新医改背景下中国区域卫生信息化发展路径研究 = Developmental approaches of regional health informatization in China in the context of new medical reform : a comparative analysis

University of Technology, Sydney. Institute for International Studies.新医改方案颁布之后，解决中国医疗信息化发展的重点及难点就成了顺利推进医改工作的首要任务。新医改的推进，对区域卫生信息化工作的要求也越来越明确，即通过信息技术实现医疗卫生服务各个环节的协同和整合，使公众能够得到最好的医疗服务，解决长久以来看病难、看病贵、看病烦的问题。文章从中国新医改的实际情况出发，运用有关的学术理论，系统深入地探讨了中国区域卫生信息化的发展问题。文章针对的是中国区域卫生信息化的发展路径，研究的重点是为什么要进行区域卫生信息化、政府和市场在区域卫生信息化过程中的角色和作用分别是怎样的、怎样的发展路径才是可持续的等等。 全文共分为六章，第一章对全文作一个基本的交待，主要介绍研究问题、研究意义、文献综述、概念界定和研究方法等。第二章试图借助于供给与付费分离的理论、利益相关者理论和协同治理理论构建一个用于分析中国区域卫生信息化的发展路径的框架。第三章偏重从新医改的背景来观察中国区域卫生信息化的现状与发展，认为在新医改的推动下，中国卫生信息化建设走上了一条从无到有、从小到大、从被忽视到受重视的发展之路，取得了显著的成绩。但是，对照深化医药卫生体制改革的目标要求，中国卫生信息化建设尚处于探索阶段。第四章侧重探讨政府主导模式的成效与问题。由于区域卫生信息化建设内容庞杂，牵涉政府、医院、市场和群众等多个利益主体，本章首先运用利益相关者理论对各利益主体及其利益进行了分析，在此基础上对政府主导的区域卫生信息化模式进行了探讨，重点分析了这种模式的历史渊源、现实条件与所存争论。第五章重点探讨作为替代的市场主导模式，通过与政府主导模式相比较，分析市场的优势。文章认为，向全体人民提供基本公共服务是政府的责任，这就要求科学界定政府职能与市场功能的边界，准确区分公共服务与非公共服务、基本公共服务与一般性公共服务。在澄清区域卫生信息化并非基本公共服务的基础上，文章对市场化的概念作出了必要的澄清，并对政府的角色进行了恰当的限制，认为政府应该在中国区域卫生信息化中大有作为，自觉地充当好“规划者”、“出资者”和“监管者”的角色，但不是在信息化过程中发挥所谓的“主导作用”。文章最后就如何进一步健全和完善中国区域卫生信息化建设提出了对策性建议。 The development of China's Regional Health Informatization (RHI) becomes the primary task of New Medical Reform (NMR) since 2009. The advancing of NMR has put forward clear requests on RHI, that is, making the public enjoying the best medical care, and solving the difficult problems of inadequate and overly expensive medical services through the improvement of information technology. This dissertation mainly discusses the development issue of China's RHI with the academic support of relevant theories and practical basis of Chinese medical reforms, and focuses on the backgrounds of RHI, different roles of government and market in RHI, different development approaches of RHI, etc. This dissertation can be divided into 6 chapters, and the contents of each chapter are as follows: Chapter one is the introduction. It brings forward the research questions. Then the key concepts are defined. After the literature review this part introduces the research method adopted and explains the reasons. Finally the so-called fragmentation theory as the research perspective and the analysis framework are introduced here. Chapter two resorts to such theories as the dichotomy of provision and financing,the stakeholder theory and collaborative governance theory, in order to frame an analysis basis for China's RHI. Chapter three describes the merits and disadvantages of China's RHI under the background of China's NMR. It concludes that the performance of RHI is obvious and the questions are unavoidable. Chapter four explains the causes which result in the current government-leading development approach of China's RHI. The causes of the current approach include the difference of multiple stakeholders, the historical path-dependence, the transition of value dimensions, and practical conditions. In addition, this paper tries to explore the theory debates on the approach. Chapter five evaluates the effect of market-leading development approach of China's RHI by comparing with government-leading approach. This article suggests that in order to clarify the boundary of government and market in RHI, it is necessary to distinguish between the public service and non-public service, and fundamental public service and general public service. It argues that since RHI is not a fundamental public service, the rights of choice should be open to all stakeholders. Government should act as a planner, investor and supervisor, but not a leading role

A quantitative trait locus for the number of days from sowing to seedling emergence in maize

