Regional Differences Research Articles

A real-world study of the differences in Traditional Chinese Medicine diagnosis and treatment rules for coronavirus disease 2019 between Northern and Southern China.

To explore the differences in Traditional Chinese Medicine (TCM) diagnosis and treatment rules for coronavirus disease 2019 (COVID-19) between Northern and Southern China based on the real-world data from 982 COVID-19 patients. All consecutive cases of COVID-19 admitted to the TCM department of designated COVID-19 hospitals in eight provinces and cities were retrospectively analyzed. Patients were divided into a Northern and a Southern group according to the location of the admitting hospital. The symptoms, syndrome elements, syndrome distribution and herbal treatments were analyzed. The core prescriptions were extracted using the multiscale backbone-based network comparison algorithm (msbNC). The distribution of syndrome elements showed that dampness was common in Northern and Southern China, wind and heat were more often present in the South, while fire toxin and spleen deficiency were more often encountered in the North. The distribution of syndromes showed that the South was dominated by heat dampness accumulating in the lung (55.69%), while the North was dominated by dampness-toxin stagnating in the lung (44.90%).The results of core prescription mining showed that dispelling dampness, dispersing wind, clearing heat and strengthening spleen were the common treatment methods in Northern and Southern China. For mild cases, Jinyinhua (Flos Lonicerae) and Lianqiao (Fructus Forsythiae Suspensae) were often used in the South to clear heat and relieve exterior symptoms, while Chaihu (Radix Bupleuri Chinensis) and Huangqin (Radix Scutellariae Baicalensis) were often used in the North to relieve muscles by expelling heat. For moderate cases, Chaihu (Radix Bupleuri Chinensis), Qinghao (Herba Artemisiae Annuae), and Shigao (Gypsum Fibrosum) were often used to clear heat of Tri-jiao Channel and stomach in the South, while Fuling (Poria), Chenpi (Pericarpium Citri Reticulatae), and Dangshen (Radix Codonopsis) were often used to invigorate spleen and remove dampness in the North. For severe cases, spleen invigoration and dampness removal as well as relaxing the bowels and discharging heat were often used in the North. There were certain North-South differences in terms of symptoms, syndrome elements and syndrome distribution of COVID-19, as well as differences in core prescriptions during different periods of the disease. The regional differences in the rules of TCM diagnosis and treatment for COVID-19 should be further considered in the process of optimization and revision of relevant treatment guidance.

Regional Differences in Diagnosis Journey and Healthcare Utilization: Results from the International Map of Axial Spondyloarthritis (IMAS).

To assess differences in thediagnosis journey and access to care in a large sample of patients with axial spondyloarthritis (axSpA)from around the world,included in the International Map of Axial Spondyloarthritis (IMAS). IMAS was a cross-sectional online survey (2017-2022) of 5557 unselected patients with axSpA from 27 countries. Across five worldwide geographic regions, the patient journey until diagnosis and healthcare utilization in the last 12 months prior to survey were evaluated. Univariable and multivariable linear regression was used to analyze factors associated with higher healthcare utilization. Of 5557 participants in IMAS, the diagnosis took an average of 7.4 years, requiring more than two visits to HCPs (77.7% general practitioner and 51.3% rheumatologist), and more than two diagnostic tests [67.5% performed human leukocyte antigen B27 (HLA-B27), 64.2% x-ray, and 59.1% magnetic resonance imaging (MRI) scans]. North America and Europe were the regions with the highest number of healthcare professional (HCP) visits for diagnosis, while the lowest number of visits was in the Asian region. In the previous 12 months, 94.9% (n=5272) used at least one healthcare resource, with an average of 29 uses per year. The regions with the highest healthcare utilization were Latin America, Europe, and North America. In the multiple linear regression, factors associated with higher number of healthcare utilization were younger age (b=-0.311), femalegender (b=7.736), higher disease activity (b=1.461), poorer mental health (b=0.624), greater functional limitation (b=0.300), greater spinal stiffness (b=1.527), and longer diagnostic delay (b=0.104). The diagnosis of axSpA usually takes more than two visits to HCPs and at least 7 years. After diagnosis, axSpA is associated with frequent healthcare resource use. Younger age, female gender, higher disease activity, poorer mental health, greater functional limitation, greater spinal stiffness, and longer diagnostic delay are associated with higher healthcare utilization. Europe and North America use more HCP visits and diagnostic tests before and after diagnosis than the other regions.

