Background Weather conditions are a possible contributing factor to age-related macular degeneration (AMD), a leading cause of irreversible loss of vision. The present study evaluated the joint effects of meteorological factors and fine particulate matter (PM2.5) on AMD. Methods Data was extracted from a national cross-sectional survey conducted across 10 provinces in rural China. A total of 36,081 participants aged 40 and older were recruited. AMD was diagnosed clinically by slit-lamp ophthalmoscopy, fundus photography, and spectral domain optical coherence tomography (OCT). Meteorological data were calculated by European Centre for Medium-Range Weather Forecasts (ECMWF) reanalysis and were matched to participants’ home addresses by latitude and longitude. Participants’ individual PM2.5 exposure concentrations were calculated by a satellite-based model at a 1-km resolution level. Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the joint effects of meteorological factors and PM2.5 on AMD. Results The prevalence of AMD in the study population was 2.6% (95% CI 2.42–2.76%). The average annual PM2.5 level during the study period was 63.1 ± 15.3 µg/m3. A significant positive association was detected between AMD and PM2.5 level, temperature (T), and relative humidity (RH), in both the independent and the combined effect models. For PM2.5, compared with the lowest quartile, the odds ratios (ORs) with 95% confidence intervals (CIs) across increasing quartiles were 0.828 (0.674,1.018), 1.105 (0.799,1.528), and 2.602 (1.516,4.468). Positive associations were observed between AMD and temperature, with ORs (95% CI) of 1.625 (1.059,2.494), 1.619 (1.026,2.553), and 3.276 (1.841,5.830), across increasing quartiles. In the interaction analysis, the estimated relative excess risk due to interaction (RERI) and the attributable proportion (AP) for combined atmospheric pressure and PM2.5 was 0.864 (0.586,1.141) and 1.180 (0.768,1.592), respectively, indicating a synergistic effect between PM2.5 and atmospheric pressure. Conclusions This study is among the first to characterize the coordinated effects of meteorological factors and PM2.5 on AMD. The findings warrant further investigation to elucidate the relationship between ambient environment and AMD. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00237.

China faces increasing health risks from climate change. The structure and function of the eye and vision were affected by extreme heat and cold. The study aimed to evaluate the impacts of heatwaves and cold spells on glaucoma. A national cross-sectional study of the Rural Epidemiology for Glaucoma (REG-China) was conducted in ten provinces of China, and 36,081 adults aged 40 years or more were included. Glaucoma signs were assessed via a standard examination. A total of 15 heatwave definitions, based on intensity (95th to 99th percentiles of temperature distribution) and duration (≥2 days, 3 days, and 4 days), were used to quantify heatwave effects, and 6 cold spell definitions were defined based on threshold temperature percentile (5th and 10th) and duration (3 days, 5 days, and 9 days). Multivariable-adjusted logistic regression models paired with interaction analysis were performed to investigate the impacts of heatwaves and cold spells on glaucoma, and the dose-response relationships were assessed using a restricted cubic spline (RCS) model. Subgroup analysis was conducted stratified by gender, age, smoking status, occupation, and family history of glaucoma. The overall prevalence of glaucoma was 2.1% (95% CI 1.94-2.25%). Higher heatwaves were significantly correlated with higher OR of glaucoma, with the OR (95% CI) ranging from 1.014 (1.009, 1.018) to 1.090 (1.065, 1.115) by different definitions. Glaucoma was affected by heatwaves more strongly than by cold spells. The effects of both heatwaves and cold spells were higher in males than females and in smokers than nonsmokers. These results of the present study evoked the attention of prospective research to elucidate the relationship between extreme temperatures and eye diseases.

