Search

Objective Data Sources and Study Setting Study Design Data Collection Principal Findings Conclusions To examine how private Medicare Advantage (MA) plans responded to slower growth in federal payments after the Affordable Care Act (ACA).We used publicly available data from the Centers for Medicare and Medicaid Services on MA plan subsidies (“benchmarks”), asking prices (“bids”), plan premiums, cost‐sharing, and covered benefits. Data covered all counties with MA plans between 2006 through 2019.We examined plan responses to changes in benchmark subsidies by comparing changes in bids, rebates, and other outcomes between counties experiencing larger changes in benchmarks and counties with smaller changes, pre‐ and post‐ACA. We used longitudinal fixed effects regression models to assess heterogeneity in how plans adjusted premiums and benefits across more and less competitive markets.Analyses included all counties with at least one MA plan available to individual beneficiaries. Plans targeting special populations were excluded.Average plan benchmarks fell by $89 per month post‐ACA, adjusted for inflation. Plans responded similarly to benchmark subsidy decreases and increases, increasing bids by 62 cents for every dollar increase in subsidies pre‐ACA (95% confidence interval [CI]: 0.56 to 0.67) and decreasing them by 57 cents for every dollar reduction in subsidies post‐ACA (95% CI: 0.49–0.65). However, post‐ACA, plans altered less salient benefits, such as cost‐sharing, by about twice as much as they had pre‐ACA. Premiums changed by similar amounts before and after the ACA (−$0.07, 95% CI: from −$0.09 to −$0.06). Plans in more competitive markets responded less to payment changes than plans did in less competitive markets, suggesting the former are operating closer to marginal costs. Finally, payments to plans declined far less than projected due in part to other changes in MA policy.Plans used partial pass‐through of benchmark subsidy decreases to shield beneficiaries from cuts and allocated benchmark decreases to benefits that were less salient to the average enrollee. These findings, combined with higher‐than‐projected payments post‐ACA, may explain the continued growth in MA enrollment. [ABSTRACT FROM AUTHOR]

The significance of democratic commitment is highlighted on a global scale by the importance placed on offering a multitude of chances to establish enduring ecosystems and foster economic progress. Social finance, capital formation, and green finance have recently received a lot of attention from this perspective. Past studies mainly examined social finance and green finance in isolation. When investigating the individual impact of these important variables on economic growth in the occurrence of important events like the COVID-19 pandemic and other environmental pollution issues, most studies have mainly focused on developed countries, ultimately ignoring the different dynamics in emerging economies. The purpose of the research is to investigate the joint interaction between social finance (Social Impact Bonds), capital formation, and green finance (green loans, green investments, and green security) on economic development in BRICS economies. This research employed a longitudinal dataset from 2013 to 2023. The generalized method of moments (GMM) and fixed effect model (FEM) were employed in this research as statistical techniques for estimating parameters. The findings of this study revealed a positive joint relationship between green finance, capital formation, and social financing on economic development of BRICS economies. Therefore, measures that jointly promote social and green finance amidst environmental challenges or economic risks could present opportunities to mitigate the vulnerability of a country's economic prosperity. This research will surely guide policymakers in developing economies on how to give considerable attention to sustainable aspects while formulating policies and strategies aimed at economic development. [ABSTRACT FROM AUTHOR]

This study establishes a multi-dimensional evaluation index system for measuring digital economy and rural revitalization. It explores the impact of digital economy on China's rural revitalization and its mechanism using dynamic balanced panel data of 30 provinces and cities in China from 2012 to 2020 and adopting two-way fixed effect and mediated effect models. The results reveal that digital economy promotes rural revitalization in China; however, differences exist in its impact on industrial prosperity, ecological livability, civilized rural customs, effective governance, and affluent living under rural revitalization. Heterogeneity analysis shows that the impact of digital economy on rural revitalization is more pronounced in eastern China, with high levels of new urbanization and areas for big-data experimentation. In addition, this thesis verifies that technological innovation and human capital are two important transmission paths through which digital economy affects rural revitalization in China. The conclusions provide theoretical guidance and practical support for China and other developing countries to vigorously develop their digital economies and comprehensively revitalize the countryside. [ABSTRACT FROM AUTHOR]

Background: Stroke frequently results in upper limb motor dysfunction, with traditional therapies often failing to yield sufficient improvements. Emerging technologies such as virtual reality (VR) and noninvasive brain stimulation (NIBS) present promising new rehabilitation possibilities. Objectives: This study systematically reviews and meta-analyses the effectiveness of VR and NIBS in improving upper limb motor function in stroke patients. Methods: Registered with PROSPERO (CRD42023494220) and adhering to the PRISMA guidelines, this study conducted a thorough search of databases including PubMed, MEDLINE, PEDro, REHABDATA, EMBASE, Web of Science, Cochrane, CNKI, Wanfang, and VIP from 2000 to December 1, 2023, to identify relevant studies. The inclusion criterion was stroke patients receiving combined VR and NIBS treatment, while exclusion criteria were studies with incomplete articles and data. The risk of bias was assessed using the Cochrane Collaboration tool. Statistical analysis was performed using Stata SE 15.0, employing either a fixed-effects model or a random-effects model based on the level of heterogeneity. Results: A total of 11 studies involving 493 participants were included, showing a significant improvement in Fugl-Meyer Assessment Upper Extremity (FMA-UE) scores in the combined treatment group compared to the control group (SMD = 0.85, 95% CI [0.40, 1.31], p = 0.017). The Modified Ashworth Scale (MAS) scores significantly decreased (SMD = − 0.51, 95% CI [− 0.83, − 0.20], p = 0.032), the Modified Barthel Index (MBI) scores significantly increased (SMD = 0.97, 95% CI [0.76, 1.17], p = 0.004), and the Wolf Motor Function Test (WMFT) scores also significantly increased (SMD = 0.36, 95% CI [0.08, 0.64], p = 0.021). Subgroup analysis indicated that the duration of treatment influenced the outcomes in daily living activities. Conclusions: The combination of VR and NIBS demonstrates significant improvements in upper limb motor function in stroke patients. The duration of treatment plays a critical role in influencing the outcomes, particularly in activities of daily living. This systematic review has limitations, including language bias, unclear randomization descriptions, potential study omissions, and insufficient follow-up periods. Future studies should focus on exploring long-term effects and optimizing treatment duration to maximize the benefits of combined VR and NIBS therapy. [ABSTRACT FROM AUTHOR]

Pediatric patients with polyuria polydipsia syndrome (PPS) represent a diagnostic challenge for clinicians because of the technical difficulties in performing the gold standard water deprivation test (WDT). Copeptin, a stable biomarker representing the C-terminal portion of the polypeptide chain of the antidiuretic hormone, is a reliable diagnostic tool. To assess the diagnostic accuracy of baseline copeptin dosing, arginine/hypertonic saline copeptin stimulation tests, and WDT. This study aimed to establish the diagnostic utility of copeptin in pediatric patients by distinguishing between central diabetes insipidus, nephrogenic diabetes insipidus, and primary polydipsia. Comparative and non-comparative primary studies published between January 2018 and August 2024 focusing on children were searched and included in PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, and Google Scholar. The QUADAS-2 tool was used to assess the risk of bias and applicability. Meta-analyses used fixed effects models because of low heterogeneity and the HSROC model. Eleven studies were included with an overall low bias and no significant applicability concerns. The mean pooled sensitivity = 0.98 (95% CI: 0.936–1.025), pooled specificity = 0.947 (95% CI: 0.920–0.973), and AUC = 0.972 (95% CI: 0.952–0.992), indicating excellent diagnostic accuracy. Stimulation methods for copeptin dosing represent an effective and less invasive diagnostic test for children with PPS, and future development of standard copeptin testing protocols is needed. [ABSTRACT FROM AUTHOR]

Improving industrial energy efficiency (IEE) is crucial for reducing CO2 emissions. Green finance (GF) provides an essential economic instrument for investment in IEE improvement. However, previous studies have not reached a consensus on whether GF can promote energy efficiency. In addition, more research is needed in the industrial sector. Therefore, this study focused on the industrial level to investigate GF's impact on IEE and its heterogeneity using a two-way fixed effects model. The moderating effect, threshold effect, and spatial lag models were used to test the various effects of GF on IEE. In addition, the spatial clustering characteristics of IEE were analyzed. The results indicate the following: GF can significantly promote IEE, positively improves IEE in the central and eastern areas, and has a negative impact in the western area; the marketization level (ML) is an important channel through which GF can further improve IEE; GF's impact on IEE exhibits a single threshold effect of the level of economic development (EDL) and green credit (GCL); GF promotes local IEE improvement but prevents neighboring IEE improvement; and IEE shows four types of clusters, but only in about one-third of the provinces. Based on these results, several recommendations are provided. [ABSTRACT FROM AUTHOR]

