Search

Background With the deepening of the new medical reform, the "short slabs" of the current financial compensation mechanism for primary care institutions has been gradually revealed. Compensation mechanism still needs to be further improved for the existence of painful and difficult problems such as insufficient "endogenous power" of primary care institutions, low efficiency in the use of financial funds, and the compensation mechanism still needs to be improved. Objective To explore and establish a service output, more simple and easy-to-use, scientific and reasonable financial compensation calculation model based on equivalent method, so as to provide a reference for the financial compensation of government-run community health service institutions. Methods Based on the cost calculation of the equivalent method, the policy analysis and literature review method were used to sort out the financial compensation policies, and the important parameters of the model were determined through expert consultation to build the financial compensation calculation model and financial compensation budget model. The application effect of the model was further evaluated by calculating the financial compensation of 14 community health care institutions in Beijing from 2019 to 2021. Results The constructed financial compensation calculation model was mainly composed of three parts, including service equivalent (D), compensation standard per equivalent (PG) and adjustment coefficient (T), the financial compensation budget model was built on this basis. 14 institutions were taken as examples to calculate the financial compensation, the average calculated financial compensation amount of each institution in 2021 was 45.961 0 million yuan, and the average actual subsidy income of each institution was 44.546 8 million yuan, slightly lower than the calculated financial compensation amount. The average budgeted service equivalent for the 14 institutions in 2022 was 1 139 900 000 equivalents and the average budgeted financial compensation was 50.234 3 million yuan. Conclusion The data source of financial compensation calculation model based on equivalent method is standardized and easily available, which is convenient for promotion and use. It was suggested to explore a new model of financial compensation and flexibly use the adjustment coefficients, so that the financial compensation model can better meet the needs of high-quality development.

Abstract In this paper, cobalt oxide‐modified graphite felt electrodes were prepared by electrodepositing cobalt nitrate on graphite felt and calcined. The surface morphology of graphite felt modified by cobalt oxide was characterized in detail by scanning electron microscope X‐ray diffraction and X‐ray photoelectron spectroscopy. Shape, microstructure, etc. And using the three‐electrode system to conduct cyclic voltammetry, electrochemical impedance spectroscopy, and single‐cell constant current charge and discharge detection on the graphite felt electrodes modified with different concentrations of cobalt oxide, and study its use as an electrode for iron‐chromium redox flow battery performance. The results show that the method of calcination after electrodeposition successfully attaches cobalt oxide to the graphite felt fiber uniformly in granular form, increases a large number of oxygen‐containing functional groups, and has the highest coulombic efficiency for the first charge‐discharge cycle at a current density of 142mAcm−2 It can reach 82 %, and the charging capacity is also increased by 1.59 times compared with the original graphite felt.

In China, the traditional early and late season double rice (DR) system is declining accompanied by the fast increase of two newly developed cropping systems: ratoon rice (RR) and rice–crawfish (RC). Three methodologies: economic analysis, emergy evaluation and life cycle assessment (LCA) were employed to evaluate the economics and sustainability of this paddy cropping system change. Economic analysis indicated that the income and profit of the RC system were far larger than those of RR and DR. The income to costs ratio of RR and RC increased by 25.5 and 122.7% compared with that of DR, respectively. RC had the highest emergy input thanks to increasing irrigation water, electricity, juvenile crawfish and forage input while RR showed a lower total emergy and nonrenewable emergy input, such as irrigation water, electricity, fertilizers and pesticides than DR. The environmental loading ratios decreased by 16.7–50.4% when cropping system changed from DR to RR or from DR to RC while the emergy sustainability indexes increased by 22.6–112.9%. The life cycle assessment indicated lower potential environmental impacts of RR and RC, whose total environmental impact indexes were 35.0–61.0% lower than that of DR. Grain yield of RR was comparable with that of DR in spite of less financial and emergy input of RR, but RC had a much lower grain yield (a 53.6% reduction compared to DR). These results suggested that RR is a suitable cropping system to achieve the food security, economic and environmental goals.