Wastewater Surveillance to Confirm Differences in Influenza A Infection between Michigan, USA, and Ontario, Canada, September 2022-March 2023.

Wastewater surveillance is an effective way to track the prevalence of infectious agents within a community and, potentially, the spread of pathogens between jurisdictions. We conducted a retrospective wastewater surveillance study of the 2022-23 influenza season in 2 communities, Detroit, Michigan, USA, and Windsor-Essex, Ontario, Canada, that form North America's largest cross-border conurbation. We observed a positive relationship between influenza-related hospitalizations and the influenza A virus (IAV) wastewater signal in Windsor-Essex (ρ = 0.785; p<0.001) and an association between influenza-related hospitalizations in Michigan and the IAV wastewater signal for Detroit (ρ = 0.769; p<0.001). Time-lagged cross correlation and qualitative examination of wastewater signal in the monitored sewersheds showed the peak of the IAV season in Detroit was delayed behind Windsor-Essex by 3 weeks. Wastewater surveillance for IAV reflects regional differences in infection dynamics which may be influenced by many factors, including the timing of vaccine administration between jurisdictions.

Spatial and temporal evolution of cost-competitive offshore hydrogen in China: A techno-economic analysis

China's ascendancy as the premier offshore wind power developer and principal hydrogen consumer underscores the expanding demand for green hydrogen, which is vital to its decarbonization trajectory. Offshore wind power is recognized as a crucial pathway for the future supply of green hydrogen, and further exploration of its development potential and economic viability can provide important insights for optimizing resource allocation, reducing greenhouse gas emissions, and ensuring energy security. This study analyzed the potential and regional economic differences in offshore wind energy for hydrogen production in China's coastal regions by considering the temporal evolution of techno-economic parameters and the spatial and temporal characteristics of geospatial resources. The findings suggest a potential hydrogen production capacity of 434–493 Mt/year in Chinese waters, with the average levelized cost of hydrogen projected to decline from 7.13 $/kgH2 in 2025 to 3.77 $/kgH2 by 2050, which is attributed to advancements in wind turbine technology and cost reductions in components. By 2030, hydrogen production of 40 Mt/year is expected to be cost-competitive, especially in Liaoning and Hebei, with projections indicating an increase to 435 Mt/year by 2050. Notably, floating wind power, contributing to 54 % of China's total offshore hydrogen capacity, holds significant promise for provinces such as Guangdong, Hainan, and Zhejiang. The study conclude that China's offshore hydrogen production has significant potential, with cost-competitive production achievable by 2030 and broad economic viability anticipated by 2050.

Temporal trends and regional variations in operative vaginal deliveries in Japan: A national representative cohort study.

To analyze temporal trends and regional variations in operative vaginal delivery (OVD) in Japan. Using the National Database of Health Insurance Claims and Specific Health Checkups of Japan from 2014 to 2021, we identified the numbers of vacuum and forceps deliveries. We analyzed annual totals and proportions of OVDs and calculated the mean age of women undergoing these deliveries. We also predicted trends in OVD for the next 20 years and compared geographical differences in the proportions of forceps deliveries among OVDs. During the observation period, out of 7 368 814 total births, 8.4% were through OVD, including 7.6% by vacuum and 0.8% by forceps. Both delivery methods showed an increasing trend from 2014 to 2021: vacuum deliveries rose from 7.0% to 8.7%, and forceps deliveries increased from 0.6% to 1.0%. Notably, the proportion of forceps deliveries in OVD increased from 8.1% to 10.5%. The mean age was higher for forceps deliveries than vacuum deliveries. According to our predictions, vacuum deliveries may continue to increase, but forceps deliveries may stabilize. The proportion of forceps deliveries among OVDs ranged from 0% to 38% across Japanese prefectures. This study shows an increase in the use of OVD in Japan from 2014 to 2021. There are large regional differences in the choice between vacuum and forceps deliveries. These findings can help us understand the practice of OVD in Japan.

