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ABSTRACT: Aflatoxin B1 (AFB1) is one of the most toxic mycotoxins. The use of probiotics is an effective approach to reduce aflatoxins content in foods. To find efficient bacterial species that can eliminate or detoxify AFB1, a bacterial strain S51 capable of degrading AFB1 was isolated from chicken intestine and soil samples by using a culture medium containing coumarin as the sole carbon source. Based on the results of 16S rRNA gene sequence analysis, this isolate (strain S51) was identified as Bacillus licheniformis strain QT338. Further characterization of strain S51 showed that it could degrade AFB1 by 61.3% after incubation at 30°C for 72 h. Additional studies demonstrated that S51 promoted good growth performance of the treated chickens, showed no hemolytic activity, carried few drug resistance genes, and exhibited a certain level of tolerance to acid and bile salts. Furthermore, to verify whether strain S51 exerts a protective effect on AFB1-induced liver injury in chickens and to elucidate the underlying mechanism, a chicken toxicity model was induced with AFB1 (100 μg/kg BW) and treated with S51(1×109CFU/mL) for 12 d. The results showed that S51 decreased the level of alanine transaminase, aspartate transaminase, and total bilirubin (P < 0.05); increased glutathione activity and total antioxidant capacityin the liver induced by AFB1, and decreased malondialdehyde production (P < 0.05). S51 also up-regulated the mRNA expression level of the antioxidant proteins HO-1 and Nrf2 and down-regulated the expression of the oxidation-related factor Keap1 in the Nrf2/Keap1 signaling pathway (P

Abstract Respiratory diseases constitute a major health problem for ruminants, resulting in considerable economic losses throughout the world. Parainfluenza type 3 virus (PIV3) is one of the most important respiratory pathogens of ruminants. The pathogenicity and phylogenetic analyses of PIV3 virus have been reported in sheep and goats. However, there are no recent studies of the vaccination of sheep or goats against PIV3. Here, we developed a purified inactivated ovine parainfluenza virus type 3 (OPIV3) vaccine candidate. In addition, we immunized sheep with the inactivated OPIV3 vaccine and evaluated the immune response and pathological outcomes associated with OPIV3 TX01 infection. The vaccinated sheep demonstrated no obvious symptoms of respiratory tract infection, and there were no gross lesions or pathological changes in the lungs. The average body weight gain significantly differed between the vaccinated group and the control group (P

Abstract Background Scientific research activity in hospitals is important for promoting the development of clinical medicine, and the scientific literacy of medical staff plays an important role in improving the quality and competitiveness of hospital research. To date, no index system applicable to the scientific literacy of medical staff in China has been developed that can effectively evaluate and guide scientific literacy. This study aimed to establish an index system for the scientific literacy of medical staff in China and provide a reference for improving the evaluation of this system. Methods In this study, a preliminary indicator pool for the scientific literacy of medical staff was constructed through the nominal group technique (n = 16) with medical staff. Then, two rounds of Delphi expert consultation surveys (n = 20) were conducted with clinicians, and the indicators were screened, revised and supplemented using the boundary value method and expert opinions. Next, the hierarchical analysis method was utilized to determine the weights of the indicators and ultimately establish a scientific literacy indicator system for medical staff. Results Following expert opinion, the index system for the scientific literacy of medical staff featuring 2 first-level indicators, 9 second-level indicators, and 38 third-level indicators was ultimately established, and the weights of the indicators were calculated. The two first-level indicators were research literacy and research ability, and the second-level indicators were research attitude (0.375), ability to identify problems (0.2038), basic literacy (0.1250), ability to implement projects (0.0843), research output capacity (0.0747), professional capacity (0.0735), data-processing capacity (0.0239), thesis-writing skills (0.0217), and ability to use literature (0.0181). Conclusions This study constructed a comprehensive scientific literacy index system that can assess medical staff's scientific literacy and serve as a reference for evaluating and improving their scientific literacy.

Abstract Background The primary health care (PHC) system plays an important role in China’s health care system, but there are challenges such as irrational allocation of health resources and inefficient operation, which need to be improved. The purpose of this study was to explore the impact of resource allocation on the efficiency of the PHC system in China. Methods The data in 31 provinces were collected from the China Statistical Yearbook 2017–2021 and the China Health Statistical Yearbook 2017–2021. The comprehensive health resource density index (CHRDI) was constructed based on the entropy method and the health resource density index (HRDI), which was used to analyze the allocation of primary health resources in each province. The adjusted efficiency of the PHC system in each province was calculated by the bootstrap data envelopment analysis (DEA). Finally, the spatial Dubin model was used to explore the effect of the CHRDI on efficiency. Results From 2016 to 2020, the allocation of primary health resources in 31 provinces showed an increasing trend, and the average efficiency after correction showed a decreasing state year by year. The spatial direct effect and spatial spillover effect coefficients of CHRDI were 0.820 and 1.471, which positively affect the efficiency. Per capita Gross Domestic Product (GDP), urbanization rate, and the proportion of the elderly were the factors affecting the efficiency of the PHC system. Conclusions The allocation of primary health resources in all provinces in China has improved each year, but there are still great differences, and efficiency must be further improved. Pay attention to the spatial spillover effect of the level of resource allocation and formulate differentiated measures for different regions. Attention should also be paid to the impact of population aging and economic development on the utilization of primary health resources by increasing health needs and choices.

Non-obstructive azoospermia (NOA) is a disease characterized by spermatogenesis failure and comprises phenotypes such as hypospermatogenesis, mature arrest, and Sertoli cell-only syndrome. Studies have shown that FA cross-linked anemia (FA) pathway is closely related to the occurrence of NOA. There are FA gene mutations in male NOA patients, which cause significant damage to male germ cells. The FA pathway is activated in the presence of DNA interstrand cross-links; the key step in activating this pathway is the mono-ubiquitination of the FANCD2-FANCI complex, and the activation of the FA pathway can repair DNA damage such as DNA double-strand breaks. Therefore, we believe that the FA pathway affects germ cells during DNA damage repair, resulting in minimal or even disappearance of mature sperm in males. This review summarizes the regulatory mechanisms of FA-related genes in male azoospermia, with the aim of providing a theoretical reference for clinical research and exploration of related genes.

Abstract Background China's family doctor contracting service is an important part of deepening the reform of the healthcare systems, aiming to further develop chronic disease management services, enhance the capacity of primary health care services and improve the health of residents. The purpose of this study was to explore the influence of multiple chronic conditions in the elderly on family doctor contracting and whether socioeconomic status played a moderating role. Methods A cross-sectional survey was conducted in Beijing, China. A total of 1814 elderly people over 60 years old were included in this study using a whole-group sampling method. The univariate analysis and logistic regression analysis was used to analyze the data. Results 21.72% of the elderly signed up with family doctors. The multiple chronic conditions was a factor influencing the elderly to sign up with family doctors (OR = 1.44, 95%CI = 1.28–1.61), and the higher the degree of multiple chronic conditions, the stronger willingness to sign up. Socioeconomic status positively moderates the effect of multiple chronic conditions on signing. Also, physical activity intensity (OR = 1.25, 95%CI = 1.03–1.54) and willingness to first visit primary care facilities (OR = 1.38, 95%CI = 1.25–1.54) influenced the elderly to sign up with family doctors. Conclusions The elderly with a high degree of multiple chronic conditions, high activity intensity, and a strong willingness to first visit primary care facilities were more likely to sign up with family doctors. The health literacy of the elderly should be further improved, and publicity on the family doctor contracting service policies for the elderly with lower socioeconomic status should be strengthened to guide them to sign up with family doctors. At the same time, the service capacity of primary care facilities should be further improved to meet the health needs of the elderly.