Background: Existing evidence on the burden of mental health problems among pregnant and postpartum women living with HIV, a vulnerable population in sub-Saharan Africa (SSA), is limited and fragmented, affecting the development of context-sensitive and integrated interventions. This systematic review aims to provide an up-to-date and comprehensive synthesis of available evidence to estimate the burden and identify the determinants of mental health problems among pregnant and postpartum women living with HIV across countries in sub-Saharan Africa. Methods: We will retrieve all relevant studies (published and unpublished) through searches in PubMed, Embase, PsycINFO, CINAHL, LILACS, Google Scholar, Scopus and Web of Science from inception to 30th June 2024, without language restriction. We will use the following search terms 'mental health disorder', 'mental health problem', 'pregnant women', 'postpartum women' and 'HIV' nested with all applicable alternate terms and the names of countries in SSA for running the searches. We will also search HINARI, African Index Medicus, African Journals Online, Academic Search Premier, medRxiv, ProQuest, EBSCO Open Dissertations, and reference lists of relevant studies. We will contact experts in the field for potentially relevant unpublished studies. All retrieved articles from the electronic databases and grey literature will be collated and deduplicated using Endnote and exported to Rayyan QCRI. Two reviewers will independently select studies using a pretested study selection flow chart developed from the pre-specified eligibility criteria. Two reviewers will extract data using a pretested data extraction form and assess the risk of bias in the included studies using the risk of bias tool for prevalence studies by Hoy et al. (2012). Any disagreements will be resolved through discussion between the reviewers. Binary outcomes (prevalence and incidence of mental health problems among pregnant and postpartum women living with HIV) will be evaluated using pooled proportions (for non-comparative studies) and odds ratio (OR) or risk ratio (RR) (for comparative studies), and mean difference for continuous outcomes, all will be reported with their 95% confidence intervals (CIs). Heterogeneity will be assessed graphically for overlapping CIs and statistically using the I2 statistic. If substantial heterogeneity is found, random-effects model meta-analysis will be performed; otherwise, fixed-effect meta-analysis will be employed. We will conduct subgroup analysis (to assess the impact of heterogeneity) and sensitivity analyses to test the robustness of the generated effect estimates to the quality domains. The overall level of evidence will be assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations). Expected outcomes: The review is expected to produce an up-to-date and comprehensive synthesis of the available evidence, allowing for the generation of country-specific estimates of the burden of mental health problems among mothers living with HIV across SSA populations. Also, the review will attempt to identify the determinants of mental health problems among pregnant and postpartum women living with HIV, to shed light on the factors that contribute to the occurrence of mental health problems in this vulnerable population. Systematic review registration: The systematic review protocol has been registered in the International Prospective Register for Systematic Reviews (PROSPERO), with registration ID CRD42023468537. [ABSTRACT FROM AUTHOR]

Background Not having an established relationship is associated with an elevated risk of Chlamydia trachomatis (CT) infection, but this might reflect selection into and out of unions. Although union formation and union separation are common events in reproductive age, little is known about changes in CT risk before and after these transitions. Methods We linked Finnish Population Register data to the National Register of Infectious Diseases and used fixed-effects linear probability models that account for all time-invariant confounders to examine changes in women's 6-month CT risk 3 years before and 3 years after entry into first cohabitation (n  = 293 554), non-marital separation (n  = 201 647) or marital separation (n  = 92 232) during 2005–14. Results From 3 years to 1 year before first union formation, the 6-month risk of CT increased slightly, peaking at 1.27% immediately prior to union formation (95% confidence interval 1.22–1.31). It declined sharply following union formation, being only 0.40% (0.34–0.46) 6–12 months after union formation with little changes thereafter. Among women separating from non-marital unions, the risk increased from 0.50% (0.42–0.57) to 1.45% (1.40–1.49) around the time of separation and decreased following separation. The pattern of findings was relatively similar for marital separation, although the observed risks and changes were smaller in magnitude. Conclusions Our results based on longitudinal data and individual fixed-effects models indicate that the period immediately after separation may be causally associated with an elevated risk of CT. This suggests that recently separated women should be identified as a high-risk group for CT. [ABSTRACT FROM AUTHOR]

Introduction: Our objective was to determine whether the educational game SonoQz can improve diagnostic performance in ultrasound assessment of ovarian tumors. Material and Methods: The SonoQz mobile application was developed as an educational tool for medical doctors to practice ultrasound assessment, based on still images of ovarian tumors. The game comprises images from 324 ovarian tumors, examined by an ultrasound expert prior to surgery. A training phase, where the participants assessed at least 200 cases in the SonoQz app, was preceded by a pretraining test, and followed by a posttraining test. Two equal tests (A and B), each consisting of 20 cases, were used as pre‐ and posttraining tests. Half the users took test A first, B second, and the remaining took the tests in the opposite order. Users were asked to classify the tumors (1) according to International Ovarian Tumor Analysis (IOTA) Simple Rules, (2) as benign or malignant, and (3) suggest a specific histological diagnosis. Logistic mixed models with fixed effects for pre‐ and posttraining tests, and crossed random effects for participants and cases, were used to determine any improvement in test scores, sensitivity, and specificity. Results: Fifty‐eight doctors from 19 medical centers participated. Comparing the pre‐ and posttraining test, the median of correctly classified cases, in Simple Rules assessment increased from 72% to 83%, p < 0.001; in classifying the lesion as benign or malignant tumors from 86% to 95%, p < 0.001; and in making a specific diagnosis from 43% to 63%, p < 0.001. When classifying tumors as benign or malignant, at an unchanged level of sensitivity (98% vs. 97%, p = 0.157), the specificity increased from 70% to 89%, p < 0.001. Conclusions: Our results indicate that the educational game SonoQz is an effective tool that may improve diagnostic performance in assessing ovarian tumors, specifically by reducing the number of false positives while maintaining high sensitivity. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. The objective of this study was to evaluate the effects of amino resin-treated soybean meal (SBM) on ruminal fermentation, nutrient digestion, and N partitioning. The treatments were (1) untreated solvent-extracted SBM, (2) amino resin-treated SBM (AR-SBM), and (3) heat-treated SBM (HT-SBM). The experimental design was arranged as a replicated 3 × 3 Latin square with 6 fermentors in a dual-flow continuous culture system. Treatments were randomly assigned to fermentors within a Latin square for each period. Each fermentor was fed 106 g/d of diet DM equally distributed in 2 feeding times daily at 0800 and 1800 h. Diets were formulated to contain 16% CP, 30% NDF, and 30% starch across treatments. The experiment consisted of 3 experimental periods, each lasting for 10 d. The first 7 d of each period were considered adaptation, and the last 3 d were used for sampling and data collection. On d 8 and 9, samples were collected for analysis of diurnal variation in concentrations of NH 3 -N, pH, and VFA during the first 8 h after feeding. On d 8, 9, and 10, samples were collected from the liquid and solid effluents accumulated over 24 h for analysis of daily averages of NH 3 -N and VFA pools, and true ruminal digestibility estimates. Data were analyzed using the MIXED procedure of SAS, and significance was declared when P ≤ 0.05. The model included the fixed effect of treatment and random effects of square, period, and fermentor within square, whereas time and interaction treatment × time were included for analyses of diurnal variation, with time as repeated measures. Compared with SBM, the cultured ruminal contents of AR-SBM and HT-SBM had lower NH 3 -N concentrations, indicating lower microbial fermentation of protein. Molar proportions of isovalerate and isobutyrate were greater in SBM than AR-SBM and HT-SBM, with greater molar proportion of isobutyrate for SBM, particularly during the first 2 h after feeding. The flow of NH 3 -N was greater for SBM compared with AR-SBM and HT-SBM, whereas NAN flow, bacterial N flow, and N efficiency were greater for AR-SBM and HT-SBM compared with SBM. Our results indicate that both the amino resin and heat treatments of SBM allow for similar decreases in microbial degradation of CP without limiting microbial protein synthesis in diets with 16% CP. Amino resin treatment may be effective in reducing microbial fermentation of protein in the rumen without adverse effects on digestibility or fermentation parameters as compared with SBM. [ABSTRACT FROM AUTHOR]

The list of standard abbreviations for JDS is available at adsa.org/jds-abbreviations-24. Nonstandard abbreviations are available in the Notes. Understanding the extent to which genetics × environment plays a role in shaping individual strategies to environmental challenges is of considerable interest for future selection of more resilient animals. The objective of this study was to evaluate the metabolic responses of goats, selected for functional longevity, to a nutritional challenge. This evaluation was based on plasma metabolites and was repeated across 2 experimental farms over 2 years. We carried out 6 different experimental trials from 2018 to 2022 (4 trials on site Bourges, 2018–2021 and 2 trials on site Grignon, 2021–2022) in which 267 first kidding goats, daughters of Alpine bucks divergently selected for functional longevity, longevity plus (n = 137), and longevity minus (n = 130), were exposed to a 2-d nutritional challenge in early lactation. The experiments consisted of a 5 or 7-d control period (prechallenge) on a standard lactation diet followed by a 2-d nutritional challenge with straw-only feeding, and then a 7- or 10-d recovery period on a standard lactation diet, for site Bourges and Grignon, respectively. During the challenge plasma metabolite composition was measured. Linear mixed models were used to analyze all traits, considering the individual as a random effect and the 2 × 2 treatments (i.e., genetic line and year nested in site) and litter size as fixed effects. The linear mixed-effects model using a piecewise arrangement was used to analyze the response/recovery profiles to the nutritional challenge. The estimates of the random effect for each individual, using the mixed models without the fixed effects of genetic line, were used in a sparse partial least square discriminant analysis (sPLS-DA) to compare the goat metabolism response to the challenge on a multivariate scale. The plasma glucose, BHB, nonesterified fatty acids (NEFA), and urea concentrations significantly responded to the 2-d nutritional challenge. Selection for functional longevity did not affect plasma glucose, NEFA, BHB, and urea response/recoveries to a 2-d nutritional challenge. However, site, trial, and litter size significantly affected these responses. Moreover, the plasma metabolites seem not to fully recover to prechallenge levels after the recovery phase. The sPLS-DA analysis did not discriminate between the 2 longevity lines. We observed meaningful between-individuals variability in plasma BHB, especially on the prechallenge and rate of response and rate of recovery from the 2-d nutritional challenge (CV = 26.2%, 36.1%, and 41.2%, repeatability = 0.749, 0.322, and 0.741, respectively). Plasma NEFA recovery from challenge also demonstrated high between-individuals variability (CV = 16.4%, repeatability = 0.323). Selection for functional longevity did not affect plasma metabolites responses to a 2-d nutritional challenge in dairy goats. Plasma NEFA and BHB response and recovery presented high between-individuals variability, indicating that individual adaptative characteristics to nutritional challenges are not related to the environmental conditions but to inherent individual characteristics. [ABSTRACT FROM AUTHOR]

