Health care utilisation amongst Shenzhen migrant workers: does being insured make a difference?

<p>Abstract</p> <p>Background</p> <p>As one of the most populous metropolitan areas in the Pearl River Delta of South China, Shenzhen attracts millions of migrant workers annually. The objectives of this study were to compare health needs, self-reported health and healthcare utilisation of insured and uninsured migrant workers in Shenzhen, China, where a new health insurance scheme targeting at migrant workers was initiated.</p> <p>Methods</p> <p>A cross-sectional survey using multi-staged sampling was conducted to collect data from migrant factory workers. Statistical tests included logistic regression analysis were used.</p> <p>Results</p> <p>Among 4634 subjects (96.54%) who responded to the survey, 55.11% were uninsured. Disease patterns were similar irrespective of insurance status. The uninsured were more likely to be female, single, younger and less educated unskilled labourers with a lower monthly income compared with the insured. Out of 1136 who reported illness in the previous two weeks, 62.15% did not visit a doctor. Of the 296 who were referred for inpatient care, 48.65% did not attend because of inability to pay. Amongst those who reported sickness, 548 were insured and 588 were uninsured.</p> <p>Those that were insured, and had easier access to care were more likely to make doctor visits than those who were uninsured.</p> <p>Conclusion</p> <p>Health care utilisation patterns differ between insured and uninsured workers and insurance status appears to be a significant factor. The health insurance system is inequitably distributed amongst migrant workers. Younger less educated women who are paid less are more likely to be uninsured and therefore to pay out of pocket for their care. For greater equity this group need to be included in the insurance schemes as they develop.</p

Cardioprotection Effects of Sevoflurane by Regulating the Pathway of Neuroactive Ligand-Receptor Interaction in Patients Undergoing Coronary Artery Bypass Graft Surgery

This study was designed to identify attractor modules and further reveal the potential biological processes involving in sevoflurane-induced anesthesia in patients treated with coronary artery bypass graft (CABG) surgery. Microarray profile data (ID: E-GEOD-4386) on atrial samples obtained from patients receiving anesthetic gas sevoflurane prior to and following CABG procedure were downloaded from EMBL-EBI database for further analysis. Protein-protein interaction (PPI) networks of baseline and sevoflurane groups were inferred and reweighted according to Spearman correlation coefficient (SCC), followed by systematic modules inference using clique-merging approach. Subsequently, attract method was utilized to explore attractor modules. Finally, pathway enrichment analyses for genes in the attractor modules were implemented to illuminate the biological processes in sevoflurane group. Using clique-merging approach, 27 and 36 modules were obtained from the PPI networks of baseline and sevoflurane-treated samples, respectively. By comparing with the baseline condition, 5 module pairs with the same gene composition were identified. Subsequently, 1 out of 5 modules was identified as an attractor based on attract method. Additionally, pathway analysis indicated that genes in the attractor module were associated with neuroactive ligand-receptor interaction. Accordingly, sevoflurane might exert important functions in cardioprotection in patients following CABG, partially through regulating the pathway of neuroactive ligand-receptor interaction

Autophagy Is a Defense Mechanism Inhibiting Invasion and Inflammation During High-Virulent Haemophilus parasuis Infection in PK-15 Cells

Bacterial infections activate autophagy and autophagy restricts pathogens such as Haemophilus parasuis through specific mechanisms. Autophagy is associated with the pathogenesis of H. parasuis. However, the mechanisms have not been clarified. Here, we monitored autophagy processes using confocal microscopy, western blot, and transmission electron microscopy (TEM) and found that H. parasuis SH0165 (high-virulent strain) but not HN0001 (non-virulent strain) infection enhanced autophagy flux. The AMPK/mTOR autophagy pathway was required for autophagy initiation and ATG5, Beclin-1, ATG7, and ATG16L1 emerged as important components in the generation of the autophagosome during H. parasuis infection. Moreover, autophagy induced by H. parasuis SH0165 turned to fight against invaded bacteria and inhibit inflammation. Then we further demonstrated that autophagy blocked the production of the cytokines IL-8, CCL4, and CCL5 induced by SH0165 infection through the inhibition of NF-κB, p38, and JNK MAPK signaling pathway. Therefore, our findings suggest that autophagy may act as a cellular defense mechanism in response to H. parasuis and provide a new way that autophagy protects the host against H. parasuis infection

