Health Service Access for Rural People Living with HIV/AIDS in China: A Critical Evaluation

The increasingly serious HIV/AIDS epidemic creates a significant burden for the public health system; however, little attention has been paid to the issue of health service access in rural China. Based on a qualitative study of 34 Chinese rural People Living with HIVIAIDS (PLWHA) and 13 health providers, this study fills a gap by examining health service access from both the demand and supply-side. Utilizing access theory, this study explores the availability, affordability and acceptability of health services in rural China. Moreover, this study focuses on access barriers and institutional obstacles that PLWHA meet during their illness and considers the influence of the current Chinese political philosophy of marketization and privatization of the health care systems

Guardauto: A Decentralized Runtime Protection System for Autonomous Driving

Due to the broad attack surface and the lack of runtime protection, potential safety and security threats hinder the real-life adoption of autonomous vehicles. Although efforts have been made to mitigate some specific attacks, there are few works on the protection of the self-driving system. This paper presents a decentralized self-protection framework called Guardauto to protect the self-driving system against runtime threats. First, Guardauto proposes an isolation model to decouple the self-driving system and isolate its components with a set of partitions. Second, Guardauto provides self-protection mechanisms for each target component, which combines different methods to monitor the target execution and plan adaption actions accordingly. Third, Guardauto provides cooperation among local self-protection mechanisms to identify the root-cause component in the case of cascading failures affecting multiple components. A prototype has been implemented and evaluated on the open-source autonomous driving system Autoware. Results show that Guardauto could effectively mitigate runtime failures and attacks, and protect the control system with acceptable performance overhead

Pain perception of older adults in nursing home and home care settings: evidence from China

Background In the past decade, the number of long-term care (LTC) services for older adults in China has grown annually by an average of 10%. Older adults, their family members, and policymakers in China are concerned about patient outcomes in different care settings because older adults who have a similar functional status and LTC needs may choose either nursing home care or home care. The aim of this study was to compare pain perception in nursing home care and home care settings for physically dependent older adults in China. Methods Multi-stage sampling method was used to recruit respondents aged 65 and older from Yichang City, China, in 2015. The researchers employed a two-step analytical strategy—zero-inflated ordered probit regression followed by propensity score matching method—to model the effect of contrasting residence types on pain perception. Results Zero-inflated ordered probit regression analysis with participants unmatched (n = 484) showed that compared with older adults who received home care, those who received nursing home care did not have more severe pain (β = 0.088, SE = 0.196, p = 0.655). After propensity-score matching, the research found that older adults in the home care group perceived less pain compared with the nursing home group (β = 0.489, SE = 0.169, p = 0.004). Conclusions The older adults who received home care perceived significantly less pain than the nursing home residents. The pain of older adults may differ based on the type of LTC services and therapy intensity they received, and home care might lead to less pain and better comfort than nursing home care

The Arabidopsis thaliana elongator complex subunit 2 epigenetically affects root development

The elongator complex subunit 2 (ELP2) protein, one subunit of an evolutionarily conserved histone acetyltransferase complex, has been shown to participate in leaf patterning, plant immune and abiotic stress responses in Arabidopsis thaliana. Here, its role in root development was explored. Compared to the wild type, the elp2 mutant exhibited an accelerated differentiation of its root stem cells and cell division was more active in its quiescent centre (QC). The key transcription factors responsible for maintaining root stem cell and QC identity, such as AP2 transcription factors PLT1 (PLETHORA1) and PLT2 (PLETHORA2), GRAS transcription factors such as SCR (SCARECROW) and SHR (SHORT ROOT) and WUSCHEL-RELATED HOMEOBOX5 transcription factor WOX5, were all strongly down-regulated in the mutant. On the other hand, expression of the G2/M transition activator CYCB1 was substantially induced in elp2. The auxin efflux transporters PIN1 and PIN2 showed decreased protein levels and PIN1 also displayed mild polarity alterations in elp2, which resulted in a reduced auxin content in the root tip. Either the acetylation or methylation level of each of these genes differed between the mutant and the wild type, suggesting that the ELP2 regulation of root development involves the epigenetic modification of a range of transcription factors and other developmental regulators

Long-term exposure to PM\u3csub\u3e2.5\u3c/sub\u3e and incidence of disability in activities of daily living among oldest old

Currently the Chinese government has adopted World Health Organization interim target-1 values as the national ambient air quality standards values. However, the population-based evidence was insufficient, especially for the oldest old (aged 80+). We evaluated the association of fine particulate matters (PM2.5) exposure and incidence of disability in activities of daily living (ADL) in 15 453 oldest old in 886 counties/cities in China from 2002 to 2014 using Cox model with penalized splines and competing risk models to evaluate the linear or non-linear association. After adjusting for potential confounders, a J-shaped association existed between PM2.5 exposure with a threshold concentration of 33 μg/m3, and incident disability in ADL. Above this threshold, the risk magnitude significantly increased with increase of PM2.5 concentrations; compared to 33 μg/m3, the hazard ratio ranged from 1.03 (1.00–1.06) at 40 μg/m3 to 2.25 (1.54–3.29) at 110 μg/m3. The risk magnitude was not significantly changed below this threshold. Each 10 μg/m3 increase in PM2.5 exposure corresponded to a 7.7% increase in the risk of disability in ADL (hazard ratio 1.077, 95% CI 1.051–1.104). Men, smokers, and participants with cognitive impairment might be more vulnerable to PM2.5 exposure. The study provided limited population-based evidence for the oldest old and detected a threshold of 33 μg/m3, and supported that reduction to current World Health Organization interim target-1value (35 μg/m3) and Chinese national ambient air quality standards (35 μg/m3) or lower may be associated with lower risk of disability in ADL