Municipalities In China Research Articles

Daily PM2.5 and PM10 forecasting using linear and nonlinear modeling framework based on robust local mean decomposition and moving window ensemble strategy

Highly accurate forecasting of particulate matter concentration (PMC) is essential and effective for establishing a reliable air pollution early warning system and has both theoretical and practical significance. To meet this demand, a novel multi-scale hybrid learning framework based on robust local mean decomposition (RLMD) and moving window (MW) ensemble strategy is developed for PM2.5 and PM10 forecasting. In this architecture, the RLMD is adopted to adaptively decompose the PMC time series (PMCTS) into several production functions and one residue with different frequencies. These subseries are simpler than the original PMCTS, but they still work alongside mode aliasing. Thus, following the well-established “linear and nonlinear” modeling philosophy, a novel hybrid learning framework, composed of the autoregressive integrated moving average (ARIMA) and combined kernel function relevance vector machine (RVMcom), is proposed to capture both the linear and nonlinear patterns in the subseries. To obtain better final outputs, based on the definition of the ensemble improvement degree, the MW ensemble method is used to merge the forecasting results of all subseries. A comprehensive experiment is conducted using PM2.5 and PM10 datasets from four municipalities in China to investigate the forecasting performance of our proposed framework, and the results demonstrate that our proposed RLMD-ARIMA–RVMcom-MW (R-A&Rcom-M) model is superior to other considered methods in terms of forecasting accuracy and generalization ability. This means that the developed forecasting architecture has a great application value in the field of PMCTS prediction.

Establishment of reference interval of vitamin A for Chinese children and adolescents based on expectation-maximization algorithm

Objective: To establish the reference interval of vitamin A for Chinese children and adolescents by indirect approach. Method: The serum retinol samples from 28 provinces, autonomous regions and municipalities in China between January 2016 and June 2019 were examined by high performance liquid chromatography in third-party clinical laboratory institutions. Using a cross-sectional study, descriptive statistics of serum vitamin A levels in children and adolescents aged 0-18 years were carried out in population, region and season. The distribution parameters of vitamin A levels were calculated iteratively by the expectation-maximization (EM) algorithm, and the reference interval was established. Results: A total of 1 096 597 cases were included in the analysis, including 631 017 males and 465 580 females, with a median age of 3(1, 6) years. Before the age of 4 years, the median serum vitamin A level increased with age [median level and its quartiles was 0.15 (0.11, 0.18) mg/L for neonates, 0.23 (0.18, 0.29) mg/L for infants aged below 1 year, and 0.27 (0.20, 0.34) mg/L for kids aged 1-<4 years]. The median serum vitamin A level was stable at the age of 4-8 years (median level ranged from 0.27 to 0.29 mg/L). Afterwards, the median serum vitamin A level reached 0.30 mg/L at the age of 9 years, and then an increasing trend with age was observed till 18 years. The median serum vitamin A level was higher in south area (male:0.33 mg/L; female:0.34 mg/L), compared with other areas (0.24-0.30 mg/L). The variation of the median serum vitamin A level among seasons was within 0.03 mg/L. Based on EM algorithm using indirect approach, the reference intervals of vitamin A for Chinese children and adolescents were as follows: newborn, 0.27-0.47 mg/L; infants aged below 1 year, 0.36-0.56 mg/L; children aged 1-<7 years, 0.35-0.54 mg/L; children aged 7-<16 years, 0.46-0.60 mg/L; and teenagers aged over 16 years, 0.38-0.59 mg/L. Conclusion: The EM algorithm can provide a basis for the establishment of vitamin A reference interval for Chinese children and adolescents, and the established reference interval needs to be further verified by direct method.

The Economic Loss Prediction of Flooding Based on Machine Learning and the Input-Output Model

As climate change becomes increasingly widespread, rapid, and intense, the frequency of heavy rainfall and floods continues to increase. This article establishes a prediction system using feature sets with multiple data dimensions, including meteorological data and socio-economic data. Based on data of historical floods in 31 provinces and municipalities in China from 2006 to 2018, five machine learning methods are compared to predict the direct economic losses. Among them, GBR performs the best with a goodness-of-fit of 90%. Combined with the input-output (IO) model, the indirect economic losses of agriculture to other sectors are calculated, and the total economic losses caused by floods can be predicted effectively by using the GBR-IO model. The model has a strong generalization ability with a minimum requirement of 80 pieces of data. The results of the data show that in China, provinces heavily reliant on agriculture suffered the most with the proportion of direct economic losses to provincial GDP exceeding 1‰. Therefore, some policy implications are provided to assist the government to take timely pre-disaster preventive measures and conduct post-disaster risk management, thereby reducing the economic losses caused by floods.

