Risk management and empirical study of the doctor-patient relationship: based on 1790 litigation cases of medical damage liability disputes in China.

BACKGROUND: Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR. METHODS: This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021. RESULTS: COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098-0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05). CONCLUSIONS: Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation.

Bibliometric and visualization analysis of risk management in the doctor-patient relationship: A systematic quantitative literature review.

OBJECTIVES: This paper analyzed the research on risk management in the doctor-patient relationship (DPR) based on a systematic quantitative literature review approach using bibliometric software. It aims to uncover potential information about current research and predict future research hotspots and trends. METHODS: We conducted a comprehensive search for relevant publications in the Scopus database and the Web of Science Core Collection database from January 1, 2000 to December 31, 2023. We analyzed the data using CiteSpace 6.2.R2 and VOSviewer 1.6.19 software to examine the annual number of publications, countries/regions, journals, citations, authors, and keywords in the field. RESULTS: A total of 553 articles and reviews that met the criteria were included in this study. There is an overall upward trend in the number of publications issued; in terms of countries/regions, the United States and the United Kingdom are the largest contributors; Patient Education and Counseling is the most productive journal (17); Physician communication and patient adherence to treatment: a meta-analysis is the most cited article (1637); the field has not yet to form a stable and obvious core team; the analysis of high-frequency keywords revealed four main research directions: the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the causes of DPR risks, coping strategies, measurement tools, and research related to people prone to doctor-patient risk characteristics; the keyword burst analysis revealed several shifts in the research hotspots for risk management in the DPR, suggesting that chronic disease management, is a future research direction for the continued development of risk management in the DPR. CONCLUSIONS: The visualization analysis of risk management literature in the DPR using CiteSpace and VOSviewer software provides insights into the current research status and highlights future research directions.

Research on the risk governance of fraudulent reimbursement of patient consultation fees.

Background: The fundamental medical insurance fund, often referred to as the public's "life-saving fund," plays a crucial role in both individual well-being and the pursuit of social justice. Medicare fraudulent claims reduce "life-saving money" to "Tang's monk meat", undermining social justice and affecting social stability. Methods: We utilized crawler technology to gather textual data from 215 cases involving fraudulent health insurance claims. Simultaneously, statistical data spanning 2018 to 2021 was collected from the official websites of the China Medical Insurance Bureau and Anhui Medical Insurance Bureau. The collected data underwent comprehensive analysis through Excel, SPSS 26.0 and R4.2.1. Differential Auto-Regressive Moving Average Model (ARIMA (p, d, q)) was used to fit the fund safety forecast model, and test the predictive validity of the forecast model on the fund security data from July 2021 to October 2023 (the fund security data of Anhui Province from September 2021 to October 2023). Results: The outcomes revealed that fraudulent claims by health insurance stakeholders adversely impact the equity of health insurance funds. Furthermore, the risk management practices of Medicare fund administrators influence the publication of fraudulent claims cases. Notably, differences among Medicare stakeholders were observed in the prevalence of fraudulent claims. Additionally, effective governance of fraudulent claims risks was found to have a positive impact on the overall health of healthcare funds. Moreover, the predictive validity of the forecast model on the national and Anhui province's fund security data was 92.86% and 100% respectively. Conclusion: We propose four recommendations for the governance of health insurance fraudulent claims risk behaviors. These recommendations include strategies such as "combatting health insurance fraudulent claims to preserve the fairness of health insurance funds", "introducing initiatives for fraud risk governance and strengthening awareness of the rule of law", "focusing on designated medical institutions and establishing a robust long-term regulatory system", and "adapting to contemporary needs while maintaining a focus on long-term regulation".

Coverage and impact of influenza vaccination among children in Minhang District, China, 2013-2020.