An Investigation of the Third Harmonic Power Line Emission in the Topside Ionosphere During the Recent Solar Minimum Period

AbstractPower line harmonic radiation (PLHR) events are radiated by electric power systems on the ground at harmonics of the base power system frequency (50 or 60 Hz, depending on the region). We analyze the global third harmonics PLHR at 150 and 180 Hz using electric field data collected by China Seismo‐Electromagnetic Satellite during the recent solar minimum between January 2019 and December 2022. The average frequency spectrum over industrialized areas shows that the third harmonic has a high occurrence rate in the U.S. region, as well as in western China and northern India, but is very low in the European region. In particular, in the China region and the U.S. region, more than 11,000 and 24,000 dayside and nightside third harmonic PLHR events have been detected from 2019 to 2022, respectively. Compared to the 150 Hz PLHR occurrence rate detected above the China region, the 180 Hz PLHR occurrence rate above the U.S. region is higher, which reveals a significant regional difference. In addition, both at nighttime and daytime, the PLHR electric field intensities at 180 Hz are higher than that at 60 Hz above the U.S. region, which is also different from the result above the China region.

Exploring autism via the retina: Comparative insights in children with autism spectrum disorder and typical development.

Autism spectrum disorder (ASD) is a widely recognized neurodevelopmental disorder, yet the identification of reliable imaging biomarkers for its early diagnosis remains a challenge. Considering the specific manifestations of ASD in the eyes and the interconnectivity between the brain and the eyes, this study investigates ASD through the lens of retinal analysis. We specifically examined differences in the macular region of the retina using optical coherence tomography (OCT)/optical coherence tomography angiography (OCTA) images between children diagnosed with ASD and those with typical development (TD). Our findings present potential novel characteristics of ASD: the thickness of the ellipsoid zone (EZ) with cone photoreceptors was significantly increased in ASD; the large-caliber arteriovenous of the inner retina was significantly reduced in ASD; these changes in the EZ and arteriovenous were more significant in the left eye than in the right eye. These observations of photoreceptor alterations, vascular function changes, and lateralization phenomena in ASD warrant further investigation, and we hope that this work can advance interdisciplinary understanding of ASD.

Reduced size in a montane butterfly at its warm range boundaries

Abstract Variation in insect size is often related to temperature during development and may affect the persistence of populations under future climate warming if smaller individuals have reduced fitness. Montane species are particularly vulnerable to climate‐driven local extinctions due to range retractions at their warm range margins, and so we examined spatial and temporal variation in body size in the butterfly Erebia epiphron (Lepidoptera: Nymphalidae) in the United Kingdom, where it is restricted to two montane regions in England and Scotland. We examined spatial and temporal variation in body size in relation to temperature. We sampled 19 populations (6–15 individuals per population) in England and Scotland between 2018 and 2019 spanning elevations from 380 to 720 m and examined museum specimens collected between 1890 and 1980. We examined individual body size (forewing length) and its relationship with the local temperature of sites, as well as temporal variation in body size over the last century in relation to the temperature during larval development. The forewing lengths of field‐collected individuals in England were on average 7%–8% smaller than in Scotland (England, mean = 14.9 mm, Scotland, mean = 15.9 mm), and warmer sites also had smaller individuals (0.13 mm reduction in wing length per 1°C increase in local site mean temperature). However, we found no effect of temporal temperature variation on body size changes during larval development. The observed smaller body size in English populations could have impacts on fecundity and dispersal ability. Future work should seek to understand the life‐cycle lengths, genetics and phenotypic plasticity of these two populations to evaluate potential explanations for regional differences.

Large scale exploration reveals rare taxa crucially shape microbial assembly in alkaline lake sediments

Alkaline lakes are extreme environments inhabited by diverse microbial extremophiles. However, large-scale distribution patterns, environmental adaptations, community assembly, and evolutionary dynamics of microbial communities remain largely underexplored. This study investigated the characteristics of microbial communities on rare and abundant taxa in alkaline lake sediments in west and northwest China. We observed that abundant taxa varied significantly with geographical distance, while rare taxa remained unaffected by regional differences. The assembly process of abundant taxa was influenced by dispersal limitation, whilst rare taxa were predominantly driven by heterogeneous selection. Network analysis indicated that rare taxa as core species for community interactions and community stability. Rare taxa exhibited higher speciation and transition rate than abundant taxa, serving as a genetic reservoir and potential candidates to become abundance taxa, highlighting their crucial role in maintaining microbial diversity. These insights underscore the significant influence of rare taxa on ecosystem biodiversity and stability in alkaline lakes.

