal and external R&D investment in China’s pharmaceutical industry,and to provide reference for some pharmaceutical enterprises to improve the inves...Objective To study the threshold effect of export trade on internal and external R&D investment in China’s pharmaceutical industry,and to provide reference for some pharmaceutical enterprises to improve the investment.Methods The panel data of pharmaceutical industry in 25 provinces and cities in China from 2009 to 2019 were selected to conduct empirical analysis by establishing a threshold regression model,and a better export trade interval was obtained.Results and Conclusion There is a threshold value for the effect of new product export on both internal and external R&D expenditures,and the threshold values are 845.2788 million yuan and 318.4198 million yuan,respectively.There is a single threshold effect of export trade on both internal and external R&D investment in China’s pharmaceutical industry,and the effect of export trade on internal and external R&D investment changes from negative to positive as the export trade develops from low to high.展开更多
New research and development(R&D)institutions are an important part of the national innovation system,playing an important role in promoting the transformation of scientific and technological achievements.In recen...New research and development(R&D)institutions are an important part of the national innovation system,playing an important role in promoting the transformation of scientific and technological achievements.In recent years,new R&D institutions have gradually become the driving force of innovation-driven development in China.Taking new R&D institutions in Zhejiang Province as the research object,this paper studies the internal talent training path and performance evaluation mechanism of new R&D institutions in Zhejiang Province by using the literature research method,comparison method,case verification method,and other methods.The investigation results show that there are problems such as lack of material and spiritual support and neglect of the absorption of local talents in the internal talent training,and there are problems such as unclear standards,insufficient data,and opaque processes in the performance evaluation mechanism,which greatly affect the establishment and improvement of the performance evaluation mechanism.Given the above problems,this paper puts forward a forward-looking,oriented,flexible,and compatible talent training path and performance evaluation mechanism,hoping to optimize the effective internal talent training path of new R&D institutions,improve the evaluation performance,and promote healthy development of new R&D institutions in Zhejiang Province.展开更多
Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through anal...Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through analyzing the impact of the population aging,the income and accumulated balance of the medical insurance fund,and other related factors on the expenditure of the medical insurance fund,development status of the medical insurance fund for urban employees in China since 2003 was obtained.Stata 16.0 was used to perform multiple linear regression analysis on related factors to determine the correlation between population aging and the change in medical insurance expenditures.Results and Conclusion The factors that have a greater impact on the expenditure of the medical insurance fund are the amount of income from the medical insurance,followed by the number of people over the age of 65 in China and the urban retired employees participating in medical insurance.We should focus on the sustainable development of the urban employee medical insurance fund to deal with the threat of aging.展开更多
Background:The Compendium of Physical Activities was published in 1993 to improve the comparability of energy expenditure values assigned to self-reported physical activity(PA)across studies.The original version was u...Background:The Compendium of Physical Activities was published in 1993 to improve the comparability of energy expenditure values assigned to self-reported physical activity(PA)across studies.The original version was updated in 2000,and again in 2011,and has been widely used to support PA research,practice,and public health guidelines.Methods:This 2024 update was tailored for adults 19-59 years of age by removing data from those≥60 years.Using a systematic review and supplementary searches,we identified new activities and their associated measured metabolic equivalent(MET)values(using indirect calorimetry)published since 2011.We replaced estimated METs with measured values when possible.Results:We screened 32,173 abstracts and 1507 full-text papers and extracted 2356 PA energy expenditure values from 701 papers.We added303 new PAs and adjusted 176 existing MET values and descriptions to reflect the addition of new data and removal of METs for older adults.We added a Major Heading(Video Games).The 2024 Adult Compendium includes 1114 PAs(912 with measured and 202 with estimated values)across 22 Major Headings.Conclusion:This comprehensive update and refinement led to the creation of The 2024 Adult Compendium,which has utility across research,public health,education,and healthcare domains,as well as in the development of consumer health technologies.The new website with the complete lists of PAs and supporting resources is available at https://pacompendium.com.展开更多