Background: Young children have a great disease burden and are particularly vulnerable to influenza. This study aimed to assess the direct effect of influenza vaccination among children and to evaluate the indirect benefit of immunizing children. Methods: The influenza vaccination records for all children born during 2013-2019 in Minhang District and surveillance data for reported influenza cases were obtained from the Minhang CDC. 17,905 children were recorded in the vaccination system and included in this study. Descriptive epidemiology methods were used for data analysis, including an ecological approach to estimate the number of influenza cases averted by vaccination and linear regression to estimate the reduction in influenza cases in the general population per thousand additional childhood vaccination doses. Results: During the study period, the annual vaccination coverage rate ranged from 10.40% in 2013-2014 to 27.62% in 2015-2016. The estimated number of influenza cases averted by vaccination ranged from a low of 0.28 (range: 0.23-0.34) during 2013-2014 (PF: 6.15%, range: 5.11-7.38%) to a high of 15.34 (range: 12.38-18.51) during 2017-2018 (PF: 16.54%, range: 13.79-19.30%). When increasing vaccination coverage rate by 10% in each town/street, a ratio of 7.27-10.69% cases could be further averted on the basis of observed cases. In four selected periods, the number of influenza cases in the general population was most significantly correlated with the cumulative childhood vaccination doses in the prior 2-5 months, and the reduction in influenza cases ranged from 0.73 to 3.18 cases per thousand additional childhood vaccination doses. Conclusion: Influenza vaccination among children is estimated to have direct effects in terms of averted cases and might provide an underlying indirect benefit to the general population. Vaccination coverage in high-coverage areas should be further expanded to avert more influenza cases.

Blood Circulation Assessment by Steadily Fluorescent Near-Infrared-II Aggregation-Induced Emission Nano Contrast Agents.

The dysfunction of the blood circulation system typically induces acute or chronic ischemia in limbs and vital organs, with high disability and mortality. While conventional tomographic imaging modalities have shown good performance in the diagnosis of circulatory diseases, multiple limitations remain for real-time and precise hemodynamic evaluation. Recently, fluorescence imaging in the second region of the near-infrared (NIR-II, 1000-1700 nm) has garnered great attention in monitoring and tracing various biological processes in vivo due to its advantages of high spatial-temporal resolution and real-time feature. Herein, we employed NIR-II imaging to carry out a blood circulation assessment by aggregation-induced emission fluorescent aggregates (AIE nano contrast agent, AIE NPs). Thanks to the longer excited wavelength, enhanced absorptivity, higher brightness in the NIR-II region, and broader optimal imaging window of the AIE NPs, we have realized a multidirectional assessment for blood circulation in mice with a single NIR-II imaging modality. Thus, our work provides a fluorescence contrast agent platform for accurate hemodynamic assessment.

Characteristics and risk assessment of chilling injury on Morchella esculenta in Western Sichuan Plateau, China.

The development of precise climate risk zoning for chilling injury of Morchella esculenta can provide scientific basis for agricultural cultivation planning, dynamic assessment of chilling injury, and disaster prevention strategies. Based on meteorological data from 17 counties (cities) that located below the altitude of 3000 m in the Western Sichuan Plateau from 2011 to 2020, we analyzed the critical meteorological conditions for M. esculenta disasters in typical years. With the average yearly cold accumulation and cold injury frequency during the first day when the temperature remained stable between 5 ℃ and 10 ℃ during mushroom emergence as zoning indicators, we established a geographical spatial distribution model of the cold injury index, and then divided the risk level of M. esculenta cold injury in the Western Sichuan Plateau, evaluated the risk of cold injury. The results showed that the temperature index for chilling injury risk of M. esculenta in the study area was the daily minimum temperature ≤2.0 ℃. The daily average temperature <6.0 ℃ would cause slow growth or the cessation of growth, which was set as a warning indicator for chilling injury risk. Along the Dadu River and Minjiang River basins, the frequency of chilling injury on M. esculenta increased from south to north. Wenchuan, Maoxian, and Lixian had the fewest overall chilling injuries during the study period, whereas Jiulong, Yajiang, and Batang had the most. The duration for cold injury was mainly 1-3 d, followed by 4-5 d, and rarely for >5 d. The frequency of chilling injury lasting for more than 5 d in Xiangcheng, Batang, Jiulong, Yajiang, and Xiaojin was more than that lasting for 4-5 d. The annual average days of chilling injury of was 3.0-27.4 d, the daily average minimum temperature was -0.84-1.36 ℃, the extreme lowest temperature was -5.8-0.1 ℃, and the average accumulated cold was 0.16-9.64 ℃·d during the period of chilling injury. With the increases of elevation and latitude, the average days of chilling injury and the average accumulated cold increased. The largest duration of chilling injury was 3-20 d, the maximum accumulated cold was 0.44-13.34 ℃·d. The risk of chilling injury to M. esculenta increased from south to north and from low elevation to high elevation. The suitable planting areas were distributed in strips and branches along the direction of mountains and rivers, mainly in the flat areas of low mountains and valleys below the altitude of 2200 m, including Kangding, Luding, Danba, Wenchuan, Lixian, Maoxian, Jiuzhaigou, and Songpan.