TransTLA: A Transfer Learning Approach with TCN-LSTM-Attention for Household Appliance Sales Forecasting in Small Towns

Deep learning (DL) has been widely applied to forecast the sales volume of household appliances with high accuracy. Unfortunately, in small towns, due to the limited amount of historical sales data, it is difficult to forecast household appliance sales accurately. To overcome the above-mentioned challenge, we propose a novel household appliance sales forecasting algorithm based on transfer learning, temporal convolutional network (TCN), long short-term memory (LSTM), and attention mechanism (called “TransTLA”). Firstly, we combine TCN and LSTM to exploit the spatiotemporal correlation of sales data. Secondly, we utilize the attention mechanism to make full use of the features of sales data. Finally, in order to mitigate the impact of data scarcity and regional differences, a transfer learning technique is used to improve the predictive performance in small towns, with the help of the learning experience from the megacity. The experimental outcomes reveal that the proposed TransTLA model significantly outperforms traditional forecasting methods in predicting small town household appliance sales volumes. Specifically, TransTLA achieves an average mean absolute error (MAE) improvement of 27.60% over LSTM, 9.23% over convolutional neural networks (CNN), and 11.00% over the CNN-LSTM-Attention model across one to four step-ahead predictions. This study addresses the data scarcity problem in small town sales forecasting, helping businesses improve inventory management, enhance customer satisfaction, and contribute to a more efficient supply chain, benefiting the overall economy.

Neural rhythms of narcissism: Facets of narcissism are associated with different neural sources in resting-state EEG.

Trait narcissism is characterized by significant heterogeneity across individuals. Despite advances in the conceptualization of narcissism, including the increasing recognition that narcissism is a multidimensional construct, the sources of this heterogeneity remain poorly understood. Here, we used a neural trait approach to help better understand "how," and shed light on "why," individuals vary in facets of trait narcissism. Participants (N= 58) first completed personality measures, including the Narcissistic Personality Inventory (NPI), and then in a second session sat passively while resting-state electroencephalography (rs-EEG) was recorded. We then regressed source-localized rs-EEG activity on the distinct facets of narcissism: Grandiose Exhibitionism (GE), Entitlement/Exploitativeness (EE), and Leadership/Authority (LA). Results revealed that each facet was associated with different (though sometimes overlapping) neural sources. Specifically, GE was associated with reduced activation in the dorsomedial prefrontal cortex (DMPFC). EE was associated with reduced activation in the DMPFC and right lateral PFC. LA was associated with increased activation in the left anterior temporal cortex. These findings support the idea that trait narcissism is a multidimensional construct undergirded by individual differences in neural regions related to social cognition (the DMPFC), self-regulation (right lateral PFC), and self-referential processing (left anterior temporal cortex).

Free-breathing 3D phase-resolved functional lung MRI vsbreath-hold hyperpolarized 129Xe ventilation MRI in patients with chronic obstructive pulmonary diseaseand healthy volunteers.

3D phase-resolved functional lung (PREFUL) MRI offers evaluation of pulmonary ventilation without inhalation of contrast agent. This study seeks to compare ventilation maps obtained from 3D PREFUL MRI with a direct ventilation measurement derived from 129Xe MRI in both patients with chronic obstructive pulmonary disease (COPD) and healthy volunteers. Thirty-one patients with COPD and 12 healthy controls underwent free-breathing 3D PREFUL MRI and breath-hold 129Xe MRI at 1.5 T. For both MRI techniques, ventilation defect (VD) maps were determined and respective ventilation defect percentage (VDP) values were computed. All parameters of both techniques were compared by Spearman correlation coefficient (r) and the differences between VDP values were quantified by Bland-Altman analysis and tested for significance using Wilcoxon signed-rank test. In a regional comparison of VD maps, spatial overlap and Sørensen-Dice coefficients of healthy and defect areas were computed. On a global level, all 3D PREFUL VDP values correlated significantly to VDP measure derived by 129Xe ventilation imaging (all r > 0.65; all p < 0.0001). 129Xe VDP was significantly greater than 3D PREFUL derived VDPRVent (mean bias = 10.5%, p < 0.001) and VDPFVL-CM (mean bias = 11.3%, p < 0.0001) but not for VDPCombined (mean bias = 1.7%, p = 0.70). The total regional agreement of 129Xe and 3D PREFUL VD maps ranged between 60% and 63%. Free-breathing3D PREFUL MRI showed a strong correlation with breath-hold hyperpolarized 129Xe MRI regarding the VDP values and modest differences in the detection of VDs on a regional level. 3D PREFUL MRI correlated with 129Xe MRI, unveiling regional differences in COPD defect identification. This proposes 3D PREFUL MRI as a ventilation mapping surrogate, eliminating the need for extra hardware or inhaled gases. Current non-invasive evaluation techniques for lung diseases have drawbacks; 129Xe MRI is limited by cost and availability. 3D PREFUL MRI correlated with 129Xe MRI, with regional differences in identifying COPD defects. 3DPREFUL MRI can provide ventilation mapping without the need for additional hardware or inhaled gases.

