Development Research Center

Alectinib was approved by the US, Europe and China in 2024 as the first adjuvant targeted therapy for ALK+ NSCLC, lowering risk of disease recurrence or death by 76%. Alectinib addresses a critical gap in postoperative adjuvant therapy for ALK+ NSCLC. From Chinese healthcare-system perspective, this study evaluates the impact of introducing alectinib in adjuvant therapy for stage IB (tumor ≥ 4 cm) to IIIA (UICC/AJCC 7th edition) ALK+ NSCLC on prevention of recurrence and the associated direct medical costs, compared to platinum-based chemotherapy. A Markov model was developed to estimate the number of locoregional and metastatic recurrences over a 10-year period by defining four health states: disease-free survival, locoregional recurrence, metastatic recurrence, and death. In the control group, all patients received platinum-based chemotherapy, while in the intervention group, 75% received alectinib and 25% received platinum-based chemotherapy. Clinical data were collected from open-label, randomized phase 3 trials ALINA and ALEX. Cost parameters were derived from local charges, expert consultation, and published literature. Compared to control group, the intervention group would reduce recurrences by 11,300 cases over 10 years, including 3,684 locoregional and 7,616 metastatic cases. This corresponds to a 45.82% lower recurrence rate. Estimated recurrence-related cost savings amounted to 6.910 billion RMB, with 1.445 billion RMB saved from locoregional recurrences and 5.465 billion RMB from metastatic recurrences. This represents a 41.49% reduction in costs compared to control group. These findings were robust across various scenario analyses. Using alectinib in postoperative adjuvant therapy significantly reduces both the recurrence rate and recurrence-related treatment costs for stage IB (tumor ≥ 4 cm) to IIIA ALK+ NSCLC patients, compared to platinum-based chemotherapy. From perspective of Chinese healthcare system, this approach shows substantial potential for preventing recurrence and achieving cost savings.

Exploring the spatiotemporal evolution of building stock in African countries is of great significance for understanding the urbanization process, regional development disparities, and sustainable development pathways in the Global South. Integrating long-term (1975–2020), 100 m resolution building stock data for Tanzania with multi-source environmental and socioeconomic datasets, this study employed GIS spatial analysis techniques—including optimized hotspot analysis, standard deviational ellipse, and geographical detector—to investigate the spatiotemporal evolution characteristics and influencing factors of building differentiation. The results indicate that over the 45-year period, Tanzania’s building stock underwent rapid expansion, with a 3.83-fold increase in volume and a 4.93-fold increase in area, while the average height decreased continuously by 1.04 m. This growth was predominantly driven by the expansion of residential buildings. The spatial distribution of buildings exhibited a “north-dense, south-sparse” pattern with agglomeration along traffic axes. During 1975–1990, building growth hotspots were concentrated in western and southern regions, shifting to areas surrounding Lake Victoria and central administrative centers during 2005–2020. In contrast, coldspots expanded progressively from northern, northeastern regions and Zanzibar Island to parts of the southern and eastern coasts. The building distribution consistently maintained a northwest–southeast spatial orientation, with increasingly prominent directional characteristics; the centroid of building distribution moved more than 90 km northwestward, and the agglomeration intensity continued to increase. Socioeconomic factors—including population density, road network density, and GDP density—have a significantly stronger influence on building distribution than natural factors. Among natural factors, only river network density exhibits a significant effect, while constraints such as slope and terrain relief are relatively insignificant.

Problematic Internet use is recognized as a significant public health concern among adolescents. Previous research has shown that adolescents with problematic Internet use tend to experience higher levels of anxiety and depression compared to non-problematic Internet users. Nevertheless, when it comes to differences in specific symptoms, the evidence is less clear-cut. This study conducted Gaussian graphical model and Bayesian network analysis to compare the network structures of anxiety symptoms and depression symptoms among adolescents with problematic and non-problematic Internet use. A total of 1,139 Chinese adolescents (540 problematic Internet users, M age = 15.96; 599 non-problematic Internet users, M age = 16.03) were included in the study. The results showed that compared to adolescents with non-problematic Internet use, most anxiety symptoms (e.g., inability to stop or control worries) emerged as upstream nodes with significant downstream effects on a series of emotional symptoms of anxiety and depression among adolescents with problematic Internet use. “Fear of something terrible happening,” “irritability,” “feeling fearful” and “feeling effortful” were symptomatic targets for intervening problematic Internet use and improving mental health. These findings offer novel data-driven insights on the core symptoms and directional relationships of anxiety-depression comorbidity network among Chinese adolescents with different Internet use states.