Enhanced adsorption of Congo red from urea/calcium chloride co-modified biochar: Performance, mechanisms and toxicity assessment.

Adsorbents with excellent physicochemical properties and green synthetic routes are desired for efficient removal of Congo red (CR) wastewater. Hence, a novel approach was proposed within this work. Biochar NCBC obtained from Medulla Tetrapanacis was synthesized through co-modification with urea/calcium chloride. NCBC exhibited an enormous surface area (750.09 m2/g) and a micro-mesoporous composite structure. Higher nitrogen content was detected on the surface of NCBC (8.17%) compared to that of urea directly modified biochar (4.63%). Nitrogen observed on the surface of NCBC was presented as graphitic N, pyrrolic N, amine N as well as pyridinic N. Kinetic and isothermal investigations revealed the active sites on NCBC to be homogeneous and bind to CR mainly by chemisorption. Calculated maximum sorption of CR on NCBC was 2512.82 mg/g basing on Langmuir model. Moreover, the practicality of NCBC was further proved by the cultivation of Nelumbo nucifera Gaertn. and Penicillium.

Analysis of spatial characteristics and geographic weighted regression of tuberculosis prevalence in Kashgar, China.

Number of cases of tuberculosis (TB) was higher than that of the national level in Kashgar, China. This study aimed to analyze the spatial and temporal distribution of TB and the relationship between TB and social factors, which can provide a reference for the prevention and control of TB. We applied spatial autocorrelation analysis to study the distribution of tuberculosis in Kashgar. We used a geographically weighted regression (GWR) model to analyze the relationship between TB and social factors. A total of 100,330 cases of TB in Kashgar from 2016 to 2021 were analyzed. The number of TB cases in Kashgar was higher in the east, lower in the west, and most elevated in the center. The highest cumulative number of cases was found in Shache county. Global Moran's I ranged from -0.212 to -0.549, and local spatial autocorrelation analysis identified four clusters. According to our analysis, the incidence of tuberculosis was negatively correlated among the regions of Kashgar, and the related causes need to be analyzed in depth in future studies. Per capita gross domestic product (GDP), number of medical institutions per capita, and total population influenced the incidence of tuberculosis in Kashgar. Based on our findings, we suggest some effective measures to reduce the risk of TB infection, such as improving the living standard, developing the regional economy, and distributing health resources rationally.

Accumbal adenosine A2A receptor inactivation biases for large and costly rewards in the effort- but not delay-based decision making.

