Priority Allocation Research Articles

Work and life: the relative importance of job quality for general well-being, and implications for social surveys

Abstract We investigate the relative importance of variations in job quality in accounting for variations in general well-being among employed people in Europe, the USA, Australia and South Korea. We find that the importance of job quality is everywhere of a similar magnitude to that of health, while both are far more important than other conventional determinants, including education, gender, marital status, parental status, age or household income. Job quality accounts for somewhat more of well-being’s variation among men than among women. Within the majority of European countries, the R2 for the variation accounted for ranges between 14 and 19%. The paper’s findings, alongside rising policy interest, support the allocation of a greater priority for job quality in general socio-economic and labour force surveys than hitherto.

Trends in the development and implementation of competition policy

Aim. To study the trends in the formation and implementation of competition policy.Objectives. To analyze global trends in the process of formation of competitive policy; to identify the influence of endogenous and exogenous factors in the process of competitive policy development; to determine the general trends of the leading states of the world that contribute to the support of competitive relations.Methods. The research utilized general scientific methods (comparative, complex, systemic, structural analysis), the method of cause-and-effect relationship, logical method.Results. Competitive policy in modern conditions has acquired a dualistic character. It combines in a contradictory unity the regulation of firms and households in the domestic and foreign markets, different measures of influence on the subjects of partner and adversary countries, control and influence on the markets of monopolized and competitive industries. The function of competitiveness development includes protection from monopolism and from the rivalry of foreign commodity producers. The boundaries of fair and unfair competition are gradually blurring. Changes in the rules of economic activity legitimize the behavior of economic entities, which previously was defined as unfair and was subject to sanctions provided for by the legislation. A trend common to many countries is the application of standards and norms established at the global level by their authorities regulating competition relations to the market activities of all economic entities in the country. Attempts to adapt the best world experience in supporting competitive relations to the national and historical peculiarities of each country have become widespread.Conclusions. The analyzed trends in the development of competition policy under the influence of the ratio of exogenous and endogenous factors in each country are manifested in two main variants. One of them is the policy of openness, inclusion of the national economy in the global economic system. Another option is the policy of isolation and restraint of competition from foreign market participants. A smaller part of the states prefer to choose one of these options, the majority tries to move along a compromise path, which can bring them success with the right allocation of priorities.

Systemic sclerosis associated respiratory involvement: Scopus-based analysis of articles in 2013-2022.

Systemic sclerosis (SSc), a complex autoimmune disorder, manifests as a convergence of rheumatologic, dermatologic, and pulmonary challenges. Among the severe complications contributing to morbidity and mortality are SSc Associated Interstitial Lung Disease (SSc-ILD) and pulmonary hypertension. Over the past decade, research on pulmonary involvement in SSc has intensified, leading to a heightened understanding of its pathogenesis, diagnostic methods, and therapeutic strategies. This study aims to provide a data-driven overview of the current state of systemic sclerosis research, identifying emerging trends and fostering informed decisions regarding resource allocation and research priorities. A literature search was conducted in the Scopus database, using MESH keywords such as "systemic sclerosis" AND "lungs" OR "pulmonary hypertension" OR "interstitial lung disease". After applying exclusion criteria, a thorough analysis was performed, considering factors such as document category, authorship, journal source, citation frequency, country of publication, language, and keywords. The bibliometric analysis utilized Scopus as the preferred database, leveraging its extensive coverage, user-friendly interface, and commitment to data accuracy. Visual networks were constructed using VOSviewer software to map the relationships between keywords, countries, and authors. Altmetric Attention Scores (AAS) were employed to assess the social impact of articles. The analysis revealed a total of 2538 scholarly items, with 55.7% identified as open access. The USA (n = 532), Italy (n = 458), France (n = 304), Japan (n = 271), and the UK (n = 236) emerged as primary contributors, with English being the predominant language. A notable upward tendency in annual publication and citation scores indicated sustained interest and relevance in SSc-ILD research. The top journals, including Rheumatology United Kingdom, Clinical and Experimental Rheumatology, Clinical Rheumatology, Arthritis and Rheumatology, and Journal of Rheumatology, played a pivotal role in scholarly output. Original Articles (n = 1795; 70.7%) constituted the majority of publications, followed by Reviews, Letters, Notes, and Editorials. The analysis of publication impact within different scholarly formats revealed varying citation patterns, with Original Articles and Reviews leading in influence. The identification of influential research hubs and key contributors provided insights into collaborative efforts and geographic distribution. A strong correlation (rho = 0.612, p < 0.001) was observed between the quantity of Mendeley readers and the citations received by scholarly articles. This bibliometric analysis offers a comprehensive overview of SSc-ILD research, highlighting its dynamic and interdisciplinary nature. The surge in publications, citation scores, and the identification of key contributors underscore the continued relevance and impact of this field. The nuanced relationships between social attention and scientific recognition, as revealed by Mendeley readership and AAS, contribute to a deeper understanding of the multifaceted nature of scholarly impact.

