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A ligand-controlled regiodivergent and enantioselective ring expansion of benzosilacyclobutenes with internal naphthyl alkynes has been achieved by adjusting the ligand cavity size. The ligand (S)-8H-binaphthyl phosphoramidite, featuring small methyl groups on its arms, provides a spacious cavity that favors sterically demanding Si-Csp3 ring expansion, predominantly yielding axially chiral (S)-1-silacyclohexenyl arenes. In contrast, the ligand (R)-spiro phosphoramidite, with bulky t-Bu groups on its arms, offers a compact cavity that facilitates less sterically demanding Si-Csp2 ring expansion, leading primarily to axially chiral (S)-2-silacyclohexenyl arenes. Density functional theory calculations delineate distinct mechanistic pathways for each ring expansion route and elucidate their regio- and enantioselectivity.
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Particle rafts are a new kind of soft matter formed by self-organization on the interface, which possesses mechanical properties between fluid and solid, and they have been widely used in many industrial fields. In the present study, the compression experiment of a circular particle raft is first performed, where an SDS (sodium dodecyl sulfate)-coated metal ring is placed around its periphery. When the surfactant diffuses, the particle raft shrinks, and its shrinkage ratio increases with the increase in the surfactant concentration, where the experimental results are consistent with the numerical simulation. Next, the relationship between the initial surface tension difference of SDS and the radius shrinkage of the particle raft is obtained by dimensional analysis. In what follows, the diffusion model is built to quantify the diffusion process of SDS at the liquid-gas interface, and then the analytical concentration solution of the concentration of SDS at the periphery of particle raft is given. The particle raft is viewed as an elastic circular plate under the action of the radial pressure, which originates from the surface tension difference, which has been verified by the experimental result. These explorations cast a new light on how to apply loads to measure mechanical properties of soft matter, which also provide some inspirations on the design of microsensors and microfluidics.
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BACKGROUND: The Omicron variant broke out in China at the end of 2022, causing a considerable number of severe cases and even deaths. The study aimed to identify risk factors for death in patients hospitalized with SARS-CoV-2 Omicron infection and to establish a scoring system for predicting mortality. METHODS: 1817 patients were enrolled at eight hospitals in China from December 2022 to May 2023, including 815 patients in the training group and 1002 patients in the validation group. Forty-six clinical and laboratory features were screened using LASSO regression and multivariable logistic regression. RESULTS: In the training set, 730 patients were discharged and 85 patients died. In the validation set, 918 patients were discharged and 84 patients died. LASSO regression identified age, levels of interleukin (IL) -6, blood urea nitrogen (BUN), lactate dehydrogenase (LDH), and D-dimer; neutrophil count, neutrophil-to-lymphocyte ratio (NLR) as associated with mortality. Multivariable logistic regression analysis showed that older age, IL-6, BUN, LDH and D-dimer were significant independent risk factors. Based on these variables, a scoring system was developed with a sensitivity of 83.6% and a specificity of 83.5% in the training group, and a sensitivity of 79.8% and a sensitivity of 83.0% in the validation group. CONCLUSIONS: A scoring system based on age, IL-6, BUN, LDH and D-dime can help clinicians identify patients with poor prognosis early.