The cost-benefit decision-making (CBDM) is critical to normal human activity and a diminished willingness to expend effort to obtain rewards is a prevalent/noted characteristic of neuropsychiatric disorders such as schizophrenia, Parkinson's disease. Numerous studies have identified nucleus accumbens (NAc) as an important locus for CBDM control but their neuromodulatory and behavioral mechanisms remain largely under-explored. Adenosine A2A receptors (A2ARs), which are highly concentrated in the striatopallidal neurons, can integrate glutamate and dopamine signals for controlling effort-related choice behaviors. While the involvement of A2ARs in effort-based decision making is well documented, the role of other decision variables (reward discrimination) in effort-based decision making and the role of A2AR in delay-based decision making are less clear. In this study, we have developed a well-controlled CBDM behavioral paradigm to manipulate effort/cost and reward independently or in combination, allowing a dissection of four behavioral elements: effort-based CBDM (E-CBDM), delay-based CBDM (D-CBDM), reward discrimination (RD), effort discrimination (ED), and determined the effect of genetic knockdown (KD) of NAc A2AR on the four behavioral elements. We found that A2AR KD in NAc increased the choice for larger, more costly reward in the E-CBDM, but not D-CBDM. Furthermore, this high-effort/high-reward bias was attributable to the increased willingness to engage in effort but not the effect of discrimination of reward magnitude. Our findings substantiate an important role of the NAc A2AR in control of E-CBDM and support that pharmacologically targeting NAc A2ARs would be a useful strategy for treating the aberrant effort-based decision making in neuropsychiatric disorders.

Analysis of the Operational Efficiency of Basic Medical Insurance for Urban and Rural Residents: Based on a Three-Stage DEA Model.

Following the integration of the urban residents' medical insurance into the new rural cooperative medical insurance in 2016, China has now formed a basic medical insurance system with the urban workers' basic medical insurance system and the rural residents' basic medical insurance system as the main entities. With the development of basic medical insurance, the protection for residents is becoming more and more comprehensive, and its fund expenditure also increases, so it is necessary to research the efficiency of the medical insurance fund expenditure. This paper conducts a three-stage DEA analysis of the efficiency of basic health insurance for urban and rural residents in 31 provinces, based on a Chinese panel data from 2017 to 2020. It is found that China's health insurance operation is still in the development stage, with four regions in the efficiency frontier and Guizhou province having the lowest efficiency value nationwide. The GDP and fiscal investment on social security effectively reduce the input redundancy in the basic health insurance operation, which contributes to the efficiency of the health insurance operation. This study further proposes suggestions and countermeasures to improve the operational efficiency of China's basic health insurance, based on the empirical results: (1) develop the economy and broaden the financing sources; (2) improve the level of health care services and improve the efficiency driven by quality; and (3) improve the level of health insurance supervision through multiple measures.

Factors influencing innovation performance of China's high-end manufacturing clusters: Dual-perspective from the digital economy and the innovation networks.

In the era of digital economy, the impact of innovation resources on high-quality economic growth has become increasingly prominent. There are many researches on the influencing factors of innovation performance. The purpose of this study is to explore the factors that affect the innovation performance of high-end manufacturing clusters in China based on the dual perspectives of digital economy and innovation network. A total of 194 valid questionnaires were collected. And structural equation modeling has been used to test the proposed research models and hypotheses. The results indicated that, the higher the centrality of the innovation network, the more the cluster enterprises can play the centrality advantage, which has a significant positive impact on the innovation performance of the cluster. Similarly, both the strength and density of innovation networks also impacted on cluster innovation performance, but to a lesser extent. We also found that the digital empowerment derived from the digital economy can get rid of the limitations caused by spatial distance and lead to the improvement of resource utilization, which plays a positive moderating role between innovation network and innovation capacity. Implications for digital economy and innovation networks to improve the quality of innovation performance are provided.

Self-interest is intuitive during opportunity (in)equity: Evidence from multivariate pattern analysis of electroencephalography data.