Quantitative trait locus (QTL) mapping provides useful information for breeding programs since it allows the estimation of genomic locations and genetic effects of chromosomal regions related to the expression of quantitative traits. The number of days from sowing to seedling emergence (NDSSE) is an important agronomic trait in a maize (Zea mays L.) breeding project which is related to yield. To determine its genetic basis, a recombinant inbred line (RIL) population and two nitrogen (N) regimes were used to detect the QTLs associated with NDSSE; as a result, one QTL was identified under high N regime, on chromosome 9, which could explain 6.20% of phenotypic variance and a decrease of 0.18 of NDSSE due to an additive effect. These results are beneficial for understanding the genetic basis of NDSSE in maize breeding project.Key words: Maize (Zea mays L.), quantitative trait locus, recombinant inbred line, nitrogen

Inferring short-term volatility indicators from Bitcoin blockchain

In this paper, we study the possibility of inferring early warning indicators (EWIs) for periods of extreme bitcoin price volatility using features obtained from Bitcoin daily transaction graphs. We infer the low-dimensional representations of transaction graphs in the time period from 2012 to 2017 using Bitcoin blockchain, and demonstrate how these representations can be used to predict extreme price volatility events. Our EWI, which is obtained with a non-negative decomposition, contains more predictive information than those obtained with singular value decomposition or scalar value of the total Bitcoin transaction volume

Requirement of RIZ1 for cancer prevention by methyl-balanced diet

The typical Western diet is not balanced in methyl nutrients that regulate the level of the methyl donor S-adenosylmethionine (SAM) and its derivative metabolite S-adenosylhomocysteine (SAH), which in turn may control the activity of certain methyltransferases. Feeding rodents with amino acid defined and methyl-imbalanced diet decreases hepatic SAM and causes liver cancers. RIZ1 (PRDM2 or KMT8) is a tumor suppressor and functions in transcriptional repression by methylating histone H3 lysine 9. Here we show that a methyl-balanced diet conferred additional survival benefits compared to a tumor-inducing methyl-imbalanced diet only in mice with wild type RIZ1 but not in mice deficient in RIZ1. While absence of RIZ1 was tumorigenic in mice fed the balanced diet, its presence did not prevent tumor formation in mice fed the imbalanced diet. Unlike most of its related enzymes, RIZ1 was upregulated by methyl-balanced diet. Methyl-balanced diet did not fully repress oncogenes such as c-Jun in the absence of RIZ1. The data identify RIZ1 as a critical target of methyl-balanced diet in cancer prevention. The molecular understanding of dietary carcinogenesis may help people make informed choices on diet, which may greatly reduce the incidence of cancer

Which game narratives do adolescents of different gameplay and sociodemographic backgrounds prefer? a mixed-methods analysis

OBJECTIVE: The aim of this study was to investigate which narrative elements of digital game narratives are preferred by the general adolescent population, and to examine associations with gender, socioeconomic status (SES), and gameplay frequency. Further, the study aims to discuss how results can be translated to serious digital games. MATERIALS AND METHODS: Adolescents were recruited through school to complete a survey on narrative preferences in digital games. The survey included questions on sociodemographic information, frequency of gameplay, and an open-ended question on what could be an appealing narrative for them. Data were analyzed in a mixed-methods approach, using thematic analysis and chi-square analyses to determine narrative preferences and the associations between game narrative elements and player characteristics (gender, SES, and frequency of gameplay). RESULTS: The sample consisted of 446 adolescents (12-15 years old) who described 30 narrative subthemes. Preferences included human characters as protagonists; nonhuman characters only as antagonists; realistic settings, such as public places or cities; and a strong conflict surrounding crime, catastrophe, or war. Girls more often than boys defined characters by their age, included avatars, located the narrative in private places, developed profession-related skills, and included a positive atmosphere. Adolescents of nonacademic education more often than adolescents of academic education defined characters by criminal actions. Infrequent players more often included human characters defined by their age than frequent players. After performing a Bonferroni correction, narrative preferences for several gender differences remained. CONCLUSION: Different narrative elements related to subgroups of adolescents by gender, SES, and frequency of gameplay. Customization of narratives in serious digital health games should be warranted for boys and girls; yet, further research is needed to specify how to address girls in particular

Improved Constraints on Sterile Neutrino Mixing from Disappearance Searches in the MINOS, MINOS+, Daya Bay, and Bugey-3 Experiments.

