Toxicity assessment of organophosphate flame retardant triphenyl phosphate (TPHP) on intestines in mice.

Triphenyl phosphate (TPHP), one widely used organophosphate flame retardant, has attracted accumulating attention due to its high detection rate in human biological samples. Up to date, the effects of TPHP exposure on intestinal health remain unexplored. In this study, BALB/c mice were used as a model and exposed to TPHP at dose of 2, 10, or 50 mg/kg body weight for 28 days. We observed Crohn's disease-like features in ileum and ulcerative colitis disease-like features in colon, such as shorter colon length, ileum/colon structure impairment, intestinal epithelial cell apoptosis, enrichment of proinflammatory cytokines and immune cells, and disruption of tight junction. Furthermore, we found that TPHP induced production of reactive oxygen species and apoptosis in intestinal epithelial Caco-2 cells, accompanied by disruption of tight junction between cells. To understand the molecular mechanism underlying TPHP-induced changes in intestines, we build the adverse outcome pathway (AOP) framework based on Comparative Toxicogenomics and GeneCards database. The AOP framework revealed that PI3K/AKT and FoxO signaling pathway might be associated with cellular apoptosis, an increase in ROS production, and increased inflammation response in mouse ileum and colon tissues challenged with TPHP. These results identified that TPHP induced IBD-like features and provided new perspectives for toxicity evaluation of TPHP.

Comparison of diagnosis-related group based reimbursement and case-mix index within hospitalized patients before and after modified malnutrition diagnosis.

BACKGROUND AND OBJECTIVES: Lack of professional and accurate diagnosis of malnutrition led to a reduction in Diagnosis Related Group (DRG) payment and a decrease in Case-Mix Index (CMI). The aim of this study was to explore the effects of adding a proper nutritional diagnosis and modifying complication groups on DRG payment and CMI. METHODS AND STUDY DESIGN: Retrospective analysis was performed on patients ad-mitted to the hospital from January to June 2022 who had received a nutritional assessment. Patients were diagnosed as well-nourished, mild malnutrition, moderate malnutrition or severe malnutrition according to patient-generated subjective global assessment (PG-SGA) scores within 24 hours of admission. CMI and DRG hospital internal control standards were recalculated and compared with the original values. RESULTS: A total of 254 patients were enrolled, including 40 patients with mild malnutrition, 74 patients with moderate malnutrition and 122 patients with severe malnutrition. Of all subjects, 111 changed complication groups. The median of the DRG hospital internal control standard (12006.09 vs. 13797.19, p=0.01) and the median of CMI (0.91 vs. 1.04, p=0.026) were significantly higher than those before the diagnostic change. In patients with inflammatory bowel disease (IBD), the CMI value, hospital control standard of DRG, and the classification of DRG were significantly different from those before diagnosis revision (p<0.001). CONCLUSIONS: Fully identification and correct coding of malnutrition cases are conducive for hospitals to receive appropriate DRG compensation, and further contribute to the improvement of medical quality and the economic sustain-ability of hospitals.

Complexity of Government response to COVID-19 pandemic: a perspective of coupled dynamics on information heterogeneity and epidemic outbreak.

This study aims at modeling the universal failure in preventing the outbreak of COVID-19 via real-world data from the perspective of complexity and network science. Through formalizing information heterogeneity and government intervention in the coupled dynamics of epidemic and infodemic spreading, first, we find that information heterogeneity and its induced variation in human responses significantly increase the complexity of the government intervention decision. The complexity results in a dilemma between the socially optimal intervention that is risky for the government and the privately optimal intervention that is safer for the government but harmful to the social welfare. Second, via counterfactual analysis against the COVID-19 crisis in Wuhan, 2020, we find that the intervention dilemma becomes even worse if the initial decision time and the decision horizon vary. In the short horizon, both socially and privately optimal interventions agree with each other and require blocking the spread of all COVID-19-related information, leading to a negligible infection ratio 30 days after the initial reporting time. However, if the time horizon is prolonged to 180 days, only the privately optimal intervention requires information blocking, which would induce a catastrophically higher infection ratio than that in the counterfactual world where the socially optimal intervention encourages early-stage information spread. These findings contribute to the literature by revealing the complexity incurred by the coupled infodemic-epidemic dynamics and information heterogeneity to the governmental intervention decision, which also sheds insight into the design of an effective early warning system against the epidemic crisis in the future.

Global, regional and national burden of alcohol cardiomyopathy from Global Burden of Disease Study 2019.