Fairness is a remarkable preference for human society, involving both outcome and opportunity equity. Most previous studies have explored whether fairness itself or self-interest is intuitive during outcome (in)equity. However, intuition during outcome (in)equity can be affected by both fairness level and actual payoff. Since opportunity (in)equity is only affected by the fairness level, we explored only intuition during fairness by measuring event-related potential responses to opportunity (in)equity. Participants played a social non-competitive two-person choice game with advantage opportunity inequity (AI), opportunity equity (OE), and disadvantage opportunity inequity (DI). The behavioral results suggested an opportunity inequity bias, with greater feelings of fairness and pleasantness during OE than during AI and DI. However, multivariate pattern analysis of the event-related potential (ERP) data suggested that AI, OE, and DI can be significantly distinguished from each other in relatively early windows overlapping with early positive negativity (EPN), and AI and DI can be significantly further distinguished during a relatively late window overlapping with late positive potential (LPP). Moreover, the conventional ERP analysis found that EPN amplitudes were more negative for AI than for OE and DI, as well as for OE than for DI, suggesting a pleasure bias for increased self-interest. LPP amplitudes were greater for DI than for AI and OE, suggesting enhanced sensitivity to DI. These results suggest that self-interest is intuitive during opportunity (in)equity.

Pharmaceuticals in drinking water sources and tap water in a city in the middle reaches of the Yangtze River: occurrence, spatiotemporal distribution, and risk assessment.

The occurrence of ten target pharmaceuticals was investigated in drinking water sources and tap water in a city in the middle reaches of the Yangtze River, including erythromycin (ERY), roxithromycin (RTM), ciprofloxacin (CPX), ofloxacin (OFX), sulfadiazine (SDZ), sulfamethoxazole (SMX), oxytetracycline (OTC), tetracycline (TC), ibuprofen (IBF), and naproxen (NPX). And the corresponding ecological risk for three classes of aquatic organisms and human health risk for different life stages were estimated. Results demonstrated that nine pharmaceuticals except for TC were detected with the frequencies of 20-100% and the concentrations of

The role of remittance inflow and renewable and non-renewable energy consumption in the environment: Accounting ecological footprint indicator for top remittance-receiving countries.

This study examines the impact of remittance inflow and foreign direct investment on ecological footprint in top ten remittance-receiving counties in the presence of economic growth and renewable and non-renewable energy under the framework of environmental Kuznets curve (EKC) hypothesis over the period of 1990-2018 by employing the continuously updated fully modified (CUP-FM) and the continuously updated bias-corrected (CUP-BC) estimators. The results show that remittance inflow, foreign direct investment, and non-renewable energy utilization affect the ecological footprint positively while renewable energy utilization negatively impacts on ecological footprint. This study also supports the pollution haven hypothesis and inverted U-shaped EKC hypothesis. The turning point obtained from long-run regression was found to be approximately $1368.65 outside of the sample period. Besides, the results are robust to various robustness analyses that we have executed for inspection of the reliability of our main findings. Finally, this study presents important policy implications with respect to the top remittance-receiving countries.

Brønsted-acid sites promoted degradation of phthalate esters over MnO2: Mineralization enhancement and aquatic toxicity assessment.

Advanced oxidation processes (AOPs) are important technologies for aqueous organics removal. Despite organic pollutants can be degraded via AOPs generally, high mineralization of them is hard to achieve. Herein, we synthesized a manganese oxide nanomaterial (H2-OMS-2) with abundant Brønsted-acid sites via ion-exchange of cryptomelane-type MnO2 (OMS-2), and tested its catalytic performance for the degradation of phthalate esters via peroxymonosulfate (PMS) activation. About 99% of dimethyl phthalate (DMP) at a concentration of 20 mg/L could be degraded within 90 min and 82% of it could be mineralized within 180 min over 0.6 g/L of catalyst and 1.8 g/L of PMS. The catalyst could activate PMS to generate SO4-˙ and ·OH as the dominant reactive oxygen species to reach complete degradation of DMP. Especially, the higher TOC removal rate was obtained due to the rich Brønsted-acid sites and surface oxygen vacancies on the catalyst. Kinetics and mechanism study showed that MnII/MnIII might work as the active sites during the catalytic process with a lower reaction energy barrier of 55.61 kJ/mol. Furthermore, the catalyst could be reused for many times through the regeneration of the catalytic ability. The degradation and TOC removal efficiencies were still above 98% and 65% after seven consecutive cycles, respectively. Finally, H2-OMS-2-catalyzed AOPs significantly reduced the organismal developmental toxicity of the DMP wastewater through the investigation of zebrafish model system. The present work, for the first time, provides an idea for promoting the oxidative degradation and mineralization efficiencies of aqueous organic pollutants by surface acid-modification on the catalysts.