Background and Objectives: Self-employment is a vital alternative to waged employment for older workers. Recent research has shown that employment transitions frequently occur when individuals approach retirement. However, evidence of how older people's health changes when they switch between self and waged employment is lacking, particularly outside Western contexts. To address this research gap, we explored the health impact of employment transitions for the older working population in China by hukou (urban or rural household registration status), region, and education. Research Design and Methods: We employed fixed effect models to examine the impact of employment transitions on cognitive, mental, and physical health and life satisfaction drawing on data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study (N = 4,606). Given China's unique context, we analyzed the results of agricultural and nonagricultural work separately. Results: Individuals transitioning into or remaining in self-employment had lower self-rated health and life satisfaction than those remaining in waged employment. There was no significant difference in cognitive functioning or depressive symptoms. Additionally, those who transitioned from self-employment into waged employment rated their health worse than those who remained in waged employment. The health impacts were more apparent for agricultural than nonagricultural self-employment, particularly for older workers living in urban regions with rural hukou and lower education levels. Discussion and Implications: Most older Chinese transitioning into or staying self-employed are or were pushed into self-employment due to their low human capital and socioeconomic status, which affects their subsequent health. Pension reform and policies supporting older adults to stay in the workforce could help close the economic and health gaps between rural and urban older adults. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the variation in COVID-19 inpatient care mortality among hospitals reimbursed by the Unified Health System (SUS) in the first two years of the pandemic in São Paulo state and make performance comparisons within periods and over time. Methods: Observational study based on secondary data from the Hospital Information System. The study universe consisted of 289,005 adult hospitalizations whose primary diagnosis was COVID-19 in five periods from 2020 to 2022. A multilevel regression model was applied, and the death predictive variables were sex, age, Charlson Index, obesity, type of admission, Brazilian Deprivation Index (BrazDep), the month of admission, and hospital size. Then, the total observed deaths and total deaths predicted by the model's fixed effect component were aggregated by each hospital, estimating the Standardized Mortality Ratio (SMR) in each period. Funnel plots with limits of two standard deviations were employed to classify hospitals by performance (higher-than-expected, as expected, and lower-than-expected) and determine whether there was a change in category over the periods. Results: A positive association was observed between hospital mortality and size (number of beds). There was greater variation in the percentage of hospitals with as-expected performance (39.5 to 76.1%) and those with lower-than-expected performance (6.6 to 32.3%). The hospitals with higher-than-expected performance remained at around 30% of the total, except in the fifth period. In the first period, 64 hospitals (18.3%) had lower-than-expected performance, with standardized mortality ratios ranging from 1.2 to 4.4, while in the last period, only 23 (6.6%) hospitals were similarly classified, with ratios ranging from 1.3 to 2.8. A trend of homogenization and adjustment to expected performance was observed over time. Conclusion: Despite the study's limitations, the results suggest an improvement in the COVID-19 inpatient care performance of hospitals reimbursed by the SUS in São Paulo over the period studied, measured by the standardized mortality ratio for hospitalizations due to COVID-19. Moreover, the methodological approach adapted to the Brazilian context provides an applicable tool to follow-up hospital's performance in caring all or specific-cause hospitalizations, in regular or exceptional emergency situations. [ABSTRACT FROM AUTHOR]

This document is a reply to a study on twinning in humans. The authors analyzed a large dataset of birth records from Northern and Central Europe to understand the relationship between twinning and fertility. They found a negative relationship between the probability of a mother having multiple offspring per birth and her total number of births, challenging the idea that mothers who are more fertile are more likely to have twins. The authors argue that the differences between their study and the previous study are due to the demographic transition and that both studies support the conclusion that the heterogeneity/maternal capacity hypothesis is not supported. They caution against removing specific births from the data and encourage further exploration of complex scenarios using their statistical framework. [Extracted from the article]

With the increasingly prominent environmental issues in China, the government and citizens alike have intensified their focus on corporate investments in green environmental protection. Nevertheless, as government regulations become more stringent, there is substantial debate over whether environmental regulatory policies can consistently encourage listed companies to increase green environmental investments. Simultaneously, independent board supervision plays a crucial role in promoting the compliance and sustainability of listed companies regarding environmental protection. This paper selected a sample of 246 Chinese listed companies from 2010 to 2019, and used a fixed effects model to examine the impact of environmental regulation on the environmental investment of listed companies in China. Moreover, we used a mediation effect model to analyze the role of independent director supervision in influencing the relationship between environmental regulation and companies' green environmental investment. Additionally, we discuss the heterogeneous impact of environmental regulations on corporate environmental investments. Our findings are as follows: first, during the sample period, the tightening of environmental regulations significantly reduces the growth of environmental investment among the studied firms. As government environmental regulatory policies gradually intensify, the negative impact on environmental investments by listed companies becomes increasingly evident. Second, independent directors help alleviate the adverse impacts of environmental regulations on the environmental investment levels of listed companies. This suggests that the inclusion of independent directors in board governance plays a role in assessing government environmental regulatory policies and overseeing corporate decisions related to environmental investment. Lastly, the heterogeneity analysis indicates that environmental regulation significantly negatively impacts the environmental investment of listed companies in pollution-intensive industries and those located in the western regions. Furthermore, environmental regulatory policies impose greater constraints on the environmental investments of smallsized listed companies compared to their large-sized counterparts. [ABSTRACT FROM AUTHOR]

Background: Participation in youth sports is a major determinant of current and future health, yet participation rates are declining. It is of great importance to examine the factors that potentially influence adolescents' levels of participation in organised sports. Aim: First, we examined change in participation over two years from the start of secondary education. Second, we examined whether a combination of factors (i.e. motives, barriers, perceived competence, encouragement and motor skills) based on the Youth Physical Activity Promotion model was associated with participation after one year. Third, we examined whether the associations between each of the factors and participation in organised sports changed over time. Methods: Data were collected on three occasions between October 2020 and November 2022 using questionnaires, motor skill test items and anthropometric measurements. We analysed data from 204 Dutch adolescents (11 to 14 years) using dependent t tests, Cochran's Q test and multilevel linear fixed effects regression models. Results: First, participation in organised sports was stable during the first years of secondary education. Second, adolescents who reported higher motives, higher perceptions of competence and more encouragement spent more time in organised sports one year later. Barriers and motor skills did not predict participation. Third, relationships of each of the six factors with participation remained stable over time. Conclusion: Although participation in organised sports is often considered to decline during the first years of secondary education, it can be stable for a significant portion of the population. Motives, perceived competence, and encouragement seem crucial to stimulate adolescents' participation in organised sports. [ABSTRACT FROM AUTHOR]

Throughout, the effects of related-party transactions (RPTs) have been a hot topic in financial markets and corporate governance research. This paper analyzes the theoretical foundation of the effects of RPTs and constructs a new indicator, the quasi-profit margin, to assess the effects of RPTs by studying their impact on the quasi-profit margin. Based on the information asymmetry between transaction parties and the information screening theory, the paper proposes the buying inferior to selling theory, systematically explaining the impact of transaction direction on the effects of RPTs. Subsequently, using panel data from Chinese A-share listed companies from 2016 to 2021, the paper constructs fixed-effects models and conducts empirical studies from both exogenous and endogenous perspectives, employing estimation methods such as high dimensional fixed effects method, two-stage least squares method, and three-stage least squares method. The research indicates that RPTs of Chinese A-share listed companies generally exhibit a tunneling effect, and the transaction direction significantly affects the effects of RPTs. The higher the proportion of RPTs conducted as sellers to the total RPTs, the smaller the overall tunneling effect of the RPTs. This study has implications for reducing the tunneling risk of RPTs and improving corporate governance for listed companies, as well as providing some references for financial regulatory authorities to identify and rectify illegal RPTs. [ABSTRACT FROM AUTHOR]

Agricultural mechanization is a crucial indicator of modernization in agriculture. It improves productivity and underpins the evolution of a modern state. This study scrutinizes the enduring effects of government subsidies on farm machinery acquisition, income growth, and capital accumulation in rural households. It is based on policies about targeted poverty alleviation and rural revitalization. Research findings indicate that government subsidies have significantly increased the per capita net income of rural households. However, in the post-poverty alleviation era, for households that already possess agricultural machinery, the benefits brought by government subsidies in the early stages of the policy cycle tend to diminish over time. From 2016 to 2020, government subsidies continued to enhance the value of agricultural machinery in rural households. Their impact on ownership rates first slightly declined and then increased again. The promotional effect in 2020 was not significantly better than in 2016. When China is fighting against poverty, it is essential to encourage rural households to use their income and government subsidies to accumulate production capital. A long-term mechanism has been established to protect the achievements of poverty alleviation, promote agricultural mechanization and rural modernization, and support rural revitalization. [ABSTRACT FROM AUTHOR]

Background: Anemia in pregnancy has been associated with a number of adverse birth outcomes, such as low birth weight (LBW) or preterm birth (PTB). However, the evidence from primary studies on anemia in pregnancy with LBW and PTB is contentious. Moreover, a systematic review and meta-analysis to summarize these findings have not been conducted for Ethiopia. This study aimed to synthesize the best available evidence and quantify the strength and direction of the association of anemia in Ethiopia. Methods: This review examined women with singleton pregnancies with low birth weight (LBW) and preterm birth (PTB). We retrieved studies from PubMed, Wiley, Cochrane databases, and Google Scholar from inception to February 2, 2024. The World Health Organization (WHO) defines anemia in pregnancy as a low blood haemoglobin (Hgb) concentration below 11 g/dl or a hematocrit level of < 33%. When the newborn's weight was below 2500 g, LBW was considered. Preterm birth refers to the birth of a baby before 37 completed weeks of gestation. Meta-analysis was conducted using fixed and random effects models. The degree of heterogeneity, publication bias, and quality of the evidence of studies was assessed. Results: There were 35 and 8 studies, with 14,319 and 3,265 respondents included in the meta-analysis for LBW and PTB, respectively. Neonates born to women who had normal Hgb levels were less likely to be LBW [pooled odds ratio (POR) = 0.22, 95% CI: (0.17, 0.28); I2 = 80%] (low-quality evidence). Neonates born to women with normal Hgb levels had a lower risk of PTB [POR = 0.22, 95% CI: 0.18, 0.28; I2 = 19%] (very low-quality evidence). The effect size estimate remained significant after sub-group analysis based on study design and province, except in two retrospective cohort studies for LBW. Conclusion: The findings suggest major implications for strengthening the implementation of nutrition policies to prevent anemia during pregnancy in Ethiopia. Further research is warranted to assess interventions that are effective in combating maternal anemia to reduce rates of LBW and PTB. [ABSTRACT FROM AUTHOR]