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COVID-19 , SARS-CoV-2 , Humanos , COVID-19/mortalidade , Masculino , Feminino , Pessoa de Meia-Idade , China/epidemiologia , Idoso , Fatores de Risco , Hospitalização/estatística & dados numéricos , Adulto , Prognóstico , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Fatores Etários , Modelos Logísticos , Neutrófilos , Nitrogênio da Ureia Sanguínea , L-Lactato Desidrogenase/sangueRESUMO
The purpose of this study was to explore the protective effect of SeMet on renal injury induced by AFB1 in rabbits and its molecular mechanism. Forty rabbits of 35 days old were randomly divided into control group, AFB1 group (0.3 mg AFB1/kg b.w), 0.2 mg/kg Se + AFB1 group (0.3 mg AFB1/kg b.w + 0.2 mg SeMet/kg feed) and 0.4 mg/kg Se + AFB1 group (0.3 mg AFB1/kg b.w + 0.4 mg SeMet/kg feed). The SeMet treatment group was fed different doses of SeMet diets every day for 21 days. On the 17-21 day, the AFB1 treatment group, the 0.2 mg/kg Se + AFB1 group and the 0.4 mg/kg Se + AFB1 group were administered 0.3 mg AFB1 /kg b.w by gavage (dissolved in 0.5 ml olive oil) respectively. The results showed that AFB1 poisoning resulted in the changes of renal structure, the increase of renal coefficient and serum biochemical indexes, the ascent of ROS and MDA levels, the descent of antioxidant enzyme activity, and the significant down-regulation of Nrf2, HO-1 and NQO1. Besides, AFB1 poisoning increased the number of renal apoptotic cells, rised the levels of PTEN, Bax, Caspase-3 and Caspase-9, and decreased the levels of PI3K, AKT, p-AKT and Bcl-2. In summary, SeMet was added to alleviate the oxidative stress injury and apoptosis of kidney induced by AFB1, and the effect of 0.2 mg/kg Se + AFB1 is better than 0.4 mg/kg Se + AFB1.
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Rim , Estresse Oxidativo , Selenometionina , Animais , Coelhos , Antioxidantes/farmacologia , Antioxidantes/metabolismo , Apoptose/efeitos dos fármacos , Proteína 1 Associada a ECH Semelhante a Kelch/metabolismo , Rim/patologia , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais , Selenometionina/farmacologia , Aflatoxina B1/toxicidade , NAD(P)H Desidrogenase (Quinona)/efeitos dos fármacos , NAD(P)H Desidrogenase (Quinona)/metabolismoRESUMO
Platinum metal (PtM, M=Ni, Fe, Co) alloys catalysts show high oxygen reduction reaction (ORR) activity due to their well-known strain and ligand effects. However, these PtM alloys usually suffer from a deficient ORR durability in acidic environment as the alloyed metal is prone to be dissolved due to its high electronegativity. Herein, we report a new class of PtMn alloy nanodendrite catalyst with low-electronegativity Mn-contraction for boosting the oxygen reduction durability of fuel cells. The moderate strain in PtMn, induced by Mn contraction, yields optimal oxygen reduction activity at 0.53â A mg-1 at 0.9â V versus reversible hydrogen electrode (RHE). Most importantly, we show that relative to well-known high-electronegativity Ni-based Pt alloy counterpart, the PtMn nanodendrite catalyst experiences less transition metals' dissolution in acidic solution and achieves an outstanding mass activity retention of 96 % after 10,000 degradation cycles. Density functional theory calculation reveals that PtMn alloys are thermodynamically more stable than PtNi alloys in terms of formation enthalpy and cohesive energy. The PtMn nanodendrite-based membrane electrode assembly delivers an outstanding peak power density of 1.36â W cm-2 at a low Pt loading and high-performance retention over 50â h operations at 0.6â V in H2 -O2 hydrogen fuel cells.
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A photonics-assisted radar receiver based on compressed sensing (CS) technology is proposed to receive frequency domain non-sparse radar signals. The radar echo signal is mixed with a pseudo-random binary sequence (PRBS) in a photonic random demodulator (RD) consisting of a laser diode (LD), a dual-drive Mach-Zehnder modulator (DD-MZM), and a photodetector (PD). After the mixed signal from the photonic RD is undersampled by an analog-to-digital converter (ADC), the echo signal is reconstructed in the digital domain using an overcomplete dictionary generated by the dictionary learning algorithm and sparse reconstruction algorithm. The target range can be then obtained by correlating the reconstructed echo signal and the transmitted one. Experimental results show that the proposed system can successfully reconstruct different kinds of undersampled non-sparse radar echo signals. When the compression ratio is 20, the ranging errors do not exceed 5â cm. The system provides a promising solution for recovering undersampled frequency domain non-sparse radar signals through photonics-assisted CS.