Spatial distinction analysis on marine ranch development potential in coastal areas of China

According to the 14th Five-Year Plan and the outline of 2035 long-term goals, a modern marine industrial system should be built, the layout of green offshore aquaculture should be optimized, and marine ranching should be built. The research on the construction of marine ranching can provide new ideas for sustainable ecological fishery and inject new vitality into the development of marine industry. In the future, the construction of marine ranching will be a vast world. In this paper, from the perspective of geography, the GC-TOPSIS method combined with the entropy weight TOPSIS method and the grey correlation method were used to construct 22 evaluation index systems to estimate the development potential of marine ranching construction in ten coastal provinces and municipalities of China from 2011 to 2016. The results showed that the overall development potential of marine ranching in ten provinces and urban areas had regional differences (north, central and south), and the differences in the north and south regions were obvious. The regional differences in the central coastal areas of China were not significant, and the development potentials of marine ranching in ten provinces and urban areas were all medium. The development potential of four criteria layers of marine ranching in ten coastal provinces and regions of China is different in space, and the development potential of marine ranching in the same region is unbalanced in all aspects of the criteria layers. To estimate the development potential of marine ranching in China’s ten coastal provinces and regions provides scientific support for the sustainable development of ecological fisheries, and has practical application value for the scientific planning of marine ranching and the selection of demonstration areas.

Nexus between green finance, fintech, and high-quality economic development: Empirical evidence from China

This study empirically examines the effect of green finance and fintech on high-quality economic development. Using data from 30 provinces and municipalities in China from 2007 to 2019, this study applies panel regression analysis to investigate the relationships between green finance, fintech, and high-quality economic development, and adopts a two-step generalized method of moments (GMM) to defaecate the endogeneity issue. This study finds that green finance comprehensively facilitates high-quality economic development by positively affect its all three aspects (i.e., ecological environment, economic efficiency, and economic structure). Additionally, fintech strengthens the positive impact of green finance in the aspects of ecological environment and economic structure, while having limited effects on the relationship between green finance and economic efficiency. Based on these findings, our study proposes three policy suggestions for policymakers, including reinforcing the integration of fintech development with green finance, building an environmental disclosure framework to supervise local governments in improving efficiency of green finance, and developing medium- and long-term favorable policies as an external intervention measure to promote green finance in the private sector.

Shale gas development and regional economic growth: Evidence from Fuling, China

Climate change, the imbalance between China's domestic energy supply and demand, and the success of the shale gas revolution in the United States have been the main motivators for China to actively issue shale gas development policies and explore its own path on this industry. This paper estimates three indicators of economic development: regional GDP, employment level, and the housing price index by using data from China's largest shale gas region, the Fuling District in Chongqing (a municipality in China). The analysis uses a Synthetic Control Method (SCM) model based on data from Fuling itself and other 34 counties of the Chongqing municipality over the period from 2005 to 2018. The results demonstrate that shale gas development has a significant positive effect on both regional GDP and employment level, with average impact growth rates respectively of 9.8% and 12.0%. By contrast, we find an insignificant effect of shale gas development on housing prices. These results support the case for further development of shale gas in China. Note that in some areas our results differ from existing literature, providing a reference for further research in this area.

