Human resource allocation status and equity research of Centers for Disease Control and Prevention in China from 2016 to 2020.

Background: In recent years, the development of global public health has become a matter of great concern and importance for governments worldwide. China, as the largest developing country, plays a crucial role in shaping the development of the public health and its ability to respond to sudden public health emergencies through the fairness of its human resource allocation in center for disease control and prevention (CDC). Objective: This study aims to analyze the situation of health human resource allocation in the China Centers for Disease Control and Prevention (China CDCs), assess the fairness of the allocation, and provide reference for the rational allocation of human resources. Methods: We selected data from the China Health Statistics Yearbook on healthcare technical personnel, other technical personnel, managerial personnel, and workforce technical personnel of China CDCs for the period of 2016-2020. We utilized the Health Resource Density Index to evaluate the level of human resource allocation in China CDCs. Additionally, we used the Gini coefficient and Theil index to assess the fairness of human resource allocation in China CDCs from both a population and geographical perspective. Results: Firstly, the educational qualifications and professional titles of CDC staff have improved, but the workforce is aging. Secondly, HRDI development trends vary among different personnel types and regions with varying levels of economic development. Finally, the results of the Gini coefficient and Theil index indicate that population distribution fairness is better than geographical distribution fairness. Overall, the unfair population distribution is primarily due to regional disparities. Conclusion: The China CDCs should tailor different standards for the allocation of health human resources based on regional characteristics, aiming to enhance the accessibility of health human resources in various regions and achieve equitable allocation.

The impact of admission modes on the treatment outcome and in-hospital mortality rate of STEMI patients undergoing PPCI.

The current research on ST elevation myocardial infarction (STEMI) patients has been mostly limited to Door-to-Balloon (D-to-B) time. This study aimed to compare the effects of different hospital admission modes to on the time metrics of patients undergoing primary percutaneous coronary intervention (PPCI). It also examined the effects of these modes on in-hospital mortality and other influencing factors. The goal was to prompt healthcare facilities at all levels, including chest hospitals, the Centers for Disease Control and Prevention (CDC), and communities to take measures to enhance the treatment outcomes for patients with STEMI. A total of 1053 cases of STEMI patients admitted to Tianjin Chest Hospital from December 2016 to December 2023 and successfully underwent PPCI were selected for this study. They were divided into three groups based on the admission modes: the ambulances group (363 cases), the self-presentation group (305 cases), and the transferred group (385 cases). Multivariate logistic regression was used to explore the impact of different modes of hospital admission on the standard-reaching rate of key treatment time metrics. The results showed that the S-to-FMC time of transferred patients (OR = 0.434, 95% CI 0.316-0.596, P < 0.001) and self-presentation patients (OR = 0.489, 95% CI 0.363-0.659, P < 0.001) were more likely to exceed the standard than that of ambulance patients; The cath lab pre-activation time of self-presented patients was also less likely to meet the standard than that of ambulance patients (OR = 0.695, 95% CI 0.499-0.967, P = 0.031); D-to-W time of self-presentation patients was less likely to reach the standard than that of ambulance patients (OR = 0.323, 95% CI 0.234-0.446, P < 0.001);However, the FMC-to-ECG time of self-presentation patients was more likely to reach the standard than that of ambulance patients (OR = 2.601, 95% CI 1.326-5.100, P = 0.005). The Cox proportional hazards model analysis revealed that for ambulance patients, the time spent at each key treatment time point is shorter, leading to lower in-hospital mortality rate (HR0.512, 95% CI 0.302-0.868, P = 0.013) compared to patients admitted by other means. We found that direct arrival of STEMI patients to the PCI hospital via ambulance at the onset of the disease significantly reduces the S-to-FMC time, FMC-to-ECG time, D-to-W time, and catheterization room activation time compared to patients who self-present. This admission mode enhances the likelihood of meeting the benchmark standards for each time metric, consequently enhancing patient outcomes.

The bricolage mode of emergency medical teams in China: deficient and in urgent need of transformation-A qualitative study.

Introduction: Emergency medical rescue plays a vital role in alleviating the harm of all kinds of emergencies to people's physical and mental health and life safety. The current emergency medical teams (EMTs) formation model is not unified. We focused on the disadvantages of the bricolage mode of China EMTs and put forward empirical-based countermeasures to improve the emergency management ability of EMTs. Methods: From March to September 2022, 23 leaders of EMTs in North China (Tianjin) were selected by objective sampling method to conduct one-to-half structured in-depth interviews. Nvivo12.0 software was used for three-level coding. The disadvantages of the bricolage model of EMT were analyzed. Results: Based on the three-level coding, 150 initial concepts, 36 sub-coding, 17 main coding, six categories, and two core categories were sorted out. Management structure, internal stability, and support are recognized as the crucial elements armed with the EMTs. Discussion: The bricolage EMTs have disadvantages such as a chaotic management structure, weak internal stability, and inadequate support. It is necessary to construct full-time EMTs that incorporate a standardized personnel admission mechanism, full-time training and exercise mechanism, diversified incentive mechanism, and multi-agent cooperation mechanism, etc.

