Economic Rank Research Articles

Targeted therapies and conventional care for the treatment of ankylosing spondylitis in China: a cost-effectiveness analysis based on the network-meta analysis

ObjectiveThis study aimed to evaluate the long-term cost-effectiveness of conventional care (CC) and seven first-line targeted therapies marketed in China for the treatment of patients with ankylosing spondylitis (AS)–namely secukinumab, ixekizumab, infliximab, etanercept, adalimumab and golimumab and tofacitinib–from the perspective of the Chinese health care system.MethodsThe York model was structured as a 12-week decision tree leading into two Markov models. This study set 1 year as a recurring cycle and a lifetime timeframe for the model. Primary model outcomes included the costs in Chinese yuan (CNY), health outcomes in quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER) under a willingness-to-pay threshold of ¥89,358 (equal to the per capita gross domestic product in China in 2023) per QALY. Parameters in the York model were captured from network meta-analyses and literature including treatment response, short-term disease progression, patient functioning and long-term structural disease progression. Utilities are dependent on indicators such as the BASDAI score, the BASFI score, gender and age. Drug prices were analysed using the median price of the Chinese market from YAOZH net in the basic analysis. Costs and outcomes were discounted at 5.0%. We performed deterministic and probabilistic sensitivity analyses to investigate the robustness of the results. The prices of original drugs and generic drugs were used in the scenario analysis.ResultsCompared with CC, the ICER of golimumab was ¥104,217.4/QALY, which is between 1 and 3 times the GDP per capita, while the ICERs of the other six targeted therapies were less than ¥89,358/QALY. The specific economic rank of the targeted therapy was as follows:secukinumab > ixekizumab > tofacitinib > infliximab > etanercept > adalimumab > golimumab. Treatment response rates such as the BASDAI50, changes in the BASDAI/BASFI scores and the discounting rate were key model drivers. According to the scenario analysis, IL-17 inhibitors were still the most economical intervention when original drugs and generic drugs were used.ConclusionTargeted therapies are cost-effective treatments for AS. Overall, IL-17 inhibitors were the dominant treatment. The choice of the brand-new prices or generic drug prices can greatly affect economics.

Predicting unmet activities of daily living needs among the oldest old with disabilities in China: a machine learning approach.

The ageing population in China has led to a significant increase in the number of older persons with disabilities. These individuals face substantial challenges in accessing adequate activities of daily living (ADL) assistance. Unmet ADL needs among this population can result in severe health consequences and strain an already burdened care system. This study aims to identify the factors influencing unmet ADL needs of the oldest old (those aged 80 and above) with disabilities using six machine learning methods. Drawing from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2017-2018 data, we employed six machine learning methods to predict unmet ADL needs among the oldest old with disabilities. The predictive effects of various factors on unmet ADL needs were explored using Shapley Additive exPlanations (SHAP). The Random Forest model showed the highest prediction accuracy among the six machine learning methods tested. SHAP analysis based on the Random Forest model revealed that factors such as household registration, disability class, economic rank, self-rated health, caregiver willingness, perceived control, economic satisfaction, pension, educational attainment, financial support given to children, living arrangement, number of children, and primary caregiver played significant roles in the unmet ADL needs of the oldest old with disabilities. Our study highlights the importance of socioeconomic factors (e.g., household registration and economic rank), health status (e.g., disability class and self-rated health), and caregiving relationship factors (e.g., caregiver willingness and perceived control) in reducing unmet ADL needs among the oldest old with disabilities in China. Government interventions aimed at bridging the urban-rural divide, targeting groups with deteriorating health status, and enhancing caregiver skills are essential for ensuring the well-being of this vulnerable population. These findings can inform policy decisions and interventions to better address the unmet ADL needs among the oldest old with disabilities.

Prediction of Marine Water Quality Index Using a Stacked Classifier Under Machine Learning Architecture

The health of humankind is intrinsically associated with the health of the marine and ocean ecosystems. The pollution of the coastal region due to urbanization, for example, principally harms the growth of the ecosystem with poor-quality of water, which aggravates the survival of marine organisms and animals. The toxicity of the contaminated seafood would affect the human-ocean ecosystem thereby bringing down the economic rank of the region as well. Therefore, it is mandatory to assess the quality of the marine and ocean water to initiate any statutory measures to protect the regional marine water against pollution and dumping of toxic matter. This paper, therefore, presented an architecture of machine learning techniques to assist in classifying marine water quality. The proposed framework evaluated various classification models and selected the best fit out of the top-performing algorithms through training and optimizing. The finalized model was a stacked classifier, which was then deployed to predict the marine water quality index from the physicochemical and biological properties of the water.