A multimodal intervention to improve hand hygiene compliance via social cognitive influences among kindergarten teachers in China

Children attending kindergarten are at high risk for contracting infections, for which hand hygiene (HH) has been recognized as the most cost-effective prevention measure globally. Kindergarten teachers’ HH behavior plays a vital role in encouraging favorable hygiene techniques and environment. This study aims to evaluate the effectiveness of a multimodal intervention at changing kindergarten teachers’ HH behavior and social cognitive factors that influences HH behavior in China

Clinical Characteristics of 26 Human Cases of Highly Pathogenic Avian Influenza A (H5N1) Virus Infection in China

BACKGROUND: While human cases of highly pathogenic avian influenza A (H5N1) virus infection continue to increase globally, available clinical data on H5N1 cases are limited. We conducted a retrospective study of 26 confirmed human H5N1 cases identified through surveillance in China from October 2005 through April 2008. METHODOLOGY/PRINCIPAL FINDINGS: Data were collected from hospital medical records of H5N1 cases and analyzed. The median age was 29 years (range 6-62) and 58% were female. Many H5N1 cases reported fever (92%) and cough (58%) at illness onset, and had lower respiratory findings of tachypnea and dyspnea at admission. All cases progressed rapidly to bilateral pneumonia. Clinical complications included acute respiratory distress syndrome (ARDS, 81%), cardiac failure (50%), elevated aminotransaminases (43%), and renal dysfunction (17%). Fatal cases had a lower median nadir platelet count (64.5 x 10(9) cells/L vs 93.0 x 10(9) cells/L, p = 0.02), higher median peak lactic dehydrogenase (LDH) level (1982.5 U/L vs 1230.0 U/L, p = 0.001), higher percentage of ARDS (94% [n = 16] vs 56% [n = 5], p = 0.034) and more frequent cardiac failure (71% [n = 12] vs 11% [n = 1], p = 0.011) than nonfatal cases. A higher proportion of patients who received antiviral drugs survived compared to untreated (67% [8/12] vs 7% [1/14], p = 0.003). CONCLUSIONS/SIGNIFICANCE: The clinical course of Chinese H5N1 cases is characterized by fever and cough initially, with rapid progression to lower respiratory disease. Decreased platelet count, elevated LDH level, ARDS and cardiac failure were associated with fatal outcomes. Clinical management of H5N1 cases should be standardized in China to include early antiviral treatment for suspected H5N1 cases

Human Cytomegalovirus IE1 Protein Elicits a Type II Interferon-Like Host Cell Response That Depends on Activated STAT1 but Not Interferon-γ

Human cytomegalovirus (hCMV) is a highly prevalent pathogen that, upon primary infection, establishes life-long persistence in all infected individuals. Acute hCMV infections cause a variety of diseases in humans with developmental or acquired immune deficits. In addition, persistent hCMV infection may contribute to various chronic disease conditions even in immunologically normal people. The pathogenesis of hCMV disease has been frequently linked to inflammatory host immune responses triggered by virus-infected cells. Moreover, hCMV infection activates numerous host genes many of which encode pro-inflammatory proteins. However, little is known about the relative contributions of individual viral gene products to these changes in cellular transcription. We systematically analyzed the effects of the hCMV 72-kDa immediate-early 1 (IE1) protein, a major transcriptional activator and antagonist of type I interferon (IFN) signaling, on the human transcriptome. Following expression under conditions closely mimicking the situation during productive infection, IE1 elicits a global type II IFN-like host cell response. This response is dominated by the selective up-regulation of immune stimulatory genes normally controlled by IFN-γ and includes the synthesis and secretion of pro-inflammatory chemokines. IE1-mediated induction of IFN-stimulated genes strictly depends on tyrosine-phosphorylated signal transducer and activator of transcription 1 (STAT1) and correlates with the nuclear accumulation and sequence-specific binding of STAT1 to IFN-γ-responsive promoters. However, neither synthesis nor secretion of IFN-γ or other IFNs seems to be required for the IE1-dependent effects on cellular gene expression. Our results demonstrate that a single hCMV protein can trigger a pro-inflammatory host transcriptional response via an unexpected STAT1-dependent but IFN-independent mechanism and identify IE1 as a candidate determinant of hCMV pathogenicity