Environmental issues have gradually become a key concern for society. The public has been paying increasing attention to corporate environmental disclosure and performance. With the "go global" trend, more and more enterprises are looking to overseas markets for new technologies and resources. Multinational enterprises (MNEs) are facing more challenges than domestic enterprises. To remain competitive and sustainable, enterprises from developing countries need to gain a foothold in developed countries. We explore how MNEs' internationalization impacts environmental disclosure, specifically focusing on the role of green investors as stakeholders. We draw evidence from Chinese-listed MNEs, with a total of 4,709 panel data observations. For the main analysis, we use a fixed effect model. The findings suggest that a higher level of internationalization can improve both the willingness and quality of environmental disclosure for MNEs, and this relationship is further strengthened by green investors. A heterogeneity analysis reveals that the positive effect of internationalization on environmental disclosure is mainly present in state-owned enterprises (SOEs) and developed host countries. We find that external pressure from host countries motivates MNEs to increase environmental disclosure willingness and quality. This study provides valuable insights for MNEs from emerging economies on how to achieve legitimacy and a positive reputation in overseas markets through environmental disclosure strategies. This study proposes the importance of green investors on environmental disclosure issues from a stakeholder perspective and provides new theoretical insights for environmental policy reform in developing countries such as China. [ABSTRACT FROM AUTHOR]

Background: The combination of CDK4/6 inhibitors (CDK4/6i) and endocrine therapy (ET) is currently the standard first-line treatment for patients with metastatic hormone receptor positive (HR+), and HER2-negative (HER2-) breast cancer. However, the impact of HER2 status on the prognosis of patients receiving CDK4/6i and ET remains unclear. The meta-analysis was conducted to evaluate different outcomes between HER2-low and HER2-zero patients in advanced HR+ breast cancer receiving CDK4/6i and ET. Methods: A systematic search was performed in PubMed and EMBASE databases for relevant published literature. Objective response rate (ORR), overall survival (OS), and progression-free survival (PFS) were pooled by fixed or random effects models. Results: Overall, 12 studies with 3567 patients were eligible for analysis. The pooled analysis suggested that no significant differences were observed in terms of ORR and OS between HER2-low and HER2-zero patients who underwent CDK4/6i and ET. Similarly, no significant difference in PFS was found between HER2-low and HER2-zero patients who underwent post-line CDK4/6i and ET or first-line Palbociclib and ET. However, in patients who received mixed-line (not a single treatment line) or first-line CDK4/6i and ET, the PFS was significantly shorter in the HER2-low subgroup than in the HER2-zero subgroup (mixed-line: HR = 1.36; 95% CI = 1.11–1.65; P = 0.002; first-line: HR = 1.14; 95% CI = 1.01– 1.28; P = 0.04). A similar phenomenon was observed in patients who received mixed-line or post-line Palbociclib and ET (mixed-line: HR = 1.60; 95% CI = 1.09–2.34; P = 0.02; post-line: HR = 1.43; 95% CI = 1.03–2.00; P = 0.03). Conclusion: These results indicated that HER2-low status did not have a significant association with ORR and OS, but it may have a worse impact on PFS in patients who received mixed-line or first-line CDK4/6i and ET, as well as mixed-line or post-line palbociclib plus ET. [ABSTRACT FROM AUTHOR]

Agricultural modernization can only be attained through the high-quality development of agriculture, which is made possible by the deep integration of the digital economy with traditional agriculture. From the perspective of the entire agricultural industry chain, this paper offers a theoretical and empirical examination of the digital economy's role in enabling high-quality agricultural development. The fixed effects model, convergence test, threshold model, and spatial error model were implemented based on the panel data of 13 cities in Jiangsu Province from 2013 to 2021 to validate the role of the digital economy in enabling high-quality agricultural development. The findings indicated that first, for every 1% increased in the level of digital economy development, the level of high-quality agricultural development increased by approximately 0.183%. Second, the high-quality development of agriculture had the characteristics of absolute convergence and conditional convergence, and there was a non-linear character in the role of the digital economy in the high-quality agricultural development. Third, for every 1% increase in the development level of digital inclusive finance, the level of high-quality agricultural development in surrounding areas with similar economic levels will be improved by about 0.188%.In this regard, Jiangsu Province should grasp the opportunity of the era of digital economic development, continue to strengthen the construction of digital economic development in backward areas, and attach great importance to inter-regional exchanges and cooperation in the construction of digital agriculture. [ABSTRACT FROM AUTHOR]

Abstract–This work aims to study off-policy evaluation (OPE) under scenarios where two key reinforcement learning (RL) assumptions—temporal stationarity and individual homogeneity are both violated. To handle the “double inhomogeneities”, we propose a class of latent factor models for the reward and transition functions, under which we develop a general OPE framework that consists of both model-based and model-free approaches. To our knowledge, this is the first article that develops statistically sound OPE methods in offline RL with double inhomogeneities. It contributes to a deeper understanding of OPE in environments, where standard RL assumptions are not met, and provides several practical approaches in these settings. We establish the theoretical properties of the proposed value estimators and empirically show that our approach outperforms state-of-the-art methods. Finally, we illustrate our method on a dataset from the Medical Information Mart for Intensive Care. An R implementation of the proposed procedure is available at https://github.com/ZeyuBian/2FEOPE. Supplementary materials for this article are available online, including a standardized description of the materials available for reproducing the work. [ABSTRACT FROM AUTHOR]

Improvement of water and sanitation conditions may reduce infant mortality, particularly in countries like India where open defecation is highly prevalent. We conducted a quasi-experimental study to investigate the association between the Swachh Bharat Mission (SBM)—a national sanitation program initiated in 2014—and infant (IMR) and under five mortality rates (U5MR) in India. We analyzed data from thirty-five Indian states and 640 districts spanning 10 years (2011–2020), with IMR and U5MR per thousand live births as the outcomes. Our main exposure was the district-level annual percentage of households that received a constructed toilet under SBM. We mapped changes in IMR and U5MR and toilet access at the district level over time. We fit two-way fixed effects regression models controlling for sociodemographic, wealth, and healthcare-related confounders at the district-level to estimate the association between toilets constructed and child mortality. Toilet access and child mortality have a historically robust inverse association in India. Toilets constructed increased dramatically across India following the implementation of SBM in 2014. Results from panel data regression models show that districts with > 30% toilets constructed under SBM corresponds with 5.3 lower IMR (p < 0.05), and 6.8 lower U5MR (p < 0.05). Placebo, falsification tests and robustness checks support our main findings. The post-SBM period in India exhibited accelerated reductions in infant and child mortality compared to the pre-SBM years. Based on our regression estimates, the provision of toilets at-scale may have contributed to averting approximately 60,000–70,000 infant deaths annually. Our findings show that the implementation of transformative sanitation programs can deliver population health benefits in low- and middle-income countries. [ABSTRACT FROM AUTHOR]

The study was carried out in five regions of Bangladesh--Gazipur, Bogura, Jamalpur, Jashore, and Chattogram--utilizing a randomized complete block design and involving 17 genotypes of sweet potatoes. The objective was to evaluate their performance, environmental adaptability, and stability in terms of root yield. The analysis was carried out using fixed and random effects models. The results revealed that BARI Mistialu-12 had the highest storage root yield (45.35 t/ha). Among the locations, Bogura (sandy loam soil) achieved the highest yield, at 37.05 t/ha, followed by Jamalpur (36.15 t/ha). ANOVA showed significant variation in root yield across genotype, environment, and their interaction (GEI). Both the additive main effects and multiplicative interaction (AMMI) effect models and a linear mixed model (LMM) confirmed substantial GEI variance. Considering LMM, 53.58% of the total variation was due to genotypes, with a selection accuracy of 94%, leading to the use of a best linear unbiased prediction (BLUP) index for genotype selection. BARI Mistialu-12, BARI Mistialu-16, BARI Mistialu-11, BARI Mistialu-8, BARI Mistialu-2, and BARI Mistialu-13 were identified as high-performing genotypes in the BLUP index. Based on the AMMI stability value (ASV), the first two principal components explained 74.60% of the total GEI variance (20.16%), with BARI Mistialu-14 being the most stable genotype. Additionally, the interaction principal components axis analysis identified Bogura, Jashore, and Chattogram as key testing sites for root yield. The weighted average of absolute scores biplot highlighted BARI Mistialu-16 as the most stable variety. In the megaenvironment analysis, BARI Mistialu-11 and BARI Mistialu-2 excelled in Jamalpur, while BARI Mistialu-12 and BARI Mistialu-16 led in Gazipur, Bogura, and Jashore. Bogura was the best location for production. These findings are crucial for future breeding efforts to expand the sweet potato industry, demonstrating consistent high-yield potential across various agroecological conditions. [ABSTRACT FROM AUTHOR]