What drives the temporal and spatial differences of CO2 emissions in the transport sector? Empirical evidence from municipalities in China

To formulate efficient emission reduction policies, we explore the driving forces of CO2 emissions from the transport sector of four municipalities in China during 2000–2017 based on the temporal-spatial decomposition analysis model. The key factors causing the differences in CO2 emissions will be investigated in important years (i.e., 2000, 2005, 2010, and 2017). Two main results are found: (1) Energy intensity, as well as transportation intensity, is the dominant restraining factor confronting the transport sector’s CO2 emissions, while the income effect is reversed. (2) The results of the analysis further show what drives different emission levels (e.g., income effect, energy structure, and transportation structure) and four municipalities have greater potential in the reduction of CO2 emissions. We further discuss the root causes of the spatial-temporal differences in carbon emissions in the transport sector and analyse their future trends in detail. Based on this, we propose to pay attention to strengthen coordinated emission reduction, optimize the transportation mode, adjust the energy consumption structure, and select emission reduction strategies according to local conditions. In addition, emission reductions in the transportation sector are also affected by various factors such as social systems and transformation costs, and further research is needed in the future.

Epidemiology, Molecular Characteristics of Methicillin-Resistant Staphylococcus Aureus in China: A Multicenter Longitudinal Study Based on Whole-Genome Sequencing

The aim of this study was to investigate the genomic epidemiology of MRSA in China to identify predominantly linages and their associated antimicrobial resistance and virulence profiles. In this study, we conducted whole-genome sequencing (WGS) on 565 MRSA isolates from 7 provinces and municipalities of China between 2014 and 2020. MRSA isolates were subjected to MLST, spa typing staphylococcal cassette chromosome mec (SCC mec) typing, analysis of virulence determinants and antimicrobial susceptibility testing. Among 565 MRSA isolates tested, clonal complex (CC) 59 (31.2%), CC5 (23.4%) and CC8 (13.63%) were the major lineages, and the clonal structure was dominated by ST59-t437-IV (14.9%), ST239-t030-III (6.4%), ST5-t2460-II (6.0%). Of note, CC8, the predominant lineage in 2014-2015, was replaced by CC59 in 2016-2017 and since then alternately dominant with CC5. Interestingly, the complicated dynamic change of CC5 population structure was observed with ST764-t1084-II, ST5-t2460-II, ST764-t1084-II and ST764-t002-II successively dominant. Further analysis revealed that virulence determinant profiles and antibiograms were closely associated with the clonal lineage. The CC59 MRSA less resistance to most tested antimicrobial and relatively lower methicillin MIC, while ciprofloxacin, sulfamethoxazole/trimethoprim and rifampicin resistance was closely linked with CC8. MRSA isolates conservatively carried multiple virulence genes for capsule, exoenzymes, secretion, iron uptake and metabolism, biofilm formation and hemolysis. PVL encoding genes was markedly more common in ST338, CC30, CC398, ST8 and CC22, while tsst-1 was associated with ST5. In conclusion, the community-associated CC59-ST59-t437-IV lineage was found to be most predominant in China, with diverse clonal isolates alternately circulating in various geographical locations. Our study highlights the need for MRSA surveillance in China in order to monitor changes in MRSA epidemiology. Funding Information: This study was funded by grants from the Natural Science Fund of China (82072343). Declaration of Interests: The authors declare that there are no conflicts of interest.

Acute carbon monoxide poisoning with low saturation of carboxyhaemoglobin: a forensic retrospective study in Shanghai, China

Carbon monoxide (CO) poisoning is a common cause of death, leading to morbidity and mortality worldwide. Features of the CO poisoning with low carboxyhemoglobin (COHb) levels remain to be characterized. This study collected a total of 307 CO poisoning cases from Shanghai Public Security Bureau, an official organization that handles the most complicated and life-threatening cases across Shanghai municipality in China, and regrouped these cases into three categories: group 1, 10% < COHb% < 30% (n = 58); group 2, 30% ≤ COHb% < 50% (n = 79); group 3, COHb% ≥ 50% (n = 170). Epidemiological, demographic, and forensic aspects of the CO poisoning cases, particularly those with low COHb levels, were analyzed. Our results showed that group 2 and 3 were mostly observed in younger victims (≤ 30 years), while group 1 equally distributed to all age groups (p = 0.03). All the CO poisoning from group 2 and 3 occurred in enclosed spaces, whereas cases from group 1 died additionally in outdoor spaces (p = 0.01). 81.03% of group 1 cases died in fire circumstances, while only 45.57% from group 2 and 30.59% from group 3 were fire-related (p = 0.00). Accordingly, group 1 was mostly related with fire burns, while group 2 or 3 were largely associated with gas leakage (p = 0.00). A combination with alcohol, but not other psychotropic drugs, associated with significant higher levels of blood COHb% in fire-unrelated (p = 0.021) but not fire-related cases (p = 0.23). Five extremely low COHb% (< 30%)-related poisoning deaths were negative of any cardiopulmonary pathology and psychoactive substances. In conclusion, CO poisoning with low COHb% significantly associates with fire circumstances and outdoor spaces and has no age preference. Further diagnostic markers mandates to be identified in order to avoid disputes in cases of extremely low COHb%-related poisoning.

