Non-communicable diseases sustained high call: China's health care model should be transformed as soon as possible

Background: There is sufficient evidence that the prevalence of non-communicable diseases (NCDs) in China is increasing rapidly. Results from the Fourth China National Health Services Survey (2008) show that compared to 2003, the prevalence of chronic diseases in China increased by 5%, while results from the Fifth National Health Services Survey (2013) showed an increase of 9% since 2008. As the world's most populous country and in the face of the rapid rise of non-communicable diseases, China lacks effective measures to achieve significant results on aspects of tobacco use, unhealthy diet, lack of exercise, harmful alcohol use and other risk factors. Of more concern is that the Chinese health care model is still stuck in the "medical services" stage. The "therapy" of health care models not only cause China to experience high health costs - there is also a steady increase in adverse health outcomes, with a failure to timely and effectively respond to the challenges of NCDs. Purpose: This article aims to analyze health care inputs and outputs since Chinese health care reform, and to provide a useful reference to improve Chinese future health care policies

Prototypical Kernel Learning and Open-set Foreground Perception for Generalized Few-shot Semantic Segmentation

Generalized Few-shot Semantic Segmentation (GFSS) extends Few-shot Semantic Segmentation (FSS) to simultaneously segment unseen classes and seen classes during evaluation. Previous works leverage additional branch or prototypical aggregation to eliminate the constrained setting of FSS. However, representation division and embedding prejudice, which heavily results in poor performance of GFSS, have not been synthetical considered. We address the aforementioned problems by jointing the prototypical kernel learning and open-set foreground perception. Specifically, a group of learnable kernels is proposed to perform segmentation with each kernel in charge of a stuff class. Then, we explore to merge the prototypical learning to the update of base-class kernels, which is consistent with the prototype knowledge aggregation of few-shot novel classes. In addition, a foreground contextual perception module cooperating with conditional bias based inference is adopted to perform class-agnostic as well as open-set foreground detection, thus to mitigate the embedding prejudice and prevent novel targets from being misclassified as background. Moreover, we also adjust our method to the Class Incremental Few-shot Semantic Segmentation (CIFSS) which takes the knowledge of novel classes in a incremental stream. Extensive experiments on PASCAL-5i and COCO-20i datasets demonstrate that our method performs better than previous state-of-the-art.Comment: Accepted by ICCV202

How would big data support societal development and environmental sustainability? Insights and practices

The theme of this Special Volume (SV) focuses on improving natural resource management and human health to ensure sustainable societal development. Natural resources have been exploited unduly regardless of the consequences, which has resulted in inappropriate management natural resources and has caused severe environmental degradation. Contributions in this SV addressed improved environmental management, utilization, and allocation of natural resources; evaluation of sustainable natural resource management; pollution prevention and treatment; and evaluation and suggestions for improved natural resource-related policies. The authors presented an inspiring panorama of the initiatives that have been developed throughout the world for sustainable natural resource management and improve societal development. Theoretically, new approaches to bridge the gaps between the economic development and environmental protection were increasingly dominant. Empirically, many of the papers provided case studies of regions in China and other regions. The authorship reflected growing collaboration between researchers from many different countries or universities. While the great diversity of contributions on the topic reflected the wealth of insights generated on the topic in recent years, there is much more that must be done to achieve societal sustainability in natural resource management.No Full Tex

Conservation of Carbohydrate Binding Interfaces — Evidence of Human HBGA Selection in Norovirus Evolution

Human noroviruses are the major viral pathogens of epidemic acute gastroenteritis. These genetically diverse viruses comprise two major genogroups (GI and GII) and approximately 30 genotypes. Noroviruses recognize human histo-blood group antigens (HBGAs) in a diverse, strain-specific manner. Recently the crystal structures of the HBGA-binding interfaces of the GI Norwalk virus and the GII VA387 have been determined, which allows us to examine the genetic and structural relationships of the HBGA-binding interfaces of noroviruses with variable HBGA-binding patterns. Our hypothesis is that, if HBGAs are the viral receptors necessary for norovirus infection and spread, their binding interfaces should be under a selection pressure in the evolution of noroviruses.Structural comparison of the HBGA-binding interfaces of the two noroviruses has revealed shared features but significant differences in the location, sequence composition, and HBGA-binding modes. On the other hand, the primary sequences of the HBGA-binding interfaces are highly conserved among strains within each genogroup. The roles of critical residues within the binding sites have been verified by site-directed mutagenesis followed by functional analysis of strains with variable HBGA-binding patterns.Our data indicate that the human HBGAs are an important factor in norovirus evolution. Each of the two major genogroups represents an evolutionary lineage characterized by distinct genetic traits. Functional convergence of strains with the same HBGA targets subsequently resulted in acquisition of analogous HBGA binding interfaces in the two genogroups that share an overall structural similarity, despite their distinct locations and amino acid compositions. On the other hand, divergent evolution may have contributed to the observed overall differences between and within the two lineages. Thus, both divergent and convergent evolution, as well as the polymorphic human HBGAs, likely contribute to the diversity of noroviruses. The finding of genogroup-specific conservation of HBGA binding interfaces will facilitate the development of rational strategies to control and prevent norovirus-associated gastroenteritis

