A preliminary analysis of the effect of the new rural cooperative medical scheme on inpatient care at a county hospital

BACKGROUND: China in 2009 committed to reach universal health coverage by promoting three forms of health insurance; NCMS for the rural population, UEBMI for formally employed urban residents and URBMI for other urban residents. NCMS has expanded to near universal coverage in rural China since launching in 2003. The objective of this study aimed to assess the effect of NCMS on inpatient care utilization from 2003 to 2012 at Longyou county hospital, Zhejiang province. METHODS: The research was conducted at Longyou county, Zhejiang province. All registered inpatient admissions from January 1, 2003, to June 30, 2012, were included in the study. The PLSQL Developer software was used to select the interesting variables in the hospital information database and saved in an Excel 2003 file. The interesting variables included the patients’ general information (name, gender, age, payment method), discharge diagnosis, length of hospital stay, and expenditure (total expenditure and out-of-pocket payment). Two common diseases (coronary arteriosclerotic disease and pneumonia) were selected as tracer conditions. RESULTS: 292,400 rural residents were enrolled in the Longyou county NCMS by 2011, 95.4% of the eligible population. A total of 145,744 inpatient admissions were registered from 1 January 2003 to 30 June 2012. The proportion of inpatients covered by NCMS increased from 30.3% in 2004 to 54.2% in 2012 while the proportion of inpatients covered by UEBMI increased from 7.7% in 2003 to 14.7% in 2012. The average expenditure for UEBMI insured inpatients was higher than the average for NCMS insured inpatients, although the gap was narrowing. The average length of hospital stay increased every year for all inpatients, but was higher for UEBMI inpatients than for NCMS insured inpatients. For both tracer conditions the results were similar to the above findings. CONCLUSIONS: NCMS has improved coverage height for its enrollees and resulted in increased cost of care per inpatient admission at the county hospital. However, wide differences persist between the two insurance systems in coverage height. Both systems are associated with increasing lengths of stay and rising cost per inpatient admission. We found that around 30% of inpatients were not covered by any of the two public health insurance systems, which calls for further studies

Mucin Production and Mucous Cell Metaplasia in Otitis Media

Otitis media (OM) with mucoid effusion, characterized by mucous cell metaplasia/hyperplasia in the middle ear cleft and thick fluid accumulation in the middle ear cavity, is a subtype of OM which frequently leads to chronic OM in young children. Multiple factors are involved in the developmental process of OM with mucoid effusion, especially disorders of mucin production resulting from middle ear bacterial infection and Eustachian tube dysfunction. In this review, we will focus on several aspects of this disorder by analyzing the cellular and molecular events such as mucin production and mucous cell differentiation in the middle ear mucosa with OM. In addition, infectious agents, mucin production triggers, and relevant signaling pathways will be discussed

A Survey on Service Route and Time Prediction in Instant Delivery: Taxonomy, Progress, and Prospects

Instant delivery services, such as food delivery and package delivery, have achieved explosive growth in recent years by providing customers with daily-life convenience. An emerging research area within these services is service Route\&Time Prediction (RTP), which aims to estimate the future service route as well as the arrival time of a given worker. As one of the most crucial tasks in those service platforms, RTP stands central to enhancing user satisfaction and trimming operational expenditures on these platforms. Despite a plethora of algorithms developed to date, there is no systematic, comprehensive survey to guide researchers in this domain. To fill this gap, our work presents the first comprehensive survey that methodically categorizes recent advances in service route and time prediction. We start by defining the RTP challenge and then delve into the metrics that are often employed. Following that, we scrutinize the existing RTP methodologies, presenting a novel taxonomy of them. We categorize these methods based on three criteria: (i) type of task, subdivided into only-route prediction, only-time prediction, and joint route\&time prediction; (ii) model architecture, which encompasses sequence-based and graph-based models; and (iii) learning paradigm, including Supervised Learning (SL) and Deep Reinforcement Learning (DRL). Conclusively, we highlight the limitations of current research and suggest prospective avenues. We believe that the taxonomy, progress, and prospects introduced in this paper can significantly promote the development of this field