Oral Health-Related Knowledge, Attitudes and Behaviours of Arab Dental Students: Multi-National Cross-Sectional Study and Literature Analysis 2000-2020.

Dental students are the future leaders of oral health in their respective communities; therefore, their oral health-related attitudes and behaviours are of practical value for primary disease prevention. The present study aimed to evaluate oral health-related knowledge, attitudes, and behaviours of dental students in Arab countries and explore the potential sociodemographic predictors of their oral health outcomes. A multi-centre, cross-sectional study was conducted during the academic year 2019/2020 in three Arab countries: Lebanon, Syria, and Tunisia. The study used a validated Arabic version of the Hiroshima University Dental Behavioural Inventory (HU-DBI) composed of original twenty items that assess the level of oral health-related knowledge, attitudes, and behaviours, and four additional dichotomous items related to tobacco smoking, alcohol drinking, problematic internet use, and regular dental check-up The HU-DBI score ranges between 0 and 12. A total of 1430 students took part in this study, out of which 60.8% were females, 57.8% were enrolled in clinical years, 24.5% were tobacco smokers, 7.2% were alcohol drinkers, and 87% reported internet addiction. The mean HU-DBI score was 6.31 ± 1.84, with Lebanon having the highest score (6.67 ± 1.83), followed by Syria (6.38 ± 1.83) and Tunisia (6.05 ± 1.83). Clinical students (6.78 ± 1.70) had higher HU-DBI scores than their preclinical peers (5.97 ± 1.86). The year-over-year analysis revealed that dental public health and preventive dentistry courses had significantly and positively impacted the undergraduate students’ knowledge, attitudes, and behaviours. The gender-based differences were not statistically significant, with a modest trend favouring males, especially oral health behaviours. Tobacco smoking, alcohol drinking, and problematic internet use were associated with lower HU-DBI scores. In the Arab world, the economic rank of the country where the dental students live/study was weakly correlated with the students’ mean HU-DBI score.

Rolling the Dice to Learn in Social Studies

Board games are enjoying increased popularity with thousands of new games introduced annually. The most popular mechanical element of board games is rolling dice and economic topics rank in the top three most common board game themes. The dice game Left, Center, Right employs dice and is easy to learn. This essay presents a variety of social topics illustrated while playing the game. The game is not intended to teach specific disciplinary concepts or topics, but a teacher can employ the game to introduce topics and to encourage discussion that contributes to schema formation needed for effective learning.

Use and Cost of Orthosis in Conservative Treatment of Acute Thoracolumbar Fractures: A Survey of European and North American Experts.

Survey study. Assess practices and opinions of spine specialists from Europe and North America on orthosis use in adult patients with acute thoracolumbar (TL) fractures. Evaluate cost of the devices. Although orthosis are traditionally used in conservative treatment of TL fractures, recent systematic reviews showed no benefit in patient's outcomes. A search for contact authors with publications on spine fractures from all European and North American countries was performed. An online questionnaire was sent on demographic data, practice setting, mean number of fractures treated, use of orthosis upon choice for conservative treatment, and average orthosis cost. Data was analyzed based in world regions, economic rank of the country, and health expenditure. We received 130 answers, from 28 European and five North American countries. Most responders had more than 9 years of practice and worked at a public hospital. 6.2% did not prescribe a brace in any patient with acute TL fractures conservatively treated and 11.5% brace all patients. In a scale from 1 to 5, 21 considered that there is no/low benefit (1) and 14 that bracing is essential (5), with a mean of 3.18. Europeans use orthosis less commonly than North Americans (P < 0.05). Orthosis mean cost was $611.4 ± 716.0, significantly higher in North America compared with Europe and in high income, when compared with upper middle income countries (both P < 0.05). Although hospital costs were not evaluated, orthosis is costlier when it involves admission of the patient (P < 0.05). An increase in orthosis cost associated with higher gross domestic product (GDP) per capita and higher health expenditure was found. More than 90% of spine specialists still use orthosis in conservative treatment of adult patients with acute TL fractures. Orthosis cost vary significantly between continents, and it is influenced by the country's economy.Level of Evidence: 4.

