A quasi-experimental study of the volume-based procurement (VBP) effect on antiviral medications of hepatitis B virus in China

Background: The Pilot Plan of National Centralized Volume-Based Procurement (NCVBP) was adopted to cope with the rapid increase in drug expenditures. This research aimed to quantitatively evaluate the impact of the NCVBP on antiviral medications for the hepatitis B virus.Methods: Data on nucleoside analogs (NAs) medications of hepatitis B virus monthly procurement records in the pilot cities from January 2018 to December 2019 were extracted from the China Drug Supply Information Platform (CDSIP). The impacts of the NCVBP on purchased volumes, expenditures, and pre-defined daily dose costs were evaluated by interrupted time-series (ITS) analysis using Stata 16.0. We constructed two segments with one interruptive point (March 2019).Results: Compared to the same period between pre-and post-intervention, the purchased volume of NAs medications were increased by 92.85%, and selected medications were increased by 119.09%. Analysis of changes in the level of NAs medication followed a decrease in purchased expenditure (coefficient: 5364.88, p < 0.001), meanwhile, the purchased volume was increased with statistical significance (coefficient:605.49, p < 0.001). The Defined Daily Dose cost (DDDc) of NAs medication followed a decrease (coefficient: 8.90, p < 0.001). The NCVBP reform was followed by an increase of 618.41 ten thousand Defined Daily Dose (DDD) (p < 0.001) in purchased volume and a reduction of 5273.84 ten thousand Chinese Yuan (CNY) (p < 0.001) in the purchased expenditure of selected medications in the level. The DDDc of selected medications decreased in the level (coefficient: 9.87, p < 0.001), while the DDDc of alternative medications increased in the slope (coefficient:0.07, p = 0.030). The purchased volume and expenditure of bid-winning products increased by 964.08 ten thousand DDD and 637.36 ten thousand CNY in the level (p < 0.001). An increase of 633.46 ten thousand DDD (p < 0.001) in purchased volume and a reduction of 4285.32 ten thousand CNY (p < 0.001) in the purchased expenditure of generic drugs in the level was observed.Conclusion: The NCVBP reduced the DDDc of NAs medication, improved the utilization of the selected medications, and promoted the usage of generic products

Large effective magnetic fields from chiral phonons in rare-earth halides

Time-reversal symmetry (TRS) is pivotal for materials optical, magnetic, topological, and transport properties. Chiral phonons, characterized by atoms rotating unidirectionally around their equilibrium positions, generate dynamic lattice structures that break TRS. Here we report that coherent chiral phonons, driven by circularly polarized terahertz light pulses, can polarize the paramagnetic spins in CeF3 like a quasi-static magnetic field on the order of 1 Tesla. Through time-resolved Faraday rotation and Kerr ellipticity, we found the transient magnetization is only excited by pulses resonant with phonons, proportional to the angular momentum of the phonons, and growing with magnetic susceptibility at cryogenic temperatures, as expected from the spin-phonon coupling model. The time-dependent effective magnetic field quantitatively agrees with that calculated from phonon dynamics. Our results may open a new route to directly investigate mode-specific spin-phonon interaction in ultrafast magnetism, energy-efficient spintronics, and non-equilibrium phases of matter with broken TRS

Study on the Dynamic Compound Structure Composed of Mast Cells, Blood Vessels, and Nerves in Rat Acupoint

Background. Circulation system, immunity system, and nervous system have a close relationship with meridian phenomen. However, there is still lack of the results of dynamic changes of these structures in acupoint. The aim of this study is to explore the interrelationship by composite staining techniques. Methodology/Principal Findings. Twenty rats were separated into electroacupuncture group (EA) and control group (Con) randomly. In EA group, the Zusanli and Weishu were stimulated with the 0.1 mA for 25 min. The tissue of these acupoints was double-stained with acetylcholinesterase and Toluidine blue. The compound structure of mast cells, nervous fibers, and mast cells in the acupoint was observed. Conclusions/Significance. The blood vessels, mast cells and acetylcholinesterase responded nerves were clearly observed in acupoint tissues. EA can result in the mast cell recruitment and migration along the blood vessels and nervous bundle, which conformed the dynamic compound structure and played important roles in acupuncture

