Reimbursement and hospital competition in China

Quality and the costs of health care are of concern among patients. Differing from previous research into hospital competition, this article captures the impact of price subsidy of public hospitals on the quality of private hospitals, considering both horizontal and vertical product differentiation by employing a two-stage dynamic game under Cournot and Stackelberg competition. Firstly, the results of this study indicate that medical reimbursement of public hospitals has stimulating effects on the quality of private hospitals and the improvement of quality is related to the degree of hospital competition. Second, the quality of health care and patients’ surplus and social welfare are the highest under Stackelberg competition if the public hospital is the leader while the private hospital is the follower. Finally, the demand for health care rises with the price subsidy of public hospitals. These conclusions have significant policy implications for health care system reform, especially for China

Effects of celebrity endorsement on firms’ competition: from industrial organisation perspective

Product endorsement is employed by many firms and most studies have proceeded based on management perspectives and ignored the strategic effects (or indirect effects). However, as a non-price competition, product endorsement behaviour’s strategic effects are valuable to be considered and convenient to be captured by industrial organisation perspective. So, this paper’s purpose is to reveal the strategic effects of product endorsement by industrial organisation perspective. First, the results of this paper show that celebrity endorsement decreases the rival’s benefits. Second, under a unique endorser, the lower efficiency (measured by marginal production cost) firm’s celebrity endorsement improves price difference and dispersion, which are direct effects of product endorsement. The higher efficiency firm’s endorsement promotes the producer surplus, consumer surplus and social welfare, which are called indirect effects. Finally, celebrity endorsement has trigger effects. If one firm launches celebrity endorsement, the rational reaction for its rivals is also to engage in a similar behaviour. This paper expands the celebrity endorsement issue from management to economics perspective

Utilization and Predictors of adjuvant Metformin For Children and adolescents On Mixed Receptor antagonists (Second-Generation antipsychotics)

OBJECTIVE: to examine utilization and predictors of adjuvant metformin among pediatric recipients of second-generation antipsychotics (SGAs) (mixed receptor antagonist). METHOD: This study used 2016-2021 data of a national electronic medical record database. Eligible participants were children aged 6 to 17 with a new SGA prescription for at least 90 days. Predictors of prescribing adjuvant metformin in general and to nonobese pediatric SGA recipients in particular were assessed using conditional logistic regression and logistic regression analyses, respectively. RESULTS: Of 30,009 pediatric SGA recipients identified, 2.3% (n = 785) received adjuvant metformin. Among 597 participants with a body mass index z score documented during the 6-month period before metformin initiation, 83% were obese, and 34% had either hyperglycemia or diabetes. Significant predictors for metformin prescribing were high baseline body mass index z score (odds ratio [OR] 3.5, 95% CI 2.8-4.5, p \u3c .0001), having hyperglycemia or diabetes (OR 5.3, 95% CI 3.4-8.3, p \u3c .0001), and undergoing a switch from a higher metabolic risk SGA to a lower risk one (OR 9.9, 95% CI 3.5-27.5, p = .0025) or a switch in the opposite direction (OR 4.1, 95% CI 2.1-7.9, p = .0051) compared with no switch. Nonobese metformin users were more likely to have a positive body mass index z score velocity before metformin initiation than their obese counterparts. Receiving the index SGA prescribed by a mental health specialist was associated with higher likelihood of receiving adjuvant metformin and receiving metformin before the development of obesity. CONCLUSION: Utilization of adjuvant metformin among pediatric SGA recipients is uncommon, and early introduction of the medication among nonobese children is rare

CXCL-8 Regulates Head and Neck Carcinoma Progression through NOD Signalling Pathway

Head and neck squamous cell carcinoma (HNSCC) ranks sixth among the most common cancers in the world. Interlukin-8 (CXCL-8), a major role in inflammatory response and tumor microenvironment, correlates with tumor progression, metastasis and invasion. We explored CXCL-8 promotes tumor progression in different differentiation HNSCC cells. This project would apply to development on biomarker and target in HNSCC as well as provide a basis of early diagnosis and treatment for clinical. CXCL-8, NOD1 (nucleotide-binding oligomerization domain-containing protein 1) and receptor-interacting protein kinase (RIPK2) levels were detected statistically higher in patient tissue with HNSCC than in non-cancerous matched tissue (NCMT) in the microarray and qRT-PCR study, whereas NOD2 was weakly expressed. Similar results were obtained for CXCL-8, NOD1, NOD2 and RIP2 from RT-PCR and western blotting. High CXCL-8, NOD1 and RIP2 expressions were found on HNSCC patient tissue than that of NCMT, whereas NOD2 was weakly expressed. The analytical results indicate that CXCL-8 is required in NOD 1-mediated signalling pathways in HNSCC