The fourth industrial revolution has contributed significantly towards the growing global technological transfers that enhance productivity, employment and standard of living. The outbreak of the COVID-19 pandemic has undeniably disrupted lives globally; however, it enhanced technological transformation by causing an abrupt shift towards digital technology usage. The development and diffusion of digitalisation is expected to drive economic growth as we move towards the 2030 Sustainable Development Agenda. This study examines the impact of digitalisation on economic growth for 14 Southern African Development Community (SADC) countries from 2000 to 2020 employing the Fixed Effects model. Results reveal that all digitalisation indicators employed tend to have a positive impact on economic growth. A percentage change in individual usage of information communication technologies (ICTs), fixed broadband subscriptions, and mobile cellular subscriptions leads to a 0.17%, 0.11% and 0.12% increase in GDP per capita, respectively. Therefore, usage of and access to digital technologies stimulate economic growth in the SADC region. Public policies should seek to stimulate private sector investments in technological infrastructure and liberalise the telecommunications and innovation market. This accelerates digitalisation and consequently leads to higher economic growth and development in the SADC region. [ABSTRACT FROM AUTHOR]

Fractional cointegration in time series data has been explored by several authors, but panel data applications have been largely neglected. A previous study of ours discovered that the Chen and Hurvich fractional cointegration test for time series was fairly robust to a moderate degree of heterogeneity across sections of the six tests considered. Therefore, this paper advances a customized version of the Chen and Hurvich methodology to detect cointegrating connections in panels with unobserved fixed effects. Specifically, we develop a test statistic that accommodates variation in the long-term cointegrating vectors and fractional cointegration parameters across observational units. The behavior of our proposed test is examined through extensive Monte Carlo experiments under various data-generating processes and circumstances. The findings reveal that our modified test performs quite well comparatively and can successfully identify fractional cointegrating relationships in panels, even in the presence of idiosyncratic disturbances unique to each cross-sectional unit. Furthermore, the proposed modified test procedure established the presence of long-run equilibrium between the exchange rate and labor wage of 36 countries' agricultural markets. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis with a systematic review was undertaken to assess the association between APOE allelic genotypes and the risk of Alzheimer's disease (AD) in the Italian population. Methods: The Web of Science, PubMed, and Scopus databases were searched until 15 November 2023. The odds ratio (OR) with a 95% confidence interval (CI) was calculated using fixed and random effect models, depending on the I2 statistic value. The systematic review and meta-analysis were conducted in agreement with the PRISMA guideline and registered with PROSPERO (CRD42023492580). Results: Our meta-analysis based on 15 studies revealed a higher risk of AD among Italian individuals carrying the APOE ε4 allele (OR = 3.60, 95% CI [2.90–4.47], p < 0.0001). The association of AD genotype APOE ε2ε4 (OR = 1.36, 95% CI [0.76–2.41], p = 0.29) was not statistically significant, while APOE ε3ε4 (OR = 3.43, 95% CI [2.95–3.99], p < 0.0001) has a high risk of AD development; the risk is more notably in the APOE ε4ε4 genotype (OR = 7.08, 95% CI [4.22–11.86], p < 0.0001). The APOE ε2 allele has a protective effect (APOE ε2 (OR = 0.47, 95% CI [0.29–0.74], p = 0.0013)), and similar results were achieved by APOE ε3 (OR  =  0.49, 95% CI [0.37–0.65], p < 0.0001). Subgroup analysis of three areas of Italy (southern, northern, and center) revealed that that APOE ε4 allele was a risk factor with a higher OR in northern Italy (OR 4.22; 95% CI [3.46–5.16], p < 0.0001) compared to southern and center Italy (OR 3.02; 95% CI [2.28–4.01], p < 0.0001 and OR 3.97; 95% CI [1.37–11.56], p < 0.0001, respectively). As well, APOE ε4ε4 genotype carriers had a significantly higher OR in northern Italy (OR 9.69; 95% CI [4.94–18.99], p < 0.0001) compared to in southern and center Italy (OR 4.38; 95% CI [1.54–12.47], p < 0.0001 and OR 3.59; 95% CI [0.87–14.86], p < 0.0001, respectively). Conclusions: This systematic review with a meta-analysis of the Italian population on APOE alleles, genotyping, and AD incidence, highlights that individuals harboring APOE ε4 have a higher risk of developing AD compared to those with other alleles. It also supports the protective effect of the APOE ε2 allele against the progress of AD. The qualitative analysis on the complex genetic interactions influencing Alzheimer risk emphasizes the need for further research on genetic and environmental factors for effective prevention strategies. [ABSTRACT FROM AUTHOR]

Objective: Recurrent laryngeal nerve (RLN) injury is a serious complication during thyroid reoperation. Intraoperative neuromonitoring (IONM) is one of the means to reduce RLN paralysis. However, the role of IONM during thyroidectomy is still controversial. The aim of this study was to assess whether the IONM could reduce the incidence of RLN injury during thyroid reoperation. Methods: We performed a systematic review to identify studies in English language which were published between January 1, 2004, and March 25, 2023 from PubMed, EMBASE, and Cochrane Library, comparing the use of IONM and Visualization Alone (VA) during thyroid reoperation. The RLN injury rate was calculated in relation to the number of nerves at risk. All data were analyzed using Review Manger (version 5.3) software. The Cochran Q test (I2 test) was used to test for heterogeneity. Odds ratios were estimated by fixed effects model or random effects model, according to the heterogeneity level. Results: Eleven studies (3655 at-risk nerves) met criteria for inclusion. Data presented as odds ratio(OR) and their 95% confidence intervals(CI). Incidence of overall, temporary, and permanent RLN injury in IONM group were, respectively, 4.67%, 4.17%, and 2.39%, whereas for the VA group, they were 8.30%, 6.27%, and 2.88%. The summary OR of overall, temporary, and permanent RLN injury compared using IONM and VA were, respectively, 0.68 (95%CI 0.4-1.14, p=0.14), 0.82 (95%CI 0.39-1.72, p=0.60), and 0.62 (95%CI 0.4-0.96, p=0.03). Conclusions: The presented data showed benefits of reducing permanent RLN injury by using IONM, but without statistical significance for temporary RLN injury. [ABSTRACT FROM AUTHOR]

When accounting for the social–ecological impact of an ecological restoration program, both objective environmental contexts and people's subjective perceptions are required. While this kind of environmental impact assessment lacks a comprehensive perspective. We use the difference-in-differences model to evaluate the effect of the greenness of the landscape after ecological migration in the Qilian Mountains in China; and analysis of variance and fixed effects models are used to evaluate the effects of such ecological restoration programs on local people's perceptions. The results show that the ecological migration program in the Qilian Mountains has been successful at not only significantly improving remotely sensed greenness at the landscape scale, but also at enhancing immigrants' environmental perceptions. These findings demonstrate the environmental impacts of ecological migration from a social–ecological perspective, and can provide methodological implications for landscape planning to support a better understanding of ecological restoration programs in the drylands. [ABSTRACT FROM AUTHOR]

Due to some social, economic, and environmental factors, the under-5 mortality rates in low-income countries (LICs) are usually high. The primary purpose of this study is to determine the impact of health expenditures, electricity consumption, economic growth, renewable energy, urbanization, and fertility rates on the under-5 mortality rates in low-income countries. For the theoretical framework, the Grossman health production theory is conducted. Due to the existence of the cross-sectional dependency problem and the unit-roots problem, the static and dynamic models are employed to evaluate the long-run estimation findings. The static and dynamic models of the fixed effect, random effect, system generalized method of moments, and dynamic generalized method of moments illustrated that health expenditure, electricity, GDP, and urbanization significantly alleviated the infants' mortality rates under-5 in the low-income countries, by contrast, renewable energy, and fertility rates contributed to the increase of the mortality rates under -5. The quantile regression evaluates the validity and robustness of the results. The robust outcomes narrated that health expenditure, electricity, GDP, and urbanization declined the mortality rates whenever the fertility rate increased the mortality rates. The research suggests important policy recommendations for low-income countries. [ABSTRACT FROM AUTHOR]

The use of fossil fuels, which is still seen as the cheapest energy source today, has increased carbon emissions and contributed to the formation of greenhouse gases, and this gas has reached levels that threaten world health. While studies on this problem often question the relationship between production volume, energy use, and carbon emissions, few studies question the effects of the financial assets, which are the providers of investments made for production purposes, on environmental degradation. This study used the fixed effect model and system GMM technique to analyse the moderating effect of green finance in connection to financial openness and environmental quality from 2015 to 2020 in the CEE countries. Findings show, among other things that (1) CO2 in CEE countries is still growing; (2) financial openness is a positive and significant indicator of CO2 emission; and (3) that green finance usage reduces the positive impact of financial openness on CO2 emissions. The study suggests that financial openness, renewable energy (RE) investment, and green technology innovation (GTI)– consistently drive CO2 emissions in CEE countries. The study suggests that policies promoting green finance, particularly RE investment and GTI, can help mitigate environmental degradation and reduce CO2 emissions. [ABSTRACT FROM AUTHOR]

This paper seeks to investigate how earnings quality is affected by related party transactions (RPTs). The research also examines the impact of ownership structure as a moderating variable on this relationship. Panel data with the firm fixed effects model are utilized in the paper. A sample of 91 non-financial companies listed on the Saudi Stock Exchange between 2018 and 2022 were included, resulting in 429 observations of company performance over that time period. This paper finds that there is a negative association between RPTs and earnings quality. Furthermore, the study found that the adverse effect of RPTs on earnings quality is intensified when there is managerial ownership and institutional ownership as moderating variables. The study's conclusions are robust and reliable, as the sensitivity analysis results reinforce those of the basic analysis. To the authors' knowledge, there is relatively little available evidence on the connection between RPTs and their correlation with earnings quality, particularly in the context of ownership structure acting as a moderating variable. Moreover, the study's findings hold important implications for enhancing earnings quality in developing economies. To the authors' knowledge, no studies have been conducted in Saudi Arabia thus far to investigate the impact of ownership concentration, institutional ownership, managerial ownership, foreign ownership, and state ownership on the association between RPTs and earnings quality. Therefore, this paper expands the literature by modeling how the interaction between ownership structure and related party transactions may influence earnings quality. In this way, the authors contribute to the body of knowledge by unveiling a more robust control mechanism, particularly in developing economies with ineffective markets for corporate control. [ABSTRACT FROM AUTHOR]