Catalyst Performance Studies on the Guerbet Reaction in a Continuous Flow Reactor Using Mono- and Bi-Metallic Cu-Ni Porous Metal Oxides

Higher alcohols like 1-butanol are considered important biofuels with superior properties compared to the more readily available bio-ethanol. An attractive route to prepare 1-butanol from ethanol is the Guerbet reaction. We here report the use of hydrotalcite-derived mono- (Cu-PMO or Ni-PMO) and bi-metallic (CuNi-PMO) porous metal oxide catalysts for the Guerbet coupling of ethanol to 1-butanol in a continuous flow reactor (320 °C, 0.1 MPa, LHSV = 15 mL g−1 h−1) at extended times on stream (~160 h). Two distinct regimes with different product distributions were observed for the Cu-PMO and CuNi-PMO catalyst with time on stream. At the start of the run, the initial conversion of ethanol dropped from about 85% to less than 20% after 60 h and acetaldehyde was the main product (regime 1). At prolonged times on stream (60–160 h), fairly constant low conversions of ethanol (14%) were observed and 1-butanol was the main product (regime 2). Performance of the monometallic Cu-PMO catalyst in terms of 1-butanol yield and stability was lower compared to the bi-metallic CuNi-PMO. Detailed catalyst characterization studies (XRD, H2-TPR, sorption of acrylic acid, TGA, TEM, HAADF-STEM, and EDS mapping) on both fresh and spent CuNi-PMO taken at various times on stream was performed to determine the changes in catalyst morphology and composition during a run, and particularly to obtain information on changes in catalyst structure operating in regime 1 or 2. The change in chemoselectivity is in line with an increase in basicity of the catalyst at extended runtimes

Experimental study and application of hydraulic fracturing in underlying coal seam

The coalbed methane resource under goaf is rich, but has not been effectively developed for a long time. Hydraulic fracturing technology stands as an effective means to augment coalbed methane recovery. The extraction and re-compaction of overlying coal seam will directly affect the expansion behavior of hydraulic fractures in the underlying coal seam. Though the large-scale (300 mm×300 mm×300 mm) true triaxial hydraulic fracturing experiments, the mechanical and acoustic emission response characteristics of coal were analyzed under different levels of loading and unloading stress perturbations. The damage variable T was proposed to characterize the degree of coal damage, and the relationship between damage and the initiation and expansion patterns of hydraulic fractures was elucidated. The results revealed that, the damage induced by vertical stress loading in the underlying coal significantly exceeded that in the unloading stage. When the vertical loading stress was below 11 MPa, the coal remained in an elastic stage with minimal damage. Loading between 11~15 MPa corresponded to the yielding stage, witnessing a substantial increase in damage. Loading between 15~18 MPa led to the strengthening stage, the pores and fractures of coal were gradually compacted. Damage variables T can effectively characterize the degree of internal damage of coal. When T=Tc, the internal damage of coal was comparable to that of a coal that has not disturbed by loading and unloading stress.Tc is the damage variable of coal without loading and unloading stress disturbance. When T＞Tc , the coal exhibited a stress-damaged state, with higher values of T corresponding to increasing damage levels. Conversely, when T＜Tc, the coal demonstrated a stress-compacted state, with smaller values of T indicating higher compaction degrees. The degree of stress damage in coal was negatively correlated with the fracture pressure, a high degree of damage made coal more prone to fracture, and it was favor to form the primary hydraulic fractures near the wellbore, which was conducive to hydraulic fracturing. The degree of compaction of coal was positively correlated with fracture pressure. The high degree of compaction weakened the effect of horizontal stress difference on hydraulic fracture expansion, and the hydraulic fracture near the wellbore was more developed, which hindered the formation of primary hydraulic fractures. Based on the research results, the principle of hydraulic fracturing construction scheme optimization for underlying coal seam in goaf was formulated and applied in the field. The hydraulic fracturing ability of the optimized scheme was significantly improved

Compound heterozygous SCN5A gene mutations in asymptomatic Brugada syndrome child