Purpose:To describe the development of a Compendium for estimating the energy costs of activities in adults>60 years(OA Compendium).Methods:Physical activities(PAs)and their metabolic equivalent of task(MET)values ...Purpose:To describe the development of a Compendium for estimating the energy costs of activities in adults>60 years(OA Compendium).Methods:Physical activities(PAs)and their metabolic equivalent of task(MET)values were obtained from a systematic search of studies published in 4 sport and exercise databases(PubMed,Embase,SPORTDiscus(EBSCOhost),and Scopus)and a review of articles included in the 2011 Adult Compendium that measured PA in older adults.MET values were computed as the oxygen cost(VO_(2),mL/kg/min)during PA divided by 2.7 m L/kg/min(MET_(60+))to account for the lower resting metabolic rate in older adults.Results:We identified 68 articles and extracted energy expenditure data on 427 PAs.From these,we derived 99 unique Specific Activity codes with corresponding MET_(60+)values for older adults.We developed a website to present the OA Compendium MET_(60+)values:https://pacompendium.com.Conclusion:The OA Compendium uses data collected from adults>60 years for more accurate estimation of the energy cost of PAs in older adults.It is an accessible resource that will allow researchers,educators,and practitioners to find MET_(60+)values for older adults for use in PA research and practice.展开更多
Objective: Cervical squamous intraepithelial lesion(SIL) and cervical cancer are major threats to females' health and life in China, and we aimed to estimate the economic burden associated with their diagnosis and...Objective: Cervical squamous intraepithelial lesion(SIL) and cervical cancer are major threats to females' health and life in China, and we aimed to estimate the economic burden associated with their diagnosis and treatment.Methods: A nationwide multicenter, cross-sectional, hospital-based survey was conducted in 26 qualified hospitals across seven administrative regions of China. We investigated females who had been pathologically diagnosed with SIL and cervical cancer, and included five disease courses(“diagnosis”, “initial treatment”,“chemoradiotherapy”, “follow-up” and “recurrence/progression/metastasis”) to estimate the total costs. The median and interquartile range(IQR) of total costs(including direct medical, direct non-medical, and indirect costs), reimbursement rate by medical insurance, and catastrophic health expenditures in every clinical stage were calculated.Results: A total of 3,471 patients in different clinical stages were analyzed, including low-grade SIL(LSIL)(n=549), high-grade SIL(HSIL)(n=803), cervical cancer stage ⅠA(n=226), ⅠB(n=610), ⅡA(n=487), ⅡB(n=282), Ⅲ(n=452) and Ⅳ(n=62). In urban areas, the estimated total costs of LSIL and HSIL were $1,637.7(IQR:$956.4-$2,669.2) and $2,467.1(IQR:$1,579.1-$3,762.3), while in rural areas the costs were $459.0(IQR:$167.7-$1,330.3) and $1,230.5(IQR:$560.6-$2,104.5), respectively. For patients with cervical cancer stage ⅠA,ⅠB, ⅡA, ⅡB, and Ⅲ-Ⅳ, the total costs were $15,034.9(IQR:$11,083.4-$21,632.4), $19,438.6(IQR:$14,060.0-$26,505.9), $22,968.8(IQR:$16,068.8-$34,615.9), $26,936.0(IQR:$18,176.6-$41,386.0) and $27,332.6(IQR:$17,538.7-$44,897.0), respectively. Medical insurance covered 43%-55% of direct medical costs for cervical cancer patients, while the coverage for SIL patients was 19%-43%. For most cervical cancer patients, the expense was catastrophic, and the extent of catastrophic health expenditure was about twice large for rural patients than that for urban patients in each stage.Conclusions: The economic burden of SIL and cervical cancer in China is substantial, with a significant proportion of the costs being avoidable for patients with LSIL. Even for those with medical insurance, catastrophic health expenditures are also a major concern for patients with cervical cancer, particularly for those living in rural areas.展开更多
Promoting agricultural modernisation through technological change is an important strategy for China.China's carbon neutrality strategy is leading to systemic socio-economic changes that could exacerbate the uncer...Promoting agricultural modernisation through technological change is an important strategy for China.China's carbon neutrality strategy is leading to systemic socio-economic changes that could exacerbate the uncertainty of agricultural development.Therefore,applying a computable general equilibrium(CGE)model,this study characterises the agricultural sector in detail,introducing endogenous technological change proxied by research and development(R&D)to assess the impact of different technological change scenarios on agricultural development under the carbon neutrality target.The results show that allocating carbon revenue for R&D inputs can mitigate the significant negative impact of achieving carbon neutrality on knowledge capital and production in agricultural sectors.Overall,using carbon revenue only for R&D input in crop sectors has the optimal effect on increasing the agricultural sectors'knowledge capital,improving crop production and profit,reducing crop external dependence and promoting the synergistic reduction of carbon and pollutant emissions.However,this scenario has the largest negative impact on macro-economics and household welfare.In contrast,allocating carbon revenue to promote technological change in broader non-energy sectors or both crops and non-energy sectors can effectively mitigate negative socio-economic impacts,but the positive impact on agricultural development is minimal.These findings provide practical insights for the rational use of carbon revenue to expand agricultural R&D investment and ensure balanced agricultural and economic development under the carbon neutrality target.展开更多
文摘Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.