Regional Differences in Hepatitis C-Related Hospitalization Rates, United States, 2012-2019.

In the United States, hepatitis C is the most commonly reported bloodborne infection. It is a leading cause of liver cancer and death from liver disease and imposes a substantial burden of hospitalization. We sought to describe regional differences in hepatitis C virus (HCV)-related hospitalizations during 2012 through 2019 to guide planning for hepatitis C elimination. We analyzed discharge data from the National Inpatient Sample for 2012 through 2019. We considered hospitalizations to be HCV-related if (1) hepatitis C was the primary diagnosis or (2) hepatitis C was any secondary diagnosis and the primary diagnosis was a liver disease-related condition. We analyzed demographic and clinical characteristics of HCV-related hospitalizations and modeled the annual percentage change in HCV-related hospitalization rates, nationally and according to the 9 US Census Bureau geographic divisions. During 2012-2019, an estimated 553 900 HCV-related hospitalizations occurred in the United States. The highest hospitalization rate (34.7 per 100 000 population) was in the West South Central region, while the lowest (17.6 per 100 000 population) was in the West North Central region. During 2012-2019, annual hospitalization rates decreased in each region, with decreases ranging from 15.3% in the East South Central region to 48.8% in the Pacific region. By type of health insurance, Medicaid had the highest hospitalization rate nationally and in all but 1 geographic region. HCV-related hospitalization rates decreased nationally and in each geographic region during 2012-2019; however, decreases were not uniform. Expanded access to direct-acting antiviral treatment in early-stage hepatitis C would reduce future hospitalizations related to advanced liver disease and interrupt HCV transmission.

Effects of Metformin on CIMT and FMD in PCOS patients: a systematic review and meta-analysis

BackgroundThis study aims to analyze the efficacy of metformin on carotid intima media thickness (CIMT) and flow-mediated dilation (FMD) for patients with polycystic ovary syndrome (PCOS).MethodsA literature search of PubMed, Embase, and the Cochrane Library from inception to December 2023 was conducted. Then, after studies selection and data extraction, the mean difference (MD) with a 95% confidence interval (CI) was used to evaluate metformin efficacy in CIMT and FMD for PCOS patients. Heterogeneity was investigated through subgroup and sensitivity analysis. The protocol of our study has been registered in PROSPERO (CRD42024497239).ResultsA total of 12 studies with 248 patients were included. CIMT was lower in the endpoint group (after metformin) compared with the baseline group (before metformin) (MD = -0.11, 95% CI = -0.21 to -0.01, p = 0.04). FMD was higher in the endpoint group compared with the baseline group (MD = 3.25, 95% CI = 1.85 to 4.66, p < 0.01). No statistically significant difference was observed in nitroglycerin-mediated dilation (NMD) between the two groups (MD = 0.65, p = 0.51). Subgroup analysis showed that a relatively lower MD of CIMT in PCOS patients from Europe in the endpoint group compared with the baseline group (MD = -0.09, 95% CI = -0.14 to -0.04, p < 0.001). However, the MD in CIMT was not significantly different between the endpoint group and baseline group in PCOS patients from Asia (p = 0.270).ConclusionMetformin may have a beneficial effect on CIMT and FMD, but not on NMD, suggesting that metformin may help reduce cardiovascular events in PCOS patients. Notably, the clinical efficacy of metformin can be influenced by regional differences and study types.

