Current Status and Prospects Towards the Road of Universal Health Coverage (UHC) in China: a Systematic Review

Background: Over the past decade, China has successfully extended its basic healthcare safety net to more than 95% of the population. The Chinese government aims to provide universal health coverage for all citizens by 2030. However, China still suffers from an inadequate tiered medical care system, lack of information sharing on hospital visits, and medical staff with low salaries and excessive overtime. This paper will further discuss China's current status and prospects in six building blocks of the WHO health system framework. Methods: We used various popular search engines, such as PubMed, Google, Google Scholar, etc., to identify studies on achieving universal health in China. The purpose of the search was to understand the state of the existing health system in China, especially in mobile health (mhealth), mental health, and medical personnel protection. Findings: We found nine articles related to health service delivery, three articles related to the medical workforce, four articles related to health information systems, three articles related to medical products, vaccines, and technologies, five articles related to health financing, and five articles related to health system management. Discussion: The findings based on the six health system building blocks are summarized in conjunction with other literature

A novel method for objectively, rapidly and accurately evaluating burn depth via near infrared spectroscopy

The accurate and objective evaluation of burn depth is a significant challenge in burn wound care. Herein, we used near infrared spectroscopy (NIRS) technology to measure the different depth of thermal burns in ex vivo porcine models. Based on the intensity of the spectral signals and the diffuse reflection theory, we extracted the optical parameters involved in functional (total hemoglobin and water content) and structural (tissue scattered size and scattered particles) features that reflect the changes in burn depth. Next, we applied support vector regression to construct a model including the optical property parameters and the burn depth. Finally, we histologically verified the burn depth data collected via NIRS. The results showed that our inversion model could achieve an average relative error of about 7.63%, while the NIRS technology diagnostic accuracy was in the range of 50 μm. For the first time, this novel technique provides physicians with real-time burn depth information objectively and accurately

Transcriptomics yields valuable information regarding the response mechanisms of Chinese Min pigs infected with PEDV

Porcine epidemic diarrhea virus (PEDV) causes porcine epidemic diarrhea (PED), a highly infectious disease, which has resulted in huge economic losses for the pig industry. To date, the pathogenic and immune response mechanism was not particularly clear. The purpose of this study was to investigate the pathogenic and immune responses of pigs infected with PEDV.In this study, 12 Min pigs were randomly selected without taking colostrum. At 3 days old, eight piglets were infected with 1 mL of PEDV solution (10 TCID50/ml), and the remaining four piglets were handled by 1 mL of 0.9% normal saline. Within the age of 7 days old, four piglets died and were considered as the death group. Correspondingly, four alive individuals were classified into the resistance group. Tissues of the duodenum, jejunum, ileum, colon, cecum, and rectum of piglets in the three groups were collected to measure the PEDV content. Additionally, the jejunum was used for the measurements and analyses of Hematoxylin-eosinstaining (HE), immunohistochemical sections, and transcriptomics. The phenotypes of Min piglets infected with PEDV showed that the viral copy numbers and jejunal damage had significant differences between the death and resistance groups. We also observed the transcriptome of the jejunum, and the differentially expressed (DE) analysis observed 6,585 DE protein-coding genes (PCGs), 3,188 DE long non-coding RNAs (lncRNAs), and 350 DE microRNAs (miRNAs), which were mainly involved in immune response and metabolic pathways. Furthermore, the specific expressed molecules for each group were identified, and 97 PCGs,108 lncRNAs, and 51 miRNAs were included in the ceRNA-regulated networks. By weighted gene co-expression network analysis (WGCNA) and transcription factor (TF) prediction, 27 significant modules and 32 significant motifs (E-value < 0.05) annotated with 519 TFs were detected. Of these TFs, 53 were DE PCGs. In summary, the promising key PCGs, lncRNAs, and miRNAs related to the pathogenic and immunological response of pigs infected with PEDV were detected and provided new insights into the pathogenesis of PEDV

Catalytic Hydrogen Evolution of NaBH4_4 Hydrolysis by Cobalt Nanoparticles Supported on Bagasse-Derived Porous Carbon

As a promising hydrogen storage material, sodium borohydride (NaBH4) exhibits superior stability in alkaline solutions and delivers 10.8 wt.% theoretical hydrogen storage capacity. Nevertheless, its hydrolysis reaction at room temperature must be activated and accelerated by adding an effective catalyst. In this study, we synthesize Co nanoparticles supported on bagasse-derived porous carbon (Co@xPC) for catalytic hydrolytic dehydrogenation of NaBH$_4$. According to the experimental results, Co nanoparticles with uniform particle size and high dispersion are successfully supported on porous carbon to achieve a Co@150PC catalyst. It exhibits particularly high activity of hydrogen generation with the optimal hydrogen production rate of 11086.4 mL$_{H2}$∙min$^{H2}$∙g$_{Co}$$^{H2}$ and low activation energy (E$_{a}$) of 31.25 kJ mol$^{H2}$. The calculation results based on density functional theory (DFT) indicate that the Co@xPC structure is conducive to the dissociation of [BH$_{4}$]$^{-}$, which effectively enhances the hydrolysis efficiency of NaBH$_4$. Moreover, Co@150PC presents an excellent durability, retaining 72.0% of the initial catalyst activity after 15 cycling tests. Moreover, we also explored the degradation mechanism of catalyst performance

