How Poverty, Residence Status and Health Insurance Predict Unmet Healthcare Needs among Chinese Elders?

This study focuses on the variability in unmet healthcare needs among vulnerable Chinese elders and the degree to which these unmet needs are associated with socioeconomic disadvantages. We use the 2013 wave of China Health and Retirement Longitudinal Study (CHARLS) and a multinomial logistic model to investigate how poverty, residence status and particular health insurance schemes influence unmet healthcare needs independently and in combination. Our results show that poverty and rural residence are strong predictors of unmet healthcare needs due to financial and non-financial constraints, respectively. Although health insurance can reduce financial barriers, its influence varies with different insurance schemes, thus generating unequal healthcare access among heterogeneous vulnerable subgroups of elders and putting poor rural migrants at the highest risk for unmet healthcare needs. Our findings direct attention to the differences in resources available to various subgroups of elders and the importance of social stratification in predicting unmet health care needs

Enhancing Treatment Effect Estimation: A Model Robust Approach Integrating Randomized Experiments and External Controls using the Double Penalty Integration Estimator

Randomized experiments (REs) are the cornerstone for treatment effect evaluation. However, due to practical considerations, REs may encounter difficulty recruiting sufficient patients. External controls (ECs) can supplement REs to boost estimation efficiency. Yet, there may be incomparability between ECs and concurrent controls (CCs), resulting in misleading treatment effect evaluation. We introduce a novel bias function to measure the difference in the outcome mean functions between ECs and CCs. We show that the ANCOVA model augmented by the bias function for ECs renders a consistent estimator of the average treatment effect, regardless of whether or not the ANCOVA model is correct. To accommodate possibly different structures of the ANCOVA model and the bias function, we propose a double penalty integration estimator (DPIE) with different penalization terms for the two functions. With an appropriate choice of penalty parameters, our DPIE ensures consistency, oracle property, and asymptotic normality even in the presence of model misspecification. DPIE is more efficient than the estimator derived from REs alone, validated through theoretical and experimental results

Feedback vertex number of Sierpi\'{n}ski-type graphs

The feedback vertex number $\tau(G)$ of a graph $G$ is the minimum number of vertices that can be deleted from $G$ such that the resultant graph does not contain a cycle. We show that $\tau(S_p^n)=p^{n-1}(p-2)$ for the Sierpi\'{n}ski graph $S_p^n$ with $p\geq 2$ and $n\geq 1$. The generalized Sierpi\'{n}ski triangle graph $\hat{S_p^n}$ is obtained by contracting all non-clique edges from the Sierpi\'{n}ski graph $S_p^{n+1}$. We prove that $\tau(\hat{S}_3^n)=\frac {3^n+1} 2=\frac{|V(\hat{S}_3^n)|} 3$, and give an upper bound for $\tau(\hat{S}_p^n)$ for the case when $p\geq 4$

Trigonoside II mitigates sepsis-induced myocardial injury via reduction in oxidative stress and regulation of TLR- 4/NF-kB inflammatory pathway

Purpose: To investigate the protective effect of trigonoside II against sepsis-induced myocardial injury in rats, and the mechanism involved. Methods: Adult male Sprague Dawley rats (n = 30) weighing 200 - 230 g (mean weight = 215 ± 15 g) were used for this study. The rats were randomly assigned to 3 groups (10 rats/group): sham, cecal ligation puncture (CLP), and trigonoside II. Rats in the treatment group received trigonoside II at a dose of 2 mg/kg intraperitoneally (i.p.) at 3, 12 and 24 h post-surgery. Sepsis was induced using CLP method. Lactate  dehydrogenase (LDH) and creatine kinase (CK-MB) activities, and hemodynamic functions were determined in the rats. The levels of interleukin (IL)-1β and IL-6, and tumor necrosis factor α (TNF-α) were assayed in rat serum. Oxidative stress and myocardial cell apoptosis were determined by measuring malondialdehyde (MDA) levels, while activities of glutathione peroxidase (GPx), superoxide dismutase (SOD) and myeloperoxidase (MPO), as well as levels of expression of bax, bcl-2 and caspase-3 were also assessed. Results: Treatment of myocardial injury rats with trigonoside II led to significant reductions in the activities of LDH, CK-MB and MPO, and decreases in levels of IL-1β, IL-6 and TNF-α (p < 0.05). It also significantly reversed the effects of sepsis on rat hemodynamic functions (p < 0.05). Trigonoside IItreatment significantly reduced MDA levels in rat myocardial tissues, but significantly increased SOD and GPx activities (p < 0.05). It significantly down-regulated protein expressions of NF-kB and TLR-4 in myocardial tissues (p < 0.05). The number of apoptotic cells and activity of caspase-3 were significant increased in myocardial tissues of rats in CLP group, when compared with sham group, but were reduced significantly in myocardial tissues of trigonoside II-treated rats (p < 0.05). Similarly, trigonoside II treatment down-regulated the protein expressions of caspase-3 and bax, but upregulated bcl-2 protein expression in the rat myocardial tissues (p < 0.05). Conclusion: The results of this study indicate that trigonoside II confers protection on sepsis-induced myocardial injury via reduction in oxidative stress and regulation of TLR-4/NF-kB inflammatory pathway. Keywords: Cecal ligation puncture, Myocardial injury, Oxidative stress, Sepsis, Trigonoside I

Genome-wide characterization and expression of two-component system genes in cytokinin-regulated gall formation in Zizania latifolia

The thickening of Zizania latifolia shoots, referred to as gall formation, depends on infection with the fungal endophyte Ustilago esculenta. The swollen and juicy shoots are a popular vegetable in Asia. A key role for cytokinin action in this process was postulated. Here, trans-zeatin stimulated swelling in fungi-infected Z. latifolia. A two-component system (TCS) linked cytokinin binding to receptors with transcriptional regulation in the nucleus and played important roles in diverse biological processes. We characterized 69 TCS genes encoding for 25 histidine kinase/histidine-kinase-like (HK(L)) (21 HKs and 4 HKLs), 8 histidine phosphotransfer proteins (HP) (5 authentic and 3 pseudo), and 36 response regulators (RR; 14 type A, 14 type B, 2 type C, and 6 pseudo) in the genome of Z. latifolia. These TCS genes have a close phylogenetic relationship with their rice counterparts. Nineteen duplicated TCS gene pairs were found and the ratio of nonsynonymous to synonymous mutations indicated that a strong purifying selection acted on these duplicated genes, leading to few mutations during evolution. Finally, ZlCHK1, ZlRRA5, ZIRRA9, ZlRRA10, ZlPRR1, and ZlPHYA expression was associated with gall formation. Among them, ARR5, ARR9, and ZlPHYA are quickly induced by trans-zeatin, suggesting a role for cytokinin signaling in shoot swelling of Z. latifolia. Keywords: two-component system; Z. latifolia; shoot swelling; cytokinin signal