ObjectiveThis study aimed to investigate the prevalence of glaucoma with associated factors in the rural populations of 10 provinces in China.DesignA population-based cross-sectional study.MethodsAll participants aged 6 years or older from 10 provinces completed visual acuity testing, slit-lamp examination, ophthalmoscopy and non-contact tonometry. Glaucoma suspects underwent fundus photography, Goldmann applanation tonometry, visual field testing and gonioscopy. Glaucoma was determined according to the International Society of Geographical and Epidemiological Ophthalmology classification scheme. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models.ResultsFrom June 2017 to October 2018, 48 398 of 52 041 participants were included in the final analyses. The age-standardised prevalence of glaucoma was 1.7% (95% CI 1.55% to 1.78%) among the participants older than 6 years, which was 2.1% (95% CI 1.93% to 2.23%) in participants aged over 40 years. The constituent ratios of glaucoma were: 44.4% primary angle-closure glaucoma (PACG), 34.7% primary open-angle glaucoma, 2.6% congenital glaucoma and 18.3% other types of glaucoma. Increasing age, smoking, cerebral stroke, type 2 diabetes, higher education (college or more) and higher personal income were significant risk factors for PACG. The unilateral and bilateral blindness rates in the entire study population were 4.692% and 1.068%, respectively. A family history of glaucoma was a significant risk factor for the prevalence of glaucoma and blindness in at least one eye.ConclusionsRural populations have a high prevalence of glaucoma, which should be included in chronic disease management programmes in China for long-term care.

在当前复杂的国际形势下,充分发挥产业政策对企业出口产品质量的提升作用,对于推动构建以国内大循环为主体,国内国际双循环相互促进的新发展格局尤为重要.基于全新构建的地方政府产业政策数据库,本文考察了地方政府产业政策对企业出口产品质量的影响及作用机制,以及上述影响在企业及地区层面的异质性.研究发现,总体而言,地方政府产业政策能显著促进辖区内企业出口产品质量的提升,并且该结果具有稳健性;关于上述影响作用机制的检验表明,提升研发密度及产业集聚程度,是地方政府产业政策促进企业出口产品质量提升的两个有效渠道;此外,地方政府产业政策对企业出口产品质量的促进作用表现出企业及地区异质性.

BACKGROUND:A growing body of evidence has confirmed the association between fine particulate matter (PM2.5) and ocular diseases, but little is known on the effect of long-term PM2.5 exposure on glaucoma. METHODS:A national cross-sectional study of the Rural Epidemiology for Glaucoma was conducted in 10 provinces of China, and 33,701 adults aged 40 years or more were included. A satellite-based model at 1-km resolution level was used to estimate PM2.5 concentrations which were assigned to each participant according to geocoded home addresses. Logistic regression model was performed to investigate associations of long-term PM2.5 exposure with glaucoma and its subtypes. RESULTS:Estimated PM2.5 concentrations ranged from 28.0 to 96.4 μg/m3. For each 10 μg/m3 increment in PM2.5, the adjusted odds ratios (ORs) were 1.07 (95% CI: 1.00-1.15) and 1.14 (95% CI: 1.02-1.26) for glaucoma and primary angle-closure glaucoma (PACG), respectively. A positive but non-significant association (OR = 1.05, 95% CI: 0.92-1.18) was detected between long-term exposure to PM2.5 and odds of primary open-angle glaucoma. The middle aged residents and non-smokers were more sensitive to the adverse effects of PM2.5. CONCLUSIONS:Long-term PM2.5 exposure was associated with glaucoma and PACG in Chinese adults, which provided new insights on adverse ophthalmic effect of PM2.5.