A modified ‘skeleton/skin’ strategy for designing CoNiP nanosheets arrayed on graphene foam for on/off switching of NaBH4_{4} hydrolysis

CoNiP nanosheet array catalysts were successfully prepared on three-dimensional (3D) graphene foam using hydrothermal synthesis. These catalysts were prepared using 3D Ni–graphene foam (Ni/GF), comprising nickel foam as the ‘skeleton’ and reduced graphene oxide as the ‘skin’. This unique continuous modified ‘skeleton/skin’ structure ensure that the catalysts had a large surface area, excellent conductivity, and sufficient surface functional groups, which promoted in situ CoNiP growth, while also optimizing the hydrolysis of sodium borohydride. The nanosheet arrays were fully characterized and showed excellent catalytic performance, as supported by density functional theory calculations. The hydrogen generation rate and activation energy are 6681.34 mL min$_{−1}$ g$_{−1}$ and 31.2 kJ mol$_{−1}$, respectively, outperforming most reported cobalt-based catalysts and other precious metal catalysts. Furthermore, the stability of mockstrawberry-like CoNiP catalyst was investigated, with 74.9% of the initial hydrogen generation rate remaining after 15 cycles. The catalytic properties, durability, and stability of the catalyst were better than those of other catalysts reported previously

The bracteatus pineapple genome and domestication of clonally propagated crops

Domestication of clonally propagated crops such as pineapple from South America was hypothesized to be a 'one-step operation'. We sequenced the genome of Ananas comosus var. bracteatus CB5 and assembled 513 Mb into 25 chromosomes with 29,412 genes. Comparison of the genomes of CB5, F153 and MD2 elucidated the genomic basis of fiber production, color formation, sugar accumulation and fruit maturation. We also resequenced 89 Ananas genomes. Cultivars 'Smooth Cayenne' and 'Queen' exhibited ancient and recent admixture, while 'Singapore Spanish' supported a one-step operation of domestication. We identified 25 selective sweeps, including a strong sweep containing a pair of tandemly duplicated bromelain inhibitors. Four candidate genes for self-incompatibility were linked in F153, but were not functional in self-compatible CB5. Our findings support the coexistence of sexual recombination and a one-step operation in the domestication of clonally propagated crops. This work guides the exploration of sexual and asexual domestication trajectories in other clonally propagated crops

The interplay between mast cells, pineal gland, and circadian rhythm: Links between histamine, melatonin, and inflammatory mediators

Our daily rhythmicity is controlled by a circadian clock with a specific set of genes located in the suprachiasmatic nucleus in the hypothalamus. Mast cells (MCs) are major effector cells that play a protective role against pathogens and inflammation. MC distribution and activation are associated with the circadian rhythm via two major pathways, IgE/FcεRI- and IL-33/ST2-mediated signaling. Furthermore, there is a robust oscillation between clock genes and MC-specific genes. Melatonin is a hormone derived from the amino acid tryptophan and is produced primarily in the pineal gland near the center of the brain, and histamine is a biologically active amine synthesized from the decarboxylation of the amino acid histidine by the L-histidine decarboxylase enzyme. Melatonin and histamine are previously reported to modulate circadian rhythms by pathways incorporating various modulators in which the nuclear factor–binding near the κ light-chain gene in B cells, NF-κB, is the common key factor. NF-κB interacts with the core clock genes and disrupts the production of pro-inflammatory cytokine mediators such as IL-6, IL-13, and TNF-α. Currently, there has been no study evaluating the interdependence between melatonin and histamine with respect to circadian oscillations in MCs. Accumulating evidence suggests that restoring circadian rhythms in MCs by targeting melatonin and histamine via NF-κB may be promising therapeutic strategy for MC-mediated inflammatory diseases. This review summarizes recent findings for circadian-mediated MC functional roles and activation paradigms, as well as the therapeutic potentials of targeting circadian-mediated melatonin and histamine signaling in MC-dependent inflammatory diseases

A memória da luz : customizações e encontros com o espectador

Tese (doutorado)—Universidade de Brasília, Instituto de Artes, Departamento de Artes Visuais, 2017.O presente trabalho fala do desenvolvimento e aplicação de simulacros computacionais da luz como opção poética que é estética e empiricamente investigada de modo a envolver a comparação de minhas percepções e meus horizontes, como artista, com os de meus espectadores, como forma de encontrar aproximações e distâncias entre essas percepções e horizontes enquanto criações necessariamente implicadas na fruição esteticamente qualificada desses simulacros, em favor de um maior entendimento sobre o que poderia ser um encontro ou comunicação possível entre autor e receptor e na expectativa de obter, pelo somatório de percepções e horizontes colhidos desses espectadores, uma revelação paulatina das propostas artísticas correspondentes a esses simulacros.This work is about the development and application of computer light simulacra as poetic option that is aesthetically and empirically investigated in a way that involves the comparison of my perceptions and horizons, as an artist, with those of my spectators, as a way to find the proximities and distances between those perceptions and horizons as creations necessarily implied in the fruition aesthetically qualified of these simulacra, in favor of a greater understanding of what could be a possible encounter or communication between author and receiver and in the expectation of a gradual revelation of the artistic proposals corresponding to these simulacra, by the sum of perceptions and horizons taken from those spectators

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570