Ethical Frameworks and Global Health: A Narrative Review of the "Leave No One Behind" Principle.

The "Leave No One Behind" (LNOB) principle, a fundamental commitment of the United Nations' Sustainable Development Goals, emphasizes the urgent need to address and reduce global health inequalities. As global health initiatives strive to uphold this principle, they face significant ethical challenges in balancing equity, resource allocation, and diverse health priorities. This narrative review critically examines these ethical dilemmas and their implications for translating LNOB into actionable global health strategies. A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, and Semantic Scholar, covering publications from January 1990 to April 2024. The review included peer-reviewed articles, gray literature, and official reports that addressed the ethical dimensions of LNOB in global health contexts. A thematic analysis was employed to identify and synthesize recurring ethical issues, dilemmas, and proposed solutions. The thematic analysis identified 4 primary ethical tensions that complicate the operationalization of LNOB: (1) Universalism versus Targeting, where the challenge lies in balancing broad health improvements with targeted interventions for the most disadvantaged; (2) Resource Scarcity versus Equity; highlighting the ethical conflicts between maximizing efficiency and ensuring fairness; (3) Top-down versus Bottom-up Approaches, reflecting the tension between externally driven initiatives and local community needs; and (4) Short-term versus Long-term Sustainability, addressing the balance between immediate health interventions and sustainable systemic changes. To navigate these ethical challenges effectively, global health strategies must adopt a nuanced, context-sensitive approach incorporating structured decision-making processes and authentic community participation. The review advocates for systemic reforms that address the root causes of health disparities, promote equitable collaboration between health practitioners and marginalized communities, and align global health interventions with ethical imperatives. Such an approach is essential to truly operationalize the LNOB principle and foster sustainable health equity.

The impact of high volumes of COVID-related lung transplant on waitlist mortality for non-COVID candidates in the United States.

Some patients with coronavirus disease 19 (COVID) develop serious, irreversible lung disease, including acute respiratory distress syndrome or pulmonary fibrosis. For select candidates, lung transplant is the only option to improve quality and length of life. Because of the severity of end-stage COVID-related lung disease, these candidates receive high allocation priority in the United States, including higher priority than many patients without COVID-related lung disease. This study assessed whether transplant centers with a large volume of COVID-related lung transplants experienced an increase in waitlist mortality for non-COVID transplant candidates. Nineteen centers were included as high-volume programs, defined as being in the top third of centers who transplanted COVID patients. Of the 2867 non-COVID patients waitlisted at these centers, there was no significant difference in waitlist mortalities of non-COVID transplant candidates between the pre-COVID transplant era (January 2018-February 2020) and during the period of high COVID transplant volume (March 2020-October 2022) (subhazard ratio: .92 [95% CI=.81-1.05], p=.22). Among high volume centers, the decision to transplant and to prioritize patients with COVID-related lung disease did not significantly impact the waitlist mortality of other candidates.