Based on the Policy Modeling Consistency (PMC) index model, this study systematically evaluates 19 national-level and 13 regional-level rare disease policy documents from 2016 to 2025, aiming to reveal the structural characteristics and consistency level of China's rare disease policy system. Using ROSTCM 6.0 software, high-frequency keywords and semantic networks from the policy texts were extracted to identify policy focus and thematic evolution. A PMC evaluation system was constructed to assign values and conduct a visual analysis of the sample policies. Results show that the average PMC index for China's rare disease policies is 5.31 (national level) and 4.94 (local level), falling within the "excellent-acceptable" range overall, indicating that the structure of China's rare disease policy system is well-developed. Among the indicators, policy nature (X2), policy function (X8), and outcome orientation (X4) scored higher, reflecting strategic planning and institutional characteristics at the national level. In contrast, incentive measures (X5), patient support (X6), and social support (X9) scored lower, highlighting deficiencies in research and development incentives, social integration, and long-term support mechanisms. Further comparisons reveal that national policies emphasize top-level design and institutional development. In contrast, local policies focus more on exploratory efforts in medical assistance and policy innovation. To optimize China's rare disease policy system, it is essential to improve incentive and social support systems, promote coordinated legislation between national and local levels, establish a national rare disease information platform and a dedicated fund, and build a comprehensive policy chain.

Background/Objectives: Atrial fibrillation (AF), characteristic of chaotic atrial electrical activity along with ineffective atrial systole, remains the most frequent sustained cardiac dysrhythmia, with an overall lifetime risk for AF being approximately 15% to 40% in the global population. AF is associated with substantially enhanced risks for multiple adverse clinical outcomes, including thromboembolic cerebral stroke, dementia, chronic kidney disease, myocardial infarction, cardiac failure, and even premature cardiac demise. Although remarkable advances have been achieved toward unravelling the complex hereditary etiopathogenesis underpinning AF, it has become increasingly clear that inherited determinants predisposing to AF in a vast majority of individuals are still uncertain. Methods: A Chinese pedigree with idiopathic AF and another group of 236 cases suffering idiopathic AF along with 312 unrelated healthy volunteers were prospectively recruited. Exome-wide sequencing and Sanger sequencing assays were implemented in research participants. The functional effects of the discovered variations in the SOX5 gene were explored through dual-luciferase reporter analysis. Results: Two novel SOX5 mutants, NM_006940.6: c.355C>T; p.(Gln119*) and NM_006940.6: c.640G>T; p.(Glu214*), were identified in the AF pedigree and one of the 236 unrelated patients affected with AF, respectively. These two heterozygous truncating SOX5 variations were absent from the 624 control chromosomes. Quantitative luciferase reporter assays unraveled that both Gln119*- and Glu214*-mutant SOX5 lost the ability to transactivate GJA1. Additionally, the two variations abolished the synergistic transactivation of SCN5A by SOX5 and SHOX2. Conclusions: The current findings indicate SOX5 as a novel gene contributing to AF, which adds more insight to the molecular pathogenesis of AF, and provides a potential target for personalized precision medicine.