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BACKGROUND: A number of human diseases have been associated with Centromere protein N (CENPN), but its role in breast cancer is unclear. METHODS: A pan-cancer database of Genotype Tissue Expression (GTEx) and the Cancer Genome Atlas (TCGA) were used to examine the expression of CENPN. Using TCGA clinical survival data and breast cancer specimens from our center for validation, the relationship between CENPN expression, breast cancer prognosis, and clinicopathological characteristics of patients was examined. Bioinformatics was utilized to conduct an enrichment study of CENPN. Additionally, the potential of CENPN as a predictive biomarker for immunotherapy success was confirmed by analyzing the co-expression of CENPN with immune-checkpoint related genes, reviewing the TCGA database, and evaluating the correlation between CENPN expression and immune cell infiltration. Using the CCK8 test and colony formation assay, CENPN was evaluated for its ability to inhibit breast cancer cell proliferation. Transwell assays and scratch tests were used to assess the impact of CENPN on breast cancer cell migration. RESULTS: CENPN is found in a wide range of tumors, including breast cancer. Additional investigation revealed that CENPN was co-expressed with the majority of immune checkpoint-related genes, had the potential to serve as a predictive biomarker for immunotherapy effectiveness, and that high CENPN expression was linked to high Tregs and low CD8 + T cells and NK cells. Breast cancer cells' malignant characteristics, such as migration and cell proliferation, were inhibited by CENPN knockdown. CONCLUSIONS: According to our findings, CENPN may be an oncogene in breast cancer, as well as a new therapeutic target for immune checkpoint inhibitors.
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Neoplasias da Mama , Proteínas Cromossômicas não Histona , Feminino , Humanos , Neoplasias da Mama/genética , Proliferação de Células/genética , Biologia Computacional , OncogenesRESUMO
Wearing of vehicle parts could release many chemical additives into the environment, such as benzotriazoles (BTRs), benzothiazoles (BTHs), and p-phenylenediamines (PPDs), which are potentially toxic to wildlife and humans. This study investigated the occurrence, source, and risks of BTRs, BTHs, and PPDs in a source catchment providing water to Guangzhou, a megacity in South China, covering groundwater, surface water, and stormwater. The results showed that BTRs and BTHs were predominant in surface water and groundwater. Unexpectedly, the BTR and BTH concentrations were lower in surface water than groundwater in a third of the paired samples. For the first time, 6PPD-quinone, a toxic ozonation product of N-(1,3-dimethylbutyl)-N'-phenyl-1,4-phenylenediamine (6PPD), was extensively detected in source waters. Stormwater decreased the BTR concentrations but increased the 6PPD-quinone concentrations in surface water owing to their affiliation to suspended particles. From natural to urban segments of Liuxi river, a downstream increasing trend in BTR and BTH concentrations was observed, confirming that they are indicative of urban anthropogenic activities. Strong correlations between industrial activities and BTR or BTH concentrations in surface water indicated that industrial activities were their main sources. Six compounds were prioritized as potentially persistent, mobile, and toxic (PMT) chemicals, combing our monitoring results and REACH criterion. This study improves our understanding of the environmental fates and risks of water-soluble tire-wear chemicals, which provides important information for chemical management, and indicates attention should be paid to the risk posed by 6PPD-quinone in the source water.