Abstract Premature ovarian insufficiency (POI) is a clinically heterogeneous disease that may seriously affect the physical and mental health of women of reproductive age. POI primarily manifests as ovarian function decline and endocrine disorders in women prior to age 40 and is an established cause of female infertility. It is crucial to elucidate the causative factors of POI, not only to expand the understanding of ovarian physiology, but also to provide genetic counselling and fertility guidance to affected patients. Factors leading to POI are multifaceted with genetic factors accounting for 7% to 30%. In recent years, an increasing number of DNA damage-repair-related genes have been linked with the occurrence of POI. Among them, DNA double-strand breaks (DSBs), one of the most damaging to DNA, and its main repair methods including homologous recombination (HR) and non-homologous end joining (NHEJ) are of particular interest. Numerous genes are known to be involved in the regulation of programmed DSB formation and damage repair. The abnormal expression of several genes have been shown to trigger defects in the overall repair pathway and induce POI and other diseases. This review summarises the DSB-related genes that may contribute to the development of POI and their potential regulatory mechanisms, which will help to further establish role of DSB in the pathogenesis of POI and provide theoretical guidance for the study of the pathogenesis and clinical treatment of this disease.

Abstract Epithelial ovarian cancer (EOC) is a gynecological disease with the highest mortality. With the lack of understanding of its pathogenesis, no accurate early diagnosis and screening method has been established for EOC. Studies revealed the multi-faceted function of Wilms’ tumor (Wt1) genes in cancer, which may be related to the existence of multiple alternative splices. Our results show that Wt1 (+KTS) or Wt1 (−KTS) overexpression can significantly promote the proliferation and migration of human ovarian epithelial cells HOSEpiC, and Wt1 (+KTS) effects were more evident. To explore the Wt1 (+/−KTS) variant mechanism in HOSEpiC proliferation and migration and ovarian cancer (OC) occurrence and development, this study explored the differential regulation of Wt1 (+/−KTS) in HOSEpiC proliferation and migration by transcriptome sequencing. OC-related hub genes were screened by bioinformatics analysis to further explore the differential molecular mechanism of Wt1 (+/−KTS) in the occurrence of OC. Finally, we found that the regulation of Wt1 (+/−KTS) variants on the proliferation and migration of HOSEpiC may act through different genes and signaling pathways and screened out key genes and differentially regulated genes that regulate the malignant transformation of ovarian epithelial cells. The implementation of this study will provide new clues for the early diagnosis and precise treatment of OC.

Simultaneous localization and mapping has become one of the core modules of unmanned platforms. High-precision localization and mapping play an important role in the collision avoidance and planning of robots in complex environments. One of the key technologies for improving the accuracy of LiDAR-Odometry is point cloud distortion removal. In existing research, laser point cloud undistortion is mostly performed on the entire frame of the point cloud, and the lower the frequency of the point cloud, the more difficulty it is to remove distortion. The main innovation of this study is the proposal of a robust point cloud partition boundary division method, Section-LIO, that takes into account the matching and undistortion effects of each point cloud. The accuracy of the overall laser odometer is improved using inertial measurement unit to remove distortion from the segmented point cloud. Section-LIO supports both 360° mechanical rotation LiDAR and light and small solid-state LiDAR. In experiments with public and private datasets, Section-LIO outperforms three existing state-of-the-art algorithms in terms of accuracy. All implementations of our Section-LIO are open-sourced on GitHub.

This paper combines real-time temperature detection of MOSFETs inside solid-state switches with a temperature field model, and proposes a current limiting protection control strategy based on real-time heat management of MOSFETs. This strategy can avoid the unreasonable setting of current limiting protection time in solid-state switches during short circuit faults, leading to overheating and failure of MOSFET, and thus causing faults in HVDC power distribution system. Firstly, we analyzed the protection characteristics and shortcomings of solid-state switches such as solid-state power controller(SSPC) and solid-state circuit breakers (SSCB). Secondly, we optimized the circuit design of the solid-state power controller and the conversion relationship under different operating conditions, and elaborate on the implementation method of this control strategy in detail. Thirdly, we established a heat dissipation model for the MOSFET of SSPC, conduct theoretical and simulation analysis, and obtain the temperature field distribution of the MOSFET; Finally, the temperature of the MOSFET core is calculated by collecting the temperature of the position through the solid-state power controller temperature sensor, achieving accurate measurement. This paper also developed a prototype of a solid-state power controller with a rated current of 20A at 270V DC, and conducted short-circuit current limiting protection tests at 5 times the rated current; Experiments have shown that this control strategy can effectively prevent the overheating failure of the MOSFET.

Peripheral nerve injury (PNI) is a common and complex clinical disease with high morbidity, limited treatment options and poor clinical outcomes. Several million cases of PNI in the world every year have brought a heavy burden to the patients and the social economy. Autologous nerve grafting has long been the “gold standard” in the treatment of PNI repair, but it still has some shortcomings, such as donor area injury, limited graft source and mismatch of nerve thickness after transplantation. In recent years, many artificial nerve guidance conduits (NGCs) have emerged for replacing autologous nerve grafts, and their effectiveness has been proven. Currently, there are already clinical products obtained from the European CE Certification, and approved by the Food and Drug Administration (FDA), China Food and Drug Administration (CFDA), Therapeutic Goods Administration (TGA) in Australia, etc. The preparation of NGCs requires interdisciplinary studies and has received considerable attention from researchers in recent years. At present, among emerging and mature manufacturing technologies, textile methods to prepare NGCs are relatively simple and have wide material sources, which has become a hotspot in textile research. This paper mainly reviewed the current situation and recent technological achievements of NGCs that were prepared by textile methods. Several other common methods were also briefly summarized. Furthermore, current NGCs products and their clinical applications were reported. Finally, the future development direction of textile-based NGCs is discussed in this review.

In recent years, marine engineers have increasingly relied on multiship collaborative work to complete complex tasks at sea and improve maritime transport efficiency. Ship formation significantly contributes to the maintenance of stability during multiship-coordinated operations, but establishing the formation structure while ensuring the safety of each ship remains challenging. Therefore, this study proposes an improved leader–follower-based formation algorithm as a solution to this issue. First, the fast marching square method was used for global static path planning. The leader–follower formation control method then enabled the path tracking of the follower ship to the leader ship. Finally, an improved artificial potential field method was used for local collision avoidance, and virtual obstacles were added to improve the situation in which the ship probably entered a local minimum point. The experimental results revealed that the proposed algorithm could plan a route with time, smoothness, and safety advantages for the formation leader and quickly form a stable formation. Notably, the ship can quickly initiate collision avoidance operations when it encounters an obstacle posing a collision risk.