Background Vision health is an important aspect of health worldwide. Visual impairment (VI) is associated with poor quality of life and is usually more prevalent in rural areas. To help rural populations obtain vision care, health insurance policies have emerged throughout the world. However, some existing literatures show that health insurance enrollment’s impact on the overall physical health of rural population has been minimal. Focusing on vision health among adults in rural China, our study aims to investigates the impact of health insurance on vision health, heterogeneity of the effect, and the moderating effect of health insurance enrollment on the impact of chronic physical diseases and basic eye diseases on vision health. Methods Primary data were collected through a nation-wide epidemiological survey of vision health conducted in rural China in 2018, with a sample size of 28,787 used in our statistical analysis. Instrumental variables regression and Heckman selection models were conducted to examine the impact of health insurance enrollment and reimbursement ratio adults’ vision health outcomes. Subsample regressions by sex, age, education level, and whether with eye diseases were further conducted to explore the heterogeneity in our results. We then examined whether health insurance enrollment moderates the impact of chronic physical diseases and basic eye diseases on vision health through the method of introducing interaction terms. Results Participating in health insurance reduced the probability of VI by 2.15 %. The reimbursement rate increasing by 1 % point may reduce the probability of worsening VI by 6.12 %. Men (-0.0235, P = 0.0002) benefit more from insurance enrollment than women (-0.0201, P = 0.0082) with respect to vision health. From the young adult group to the oldest group, the marginal effect of health insurance increased from − 0.0068 ( P = 0.0394) to -0.0753 ( P < 0.0001). The marginal effect on VI was most significant in people with lower education levels and weakened with increased education levels. People with basic eye diseases (-0.0496, P = 0.0033) benefit more from participating insurance than the people without basic eye diseases (-0.0196, P = 0.0001) with respect to vision health. The moderating effects of health insurance enrollment on the impacts of cerebral infarction (-0.1225, P < 0.0001), diabetes (-0.0398, P = 0.0245), hyperlipidemia (-0.1364, P = 0.0271), mental illness (-0.1873, P = 0.0010), glaucoma (-0.1369, P = 0.0073), diabetic retinopathy (-0.1560, P = 0.0043), and retinal vein obstruction (-0.2018, P = 0.0155) on vision health were significantly negative. Conclusions The results suggest that participation in health insurance and higher health insurance reimbursement ratios reduced the risk of VI in the sampled adults. Health insurance has the most significant effect in in vulnerable groups. Heath insurance enrollment moderates the impacts of several chronic physical and basic eye conditions on vision health. Our findings have potential implications for reforming health insurance policies to improve vision health conditions in rural areas of developing countries.

This study investigates the effects of different subsidy use patterns on economic performance, the effect mechanisms, and differences among enterprises with heterogeneous economic performance. A theoretical model is built to analyze the factors influencing subsidy use. Applying ordinary least squares and panel quantile regressions on panel data of China’s 3,565 A-share listed companies from 2007 to 2017, we find that subsidies can significantly improve economic performance. Specifically, enterprises usually use subsidies in three different ways (i.e. R&D input, expansion of production capacity for existing products, and human resource training), and the positive impact of these three use patterns on economic performance is moderated by two factors (i.e. the proportions of both R&D operating expenses and human resource training cost) in different degrees. Moreover, the effects are more significant in the lower quantile of economic performance; hence, heterogeneity of economic performance must be considered when formulating relevant policies.

Background: While the relationship between ambient air pollution and diabetes mellitus has recently been reported, data on the association between fine particulate matter (PM2.5) and diabetic complications are limited, especially in microvascular diseases such as diabetic retinopathy. Objectives: To investigate the associations between long-term exposure to PM2.5 and the prevalence of diabetic retinopathy in adult diabetic patients in rural China. Methods: The study population was based on the Rural Epidemiology for Glaucoma in China (REG-China), a national cross-sectional survey conducted in rural China. This analysis selected diabetic patients with or without diabetic retinopathy. A satellite-based spatiotemporal model was used to estimate personal PM2.5 exposure. Logistic regression models were used to investigate the effect of long-term PM2.5 exposure on diabetic retinopathy. Results: The analysis included 3111 diabetic participants, 329 of whom were diagnosed with diabetic retinopathy. The median level of exposure to PM2.5 from 2000 to2016 was 59.9 mu g/m3. For each 10 mu g/m3 increase in PM2.5, the adjusted odds ratio (95% confidence interval) for diabetic retinopathy was 1.41 (1.27, 1.57). In subgroup analyses, the effect of PM2.5 on diabetic retinopathy was significantly stronger in participants who selfreported alcohol consumption. Conclusion: These findings suggest that long-term exposure to high PM2.5 was associated with the risk of diabetic retinopathy among diabetic patients in rural China.