The effects of mother education and intervening mechanisms on rural-urban child stunting: evidence from Pakistan

OBJECTIVES: Estimate the impact of mother schooling on rural-urban child chronic malnutrition from Pakistan. MATERIALS AND METHODS: The data on all education based pathways, such as socio-demographic and behavioral, were taken from Pakistan Demographic and Health Survey 2012-13 dataset. The data on all infants aged 0-59 months, whose height and weight were measured at the survey time, were selected for empirical analysis. Analyses with binary logistic regression model were used to determine the effect of mother formal schooling on rural-urban infant stunting after controlling for other factors deeply linked to her schooling. RESULTS: Empirical results showed that urban mothers having primary and secondary/higher education have less likelihood of stunting for their infants than rural mothers relative to illiterate mothers, implying that illiterate mothers have more stunted kids. Male household head and poor economic rank have more likelihood of stunting in both locations, relative to female household head and rich households. Among explanatory variables, maternal schooling, health seeking attitude, socioeconomic rank, empowerment, and child weight are highly significant predictors of stunting in rural-urban Pakistan. Despite of earlier significant outcomes, targeted interventions are important aiming at mothers having no education. CONCLUSION: Female education, along with various other pathways (her socioeconomic, empowerment and heal seeking thought), has reduced chronic malnutrition and has been a guarantee of better living standard, still targeted interventions are important aiming at mothers having no education by specifying a big share of federal and regional budget on female education.

The Fictitious Liberal Divide

The main question dividing classical and high liberals is about how economic rights rank compared to other rights and public goals. That is, the question is about what can or cannot outweigh such rights. High liberals argue that economic rights can be outweighed by any legitimate state interest, such that they are prima facie rights. Neoclassical liberals, conversely, have recently sought to elevate economic rights to basic rights, which could then only be outweighed by other basic rights. This paper shows where the real debate should be for classical liberals, challenging Samuel Freeman’s widely held distinction between classical and high liberalism. Economic rights are prima facie for all liberals in that they can be outweighed by, say, considerations of utility or social justice. Although neoclassical liberals are correct to say that such rights are much more important than high liberals normally recognize, it does not follow that economic rights are basic.

Practical Issues with Decision Preparation of Facility Investments in the National Manufacturing Industry

This study deals with a few practical issues related to preparing facility investment decisions and is based on the findings of a questionnaire survey conducted in 2016. This study discusses the length of time required to prepare economic decisions on investing in facilities, the people to be engaged in investment preparation processes and corporate practices concerning analyses of economic efficiency and ranking of projects. Survey findings show that companies spend several months preparing decisions about facility investments and involve not only owners and top management in this process, but also financiers and investment experts. A relatively high proportion of companies usually evaluate the economic efficiency and rank the investments.

Human Development Inequality Index and Cancer Pattern: a Global Distributive Study.

This study aimed to quantify associations of the human development inequality (HDI) index with incidence, mortality, and mortality to incidence ratios for eight common cancers among different countries. In this ecological study, data about incidence and mortality rates of cancers was obtained from the Global Cancer Project for 169 countries. HDI indices for the same countries was obtained from the United Nations Development Program (UNDP) database. The concentration index was defined as the covariance between cumulative percentage of cancer indicators (incidence, mortality and mortality to incidence ratio) and the cumulative percentage of economic indicators (country economic rank). Results indicated that incidences of cancers of liver, cervix and esophagus were mainly concentrated in countries with a low HDI index while cancers of lung, breast, colorectum, prostate and stomach were concentrated mainly in countries with a high HDI index. The same pattern was observed for mortality from cancer except for prostate cancer that was more concentrated in countries with a low HDI index. Higher MIRs for all cancers were more concentrated in countries with a low HDI index. It was concluded that patterns of cancer occurrence correlate with care disparities at the country level.