Global warming is a challenge to the sustainable development of all humanity. Innovation is the main driver of the world's development and a powerful response to economic development and environmental protection. In this paper, a bidirectional fixed effect model and spatial Durbin model are used to explore the impact mechanism, heterogeneity and spatial impact of the low-carbon effect of technological innovation based on panel data of 279 Chinese cities from 2010 to 2019. The findings indicate that (1) technological innovation significantly negatively impacts carbon intensity, while the impact of high-quality technological innovation is greater. After the robustness test with the instrumental variable method and DID method, the conclusion is still valid. (2) The low-carbon effect is stronger in cities where governments pay more attention to green development and in central China. (3) Technological innovation improves energy efficiency (direct mechanism) and optimizes energy and industrial structures (indirect mechanism), and the digital economy strengthens this effect. (4) Furthermore, innovation can negatively impact the carbon intensity of adjacent cities. This paper provides new evidence and perspectives on the impact of technological innovation on carbon emissions more precisely at the city level. Additionally, this study provides an essential reference for countries to cope with global climate change and formulate differentiated policies among regions. [ABSTRACT FROM AUTHOR]

The rapid growth of two-way foreign direct investment (FDI) is a striking feature of the Belt and Road (B&R). Can two-way FDI promote green technology spillover (GTS) from the B&R countries? Does the technology gap moderate GTS? And what is the underlying mechanism? To this end, this paper systematically analyses the impact of two-way FDI on GTS based on panel data of 64 B&R countries from 2001 to 2020. Three significant findings were obtained: first, there is a dynamic effect between two-way FDI and GTS, and the technology gap always adjusts this relationship positively. Second, "Iron needs to be hard." Whether "going out" or "coming in," GTS is confined to a certain extent. The B&R countries must rely on their capabilities to build higher-quality, independently controllable key technology chains. Finally, the technology effect of two-way FDI always inhibits GTS, and the technology gap between the B&R countries and technology frontier countries is the "valley of death" which is difficult to cross but has to cross. These findings have targeted policy implications for the B&R countries to capture better GTS. [ABSTRACT FROM AUTHOR]

This study explores the impact of International Monetary Fund (IMF)-linked conditionality on government education expenditures in the Middle East and North Africa (MENA) region. Understanding the impact of conditional lending by international financial institutions on education spending is important due to the pivotal role education plays in fostering social and economic development. We use country-level panel data encompassing a representative set of 10 MENA countries from 1990 to 2020 and employ a cross-national fixed effects regression model. Our findings suggest that IMF conditionality demonstrates a positive relationship with government education expenditures in the MENA region. The proposed explanation is that the application of IMF policy advice can have a catalytic effect on donor financing, including for education. This indicates that the Fund's financing arrangements in the region can free up fiscal space for social spending, which, in turn, signals a sort of departure of the IMF from the reputation that typically precedes it—its traditional bias for macroeconomic stability irrespective of social costs. We argue that our findings are instructive for policy, especially if one shares the idea that education is a necessary prerequisite for achieving Sustainable Development Goal (SDG) 4: guaranteeing inclusive and equitable quality education and promoting enduring learning opportunities for all. [ABSTRACT FROM AUTHOR]

Background: Price levels of medical services may vary across regions with different income levels, which would raise concerns about the equal access to medical services. This study aimed to estimate the spatial price index of medical services to measure price levels across 31 provincial regions in China. Methods: Price data were collected from medical service price schedule in each region. Two methods based on the Purchasing Power Parities were used to estimate the spatial price index and measure price differences across regions. The two-way fixed effects models were used to examine the association between medical service price levels and income levels, and further investigate the impacts of price differences on utilization of medical services and medical expenditure. Results: The consistent estimation results were given by two methods. Medical service price level in the highest-price region was found to be 74% higher than the lowest. There was a significant negative correlation between price levels and income levels, as well as price levels and the utilization of outpatient services. Moreover, we also found a 1% increase in medical service price level was significantly associated with a 0.34% and 0.24% increase in the medical service expense per outpatient visit and per inpatient respectively. Conclusions: Regions in China had significant gaps in medical service price levels. Policymakers should pay more attention to regional price differences and take great measures such as enhancing financial protection to ensure the equal access to medical services and better achieve the universal health coverage. [ABSTRACT FROM AUTHOR]

Background: Sodium glucose cotransporter-2 (SGLT-2) inhibitors are known to reduce hospitalization and cardiovascular mortality in various heart failure (HF) populations, potentially through enhanced excretion of water and sodium. However, there are concerns regarding the risk of acute kidney injury (AKI) associated with their use. This meta-analysis aimed to unravel the effects of SGLT-2 inhibitors on risk of AKI in a variety of patients with HF. Methods: This study conducted a comprehensive literature search using PubMed, EMBASE, Cochrane Library, and clinicaltrials.gov for studies published up to January 1, 2024. Data were analyzed using both random-effects or fixed-effects models to estimate the overall relative risk (RR) with a 95% confidence interval (CI). Results: Our analysis included 25,172 patients with HF from 16 randomized controlled trials. Treatment with SGLT-2 inhibitors led to a 28% reduction in the risk of AKI progression compared to placebo (RR 0.72, 95% CI 0.61–0.85, p<0.0001), without an increased risk of hypotension (RR 1.21, 95% CI 0.87–1.70, p = 0.26) and hypovolemia (RR 2.26, 95% CI: 0.70–7.33, p = 0.17). Notably, SGLT-2 inhibitors significantly decreased AKI in specific subgroups, including patients with HF with reduced ejection fraction (RR 0.59, 95% CI 0.43–0.80, p = 0.0007), those treated with empagliflozin (RR 0.70, 95% CI 0.57–0.88, p = 0.002) or dapagliflozin (RR 0.74, 95% CI 0.57–0.98, p = 0.04), in studies with a follow-up of at least 1 year (RR 0.67, 95% CI 0.55–0.82, p = 0.0001), and in patients aged 65 years or older (RR 0.72, 95% CI 0.61–0.85, p < 0.0001). Conclusion: Use of SGLT-2 inhibitors did not increase the incidence of AKI regardless of the ejection fraction environment (chronic and acute), type of SGLT-2 inhibitors, or patient age. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of intravenous immunoglobulin (IVIG) therapy on unexplained recurrent spontaneous abortion (URSA). Methods: We retrieved all randomized controlled trials (RCTs) related to the effect of IVIG therapy on URSA in the following databases: PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials before April 30, 2023, according to the PRISMA statement. The therapeutic effect of IVIG was measured by live birth rates. Quality assessment was conducted independently by two reviewers, based on the Newcastle-Ottawa scale. For the meta-analysis, we used odds ratios (random effects model and fixed effects model). The between-study heterogeneity was assessed by the Q test. Publication bias was assessed by funnel plots. Results: A total of 12 studies with 751 participants were included in this metaanalysis. There was no statistical significance [OR = 1.07, 95%CI (0.65, 1.75), P=0.80] between the IVIG group and the non-IVIG group, including low molecular weight heparin (LMWH) plus low-dose aspirin (LDA), intralipid, multivitamins, albumin, and normal saline. A subgroup analysis was conducted according to the different treatment regimens of the non-IVIG group. Compared to the placebo group, including multivitamins, albumin, and saline, the live birth rate of the IVIG group is superior, but there was no statistical significance [OR =1.43, 95%CI (0.99, 2.07), P=0.05]. Another subgroup analysis was performed according to URSA with positive for antiphospholipid antibodies (aPLs). Results showed the live birth rate of IVIG on URSA with positive for aPLs is inferior to that of LMWH plus LDA [OR = 0.25, 95%CI (0.11, 0.55), P=0.0007]. Conclusions: IVIG didn't increase the live birth rate of URSA compared to placebo. Conversely, compared with the IVIG, the LMWH plus LDA treatment schedule can increase the live birth rate of URSA with positive for aPLs. [ABSTRACT FROM AUTHOR]

Prevalence studies about family meals, including large and representative samples of children and adolescents on this topic, are scarce. Therefore, the aim of this study was twofold: first, to determine the prevalence of daily family meals in large and representative samples of school‐going children and adolescents from 43 countries, and second, to identify the sex, age, socioeconomic status (SES), family structure, immigrant status and parental labour market status inequalities associated with this prevalence. Using data from the 2017/2018 wave of the Health Behaviour in School‐aged Children study, a total of 179,991 participants from 43 countries were involved in this cross‐sectional study. Family meals were assessed by the following question: ‘How often do you and your family usually have meals together?’. Participants had five different response options: ‘every day’, ‘most days’, ‘about once a week’, ‘less often’, and ‘never’. The meta package was utilized for conducting a meta‐analysis of single proportions, specifically applying the metaprop function. The analysis involved pooling the data using a random‐effects model and presenting the outcomes through a forest plot generated using the inverse variance method. Moreover, we applied generalized linear mixed models to explore the relationships between the studied sociodemographic factors as fixed effects, country as a random effect and the status of daily family meals as an outcome. Overall, the prevalence of daily family meals was 49.12% (95% confidence interval [CI]: 45.00–53.25). A greater probability of having daily family meals was identified for children aged 10–12 years (61.55%; 95% CI: 57.44%–65.49%), boys (61.55%, 95% CI: 57.44%–65.49%), participants with high SES (64.66%, 95% CI: 60.65%–68.48%), participants with both parents at home (65.05%, 95% CI: 61.16%–68.74%) and those with both unemployed parents (61.55%, 95% CI: 57.44%–65.49%). In the present study, which included large representative samples of school‐going children and adolescents from 43 countries, more than half of the participants did not have daily family meals. [ABSTRACT FROM AUTHOR]