Pediatric priority in kidney allocation after the age of 18 years

Children registered for kidney transplants prior to the age of 18 years retain “pediatric” allocation status after their 18th birthday. There are no data on the impact of this policy. We performed a retrospective cohort study of 7097 candidates listed for kidney transplant prior to 18 years of age who remained on the waitlist after their 18th birthday between January 1, 2015, and April 1, 2022, using United Network for Organ Sharing data. A total of 1193 candidates remained on the waitlist after their 18th birthday. The median age at listing was 17 years (IQR: 17-17 years). A total of 588 candidates (8% of 7097 pediatric candidates) received a kidney transplant with pediatric status at the age of 18 years or older; 465 (79%) were deceased-donor transplants. The median age at deceased-donor transplants was 18 years (IQR: 18-19 years); 97% were performed before the age of 21 years. In the 7.25 years of the study, 12 adults aged 21 years and older received a deceased-donor kidney transplant with pediatric allocation priority. Deceased-donor transplants with pediatric priority after the age of 18 years are rare, comprising an estimated 0.4% of all adult deceased-donor transplants. Candidates with pediatric priority after 18 years of age typically progress to transplant within 3 years. Ongoing monitoring of this population is important to fully understand the allocation policy.

Көліктік-логистикалық орталықтар менеджментінің оңтайлы құрылымының бизнес моделі

Transport logistics are transport enterprises that are participants in the process of distributing goods, aimed at obtaining a single economic result in the logistics chain. This article discusses the main factors of the company's productivity growth and the priority allocation system. The expansion of transport and logistics systems through the construction and modernization of transport and logistics centers at major transport hubs, mainly in regional centers, is also being considered. The expediency of the applied projects is proved using regression analysis based on the classical modeling method. Optimal management of the management of transport and logistics centers has a number of advantages over the traditional management method, and is also carried out by balancing the requirements of the main groups. The management model in the management of a transport and logistics center is based on five special management processes. In general, this analysis is a classical basic probability method, i.e. fully examines the economic indicators of the enterprise. The model is based on five special management processes. When studying the activities of the supply chain, a single plan provides for the intersection of the processes of supply of raw materials, product preparation, delivery and return, according to which the activities of all partner companies of the chain are coordinated. Companies need to have a good understanding of their place in the supply chain and the possibilities for improving work efficiency.

Efficient and privacy-preserving multi-agent systems for smart city carpooling with k-regret queries and differential privacy

Multi-Agent Systems are characterized by the presence of multiple independent agents and find diverse applications. In the context of smart cities, MAS is employed in traffic management to enhance operational efficiency, optimize resource utilization, and improve the quality of life for residents. This research paper focuses on the design of a multi-agent intelligent scheduling system, where passengers, vehicles, and carpooling platforms serve as intelligent agents. The primary objective of passengers is to identify suitable shared vehicles based on criteria such as waiting time, budget constraints, and willingness to carpool. Vehicles, on the other hand, organize their schedules based on passenger demands and designated routes. The carpooling platform takes into account resource allocation priority and optimization problems to ensure the efficient operation of the system. To address the issue of vehicle ordering, k-regret queries are utilized, while passenger preferences provide insight into determining loss factors. To safeguard privacy, differential privacy techniques and a random response mechanism are employed when dealing with multiple passenger queries. Furthermore, a direction-preserving insertion verification method is implemented to mitigate computational complexity. The effectiveness and efficiency of the proposed approach are validated through experimentation.

Evaluating the Impact of Data Transformation Techniques on the Performance and Interpretability of Software Defect Prediction Models