An Application of Factor Analysis in the Evaluation of Country Economic Rank

The economic parameters play an important role in economic growth and it also affects economic performance of a country. This paper described the basic principles of factor analysis, and used this method to perform a comprehensive analysis and evaluation of economic development of 20 countries on 21 economic parameters. The performance of our work is evaluated using IMF dataset for 20 countries and result shows the economic rank of countries (Kuwait, Germany, Iceland, Belgium, Denmark, Taiwan, Qatar, Ireland, Sweden, Luxemburg, Austria, Singapore, Norway, Netherland, Hong Kong, Brunei, us, Switzerland, Canada, and Australia). We saw that our calculated rank and the rank provided by world ranking list is almost same which confirms that it is successful to apply factor analysis into countries economic evaluation.

National Forest Parks development through Internet technologies for economic perspectives

National Forest Parks are protected under national and international environment laws because of their recognized natural, ecological or cultural values. Since they provide economic perspectives through recreational and tourism opportunities for the public, the visitors’ overuse and the supplementary development of facilities and services in these protected areas are the main threats to their ecological integrity. Within the current digital innovations, Internet has become a viable alternative business channel and many firms have already created their internet presence. The aim of the paper is to study the employ of internet technologies in Greek National Forest Parks for economic perspectives and rank the websites, respectively. Internet presence of Greek National Forest Parks is evaluated qualitatively according to their content, used as criteria. Following, the multicriteria method of PROMETHEE II is applied for the total ranking. Furthermore, the optimum National Forest Parks internet presences are identified and described to be used as models with the total exploitation of internet technologies. Finally, necessary recommendations for website optimization are presented.

Self-assessed well-being and economic rank in South Africa

This study explores subjective measures of well-being in South Africa collected in the first two waves of the National Income Dynamics Study. These subjective measures include individual life satisfaction, current self-assessed economic rank and expected economic rank in the future. The paper describes how the distributions of these measures have changed over the course of the panel and it investigates the relationship between life satisfaction and perceived economic rank in a multivariate context, controlling for individual fixed effects. The panel data suggest a leftward shift in the distribution of life satisfaction over the two waves. Moreover, the majority of adults did not perceive their economic rank as having improved and they reported lower expectations of future upward economic mobility. Perceptions of current and future economic rank are key correlates of life satisfaction, findings that remain robust to controls for unobserved individual heterogeneity.

Quality of life and symptom burden in Chinese cancer patients: Results of a multicenter research project.

e20695 Background: McGill QOL Questionnaire is a well known tool in the evaluation of both psychological and physical states in cancer patients. A number of translations have been made. It is widely used in western developed countries, yet little research has been performed in caner patients in Mainland China who speak Mandarin. Methods: In the first application of the MQOL-Chinese version, which was translated from the MQOL-English version, reliability, content and construct validity testing has been performed among the 126 cancer patients, screened from Tongji Hospital, a medical unit which can deliver comprehensive cancer palliative care. And then 170 patients from 4 different hospitals in China were randomly selected to fill in this scale. Results: First Test-retest reliability of the questionnaire is highly favorable, and all MQOL scores are internally consistent. Using a scientific Stratified Analysis, in the psychological domain, men report less negative emotions than females (question 5\6\8 P=0,002 \0,047\0,016), and patients with head and neck cancer have less negative emotions than those with thoracic cancer (question14 P=0.035).Furthermore, cancer patients less than 20 years old tend to be mentally stronger while people at 40-60 years old seem to have the greatest psychological burden (question6/7 P=0.034/0.017). In the semi-open questions in the second part about the physical domain, poor appetite is reported as the most troublesome problem (M=6.6/10, SD=2.77), while sleep problems rank the least distessing (M=4.2/10,SD=2.15).In the fourth part of the open questions, feeling encouraged is the most frequently mentioned, and physical and economic burden rank the 2nd and 3rd respectively. Conclusions: First of all, the MQOL-Chinese version is a valid instrument for measuring quality of life for cancer patients in Mainland China who speak Mandarin. Moreover, the outcomes above indicated that the psychological and physical domain need to receive more attention, and economic burden is also an urgent problem which needs to be improved among cancer patients especially in China, which is still a developing country with a huge population.