Background: Ibuprofen is one of the most commonly used analgesic and antipyretic drugs in children. However, its potential causal role in childhood asthma pathogenesis remains uncertain. In this systematic review, we assessed the association between ibuprofen administration in children and the risk of developing or exacerbating asthma. Methods: We searched MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, and Scopus from inception to May 2022, with no language limits; searched relevant reviews; and performed citation searching. We included studies of any design that were primary empirical peer-reviewed publications, where ibuprofen use in children 0–18 years was reported. Screening was performed in duplicate by blinded review. In total, 24 studies met our criteria. Data were extracted according to PRISMA guidelines, and the risk of bias was assessed using RoB2 and NOS tools. Quantitative data were pooled using fixed effect models, and qualitative data were pooled using narrative synthesis. Primary outcomes were asthma or asthma-like symptoms. The results were grouped according to population (general, asthmatic, and ibuprofen-hypersensitive), comparator type (active and non-active) and follow-up duration (short- and long-term). Results: Comparing ibuprofen with active comparators, there was no evidence of a higher risk associated with ibuprofen over both the short and long term in either the general or asthmatic population. Comparing ibuprofen use with no active alternative over a short-term follow-up, ibuprofen may provide protection against asthma-like symptoms in the general population when used to ease symptoms of fever or bronchiolitis. In contrast, it may cause asthma exacerbation for those with pre-existing asthma. However, in both populations, there were no clear long-term follow-up effects. Conclusions: Ibuprofen use in children had no elevated risk relative to active comparators. However, use in children with asthma may lead to asthma exacerbation. The results are driven by a very small number of influential studies, and research in several key clinical contexts is limited to single studies. Both clinical trials and observational studies are needed to understand the potential role of ibuprofen in childhood asthma pathogenesis. [ABSTRACT FROM AUTHOR]

Introduction: Culex quinquefasciatus is one of the most important carriers of human pathogens. Using the insecticides is one of the most important methods of combating this vector. But the genetic resistance created in Culex quinquefasciatus led to disruption in the fight against this pest. Consequently, it is necessary to know the level of resistance to fight this vector. Based on this, the present study was conducted to investigate the prevalence of kdr resistance in Culex quinquefasciatus against organochlorine insecticides in the world. Methods: This study was conducted by systematic review, and meta-analysis on the prevalence of kdr resistance and mortality rate in Culex quinquefasciatus against organochlorine insecticides in the world. All pertinent articles were extracted and analyzed in accordance with this information during an unrestricted search of the scientific databases Web of Science, PubMed, Scopus, biooan.org, Embase, ProQuest, and Google Scholar until the end of November 2023. Statistical analysis of data was done using fixed and random effects model in meta-analysis, I2 index, Cochran's test, and meta-regression by STATA version 17 software. Results: Seventy articles were included in the meta-analysis process. Based on the findings, the prevalence of Kdr in Culex quinquefasciatus against organochlorine insecticide was estimated at 63.1%. Moreover, the mortality rate against the insecticide deltamethrin was 46%, DDT 18.5%, permethrin 42.6%, malathion 54.4% and lambdacyhalothrin 53%. Conclusion: More than half of Cx. quinquefasciatus had Kdr. This vector was relatively resistant to DDT and permethrin insecticides and sensitive to malathion, deltamethrin and lambdacyhalothrin. In order to prevent the development of resistance to alternative insecticides, it is consequently critical to combat this vector with efficacious insecticides. Author summary: Using the insecticides is one of the most important methods of combating this vector. Based on this, the present study was conducted to investigate the prevalence of kdr resistance in Culex quinquefasciatus against organochlorine insecticides in the world. This study was conducted by systematic review, and meta-analysis on the prevalence of kdr resistance and mortality rate in Culex quinquefasciatus against organochlorine insecticides in the world. Based on the findings, the prevalence of Kdr in Culex quinquefasciatus against organochlorine insecticide was estimated at 63.1%. Moreover, the mortality rate against the insecticide deltamethrin was 46%, DDT 18.5%, permethrin 42.6%, malathion 54.4% and lambdacyhalothrin 53%. More than half of Cx. quinquefasciatus had Kdr. This vector was relatively resistant to DDT and permethrin insecticides and sensitive to malathion, deltamethrin and lambdacyhalothrin. [ABSTRACT FROM AUTHOR]

Background: Ensuring that the scale and hierarchical structure of health human resources are rational, and that medical services are efficient and fair, is an important task of practical significance. On this basis, examining the impact of health human resources on the level of medical services presents a new and formidable challenge. This study aims to delve into how the scale and hierarchical structure of health human resources in China's four major economic regions affect the fairness and efficiency of medical services, and to identify optimization strategies. Methods: This study utilizes provincial panel data from China's four major economic regions spanning the years 2009 to 2021. Initially, it provides a statistical description of the current state of health human resources and the level of medical services. Subsequently, it employs a fixed-effects model to analyze the impact of the scale and hierarchical structure of health human resources, as well as their interactive effects, on the fairness and efficiency of medical services, and discusses the interactive mechanisms between medical service fairness and medical service efficiency. Furthermore, after conducting a comprehensive evaluation of the level of medical services using the entropy weight method, it explores the regional heterogeneity and temporal dynamics in the influence of the scale and hierarchical structure of health human resources on the level of medical services. Finally, the study examines the scientific validity and rationality of the research findings through various robustness checks, including the substitution of research variables and models. Results: The study found that the scale of health human resources has a promoting effect on the equity of medical services (β ≤ 0.643, p ≤ 0.01), but exhibits an inhibitory effect on the efficiency of medical services (β ≥ -0.079, p ≤ 0.1); the hierarchical structure of health human resources shows a positive impact on both the equity and efficiency of medical services (βequity ≤ 0.160, p ≤ 0.01; βefficiency ≤ 0.341, p ≤ 0.05); at the same time, the results indicate that the interactive effect of the scale and hierarchical structure of health human resources promotes equity in medical services (β = 0.067, p ≤ 0.01), but restricts the efficiency of medical services (β ≥ -0.039, p ≤ 0.01); the mechanism by which health human resources affect the level of medical services in China's western and northeastern regions is more pronounced than in the central and eastern regions; after the implementation of the "Healthy China 2030" Planning Outline, the role of health human resources in the level of medical services has been strengthened; in the robustness tests, the model remains robust after replacing the core explanatory variables, with R2 maintained between 0.869 and 0.972, and the dynamic GMM model test shows a significant second-order lag in the level of medical services (βequity ≤ 0.149, p ≤ 0.01; βefficiency ≤ 0.461, p ≤ 0.01); the channel test results prove that managerial personnel and other technical personnel are key pathways in regulating the impact of medical staff on the level of medical services. Conclusion: This study provides an in-depth analysis of the impact of health human resources on the level of medical services, revealing that both the scale and hierarchical structure of health human resources significantly affect the equity and efficiency of medical services. Furthermore, the influence of health human resources on the level of medical services exhibits regional heterogeneity and temporal characteristics. Robustness tests ensure the scientific validity and robustness of the research conclusions. This provides effective references for optimizing the allocation of health human resources and improving the level of medical services. [ABSTRACT FROM AUTHOR]

Land consolidation has become an organized and widely implemented project in rural areas. However, research remains somewhat scarce on the contributing mechanism of land consolidation to farmer income in developing countries. Using provincial panel data from China, this study employs a fixed effects model to analyze the influence of high-standard farmland construction on farmer income and underlying mechanisms. Results suggest that the implementation of high-standard farmland construction can significantly augment farmer income. Reduction in agricultural production cost, improvement in agricultural management benefit and increase in non-farm income have led to the boost in income. The relationship between income and high-standard farmland construction exhibits regional disparities, with the most significant impacts concentrated in economically developed areas and low relief degree areas. Our findings suggest that it is imperative for the Chinese government to persistently promote the establishment of high-standard farmland, and further enhance its positive influence on advancing agricultural cost-effectiveness and expanding non-farm income channels for farmers. [ABSTRACT FROM AUTHOR]

Background: Sedentary behavior is linked to excess fat mass; however, this association may be inconclusive due to potential measurement errors in self-reported sedentary behavior. Objective: To assess the association between changes in sedentary behavior and fat mass in a Cohort of Health Workers (HWCS) from 2004 to 2010. Methods: A total of 1,285 adults participating in the Cohort of Health Workers were evaluated in 2004 and 2010. Fat mass (kg) was measured by dual X-ray absorptiometry. A self-administered questionnaire was used to estimate the sedentary behavior. Sedentary behavior was also estimated using accelerometry in a sample of 142 health workers. Accelerometry data were used to correct self-reported sedentary behavior using a generalized linear model, which included values for sleeping time, age, sex, sedentary behavior, glucose, and triglycerides. Concordance between both methods was assessed using a kappa and Bland–Altman analysis. Once sedentary behavior was corrected, the values were used to evaluate the association between changes in sedentary behavior and body fat mass using a fixed effect model in the cohort, adjusting for confounders. Results: Self-reported sedentary behavior was 2.8 ± 1.8 and 2.3 ± 1.6 h/day, and body fat mass was 24.9 ± 8.1 and 26.8 ± 8.5 kg in 2004 and 2010, respectively. After applying the correction model, the self-reported sedentary behavior was 7.6 ± 1.2 and 7.5 ± 1.2 h/day in 2004 and 2010, respectively. For every hour increase in corrected sedentary behavior, there was an observed increase of 0.847 (p > 0.001) kg in body fat mass during the 6.8 years in the Cohort of Health Workers from 2004 to 2010. Conversely, non-corrected self-reported sedentary behavior was associated with a non-significant reduction of 0.097 kg (p = 0.228) for every hour of sedentary behavior. Conclusions: Increased sedentary behavior was associated with increased body fat mass when corrected self-reported sedentary behavior was used. Implementing public health strategies to reduce sedentary behavior is imperative. [ABSTRACT FROM AUTHOR]