ObjectiveTo determine the safety and efficacy of vedolizumab for the prophylaxis and treatment of gastrointestinal involvement of acute graft-versus-host disease (GVHD) (GI-aGVHD).MethodsLiterature search within PubMed, EMBASE, Web of Science, and Cochrane Library for observational studies and clinical trials that evaluated the effect of vedolizumab on GI-aGVHD was done through 17 May 2022. A bivariate and random-effect meta-analysis derived the pooled observational percentages and pooled risk ratios (RRs) from baseline of primary endpoints including overall response, complete response, mortality, and adverse events.ResultsThere was a total of 122 participants in eight eligible studies, including one study on the prophylactic use of vedolizumab and seven studies on vedolizumab for the treatment of GI-aGVHD. Of seven studies that reported details on baseline grades of GI-aGVHD, a total of 47 patients (47.95%) were of stage 4, 31 patients (31.63%) were of stage 3, 10 patients (10.2%) were of stage 2, and 10 patients (10.2%) were of stage 1. The use of vedolizumab for the treatment of GI-aGVHD yielded a significantly improved objective response rate (ORR) at 14 days (pooled ORR = 60.53%, pooled RR = 14.14, 95% CI: 2.95–67.71), 28 days (pooled ORR = 50%, RR = 7.36, 95% CI = 2.14–25.37), and 12 months (pooled ORR = 76.92%, RR = 13.66, 95% CI = 3.5–53.35) from baseline. Likewise, the use of vedolizumab was followed by a significantly improved complete response (CR) at 12 months (pooled CR = 27.27%, RR = 5.50, 95% CI = 1.01–29.95), yet the CR at 14 days and 28 days did not reach statistical significance. Fifty-seven out of 87 (pooled overall survival, OS = 34.5%) and 46 out of 65 (pooled OS = 29.2%) patients expired at 6 and 12 months after the use of vedolizumab, respectively. Prophylactic use of vedolizumab was not associated with any specific type of reported adverse events, while patients with GI-aGVHD on vedolizumab presented with significantly increased risks of adverse events including infections (RR = 7.55) and impaired metabolism or nutritional complications (RR = 9.00). All analyses were of a low heterogeneity (all I-squares = 0%).ConclusionVedolizumab was safe and effective for the prophylaxis and management of early grade GI-aGVHD. More clinical evidence is warranted to validate these findings.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=345584, identifier CRD42022345584.

Concerns about the impact of space radiation on spacecraft and their internal instruments have prompted the need for effective protection. However, excessive protection can increase the costs and difficulty of space launches, making it crucial to achieve better shielding protection of lighter weights. In real space orbits, we observed the interference of charged particles on photon-counting imaging detectors and plan to address this issue by adding a shielding ring to the side wall of the detector input terminal. Additionally, a local protection structure was proposed for electronics, where the outer edge was increased to enable particles to reach the same thickness as the shielding box within the PCB range. This approach resulted in an omnidirectional spatial shielding thickness that was nearly identical at any point on the PCB surface. Furthermore, we used the Monte Carlo method to calculate the energy loss of electrons and protons in materials such as aluminum (Al), tantalum (Ta), and high-density polyethylene (HDPE). Through this analysis, we determined the optimal mass ratio of Al, Ta, and HDPE to achieve the lowest ionization doses at an object’s location in the particle environment of the FY-3 satellite orbit. This protection strategy provides a useful design concept for photoelectric detection instruments with high sensitivity.

Fusarium head blight (FHB), which is primarily caused by Fusarium graminearum, is a widespread and devastating disease of wheat. In the absence of resistant varieties, the control of FHB relies heavily on the application of fungicides, and the new generation SDHI fungicide, pydiflumetofen, has recently been registered in China for the control of FHB in wheat. The current study explored three genetically stable, highly resistant laboratory mutants (S2-4-2R, S27-3R, and S28-2R, with EC50 values of 25.10, 28.57, and 19.22 μg/mL, respectively) to investigate the potential risks associated with pydiflumetofen resistance. Although the mycelial growth of the mutants differed little compared to their parental isolates, the study found that the resistant mutants exhibited significantly reduced (p < 0.05) levels of sporulation and pathogenicity, which suggests a significant fitness cost associated with pydiflumetofen resistance in F. graminearum. Sequence analysis of the Sdh target protein identified numerous amino acid substitutions in the predicted sequences of the four subunits: FgSdhA, FgSdhB, FgSdhC, and FgSdhD. Indeed, the mutants were found to have a series of substitution in multiple subunits such that all three exhibited five identical changes, including Y182F in the FgSdhA subunit; H53Q, C90S, and A94V in FgSdhB; and S31F in FgSdhC. In addition, gene expression analysis revealed that all of the FgSdh genes had significantly altered expression (p < 0.05), particularly FgSdhA and FgdhC, which exhibited remarkably low levels of expression. However, the study found no evidence of cross-resistance between pydiflumetofen and tebuconazole, fludioxonil, prochloraz, fluazinam, carbendazim, pyraclostrobin, or difenoconazole, which indicates that these fungicides, either in rotation or combination with pydiflumetofen, could mitigate the risk of resistance emerging and provide ongoing control of FHB to ensure high and stable wheat yields.