Preferences for Physical Examination Service in Community Health Service Center in China: A Discrete Choice Experiment.

Objective: Physical examination services play a crucial role in the early detection of diseases, improving the effectiveness of treatment. However, the current physical examination services provided by community health service centers are limited. The objective of this study was to investigate the aspects of physical examination services that are most valued by residents. Methods: Identify and develop attributes and levels through literature research and expert group interviews. A discrete choice experiment was designed. The main effects design gives rise to 16 choice sets. The 16 choice sets were grouped into 2 blocks, and respondents were randomly assigned to one of the blocks. In each choice set, respondents were asked to choose from two alternatives with an opt-out option. In 2023, the discrete choice experiment was administered in several community health service centers within a China population sample. A mixed logit and a latent class analysis were conducted. Results: Participants (n = 399) preferred to receive health advice service. The services provided by the basic team with clinical experts are preferred over those provided solely by the basic team. The results indicated a preference for a participant to be serviced by face-to-face or telephone compared with WeChat. Low cost is also preferred. As participants grow older, their preference for face-to-face or telephone-based services increased. As participants' service demand increase, participants more preferred to receive interpretation of physical examination report and follow-up of important abnormal results, participants more preferred to be serviced by basic team with clinical experts or basic team with health manager etc. Conclusion: We should improve the construction of the service team, optimize the service mode, expand the scope of examination services, reduce the cost of examination services, and meet the needs of residents for physical examination services. More attention should be paid to the needs of elderly and rural residents.

Synthesis and fungicidal activity of novel chloro-containing 1-aryl-3-oxypyrazoles with an oximino ester or oximino amide moiety.

Six novel chloro-containing 1-aryl-3-oxypyrazoles TMa-TMf with an oximino ester or an oximino amide moiety were prepared by the reaction of 1-aryl-1H-pyrazol-3-ols with benzyl bromide. Their structures were characterized by 1H-NMR, 13C-NMR, IR, MS, and elemental analysis. A preliminary in vitro bioassay indicated that compounds TMa, TMe and TMf displayed excellent fungicidal activity against Rhizoctonia solani and could be used as potential lead compounds for further development of novel fungicides.

Synthesis, spectroscopic characterization, X-ray structure, and DFT calculations of some new 1,4-dihydro-2,6-dimethyl-3,5-pyridinedicarboxamides.

A series of novel 1,4-dihydro-2,6- dimethyl-3,5-pyridinedicarboxamides were synthesized and characterized by infrared absorption spectrum (IR), proton nuclear magnetic resonance (1H NMR), elemental analysis, ultraviolet spectrum (UV), and fluorescence techniques, together with X-ray single crystal diffraction. The results of density functional theory (DFT) and time-dependent density functional theory (TDDFT) calculations provided a reasonable explanation on the molecular structures, the molecular frontier orbital, and the spectra of electronic absorption and emission. The present work will be helpful to systematically understanding of the structures and the optical properties of 1,4-dihydropyridines for studying the structure-activity relationship and to develop new drugs and their analytical methods.

Synthesis, crystal structure, vibration spectral, and DFT studies of 4-aminoantipyrine and its derivatives.

Three compounds derived from 4-aminoantipyrine (AA) were synthesized and their structures confirmed by melting point, elemental analysis, FT-IR, and 1H-NMR. The molecular structures of the four compounds were characterized by single-crystal X-ray diffraction and calculated by using the density functional theory (DFT) method with 6-31G (d) basis set. The calculated molecular geometries and the vibration frequencies of the AA derivatives in the ground state have been compared with the experimental data. The results show that the optimized geometries can reproduce well the crystal structural parameters, and the theoretical vibration frequencies show good agreement with the experimental data, although the experimental data are different from the theoretical ones due to the intermolecular forces. Besides, the molecular electrostatic potential (MEP) and the frontier molecular orbital (FMO) analysis of the compounds were investigated by theoretical calculations.

N-(1,5-Dimethyl-3-oxo-2-phenyl-2,3-dihydro-1H-pyrazol-4-yl)formamide.

In the title compound, C(12)H(13)N(3)O(2), the dihedral angle between the pyrazole and benzene rings is 50.0 (3)°. In the crystal, mol-ecules are linked by inter-molecular N-H⋯O hydrogen bonds to form a three-dimensional network. Two weak C-H⋯π inter-actions reinforce the crystal packing.

N-(4-Butanoyl-3-hy-droxy-phen-yl)butanamide.

The title compound, C(14)H(19)NO(3), was prepared via the intra-molecular rearrangement of 3-(butanoyl-amino)-phenyl butano-ate in the presence of anhydrous aluminium chloride. The near coplanarity of the aromatic ring, the amide group and the carbonyl group of the butanoyl fragment [N-C-C-C = -179.65 (17) and O-C-C-C = -178.34 (17)°] results from the intra-molecular O-H⋯O and C-H⋯O hydrogen bonds. In the crystal, the mol-ecules form a one-dimensional polymeric structure via N-H⋯O inter-actions between their amide groups.