The performance of software defect prediction (SDP) models determines the priority of test resource allocation. Researchers also use interpretability techniques to gain empirical knowledge about software quality from SDP models. However, SDP methods designed in the past research rarely consider the impact of data transformation methods, simple but commonly used preprocessing techniques, on the performance and interpretability of SDP models. Therefore, in this paper, we investigate the impact of three data transformation methods (Log, Minmax, and Z-score) on the performance and interpretability of SDP models. Through empirical research on (i) six classification techniques (random forest, decision tree, logistic regression, Naive Bayes, K-nearest neighbors, and multilayer perceptron), (ii) six performance evaluation indicators (Accuracy, Precision, Recall, F1, MCC, and AUC), (iii) two interpretable methods (permutation and SHAP), (iv) two feature importance measures (Top-k feature rank overlap and difference), and (v) three datasets (Promise, Relink, and AEEEM), our results show that the data transformation methods can significantly improve the performance of the SDP models and greatly affect the variation of the most important features. Specifically, the impact of data transformation methods on the performance and interpretability of SDP models depends on the classification techniques and evaluation indicators. We observe that log transformation improves NB model performance by 7%–61% on the other five indicators with a 5% drop in Precision. Minmax and Z-score transformation improves NB model performance by 2%–9% across all indicators. However, all three transformation methods lead to substantial changes in the Top-5 important feature ranks, with differences exceeding 2 in 40%–80% of cases (detailed results available in the main content). Based on our findings, we recommend that (1) considering the impact of data transformation methods on model performance and interpretability when designing SDP approaches as transformations can improve model accuracy, and potentially obscure important features, which lead to challenges in interpretation, (2) conducting comparative experiments with and without the transformations to validate the effectiveness of proposed methods which are designed to improve the prediction performance, and (3) tracking changes in the most important features before and after applying data transformation methods to ensure precise and traceable interpretability conclusions to gain insights. Our study reminds researchers and practitioners of the need for comprehensive considerations even when using other similar simple data processing methods.

Risk ranking of foodborne diseases in Denmark: Reflections on a national burden of disease study

National burden of foodborne disease (FBD) studies are useful for risk ranking and identifying priorities for food safety resource allocation. FBD are caused by microbiological and chemical hazards, which have different incidence and mortality, and lead to health-outcomes varying in severity and duration. Due to their different origins and characteristics, distinct prevention strategies can be implemented. We present the Danish initiative to estimate the burden of FBD caused by pathogens and chemicals. We describe the methodological approaches and data used, present an overview of results for the reference year 2019, and discuss lessons learned throughout more than seven years of the project. Our estimates show that the leading causes of FBD in Denmark include both pathogens and chemicals, suggesting that food safety strategies should be diversified to tackle different issues. The experiences with this national study are useful for other countries planning to implement a burden of FBD study.

Abstract 15491: Have Heart Transplant Allocation Policy Changes Brought Improvements in Mortality for Children and Adults With Congenital Heart Disease? A UNOS Database Analysis

Introduction: The United Network of Organ Sharing (UNOS) made changes to the priority for allocation of hearts for transplantation (HT) in 2016 for pediatric patients and 2018 for adult patients. There are limited data describing the association of these changes with waitlist outcomes in patients with congenital heart disease (CHD). Methods: The United Network for Organ Sharing (UNOS) database was queried for pediatric (&lt;18 y/o, PCHD), and adult (18yo-50yo, ACHD), patients with a CHD diagnosis listed for HT. Cohorts were grouped into pre and post-allocation change eras: PCHD 1/1/11-3/21/15 and 1/1/17-12/31/21, ACHD 1/1/15-10/17/18 and 1/1/19 to 12/31/21. Differences in era for survival from the time of listing for HT were compared using competing risk models. Results: We identified 3,646 patients listed for HT during the study period including 1,520 PCHD and 432 ACHD pre-allocation change and 1,443 and 251 post. More PCHD patients in the post cohort were supported with ventricular assist devices (7.6% vs 3.2%) while fewer were on inotropes (41% vs 47%), intubated (18% vs 21%) or on ECMO (5.3% vs 7.9%) (p for all &lt;0.01 ). For ACHD, ECMO (4.8% vs 1.9%) and intra-aortic balloon pump (6.8% vs 1.9%) use was more prevalent in the post era (p&lt;0.05 for both). In a competing risk model adjusting for illness severity, the HR for death or waitlist removal within 1 year of HT listing was higher in the pre-allocation era compared to post for PCHD (HR 1.27 [95% CI 1.06-1.52]) but unchanged for ACHD (HR 1.36 [95% CI 0.77-2.41]). Figure 1 Conclusions: ACHD patients did not have the mortality benefit from policy changes which other groups, including PCHD, have experienced. Incorporating measures into the allocation system which more completely capture the illness severity that comes with ACHD are warranted, as are strategies to improve long term survival in this growing population.

Climate warming could free cold-adapted trees from C-conservative allocation strategy of storage over growth.