This study aimed to provide up-to-date and comprehensive estimates on the global alcohol cardiomyopathy (ACM) from 1990 to 2019. Detailed data on the prevalence, disability-adjusted life-years (DALYs), deaths,percentage change in the number of cases and estimated annual percentage change (EAPC) of ACM worldwide from 1990 to 2019 were obtained or calculated from the Global Burden of Disease Study (GBD) 2019. Globally, the estimated prevalent cases of ACM in 2019 were 707,652 [95% uncertainty interval (UI): 545,182-924,392], with a 35.4% (28.2-44.2) increase from 522,616 (95% UI: 394,118-683,206) in 1990, while the age-standardized prevalence rate (ASPR) was slightly decreased with an overall EAPC of - 1.30 (- 1.38 - - 1.22). Similar to ASPR, the global age-standardized DALYs rate and age-standardized death rate (ASDR) also declined, with an EAPC of - 1.12(- 2.09 - - 0.14) and - 1.53(- 2.36 - - 0.70) from 1990 to 2019, respectively. Conversely, the number of ACM-related DALYs cases in 2019 was 2,441,108 (95% UI: 2,046,734-2,782,542), with an increase of 38.8%(2.8-59.9) over the past 30 years, and the number of ACM-related deaths in 2019 was 71,723 (95% UI: 60,167-81,995), with an increase of 33.1% (0.5- 51.9) compared with 1990. A significant variation in the burden of ACM was observed between different regions and countries. Although the ASPR, age-standardized DALYs rate and ASDR slightly decreased from 1990 to 2019, the absolute number of prevalent cases, DALYs cases and deaths significantly increased. This showed that the burden of ACM remains an important global public health concern. Public health policy and decision-makers should develop and implement more effective strategies specific to geographical location to combat and reduce the burden of ACM in the future.

To Float or Not to Float? Internal Migration of Skilled Laborers in China.

This paper uses data from job-recruiting platforms to study the distribution patterns and migration destination choices of a skilled internal migrant population. We find that, in most first-tier cities and most emerging second-tier cities, more than half of the skilled jobseekers do not hold local household registration. The most important finding of this paper is the heterogeneity of attributes prioritizations between intra- and inter- provincial migrants. Intra-provincial skilled migrants put more value on employment opportunities than on amenity attributes, while their inter-provincial counterparts prioritize amenity over employment aspects.

Gender differences in self-view and desired salaries: A study on online recruitment website users in China.

One explanation for the gender pay differences in labor markets is that women propose lower desired salaries. By using an actual job seeking resume database and applying text mining techniques, we are able to observe both the extent of gender differences in desired salaries and job-related self-view. We find gender differences in global self-view favoring females, and in some domain-specific self-view favoring males. Previous findings of disadvantaged groups having levels of self-view at least as high as those of advantaged groups lend credibility to our findings. Moreover, we argue that the differences in global self-view favoring females may be related to the theories of "belief flipping", since women in our sample of online-recruitment markets are distinct from the general population, with on average 15.2 years of education and 8.99 years of work experience, due to self-selection. In addition, we find that women do propose lower desired salary than men, after controlling for various factors such as human capital, marital status, industries. We further investigate the role of self-view and find it contributes to explain desired salaries, with modest mediator effect but little moderator effect on gender differences in desired salaries.

Understanding Dynamic Status Change of Hospital Stay and Cost Accumulation via Combining Continuous and Finitely Jumped Processes.

The Coxian phase-type models and the joint models of longitudinal and event time have been extensively used in the studies of medical outcome data. Coxian phase-type models have the finite-jump property while the joint models usually assume a continuous variation. The gap between continuity and discreteness makes the two models rarely used together. In this paper, a partition-based approach is proposed to jointly model the charge accumulation process and the time to discharge. The key construction of our new approach is a set of partition cells with their boundaries determined by a family of differential equations. Using the cells, our new approach makes it possible to incorporate finite jumps induced by a Coxian phase-type model into the charge accumulation process, therefore taking advantage of both the Coxian phase-type models and joint models. As a benefit, a couple of measures of the "cost" of staying in each medical stage (identified with phases of a Coxian phase-type model) are derived, which cannot be approached without considering the joint models and the Coxian phase-type models together. A two-step procedure is provided to generate consistent estimation of model parameters, which is applied to a subsample drawn from a well-known medical cost database.

Toxicity assessment of 7 anticancer compounds in zebrafish.

Toxicity is one of the major reasons for failure in drug development. Zebrafish, as an ideal vertebrate model, could also be used to evaluate drug toxicity. In this study, we aimed to show the predictability and highlight novel findings of toxicity in zebrafish model. Seven anticancer compounds, including triptolide (TP), gambogic acid (GA), mycophenolic acid (MPA), curcumin, auranofin, thalidomide, and taxol, were assessed in zebrafish for their toxicity. Three compounds (GA, TP, and taxol) showed highest acute lethality, with 50% lethal concentration ≈ 1 µmol/L. Missing tails, severe pericardial edema, and enlarged yolk sacs were observed in MPA-treated embryos. The development of pectoral fins was severely disturbed in thalidomide-, GA-, and TP-treated embryos. Bradycardia was observed in MPA- and thalidomide-treated groups. Our findings suggested that the zebrafish are a good model for toxicity assessment of anticancer compounds.