Impact of digital infrastructure construction on financial development: Evidence from the “broadband China” Strategy

The “Broadband China” has enabled China to achieve leapfrog development in the construction of its high-speed broadband networks, thereby accelerating the development of digital infrastructure and unleashing the potential for financial sector growth. This has created a strong impetus for economy to shift towards high-quality development. An in-depth understanding of the empirical correlation between the development of digital infrastructure and financial progress is absent, leaving an unexplored domain of research concerning the impact of the “Broad China” strategy on financial agglomeration (Finagg), financial scale (Finscal), and digital finance (Digfina). In order to evaluate the dynamic impacts of this policy on financial development, this research builds a multi-period difference in differences (DID) model using panel data from 269 prefecture-level cities between 2011 and 2020. The study concludes that the “Broadband China” policy significantly fosters the growth of Finagg, Finscal, and Digfina, in China, and found that the “Broadband China” policy has a significant impact on the regional heterogeneity of financial agglomeration and digital finance. There are significant variations in the effects of this policy on different regions, while the regional heterogeneity differences in the impact on financial scale are relatively small. Additionally, the three mediating variables of technological innovation, fund support, and talent agglomeration play a mediating role in the mechanism of digital infrastructure on financial development.

Metal/Metalloid Presence and Health Risks in Drinking Water Plants—Insights from Nanjing, China

Metal contamination in drinking water is well known; however, detailed insights into the metals/metalloids in finished water and their health effects are lacking. Water samples collected over four seasons from August 2022 to April 2023 from three locations in the Yangtze River basin in Nanjing were analyzed using inductively coupled plasma mass spectrometry to detect 33 metal/metalloid types. This study assessed seasonal and spatial variations and evaluated the removal efficiencies of advanced treatment processes. Health risks from metal/metalloid ingestion were calculated using a risk assessment model from the United States Environmental Protection Agency (USEPA). No significant regional differences in total metal/metalloid concentrations were found between the source and finished waters. Metals such as Cr, Ga, Hg, Pb, and Rb varied seasonally, peaking in winter. The advanced treatment process outperformed the conventional process for As removal. However, the removal efficiencies were lower for Mn, Cd, Hg, Se, and Zn than those of the conventional process. Positive correlations were observed among several metals, suggesting that metals may have similar sources of contamination. The main carcinogenic risk exceeded the acceptable levels in children according to the USEPA. Non-carcinogenic risks were below the threshold values, but As, Tl, and V were highlighted as key risk elements. Seasonal changes markedly influenced metal/metalloid concentrations and distributions in water, necessitating risk management focused on arsenic.

Patterns of environmental regulation and green innovation in China

Green technology innovation is an important means to achieve sustainable development. The study is an exploration of the bilateral perspective on the relationship between different types of environmental regulations and green innovation. Based on the data set of 30 provinces in China from 2006 to 2018, the two-sided effects of command-and-control environmental regulation and market-based environmental regulation on green innovation are analysed and the net effects are calculated by using the two-tier stochastic frontier models. First, empirical research shows that the effects of command-and-control environmental regulation and market-based environmental regulation on green innovation are both highlighted by negative characteristics. Command-and-control environmental regulation has a smaller effect on green innovation, with an average positive effect of 0.00005, which is smaller than the average negative effect of 0.0008. Meanwhile, the positive effect of market-based environmental regulation on green innovation is 0.00291, smaller than the negative effect of 0.00461. Second, the negative impact of command-and-control environmental regulation on green innovation underwent a "back-to-N" change process in 2006–2018, while the negative effect of market-based environmental regulation on green innovation did not decline until after 2011. Third, the provinces where command-and-control environmental regulation policies have a greater negative effect are concentrated in the energy-intensive regions of central and western China, while the provinces where market-based environmental regulation policies can promote green innovation are from the energy-intensive or developed eastern regions of China. Based on the research conclusions, to better promote green innovation, there is a need to implement environmental regulatory policies that address regional differences and to establish a national system of green innovation markets.

Development of a Global Metabo-Lipid-Prote-omics Workflow to Compare Healthy Proximal and Distal Colonic Epithelium in Mice.