Carbon allocation has been fundamental for long-lived trees to survive cold stress at their upper elevation range limit. Although carbon allocation between non-structural carbohydrate (NSC) storage and structural growth is well-documented, it still remains unclear how ongoing climate warming influences these processes, particularly whether these two processes will shift in parallel or respond divergently to warming. Using a combination of an insitu downward-transplant warming experiment and an ex situ chamber warming treatment, we investigated how subalpine fir trees at their upper elevation limit coordinated carbon allocation priority among different sinks (e.g., NSC storage and structural growth) at whole-tree level in response to elevated temperature. We found that transplanted individuals from the upper elevation limit to lower elevations generally induced an increase in specific leaf area, but there was no detected evidence of warming effect on leaf-level saturated photosynthetic rates. Additionally, our results challenged the expectation that climate warming will accelerate structural carbon accumulation while maintaining NSC constant. Instead, individuals favored allocating available carbon to NSC storage over structural growth after 1 year of warming, despite the amplification in total biomass encouraged by both insitu and ex situ experimental warming. Unexpectedly, continued warming drove a regime shift in carbon allocation priority, which was manifested in the increase of NSC storage in synchrony to structural growth enhancement. These findings imply that climate warming would release trees at their cold edge from C-conservative allocation strategy of storage over structural growth. Thus, understanding the strategical regulation of the carbon allocation priority and the distinctive function of carbon sink components is of great implication for predicting tree fate in the future climate warming.

The controversial role of energy crops in the future German energy system: The trade offs of a phase-out and allocation priorities of the remaining biomass residues

Multiple global crises are adding new elements to the discussion on securing and shaping a resilient, renewable energy system in Germany. Biomass from residues, forest wood and energy crops are major renewable energy contributors in Germany today. The role of energy crops within that system is controversially discussed for a long time and a phase-out from cultivated biomass is again in the focus. But what kind of trade-offs would be connected with such a phase-out and what would be the optimal allocation priorities of the remaining biomass potential? Through a detailed representation of biomass potentials, prices and conversion technologies in an energy system optimisation model, it could be shown in a scenario analysis that a phase-out increases the demand for energy imports by 1400 PJ per year, which is associated with on-costs of €14–25 billion annually in the long term. Finally, the results show that the decision on whether to grow energy crops in the future is directly influencing the future transformation strategy for high-temperature industrial heat applications. Solid biomass is identified as the future cost-optimal solution to fully transform this sector. However, a phase-out of energy crops changes the cost-optimal allocation priorities completely.

Transitions in and out of work across the life course of patient with a NCD diagnosis

Abstract Background Coupled with its impact on quality of life, non-communicable Diseases (NCD) may degrade both the quality and quantity of the workforce, and stunt economic growth and productive employment. However, there is limited information about the social costs of NCDs to identify priorities in resource allocation, particularly in regard to retirement policies. In this paper, we investigate if NCDs affect them employment status, i.e., the patients’ ability to work beyond middle age, using longitudinal data. Methods We used longitudinal data from employed men and women who responded to the sixth and seventh waves of the SHARE project from several European countries and Israel. We restricted the sample to all people working up to 3 years before the expected retirement age for each country. To achieve a representative sample of employed people from each country we calculated calibrated longitudinal individual weights for participants in these two waves. It was to adjust for non-response, sample selection bias, and attrition (N = 9645). We modelled the probability to change employment status on Wave 7 as function of having a NCD, adjusting for age, gender, marital status, job satisfaction, education level, and country, using multinominal logistic regressions. Results Overall, 30.3% of the study population self-reported one NCD and 28.3% mentioned at least two chronic health conditions (multimorbidity). Among multimorbid individuals the risk of unemployment is 1.27 times more (OR = 1.271, 95% CI (1.266-1.276).), while the risk of retirement is multiplied by 1.26 (OR = 1.259, 95%CI (1.255-1.262)). Conclusions Having one NCD or multimorbidity is a common phenomenon in the working middle-aged European population. It is associated with unemployment and retirement, controlling for educational level, age, marital status, gender, job satisfaction, and country. This result highlights that early retirement will persist unless health policies are implemented to decrease the burden of NCDs. Key messages • This study shows that there is a strong association between having one or more NCD with unemployment and retirement, controlling for educational, age, and occupational type. • Results reinforce that we need health policies focused on alerting society about real impact of NCD on employment.