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Benzoquinonas , Benzotiazóis , Água Subterrânea , Fenilenodiaminas , Rios , Poluentes Químicos da Água , Recursos Hídricos , Humanos , Benzotiazóis/análise , China , Cidades , Monitoramento Ambiental , Poluentes Químicos da Água/análise , Água Subterrânea/química , Benzoquinonas/análise , Rios/química , Efeitos AntropogênicosRESUMO
BACKGROUND: China has made substantial efforts aimed to promote the uptake of antiviral treatment of hepatitis B (HB). It is unclear whether these policies achieved the desired impact. This study adopted medicines procurement data from 31 provinces to generate the first evidence about the number of standard antiviral treatment of HB overtime at both national and provincial levels in China. METHODS: We performed the panel data analyses and quasi-experimental design with the time-varying difference-in-difference method combined with the event study approach to estimate the uptake of HB antiviral treatment before and after national policy changes. RESULTS: The overall trends in HB antiviral treatment at the national level increased incrementally during 2013-2020. There was 2.8862 million 12-month (person-year) antiviral standard treatment in 2020, which was only 8.93% of the eligible people estimated to need treatment. The number of monthly antiviral standard treatment increased by 42.4% (p = .001) overall following the nationwide adoption of the '4 + 7' pilot-pooled procurement prices in 2019, which brought substantial price reduction of core antivirals. CONCLUSIONS: A low treatment rate is a critical issue in reaching the elimination of viral hepatitis as a public health threat in China. Affordability is an important but not the only factor that determines the uptake of hepatitis treatment. Further scaling up and acceleration of treatment uptake will need strategies improving public awareness of HB, strengthening diagnosis, linking people who are infected to chronic care, reducing loss to follow-up, and ensuring people who are eligible get timely treatment.
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Antivirais , Hepatite B , Antivirais/uso terapêutico , China/epidemiologia , Análise de Dados , Hepatite B/tratamento farmacológico , Hepatite B/epidemiologia , HumanosRESUMO
Wastewater from certain industrial processes can be primary emission sources of per- and polyfluoroalkyl substances (PFAS) and fluorinated alternatives like chlorinated polyfluorinated ether sulfonates (Cl-PFESA). Two such industrial processes are electroplating and textile printing and dyeing (PD). This study focused on the fate of Cl-PFESA in wastewater from these two industrial processes, in comparison to other PFAS, as they went through different wastewater treatment plants located in southeast China. The total target PFAS concentrations were 520 ± 30 and 4200 ± 270 ng/L at the effluents of the PD WWTP and electroplating WWTP, respectively. Specifically, 6:2 Cl-PFESA (18%) and 8:2 Cl-PFESA (0.7%) were abundant in electroplating-wastewater. Cl-PFESA were also detected in PD wastewater but at trace concentrations and were likely present due to diffuse emissions. The dissolved-phase Cl-PFESA and PFAS mass flows through the WWTPs were fairly constant throughout both facilities. The majority of Cl-PFESA was captured by sludge sedimentation. However, there were individual treatment processes that could cause the wastewater concentrations to fluctuate, and also could lead to relative enrichment of specific Cl-PFESAs as indicated by the 6:2/8:2 Cl-PFESA ratios. Cl-PFESA and perfluoroalkyl sulfonic acids were more influenced by the investigated treatment processes than perfluorocarboxylic acids.
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Ácidos Alcanossulfônicos , Fluorocarbonos , Purificação da Água , Alcanossulfonatos , China , Éter , Éteres , Fluorocarbonos/análise , Águas ResiduáriasRESUMO
Methoxyphenols are an important class of compounds emerging from biomass combustion, and their reactions with ozone can generate secondary organic aerosols in the atmosphere. Here, we use a vertical wetted wall flow tube reactor to evaluate the effect of ionic strength on the heterogeneous reaction of gas-phase ozone (O3) with a liquid film of o-vanillin (o-VL) (2-hydroxy-3-methoxybenzaldehyde), as a proxy for methoxyphenols. Typical for moderately acidic aerosols, at fixed pH = 5.6, the uptake coefficients (γ) of O3 on o-VL ([o-VL] = 1 × 10-5 mol L-1) increase from γ = (1.9 ± 0.1) × 10-7 in the absence of Na2SO4 to γ = (6.8 ± 0.3) × 10-7 at I = 0.2 mol L-1, and then, it decreases again. The addition of NO3- ions only slightly decreases the uptakes of O3. Ultrahigh-resolution electrospray ionization Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) reveals that the formation of multicore aromatic compounds is favored upon heterogeneous O3 reaction with o-VL, in the presence of SO42- and NO3- ions. The addition of NO3- ions favors the formation of nitrooxy (-ONO2) or oxygenated nitrooxy group of organonitrates, which are components of brown carbon that can affect both climate and air quality.