Plasma biomarkers inclusive of α-synuclein/amyloid-beta40 ratio strongly correlate with Mini-Mental State Examination score in Parkinson's disease and predict cognitive impairment

Plasma biomarkers for Parkinson’s disease (PD) diagnosis that carry predictive value for cognitive impairment are valuable. We explored the relationship of Mini-Mental State Examination (MMSE) score with plasma biomarkers in PD patients and compared results to vascular dementia (VaD) and normal controls. The predictive accuracy of an individual biomarker on cognitive impairment was evaluated using area under the receiver operating characteristic curve (AUROC), and multivariate logistic regression was applied to evaluate predictive accuracy of biomarkers on cognitive impairment; 178 subjects (41 PD, 31 VaD and 106 normal controls) were included. In multiple linear regression analysis of PD patients, α-synuclein, anti-α-synuclein, α-synuclein/Aβ40 and anti-α-synuclein/Aβ40 were highly predictive of MMSE score in both full model and parsimonious model (R2 = 0.838 and 0.835, respectively) compared to non-significant results in VaD group (R2 = 0.149) and in normal controls (R2 = 0.056). Α-synuclein and anti-α-synuclein/Aβ40 were positively associated with MMSE score, and anti-α-synuclein, α-synuclein/Aβ40 were negatively associated with the MMSE score among PD patients (all Ps < 0.005). In the AUROC analysis, anti-α-synuclein (AUROC = 0.788) and anti-α-synuclein/Aβ40 (AUROC = 0.749) were significant individual predictors of cognitive impairment. In multivariate logistic regression, full model of combined biomarkers showed high accuracy in predicting cognitive impairment (AUROC = 0.890; 95%CI 0.796–0.984) for PD versus controls, as was parsimonious model (AUROC = 0.866; 95%CI 0.764–0.968). In conclusion, simple combination of biomarkers inclusive of α-synuclein/Aβ40 strongly correlates with MMSE score in PD patients versus controls and is highly predictive of cognitive impairment

Tyrosinase Inhibitory Effect and Antioxidative Activities of Fermented and Ethanol Extracts of Rhodiola rosea

This is the first study to investigate the biological activities of fermented extracts of Rhodiola rosea L. (Crassulaceae) and Lonicera japonica Thunb. (Caprifoliaceae). Alcaligenes piechaudii CC-ESB2 fermented and ethanol extracts of Rhodiola rosea and Lonicera japonica were prepared and the antioxidative activities of different concentrations of samples were evaluated using in vitro antioxidative assays. Tyrosinase inhibition was determined by using the dopachrome method with L-DOPA as substrate. The results demonstrated that inhibitory effects (ED50 values) on mushroom tyrosinase of fermented Rhodiola rosea, fermented Lonicera japonica, ethanol extract of Lonicera japonica, and ethanol extract of Rhodiola rosea were 0.78, 4.07, 6.93, and >10 mg/ml, respectively. The DPPH scavenging effects of fermented Rhodiola rosea (ED50 = 0.073 mg/ml) and fermented Lonicera japonica (ED50 = 0.207 mg/ml) were stronger than effects of their respective ethanol extracts. Furthermore, the scavenging effect increases with the presence of high content of total phenol. However, the superoxide scavenging effects of fermented Rhodiola rosea was less than effects of fermented Lonicera japonica. The results indicated that fermentation of Rhodiola rosea and Lonicera japonica can be considered as an effective biochemical process for application in food, drug, and cosmetics