KwaiYiiMath: Technical Report

Recent advancements in large language models (LLMs) have demonstrated remarkable abilities in handling a variety of natural language processing (NLP) downstream tasks, even on mathematical tasks requiring multi-step reasoning. In this report, we introduce the KwaiYiiMath which enhances the mathematical reasoning abilities of KwaiYiiBase1, by applying Supervised Fine-Tuning (SFT) and Reinforced Learning from Human Feedback (RLHF), including on both English and Chinese mathematical tasks. Meanwhile, we also constructed a small-scale Chinese primary school mathematics test set (named KMath), consisting of 188 examples to evaluate the correctness of the problem-solving process generated by the models. Empirical studies demonstrate that KwaiYiiMath can achieve state-of-the-art (SOTA) performance on GSM8k, CMath, and KMath compared with the similar size models, respectively.Comment: technical report. arXiv admin note: text overlap with arXiv:2306.16636 by other author

MoIVD-Mediated Leucine Catabolism Is Required for Vegetative Growth, Conidiation and Full Virulence of the Rice Blast Fungus Magnaporthe oryzae

Isovaleryl-CoA dehydrogenase (IVD), a member of the acyl-CoA dehydrogenase (ACAD) family, is a key enzyme catalyzing the conversion of isovaleryl-CoA to β-methylcrotonyl-CoA in the third reaction of the leucine catabolism pathway and simultaneously transfers electrons to the electron-transferring flavoprotein (ETF) for ATP synthesis. We previously identified the ETF ortholog in rice blast fungus Magnaporthe oryzae (MoETF) and showed that MoETF was essential for fungal growth, conidiation and pathogenicity. To further investigate the biological function of electron-transferring proteins and clarify the role of leucine catabolism in growth and pathogenesis, we characterized MoIVD (M. oryzaeisovaleryl-CoA dehydrogenase). MoIvd is highly conserved in fungi and its expression was highly induced by leucine. The Δmoivd mutants showed reduced growth, decreased conidiation and compromised pathogenicity, while the conidial germination and appressorial formation appeared normal. Consistent with a block in leucine degradation, the Δmoivd mutants accumulated isovaleric acid, grew more slowly, fully lacked pigmentation and completely failed to produce conidia on leucine-rich medium. These defects were largely rescued by raising the extracellular pH, suggesting that the accumulation of isovaleric acid contributes to the growth and conidiation defects. However, the reduced virulence of the mutants was probably due to their inability to overcome oxidative stress, since a large amount of ROS (reactive oxygen species) accumulated in infected host cell. In addition, MoIvd is localized to mitochondria and interacted with its electron receptor MoEtfb, the β subunit of MoEtf. Taken together, our results suggest that MoIVD functions in leucine catabolism and is required for the vegetative growth, conidiation and full virulence of M. oryzae, providing the first evidence for IVD-mediated leucine catabolism in the development and pathogenesis of plant fungal pathogens

Cracks, microcracks and fracture in polymer structures: Formation, detection, autonomic repair

The first author would like to acknowledge the financial support from the European Union under the FP7 COFUND Marie Curie Action. N.M.P. is supported by the European Research Council (ERC StG Ideas 2011 n. 279985 BIHSNAM, ERC PoC 2015 n. 693670 SILKENE), and by the EU under the FET Graphene Flagship (WP 14 “Polymer nano-composites” n. 696656)

Ethylene glycol and ethanol oxidation on spinel ni-co oxides in alkaline

This article presents a systematic study on the composition dependence of Ni-Co oxides (NCOs) on their electrocatalytic activities toward ethylene glycol (EG) and ethanol (EtOH) oxidation. NCO electrodes were prepared by co-electrodeposition method followed by annealing in air. The atomic ratios of Ni / (Ni + Co) (Ni content) in NCOs were controlled by adjusting the concentration ratio of Ni and Co precursors. As the Ni content increased, the phase of materials changed from the spinel to the mixture of spinel and rock salt. The electrocatalytic activities of these NCOs toward EG and EtOH oxidation were investigated by cyclic voltammetry, differential pulse voltammetry, multi-step chronoamperometry, and electrochemical impedance spectroscopy techniques. It was found that the performance of NCOs for EG and EtOH oxidation exhibited a firstly-increase-then-decrease trend with the increase of Ni content and the best performance was found at 46% Ni. The presence of Ni probably can facilitate EG and EtOH oxidation. Increasing the concentration of reactants or pH can improve the reaction rates. The products from EG and EtOH oxidation were analyzed by nuclear magnetic resonance, which indicated that the oxidation reaction was a process from hydroxyl group to carboxyl group.NRF (Natl Research Foundation, S’pore)MOE (Min. of Education, S’pore)Published versio