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Ozônio , Aerossóis , Benzaldeídos , Carbono , Concentração Osmolar , Ozônio/análiseRESUMO
BACKGROUND: Papillary thyroid cancer cells can express oestrogen receptor alpha, which is encoded by the ESR1 gene and may bind to oestrogen to induce the occurrence and development of papillary thyroid cancer. The BRAFV600E mutation is also an important biomarker for the occurrence and progression of papillary thyroid cancer. However, the association between the BRAFV600E mutation and oestrogen receptor alpha expression has not been identified. This study aims to investigate the association between ESR1 expression and the BRAFV600E mutation and its clinical significance. METHODS: Oestrogen receptor alpha and BRAFV600E proteins were detected by immunohistochemical staining of formalin-fixed paraffin-embedded thyroid tissues from 1105 patients with papillary thyroid cancer at our institution. Messenger RNA expression counts of ESR1 and clinicopathologic information were obtained from The Cancer Genome Atlas database. RESULTS: Oestrogen receptor alpha protein expression was significantly associated with BRAFV600E protein. The positive rate of oestrogen receptor alpha protein in papillary thyroid cancer patients was significantly higher in males, younger patients and patients with the multifocal type. In papillary thyroid cancer patients with positive BRAFV600E protein, oestrogen receptor alpha expression was significantly correlated with central lymph node metastasis. Data from the The Cancer Genome Atlas database also suggested that the ESR1 messenger RNA level was associated with the BRAFV600E mutation. Furthermore, classification analysis performed according to a tree-based classification method demonstrated that higher ESR1 messenger RNA expression indicated poorer overall survival in papillary thyroid cancer patients with the BRAFV600E mutation. CONCLUSIONS: The percentage of BRAFV600E mutations is increased in patients with higher ESR1 messenger RNA levels, and the BRAFV600E protein might be co-expressed with oestrogen receptor alpha, which could be an indicator of cervical lymph node metastasis and poor overall survival in patients with papillary thyroid cancer.
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Receptor alfa de Estrogênio , Proteínas Proto-Oncogênicas B-raf , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Receptor alfa de Estrogênio/genética , Receptor alfa de Estrogênio/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas B-raf/metabolismo , Câncer Papilífero da Tireoide/genética , Câncer Papilífero da Tireoide/metabolismo , Neoplasias da Glândula Tireoide/genética , Neoplasias da Glândula Tireoide/metabolismoRESUMO
BACKGROUND: Launched in 2000, the truth campaign was one of the first health-related campaigns to embrace the building of a brand to further amplify its message, such as by building brand equity. Brand equity is an asset that represents the audience's perception of the brand. Previous research supports that strong brand equity is associated with lower tobacco intentions and behaviors; however, brand equity and its change over time have not been studied as it relates to e-cigarettes. This study examines the effects of change in brand equity on e-cigarette attitudes, intentions, and behaviors among youth and young adults. METHODS: The sample (N = 6427) is from the Truth Longitudinal Cohort, a nationally representative, longitudinal cohort of youth and young adults, ages 15-24. Variables include brand equity tobacco scale, demographic characteristics, and e-cigarette use status. The outcomes included anti-e-cigarette attitudes, intentions to use e-cigarettes, and use of e-cigarettes. Multiple and logistic regression models determined the relationship between change in brand equity from respondents at Spring 2018 to Spring 2019 and respondent e-cigarette outcomes at Fall 2019. All models controlled for demographic characteristics and cigarette use. RESULTS: Mean brand equity scores in Spring 2018 were significantly associated with greater anti-e-cigarette attitudes (ß = 0.17, 95% CI: 0.15, 0.19), lower odds of intention to use (OR = 0.75, 95% CI: 0.66, 0.85), and lower odds of current use (OR = 0.81, 95% CI: 0.72, 0.92). Change in brand equity from Spring 2018 to Spring 2019 was significantly associated with greater anti-e-cigarette attitudes (ß = 0.09, 95% CI: 0.06, 0.11) and lower odds of intention to use (OR = 0.79, 95% CI: 0.67, 0.93), but not associated with current use behaviors. CONCLUSIONS: Strengthening brand equity is an effective strategy for influencing anti-e-cigarette related attitudes and intentions, much like it is for anti-smoking campaigns. More research needs to be done on the relationship between change in brand equity and e-cigarette behavior to better understand how brand equity can be wielded to influence change in e-cigarette use behavior.