The Role of Socioeconomic Status, Family Resilience, and Social Support in Predicting Psychological Resilience Among Chinese Maintenance Hemodialysis Patients.

Objectives: Evidence regarding the possible influence of social factors on psychological resilience among maintenance hemodialysis patients is scarce. The aim of this study was to explore the relationship among socioeconomic status, family resilience, and social support, and psychological resilience among Chinese maintenance hemodialysis patients. Methods: This cross-sectional study was conducted in the hemodialysis centers of three comprehensive hospitals in China from September to December 2020 using convenience sampling. Two hundred fifty-eight patients receiving maintenance hemodialysis were investigated using a sociodemographic questionnaire, the Chinese version of the Medical Outcomes Study-Social Support Survey (MOS-SSS), Chinese Family Resilience Assessment Scale (C-FRAS), and Chinese version of the Conner and Davidson resilience scale (CD-RISC). Results: Maintenance hemodialysis patients reported a low level of physical resilience, with a score of (58.92 ± 15.27). Hierarchical linear regression analysis showed that education level (ß = 0.127, p = 0.018), maintenance of a positive outlook by the family (ß = 0.269, p = 0.001), positive social interaction support from the family (ß = 0.233, p = 0.002), and tangible support (ß = -0.135, p = 0.037) were significantly associated with psychological resilience. Conclusion: SES, family resilience and social support may be potential predictive factors of psychological resilience. Interventions to improve the family resilience and social support may be beneficial to promote the psychological resilience of Chinese maintenance hemodialysis patients.

Trial Design and Statistical Considerations on the Assessment of Pharmacodynamic Similarity.

Pharmacodynamics (PD) similarity is an important component to support the claim of similarity between two drugs or devices. This article investigates the trial design and statistical considerations in the equivalence test of PD endpoints. Using bone resorption marker CTX as a case study, the relationship between the PD readouts and drug potency was explored to evaluate the sensitivity of the PD endpoint and guide equivalence margin selection. For PD data that have high baseline variability, one conventional similarity assessment method was to apply baseline-normalization followed by the standard bioequivalence (BE) test (Lancet Haematol. 4:e350-61, 2017, Ann Rheum Dis. 2017). This study showcased the drawbacks of the conventional method for PD data that were close to inhibition saturation, as the baseline-normalization significantly skewed the distribution of the PD data toward non-log-normal. In such cases, the standard BE test can produce an inflated type I error. Alternatively, ANCOVA, when applied to the un-normalized PD data with the baseline as a covariate, produced a satisfactory type I error with sufficient power. Therefore, ANCOVA was recommended for equivalence test of PD markers that has a saturated inhibition profile and high variability at baseline. Moreover, the relationship between PD readouts and drug potency was used to explore the sensitivity of the PD endpoint and it could help justify the equivalence margins, since the standard 80% to 125% BE margin often does not apply to PD. Finally, a decision tree was proposed to help guide the design of the PD equivalence study in the choice of PD endpoints and statistical methods.

Analytical Profiling of Proanthocyanidins from Acacia mearnsii Bark and In Vitro Assessment of Antioxidant and Antidiabetic Potential.

