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Agricultural scale operations and industrialization promote the transfer of the rural labor force to the industry sector, and the non-farm employment of farmers plays a great role in increasing their income and reducing poverty. It is of great significance to explore the non-farm employment of farmers for the governance of relative poverty and the achievement of common prosperity. The propensity score matching (PSM) and generalized propensity score matching (GPSM) were used to analyze the impact of rural land transfer on farm households’ non-farm employment. According to the PSM estimation, compared to the farmers’ land not transferred, the rural land transfer significantly increased the proportion of non-farm employment personnel in farm households and the months of per year non-farm employment per person. The total land transfer, paddy land transfer and dry land transfer could significantly increase the proportion of non-farm employment personnel in farm households by 0.074, 0.029 and 0.085 units, respectively, and could significantly increase the months of per year non-farm employment per person by 0.604, 0.394 and 0.617 units, respectively. According to the GPSM estimation, different types of rural land transfer areas have significant positive effects on the proportion of non-farm workers and the months of per year non-farm employment per person, and show an obvious increasing trend of returns to scale, that is, the proportion of non-farm workers and the months of per year non-farm employment per person of farmers are higher than the increase in rural land transfer area. Additionally, the return to scale effect of dry land transfer area is more obvious. In order to raise the income of farm households and narrow the gap between urban and rural areas, the land transfer system can be further improved, urbanization with the county town as an important carrier can be vigorously promoted, the participation of farm households in non-farm employment in the local area can be promoted and the support policy system for non-farm employment of rural labor force can be improved.

Background: Malnutrition’s prognostic impact in patients with severe stroke requiring ICU admission is not well known. This study aimed to assess the nutritional status of severe stroke patients using the geriatric nutritional risk index (GNRI) and examine the association of GNRI with mortality in that population. Methods: We identified 1145 severe stroke patients requiring ICU admission from the Medical Information Mart for Intensive Care (MIMIC-III) database and divided them into low GNRI (≤98) or high GNRI (>98) groups. We used a propensity score matching (PSM) method to reduce confounding. Cox proportional hazards regression and restricted cubic splines were used to elucidate the association between GNRI and mortality. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Results: A total of 397 (35%) patients were in the low GNRI group (at risk of malnutrition). After PSM, patients in the low GNRI group still suffered higher mortality compared with the high GNRI group at 28 days (27.9 vs. 20.8%), 90 days (35.5 vs. 25.7%), and 1 year (43.4 vs. 30.9%) (p < 0.05). A low GNRI was significantly associated with an increased mortality (HR: 1.38, 95% CI 1.03–1.86 in 28 days; HR: 1.45, 95% CI 1.11–1.89 in 90 days; HR: 1.51, 95% CI 1.19–1.92 in 1 year). Sensitivity analyses yielded consistent results. Restricted cubic splines showed a progressively decreasing risk of mortality with increasing GNRI scores up to 110, approximately. Conclusion: Severe stroke patients with malnutrition experienced an increased risk of death compared to those without malnutrition. GNRI, as a simple and practical nutritional screening tool, can be used as a routine approach to the nutritional status of stroke patients.

The purpose of is to identify the necessity of neoadjuvant chemotherapy in luminal type breast cancer patients (HR-positive HER2-negative) by exploring the treatment characteristics, treatment plan, surgical choice and long-term prognosis between neoadjuvant chemotherapy and adjuvant chemotherapy. A retrospective review of all patients undergoing neoadjuvant chemotherapy at the Fourth Hospital of Hebei Medical University, China, between January 2014 and December 2018 was conducted. These were matched 1:2 by Propensity score matching method (PSM) to patients undergoing adjuvant chemotherapy. Matching variables were common tumor characteristics. Ninety-seven patients received neoadjuvant chemotherapy and 651 patients received adjuvant chemotherapy. After PSM, 79 patients in neoadjuvant chemotherapy group (study group) and 145 patients in adjuvant chemotherapy (control group) were included in the study. Median follow-up was 75 and 60 months for the patients before and after PSM, respectively. The estimated 5-year disease-free survival was 76.4% and 81.1% ( P  = 0.0208), 5-year overall survival was 77.9% and 88.6% ( P  = 0.0261) between the neoadjuvant chemotherapy group and adjuvant chemotherapy before PSM. Patients in the adjuvant treatment group had better prognosis. After PSM, the estimated 5-year disease-free survival was 79.4% and 78.3% ( P  = 0.770), 5-year overall survival was 88.7% and 87.7% ( P  = 0.400) between the neoadjuvant chemotherapy group and adjuvant chemotherapy. The 7-year update follow up DFS and OS also have no differ significantly between the two groups. It may be reasonable to forego neoadjuvant chemotherapy and prioritize surgical intervention for patients with cN1, high PR expression, Luminal B(HR+/HER2−) breast cancer.