While traditional resistance training has been widely used in distance running training, the effects of complex training combining heavy resistance and plyometric exercises on adolescent runners remain unclear. Understanding the impact of complex training on running economy and lower limb strength could provide valuable insights for optimizing training programs for young athletes. To examine the effects of an 8-week complex training program on lower limb strength and running economy in adolescent distance runners compared to traditional resistance training. Thirty-two male adolescent distance runners (age: 16.75 ± 0.68 years) were randomly assigned to either a complex training group (CT; n = 16) or a resistance training group (RT; n = 16). Both groups completed their respective training programs three times per week for 8 weeks, in addition to their regular endurance training. Running economy at three speeds (12, 14, and 16 km/h), maximal oxygen uptake (VO2max), blood lactate concentration, One-repetition maximum (1RM) squat strength, countermovement jump (CMJ), squat jump (SJ), drop jump (DJ), and reactive strength index (RSI) were assessed before and after the intervention. The CT group showed significantly greater improvements in running economy at all speeds (p < 0.001) compared to the RT group. Both groups demonstrated significant improvements in 1RM squat strength (CT: p < 0.001; RT: p < 0.001), CMJ (CT: p < 0.001; RT: p < 0.001), and SJ (CT: p = 0.005; RT: p < 0.001). The CT group exhibited superior improvements in CMJ peak power (p = 0.010), DJ performance (p = 0.017), and RSI (p < 0.001). Blood lactate concentrations at submaximal speeds decreased significantly more in the CT group compared to the RT group (p < 0.05). Complex training appears to be more effective than traditional resistance training for improving both running economy and power-related performance measures in adolescent distance runners. The combination of heavy resistance and plyometric exercises may provide superior neuromuscular adaptations that enhance both strength and running efficiency.

This study employed a hospital-based health technology assessment (HB-HTA) to evaluate the economic value of the central dialysis fluid delivery system (CDDS) compared to the single-patient dialysis fluid delivery system (SPDDS) in hemodialysis. The findings offer evidence to support hospital procurement and clinical implementation decisions regarding CDDS. A comparative cost analysis was conducted using micro-costing data collected from three hospitals. Costs were estimated for both CDDS and SPDDS, and economic efficiency was evaluated across multiple hemodialysis machine configuration scales. The analysis included total costs, cost structures, and cost savings, along with their constituent components, to identify scenarios in which CDDS provides economic advantages. In a dialysis center with 6 hemodialysis machines operating two shifts per day and serving 12 patients daily, CDDS reduced costs by 0.05% compared to SPDDS. As the number of machines increased from 6 to 50, the cost reduction rate rose from 0.05% to 21.08%, demonstrating enhanced economic benefits at larger scales. In a 50-machine center, CDDS saved approximately RMB 84 per treatment session and RMB 2,601,108 annually. The majority of cost savings came from reductions in consumables (74%) and labor (24%). One-way sensitivity analysis confirmed that CDDS consistently yielded cost savings, supporting the robustness of the costing model. CDDS demonstrates significant economic value over SPDDS by reducing consumable and labor costs, proving to be a cost-effective solution in dialysis centers with 6 or more machines serving at least 12 patients daily. Clinical engineers play a key role in its implementation. CDDS is suitable for promotion in medium- to large-scale dialysis centers in China.

Based on a comprehensive review of the research progress in ecological protection and restoration both domestically and internationally, this paper summarizes the objectives and key focuses of the planning indicators and policy monitoring for ecological protection and restoration on the Qinghai-Tibet Plateau. The core objective is to establish an indicator system based on ecosystem quality and ecosystem services, monitor and assess the ecological, economic, and social benefits of implementing ecological protection and restoration policies, and then evaluate the harmonious development of “ecology-production-livelihood” nexus within the social-ecological system. Through a systematic literature review and frequency analysis, this study screens comprehensive benefit assessment indicators for ecological restoration and constructs a monitoring and evaluation system that includes four target layers: ecosystem pattern, ecosystem quality, ecosystem services, and social economic benefits. Subsequently, the paper elaborates on the implementation plan encompassing data acquisition, indicator calculation, and weight determination. In the concluding section, it delves into strategies for conducting adaptive monitoring of the social-ecological system in the context of ecological restoration and presents recommendations for the establishment and enhancement of a long-term monitoring mechanism for ecological protection and restoration monitoring mechanism.