Abstract Background Competency-oriented medical education has become a global trend. However, most current studies focus on the independent effects of various competencies and lack an examination of the combined effects. Therefore, the purpose of this study was to explore the competency configurations of excellent pediatric residents and general pediatric residents and to provide a scientific reference for the talent training and career development of pediatric residents. Methods Behavioral event interviews were conducted with 23 pediatric residents at a children's hospital in Beijing in July and August 2019. Two researchers coded the interview data to summarize the competency of pediatric residents. The research group scored the performance of 23 pediatric residents in various aspects of competency and used the crisp-set qualitative comparative analysis method to explore the competency configurations of excellent pediatric residents and general pediatric residents. Results This study concludes that pediatric residents should have six core competencies: professional spirit, clinical skills, communication ability, learning ability, mental capacity and research ability. There are 4 combinations of competencies for becoming an excellent pediatric resident: the clinical type, scientific research type, all-around development type and high emotional intelligence type. In addition, there are 3 combinations of competencies for becoming a general pediatric resident: the comprehensive ability deficiency type, lack of professionalism and mental capacity type, lack of communication ability type. Conclusions There are differences in competence between excellent and general pediatric residents. Excellent pediatric residents do not need to possess all competencies but should specialize in clinical practice, scientific research or communication skills. This study suggests that training in mental capacity, professional spirit and communication ability should be strengthened during pediatric resident training. Pediatric residents should make career development plans according to their actual situation, and hospitals should arrange suitable positions according to the characteristics of pediatric residents.

The sulfidation of nanoscale zerovalent iron (nZVI) has received increasing attention for reducing the oxidizability of nZVI and improving its reactivity toward heavy metal ions. Here, a sulfide (S)-modified attapulgite (ATP)-supported nanoscale nZVI composite (S-nZVI@ATP) was rapidly synthesized under acidic conditions and used to alleviate Cd2+ toxicity from an aqueous solution. The degree of oxidation of S-nZVI@ATP was less than that of nZVI@ATP, indicating that the sulfide modification significantly reduced the oxidation of nZVI. The optimal loading ratio was at an S-to-Fe molar ratio of 0.75, and the adsorption performance of S-nZVI@ATP for Cd2+ was significantly improved compared with that of nZVI@ATP. The removal of Cd2+ by S-nZVI@ATP was 100% when the adsorbent addition was 1 g/L, the solution was 30 mL, and the adsorption was performed at 25 °C for 24 h with an initial Cd2+ concentration of 100 mg/L. Kinetics studies showed that the adsorption process of Cd followed the pseudo-second-order model, indicating that chemisorption was the dominant adsorption mechanism. The adsorption of Cd2+ by S-nZVI @ATP is dominated by the complexation between the iron oxide or iron hydroxide shell of S-nZVI and Cd2+ and the formation of Cd(OH)2 and CdS precipitates. HIGHLIGHTS S-nZVI was loaded on ATP, effectively preventing nZVI agglomeration, and the sulfide modification significantly reduced the oxidation of nZVI.; Cd2+ removal was mailly attributed to complex with the iron oxides or iron hydroxide shell of S-nZVI.; S-nZVI@ATP showed a stable adsorption effect on Cd2+ over a wide pH range.; The removal of Cd2+ by S-nZVI@ATP follows the quasi-second-order kinetic adsorption model.;

ObjectivesThere is currently no measure of the hospital organizational environment targeting both clinicians and nurses in China. This study was conducted with the aim of developing and testing an instrument to assess the properties of the hospital organizational environment that is applicable to Chinese medical staff.MethodsItems were developed based on a literature review, semi-structured interviews and an expert review and finalized based on corrected item-total correlation, content validity, construct validity, convergent validity, discriminant validity and reliability. The two samples for testing the first and final version of the Hospital Organizational Environment Scale (HOES) included 447 and 424 participants, respectively.ResultsThe primary test, which comprised 18 items, contained four factors: hospital culture, work situation, organizational support and scientific research situation. The Cronbach’s alphas were 0.935, 0.824, 0.943, and 0.920, respectively. The results of the validation test showed that the questionnaire had good validity and reliability.ConclusionThe HOES is a comprehensive instrument with demonstrated validity and reliability that can be adopted among medical staff to assess the organizational environment in hospitals.

ObjectiveTo improve the health of residents and promote hierarchical diagnosis and treatment to achieve an orderly pattern of medical treatment, Beijing implemented family doctor contract services (FDCSs) in 2011. The aims of this study were to analyze the current status of Beijing residents’ contracts with family doctors (FDs), compare the differences in contracting between urban and suburban residents, and explore the factors that affect residents’ contract behavior.MethodsFrom August 2020 to October 2020, a stratified sampling method was adopted to select residents from community health centers (CHCs) in districts D (urban area) and S (suburb) of Beijing to conduct a questionnaire survey. Chi-square tests, rank sum tests and logistic regression analyzes were used to analyze the current status and influencing factors of residents’ contracting with FDs.ResultsA total of 4,113 valid questionnaires were included in the final analysis. District D was rich in medical resources, and the FD contract rate of residents there (93.09%) was significantly higher than that of residents in district S (78.06%; p

In this study, the multi-year data of meteorology and O3 from remote sensing and ground observations are applied to characterize the 3-D changes of O3 in the troposphere over central and eastern China (CEC) induced by the tropical cyclones (TCs) in the tropical and subtropical ocean regions over Northwest Pacific. The CEC-regional average of near-surface O3 levels is significantly elevated with 6.0 ppb in the large coverage by the TCs in the subtropical ocean, while the TCs in the tropical ocean alter near-surface O3 weakly, indicating the latitudinal-located TCs in the subtropical offshore ocean could largely influence the O3 variations over CEC. The sub-seasonal change with the positive and negative anomalies of near-surface O3 is induced by the tropical TCs from June to July and from August to October. The peripheral circulation of TCs in the subtropical offshore ocean persistently enhances the O3 concentrations over CEC during the season of East Asian summer monsoons. The positive O3 anomalies maintain from the entire troposphere to the lower stratosphere over CEC in the peripheries of subtropical TCs, while the tropical TCs cause the positive O3 anomalies merely in the lower troposphere. The O3 transport and accumulation, photochemical production and stratospheric intrusion are climatologically confirmed as the major meteorological mechanisms of TCs affecting the O3 variations. This study reveals that the downward transport of stratospheric O3 of TCs in the subtropical ocean exerts a large impact on the atmospheric environment over CEC, while the regional O3 transport and photochemical productions dominate the lower troposphere over CEC with less impact of stratospheric intrusion from the TCs in the tropical ocean region. These results present the climatology of tropospheric O3 anomalies in China induced by the TCs over the Northwest Pacific with enhancing our comprehension of the meteorological impact on O3 variations over the East Asian monsoon region.