基金supported by the National Natural Science Foundation of China (Grant No. 32100400)Huangshan University Startup Project of Scientific Research (2020xkjq013)Environment Conservation Research Centre of Xin’an River Basin (kypt202002)。
文摘Rivers are important habitats for wintering waterbirds.However,they are easily influenced by natural and human activities.An important approach for waterbirds to adapt to habitats is adjusting the activity time and energy expenditure allocation of diurnal behavior.The compensatory foraging hypothesis predicts that increased energy expenditure leads to longer foraging time,which in turn increases food intake and helps maintain a constant energy balance.However,it is unclear whether human-disturbed habitats result in increased energy expenditure related to safety or foraging.In this study,the scan sample method was used to observe the diurnal behavior of the wintering Spot-billed Duck(Anas poecilorhyncha) in two rivers in the Xin’an River Basin from October 2021 to March 2022.The allocation of time and energy expenditure for activity in both normal and disturbed environments was calculated.The results showed that foraging accounted for the highest percentage of time and energy expenditure.Additionally,foraging decreased in the disturbed environment than that in the normal environment.Resting behavior showed the opposite trend,while other behaviors were similar in both environments.The total diurnal energy expenditure of ducks in the disturbed environment was greater than that in the normal environment,with decreased foraging and resting time percentage and increased behaviors related to immediate safety(swimming and alert) and comfort.These results oppose the compensatory foraging hypothesis in favor of increased security.The optimal diurnal energy expenditure model included river width and water depth,which had a positive relationship;an increase in either of these two factors resulted in an increase in energy expenditure.This study provides a better understanding of energy allocation strategies underlying the superficial time allocation of wintering waterbirds according to environmental conditions.Exploring these changes can help understand the maximum fitness of wintering waterbirds in response to nature and human influences.
基金This paper was supported by the National Natural Science Foundation of China(NSFC)(71973138 and 72061137002)the Ministry of Science and Technology of China(2023YFE0105009).
文摘A more resilient livelihood is increasingly recognized as an efficient way to improve vulnerable households’food security and optimize their dietary decisions.This study quantifies rural household resilience in western China,identifies the three pillars(absorptive capacity,adaptive capacity,and transformative capacity)contribution to resilience,and then establishes the estimated Resilience Capacity Index(RCI)linked with food security and dietary diversity supported by the multiple indicator multiple cause(MIMIC)model.Results show that,despite geographical heterogeneity,the RCI consistently increased from 2015 to 2021.Households with a higher RCI inheriting better capacity to deal with risk and shocks are significantly and positively correlated with increasing food expenditure and diversifying food choices.It can be because resilient households will allocate more money to food expenditure instead of saving for livelihood uncertainty.Thus,policymakers can provide more incentives for rural households to adopt more dynamic and effective risk management strategies.This,in turn,could yield positive spillover effects by preventing human capital loss associated with dietary-related chronic diseases and mortality.
文摘Green technology innovation is an important driving force and source to promote my country’s high-quality development,and it is the core path to achieve sustainable development.This paper uses my country’s provincial panel data from 2016 to 2019 to study the impact mechanism of R&D investment on green technology innovation,and introduces the level of digitization,using the panel threshold model to discuss its role in the impact mechanism of R&D investment on green technology innovation.The study found that when the level of digitalization in a region is low,increasing R&D investment does not necessarily improve the ability of green technology innovation;when the level of digitalization is relatively high,R&D investment has a positive role in promoting green technology innovation.Therefore,it is necessary to improve policies to encourage enterprises to increase investment in research and development;at the same time,it is necessary to promote the coordinated development of digital foundation,digital investment,digital literacy,digital economy and digital application,and promote the deep integration of digitalization and green technology innovation.
文摘Climate change is an alarming global challenge, particularly affecting the least developed countries (LDCs) including Liberia. These countries, located in regions prone to unpredictable temperature and precipitation changes, are facing significant challenges, particularly in climate-sensitive sectors such as mining and agriculture. LDCs need more resilience to adverse climate shocks but have limited capacity for adaptation compared to other developed and developing nations. This paper examines Liberia’s susceptibility to climate change as a least developed country, focusing on its exposure, sensitivity, and adaptive capacity. It provides an overview of LDCs and outlines the global distribution of carbon dioxide emissions. The paper also evaluates specific challenges that amplify Liberia’s vulnerability and constrain sustainable adaptation, providing insight into climate change’s existing and potential effects. The paper emphasizes the urgency of addressing climate impacts on Liberia and calls for concerted local and international efforts for effective and sustainable mitigation efforts. It provides recommendations for policy decisions and calls for further research on climate change mitigation and adaptation.