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Sistemas Eletrônicos de Liberação de Nicotina , Adolescente , Adulto , Atitude , Humanos , Intenção , Estudos Longitudinais , Prevenção do Hábito de Fumar , Adulto JovemRESUMO
OBJECTIVE: To analyze the clinical features of a Chinese pedigree affected with tuberculosis sclerosis and explore its molecular pathogenesis. METHODS: Clinical data of the proband and members of his pedigree were collected. Whole exome sequencing was carried out to detect variants of the TSC1 and TSC2 genes. Candidate variants was verified by Sanger sequencing and bioinformatic analysis. RESULTS: The proband and his mother, who also had mild features of tuberous sclerosis, were found to harbor a novel heterozygous c.4183C>T (p.Q1395X) variant of the TSC2 gene, which was absent in the 4 healthy relatives. Bioinformatic analysis suggested the variant to be likely pathogenic. CONCLUSION: The heterozygous c.4183C>T (p.Q1395X) variant of the TSC2 gene probably underlay the disease in this pedigree. Above finding has expanded the spectrum of TSC2 gene variants. The more severe symptoms in the proband may be attributed to phenotypic heterogeneity of this disease.
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Esclerose Tuberosa , China , Humanos , Mutação , Linhagem , Esclerose Tuberosa/genética , Proteína 2 do Complexo Esclerose Tuberosa/genéticaRESUMO
Lateral optical forces in a direction perpendicular to light propagation have attracted increasing interest in recent years. Up to now, all lateral forces can be attributed to the symmetry breaking in the lateral directions caused by either the morphology of the scatterer geometry or the optical fields impinging on the scatterer. Here we demonstrate, both numerically and analytically, that when an isotropic scatterer breaks the electric-magnetic symmetry, a new type of anomalous lateral force can be induced along the direction of translational invariance where the illumination striking the scatterer has no propagation, field gradient, or spin density vortex (Belinfante's spin momentum). Our analytical results are rigorous for an arbitrary size scatterer, ensuring the universality of our conclusion. Furthermore, the electric-magnetic symmetry-breaking-induced lateral force is comparable in magnitude to other components of the optical force and reversible in direction for different polarizations of the illuminating light, rendering it capable of practical optical manipulation as well as enriching the understanding of light-matter interaction.