基于我国1677家战略性新兴产业A股上市公司2007年至2017年的数据,本文实证检验了政府财政补贴对企业经济绩效、创新绩效及产能过剩的影响.首先,使用生产函数法测度企业产能利用率,之后通过三个面板模型分析政府财政补贴对企业经济绩效、创新绩效和产能过剩的影响,并进一步检验政策效应在七大子行业间的差异.结果 表明:我国战略性新兴产业总体上存在产能过剩,尤以节能环保行业最严重,生物及新能源行业产能过剩率也在逐年上升.从我国战略性新兴产业整体看,政府财政补贴在显著提升企业经济绩效的同时,也加剧了产能过剩,但对创新绩效影响不显著.从战略性新兴产业各子行业看,政府财政补贴的政策效应差异较大:有效提升了新一代信息技术、生物、新能源、新材料行业的经济绩效和新一代信息技术行业的创新绩效;加剧了节能环保、新一代信息技术、新能源汽车及新能源行业的产能过剩.最后,本文基于实证结果提出相关政策建议.

Sports-related eye injury is a series of ocular trauma that occured during exercises or games with high prevalence of eye injuries and high possibilities of causing blindness. Most of the injured patients were children or young males. This sight-threatening disease may have a huge impact on their lives. Screening of sports-related injuries is a good way for ophthalmologists and sanitarians exploring the prevalence, demographics, risk factors, causes of injury, injury types, severity, vision result, and measures for eye protection of these kind of diseases. In this chapter, we will talk about the screening of sports-related eye injuries, from the purpose, method of screening, and the importance of building up surveillance system.

Background: Glaucoma is the commonest cause of irreversible blindness worldwide. The Rural Epidemiology for Glaucoma in China (REG-China) was conducted to investigate the present status of glaucoma in rural China. Methods: The REG-China Study is a cross-sectional study in a nationally representative sample of population aged 6 years or older from ten provinces, autonomous regions, and municipalities in rural areas of China. All participants underwent a comprehensive eye examination, including visual acuity, intraocular pressure, slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Findings: From June to October 2018, 52 041 individuals were invited to participate, of whom 48 398 were included in the final analysis. The overall prevalence of glaucoma was 1·6% (95% CI 1·52–1·77) among the population aged 6 years or older. The prevalence of all types of glaucoma in persons aged 40 years or older was 2·0% (95% CI 1·96–2·85); 58·2%, and 19·8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, marital status, history of cerebral infarction, location areas and family history of glaucoma were significant risk factors for both PACG and POAG. The overall blindness rate of glaucoma was 31·1% (95% CI 25·91%-34·82%). Those who were older, men, and divorced/separated were more likely to become blindness due to glaucoma. Interpretation: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. Funding Statement: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030). Declaration of Interests: The authors declare there are no competing interests. Ethics Approval Statement: The study protocol was approved by the ethics review committee of Tianjin Medical University and other participating institutes. We obtained written informed consent from all study participants.

BACKGROUND: Glaucoma is the commonest cause of irreversible blindness worldwide. Factors associated with the development of glaucoma have been examined in several studies, but not in the Chinese rural population. The China Rural Glaucoma Cohort Study (China-RG Study) was conducted to investigate the present status of glaucoma in China. METHODS: The China-RG Study is a population-based study (June–October 2018) that included 22 rural areas from ten provinces in China and enrolled 52,041 individuals (age >6 years). Participants completed a comprehensive eye examination, including visual acuity, intraocular pressure (IOP), slit-lamp microscopy, direct ophthalmoscopy, and further investigations. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models. Disability (YLD) and quality-adjusted life-years (QALYs) were used to express adverse health outcomes of glaucoma; cost-effectiveness analysis was conducted to evaluate the superiority of glaucoma-screening program. FINDINGS: Overall prevalence of glaucoma was 1.6% (95% CI 1.52–1.77%); 58.2%, and 19.8% had primary angle-closure glaucoma (PACG) or primary open-angle glaucoma (POAG), respectively. Increasing age, history of cerebral infarction, marital status, location, and family history of glaucoma were significant risk factors for both PACG and POAG. Cost–benefit analysis indicated savings of approximately 286,56.57 million yuan in direct medical expenses nationwide by adopting the proposed screening mode. INTERPRETATION: Glaucoma should be included in chronic disease-management programs in China for long-term care and continuous management of high-risk cases. The scope and inclusions of basic public health services should be expanded, especially to include ophthalmic diseases. FUNDING STATEMENT: This research was supported by the National Natural Science Foundation of China (grant no. 81830026) and the Natural Science Foundation of Tianjin (grant no. 18ZXDBSY00030)DECLARATION OF INTERESTS: The authors declare there are no competing interests.ETHICS APPROVAL STATEMENT: Ethics approval for study conduct was obtained from the institutional ethics committee of Tianjin Medical University General Hospital; all participants provided written informed consent prior to study participation.