Should “the Perspective of South-North Contradictions” Be “Abandoned”? – Focusing on “2012 Sino-Canada BIT”

The rapid development of China’s economy not only has upgraded its international economic rank, but also has accelerated its pace of outward investment. Meanwhile, China and several dozens of other developing countries are stuck in a disadvantageous status caused by consequent remarks, such as that “China is no longer a developing country”, that “the perspective of South-North Contradictions is already outdated and should be abandoned during the process of concluding BITs and establishing international economic rules in general”, etc. However, the rationale and accuracy of these remarks as well as the exact meaning hidden behind all remain open to question. This Article, from the source and stream of South-North Contradictions and modern BITs, focusing on the typical example of two core provisions selected from the newly concluded 2012 Sino-Canada BIT, endeavors to demonstrate that the “perspective of South-North Contradictions” cannot and should not be abandoned during the process of BIT negotiations and establishing international economic rules in general.

Individual Wealth Rank, Community Wealth Inequality, and Self-Reported Adult Poor Health: A Test of Hypotheses with Panel Data (2002-2006) from Native Amazonians, Bolivia

Growing evidence suggests that economic inequality in a community harms the health of a person. Using panel data from a small-scale, preindustrial rural society, we test whether individual wealth rank and village wealth inequality affects self-reported poor health in a foraging-farming native Amazonian society. A person's wealth rank was negatively but weakly associated with self-reported morbidity. Each step up/year in the village wealth hierarchy reduced total self-reported days ill by 0.4 percent. The Gini coefficient of village wealth inequality bore a positive association with self-reported poor health that was large in size, but not statistically significant. We found small village wealth inequality, and evidence that individual economic rank did not change. The modest effects may have to do with having used subjective rather than objective measures of health, having small village wealth inequality, and with the possibly true modest effect of a person's wealth rank on health in a small-scale, kin-based society. Finally, we also found that an increase in mean individual wealth by village was related to worse self-reported health. As the Tsimane' integrate into the market economy, their possibilities of wealth accumulation rise, which may affect their well-being. Our work contributes to recent efforts in biocultural anthropology to link the study of social inequalities, human biology, and human-environment interactions.

(110) Composition and Place of Origin of Trees in Residential Neighborhoods and Embedded Parks in Phoenix, Arizona

This study evaluated the influence of social economic rank (SER) and neighborhood and park age on the composition and place of origin of trees in residential neighborhoods and embedded small urban parks in Phoenix, Ariz. During 2000 and 2001, trees were surveyed within an array of 16 residential neighborhoods and embedded small urban parks that spanned a range of socioeconomic rank (SER) and age. Parks were embedded within residential neighborhoods of similar density across three SER classifications, high, moderate, or low. Neighborhoods and parks ranged in age from about 1947 to 1997. Counts of all trees in each park were made and neighborhood tree composition was approximated by tree counts along four transects, distributed away from each park along streets in a northerly, easterly, southerly, or westerly direction, respectively. Transect widths extended about the depth of a front yard residence on both sides of the street. Park and surrounding neighborhood tree composition was calculated as total frequency (abundance) and taxa frequency (diversity) per hectare of landscape surface area. Tree abundance in parks was highest when surrounded by neighborhoods of high SER. Neighborhoods of high SER had greater tree diversity than neighborhoods of low SER. Distinct patterns of tree origin, dictated by both classifications of SER and age, were found. Overall, trees in residential neighborhoods and embedded parks tended to be indigenous to arid regions of North America, South America, Australia, south Asia, and China.

Okinawa: an exception to the social gradient of life expectancy in Japan.

This paper examines why the social gradient of life expectancy does not apply in Japan when Okinawa is considered. The social gradient thesis links differences in longevity to social rank, with people and populations in higher status hierarchical positions having lower mortality and longer life expectancies than those beneath them in the social scale. Japan has been cited as a major example of this thesis in that Japanese life expectancy improved dramatically as Japan rose to the top echelon of nations in economic rank in the late 20th century. Thus it follows that Japan's most affluent and leading prefectures should be the major catalysts behind the nation's rise in life expectancy as well to the number one position in the world. However, this is not the case as life expectancy in Okinawa, Japan's poorest prefecture, exceeds that of Japan as a whole. We find that the social gradient of life expectancy does not apply at the prefectural level and question its validity for geographical areas. We suggest that healthy lifestyles, especially diet and the social support of family and friends, are more important than sense of hierarchy for longevity in Okinawa.