Accuracy and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among primary care patients (≥40 years) in China: a cross-sectional screening test accuracy study: findings from the Breathe Well group

ObjectivesTo examine the accuracy and cost-effectiveness of various chronic obstructive pulmonary disease (COPD) screening tests and combinations within a Chinese primary care population.DesignScreening test accuracy study.SettingUrban and rural community health...

Assessing the belt and road initiatives impact on tourism development in China: insights from MOOCs learning platform

Purpose This study aims to explore the impact of the belt and road initiative (BRI) on tourism development in China and to identify the factors contributing to the BRI’s effect on tourism development. Design/methodology/approach This study evaluates the impact of the BRI on tourism development using 2007–2017 panel data from 31 provinces and municipalities in China. The data are analyzed using the difference-in-differences method and the factors contributing to the BRI’s effect on tourism development are identified through an analysis of online reviews by users of a massive open online course offered on the FutureLearn platform. Findings The result suggests that the BRI has boosted total tourism revenue and total tourist arrivals in the BRI region comparing with other regions. Four factors contributing to the BRI’s impact on tourism development in China are identified: macro-environmental factors, transit factors, destination factors and tourism policy and promotional factors. Originality/value The BRI has had a significant impact on regional tourism development, yet very few empirical studies have systematically examined the impact of BRI on tourism development. Thus, this paper also addresses this research gap by evaluating the extent to which BRI impacts tourism development and contributes to the factors affecting tourism development.

Authorized, clear and timely communication of risk to guide public perception and action: lessons of COVID-19 from China

BackgroundsThis study examined the dynamic association between risk communication and the public’s risk perception and action across the COVID-19 outbreak timeline in China.MethodsThis study collected publicly available information on COVID-19 released on official channels (e.g., government websites and official media) by the Parehub tool. Also, the study used the Zhongyun Big Data Platform to search public datasets about released COVID-19 information on Chinese social media, such as TikTok and Weibo. An online survey was conducted via WeChat to Chinese citizens using a snowball sampling method. The questionnaire assessed changes in participants’ risk perception and action against COVID-19. The data analysis examined information content and release-time trajectories against the public’s risk perception and actions over time.ResultsAltogether, the collected data includes 1477 pieces of authorized information and 297,000 short videos on COVID-19. Of 1362 participants recruited from 33 provinces and municipalities of China, 1311 respondents (25–60 years, 42% male) were valid for future analysis. The study indicated that 85.7% of participants mainly relied on official channels to obtain information. Alongside the outbreak’s progress, there was a gradual rise in information quantity, publishing frequency, and content variation. Correspondingly, the public’s risk perception that “take it seriously” rose from 13 to 80%, 87.1% of those who took “multiple actions” compared to 25.9% initially.ConclusionsOur findings indicated that insufficient information freely-accessible at the early stages of the outbreak might lead to the lack of risk awareness and the public’s inadequate protective actions. Given the current global situation of COVID-19, the study highlights authorized, transparent, and timely two-way risk communication is vital to guide public perception and actions. Furthermore, our study provides risk communication recommendations and may contribute to developing full measures to address future crises.