Shifts in energy allocation and reproduction in response to temperature in a small precocial mammal

BackgroundSpecies adjust to changes in temperature and the accompanying reduction in resource availability during the annual cycle by shifts in energy allocation. As it gets colder, the priority of energy allocation to maintenance increases and reproduction is reduced or abandoned.ResultsWe studied whether and how young female guinea pigs (Cavia porcellus) adjust even under ad libitum food conditions growth, storage of fat reserves and reproduction when kept at 5 °C versus 15 °C, and how offspring born into these conditions compensate during development to independence. Reproducing females grew less in the cold. Their lower weight resulted largely from less fat storage whereas growth in fat free mass was about the same for both groups. The increased need for thermoregulation diminished fat storage most likely due to the development of more brown fat tissue. Reproductive activity did not differ between groups in terms of litter frequency, mass and size. However, females in 5 °C weaned pups later (around day 25) than females in 15 °C (around day 21). Later weaning did not make up for the higher energy expenditure of pups in cold conditions leading to slower growth and less fat storage. Female pups born into the cold matured later than those born in 15 °C. Investment in reproduction continued but allocation to individual pups declined.ConclusionsIn more thermally demanding conditions female guinea pigs - even under ad libitum food abundance - transfer the higher costs of maintenance and reproduction largely to offspring.

Production of bioactive and aroma volatile compounds of Lawsonia inermis L. cultivated under different growth conditions

The present study aimed to investigate the influence of different growing conditions on the amount of leaf pigments (chlorophylls, carotenoids), bioactive metabolites, such as polyphenols, flavonoids, lawsone and volatile organic compounds (VOCs) of Lawsonia inermis L. (henna) plants. Young henna plants were cultivated for two months in a growth chamber (GC) and in open-air conditions during summer under the Mediterranean climate (OF), and leaves were analysed to evaluate their adaptive responses. The different growth conditions modified the carbon allocation priorities, increasing antioxidant metabolites (e.g. phenolic and flavonoid compounds) while decreasing lawsone in GC conditions. Quali-quantitative changes were observed for VOCs. This study revealed that GC conditions permit an alternative use of Lawsonia cultivation, because of the increase in the endogenous content of bioactive secondary metabolites with many potential biological activities.

Heavy Metal and the Mineral Ions Assessment of Borehole Water Used in Port Harcourt Oil Refinery Host Communities

This study presents the findings of an assessment conducted to determine the levels of heavy metals and mineral ions in borehole water used in the Port Harcourt oil refinery host communities. The study area comprised six selected communities located in the vicinity of the oil refinery in Rivers State, Nigeria. Water samples were collected from various boreholes in each community and analyzed for heavy metal concentrations and mineral ion content within the World Health Organisation (WHO) and National Standard for Drinking water Quality (NSDWQ) standard. The results revealed significant variations in heavy metal and mineral ion levels across the selected communities, with some areas exhibiting elevated concentrations of lead, arsenic, and cadmium. These heavy metals are known to pose health risks to humans, even at low concentrations, and raise concerns about the safety of the borehole water for consumption and agricultural use. It is highly recommended that borehole water in Port Harcourt Refinery be properly and routinely investigated as well as other water parameters checked. And Nigerian government in partnership with Non-governmental organization should conduct water security mapping to help identify vulnerable areas (communities) where there is high water stress such that the areas are given priority in borehole allocation

ADFPA – A Deep Reinforcement Learning-based Flow Priority Allocation Scheme for Throughput Optimization in FANETs