This study focuses on addressing the pollution caused by Ni in water. To enhance the removal efficiency of Ni2+, attapulgite (ATP) from Linze County, Gansu Province, China, was used as a carrier to prepare attapulgite loaded with nanoscale zero-valent iron (nZVI@ATP) via a liquid-phase reduction. This approach aims to mitigate the aggregation and oxidation tendencies of nZVI, thereby improving its performance in Ni2+ removal. The results revealed that nZVI@ATP exhibited a mesoporous structure with a specific surface area and an average pore size of 51.79 m2/g and 9.22 nm. Notably, nZVI@ATP showed a remarkably reduced agglomeration phenomenon. In addition, nZVI@ATP demonstrated a considerably more excellent adsorption performance for Ni2+ than raw ATP and pure nZVI, as its highest adsorption capacity was 143.20 mg/g when the iron–ATP ratio was 2:1 (initial concentration: 200 mg/L, initial pH: 5, temperature: 298 K, and dosing amount: 1 g/L). The adsorption of Ni2+ by nZVI@ATP followed the quasi-secondary kinetic model, and the removal rate of Ni2+ was inversely proportional to the initial concentration and directly proportional to the dosage. The adsorption capacity tended to increase and then decrease as the pH increased. The removal mechanism of Ni2+ by nZVI@ATP involved adsorption, reduction, and precipitation, with the significant mechanism being the induced Ni(OH)2 precipitation on the nZVI@ATP surface.

Compliance mismatch between artificial blood vessel and host vessel can cause abnormal hemodynamics and is the main mechanical trigger of intimal hyperplasia (IH) after transplantation. To explore the specific effects of the degree of compliance mismatch on hemodynamics, the concept of “compliance mismatch degree” was defined in this paper. Numerical results showed that when the compliance mismatch degree was less than −22.21% or more than 3.16%, the minimum WSS in the anastomotic site was less than the safety threshold of 0.5 ​Pa, which is easy to induce IH. In addition, the compliance mismatch caused different radial displacements first, which in turn affected the hemodynamics. Inspired by this, a novel medium convex artificial blood vessel was proposed, and the simulation results theoretically validated its desired effect on reducing the compliance mismatch. An increase of 0.22 ​mm in the diameter of the artificial blood vessel corresponded to a decrease of 0.88% in compliance mismatch degree. The feasibility of preparing real medium convex artificial blood vessel was also investigated. The PLCL medium convex artificial blood vessel with good mechanical properties was prepared by dip-coating and electrospinning composite method. These findings are valuable for the design and preparation of novel artificial blood vessel which can make up for the mismatch of compliance.

Rock failure generally leads to serious consequences, and it is significant to obtain the precursor information prior to failure using associated techniques. Acoustic emission (AE) is one of the indispensable methods for disaster warning of hard and brittle rock. Acoustic emission detection technology can effectively monitor real-time information about changes in the rock interior and predict the process of rock damage failure. To probe the relationship among the AE precursor information of red sandstone under different intermediate principal stresses, an experimental study was conducted by us to examine the alterations in AE parameters during the failure of red sandstone under both loading and unloading circumstances. The study shows that the ringing count rate and absolute energy versus time curves are divided into four stages, namely, quiet, frequent, sudden increase and decline periods. The cumulative count curve is also divided into four phases: pre-unloading period, post-unloading period, sharp increase period, and decrease period. With the rise of the intermediate principal stress, the ringing count rate and energy exhibited during the frequent period of AE demonstrate a consistent increase, with a larger increase in the maximum value and a smaller increase in the average value. In addition, the peak value of AE signals during failure also increases accordingly. The occurrence moment and clarity of the frequent period determine the reliability and priority of the information related to the rock’s failure precursor; moreover, the reliability and priority of the AE precursor information will increase with the increase of the intermediate principal stress. After comparison, it is found that the AE precursor information occurs prior to the thermal infrared precursor information.

Wheat gluten (WG) foam was successfully prepared by heating, stirring and freeze-drying. The effects of WG concentration, content of glycerol and glutaraldehyde on the macroscopic appearance, microstructure, swelling property and self-expansion, as well as mechanical compressibility, were studied. Results showed that the density and structure of foam can be changed by adjusting the concentration of WG, glycerol, and glutaraldehyde. The addition of glycerol softens the WG foams, while glutaraldehyde significantly improved their mechanical properties and stability in wet state. The swollen foams were repeatedly pressed and exhibited rapid water-triggered shape recovery performance (less than 3 ​s). Moreover, WG foams displayed excellent biodegradability and hemocompatibility. In vitro studies of drug loading and release were performed using an antibacterial drug, chlorhexidine gluconate (CHG), and showed sustained drug-release activity. The above advantages make the foams hold great potential for application in self-expanding, antibacterial hemostatic medical dressings.

Objectives Chinese public hospitals are managed like a bureaucracy, which is divided into two levels of hospital and departmental management. Improving strategic human resource management ability (SHRMA) within clinical departments can improve department performance and service quality, which is an important way for public hospitals to obtain an advantage in a diversified competitive medical market. However, there is a lack of specialised evaluation tools for SHRMA in clinical departments to support this effort. Therefore, this study aims to develop an index for evaluating the SHRMA of clinical departments in public hospitals.Study design and setting The Delphi technique was carried out with 22 experts, and an evaluation index of the SHRMA in the clinical departments of public hospitals was constructed. The weight of each indicator was calculated by the intuitive fuzzy analytic hierarchy process.Results The SHRMA index constructed in this study for the clinical departments in public hospitals includes 5 first-level indicators, 13 second-level indicators and 36 third-level indicators. The first-level indicators are distributed in weight among human resource maintenance (0.204), human resource planning (0.201), human resource development (0.200), human resource stimulation (0.198) and human resource absorption (0.198). The top three weighted indicators on the second level are job analysis and position evaluation (0.105), career management (0.103) and salary incentivisation (0.100).Conclusions The index constructed in this study is scientific and feasible and is expected to provide an effective tool for the quantitative evaluation of SHRMA in the clinical departments of public hospitals in China.

Liver-expressed antimicrobial peptide 2 (LEAP-2) is an important component of innate immunity, a well-conserved, evolutionarily ancient host defensive mechanism. In this study, three novel full-length LEAP-2 cDNAs were identified and characterized from G. zanaensis. The deduced precursors of GzLEAP-2A, GzLEAP-2B and GzLEAP-2 C, are composed of 94, 74, and 83 amino acids, which possess four, three, and four conserved cysteine residues in the mature peptide, respectively. GzLEAP-2 s are highly conserved in evolution, with GzLEAP-2A and GzLEAP-2 C showing a close topologic relationship with LEAP-2 from Ictalurus furcatus and Danio rerio, respectively. Quantitative real-time polymerase chain reaction analysis indicated that GzLEAP-2 s ubiquitously existed in all examined tissues, with higher mRNA expression levels observed in muscle, intestine, and liver. Antimicrobial assay showed that synthetic GzLEAP-2A and GzLEAP-2B displayed specific antimicrobial activity against aquatic strains, whereas GzLEAP-2 C did not show any detectable antimicrobial activity. All GzLEAP-2 s were found to possess potent 2,2-diphenyl-1-picrythydrazyl (DPPH) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS)+ radical scavenging activities, and high doses of GzLEAP-2B and GzLEAP-2 C pre-treatment significantly promoted macrophage phagocytic activity. Moreover, no toxicity of GzLEAP-2 s against tested cells was observed at the effective concentrations. The distinct tissue distribution and pleiotropic roles of GzLEAP-2 s suggest a sophisticated and multilevel antimicrobial defensive network of G. zanaensis.