Lagrangian Floer superpotentials and crepant resolutions for toric orbifolds

We investigate the relationship between the Lagrangian Floer superpotentials for a toric orbifold and its toric crepant resolutions. More specifically, we study an open string version of the crepant resolution conjecture (CRC) which states that the Lagrangian Floer superpotential of a Gorenstein toric orbifold $\mathcal{X}$ and that of its toric crepant resolution $Y$ coincide after analytic continuation of quantum parameters and a change of variables. Relating this conjecture with the closed CRC, we find that the change of variable formula which appears in closed CRC can be explained by relations between open (orbifold) Gromov-Witten invariants. We also discover a geometric explanation (in terms of virtual counting of stable orbi-discs) for the specialization of quantum parameters to roots of unity which appears in Y. Ruan's original CRC ["The cohomology ring of crepant resolutions of orbifolds", Gromov-Witten theory of spin curves and orbifolds, 117-126, Contemp. Math., 403, Amer. Math. Soc., Providence, RI, 2006]. We prove the open CRC for the weighted projective spaces $\mathcal{X}=\mathbb{P}(1,\ldots,1,n)$ using an equality between open and closed orbifold Gromov-Witten invariants. Along the way, we also prove an open mirror theorem for these toric orbifolds.Comment: 48 pages, 1 figure; v2: references added and updated, final version, to appear in CM

Spatiotemporal analysis of air pollution and asthma patient visits in Taipei, Taiwan

[[abstract]]Background: Buffer analyses have shown that air pollution is associated with an increased incidence of asthma, but little is known about how air pollutants affect health outside a defined buffer. The aim of this study was to better understand how air pollutants affect asthma patient visits in a metropolitan area. The study used an integrated spatial and temporal approach that included the Kriging method and the Generalized Additive Model (GAM). Results: We analyzed daily outpatient and emergency visit data from the Taiwan Bureau of National Health Insurance and air pollution data from the Taiwan Environmental Protection Administration during 2000-2002. In general, children (aged 0-15 years) had the highest number of total asthma visits. Seasonal changes of PM10, NO2, O3 and SO2 were evident. However, SO2 showed a positive correlation with the dew point (r = 0.17, p < 0.01) and temperature (r = 0.22, p < 0.01). Among the four pollutants studied, the elevation of NO2 concentration had the highest impact on asthma outpatient visits on the day that a 10% increase of concentration caused the asthma outpatient visit rate to increase by 0.30% (95% CI: 0.16%??.45%) in the four pollutant model. For emergency visits, the elevation of PM10 concentration, which occurred two days before the visits, had the most significant influence on this type of patient visit with an increase of 0.14% (95% CI: 0.01%??.28%) in the four pollutants model. The impact on the emergency visit rate was non-significant two days following exposure to the other three air pollutants. Conclusion: This preliminary study demonstrates the feasibility of an integrated spatial and temporal approach to assess the impact of air pollution on asthma patient visits. The results of this study provide a better understanding of the correlation of air pollution with asthma patient visits and demonstrate that NO2 and PM10 might have a positive impact on outpatient and emergency settings respectively. Future research is required to validate robust spatiotemporal patterns and trends

UMARS: Un-MAppable Reads Solution

[[abstract]]Background: Un-MAppable Reads Solution (UMARS) is a user-friendly web service focusing on retrieving valuable information from sequence reads that cannot be mapped back to reference genomes. Recently, next-generation sequencing (NGS) technology has emerged as a powerful tool for generating high-throughput sequencing data and has been applied to many kinds of biological research. In a typical analysis, adaptor-trimmed NGS reads were first mapped back to reference sequences, including genomes or transcripts. However, a fraction of NGS reads failed to be mapped back to the reference sequences. Such un-mappable reads are usually imputed to sequencing errors and discarded without further consideration.Methods: We are investigating possible biological relevance and possible sources of un-mappable reads. Therefore, we developed UMARS to scan for virus genomic fragments or exon-exon junctions of novel alternative splicing isoforms from un-mappable reads. For mapping un-mappable reads, we first collected viral genomes and sequences of exon-exon junctions. Then, we constructed UMARS pipeline as an automatic alignment interface.Results: By demonstrating the results of two UMARS alignment cases, we show the applicability of UMARS. We first showed that the expected EBV genomic fragments can be detected by UMARS. Second, we also detected exon-exon junctions from un-mappable reads. Further experimental validation also ensured the authenticity of the UMARS pipeline. The UMARS service is freely available to the academic community and can be accessed via http://musk.ibms.sinica.edu.tw/UMARS/.Conclusions: In this study, we have shown that some un-mappable reads are not caused by sequencing errors. They can originate from viral infection or transcript splicing. Our UMARS pipeline provides another way to examine and recycle the un-mappable reads that are commonly discarded as garbage