The proanthocyanidins from ethanol extracts (80%, v/v) of Acacia mearnsii (A. mearnsii) bark on chemical-based and cellular antioxidant activity assays as well as carbolytic enzyme inhibitory activities were studied. About 77% of oligomeric proanthocyanidins in ethanol extracts of A. mearnsii bark were found by using normal-phase HPLC. In addition, HPLC-ESI-TOF/MS and MALDI-TOF/TOF MS analyses indicated that proanthocyanidins from A. mearnsii bark exhibited with a degree of polymerization ranging from 1 to 11. These results of combined antioxidant activity assays, as well as carbolytic enzyme inhibitory activities of proanthocyanidins from A. mearnsii bark, indicated an encouraging antioxidant capacity for the high polyphenol content and a potential for use as alternative drugs for lowering the glycemic response.

HDAC4 mediates IFN-γ induced disruption of energy expenditure-related gene expression by repressing SIRT1 transcription in skeletal muscle cells.

Metabolic homeostasis is achieved through balanced energy storage and output. Impairment of energy expenditure is a hallmark event in patients with obesity and type 2 diabetes. Previously we have shown that the pro-inflammatory cytokine interferon gamma (IFN-γ) disrupts energy expenditure in skeletal muscle cells via hypermethylated in cancer 1 (HIC1)-class II transactivator (CIITA) dependent repression of SIRT1 transcription. Here we report that repression of SIRT1 transcription by IFN-γ paralleled loss of histone acetylation on the SIRT1 promoter region with simultaneous recruitment of histone deacetylase 4 (HDAC4). IFN-γ activated HDAC4 in vitro and in vivo by up-regulating its expression and stimulating its nuclear accumulation. HIC1 and CIITA recruited HDAC4 to the SIRT1 promoter and cooperated with HDAC4 to repress SIRT1 transcription. HDAC4 depletion by small interfering RNA or pharmaceutical inhibition normalized histone acetylation on the SIRT1 promoter and restored SIRT1 expression in the presence of IFN-γ. Over-expression of HDAC4 suppressed the transcription of genes involved in energy expenditure in a SIRT1-dependent manner. In contrast, HDAC4 knockdown/inhibition neutralized the effect of IFN-γ on cellular metabolism by normalizing SIRT1 expression. Therefore, our data reveal a role for HDAC4 in regulating cellular energy output and as such provide insights into rationalized design of novel anti-diabetic therapeutics.

Fitness costs and stability of Cry1Ab resistance in sugarcane borer, Diatraea saccharalis (F.).

The sugarcane borer, Diatraea saccharalis (F.), is a major target species of transgenic corn expressing Bacillus thuringiensis (Bt) proteins in South America and the U.S. mid-south region. In this study, the fitness of seven insect genotypes of D. saccharalis were assayed on non-toxic diet, which included a Cry1Ab-susceptible strain (SS-2009), two Cry1Ab-resistant strains (RR-43A(BC), RR-L5B(BC)), and four F1 hybrids (F1-R43A(m)S(f), F1-R43A(f)S(m), F1-R5B(m)S(f), and F1-R5B(f)S(m)). The F1 hybrids were generated by reciprocal crosses of SS-2009 with RR-43ABC and RR-L5BBC, respectively. Biological parameters measured were neonate-to-pupa survivorship, neonate-to-pupa development time, pupal mass, pupa-to-adult emergence rate, and progeny (neonates) production. The overall performance of the two resistant strains and the four F1 genotypes was either similar or better than SS-2009 for all biological parameters measured, suggesting a lack of fitness costs associated with the Cry1Ab resistance traits in both RR-43A(BC) and RR-L5B(BC). In addition, resistance stability was evaluated by measuring the Cry1Ab susceptibility of RR-43A(BC) and RR-L5B(BC) in the absence of selection pressure. Laboratory bioassays showed that larval mortality of the two resistant strains did not significantly increase after selection pressure was removed for 16 generations across all Cry1Ab concentrations assayed. The results provide valuable information on assessing resistance risk and developing effective management strategies for the sustainable use of Bt corn technology.