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ObjectiveTo analyze the cost changes of cervical cancer inpatients after the implementationof diagnosis related group (DRG) payment in public grade-A tertiary hospitals, and to provide reference for public hospitals to improve management strategies and optimize the utilization of medical insurance funds.MethodsCase data of cervical cancer patients discharged from a public grade-A tertiary hospital in Shandong Province from April to December 2021 (before the implementation of DRG) and from April to December 2022 (after the implementation of DRG) were retrospectively collected. Patients with medical insurance were treated as the policy group and patients with full self-payment were treated as the control group. The changes in the relevant indicators such as total hospitalization costs, drug costs and consumable costs of cervical cancer patients before and after the implementation of the DRG policy were analyzed using the double difference-in-difference (DID) method.ResultsA total of 10 383 hospitalized patients with cervical cancer were enrolled in this study, including 9711 cases in the policy group (including 5418 cases before the implementation of DRG and 4293 cases after the implementation of DRG) and 672 cases in the control group (including 426 cases before the implementation of DRG and 246 cases after the implementation of DRG). Compared with the pre-DRG policy implementation, there were no significant changes in the complication rate, mortality rate, unplanned rehospitalization rate within 30 days, and length of hospital stay between the patients in the policy group and the control group after the DRG policy implementation. However, the total cost of the policy group decreased from ￥11 453.49 to ￥8780.94 (a decrease of 23.33%), in which the cost of medicines decreased by ￥617.37 (a decrease of 25.17%), and the cost of consumables decreased by ￥28.93(a decrease of 28.49%). The results of the double DID mode showed that the total cost of hospitalization in the policy group decreased by 14.40%(R2=0.616, P < 0.05), the cost of medicines decreased by 13.80%(R2=0.364, P < 0.01), and the cost of consumables decreased by 15.40%(R2=0.565, P < 0.01) compared to the control group after the implementation of the DRG policy.ConclusionsThe implementation of DRG policy can reasonably reduce the cost of disease groups and achieve more effective utilization of medical resources on the basis of ensuring accurate clinical diagnosis and high treatment standards.

Solar-induced chlorophyll fluorescence (SIF) can accurately reflect the photosynthetic capacity of vegetation and information on the physiological status of vegetation, which is of great research significance and application value. However, the low resolution of the solar-induced chlorophyll fluorescence product of the inverse performance makes it difficult to perform fine-scale studies. Therefore, concerning the above problem, this study proposes a random-forest-based downscaling method based on random forest. We used MODIS reflectance data to analyze GOME-2 SIF data at 0.5° resolution over the Chinese mainland in 2011 and created a monthly SIF product at 0.05° resolution for the Chinese mainland through downscaling. Then we performed a veracity check on the downscaled SIF data, analyzed factors (land cover type, climate zone type, and DEM) that could affect its accuracy, and explored the feasibility of using MODIS data in future GOME-2 SIF downscaling studies. The results show that the downscaled SIF is in remarkable agreement with the GOME-2 SIF, with an improved spatial resolution from 0.5° to 0.05°, and that the structural and physiological information of the SIF is well represented in the downscaled SIF, which is essential for assessing global photosynthesis. In addition, in the region with grassland land cover type, temperate grassland climate region, alpine vegetation climate region of Qinghai–Tibet Plateau, as well as the region with high altitude and complex terrain, the accuracy of using MODIS to downscale the GOME-2 SIF data is low. [ABSTRACT FROM AUTHOR]

The photoelectrochemical biosensor based on double redox cycle amplification technology coupled with Tungsten diselenide and MXene-modified electrode was developed. Signal amplification technology is a commonly used method to improve the sensitivity. In this article, in the double redox cycle amplification method, p-aminophenol is used as the signal molecule, and squaric acid acts as a redox indicator. Tris(2-carboxyethyl) phosphine is an excellent reducing agent, which greatly improves the photoelectric response. Tungsten diselenide and MXene are used as photosensitive materials. In the presence of model target, respiratory syncytial virus RNA, the recombinase polymerase amplification process occurred because there is amplification template, so that the signal molecule p-aminophenol will be produced, leading to redox cycle was carried out, and the photocurrent signal is improved. In the absence of syncytial virus RNA, the photocurrent signal is low. The detection range of the biosensor is from 0.2 fM to 80 fM, and the detection limit reaches 30 aM for respiratory syncytial virus RNA. The method of introducing redox cycle amplification and Tungsten diselenide, MXene into photoelectrochemical biosensing provides a new idea for future biological analysis and has application potential., (Copyright © 2022 Elsevier B.V. All rights reserved.)