基金Research on Innovation and Development Strategy of Pharmaceutical Industry in Liaoning Province(2020lslktyb-095).
文摘Objective To study the threshold effect of export trade on internal and external R&D investment in China’s pharmaceutical industry,and to provide reference for some pharmaceutical enterprises to improve the investment.Methods The panel data of pharmaceutical industry in 25 provinces and cities in China from 2009 to 2019 were selected to conduct empirical analysis by establishing a threshold regression model,and a better export trade interval was obtained.Results and Conclusion There is a threshold value for the effect of new product export on both internal and external R&D expenditures,and the threshold values are 845.2788 million yuan and 318.4198 million yuan,respectively.There is a single threshold effect of export trade on both internal and external R&D investment in China’s pharmaceutical industry,and the effect of export trade on internal and external R&D investment changes from negative to positive as the export trade develops from low to high.
文摘New research and development(R&D)institutions are an important part of the national innovation system,playing an important role in promoting the transformation of scientific and technological achievements.In recent years,new R&D institutions have gradually become the driving force of innovation-driven development in China.Taking new R&D institutions in Zhejiang Province as the research object,this paper studies the internal talent training path and performance evaluation mechanism of new R&D institutions in Zhejiang Province by using the literature research method,comparison method,case verification method,and other methods.The investigation results show that there are problems such as lack of material and spiritual support and neglect of the absorption of local talents in the internal talent training,and there are problems such as unclear standards,insufficient data,and opaque processes in the performance evaluation mechanism,which greatly affect the establishment and improvement of the performance evaluation mechanism.Given the above problems,this paper puts forward a forward-looking,oriented,flexible,and compatible talent training path and performance evaluation mechanism,hoping to optimize the effective internal talent training path of new R&D institutions,improve the evaluation performance,and promote healthy development of new R&D institutions in Zhejiang Province.
文摘Objective To explore the impact of population aging on the expenditures of medical insurance funds against the background that great changes in population structure influences economic development.Methods Through analyzing the impact of the population aging,the income and accumulated balance of the medical insurance fund,and other related factors on the expenditure of the medical insurance fund,development status of the medical insurance fund for urban employees in China since 2003 was obtained.Stata 16.0 was used to perform multiple linear regression analysis on related factors to determine the correlation between population aging and the change in medical insurance expenditures.Results and Conclusion The factors that have a greater impact on the expenditure of the medical insurance fund are the amount of income from the medical insurance,followed by the number of people over the age of 65 in China and the urban retired employees participating in medical insurance.We should focus on the sustainable development of the urban employee medical insurance fund to deal with the threat of aging.
文摘Background:The Compendium of Physical Activities was published in 1993 to improve the comparability of energy expenditure values assigned to self-reported physical activity(PA)across studies.The original version was updated in 2000,and again in 2011,and has been widely used to support PA research,practice,and public health guidelines.Methods:This 2024 update was tailored for adults 19-59 years of age by removing data from those≥60 years.Using a systematic review and supplementary searches,we identified new activities and their associated measured metabolic equivalent(MET)values(using indirect calorimetry)published since 2011.We replaced estimated METs with measured values when possible.Results:We screened 32,173 abstracts and 1507 full-text papers and extracted 2356 PA energy expenditure values from 701 papers.We added303 new PAs and adjusted 176 existing MET values and descriptions to reflect the addition of new data and removal of METs for older adults.We added a Major Heading(Video Games).The 2024 Adult Compendium includes 1114 PAs(912 with measured and 202 with estimated values)across 22 Major Headings.Conclusion:This comprehensive update and refinement led to the creation of The 2024 Adult Compendium,which has utility across research,public health,education,and healthcare domains,as well as in the development of consumer health technologies.The new website with the complete lists of PAs and supporting resources is available at https://pacompendium.com.
文摘Purpose:To describe the development of a Compendium for estimating the energy costs of activities in adults>60 years(OA Compendium).Methods:Physical activities(PAs)and their metabolic equivalent of task(MET)values were obtained from a systematic search of studies published in 4 sport and exercise databases(PubMed,Embase,SPORTDiscus(EBSCOhost),and Scopus)and a review of articles included in the 2011 Adult Compendium that measured PA in older adults.MET values were computed as the oxygen cost(VO_(2),mL/kg/min)during PA divided by 2.7 m L/kg/min(MET_(60+))to account for the lower resting metabolic rate in older adults.Results:We identified 68 articles and extracted energy expenditure data on 427 PAs.From these,we derived 99 unique Specific Activity codes with corresponding MET_(60+)values for older adults.We developed a website to present the OA Compendium MET_(60+)values:https://pacompendium.com.Conclusion:The OA Compendium uses data collected from adults>60 years for more accurate estimation of the energy cost of PAs in older adults.It is an accessible resource that will allow researchers,educators,and practitioners to find MET_(60+)values for older adults for use in PA research and practice.
