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Gravitational mass wasting on steep slopes plays an important role in permanent gully development. This is typically driven by hydrological processes in the head cut and the hydromechanical response within the soil mass. In this study, erosion intensities were observed in the head cuts of two permanent gullies in the mollisol region of Northeast China during the rainy and snow melting seasons. To understand the physical process, soil water storage and drainage capacity, and suction stress during the 111 d of the rainy season and 97 d of the snow melting season, critical parameters such as soil moisture, temperature, and precipitation were investigated. This analysis also examined the increase in pore water pressure, dissipation properties, and hydromechanical properties of the mollisols. Under the same confining stress, the mollisols in the interrupted head cut of Gully No. II increased more rapidly and dissipated pore water pressure more than at the uninterrupted head cut of Gully No I. The combination of the soil water characteristic curve and the hydraulic conductivity function indicates that the mollisols of Gully No. II had a higher air entry pressure and saturated hydraulic conductivity during the wetting and drying cycles than Gully No. I. The head cut area of Gully No. II exhibited rapid water infiltration and drainage responses during rain events, with a high soil water storage capacity during torrential rain, rainstorms, and snow melting seasons. The absolute suction stresses within the mollisols of Gully No. II was lower than that in Gully No. I, which could lead to high erosion per unit of steep slope area. Soil loss from gravitational mass wasting on steep slopes is closely related to soil suction stress and we observed a correlation between erosion per unit gully bed area and the soil water storage. These findings have deepened our understanding of the physical process of permanent gully development from the perspective of the hydrological and hydromechanical behavior of gully head cuts. [ABSTRACT FROM AUTHOR]

Background and objective: Developing harmonious doctor-patient relationships is a powerful way to promote the construction of a new pattern of medical reform in developing countries. We aim to analyze the effects of China's hierarchical medical system on doctor-patient relationships, thus contributing to China's medical and health system reform. Methods: With panel data on prefectural-level cities in China from 2012 to 2019, we used a time-varying difference-in-differences model to evaluate the effect of hierarchical medical treatment policy. Results: Hierarchical medical treatment policies can significantly improve doctor-patient relationships, and this conclusion is supported by various robustness tests. And improving doctor-patient relationships can be indirectly realized by the optimization of resource allocation and saving of medical costs. In addition, the marginal effect of the pilot policy on doctor-patient relationships decreased with age within the city population. In focal cities and cities with high levels of fiscal spending on health care, the effect of the pilot policy on doctor-patient relationships was stronger. Conclusion: While reinforcing the literature on the doctor-patient relationship, this study also provides a reference for further exploration of the pilot policy of hierarchical medical treatment and the development of new medical and health system reform in developing countries. [ABSTRACT FROM AUTHOR]

The N6-methyladenosine (m 6 A) modification of RNA is an emerging epigenetic regulatory mechanism that has been shown to participate in various pathophysiological processes. However, its involvement in modulating neuropathic pain is still poorly understood. In this study, we elucidate a functional role of the m 6 A demethylase alkylation repair homolog 5 (ALKBH5) in modulating trigeminal-mediated neuropathic pain. Peripheral nerve injury selectively upregulated the expression level of ALKBH5 in the injured trigeminal ganglion (TG) of rats. Blocking this upregulation in injured TGs alleviated trigeminal neuropathic pain, while mimicking the upregulation of ALKBH5 in intact TG neurons sufficiently induced pain-related behaviors. Mechanistically, histone deacetylase 11 downregulation induced by nerve injury increases histone H3 lysine 27 acetylation (H3K27ac), facilitating the binding of the transcription factor forkhead box protein D3 (FOXD3) to the Alkbh5 promoter and promoting Alkbh5 transcription. The increased ALKBH5 erases m 6 A sites in Htr3a messenger RNA (mRNA), resulting in an inability of YT521-B homology domain 2 (YTHDF2) to bind to Htr3a mRNA, thus causing an increase in 5-HT3A protein expression and 5-HT3 channel currents. Conversely, blocking the increased expression of ALKBH5 in the injured TG destabilizes nerve injury-induced 5-HT3A upregulation and reverses mechanical allodynia, and the effect can be blocked by 5-HT3A knockdown. Together, FOXD3-mediated transactivation of ALKBH5 promotes neuropathic pain through m 6 A-dependent stabilization of Htr3a mRNA in TG neurons. This mechanistic understanding may advance the discovery of new therapeutic targets for neuropathic pain management., Competing Interests: Competing interests statement:The authors declare no competing interest.