Flying ad hoc networks (FANETs) are easy to deploy and cost-efficient, however they are limited by the static protocols used in 802.11 and CSMA-based networks to support high bandwidth multi-UAV applications. This work proposes an Anticipatory Dynamic Flow Priority Allocation (ADFPA) scheme to optimize the priority levels of outgoing traffic flows for a transmitting node to maximize the total network throughput. Unlike other deep reinforcement learning (DRL)-based schemes in centralized networks, ADFPA is designed to be distributed, multi-agent, and proactive. It uses current and forecasted multi-context information to optimize the priority levels of traffic flows in a decentralized and dynamic FANET. Furthermore, a traffic flow sampling and padding algorithm is proposed so that a trained agent can be redeployed in different environments without retraining to address the practicality issue. Our evaluations show that ADFPA outperforms other state-of-the-art schemes by a maximum of 37% and 59.4% in terms of the network throughput in the single and multi-transmitting nodes environment, respectively, while achieving the best fairness amongst all schemes. These improvements translate to better data transmission capabilities in a conventional FANET, and the proposed scheme can enable the use of a FANET architecture in more demanding applications without switching to centralized solutions.

Cost and health-related quality of life for children hospitalized with respiratory syncytial virus in Central China.

The economic burden of respiratory syncytial virus (RSV) infection and its impact on health-related quality of life (HRQoL) are not well-understood in China. This study assessed total cost and HRQoL for children hospitalized with RSV in Central China. Based on a prospective case series study in Henan Province in 2020-2021, inpatients aged 0-59 months with RSV-related acute respiratory infections (ARIs) were included into analysis. Total cost included direct medical cost (sum of medical cost before and during hospitalization), direct non-medical cost, and indirect cost. Direct medical cost during hospitalization data were extracted from the hospital information system. Other costs and HRQoL status were obtained from a telephone survey conducted in the caregivers of the enrolled patients. Among 261 RSV-infected inpatients, caregivers of 170 non-severe cases (65.1%, 170/261) were successfully interviewed. Direct medical cost per episode was 1055.3 US dollars (US$) (95% CI: 998.2-1112.5 US$). Direct non-medical cost and indirect cost per episode were 83.6 US$ (95% CI: 77.5-89.7 US$) and 162.4 US$ (95% CI: 127.9-197.0 US$), respectively. Quality adjusted life years (QALY) loss for non-severe RSV hospitalization was 8.9 × 10-3 (95% CI: 7.9 × 10-3 -9.9 × 10-3 ). The majority of inpatients were <1 year of age comprising significantly higher cost and more QALY loss than older children. RSV-associated hospitalization poses high economic and health burden in Central China particularly for children <1 year old. Our findings are crucial for determining the priority of interventions and allocation of health resources.

Non-structural carbohydrate concentrations in contrasting dry and wet years in early- and late-successional boreal forest trees

Key messagePatterns of non-structural carbohydrate allocation in dry and wet differ between birch and larch in southern boreal forest.An increasing area of boreal forests is currently switching from temperature to drought limitation. It is not sufficiently known how the trees’ non-structural carbohydrate (NSC) pools are affected by alternating dry and wet phases in drought-prone boreal forests and how NSC concentrations are related to growth responses. In the southern boreal forests of Mongolia, NSC concentrations (including soluble sugars and starch) were determined enzymatically in the stemwood of two tree species during a drought year (2017) that was preceded by another drought in 2015 and two subsequent wet years (2018/19). Betula platyphylla as a broadleaved pioneer tree showed reduced radial stem increment in the drought year and rapidly increasing growth in the following wet years. It had low concentrations of NSC and of soluble sugars in particular, suggesting that most assimilate were invested into growth in this early successional tree. Larix sibirica as a late-successional conifer also showed reduced growth in the drought year, but lagged reductions in NSC concentrations and less pronounced growth releases than birch in 2018/19, suggesting a longer aftereffect of the drought than in birch. Larch maintained much higher NSC concentrations throughout the three studied growing seasons, including the drought episode in 2017. The NSC pool in larch was primarily formed by soluble sugars in sapwood and heartwood. In contrast to birch, larch showed a high allocation priority for assimilates in soluble sugars before investment in biomass, which explains the aftereffect of the drought on both growth and NSC. We conclude that the high soluble sugar concentrations in larch are a key determinant of the extreme drought and cold tolerance of L. sibirica and, therefore, growth has lower allocation priority for carbon compared to birch.