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There is a question of the multiple types of intercultural communication, the mutual influence of cultures in the era of globalization. The specific term acculturation, associated with the influence of cultures on each other (ethnocultures here are mainly considered here) with a significant change in one or both of them, while maintaining a significant difference between cultures, is popular among specialists engaged in such phenomena. Considering this term in the framework of this paper, mainly in connection with social rather than personal phenomena, the author nevertheless concludes that there is a need for an ethical balance between cultures at the level of personal of intercultural communication. The author draws attention to the crisis of politics and the theory of multiculturalism of the West that does not take into account the complexity of culture as such, the complexity of intercultural communication, and does not essentially aspire to the necessary ethical balance in the field of contact between people of different nationalities in the modern world. It is also concluded that the moral force of culture is capable, if desired, to resist unnecessary influences, undergoing changes only to the extent that is necessary in certain historical conditions. It is this factor that mainly contributes to the preservation of the existing wealth of cultures in the modern world.

With rapid urbanization and the requirements for new buildings and infrastructure, cement production is expected to increase in China. Meanwhile, China's energy consumption and carbon emissions associated with cement industry are expected to increase, as cement production is one of the most energy intensive industries. Introducing new and more pertinent technologies with better management, as indicated by government goals and measures, can improve energy efficiency and reduce carbon emission. However, many challenges and uncertainties in the cement industry have been addressed without considering several interconnected processes among sectors including industry, energy, construction, and services, which lead to little improvements in the industry. Nexus approaches are recognized as effective methods to simultaneously examine interactions among multiple sectors with various elements. This research intends to provide insights for future energy-cement-carbon emission nexus, through integrated assessment capabilities, related to China's new urbanization planning toward 2050. Several challenges and uncertainties, including different trends in population growth, structural transformation of economic driving forces, and new but stricter policy targets for resource use efficiency and environment production, are put into multiple scenarios. The results of our analysis provide perspectives on future direction to underscore the growing interconnection among energy, cement and carbon emission with clear and more specific roadmap for promoting integrated planning, management and governance.

OBJECTIVE: The aim of this study was to measure the impact of zero-mark-up drug policy (ZMDP) on drug-related expenditures and use in urban hospitals. DESIGN: This was a retrospective observational study of trends in drug expenses and use in the context of the ZMDP using an interrupted time series analysis. SETTING: Twelve hospitals (three tertiary hospitals and nine secondary hospitals) in Xi'an, which is the capital of Shaanxi Province in Western China. DATA AND PARTICIPANTS: The prescription information for all outpatients and inpatients in the study hospitals from January 2016 to April 2018 was used in this study. INTERVENTIONS: The Chinese government announced the policy intervention measure of the ZMDP, which was implemented in all public hospitals as of 1 April 2017. PRIMARY MEASURES: Monthly drug expenditures, monthly medical expenditures, the percentage of drug expenditures among total medical expenditures, the average outpatient drug expenditure per visit, the percentage of prescriptions that include an injection and the percentage of prescriptions that include an antibiotic. RESULTS: Monthly total medical expenses increased in both tertiary and secondary hospitals after the ZMDP was implemented. In tertiary hospitals, the average outpatient drug expenditures per visit showed a slow decreasing trend before the intervention and an increasing trend after the intervention, with statistically significant changes in both the level (p<0.001) and the trend (p=0.02). Secondary hospitals showed a slow increasing trend both before and after the policy implementation, with no significant change in the trend (p=0.205). The proportion of prescriptions, including injections, was over 20% in secondary hospitals and less than 20% in tertiary hospitals, with no significant changes to this indicator observed after implementation of ZMDP. CONCLUSIONS: The effect of the ZMDP on drug-related expenditures and use in Chinese public hospitals was not substantially evident. Future pharmaceutical reform measures should give ...

Abstract

Background
Atmosphere is one of the sources and sinks to gas- and particle-bound brominated flame retardants (BFRs). Therefore, BFRs can enter human body via inhalation. In the present study, 79 of gas- and particle-phase samples (TSP, PM10 and PM2.5) were collected during 2015–2016 in urban area of Shanghai, China to investigate the occurrence of 25 polybrominated diphenyl ether (PBDEs) congeners, hexabromobenzene (HBB) and 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE).


Results
The total concentrations of BFRs ranged from 0.66 to 13.7 pg/m3, 25.82 to 376.27 pg/m3, 14.58 to 365.49 pg/m3 and 15.17 to 304.89 pg/m3 in gas, TSP, PM10 and PM2.5, respectively. HBB was the main compound in gas phase; while BDE-209 was the dominant congener in particle phase. Atmospheric BFRs in winter was much lower than in summer, while particle phase showed opposite seasonal tendency.


Conclusions
Clausius–Clapeyron equation suggested that BTBPE, BDE-28, -66, -99, -100, and -154 were more driven by temperature and evaporated from local contamination. Higher-brominated congeners tended to be absorbed in particle phase, while low-brominated compounds partitioned in both gas and particle phases. Gas/particle partitioning results showed that absorption into the aerosol organic matter was the dominant process for BFRs. The inhalation health risk assessment demonstrated that the hazard quotient (HQs) for most PBDEs in winter was higher than in summer.