BACKGROUND. Loss-of-function mutations in the SCN5A gene, encoding the cardiac Nav1.5 sodium channel, have been previously associated with Brugada syndrome (BrS). Despite the low prevalence of the disease, we identified a patient carrying two SCN5A mutations. We aimed at establishing a correlation between genotype, clinical phenotype and in vitro sodium current.MATERIALS AND METHODS. A 3 years old boy presented with right bundle branch block and ST-segment elevation. Genetic analysis and electrophysiology studies in transfected HEK293 cells were performed to identify possibly disease-causing variants and assess their effect on sodium channel function.RESULTS. Two SCN5A variants were identified: a new frameshift deletion causing premature truncation of the putative protein (c.3258_3261del4) and a missense substitution (p.F1293S). In vitro studies revealed that the truncated mutant did not produce functional channels and decreased total sodium current when co-expressed with p.F1293S channels compared to p.F1293S alone. In addition, p.F1293S channels presented with a steep slope of steady-state activation voltage-dependency, which was shifted towards more positive potentials by the co-expression with the truncated channel. p.F1293S channels also showed shift towards more positive potentials of the steady-state inactivation both alone and co-expressed with the deletion mutant.CONCLUSIONS. Our data identified a severe reduction of sodium channel current associated with two distinct SCN5A changes. However, all mutation carriers were asymptomatic and BrS ECG was observed only transiently in the compound heterozygous subject. These observations underline the difficulty of genotype/phenotype correlations in BrS patients and support the idea of a polygenic disorder, where different mutations and variants can contribute to the clinical phenotype

Neuronally released vasoactive intestinal polypeptide alters atrial electrophysiological properties and may promote atrial fibrillation

BACKGROUND: Vagal hyperactivity promotes atrial fibrillation (AF), which has been almost exclusively attributed to acetylcholine. Vasoactive intestinal polypeptide (VIP) and acetylcholine are neurotransmitters co-released during vagal stimulation. Exogenous VIP has been shown to promote AF by shortening action potential duration (APD), increasing APD spatial heterogeneity, and causing intra-atrial conduction block. OBJECTIVE: The purpose of this study was to investigate the effects of neuronally released VIP on atrial electrophysiologic properties during vagal stimulation. METHODS: We used a specific VIP antagonist (H9935) to uncover the effects of endogenous VIP released during vagal stimulation in canine hearts. RESULTS: H9935 significantly attenuated (1) the vagally induced shortening of atrial effective refractory period and widening of atrial vulnerability window during stimulation of cervical vagosympathetic trunks (VCNS) and (2) vagal effects on APD during stimulation through fat-pad ganglion plexus (VGPS). Atropine completely abolished these vagal effects during VCNS and VGPS. In contrast, VGPS-induced slowing of local conduction velocity was completely abolished by either VIP antagonist or atropine. In pacing-induced AF during VGPS, maximal dominant frequencies and their spatial gradients were reduced significantly by H9935 and, more pronouncedly, by atropine. Furthermore, VIP release in the atria during vagal stimulation was inhibited by atropine, which may account for the concealment of VIP effects with muscarinic blockade. CONCLUSION: Neuronally released VIP contributes to vagal effects on atrial electrophysiologic properties and affects the pathophysiology of vagally induced AF. Neuronal release of VIP in the atria is inhibited by muscarinic blockade, a novel mechanism by which VIP effects are concealed by atropine during vagal stimulation

Loss of function of hNav1.5 by a ZASP1 mutation associated with intraventricular conduction disturbances in left ventricular noncompaction

BACKGROUND: Defects of cytoarchitectural proteins can cause left ventricular noncompaction, which is often associated with conduction system diseases. We have previously identified a p.D117N mutation in the LIM domain-binding protein 3-encoding Z-band alternatively spliced PDZ motif gene (ZASP) in a patient with left ventricular noncompaction and conduction disturbances. We sought to investigate the role of p.D117N mutation in the LBD3 NM_001080114.1 isoform (ZASP1-D117N) for the regulation of cardiac sodium channel (Na(v)1.5) that plays an important role in the cardiac conduction system. METHODS AND RESULTS: Effects of ZASP1-wild-type and ZASP1-D117N on Na(v)1.5 were studied in human embryonic kidney-293 cells and neonatal rat cardiomyocytes. Patch-clamp study demonstrated that ZASP1-D117N significantly attenuated I(Na) by 27% in human embryonic kidney-293 cells and by 32% in neonatal rat cardiomyocytes. In addition, ZASP1-D117N rightward shifted the voltage-dependent activation and inactivation in both systems. In silico simulation using Luo-Rudy phase 1 model demonstrated that altered Na(v)1.5 function can reduce cardiac conduction velocity by 28% compared with control. Pull-down assays showed that both wild-type and ZASP1-D117N can complex with Na(v)1.5 and telethonin/T-Cap, which required intact PDZ domains. Immunohistochemical staining in neonatal rat cardiomyocytes demonstrates that ZASP1-D117N did not significantly disturb the Z-line structure. Disruption of cytoskeletal networks with 5-iodonaphthalene-1-sulfonyl homopiperazine and cytochalasin D abolished the effects of ZASP1-D117N on Na(v)1.5. CONCLUSIONS: ZASP1 can form protein complex with telethonin/T-Cap and Na(v)1.5. The left ventricular noncompaction-specific ZASP1 mutation can cause loss of function of Na(v)1.5, without significant alteration of the cytoskeletal protein complex. Our study suggests that electric remodeling can occur in left ventricular noncompaction subject because of a direct effect of mutant ZASP on Na(v)1.5