Objective This study aims to investigate the incidence of sarcopenia in thin and normal-weight children and analyze their body composition differences. Methods Body composition was assessed using bioelectrical impedance analysis (BIA) in children who visited the Department of Child and Adolescent Healthcare at the Children’s Hospital of Soochow University between September 2016 and September 2024. Sarcopenia was defined as a skeletal muscle mass index (SMMI) at or below the 3rd percentile, and classified as thin sarcopenia or normal-weight sarcopenia based on international body mass index (BMI) cutoff values. Propensity score matching (PSM) balances baseline characteristics, including age and sex. Results A total of 41,872 children underwent body composition assessment, of whom 1,546 (3.70%) were diagnosed with sarcopenia. After PSM, the final analysis included 367 normal-weight children with sarcopenia and 734 thin children with sarcopenia. Compared to children in the normal-weight sarcopenia group, those in the Thin Group were significantly taller ( P  < 0.05), but had lower body weight and body fat levels ( P  < 0.001). No significant differences were found between the two groups in protein content, inorganic salts, muscle mass, lean mass, skeletal muscle mass, or bone mineral content ( P  > 0.05). Children in the Thin Group had a higher percentage of skeletal muscle mass, relative muscle content, and muscle-to-fat ratio than the Normal Weight Group ( P  < 0.001). Similarly, the proportion of fat-free mass (FFM) in the extremities was significantly lower in the Thin Group compared to the Normal Weight Group ( P  < 0.001). Conclusion The coexistence rate of sarcopenia and thinness is high. The normal-weight children also require body composition analysis to identify occult sarcopenia. Sarcopenia of different body types presents two distinct physical phenotypes, which may involve different pathological mechanisms and interventions. Trial registration Not applicable.

The rapid pace of urbanization has led to severe urban problems, with urban renewal emerging as an effective strategy to mitigate them. The City Betterment and Ecological Restoration (CBER) pilot scheme was an experimental policy aimed at urban renewal. Based on an optimized propensity score matching difference-in-differences model, the impact of the CBER pilot scheme on urban disease was examined. The results were threefold. (1) The CBER pilot scheme significantly alleviated urban disease in pilot cities. (2) The impact of the CBER pilot scheme was more pronounced in eastern and central regions of China, as well as in cities with high economic development, robust government capacity and abundant human resource. (3) Industrial structure optimization, infrastructure development and consumption upgrading were all effective pathways for mitigating urban disease through urban renewal. The findings offer valuable insights for other countries and regions to address urban problems and advance urbanization.

Background To explore the correlation between the preoperative systemic immune inflammation index (SII) and the prognosis of patients with gastric carcinoma (GC). Methods The clinical data of 771 GC patients surgically treated in the Department of Gastrointestinal Surgery, Qinghai University Affiliated Hospital from June 2010 to June 2015 were retrospectively analyzed, and their preoperative SII was calculated. The optimal cut-off value of preoperative SII was determined using the receiver operating characteristic (ROC) curve, the confounding factors between the two groups were eliminated using the propensity score matching (PSM) method, and the correlation between preoperative SII and clinicopathological characteristics was assessed by chi-square test. Moreover, the overall survival was calculated using Kaplan-Meier method, the survival curve was plotted, and log-rank test was performed for the significance analysis between the curves. Univariate and multivariate analyses were also conducted using the Cox proportional hazards model. Results It was determined by the ROC curve that the optimal cut-off value of preoperative SII was 489.52, based on which 771 GC patients were divided into high SII (H-SII) group and low SII (L-SII) group, followed by PSM in the two groups. The results of Kaplan-Meier analysis showed that before and after PSM, the postoperative 1-, 3-, and 5-year survival rates in L-SII group were superior to those in H-SII group, and the overall survival rate had a statistically significant difference between the two groups ( P < 0.05). Before PSM, preoperative SII [hazard ratio (HR) = 2.707, 95% confidence interval (CI) 2.074-3.533, P < 0.001] was an independent risk factor for the prognosis of GC patients. After 1:1 PSM, preoperative SII (HR = 2.669, 95%CI 1.881–3.788, P < 0.001) was still an independent risk factor for the prognosis of GC patients. Conclusions Preoperative SII is an independent risk factor for the prognosis of GC patients. The increase in preoperative SII in peripheral blood indicates a worse prognosis.