The development trend of China’s natural gas consumption: A forecasting viewpoint based on grey forecasting model

In the context of global emission reduction, as a type of clean and eco-friendly energy, natural gas has attracted wide attention. Accurate prediction of natural gas consumption can provide reference for relevant departments to formulate the corresponding development plans and strategies. At present, there are many forecasting tools for processing and analysing natural gas consumption, but most of them have the disadvantages of complex modelling or low precision. In order to solve this problem, inspired by the polynomial regression prediction model and the discrete grey prediction model, a novel polynomial discrete grey prediction model with fractional order accumulation (abbreviated as FPDGM(1,1) model) is established in this paper. In order to find the optimal parameters of the FPDGM(1,1) model, three most popular intelligent algorithms are used to solve the parameters of the model, and then the optimal parameters from the three intelligent algorithms are selected in this paper. In addition, the advantages of the FPDGM(1,1) model over other four forecasting models are confirmed through two parts in this paper. First, the natural gas consumptions of four municipalities in China are used as cases to verify the effectiveness of the FPDGM(1,1) model in this paper. Subsequently, the FPDGM(1,1) model and several kinds of frequently used forecasting models are applied to analyse and predict China’s natural gas consumption, and the FPDGM(1,1) model is used to predict China’s natural gas consumption in the next 5 years. The results of these two parts indicate that the FPDGM(1,1) model shows the best predictive performance in all cases. Lastly, based on the predicted results of the FPDGM(1,1) model, some reasonable suggestions are put forward for China’s natural gas development plan.

Water Intake in Pregnant Women in China, 2018: The Report of a Survey.

Background: Adequate water intake in pregnant women plays an important role in their health and in fetal growth and development. However, there is insufficient applicable data to guide and evaluate the water intake of pregnant women in China. Based on a nationwide sample of pregnant women, we mainly aimed to investigate the daily total water intake (TWI) and the contribution of different beverages and food sources to the TWI, to assess the percentage of participants who comply with the adequate intake (AI) value of water set by the Chinese Nutrition Society (CNS) and the European Food Safety Authority (EFSA) and to analyze the contribution of different water sources to the daily total energy intake (TEI). Methods: A multi-stage sampling method was used to recruit pregnant women from 11 provinces and two municipalities in China. A 4-day online diary with a food atlas was used to assess water and dietary intake. Finally, 653 pregnant women were included in the analysis. The Mann–Whitney U test and the independent-sample t-test were used to compare the differences between related variables in different age groups or different gestational periods, and partial correlation was used to explore the correlation between water and energy intake. Results: The median daily TWI of pregnant women was 2190 mL, of which water from beverages and foods accounted for 52.9% and 47.1%, respectively. Approximately 80.5% of the water from beverages was mainly from plain water (r = 0.973), while in the part of the water from foods, dishes (32.4%) were the main contributors (r = 0.663). Only 16.4% and 43.8% of the total population met the TWI recommendation set by the CNS and EFSA, respectively. Among these, the contribution of the water from beverages was higher than that of the water from food. For those whose TWI did not reach the recommended level, the contribution of the water from beverages was almost equal to that of food. The median daily TEI of pregnant women was 1589 kcal, of which beverages accounted for 9.7%. Milk and milk derivatives (71.3%) were the main contributors to energy from beverages, accounting for 71.3% (r = 0.444). Although sugar-sweetened drinks only accounted for 10.1% of the energy from beverages, they were highly correlated with energy from beverages (r = 0.836). Through grouping analysis, age and gestational period had no significant effect on the above main results. Conclusions: This was the beginning of a nationwide study on the TWI of pregnant women in China, and the results provide evidence of the need for interventions to improve water intake among pregnant women and the revision of reference values for AI of TWI in pregnant women in China.

Exploring ecological civilization performance and its determinants in emerging industrialized countries: A new evaluation system in the case of China

The construction of ecological civilization has become necessary to ensure that emerging industrialized countries can achieve healthy and sustainable development under the background of tightening resource constraints, serious environmental pollution, and the deterioration of the ecological environment. In the case of China, one representative emerging industrialized economy, this paper builds an ecological civilization performance evaluation system to measure the efficiency of ecological civilization in 30 provinces and municipalities in China by using the data envelopment analysis (DEA) game cross-efficiency model. From the perspective of the “five-in-one” approach, and by taking full account of the three main bodies of government, enterprises and residents, this paper selects nine explanatory variables, namely industrial structure and degree of marketization (Economic perspective), government environmental risk awareness and government green actions (Political perspective), residents' happiness and corporate environmental responsibility (Social perspective), culture education investment (Cultural perspective), and green travel and ecological construction (Ecological perspective). Geographically Temporally Weighted Regression (GTWR) is used to analyze determinants of the Chinese ecological civilization performance. The results show that China's ecological civilization performance is low, and the efficiency ranking of most provinces fluctuates greatly. The regional development of China's ecological civilization performance presents a spatial distribution pattern that was high in the east and low in the west. The impact of various influencing factors on the China's ecological civilization performance is largely positive, and indicates regional characteristics. These results not only contribute to advancing the existing literature on ecological civilization performance evaluation, but also merit particular attention from policy makers in emerging industrialized countries.