Abstract A novel scalable four-step process has been developed to improve the synthesis of obeticholic acid (OCA). The key step of this process was the isolation of the amide intermediate, which underwent hydrogenation, basic epimerization, ketone reduction, and amide hydrolysis in a one-pot procedure. The use of efficient single recrystallization for the final purification in this process made the corresponding work-up procedure more concise and environmentally friendly. A kilogram-scale production of OCA following this process could achieve over 70% yield with all impurities controlled below 0.10%.

Biological networks are open systems that can utilize nutrients and energy from their environment for use in their metabolic processes, and produce metabolic products. System entropy is defined as the difference between input and output signal entropy, i.e., the net signal entropy of the biological system. System entropy is an important indicator for living or non-living biological systems, as biological systems can maintain or decrease their system entropy. In this study, system entropy is determined for the first time for stochastic biological networks, and a computation method is proposed to measure the system entropy of nonlinear stochastic biological networks that are subject to intrinsic random fluctuations and environmental disturbances. We find that intrinsic random fluctuations could increase the system entropy, and that the system entropy is inversely proportional to the robustness and stability of the biological networks. It is also determined that adding feedback loops to shift all eigenvalues to the farther left-hand plane of the complex s-domain could decrease the system entropy of a biological network.

Epstein-Barr virus (EBV), also known as human herpesvirus 4, is prevalent in all human populations. EBV mainly infects human B lymphocytes and epithelial cells, and is therefore associated with their various malignancies. To unravel the cellular mechanisms during the infection, we constructed interspecies networks to investigate the molecular cross-talk mechanisms between human B cells and EBV at the first (0-24 hours) and second (8-72 hours) stages of EBV infection. We first constructed a candidate genome-wide interspecies genetic-and-epigenetic network (the candidate GIGEN) by big database mining. We then pruned false positives in the candidate GIGEN to obtain the real GIGENs at the first and second infection stages in the lytic phase by their corresponding next-generation sequencing data through dynamic interaction models, the system identification approach, and the system order detection method. The real GIGENs are very complex and comprise protein-protein interaction networks, gene/microRNA (miRNA)/long non-coding RNA regulation networks, and host-virus cross-talk networks. To understand the molecular cross-talk mechanisms underlying EBV infection, we extracted the core GIGENs including host-virus core networks and host-virus core pathways from the real GIGENs using the principal network projection method. According to the results, we found that the activities of epigenetics-associated human proteins or genes were initially inhibited by viral proteins and miRNAs, and human immune responses were then dysregulated by epigenetic modification. We suggested that EBV exploits viral proteins and miRNAs, such as EBNA1, BPLF1, BALF3, BVRF1 and miR-BART14, to develop its defensive mechanism to defeat multiple immune attacks by the human immune system, promotes virion production, and facilitates the transportation of viral particles by activating the human genes NRP1 and CLIC5. Ultimately, we propose a therapeutic intervention comprising thymoquinone, valpromide, and zebularine to act as inhibitors of EBV-associated malignancies.

Clostridium difficile is the leading cause of nosocomial antibiotic-associated diarrhea and the major etiologic agent of pseudomembranous colitis. In severe cases, C. difficile infection (CDI) can cause toxic megacolon, intestinal perforation, and death. The intestinal epithelium is the first tissue encountered in the adhesion and colonization of C. difficile, and serves as a physical defense barrier against infection. Despite the well-characterized cytotoxicity, few studies have investigated the genome-wide interplay between host cells and C. difficile. The aim of this study is to investigate the genetic-and-epigenetic molecular mechanisms between human colorectal epithelial Caco-2 cells and C. difficile during the early (0–60 min) and late stages (30–120 min) of infection. To investigate the cross-talk mechanisms during the progression of infection, we introduced a systems biology approach using big data mining, dynamic network modeling, a genome-wide data identification method, system order detection scheme, and principal network projection method (PNP). We focused on the construction of genome-wide genetic-and-epigenetic interspecies networks (GEINs) and subsequent extraction of host–pathogen core networks (HPNs) to investigate the progression of underlying host/pathogen genetic-and-epigenetic mechanisms from the early to late stages of CDI. Based on our results, we suggest that the cell-wall proteins CD2787 and CD0237, which both play an important role in cell adhesion and pathogen defense mechanisms, can be considered as potential drug targets. In addition, the crucial proteins employed by C. difficile for sporulation, including CD1214, CD2629, and CD2643, can also be considered as potential drug targets since spore-mediated re-infection is a critical issue.