Abstract:Water resources are important and irreplaceable natural and economic resources. Achieving a balance between economic prosperity and protection of water resource environments is a major issue in China. This article develops a data envelopment analysis (DEA) approach with undesirable outputs by using Seiford's linear converting method to estimate water use efficiencies for 30 provinces in China, from 2008-2016,and then analyzes the influencing factors while using a DEA-Tobit model. The findings show that the overall water use efficiency of the measured Chinese provinces, when considering sewage emissions as the undesirable output, is 0.582. Thus, most regions still need improvement. Provinces with the highest water efficiency are located in economically developed Eastern China. The spatial pattern of water use efficiency in China is consistent with the general pattern of regional economic development. This study implies that factors like export dependence, technical progress, and educational value have a positive influence on water use efficiency. Further, while industrial structure has had a negative impact, government intervention has had little impact on water use efficiency. These research results will provide a scientific basis for the government to make plans for water resource development, and it may be helpful in improving regional sustainable development.

ObjectiveTo document the financial protection status of eight countries of the South-East Asian region and to investigate the main components of out-of-pocket expenditure on health care.MethodsWe calculated two financial protection indicators using data from living standards surveys or household income and expenditure surveys in Bangladesh, Bhutan, India, Maldives, Nepal, Sri Lanka, Thailand and Timor-Leste. First, we calculated the incidence of catastrophic health expenditure, defined as the proportion of the population spending more than 10% or 25% of their total household expenditure on health. Second, using World Bank poverty lines, we determined the impoverishing effect of health-care spending by households. We also conducted an analysis of the main components of out-of-pocket expenditure.ResultsAcross countries in this study, 242.7 million people experienced catastrophic health expenditure at the 10% threshold, and 56.4 million at the 25% threshold. We calculated that 58.2 million people were pushed below the extreme poverty line of 1.90 United States dollars (US$) and 64.2 million people below US$ 3.10 (per capita per day values in 2011 purchasing power parity), due to out-of-pocket spending on health. Spending on medicines was the main component of out-of-pocket spending in most of the countries.ConclusionA substantial number of people in South-East Asia experienced financial hardship due to out-of-pocket spending on health. Several countries have introduced policies to make medicines more available, but the finding that out-of-pocket expenditure on medicines remains high indicates that further action is needed to support progress towards universal health coverage.

Health education is considered to be an effective way to improve the healthcare-seeking behavior of migrant workers.This study examined the impact of health education on healthcare-seeking behavior of migrant workers in China and explored the differences in different health education methods. This paper used the 2017 China Migrants Dynamic Survey (CMDS) to analyze the relationship between health education and healthcare-seeking behavior. Our results indicated that health education could significantly improve the healthcare-seeking behavior of migrant workers, but there was still ample space for improvement. From the perspective of different health education methods, lectures, public consultation, and online education were positively correlated to healthcare-seeking behavior, while publicity materials and bulletin boards were not. Although the effects of publicity materials and bulletins were limited, these two health education methods were still the most widely used. Our results emphasized the necessity of increasing investment in lectures, public consultation, online education, and other similar health education methods. This change in health education methods can play an effective role in the spread of health education to improve the healthcare-seeking behavior of migrant workers.

Cervical cancer is a tumor with the second highest morbidity and mortality in the world, and it is also the most common cancer and the eighth lethal factor among malignant tumors in Chinese female. This study aimed to identify long noncoding RNAs (lncRNAs) that related to diagnosis and prognosis in cervical cancer to improve early diagnosis and treatment. First, we extracted transcriptome profilings of cervical cancer samples from the cancer genome atlas (TCGA) database, and then extracted the lncRNAs and mRNAs expression profiles. Based on the lncRNAs expression profiles of test set, we screened lncRNAs that related to progression of cervical cancer tumors. We found six lncRNAs associated with tumor progression in cervical cancer patients, in which five lncRNAs have highly similar expression patterns but the other one has the opposite expression pattern. We found that these six lncRNAs might be related to keratinization and immunity by enrichment analysis, and two of them (AC126474 and C5orf66-AS1) were associated with prognosis in patients with cervical cancer. And these results were validated using the validation set. Overall, we identified six lncRNAs that played an important role in the development of cervical cancer, and two of them might be associated with the prognosis of cervical cancer, which provides new insight into the diagnosis and treatment of cervical cancer. K E Y W O R D Sbiomarkers, cervical cancer, long noncoding RNA, survival

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Halls in the traditional dwellings in northern China are generally closed, whereas those in the south are open. However, in the dwellings in Zhejiang and Jiangsu, many closed halls have partition doors that separate the indoor space from the yard. Focusing on the relationship between the hall and the yard, this study investigated the space of halls in Jiangnan (southern Jiangsu and northern Zhejiang) and its surrounding areas. A total of 89 cases in and 175 cases around Jiangnan were analyzed. Results indicated that the halls in the Jiangnan area are mostly closed, whereas those in the middle and south of Zhejiang, southeastern Anhui, eastern Jiangxi, and northern Fujian are mainly open. The closed halls in Jiangnan are relatively more special compared with those in its adjacent areas. Aside from the climate of hot-summers and cold-winters, the regional culture of preferring the quality of material life to orthodox etiquette is an important factor in the distinction. A closed hall provides comfort and privacy, thereby reducing the inner openness of the dwelling. These halls also lead to the emergence of assistant alleys in large dwellings.

Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

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