The current context of economic development requires paying close attention to the energy industry. Since 2022, European countries has been facing specific problems due to energy crises against the background of the geopolitical conflict and the measures provided by European forums in order to reduce dependence on energy imports from Russia. In this context, we aim to define a new model of energy consumption and the function of energy sustainability at the European level, aspects that will lead to highlighting the position of the 27 European member states in the period 2005--2022 in terms of their energy sustainability. The methodology used is based on the study of literature, the consolidation of databases, econometric modelling, and procedures for testing the validity of modelling results. The results of the study are useful to European energy policy decision-makers in view of the necessary adjustments to achieve the objectives of the 2030 and 2050 Agenda. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff tears are a common shoulder injury that significantly impacts patients' daily lives and work abilities. Although surgical treatment methods for rotator cuff tears have been continuously improved with advances in medical technology, postoperative rehabilitation remains challenging. Therefore, finding effective rehabilitation treatments is crucial for improving patient prognosis and enhancing quality of life. This study will aim to systematically evaluate the impact of low-intensity pulsed ultrasound (LIPUS) on postoperative rehabilitation of rotator cuff tears, comprehensively assessing the efficacy and safety of LIPUS in postoperative recovery. Methods: This protocol will search multiple databases including PubMed/MEDLINE, Embase, Cochrane Library, CNKI, Scopus, and Web of Science to identify randomized controlled trials related to LIPUS for postoperative rehabilitation of rotator cuff tears. The search will encompass literature published from the inception of the databases up to April 2024. Methodological quality assessment and data extraction will be conducted using the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. Meta-analysis will be performed on appropriate studies using either random-effects or fixed-effects models, and subgroup analyses will be conducted to explore potential heterogeneity. Studies meeting the inclusion criteria will be included in the analysis. All analyses will be performed using Stata version 16.0. Results: The incidence of rotator cuff tear rates will be assessed by imaging techniques such as MRI or ultrasound. Pain intensity will be scored using standardized pain assessment scales, such as the Visual Analog Scale (VAS). Improved range of motion (ROM) in shoulder flexion, abduction, and rotation. Functional outcomes will be evaluated using effective measures such as Constant-Murley scores (CMS) and shoulder joint scores by American Shoulder and Elbow Surgeons (ASES). Adverse events associated with LIPUS therapy, including skin irritation, increased pain, or any other complications. Subgroup analysis will also be carried out if possible. Discussion and conclusion: Following the meta-analysis, we will assess the overall effect of LIPUS on postoperative rehabilitation of rotator cuff tears, and further explore its impact on aspects such as pain relief, functional improvement, and postoperative complications. It is anticipated that this study will provide comprehensive evidence regarding the role of LIPUS in postoperative rehabilitation of rotator cuff tears, guiding clinical practice and future research. The resultant manuscript will be submitted for publication in a peer-reviewed journal. Protocol registration number: CRD42024530798. [ABSTRACT FROM AUTHOR]

Objective: There is ongoing debate regarding the association between epilepsy and obesity. Thus, the aim of this study was to examine the correlation between epilepsy and obesity. Method: This study adhered to the PRISMA guidelines for systematic reviews and meta-analyses. On The Prospero website, this study has been successfully registered (CRD42023439530), searching electronic databases from the Cochr-ane Library, PubMed, Web of Sciences and Embase until February 10, 2024.The search keywords included "Epilepsy", "Obesity", "Case-Control Studies", "cohort studies", "Randomized Controlled Trial" and "Cross-Sectional Studies". The medical subject headings(MeSH) of PubMed was utilized to search for relevant subject words and free words, and a comprehensive search strategy was developed. Two reviewers conducted article screening, data extraction and bias risk assessment in strict accordance with the predefined criteria for including and excluding studies. The predefined inclusion criteria were as follows: 1) Inclusion of case-control, cohort, randomized controlled trial, and cross-sectional studies; 2) Segregation of subjects into epileptic patients and healthy controls; 3)Obesity as the outcome measure; 4) Availability of comprehensive data; 5) Publication in English. The exclusion criteria were as follows: 1) Exclusion of animal experiments, reviews, and other types of studies; 2) Absence of a healthy control group; 3) Incomplete data; 4) Unextractable or unconvertible data; 5) Low quality, indicated by an Agency for Healthcare Research and Quality(AHRQ) score of 5 or lower,or a Newcastle-Ottawa Scale (NOS) score less than 3. The subjects included in the study included adults and children, and the diagnostic criteria for obesity were used at different ages. In this study, obesity was defined as having a body mass index(BMI) of 25 kg/m2 or higher in adults and being above the 85th percentile of BMI for age in children. We used obesity as an outcome measure for meta-analysis using RevMan, version 5.3. Results: A meta-analysis was conducted on a total of 17 clinical studies, which involved 5329 patients with epilepsy and 480837 healthy controls. These studies were selected from a pool of 1497 articles obtained from four electronic databases mentioned earlier. Duplicate studies were removed based on the search strategies employed. No significant heterogeneity was observed in the outcome measure of obesity in epileptic patients compared with healthy controls(p = 0.01,I2 = 49%). Therefore, a fixed effects model was utilized in this study. The findings revealed a significant difference in obesity prevalence between patients with epilepsy and healthy controls(OR = 1.28, 95%CI: 1.20–1.38, p<0.01). Conclusion: The results of this meta-analysis indicate that epilepsy patients are more prone to obesity than healthy people, so we need to pay attention to the problem of post-epilepsy obesity clinically. Currently, there is a scarcity of largescale prospective studies. Additional clinical investigations are warranted to delve deeper into whether obesity is a comorbidity of epilepsy and whether obesity can potentially trigger epilepsy. [ABSTRACT FROM AUTHOR]

Background: In recent decades, the Loess Plateau is one of the regions in China that urgently needs ecological governance due to the severe situation of soil erosion and land desertification. Due to the impact of climate change and human activities, the threat to the ecological space security of the Loess Plateau has intensified. This paper reveals the time lag effect of ecological engineering construction on the changes in the ecosystem service capacity index of the Loess Plateau, providing a scientific basis and decision-making reference for the sustainable development of the study area and improving the quality and management of ecological engineering construction, which is of great significance for building a solid ecological security barrier on the Loess Plateau. Methods: Based on the hierarchical analysis method, quantitative indicator method, spatial correlation analysis method and two-way fixed effect model, this paper analyzes the temporal and spatial changes of the ecosystem service capacity index of the Loess Plateau under the background of ecological engineering implementation. Results: The results showed that: 1) the vegetation coverage of the Loess Plateau increased with the increase of the area of ecological engineering construction, and showed a fluctuating growth distribution characteristic from southeast to northwest in space; 2) the water conservation capacity index, wind and sand fixation capacity index, biodiversity capacity index and comprehensive service capacity index of the Loess Plateau from 2000 to 2020 all showed exponential growth, which were highly coupled with the growth and change of vegetation coverage area in time and space; 3) the cold spots and hot spots of the ecosystem service capacity index of the Loess Plateau showed a step-by-step decrease of "hot in the south and cold in the north" in spatial distribution; the hot spots and sub-hot spots showed a reciprocating cycle from aggregation to fragmentation in time and space; the cold spots and sub-cold spots were mainly distributed in the northwest region. 4) The changes in the ecosystem service capacity index of the Loess Plateau were mainly affected by factors such as the cumulative project implementation area, urbanization rate and precipitation. Conclusion: The construction of ecological engineering on the Loess Plateau has achieved remarkable results. The growth of vegetation coverage area and ecosystem service capacity index on the Loess Plateau from 2000 to 2020 has promoted the recovery of ecosystem functions. Therefore, we should actively promote the construction of ecological projects to provide scientific decisionmaking references for solving regional ecological security issues. [ABSTRACT FROM AUTHOR]

Objectives: The relationship between hepatitis B virus (HBV) infection and gynecologic cancers is controversial. We aimed to evaluate the risk of gynecologic cancers associated with HBV infection using a meta-analysis. Methods: Two independent reviewers identified publications in the PubMed, Embase and Cochrane Library databases that reported an association between HBV and the risk of gynecologic malignancy from inception to December 31, 2022. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the included articles. Pooled odds ratios (ORs) and 95% corresponding confidence intervals (CIs) were calculated using a fixed effects model or random effects model. Results: We collected data from 7 studies that met the inclusion criteria, including 2 cohort studies and 5 case-control studies. HBV was significantly associated with the risk of cervical cancer in the general population (OR 1.22, 95% CI 1.09–1.38, P = 0.001), although the same trend was not found in endometrial cancer (OR 1.30, 95% CI 0.95–1.77, P = 0.105) and ovarian cancer (OR 1.03, 95% CI 0.79–1.35, P = 0.813). Subgroup analysis showed that HBV infection was positively associated with the risk of cervical cancer (OR 1.27, 95% CI 1.13–1.44, P = 0.000) in case-control studies. Asian women infected with HBV have a significantly increased risk of cervical cancer (OR 1.24, 95% CI 1.10–1.40, P = 0.001) and endometrial cancer (OR 1.46, 95% CI 1.07–1.99, P = 0.018). Hospital-based studies were found to be associated with an increased risk of cervical cancer (OR 1.30, 95% CI 1.14–1.47, P = 0.000) and endometrial cancer (OR 1.61, 95% CI 1.04–2.49, P = 0.032). The results of Begg's and Egger's tests showed no publication bias. Conclusions: This meta-analysis shows a positive association between HBV infection and cervical cancer. HBV is positively correlated with the risk of cervical cancer and endometrial cancer in Asian women and hospital-based populations. More multicenter prospective studies are required to confirm the findings. [ABSTRACT FROM AUTHOR]