Key Factors Influencing the Operationalization and Effectiveness of Telemedicine Services in Henan Province, China: Cross-Sectional Analysis

BackgroundTelemedicine has demonstrated its potential in alleviating the unbalanced distribution of medical resources across different regions. Henan, a province in China with a population of approximately 100 million, is especially affected by a health care divide. The province has taken a proactive step by establishing a regional collaborative platform for telemedicine services provided by top-tier provincial hospitals. ObjectiveWe aim to identify the key factors that influence the current operationalization and effectiveness of telemedicine services in Henan province. The insights gained from this study will serve as valuable references for enhancing the efficient operation of telemedicine platforms in low- and middle-income regions. MethodsWe analyzed service reports from the performance management system of telemedicine services in Henan province throughout 2020. Using descriptive statistics and graphical methods, we examined key influencing factors, such as management competency; device configuration; and hospital capability, capacity, and service efficacy, across hospitals at 2 different tiers. In addition, we used generalized linear models and multiple linear regression models to identify key operational factors that significantly affect the service volume and efficacy of 2 major telemedicine services, namely teleconsultation and tele-education. ResultsAmong the 89 tier 3 hospitals and 97 tier 2 hospitals connected to the collaborative telemedicine platform, 65 (73%) and 55 (57%), respectively, have established standardized management procedures for telemedicine services. As the primary delivery method for telemedicine services, 90% (80/89) of the tier 3 hospitals and 94% (91/97) of the tier 2 hospitals host videoconferencing consultations through professional hardware terminals rather than generic computers. Teleconsultation is the dominant service type, with an average annual service volume per institution of 173 (IQR 37-372) and 60 (IQR 14-271) teleconsultations for tier 3 and tier 2 hospitals, respectively. Key factors influencing the service volume at each hospital include available funding, management competency, the number of connected upper tiers, and the number of professional staff. After receiving teleconsultations from tier 3 (65/89, 73%) and tier 2 (61/97, 63%) hospitals, patients reported significant improvements in their medical conditions. In addition, we observed that service efficacy is positively influenced by management competency, financial incentives, the number of connected upper or lower tiers, and the involvement of participating medical professionals. ConclusionsTelemedicine has become increasingly popular in Henan province, with a notable focus on teleconsultation and tele-education services. Despite its popularity, many medical institutions, especially tier 2 hospitals, face challenges related to management competency. In addition to enhancing the effectiveness of existing telemedicine services, health care decision-makers in Henan province and other low- and middle-income regions should consider expanding the service categories, such as including remote emergency care and telesurgery, which have promise in addressing crucial health care needs in these regions

Host Preference and Performance of the Yellow Peach Moth (Conogethes punctiferalis) on Chestnut Cultivars.

Suitability of plant tissues as food for insects varies from plant to plant. In lepidopteran insects, fitness is largely dependent on the host-finding ability of the females. Existing studies have suggested that polyphagous lepidopterans preferentially select certain host plant species for oviposition. However, the mechanisms for host recognition and selection have not been fully elucidated. For the polyphagous yellow peach moth Conogethes punctiferalis, we explored the effect of chestnut cultivar on the performance and fitness and addressed the mechanisms of plant-volatile-mediated host recognition. By carrying out laboratory experiments and field investigation on four chestnut Castanea mollissima cultivars (Huaihuang, Huaijiu, Yanhong, and Shisheng), we found that C. punctiferalis females preferentially select Huaijiu for oviposition and infestation, and caterpillars fed on Huaijiu achieved slightly greater fitness than those fed on the other three chestnut cultivars, indicating that Huaijiu was a better suitable host for C. punctiferalis. Plant volatiles played important roles in host recognition by C. punctiferalis. All seven chestnut volatile compounds, α-pinene, camphene, β-thujene, β-pinene, eucalyptol, 3-carene, and nonanal, could trigger EAG responses in C. punctiferalis. The ubiquitous plant terpenoids, α-pinene, camphene and β-pinene, and their specific combination at concentrations and proportions similar to the emissions from the four chestnut cultivars, was sufficient to elicit host recognition behavior of female C. punctiferalis. Nonanal and a mixture containing nonanal, that mimicked the emission of C. punctiferalis infested chestnut fruits, caused avoidance response. The outcome demonstrates the effects of chestnut cultivars on the performance of C. punctiferalis and reveals the preference-performance relationship between C. punctiferalis adults and their offspring. The observed olfactory plasticity in the plant-volatile-mediated host recognition may be important for the forming of the relationship between yellow peach moth and chestnuts since it allows the polyphagous herbivores to adjust to variation in volatile emission from their host plants

Photo-Embossed Surface Relief Structures with Improved Aspect Ratios and Their Applications in Liquid Crystal Devices

Photo-embossing has been developed as a convenient and economical method for creating complex surface relief structures in polymer films. The pursuit for large aspect ratios of the photo-embossed structures has never stopped. Here, we demonstrate a simple strategy to obtain improved aspect ratios by adding a quick solvent developing step into the photo-embossing process. A good solvent for the monomer is used to remove unreacted monomers from the unexposed region, resulting in deepened valleys of the surface reliefs. In a polymer film as thin as 2.5 µm, the height of the surface reliefs can be increased by a factor of three to around 1.0 µm. This strategy is also shown to be compatible with other methods used to improve the aspect ratios of the photo-embossed structures. Lastly, we employ these surface relief structures in the fabrication of liquid crystal (LC) devices and investigate their performances for visible light regulation