In vivo confocal microscopy assessment of meibomian glands microstructure in patients with Graves’ orbitopathy

Abstract Background To evaluate microstructural changes in the meibomian glands (MGs) in patients with active and inactive Graves’ orbitopathy (GO), using in vivo confocal microscopy (IVCM), and to investigate the correlations between clinical and confocal findings. Methods Forty patients (80 eyes) with GO (34 eyes with active GO, 46 eyes with inactive GO), and 31 age- and sex-matched control participants (62 eyes) were enrolled consecutively. A researcher recorded the clinical activity score (CAS) for each patient. A complete ophthalmic examination was then performed, including external eye, ocular surface and MGs. IVCM of the MGs was performed to determine the MG acinar density (MAD), MG longest and shortest diameters (MALD and MASD), MG orifice area (MOA), MG acinar irregularity (MAI), meibum secretion reflectivity (MSR), acinar wall inhomogeneity (AWI), acinar periglandular interstices inhomogeneity (API), and severity of MG fibrosis (MF). Results All confocal microscopy assessments of MGs significantly differed among groups (all P = 0.000). Compared to controls, GO groups showed lower MOA (1985.82 ± 1325.30 μm2 in active GO and 2021.59 ± 1367.45 μm2 in inactive GO vs. 3896.63 ± 891.90 μm2 in controls, all P = 0.000) and MAD (87.21 ± 32.69 /mm2 in active GO and 80.72 ± 35.54 /mm2 in inactive GO vs. 114.69 ± 34.90 /mm2 in controls, P = 0.001 and 0.000, respectively); greater MALD (118.11 ± 30.23 μm in active GO and 120.58 ± 27.64 μm in inactive GO vs. 58.68 ± 20.28 μm in controls, all P = 0.000) and MASD (44.77 ± 19.16 μm in active GO and 46.02 ± 20.70 μm in inactive GO vs. 27.80 ± 9.90 μm in controls, all P = 0.000); and higher degrees of MAI, MSR, and MF (all P<0.05). Eyes with active GO had higher degrees of MAI (P = 0.015), AWI (P = 0.000), and API (P = 0.000), while eyes with inactive GO had higher degrees of MSR (P = 0.000) and MF (P = 0.017). In GO groups, AWI and API were positively correlated with CAS (r = 0.640, P = 0.000; r = 0.683, P = 0.000, respectively), and MF was negatively correlated with CAS (r = − 0.228, P = 0.042). Conclusions IVCM effectively revealed microstructural changes of MGs in eyes with GO and provided strong in vivo evidence for the roles of obstruction and inflammation in the ocular surface disease process. Furthermore, it revealed discernible patterns of MG abnormalities in eyes with active GO and inactive GO, which are not easily distinguishable by typical clinical examinations

The Mediating Role of Perceived Stress and Academic Procrastination between Physical Activity and Depressive Symptoms among Chinese College Students during the COVID-19 Pandemic

Depressive symptoms, a prevalent mood illness, significantly harm college students&rsquo; physical and mental health. Individuals have experienced some degree of psychological harm as a result of the COVID-19 pandemic. Taking this into account, the purpose of this study was to investigate the relationship between physical activity (PA) and depressive symptoms among college students during the COVID-19 pandemic, as well as the mediating roles of perceived stress and academic procrastination. A total of 586 college students were subjected to the Physical Activity Scale (PARS-3), the Perceived Stress Scale (PSS-10), the Procrastination Assessment Scale-Students (PASS), and the Patient Health Questionnaire (PHQ-9). Findings from this research demonstrated that there was a significant positive correlation between perceived stress, academic procrastination, and depressive symptoms, while PA was significantly negatively correlated with perceived stress, academic procrastination, and depressive symptoms. The results of the chain mediation analysis showed that PA had a significant direct effect on depressive symptoms. Perceived stress, academic procrastination, and perceived stress-academic procrastination had significant mediating and chain mediating effects on the relationship between PA and depressive symptoms. In conclusion, PA among college students during the COVID-19 pandemic affects their depressive symptoms directly and indirectly through the independent mediating effect of perceived stress and academic procrastination, as well as the chain mediating effect of perceived stress and academic procrastination