ContextThe prehospital emergency system is essential for reducing mortality and disability in emergency patients. However, the high turnover rate of prehospital emergency physicians (PEPs) remains the most prominent problems in the prehospital emergency system. Turnover intent (TI) is predictive of actual turnover behavior; however, previous studies have mainly focused on sociodemographic factors and job characteristics, ignoring many other potential psychological factors, such as professional identity (PI) and job burnout (JB).ObjectivesTo measure the level of PI, JB, and TI of PEPs in Beijing, China. We analyze the distribution of TI in different social demography PEPs and then further explore the influence of PI and JB on TI, to provide a reference and suggestions for government departments to reduce the TI of PEPs.MethodsAn online questionnaire was distributed to 552 PEPs in Beijing, and a total of 533 valid questionnaires were included. T-test and variance analysis were used to examine the differences in the distribution of TI among different sociodemographic PEPs. Pearson's correlation analysis was used to test the correlation between PI, JB, and TI. The SEM was used to analyze the relationships among PI, JB, and TI.ResultsUnivariate analysis showed that age, marital status, education, professional title, work experience, department and hukou were significantly associated with TI. Pearson's correlation analysis showed that PI was negatively associated with JB and TI, and JB was positively associated with TI. Professional treatment identity (PTI, β = −0.24, 95% CI: −0.38~-0.11), professional meaning identity (PMI, β = −0.12, 95% CI: −0.23~0.03), and emotional exhaustion (EE, β = 0.40, 95% CI: 0.28~0.51) seem to have direct impacts on TI. Given the mediating role played by EE, PTI may have an indirect negative effect on TI (β = −0.24, 95% CI: −0.32~0.16).ConclusionPI and JB of PEPs in China are closely related to TI, which may have unexpected effects on government departments to stabilize the team of PEPs through a series of control measures. According to the above results, the professional treatment of PEPs needs to be improved, and external learning opportunities should be increased. Legalization of medical rescue workers should also be on the agenda.

Objective: This review aims to provide some theoretical guidance for the precise treatment of ovarian cancer and the development of estrogen-related drugs. Mechanism: Ovarian cancer is one of the leading causes of death in gynecological cancer patients, mainly affecting middle-aged and elderly women. It has the characteristics of hidden location, strong heterogeneity and lack of specific symptoms in the early stage. Numerous studies have shown that estrogen receptor (ER) plays an important role in different types of cancer, including ovarian cancer. Accordingly, the study of ER signaling pathways and related regulatory factors in ovarian cancer cells should help us understand the pathogenesis of ovarian cancer. Findings in Brief: The expression of estrogen receptor subtypes is related to ovarian cancer gene and leads to ovarian cancer. Estrogen receptor modulators appear to be an important factor in the prognosis of patients with ovarian cancer after hormone therapy. Conclusions: This review summarizes the regulatory mechanism of ER in the occurrence and development of ovarian cancer and outlines the specific role of estrogen receptor modulators (SERMs) in the treatment and prevention of ovarian cancer.

A quick and effective way of segmenting images is the Otsu threshold method. However, the complexity of time grows exponentially as the number of thresolds rises. The aim of this study is to address the issues with the standard threshold image segmentation method’s low segmentation effect and high time complexity. The two mutations differential evolution based on adaptive control parameters is presented, and the twofold mutation approach and adaptive control parameter search mechanism are used. Superior double-mutation differential evolution views Otsu threshold picture segmentation as an optimization issue, uses the maximum interclass variance technique as the objective function, determines the ideal threshold, and then implements multi-threshold image segmentation. The experimental findings demonstrate the robustness of the enhanced double-mutation differential evolution with adaptive control parameters. Compared to other benchmark algorithms, our algorithm excels in both image segmentation accuracy and time complexity, offering superior performance.

Small-diameter artificial blood vessels are prone to cause intimal hyperplasia (IH) after transplantation, which leads to restenosis and low long-term patency rates. The main biomechanical factor for IH formation is the compliance mismatch between the artificial and host blood vessels which can cause abnormal hemodynamics. Although there have been many studies on vascular compliance mismatches, however, little attention has been paid to the effect of the degree of compliance mismatch between graft and the host vessel on hemodynamics. At present, the research on compliance mismatch between the artificial and host blood vessels is still very limited, especially with regard to the specific impact of the compliance mismatch degree on hemodynamics. Therefore, three end-to-end anastomosis models (the compliance of the artificial blood vessel is lower than, similar to, and higher than that of the host blood vessel, called model 1, model 2, model 3, respectively) were constructed and simulated in this study. Simulation results showed that the radial displacement difference between the artificial and host blood vessels were 0.281 ​mm, 0.183 ​mm and 0.485 ​mm in model 1, model 2 and model 3, respectively. A low-velocity recirculation zone near the distal anastomosis was formed in model 1 which resulted in excessively low TAWSS (9.261 ​E-5Pa) and high OSI (0.497). Similarly, a low-velocity recirculation zone near the proximal anastomosis was formed in model 3 and lead to low TAWSS (6.007 ​E-4Pa) and high OSI (0.480). However, there was no low-velocity recirculation zone near the anastomosis stoma in model 2. The results are instructive for the design and preparation of artificial blood vessels.

Small-diameter artificial blood vessels do not match the compliance of the host blood vessels after transplantation, will directly affect the blood compatibility of small-diameter artificial blood vessels and resulting in problems such as thrombosis and intimal hyperplasia that can lead to transplantation failure. Since the compliance of small-diameter artificial blood vessels is directly related to the elasticity of the component materials, the poly(glyceryl sebacate) (PGS), a type of bioelastomer, and silk fibroin (SF) were blended to fabricate small-diameter artificial blood vessels by electrospinning. The morphology, structure, elasticity, tensile properties, suture retention strength, compliance, and in vitro degradation and biological properties of the samples were studied. Results showed that the small-diameter artificial blood vessel samples were composed of micro-fibers or nano-fibers, and had satisfactory compliance and elasticity. The compliance of the PGS/SF (70/30) samples was 3.58 %/100 ​mmHg, which were higher than or comparable to natural blood vessels. The results of radial cyclic tensile tests showed that the energy loss per cycle of PGS/SF tubular samples was very low. Adding PGS accelerated the degradation rate of small-diameter artificial blood vessel samples, and PGS/SF electrospun small-diameter artificial blood vessel samples promoted the adhesion and proliferation of human umbilical vein endothelial cells (HUVECs). The samples’ anticoagulant performance were also increased after adding heparin. PGS/SF blends have potential advantages in the preparation of small-diameter artificial blood vessels that can meet the requirements of elasticity and compliance.

Abstract Splicing factor SRSF2 acts as a critical regulator for cell survival, however, it remains unknown whether SRSF2 is involved in myoblast proliferation and myogenesis. Here, knockdown of SRSF2 in myoblasts causes high rates of apoptosis and defective differentiation. Combined conditional knockout and lineage tracing approaches show that Myf5‐cre mice lacking SRSF2 die immediately at birth and exhibit a complete absence of mature myofibers. Mutant Myf5‐derived cells (tdtomato‐positive cells) are randomly scattered in the myogenic and non‐myogenic regions, indicating loss of the community effect required for skeletal muscle differentiation. Single‐cell RNA‐sequencing reveals high heterogeneity of myf5‐derived cells and non‐myogenic cells are significantly increased at the expense of skeletal muscle cells in the absence of SRSF2, reflecting altered cell fate. SRSF2 is demonstrated to regulate the entry of Myf5 cells into the myogenic program and ensures their survival by preventing precocious differentiation and apoptosis. In summary, SRSF2 functions as an essential regulator for Myf5‐derived cells to respond correctly to positional cues and to adopt their myogenic fate.