Versatile homeotropic liquid crystal alignment with tunable functionality prepared by one-step method

Alignment layers are vital to the function of numerous devices based on liquid crystal (LC) materials. The pursue of versatile, effective and even flexible alignment layers, preferably prepared by simple methods, is still actively ongoing. Herein, we propose a facile one-step method by mixing silanes into the starting LC mixtures, which in contact with a glass substrate secede and self-assemble in-situ to form a stable and highly effective homeotropic alignment layer at the interface. Tetradecyldimethyl(3-trimethoxysilylpropyl)ammonium chloride (TDTA) is selected as the example to demonstrate the method, although a number of other silanes can produce similar results. With only 0.05 vol% of TDTA added to a mixture of liquid crystals and reactive mesogens, a uniform monolayer is chemically attached to the substrate, which automatically aligns the LCs homeotropically. Furthermore, by blending the TDTA with acrylate functionalized silanes like 3-(trimethoxysilyl)propyl methacrylate (A174), additional reactive functional groups can be easily introduced into the alignment layer, therefore offering opportunities to adjust the interface properties. An electro-responsive smart window based on the polymer stabilized liquid crystals (PSLCs) is successfully prepared using a one-step method, demonstrating excellent electro-optic performances and notably enhanced adhesion between the substrate and the in-situ formed polymer network. These findings are valuable especially for the development of flexible LC devices

Compounds emitted from intact fruits of four chestnut cultivars, Huaihuang, Huaijiu, Yanhong, and Shisheng^*.

<p>Compounds emitted from intact fruits of four chestnut cultivars, Huaihuang, Huaijiu, Yanhong, and Shisheng^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0157609#t002fn001" target="_blank">*</a>}.</p

Practical Experience of Endoscope Reprocessing and Working-Platform Disinfection in COVID-19 Patients: A Report from Guangdong China during the Pandemic

Background. No consensus exists regarding which procedures should be performed to disinfect endoscopes and working platforms after COVID-19 patients have undergone endoscopy. Methods. We analyzed the disinfection quality of endoscopes and working platforms after 11 COVID-19 patients had undergone endoscopy. Conclusions. For endoscopic preprocessing at the bedside, a key disinfection step is using a multienzyme stock solution. The nucleic acid tests for endoscopists, washers, endoscopes, and working platforms were all negative. Based on our experience with the 11 COVID-19 patients who had undergone endoscopy, we provide an endoscopic reprocessing method for the bedside endoscopic diagnosis and treatment of COVID-19 patients for reference

Field infestation rate and oviposition choice of <i>Conogethes punctiferalis</i> on four chestnut cultivars.

<p>HH = Huaihuang, HJ = Huaijiu, YH = Yanhong, SS = Shisheng. (a) Field infestation rate of four chestnut cultivars by <i>C</i>. <i>punctiferalis</i>. Bars represent means ± SE (<i>n</i> = 5). Different letters on the bars indicate significant differences among the four chestnut cultivars (Tukey-HSD test after ANOVA, <i>P</i> < 0.05), (b) Oviposition choice of <i>C</i>. <i>punctiferalis</i> among four chestnut cultivars. Bars represent means ± SE (<i>n</i> = 10) of the daily laying eggs per 10 females. Different letters on the bars indicate significant difference among the four chestnut cultivars (Tukey-HSD test after ANOVA, <i>P</i> < 0.05).</p

Quantity and proportions of chestnut volatiles in simulated blends used for behavioral and EAG assay^*.

<p>Quantity and proportions of chestnut volatiles in simulated blends used for behavioral and EAG assay^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0157609#t001fn001" target="_blank">*</a>}.</p

EAG response profiles of female <i>Conogethes punctiferalis</i> to chestnut compounds.

<p>(a) EAG responses of virgin females to chestnut compounds, (b) EAG responses of mated females to chestnut compounds, S-HH-IT = simulated blend mimicking the emission of intact Huaihuang fruits, S-HJ-IT = simulated blend mimicking the emission of intact Huaijiu fruits, S-YH-IT = simulated blend mimicking the emission of intact Yanhong fruits, S-SS-IT = simulated blend mimicking the emission of intact Shisheng fruits, S-HJ-IF60 = simulated blend mimicking the emission of Huaijiu fruits infested by <i>Conogethes punctiferalis</i> for 60 h. Bars represent mean ± SE (<i>n</i> = 15).</p

Choice distribution of female <i>Conogethes punctiferalis</i> for chestnut volatiles in dual choice assay in a Y tube.

<p>(a) Selection rates of virgin females for chestnut volatiles in dual choice assay with mineral oil as control, (b) Selection rates of mated females for chestnut volatiles with mineral oil as control, MO = mineral oil, S-HH-IT = simulated blend mimicking the emission of intact Huaihuang fruits, S-HJ-IT = simulated blend mimicking the emission of intact Huaijiu fruits, S-YH-IT = simulated blend mimicking the emission of intact Yanhong fruits, S-SS-IT = simulated blend mimicking the emission of intact Shisheng fruits, S-HJ-IF60 = simulated blend mimicking the emission of Huaijiu fruits infested by <i>Conogethes punctiferalis</i> for 60 h. Stars indicate significant difference within a choice test using <i>x</i>² test (*<i>P</i> < 0.05, **<i>P</i> < 0.001).</p