Searches for electron antineutrino, muon neutrino, and muon antineutrino disappearance driven by sterile neutrino mixing have been carried out by the Daya Bay and MINOS+ collaborations. This Letter presents the combined results of these searches, along with exclusion results from the Bugey-3 reactor experiment, framed in a minimally extended four-neutrino scenario. Significantly improved constraints on the θ_{μe} mixing angle are derived that constitute the most constraining limits to date over five orders of magnitude in the mass-squared splitting Δm_{41}^{2}, excluding the 90% C.L. sterile-neutrino parameter space allowed by the LSND and MiniBooNE observations at 90% CL_{s} for Δm_{41}^{2}<13  eV^{2}. Furthermore, the LSND and MiniBooNE 99% C.L. allowed regions are excluded at 99% CL_{s} for Δm_{41}^{2}<1.6 eV^{2}

Scanning and filling : ultra-dense SNP genotyping combining genotyping-by-sequencing, SNP array and whole-genome resequencing data

Genotyping-by-sequencing (GBS) represents a highly cost-effective high-throughput genotyping approach. By nature, however, GBS is subject to generating sizeable amounts of missing data and these will need to be imputed for many downstream analyses. The extent to which such missing data can be tolerated in calling SNPs has not been explored widely. In this work, we first explore the use of imputation to fill in missing genotypes in GBS datasets. Importantly, we use whole genome resequencing data to assess the accuracy of the imputed data. Using a panel of 301 soybean accessions, we show that over 62,000 SNPs could be called when tolerating up to 80% missing data, a five-fold increase over the number called when tolerating up to 20% missing data. At all levels of missing data examined (between 20% and 80%), the resulting SNP datasets were of uniformly high accuracy (96– 98%). We then used imputation to combine complementary SNP datasets derived from GBS and a SNP array (SoySNP50K). We thus produced an enhanced dataset of >100,000 SNPs and the genotypes at the previously untyped loci were again imputed with a high level of accuracy (95%). Of the >4,000,000 SNPs identified through resequencing 23 accessions (among the 301 used in the GBS analysis), 1.4 million tag SNPs were used as a reference to impute this large set of SNPs on the entire panel of 301 accessions. These previously untyped loci could be imputed with around 90% accuracy. Finally, we used the 100K SNP dataset (GBS + SoySNP50K) to perform a GWAS on seed oil content within this collection of soybean accessions. Both the number of significant marker-trait associations and the peak significance levels were improved considerably using this enhanced catalog of SNPs relative to a smaller catalog resulting from GBS alone at 20% missing data. Our results demonstrate that imputation can be used to fill in both missing genotypes and untyped loci with very high accuracy and that this leads to more powerful genetic analyses

Resonances in J/ψ→ϕπ+π−J/\psi \to \phi \pi ^+\pi ^- and ϕK+K−\phi K^+K^-

A partial wave analysis is presented of $J/\psi \to \phi \pi ^+\pi ^-$ and $\phi K^+K^-$ from a sample of 58M $J/\psi$ events in the BES II detector. The $f_0(980)$ is observed clearly in both sets of data, and parameters of the Flatt\' e formula are determined accurately: $M = 965 \pm 8$ (stat) $\pm 6$ (syst) MeV/c$^2$, $g_1 = 165 \pm 10 \pm 15$ MeV/c$^2$, $g_2/g_1 = 4.21 \pm 0.25 \pm 0.21$. The $\phi \pi \pi$ data also exhibit a strong $\pi \pi$ peak centred at $M = 1335$ MeV/c$^2$. It may be fitted with $f_2(1270)$ and a dominant $0^+$ signal made from $f_0(1370)$ interfering with a smaller $f_0(1500)$ component. There is evidence that the $f_0(1370)$ signal is resonant, from interference with $f_2(1270)$. There is also a state in $\pi \pi$ with $M = 1790 ^{+40}_{-30}$ MeV/c$^2$ and $\Gamma = 270 ^{+60}_{-30}$ MeV/c$^2$; spin 0 is preferred over spin 2. This state, $f_0(1790)$, is distinct from $f_0(1710)$. The $\phi K\bar K$ data contain a strong peak due to $f_2'(1525)$. A shoulder on its upper side may be fitted by interference between $f_0(1500)$ and $f_0(1710)$.Comment: 17 pages, 6 figures, 1 table. Submitted to Phys. Lett.

Measurement of the Branching Fraction of J/psi --> pi+ pi- pi0

Using 58 million J/psi and 14 million psi' decays obtained by the BESII experiment, the branching fraction of J/psi --> pi+ pi- pi0 is determined. The result is (2.10+/-0.12)X10^{-2}, which is significantly higher than previous measurements.Comment: 9 pages, 8 figures, RevTex

Search for K_S K_L in psi'' decays

K_S K_L from psi'' decays is searched for using the psi'' data collected by BESII at BEPC, the upper limit of the branching fraction is determined to be B(psi''--> K_S K_L) < 2.1\times 10^{-4} at 90% C. L. The measurement is compared with the prediction of the S- and D-wave mixing model of the charmonia, based on the measurements of the branching fractions of J/psi-->K_S K_L and psi'-->K_S K_L.Comment: 5 pages, 1 figur