In order to understand the differences of metabolites and their key metabolic pathways between traditional manual and mechanized Huangjiu, gas chromatography-mass spectrometry (GC–MS) combined with non targeted metabolomics was used to track and monitor Huangjiu in the whole post-fermentation stage. The results showed that 25 metabolites and 14 metabolites were identified as differential metabolites in manual and mechanized Huangjiu, respectively (VIP > 1, P 1, impact > 0.01). Compared with the two kinds of Huangjiu, 21 kinds of metabolites were identified as differential metabolites (VIP > 1, P 1, impact > 0.01). This study is helpful to gain insight into the underlying mechanism of flavor formation during the post-fermentation process of Huangjiu and provide a theoretical basis for the industrial development.

The regional transport of air pollutants has been identified as a critical factor that affects air quality over downwind receptor areas; however, the regional transport patterns for air pollution episodes remain poorly understood. In this study, we identified two distinct patterns of regional transport: rapid transit transport (RTT) and stationary accumulation transport (SAT), both of which induced severe PM2.5 pollution episodes in central China during 2015–2020. The differences and similarities between the two regional transport patterns of air pollution were characterized by their influencing meteorological factors. Similar meteorological conditions trigger the RTT and SAT, with a high-PM2.5 concentration air mass from the upstream regions transported to the Twain-Hu Basin (THB) by the strong northerly winds with a southward advance of cold air mass. The average rate of increase in the PM2.5 concentration of the RTT (12.5 μg/m3/h) is more than that of the SAT (5.7 μg/m3/h). However, meteorological conditions evolved differently in RTT and SAT. For RTT with the fast passage of cold air, the THB is located behind the strong cold front during the later stage, and these events rapidly ended owing to the northerly winds and wet scavenging of precipitation. For SAT with the slow cold air accumulation, the THB is mainly occupied by a weak high-pressure system with low wind speeds, strong descending airflow, and a low atmospheric boundary layer height, trapping the air pollutants accumulated in the THB and resulting in persistent heavy pollution incidents. This study provides new insights into the meteorological mechanism underlying the formation of severe air pollution episodes over a receptor region owing to the regional transport patterns of air pollutants.

Mangroves are extreme inter-tidal environments containing rich microbial communities. Actinobacteria from mangroves have an unprecedented ability to biosynthesize secondary metabolites. Therefore, the secondary metabolite production potential of actinobacteria sourced from mangroves warrants further exploration to determine whether they offer new sources of natural products. For this purpose, we selected a strain of Mycobacterium saopaulense (Actinobacteria phylum) from the mangroves in Macau for whole genome sequencing and tandem mass spectrometry analysis. The results showed that the 5,376,881-bp genome from this strain contains 5,391 protein-coding genes and a coding density of 90.53%. The main participating KEGG pathway was “Metabolism”. Altogether, the 81 gene clusters identified in its genome were associated with the production of 23 secondary metabolites. Sixteen of them were classified as antibiotics and three of them as bioactive compounds. Furthermore, two of the predicted secondary metabolites from the fermentation process were clavulanic acid and streptomycin. Both of these antibiotics were initially found to be produced by the M. saopaulense strain. This study shows that mangrove-derived actinobacteria have a large number of biosynthetic pathways with the potential to produce a range of biologically active secondary metabolites.

Rational design and fabrication of high-performance photocatalyst is of great importance for CO2 reduction into solar fuel. Here, the authors demonstrate that S-scheme heterojunction TiO2/CsPbBr3 photocatalyst exhibits enhanced CO2 photoreduction activity.

Abstract Background To promote the integration of medical resources, Beijing has built medical alliances since 2012, but this reform has not changed the state of disordered medical treatment. Patients are still willing to go to high-level hospitals for medical treatment. What causes patients to prefer high-level hospitals? To explore the reasons behind this preference for high-level medical treatment among patients and to guide patients to make visits in an orderly manner, we conducted this study and compared patients’ satisfaction with hospitals of different levels in the context of medical resource integration. Methods This study conducted a questionnaire survey among 1250 patients who were selected in 18 medical alliances in Beijing from October to December 2016. The study type is a comparative study based on cross-sectional data. Patient satisfaction was the main outcome, and descriptive analysis, chi-square tests, nonparametric tests and binary logistic regression analysis were used. The level of statistical significance was set at p

In the traditional assembly line balancing, all the workstations are assumed available and hence the unavailability of any workstation brings about the stoppage of the whole line and the waste of the production capacity in the rest workstations. Considering the planning characteristic of preventive maintenance, this paper proposes a novel methodology of integrating the preventive maintenance scenarios into assembly line balancing problems to bypass the unavailable workstation. A lexicographic model is formulated to generate multiple task assignment plans that ensure primarily the high productivity under regular operation scenario and guarantee secondarily the production continuity under preventive maintenance scenarios. And, an improved whale optimization algorithm (IWOA) with three modifications is proposed to solve this problem. Specifically, a combined crossover operator enhances better combination in exploration; three best search agents promote the exploitation; partial regeneration avoids being trapped in local optima. More than five thousand experiments demonstrate that the joint of three modifications endows the IWOA significant superiority over six variants and other six well-known algorithms. Moreover, integrating preventive maintenance scenarios into the assembly line balancing problem increases the production efficiency by 1% at the cost of small production adjustment.

A monotone fuzzy rule relabeling (MFRR) algorithm has been introduced previously for tackling the issue of a non-monotone fuzzy rule base in the Takagi-Sugeno-Kang (TSK) Fuzzy Inference System (FIS). In this paper, we further propose a new three-stage framework to develop a computationally efficient MFRR algorithm. The first stage determines the combinations of fuzzy rules to be relabeled by exploiting the prior information derived from a given non-monotone fuzzy rule base. This prior information includes the minimum number of fuzzy rules to be relabeled (denoted as $k$ ), as well as the states of fuzzy rules that must be, must not be, or may be relabeled. The second stage relabels the consequent parts of multiple sets of $k$ noisy fuzzy rules obtained from the first stage, such that a monotone fuzzy rule base is produced. The third stage selects the most suitable relabeled fuzzy rule base among the potential monotone fuzzy rule bases obtained from the second stage, either objectively or subjectively. We provide insights into MFRR and discuss its practical implementation. In addition, a network flow method is fused with the proposed MFRR framework, resulting in an efficient computation scheme. The MFRR framework is applied to Failure Mode and Effect Analysis (FMEA) problems related to a sewage treatment plant and a public hospital. It is also evaluated with real FMEA information from a semiconductor plant. The results are analyzed and discussed, which positively demonstrate the effectiveness of the proposed MFRR framework in formulating a monotone TSK-FIS model for undertaking FMEA problems.