Effect of the number of unhealthy lifestyles in middle-aged and elderly people on hypertension and the first occurrence of ischemic stroke after the disease

BackgroundTo determine the relationship between the number of controllable unhealthy lifestyles on the risk of the first occurrence of ischemic stroke after the disease in middle-aged and elderly people in the community, and to provide data support and basis for community physicians to guide hypertensive patients to control modifiable risk factors to prevent the first occurrence of ischemic stroke.MethodsThe relationship between the number of unhealthy lifestyles and the risk of hypertension was analyzed by binary logistic regression in 584 subjects using a medical record control study. A retrospective cohort study of 629 hypertensive patients was used to analyze the relationship between the number of unhealthy lifestyles and the risk of the first occurrence of ischemic stroke within 5 years of developing hypertensive disease using Cox proportional risk regression models.ResultsLogistic regression model analysis showed that taking an unhealthy lifestyle as a reference, the OR (95% CI) values of, 2, 3, 4 and 5 unhealthy lifestyle were 4.050 (2.595–6.324), 4 (2.251–7.108), 9.297 (3.81–22.686), and 16.806 (4.388–64.365), respectively. Cox Proportional risk regression model analysis showed that the risk of ischemic stroke within 5 years after developing hypertension was referenced to 5 unhealthy lifestyles, and the HR (95% CI) for 3, 2, and 1 unhealthy lifestyle were 0.134 (0.023–0.793), 0.118 (0.025–0.564), and 0.046 (0.008–0.256), respectively.ConclusionThe number of controllable unhealthy lifestyles in middle-aged and elderly people was positively associated with the risk of hypertension and first ischemic stroke after hypertension, and there was a dose-effect relationship between them. The risk of hypertension and first ischemic stroke within 5 years after hypertension onset increased with the number of unhealthy lifestyles

Structure-property relationships in graphene-based strain and pressure sensors for potential artificial intelligence applications

Wearable electronic sensing devices are deemed to be a crucial technology of smart personal electronics. Strain and pressure sensors, one of the most popular research directions in recent years, are the key components of smart and flexible electronics. Graphene, as an advanced nanomaterial, exerts pre-eminent characteristics including high electrical conductivity, excellent mechanical properties, and flexibility. The above advantages of graphene provide great potential for applications in mechatronics, robotics, automation, human-machine interaction, etc.: graphene with diverse structures and leverages, strain and pressure sensors with new functionalities. Herein, the recent progress in graphene-based strain and pressure sensors is presented. The sensing materials are classified into four structures including 0D fullerene, 1D fiber, 2D film, and 3D porous structures. Different structures of graphene-based strain and pressure sensors provide various properties and multifunctions in crucial parameters such as sensitivity, linearity, and hysteresis. The recent and potential applications for graphene-based sensors are also discussed, especially in the field of human motion detection. Finally, the perspectives of graphene-based strain and pressure sensors used in human motion detection combined with artificial intelligence are surveyed. Challenges such as the biocompatibility, integration, and additivity of the sensors are discussed as well

InaudibleKey: Generic Inaudible Acoustic Signal based Key Agreement Protocol for Mobile Devices

Secure Device-to-Device (D2D) communication is becoming increasingly important with the ever-growing number of Internetof-Things (IoT) devices in our daily life. To achieve secure D2D communication, the key agreement between different IoT devices without any prior knowledge is becoming desirable. Although various approaches have been proposed in the literature, they suffer from a number of limitations, such as low key generation rate and short pairing distance. In this paper, we present InaudibleKey, an inaudible acoustic signal based key generation protocol for mobile devices. Based on acoustic channel reciprocity, InaudibleKey exploits the acoustic channel frequency response of two legitimate devices as a common secret to generating keys. InaudibleKey employs several novel technologies to significantly improve its performance. We conduct extensive experiments to evaluate the proposed system in different real environments. Compared to state-of-the-art works, InaudibleKey improves key generation rate by 3-145 times, extends pairing distance by 3.2-44 times, and reduces information reconciliation counts by 2.5 16 times. Security analysis demonstrates that InaudibleKey is resilient to a number of malicious attacks. We also implement InaudibleKey on modern smartphones and resourcelimited IoT devices. Results show that it is energy- efficient and can run on both powerful and resource-limited IoT devices without incurring excessive resource consumption