The White Scourge: Mexicans, Blacks, and Poor Whites in Texas Cotton Culture

This ambitious and graceful work traces the interactions between Mexicans, whites, and blacks in central Texas from the turn of the century to the 1930s. As the number of Mexicans migrating to Texas sharply increased with the start of the 1910 revolution, cotton production in the region simultaneously shifted from small owners, tenant farmers, and sharecroppers to larger enterprises dependent on wage labor. Neil Foley asks how these three groups dealt with this socioeconomic shift and in the process continually redefined their own racial identities.At the heart of Foley’s analysis is a sophisticated view of the connections between material forces such as landownership, the construction of racial and gender identities, and political ideologies and organizations. Foley is particularly insistent that racial and gender identities are tightly bound and mutually reinforcing. Whiteness implied certain notions of manliness and gender roles, and vice versa.The breakdown of the “agricultural ladder” (the assumption that farm laborers would eventually work their way up to farm ownership) and the increasing competition between whites, Mexicans, and blacks led to a complex swirl of social and political consequences. Women of all races continued to be constrained by agrarian patriarchy even as their workload increased dramatically. Foley interprets the slide of poor whites into the tenancy and farm labor previously dominated by Mexicans and blacks as a “loss of whiteness as well as of economic rank” (p. 88).Agrarian politics bore the marks of these gender and racial forces. In contrast to labor organizers in East Texas and Louisiana, the Socialist party in the teens in Texas proved itself unable to incorporate African Americans on any but the most unequal of terms. Poor whites desperately clung to their whiteness, Foley argues. White socialists were able to grant Mexicans a greater and more equal place in their party and its rural organizations, however, and their description of Mexican organizing “seemed to imply that Mexicans, if not African Americans, had become almost white through their manly opposition to exploitation” (p. 96).Despite the willingness of Mexicans to join their organizations, Texan Socialists proved unable to stem the rise in tenancy and farm labor. Large industrial farms, relying on mechanization, scientific management techniques, and predominantly Mexican workforces, soon accounted for much of Texas’s cotton production. More than any other development, the growth of these corporations “rendered obsolete the notion of rising up from farm laborer to farm owner” (p. 140). The Depression and New Deal agricultural policies further strengthened the hand of these corporations and other major landowners. The aspiration to the status of landowner, in Foley’s eyes, actually impeded organizing efforts in the 1930s. Unlike their counterparts in the rest of the South and in California, white Texans remained too attached to the now-outdated agricultural ladder to form effective, interracial farm laborers’ unions.Latin Americanists in particular will have reason to dissent from the book’s nearly pathological description of agrarianism. The agrarian suspicion of wage labor, and its assumption that a free society depended on widely dispersed landholding, had roots as deep in Mexico as in Texas and could be most appealing to the landless and dispossessed. Some readers may also find that Foley overemphasizes the importance of gender in white understandings of Mexican militancy and that he too quickly racializes elite white views of poor whites. But these questions are themselves the products of Foley’s tight integration of gender and race into a particular rural class structure. This innovative and rigorous work will be of interest to scholars of Mexican Americans, gender and race formations, the U.S. South, and agrarian studies for many years to come.

Wealth and status in the upper South socioeconomic system of Northeastern Missouri

Historical-period settlement of the central Salt River valley of northeastern Missouri began in 1819, and by 1825 the region was regularly receiving immigrant agriculturists, many of whom were from the Bluegrass region of Kentucky. Colonists brought with them basic elements of what has been termed the upper South agricultural-economic pattern—a mix of hog and corn production practiced by small-scale farmers and cattle and tobacco production practiced by large-scale agriculturists. These transplanted elements became the foundation for social and economic development of the Salt River valley for decades. Immigrant families often moved to the region as parts of large kin-based networks that maintained geographic integrity by purchasing clustered tracts of land. Several lines of documentary evidence indicate considerable homogeneity in wealth existed among families within a settlement cluster and significant differences in wealth existed between clusters. Additional evidence of intracluster homogeneity in wealth is provided by ceramic items discarded by households of similar economic rank, though it is unclear how useful ceramics are in differentiating among households of unequal rank. Consumer profiles indicate households of medium wealth purchased a wide assortment of ceramic items, including porcelain and expensive white-bodied wares. They also constructed elaborate residences that apparently served as visible signs of prosperity.