As the process of agricultural modernization accelerates, exploring the impact of agricultural mechanization services on production technology efficiency has become a key issue for enhancing agricultural productivity and promoting sustainable agricultural development. The study focuses on cotton growers in the Tarim River Basin and systematically explores the impact and driving mechanisms of agricultural mechanization services (AMSs) on cotton production’s technical efficiency within the framework of the social–ecological system (SES). By employing a combination of stochastic frontier analysis (SFA) and propensity score matching (PSM), the research indicates that the adoption of AMSs significantly enhances the production technical efficiency of cotton farmers. Among the sample that adopted this service, as much as 53.04% of the farmers have their production efficiency within the range of [0.8, 0.9], demonstrating a high production capability. In contrast, the production efficiency values of the farmers who did not adopt such services are more dispersed, with inefficient samples accounting for 11.48%. Furthermore, while the technical efficiency levels across different regions are similar, there are significant efficiency differences within regions. A further analysis indicates that the age of the household head, their education level, the number of agricultural laborers in the family, the proportion of income from planting, and irrigation convenience have a positive impact on farmers’ adoption of AMSs, while the degree of land fragmentation has a negative impact. Therefore, AMSs are not only a core pathway to enhance cotton production’s technical efficiency but also an important support for promoting agricultural modernization in arid areas and strengthening farmers’ risk-resistance capabilities. Future policies should focus on optimizing service delivery, enhancing technical adaptability, and promoting regional collaboration to drive the high-quality development of the cotton industry and support sustainable rural revitalization.

The expansion of the consumption of green agricultural products is a vital direction for transforming and upgrading food consumption for China’s residents. The development of the platform economy, based on the development of electronic information technology, achieved through changing business models, economic form, and, especially, the consumption habits and channels of residents, further improves the consumption potential of green agricultural products. This paper uses micro-questionnaire survey data from 424 green agricultural product consumers nationwide and utilizes the propensity score matching (PSM) model to explore the impact of the platform economy on residents’ consumption of green agricultural products. This study found that the platform economy can significantly promote residents’ consumption of green agricultural products. In particular, the positive effect is more significant for urban residents with higher household incomes. In addition, improving residents’ health awareness and value perception is conducive to motivating residents’ green agricultural product consumption. Therefore, this paper proposes suggestions, such as focusing on strengthening the construction of platform infrastructure in rural areas, promoting the development of platform economy in urban areas through innovative application platform technologies, and cultivating residents’ basic literacy for effective participation in the platform economy, to provide new channels and ideas for expanding the consumption of green agricultural products in China.

Background The positive benefits of immediate prosthesis breast reconstruction (IPBR) are incontrovertible. During the COVID-19 pandemic, health care resources became scarce. The implementation of outpatient immediate prosthesis breast reconstruction (OIPBR) can improve the efficiency of medical care and reduce viral exposure. Very few studies have focused on OIPBR and this study aimed to fill this gap by evaluating outcomes of OIPBR compared with traditional hospitalization IPBR (THIPBR) in terms of complications and quality of life. Material and Methods The study enrolled patients undergoing IPBR at Tianjin Medical University Cancer Institute and Hospital between January 1, 2020, and September 30, 2021. Outcomes were defined as postoperative complications and quality of life before reconstruction and at 3-month follow-up. Quality of life was assessed by BREAST-Q questionnaire. Inverse probability of treatment weighting and propensity score matching (PSM) were applied to adjust for confounders. Results A total of 135 patients were enrolled, including 110 with THIPBR and 25 with OIPBR. After matching, baseline characteristics were well balanced. Patients with OIPBR had lower rates of lymphedema on the surgery side ( p  = 0.041) and readmission ( p  = 0.040) than patients with THIPBR. No statistically significant differences in the quality of life metrics of psychosocial well-being, sexual well-being, satisfaction with breast and physical well-being of the chest were found between the two groups. Conclusion OIPBR is a safe and efficient alternative to THIBPR during the COVID-19 pandemic. It is recommended when medical conditions allow to conserve medical resources. Accelerated technical training for the performance of OIPBR at the hospital level should be expedited. Level of Evidence III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The spillover effect of environmental behavior has been of wide concern in recent years. The purpose of this paper is to explore the influence of household waste sorting on green consumption (behavioral spillover) and the possible psychological mechanisms involved in such spillover of environmental concern. Though it is important, insufficient attention has been paid to exploring the relationship, and the process of its formation, between waste sorting and green consumption. To narrow this gap, survey data collected in 2018 from 688 rural households from Shaanxi Province in western China were used. The propensity score matching method was employed to measure the effect of waste sorting on rural households’ green consumption. The mediating model was employed to investigate the path of influence in the relationship between waste sorting and green consumption. The results showed that waste sorting behavior positively spilled over into green consumption, with a net effect of 0.205. Environmental concern has a mediating effect on the relationship between waste sorting and green consumption behavior, with a mediating effect of 0.3177. In summary, household waste sorting behavior has a spillover effect on green consumption behavior as a result of the mediation effect of environmental concern. The results of this article fill in our knowledge on the spillover effects of waste sorting behavior in developing countries. Policy makers and regulators should vigorously advocate and implement waste sorting behavior, increase farmers’ concern for the environment, and promote their participation in green consumption behavior, so as to maximize the spillover effect.