The influence of the underlying surface on the atmospheric environment over rivers and lakes is not fully understood. To improve our understanding, this study targeted the Twain-Hu Basin (THB) in central China, with a unique underlying surface comprising a dense “water network” over rivers and lakes. In this study, the Weather Research and Forecasting Model with Chemistry (WRF-Chem) was used to simulate the impact of this dense “water network” on a wintertime heavy PM2.5 pollution event in the THB. On this basis, the regulating effects of density and area of the lake groups, with centralized big lakes (CBLs) and discrete small lakes (DSLs), on PM2.5 concentrations over the underlying surface of the dense “water network” in the THB were clarified, and the relative contributions of thermal factors and water vapor factors in the atmospheric boundary layer to the variation of PM2.5 concentrations were evaluated. The results show that the underlying surface of dense “water networks” in the THB generally decreases the PM2.5 concentrations, but the influences of different lake-group types are not uniform in spatial distribution. The CBLs can reduce the PM2.5 concentrations over the lake and its surroundings by 4.90–17.68% during the day and night. The ability of DSLs in reducing PM2.5 pollution is relatively weak, with the reversed contribution between −5.63% and 1.56%. Thermal factors and water vapor–related factors are the key meteorological drivers affecting the variation of PM2.5 concentrations over the underlying surface of dense “water networks”. The warming and humidification effects of such underlying surfaces contribute positively and negatively to the “purification” of air pollution, respectively. The relative contributions of thermal factors and water vapor–related factors are 52.48% and 43.91% for CBLs and 65.96% and 27.31% for DSLs, respectively. The “purification” effect of the underlying surface with a dense “water network” in the THB on regional air pollution highlights the importance of environmental protection of inland rivers and lakes in regional environmental governance. In further studies on the atmospheric environment, long-term studies are necessary, including fine measurements in terms of meteorology and the environment and more comprehensive simulations under different scenarios.

Objective The low performance of primary medical institutions (PMIs) in China is a significant issue. The WHO proposed that the main reason for the failure of the healthcare system in developing countries is poor organisational capabilities. However, there is no international tool for evaluating the organisational capabilities of PMIs. Therefore, this study aimed to develop an index system for evaluating the organisational capabilities of PMIs.Design We searched the literature (English and Chinese) published before June 2020 in the PubMed, China National Knowledge Infrastructure and Wanfang databases to conduct a literature review and develop a preliminary indicator pool. Then, two rounds of Delphi expert consultations were conducted by email from June to September 2020, followed by screening, revision and supplementation of the indicators using the boundary value method. Finally, the analytic hierarchy process was used to determine the weight of the indicators.Setting The Delphi consultation questionnaire was distributed to the leaders of PMIs in districts D, F and S in Beijing, China.Participants Nineteen leaders of PMIs who had a profound understanding of PMI operations and management and were able to participate in Delphi research from a professional and comprehensive perspective were included in this study.Results The Cr values were 0.76 (first-level indicators) and 0.78 (second-level indicators), indicating that the expert consultation results were accurate and reliable. The result of the expert coordination coefficient test was significant at the p

Evidence regarding the effects of environmental factors on COVID-19 transmission is mixed. We aimed to explore the associations of air pollutants and meteorological factors with COVID-19 confirmed cases during the outbreak period throughout China. The number of COVID-19 confirmed cases, air pollutant concentrations, and meteorological factors in China from January 25 to February 29, 2020, (36 days) were extracted from authoritative electronic databases. The associations were estimated for a single-day lag as well as moving averages lag using generalized additive mixed models. Region-specific analyses and meta-analysis were conducted in 5 selected regions from the north to south of China with diverse air pollution levels and weather conditions and sufficient sample size. Nonlinear concentration–response analyses were performed. An increase of each interquartile range in PM 2.5 , PM 10 , SO 2 , NO 2 , O 3 , and CO at lag4 corresponded to 1.40 (1.37–1.43), 1.35 (1.32–1.37), 1.01 (1.00–1.02), 1.08 (1.07–1.10), 1.28 (1.27–1.29), and 1.26 (1.24–1.28) ORs of daily new cases, respectively. For 1°C, 1%, and 1 m/s increase in temperature, relative humidity, and wind velocity, the ORs were 0.97 (0.97–0.98), 0.96 (0.96–0.97), and 0.94 (0.92–0.95), respectively. The estimates of PM 2.5 , PM 10 , NO 2 , and all meteorological factors remained significantly after meta-analysis for the five selected regions. The concentration–response relationships showed that higher concentrations of air pollutants and lower meteorological factors were associated with daily new cases increasing. Higher air pollutant concentrations and lower temperature, relative humidity and wind velocity may favor COVID-19 transmission. Controlling ambient air pollution, especially for PM 2.5 , PM 10 , NO 2 , may be an important component of reducing risk of COVID-19 infection. In addition, as winter months are arriving in China, the meteorological factors may play a negative role in prevention. Therefore, it is significant to implement the public health control measures persistently in case another possible pandemic.

Wilms tumor gene (WT1) is used as a marker for the diagnosis and prognosis of ovarian cancer. However, the molecular mechanisms involving WT1 in ovarian cancer require further study. Herein, we used bioinformatics and other methods to identify important pathways and hub genes in ovarian cancer affected by WT1. The results showed that WT1 is highly expressed in ovarian cancer and is closely related to the overall survival and progression-free survival (PFS) of ovarian cancer. In ovarian cancer cell line SKOV3, WT1 downregulation increased the mRNA expression of 638 genes and decreased the mRNA expression of 512 genes, which were enriched in the FoxO, AMPK, and the Hippo signaling pathways. The STRING online tool and Cytoscape software were used to construct a Protein-protein interaction (PPI) network and for Module analysis, and 18 differentially expressed genes (DEGs) were selected. Kaplan-Meier plotter analysis revealed that 16 of 18 genes were related to prognosis. Analysis of GEPIA datasets indicated that 7 of 16 genes were differentially expressed in ovarian cancer tissues and in normal tissues. The expression of IGFBP1 and FBN1 genes increased significantly after WT1 interference, while the expression of the SERPINA1 gene decreased significantly. The correlation between WT1 expression and that of these three genes was consistent with that of ovarian cancer tissues and normal tissues. According to the GeneMANIA online website analysis, there were complex interactions between WT1, IGFBP1, FBN1, SERPINA1, and 20 other genes. In conclusion, we have identified important signaling pathways involving WT1 that affect ovarian cancer, and distinguished three differentially expressed genes regulated by WT1 associated with the prognosis of ovarian cancer. Our findings provide evidence outlining mechanisms involving WT1 gene expression in ovarian cancer and provides a rational for novel treatment of ovarian cancer.