A multimetabo-lipid-prote-omics workflow was developed to characterize the molecular interplay within proximal (PC) and distal (DC) colonic epithelium of healthy mice. This multiomics data set lays the foundation to better understand the two tissue types and can be used to study, for example, colon-related diseases like colorectal cancer or inflammatory bowel disease. First, the methyl tert-butyl ether extraction method was optimized, so that from a single tissue biopsy >350 reference-matched metabolites, >1850 reference-matched lipids, and >4500 proteins were detected by using targeted and untargeted metabolomics, untargeted lipidomics, and proteomics. Next, each omics-data set was analyzed individually and then merged with the additional omics disciplines to generate a deep understanding of the underlying complex regulatory network within the colon. Our data demonstrates, for example, differences in mucin formation, detected on substrate level as well as on enzyme level, and altered lipid metabolism by the detection of phospholipases hydrolyzing sphingomyelins to ceramides. In conclusion, the combination of the three mass spectrometry-based omics techniques can better entangle the functional and regional differences between PC and DC tissue compared to each single omics technique.

Coupling coordination degree of healthcare resource supply, demand and elderly population change in China

ObjectTo analyze the trend of the coupling and coordination of the supply and demand of healthcare resources between the elderly population and healthcare resources in China during the period of 2012–2022, to reveal the impact of the growth of the elderly population on the relationship between the supply and demand of healthcare resources, and to put forward suggestions to improve the coupling and coordination between the supply and demand of healthcare resources and the elderly population, in order to cope with the challenges of an aging society.MethodsBy obtaining relevant data from authoritative data sources such as China Statistical Yearbook, Health and Health Statistics Yearbook, and the Chinese government website from 2012 to 2022, we constructed a comprehensive measurement index for the three systems of elderly population, healthcare resource supply, and healthcare resource demand; Using the entropy value method to assign weights to the indicators, combined with the coupling coordination degree model, to reveal the changes of the elderly population change and the supply and demand of medical and health resources; using ArcGIS technology, to study the spatial characteristics of the elderly population change and the supply and demand of medical and health resources.ResultsFrom 2012 to 2022, the supply and demand of healthcare resources and the variation of the elderly population in China show a continuous growth trend, and the comprehensive development level of the system gradually climbs from a low level to a high level. The fluctuation of coupling degree and coordination degree rises, although the coordination degree has always been lower than the coupling degree, but the distance between the coordination degree and the coupling degree gradually narrows with the passage of time. The coordination degree between population aging and medical and health resources development shows spatial heterogeneity in China, with the eastern region significantly higher than the western region/.ConclusionsThe coupling degree between population aging and healthcare resource supply and demand in China from 2012 to 2022 shows a general upward trend from low coupling to medium-high coupling, but it is worth noting that even though the degree of coupling increases, the degree of coordination is still relatively lagging behind, suggesting that the government and relevant departments need to pay more attention to coordinated allocation and management of healthcare resources. At the same time, the spatial differences in the degree of coordination among provinces suggest that future policymakers should take regional differences into full consideration in policymaking and sustainable development.

"A National Review of Crowdfunding for Plagiocephaly Helmets".

Custom prescription helmets for plagiocephaly may be a significant financial burden for families, especially when not covered by insurance. This study aims to identify factors that influence the success of crowdsourcing campaigns for this therapy. GoFundMe campaigns were collected by searching terms such as "plagiocephaly" and "baby helmet." Two reviewers analyzed each campaign for variables, including demographic data, story elements, and photo characteristics. Univariate logistic regression was used to determine each variable's impact on success, defined as attaining ≥75% of a campaign goal and significance of p ≤ 0.05. Campaign data from 2011 to 2022 were analyzed. Initial search yielded 1464 campaigns; among these 413 met final inclusion criteria. On average, campaigns raised $2005 (range: $0-$7799) and requested $3151 (range: $160-$30,000). In total, 228 (54%) achieved success, 167 (40%) met their goal, and 35 (8%) raised no funds. A total of $828,256 was raised from the requested $1,301,317. The average reported age was six months (range: 2-17 m). Significant factors associated with success were military affiliation, providing multiple images, including a quoted cost, providing campaign updates, indicating a sense of urgency, diagnosis of torticollis, and mentioning possible complications without treatment. Raising additional funds for therapy, multiple helmets, and unrelated medical costs negatively impacted success. Racial disparities were observed between campaigns. Additionally, regional differences were noted between campaigns. Crowdsourcing can be a successful endeavor for some families experiencing financial hardships from helmet therapy. This study highlights current gaps within healthcare coverage for helmet treatment and identifies various factors influencing crowdfunding campaigns.