4-(9,10-Dioxo-9,10-dihydro-anthracen-1-yl)-4-oxobutanoic acid.

In the title compound, C(18)H(12)O(5), the anthracene moiety is almost planar (r.m.s. deviation = 0.0399 Å). In the crystal, mol-ecules are linked to each other by inter-molecular O-H⋯O and weak C-H⋯O hydrogen bonds.

Ethyl 4-{2,6-dichloro-4-[3-(2,6-difluoro-benzo-yl)ureido]phen-oxy}butanoate.

The title compound, C(20)H(18)Cl(2)F(2)N(2)O(5), is considered to belong to the fourth generation of insecticides with properties such as high selectivity, low acute toxicity for mammals and high biological activity. An intramolecular N-H⋯O hydrogen bond results in the formation of a six-membered ring. In the crystal structure, intermolecular N-H⋯O and C-H⋯F hydrogen bonds link the molecules.

N-{[2,5-Dichloro-4-(1,1,2,3,3,3-hexa-fluoro-prop-oxy)phen-yl]amino-carbon-yl}-2,6-difluoro-benzamide.

In the mol-ecule of the title compound, C(17)H(8)Cl(2)F(8)N(2)O(3), the two aromatic rings are oriented at a dihedral angle of 50.12 (3)°. Intra-molecular N-H⋯O, C-H⋯O and N-H⋯Cl hydrogen bonds result in the formation of two six- and one five-membered rings. The six-membered rings have flattened-boat conformations, while the five-membered ring adopts an envelope conformation. In the crystal structure, inter-molecular N-H⋯O hydrogen bonds link the mol-ecules into centrosymmetric dimers.

Methyl 2-{[3-(4,6-dimethoxy-pyrimidin-2-yl)ureido]sulfonyl-meth-yl}benzoate.

In the title compound, C(16)H(18)N(4)O(7)S, a synthetic sulfonyl-urea herbicide, there are intra-molecular N-H⋯N and C-H⋯O hydrogen bonds. Inter-molecular N-H⋯O and C-H⋯O hydrogen bonds form centrosymmetric dimers. The dihedral angle between the two rings is 50.00 (15)°.

Bis(3-amino-phen-yl) sulfone acetonitrile solvate.

In the sulfone mol-ecule of the title compound, C(12)H(12)N(2)O(2)S·C(2)H(3)N, the two benzene rings are oriented at a dihedral angle of 80.69 (3)°. Weak intra-molecular C-H⋯O hydrogen bonds result in the formation of two five-membered rings, which both have envelope conformations. In the crystal structure, inter-molecular N-H⋯O hydrogen bonds link the mol-ecules.

1-(2-Chloro-benzo-yl)-3-[4-(trifluoro-meth-oxy)phen-yl]urea.

The title compound, C(15)H(10)ClF(3)N(2)O(3), is considered to belong to a fourth generation of insecticides with properties such as high selectivity, low acute toxicity for mammals and high biological activity. The dihedral angle between the two benzene rings is 59.3 (2)°. Intra-molecular C-H⋯O and N-H⋯O hydrogen bonds are observed. Inter-molecular N-H⋯O hydrogen bonding generates a centrosymmetric dimer. The F atoms are disordered over two positions; the site occupancy factors are 0.52 and 0.48.

N,N-Dimethyl-N'-[3-(trifluoro-methyl)-phenyl]-urea.

The title compound, C(10)H(11)F(3)N(2)O, is an important urea-based herbicide. In the crystal structure, the mol-ecular packing is stabilized by two intra-molecular C-H⋯O hydrogen bonds and one inter-molecular N-H⋯O hydrogen bond, generating a C(4) graph-set motif running parallel to the [001] direction. The F atoms are disordered over two sites, with occupancies of 0.176 (9) and 0.824 (9).

Ethyl 2-{N-[N-(4-chloro-6-methoxy-pyrimidin-2-yl)carbamo-yl]sulfamo-yl}benzoate.

The asymmetric unit of the title compound, C(15)H(15)ClN(4)O(6)S, contains two independent mol-ecules, in which the pyrimidine and benzene rings are oriented at dihedral angles of 75.21 (3) and 86.00 (3)°. Intra-molecular N-H⋯N and C-H⋯O hydrogen bonds result in the formation of two five- and two six-membered rings. The six-membered rings have flattened-boat conformations, while the five-membered rings adopt envelope conformations. In the crystal structure, inter-molecular N-H⋯O hydrogen bonds link the mol-ecules.

Bis(3-nitro-phen-yl) sulfone.

The asymmetric unit of the title compound, C(12)H(8)N(2)O(6)S, an important diphenyl sulfone derivative, contains one half-mol-ecule; a mirror plane passes through the SO(2) group. The dihedral angle between the two symmetry-related benzene rings is 40.10 (13)°. An intra-molecular C-H⋯O hydrogen bond results in the formation of a five-membered ring, which adopts an envelope conformation.