Factors That Influence Perceived Organizational Support for Emotional Labor of Chinese Medical Personnel in Hubei.

At the outbreak of coronavirus disease in Wuhan, China, 42,322 medical personnel from other provinces and municipalities in China volunteered to rush to Hubei to assist their colleagues. Their all-out efforts contributed to Hubei finally winning the fight to prevent and control the pandemic. The aim of this study is to explore the influence of perceived organizational support on the emotional labor of medical personnel in Hubei Province. A group of 170 medical personnel from (tertiary) hospitals who participated in the pandemic aid operation in Hubei completed self-administered questionnaires, including the perceived organizational support scale, emotional labor scale, and professional identity scale. This study used Pearson's correlation in SPSS to analyze the three variables of organizational support, emotional labor, and professional identity. Organizational support and emotional labor (r = 0.443, P < 0.01), organizational support and professional identity (r = 0.631, P < 0.01), and emotional labor and occupational identity (r = 0.511, P < 0.01) showed a significant positive correlation. The bootstrapping mediating effect test was used to determine the overall mediating effect of occupational identity. Occupational identity was a complete mediating effect between organizational support and emotional labor. The results show that a strong sense of organizational support can promote higher emotional labor among medical workers in Hubei Province. A strong sense of organizational support will also promote a stronger professional identity; further, a strong professional identity completely mediates the effect of perceived organizational support on emotional labor. These results infer that in emergency medical and health services, medical personnel can realize a high sense of organizational support, which could enhance their professional identity; this enables them to combine their professional goals with organizational goals more actively and to finally pay higher emotional labor to achieve organizational goals.

Development of Xin-Yang 信仰 scale: understanding spirituality among Chinese college students

ABSTRACT The current study pursued a scale development process to understand spirituality among Chinese college students. From definition to item development, Chinese college students’ view and experiences were used as the bases. The validation process involved 1,207 college students from five different provinces, autonomous regions, and direct-controlled municipalities in China. Item factor analysis and structural equation modelling were performed. The study resulted in a Xin-Yang scale (Xin-Yang 信仰 is deemed as a conceptually similar concept to spirituality in Western cultures and is familiar to the Chinese college students), consisting of three factors: characteristics, mental guidance, and relationship to others. Satisfactorily, psychometric qualities were established. Furthermore, for Chinese college students, Xin-Yang信仰 is shown to be significantly and positively correlated with life satisfaction, self-esteem, and self-efficacy, and negatively with psychological symptoms. In addition, Xin-Yang 信仰is significantly and positively correlated with a Western spirituality measure. Limitations and implications were discussed.

Forest Quality Dynamic Change and Its Driving Factors Accompanied by Forest Transition in China

As ecological and environmental issues have received continuous attention, forest transition has gradually become the frontier and a hot issue, which have implications for biodiversity and ecosystem functioning. In this study, the spatial-temporal dynamics and the spatial determinants of forest quality were investigated using spatial econometric regression models at the province level, which contained 31 provinces, autonomous regions, and municipalities in China. The results showed that forest area, forest volume, forest coverage, and forest quality have greatly increased as of 2018, but uneven forest distribution is an important feature of forest adaptation to the environment. The global Moran’s I value was greater than 0.3, and forest quality of the province level had a positive spatial correlation and exhibited obvious spatial clustering characteristics. In particular, the spatial expansion of forest quality had shown an accelerated concentration. The most suitable model for empirical analysis and interpretation was the Spatial Durbin Model (SDM) with fixed effects. The average annual precipitation and the area ratio of the collective forest were positively correlated with forested quality (significance level 1%). Ultimately, this framework could guide future research, describe actual and potential changes in forest quality associated with forest transitions, and promote management plans that incorporate forest area changes.