企业过度投资问题普遍存在,始终是学界研究的热点问题.研究地方政府产业政策对制造业企业过度投资行为的影响,以及所有制属性、亏损状况、政治周期和地域的差异在上述影响中发挥的作用,可有助于地方政府制定合理的产业政策,避免企业过度投资,提升地方企业投资效率.以2007—2014年中国A股上市公司中制造业企业为样本考察省级地方政府产业政策与企业投资效率之间的关系时发现,总体上,产业政策对制造业企业过度投资有显著的推动作用,且主要通过补贴和短期银行借贷实现.具体来看,相较于未亏损企业,亏损企业得到政府补贴带来的过度投资效应更显著;相较于非国有企业,国有企业过度投资行为更易受产业政策影响;不同政治周期下,企业过度投资行为差异明显;此外,不同地区产业政策对企业过度投资行为的影响呈现显著异质性.

在我国当前制度环境下,知识产权保护水平仍然较低,企业研发投资动力不足.为鼓励企业科技研发活动,科技资助是政府经常使用的政策工具之一.以2008-2016年全国44个软件产业基地为研究样本,考察了政府科技资助对软件企业研发投入和外部融资的影响;在此基础上,进一步考察了知识产权保护水平对上述过程的调节作用;构建了4个面板数据回归模型进行实证检验.结果显示,政府科技资助能通过认证机制提高软件企业外部融资,但对企业研发投入的影响不显著;另外,知识产权保护水平越低,政府认证效应发挥的作用越强,企业获得的外部融资越多;同时,在政府科技资助影响企业研发投入的路径上,知识产权保护水平无显著影响.

在推动高新技术产业发展的过程中,政府产业政策的必要性及有效性问题,始终广受关注.本文以国家火炬计划软件产业基地为样本,通过四个面板回归模型,测度三种主要科技活动经费来源、税收、土地及人才优惠政策对经济产出和科技产出的扶持效应,并比较中央及地方政府资金的影响.结果 显示,企业资金、中央政府资金、税收优惠、土地优惠和人才优惠政策对软件基地的发展起显著促进作用,而金融贷款和地方政府资金的影响不显著;其中,税收优惠政策的扶持效应最大.因此,政府扶持政策总体上是必要且有效的,但不同扶持政策的实际效果存在差异,需优化扶持内容,增强针对性、有效性.