基金supported by the Bill and Melinda Gates Foundation (No. OPP1216421)CAMS Innovation Fund for Medical Sciences (CIFMS) (No. 2021-I2M-1004)。
文摘Objective: Cervical squamous intraepithelial lesion(SIL) and cervical cancer are major threats to females' health and life in China, and we aimed to estimate the economic burden associated with their diagnosis and treatment.Methods: A nationwide multicenter, cross-sectional, hospital-based survey was conducted in 26 qualified hospitals across seven administrative regions of China. We investigated females who had been pathologically diagnosed with SIL and cervical cancer, and included five disease courses(“diagnosis”, “initial treatment”,“chemoradiotherapy”, “follow-up” and “recurrence/progression/metastasis”) to estimate the total costs. The median and interquartile range(IQR) of total costs(including direct medical, direct non-medical, and indirect costs), reimbursement rate by medical insurance, and catastrophic health expenditures in every clinical stage were calculated.Results: A total of 3,471 patients in different clinical stages were analyzed, including low-grade SIL(LSIL)(n=549), high-grade SIL(HSIL)(n=803), cervical cancer stage ⅠA(n=226), ⅠB(n=610), ⅡA(n=487), ⅡB(n=282), Ⅲ(n=452) and Ⅳ(n=62). In urban areas, the estimated total costs of LSIL and HSIL were $1,637.7(IQR:$956.4-$2,669.2) and $2,467.1(IQR:$1,579.1-$3,762.3), while in rural areas the costs were $459.0(IQR:$167.7-$1,330.3) and $1,230.5(IQR:$560.6-$2,104.5), respectively. For patients with cervical cancer stage ⅠA,ⅠB, ⅡA, ⅡB, and Ⅲ-Ⅳ, the total costs were $15,034.9(IQR:$11,083.4-$21,632.4), $19,438.6(IQR:$14,060.0-$26,505.9), $22,968.8(IQR:$16,068.8-$34,615.9), $26,936.0(IQR:$18,176.6-$41,386.0) and $27,332.6(IQR:$17,538.7-$44,897.0), respectively. Medical insurance covered 43%-55% of direct medical costs for cervical cancer patients, while the coverage for SIL patients was 19%-43%. For most cervical cancer patients, the expense was catastrophic, and the extent of catastrophic health expenditure was about twice large for rural patients than that for urban patients in each stage.Conclusions: The economic burden of SIL and cervical cancer in China is substantial, with a significant proportion of the costs being avoidable for patients with LSIL. Even for those with medical insurance, catastrophic health expenditures are also a major concern for patients with cervical cancer, particularly for those living in rural areas.
基金supported by the National Natural Science Foundation of China[Grant No.72204234,72074022]the National Social Science Foundation of China[Grant No.22AZD094]the project for Carbon Neutral General Knowledge Course Construction of China University of Geosciences.
文摘Promoting agricultural modernisation through technological change is an important strategy for China.China's carbon neutrality strategy is leading to systemic socio-economic changes that could exacerbate the uncertainty of agricultural development.Therefore,applying a computable general equilibrium(CGE)model,this study characterises the agricultural sector in detail,introducing endogenous technological change proxied by research and development(R&D)to assess the impact of different technological change scenarios on agricultural development under the carbon neutrality target.The results show that allocating carbon revenue for R&D inputs can mitigate the significant negative impact of achieving carbon neutrality on knowledge capital and production in agricultural sectors.Overall,using carbon revenue only for R&D input in crop sectors has the optimal effect on increasing the agricultural sectors'knowledge capital,improving crop production and profit,reducing crop external dependence and promoting the synergistic reduction of carbon and pollutant emissions.However,this scenario has the largest negative impact on macro-economics and household welfare.In contrast,allocating carbon revenue to promote technological change in broader non-energy sectors or both crops and non-energy sectors can effectively mitigate negative socio-economic impacts,but the positive impact on agricultural development is minimal.These findings provide practical insights for the rational use of carbon revenue to expand agricultural R&D investment and ensure balanced agricultural and economic development under the carbon neutrality target.