National drug utilization trend of analgesics in China: an analysis of procurement data at 793 public hospitals from 2013 to 2018

BackgroundThis research aimed to evaluate analgesic utilization in public hospitals from 2013 to 2018 by analyzing the procurement data of 793 hospitals in China.MethodsThis study applied a retrospective observational study by using a database of the Chinese Pharmaceutical Association. The final dataset covers 30 provinces and municipalities in China, with a total of 793 public hospitals with complete procurement records of analgesics from January 2013 to December 2018. Procurement cost and dosage utilization were analyzed through descriptive trend statistics.ResultsFrom the procurement cost data, analgesics mainly consisted of opioids and non-steroidal anti-inflammatory drugs (NSAIDs), and the annual cost of both types of drugs increased yearly. The 6-year total cost of opioids accounts for 57% (17,800 million CNY), followed by the cost of NSAIDs accounts for 37% (11,400 million CNY). From 2013 to 2018, the annual cost of opioids nearly doubled, while the annual cost of NSAIDs doubled. The total 6-year clinical drug dosage of opioids accounts for 45% (675 million total defined daily dose (DDD)), and the NSAIDs account for 50% (747 million total DDD). From 2013 to 2018, the annual clinical drug dosage of NSAIDs increased by about 0.6 times. The annual clinical drug dosage of opioids has more than doubled. The top three opioid drugs were dezocine injection, remifentanil injection, and sufentanil injection solution. the top three NSAIDs were flurbiprofen injection, parecoxib injection, and celecoxib oral solution.ConclusionIn China, analgesics utilization increased rapidly at public hospitals from 2013 to 2018. The utilization of analgesics was highly concentrated in NSAIDs and opioids. Within the two types of analgesics, the main analgesics utilization is also highly concentrated, with some highly risky analgesics. The rational guideline for the utilization of analgesics needs to be established with the support of real-world evidence.

Sexual orientation and quality of life of people living with HIV/AIDS in China: evidence from an institutional-based cross-sectional study.

At the end of 2019, there were approximately one million people known to be living with HIV/AIDS (PLWHA) in China. Different sexual orientation groups were observed within the people living with HIV in general, and studies have found that socially marginalized groups exist among this population, such as men who have sex with men (MSM) and bisexual individuals. Correspondingly, sexual orientation may pose challenges to the emotional and psychological development of PLWHA. Under this background, we aim to analyze whether sexual orientation affects the health-related quality of life (HRQOL) of PLWHA in order to provide evidence and suggestions for how wellbeing can be enhanced for sexual minorities living with HIV/AIDS. An institutional-based cross-sectional study design was used to collect data from PLWHA in Yunnan province and Beijing municipality in China. In our study, sexual orientation was classified as heterosexual, homosexual and bisexual, and HRQOL was measured using the Chinese WHOQOL-HIV-BREF scale. Logistic regression model was used to analyze the relationships of participants' sexual orientation and HRQOL. In addition, multivariable stepwise liner regression model was used to analyze the factors influencing HRQOL of PLWHA. In total, 2610 PLWHA were included in the study, 36.5% of the participants identified as homosexual and most were males, 13.8% were bisexuals and 49.7% were heterosexuals. For the overall HRQOL, the homosexual PLWHA group scored highest (81.53 ± 12.45) with a high HRQOL score signifying a better health-related quality of life, followed by bisexuals (79.72 ± 12.81) and heterosexuals (78.02 ± 13.06). However, the bisexual group showed a markedly higher level of spiritual health. In addition, there was no statistical difference in the total HRQOL scores and domains by sex roles among the homosexual group (p > 0.01). However, sexual orientation was statistically associated with the physical and spiritual domains of HRQOL (p < 0.05). In terms of sexual orientation for those living with HIV/AIDS, a better quality of life was found for homosexual individuals, whilst being a heterosexual individual saw a negative impact on quality of life, especially in the physical and spiritual domains. Strengthening the individualized and comprehensive care for heterosexual group as well as other sexual minority populations is imperative. Moreover, heterosexual PLWHA are more likely to be ignored and require more support and care to improve their HRQOL than do those in sexual minorities.