Experimental Study on Long-Term Performance of Concrete T-Beam

In recent years, long-span concrete bridges that have been built frequently expose the problems of excessive deflection and concrete cracking, which even lead to bridge collapse in serious cases. The reason is that, in addition to the insufficient estimation of creep and long-term deflection in current regulations, the rapid growth of traffic volume and the tight use of early-age concrete in construction schedules also have a great impact on long-term deflection. However, at present, the calculation methods of long-term performance are mostly based on the results of material performance tests. However, there are relatively few studies that take bridge components as research objects and consider the influence of load and age factors. The long-term performance of concrete beams is examined and the calculation methods of long-term performance are given by considering various loading levels and ages. Specimens are fabricated using a 1:4 scale model of a standard T-beam with a length of 20 m to conduct the experiment. Based on the long-term observation of the test beam, the variation laws of the mid-span deflection of the concrete T-beam and the concrete strain in the compression zone with time are obtained under the aforementioned conditions. Following a comparative analysis of experimental results with computational results based on existing studies and relevant national and international codes, this study proposes and discusses a set of formulas for the assessment of shrinkage and creep. The obtained creep coefficient test results fall between the values of the Chinese specification and those of AASHTO, where ASSTO is the lower limit and the Chinese specification is the upper limit. The long-term deflection is as follows: 40% of the one-year value at one month, 66% of the one-year value at three months, and 80% of the one-year value at six months. However, the long-term deflection coefficient of beams with an early loading age is larger than the current standard, and the deflection coefficient of T-beams with three-day loading age reaches 6.0. We compare and discuss the test results with the calculation results and related codes obtained in different studies conducted at home and abroad. Based on our present findings, we propose formulas for shrinkage and creep evaluations

Fe-N-C Catalyst Derived from MOFs with Enhanced Catalytic Performance for Selective Oxidation of Emerging Contaminants

Fe-N-C/peroxymonosulfate (PMS) systems have demonstrated selective oxidation of pollutants, but the underlying mechanism and reasons for variability remain unclear. In this work, we synthesized a highly active Fe-N-C catalyst derived from MOFs using a pyrolysis protection strategy. We assessed its catalytic activity by employing PMS as an activator for pollutant degradation. The presence of Fe-Nx sites favored the catalytic performance of FeMIL-N-C, exhibiting 23 times higher activity compared to N-C. Moreover, we investigated the degradation performance and mechanism of the FeMIL-N-C/PMS system through both experimental and theoretical analyses, focusing on pollutants with diverse electronic structures, namely bisphenol A (BPA) and atrazine (ATZ)N-C. Our findings revealed that the degradation of ATZ primarily follows the free radical pathway, whereas BPA degradation is dominated by electron transfer pathways. Specifically, pollutants with a low LUMO- HOMO energy gap (BPA) can be degraded via the FeMIL-N-C/PMS system through the electron transfer pathway. Conversely, pollutants with a high LUMO-HOMO energy gap (ATZ) exhibit limited electron donation and predominantly undergo degradation through the free radical pathway. This work introduces novel insights into the mechanisms underlying the selective oxidation of pollutants, facilitating a deeper understanding of effective pollutant removal strategies

Polystyrene-bound diethanolamine based ionic liquids for chemical fixation of CO2

Polystyrene-bound diethanolamine based ionic liquids (PS-DHEEAB and PS-THEAB) were synthesized and applied for the chemical fixation of CO2 into cyclic carbonates without any additional co-catalyst and solvent. The effect of the catalysts with different number of hydroxyl group in the cation of the IL on the reaction was systematically investigated. Highest activity and selectivity were achieved in the presence of polystyrene supported diethanolamine ethyl bromide (PS-DHEEAB) in comparison with other catalysts employed. The catalyst was tough in stability and also found to be extended to a variety of terminal epoxides and aziridines. The relationship between high catalytic reactivity and the -OH functional groups was proposed. (C) 2012 Elsevier Ltd. All rights reserved