Purpose To examine the impacts of socio-economic status (SES) on visual impairment (VI), and the mediating role of lifestyles in developed rural areas of China. Methods A cross-sectional study was conducted among people living in rural districts of Tianjin, a developed municipality in China. An interviewer-administered survey along with free eye screenings was conducted with participants. The questionnaire included questions about demographic characteristics, SES, medical histories and lifestyles. Presenting visual acuity (PVA) and main causes of VI were identified by ophthalmologists. χ2 test was undertaken to determine whether significant differences (p<0.05) exist between VI and demographic, SES, medical history and lifestyle factors. A stepwise regression method was conducted to investigate whether lifestyles play mediating roles between SES and VI. Multivariable logistic and ordinal logistic regression were used contingent on different types of dependent variables in each regression, and adjusted odds ratio (OR) values were estimated. Results Of the 12,233 participants, 6,233 were male (50.59%); the mean age was 34.61 years; 310 (2.54%) had VI. Hypertension, diabetes and cardiopathy were main medical histories, with 1,640 had hypertension (13.41%), 854 had diabetes (6.98%) and 483 had cardiopathy (3.95%). About SES factors, higher education level (Adjusted OR, 0.84; 95% CI, 0.75–0.95) and higher income level (Adjusted OR, 0.54; 95% CI, 0.39–0.76), were significantly associated with VI in a gradient across severity of VI. Lifestyles including smoking (Adjusted OR, 1.55; 95% CI, 1.31–1.83) and drinking (Adjusted OR, 1.36; 95% CI, 1.06–1.74) played mediating roles between SES and VI when considering the full sample. Besides smoking and drinking, reading every week (Adjusted OR, 2.07; 95% CI, 1.53–2.82) and exercising more than 2h every day (Adjusted OR, 0.39; 95% CI, 0.15–1.00) also played mediating roles between SES and VI when considering the subsample (age≥16). Conclusion This study revealed the crucial impacts of SES factors on VI, and the mediating role played by several lifestyles. Targeted public health interventions for reducing VI should thus be proposed in developed rural areas of China.

近年来,我国政府为鼓励科技创新活动投入了大量研发补贴,而政府研发补贴是否有效提升了创新绩效？其具体影响机制是怎样的？企业创新能力和区域创新能力又发挥着何种作用？这些问题都亟待研究.本文以全国31个省份规模以上工业企业为研究样本,基于2008-2016年的省级面板数据,通过构建五个固定效应面板回归模型,研究了政府研发补贴对创新绩效的影响,同时,从企业创新能力和区域创新能力的视角,探讨了该影响路径上的中介效应和调节效应.结果表明,我国政府研发补贴对创新绩效有一定的促进作用;同时,企业创新能力在该影响路径上起重要的中介作用,区域创新能力对研发补贴与企业创新能力的关系起正向调节作用.本文研究结果,填补了政府研发补贴影响创新绩效的路径上,关于内部影响机制研究的空白;同时,对我国制定并完善有利于市场竞争的研发补贴政策有一定参考价值.

本文首先使用DEA方法的BCC模型和Malmquist指数模型,分别估计2009年至2016年我国各省医疗卫生机构年度效率和跨期效率变化,在此基础上,通过构建四个面板Tobit回归模型,考察了政府投入对我国不同地区医疗卫生机构静态运营效率、动态运营效率及其分解要素的影响.结果表明:全国医疗卫生机构静态运营效率东部最高,中部最低,动态运营效率表现为由西至东逐渐升高;此外,政府投入对医疗卫生机构的影响程度,随地区运营效率的上升而下降,具体表现为,政府投入对东部地区的静态和动态运营效率均无显著影响,对西部地区通过提升技术水平产生正向影响,对中部地区由于降低了其效率水平对动态运营效率产生负向影响.针对实证结果,本文提出相关政策建议.

Purpose - The purpose of this paper is to study the influences of corporate governance on intellectual capital disclosures in chief executive officers' (CEOs') statements in annual reports.Design/methodology/approach - Index score, word count and overall tone of CEOs' intellectual capital disclosures are calculated to represent the extent, amount and tone of these disclosures, respectively. With a sample of 78 FTSE 100 companies, this paper uses content analysis and empirical analysis to examine the impacts of board size, board composition and shares concentration on the above three measures of CEOs' intellectual capital disclosures, controlling for company size, profitability and leverage ratio.Findings - Empirical results demonstrate a significant positive relationship between board composition and the extent, amount and tone of CEOs' intellectual capital disclosures and a significant negative relationship between shares concentration and the amount of these disclosures.Originality/value - This paper focuses on the impacts of corporate governance on CEOs' intellectual capital disclosures. It also groundbreakingly measures the tone of CEOs' disclosures.