Intestinal microbiota is involved in immune response and metabolism of the host. The frequent use of anthelmintic compounds for parasite expulsion causes disturbance to the equine intestinal microbiota. However, most studies were on the effects of such treatment on the intestinal bacterial microbes; none is on the entire microbial community including archaea and eukaryotic and viral community in equine animals. This study is the first to explore the differences of the microbial community composition and structure in Przewalski's horses prior to and following anthelmintic treatment, and to determine the corresponding changes of their functional attributes based on metagenomic sequencing. Results showed that in archaea, the methanogen of Euryarchaeota was the dominant phylum. Under this phylum, anthelmintic treatment increased the Methanobrevibacter genus and decreased the Methanocorpusculum genus and two other dominant archaea species, Methanocorpusculum labreanum and Methanocorpusculum bavaricum. In bacteria, Firmicutes and Bacteroidetes were the dominant phyla. Anthelmintic treatment increased the genera of Clostridium and Eubacterium and decreased those of Bacteroides and Prevotella and dominant bacteria species. These altered genera were associated with immunity and digestion. In eukaryota, anthelmintic treatment also changed the genera related to digestion and substantially decreased the relative abundances of identified species. In virus, anthelmintic treatment increased the genus of unclassified_d__Viruses and decreased those of unclassified_f__Siphoviridae and unclassified_f__Myoviridae. Most of the identified viral species were classified into phage, which were more sensitive to anthelmintic treatment than other viruses. Furthermore, anthelmintic treatment was found to increase the number of pathogens related to some clinical diseases in horses. The COG and KEGG function analysis showed that the intestinal microbiota of Przewalski's horse mainly participated in the carbohydrate and amino acid metabolism. The anthelmintic treatment did not change their overall function; however, it displaced the population of the functional microbes involved in each function or pathway. These results provide a complete view on the changes caused by anthelmintic treatment in the intestinal microbiota of the Przewalski's horses.

Abstract Background Fowl adenovirus (FAdV) is an infectious agent that can cause jaundice, severe anaemia, dyspnoea and reproductive disorders in fowls. Since 2015, FAdV disease has been rapidly spreading among broiler chickens in China, where it has caused significant economic losses. In this study, a loop-mediated isothermal amplification (LAMP) real-time turbidity method with strong specificity to FAdV was established. Results The established assay was specific to FAdV-4, and the lower limit of detection was 75 copies/μL of extracted DNA. The positive detection rate for the suspected tissue samples was 33.3% (14/42), which was consistent with that of the real-time PCR. Conclusion The proposed LAMP method can quickly and accurately detect prevalent FAdV via real-time turbidity assay, thereby providing a diagnostic platform for the prevention and control of the FAdV disease.

Abstract Background To improve the efficiency of the use of medical resources, China has implemented medical alliances (MAs) to implement a hierarchical diagnosis and treatment system. The willingness to undertake a first visit to primary care institutions (PCIs) is an important indicator of the effect of this system. Beijing has also built MAs since 2013, but to date, there have been few studies on the first visit to PCIs in Beijing. The purpose of this study is to analyze patients’ willingness to make their first visit to PCIs and its influencing factors to provide references for the realization of a hierarchical diagnosis and treatment system. Methods Two relatively different districts with large differences in resources in Beijing, D and F, were selected, and a self-reported questionnaire and convenience sampling method were applied. A cross-sectional survey was administered to 1221 patients of MAs. The chi-square test and binary logistic regression were used to analyze the influencing factors of patients’ willingness to undertake a first visit to a PCI. Results Fewer patients in District D received medical alliance services (44.42%) than those in District F (59.25%), but patients in District D had a higher degree of satisfaction with the services they received (72.04%) than those in District F (28.96%). Patients in District D had a higher willingness to undertake a first visit (64.00%) than those in District F (58.18%). Patients of an older age, low medical expenses, participation in urban employees’ basic medical insurance, a high understanding of MAs and high satisfaction with medical services were indicators of being more willing to choose primary care institutions for their first visit. Conclusions The different medical resources and MA constructions in the two districts have resulted in a difference between the two districts in terms of the willingness of individuals to make their first visit to PCIs. Strengthening the service capabilities of PCIs remains a priority. The government should propose solutions to solve the problems encountered in practice and actively promote the realization of MAs and hierarchical diagnosis and treatment.

Purpose Standardised Training of Paediatric Resident (STPR) plays an essential role in training qualified paediatricians. Until now, China had no paediatric resident competency index system to effectively guide and evaluate the competence of paediatric residents. This study aimed to establish a competency index system for paediatric residents in China to provide a reference for improving the training system and quality of STPR.Study design and setting This study conducted two rounds of Delphi expert consultation survey among paediatric medical experts (n=16), followed by screening, revising and supplementing indicators using the boundary value method. Next, the analytic hierarchy process was used to determine the weight of indicators and finally establish a competency index system for paediatric residents.Results The results of the statistical analysis revealed a positive coefficient of 100% for both rounds of expert consultation. The expert authority coefficient values were 0.82 and 0.83, and the expert coordination coefficient test was p

Objective Since China launched its nationwide systemic healthcare reform in 2009, policies such as the elimination of drug markups and the reform of medical insurance payments have forced some hospitals into a crisis threatening their survival. Both public and private hospitals have been building and strengthening their capacity to achieve sustainable development. However, the existing research has not provided a comprehensive evaluation tool required to support this effort. Therefore, this study develops an organisational capability evaluation index system to help public and private hospitals assess their current conditions.Design The Delphi method was used to construct a hospital organisational capability evaluation index system in conjunction with the boundary value method and an analytic hierarchical process. Then, a questionnaire survey was administered in 55 hospitals (32 non-profit and 23 for-profit hospitals), and Cronbach’s α and a factor analysis were used to verify the index system’s reliability and validity.Setting and participants A literature review and semistructured interviews with 23 hospital managers and scholars clarified the definition of hospital organisational capability and formed an indicator pool. Additionally, 20 hospital directors were selected from public and private hospitals to participate in two rounds of the Delphi consultation.Results The Delphi consultation resulted in an index system including 12 primary and 40 secondary indicators demonstrated to be reliable and valid. The three indicators with the largest weights were ‘regulation capability’ (0.251), ‘decision-making capability’ (0.121) and ‘executive capability’ (0.105).Conclusion This study constructed an index system based on theoretical and practical considerations, and is expected to be applied to quantitatively evaluate the organisational capability of both public and private hospitals in China, and support their adaptation to external environmental changes.

Horse botflies have been a threat to the Przewalski's horses in the Kalamaili Nature Reserve in Xinjiang of China since their reintroduction to the original range. As larvae of these parasites could infest the intestine of a horse for months, they could interact with and alter the structure and composition of its intestinal microbiota, affecting adversely its health. Nonetheless, there are no such studies on the rewilded Przewalski's horses yet. For the first time, this study characterizes the composition of the intestinal microbiota of 7 rewilded Przewalski's horses infected severely by Gasterophilus pecorum following and prior to their anthelmintic treatment. Bioinformatics analyses of the sequence data obtained by amplicon high throughput sequencing of bacterial 16S rRNA genes showed that G. pecorum infestation significantly increased the richness of the intestinal microbial community but not its diversity. Firmicutes and Bacteroidetes were found the dominant phyla as in other animals, and the parasitic infestation decreased the F/B ratio largely by over 50%. Large reduction in relative abundances of the two genera Streptococcus and Lactobacillus observed with G. pecorum infestation suggested possible changes in colic and digestion related conditions of the infected horses. Variations on the relative abundance of the genus groups known to be pathogenic or symbiotic showed that adverse impact of the G. pecorum infestation could be associated with reduction of the symbiotic genera Lactobacillus and Bifidobacterium that are probiotics and able to promote immunity against parasitic infection.