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PURPOSE: To systematically compare the efficacy and safety of sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia (CSEA), a systematic review and meta-analysis of randomized controlled trials targeting parturients requesting labor analgesia was conducted. METHODS: The primary outcome measure was visual analog scale scores assessed at 10, 15, 30, and 60 min after intrathecal injection. Secondary outcomes included duration of spinal analgesia, incidence of side effects in parturients, and neonatal Apgar scores. RESULTS: Twelve randomized controlled trials, including data from 881 patients fulfilled the inclusion criteria. No clinically meaningful differences in pain reduction after intrathecal injection were found between the two analgesics. Sufentanil extended the duration of spinal analgesia by 25.40 min (95% CI 21.82 to 28.98 min; p < 0.00001) compared with fentanyl. The risk for pruritus, nausea, and vomiting among parturients was 82% for those using sufentanil (relative risk 0.82 [95% CI 0.67-0.99]; p = 0.04) and 48% for those using fentanyl (relative risk 0.48 [95% CI 0.29-0.80]; p = 0.005). Both the synthesis results and sensitivity analysis demonstrated no differences in the risk for respiratory depression between parturients using sufentanil versus fentanyl. The neonates in sufentanil group exhibited higher Apgar scores than the fentanyl group 5 min after delivery (weighted mean difference 0.10 [95% CI 0.05-0.16]; p = 0.0002). CONCLUSION: Existing evidence suggests that compared with fentanyl, sufentanil used for analgesia in combined spinal-epidural during labor is more effective in extending the duration of spinal analgesia, and may be safer for the infant. There was overall low clinical and statistical heterogeneity among the included studies. For all outcomes, variations caused by heterogeneity across trials were acceptable. Thus the findings of this meta-analysis may provide additional evidence for future clinical practices of pain relief in labor involving CSEA. Stronger evidence supporting this conclusion will require data from more high-quality and multicenter randomized controlled trials.
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Analgesia Epidural/métodos , Analgesia Obstétrica/métodos , Analgésicos Opioides/uso terapêutico , Fentanila/uso terapêutico , Trabalho de Parto/efeitos dos fármacos , Dor/tratamento farmacológico , Sufentanil/uso terapêutico , Analgésicos Opioides/administração & dosagem , Índice de Apgar , Feminino , Fentanila/administração & dosagem , Humanos , Recém-Nascido , Injeções Espinhais , Gravidez , Sufentanil/administração & dosagemRESUMO
BACKGROUND: Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health-care reform in China. This paper aimed to explore patient- and hospital-level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient-oriented health-care system. METHODS: The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. RESULTS: Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse-to-bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. CONCLUSION: Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well-functioning health-care delivery system in order to better serve patients in China.
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Pacientes Internados/estatística & dados numéricos , Cuidados de Enfermagem/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Idoso , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Based on the full wave simulation, we demonstrate that a circularly polarized vector Airy beam can selectively transport small chiral particles along a curved trajectory via the chirality-tailored optical forces. The transverse optical forces can draw the chiral particles with different particle chirality towards or away from the intensity maxima of the beam, leading to the selective trapping in the transverse plane. The transversely trapped chiral particles are then accelerated along a curved trajectory of the Airy beam by the chirality-tailored longitudinal scattering force, rendering an alternative way to sort and/or transport chiral particles with specified helicity. Finally, the underlying physics of the chirality induced transverse trap and de-trap phenomena are examined by the analytical theory within the dipole approximation.
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Objective: To examine the relationship between menthol perceptions and support for a national menthol ban. Participants: Data were collected from a nationally representative probability-based panel of adults aged ≥18 years during June 21, 2016 through July 18, 2016. A total of 1,303 respondents, including an oversample of 300 African Americans, completed the survey. Main Outcome Measures: Weighted logistic regression models examined the relationship between menthol perceptions, specifically related to health and addiction, and the outcome measure: support for a menthol ban, by menthol smoking status. All models controlled for age, sex, education level, and race/ethnicity. Results: The association between reporting accurate menthol health perceptions differed by menthol preference. Among non-menthol smokers, there was no association between accurate menthol health perceptions and support of a menthol ban while more accurate menthol perceptions of addiction were associated with greater support of a menthol ban (aOR=2.83, CI=1.19-6.72). Among menthol smokers, more accurate health-related menthol perceptions were associated with increased odds of supporting a menthol ban (aOR=3.90, CI=1.02-14.79) while more accurate menthol addiction perceptions were not. Conclusions: Fewer current menthol smokers support a menthol ban than current non-menthol smokers given its effect on their preferred product. Given the large proportions of smokers who have misperceptions of the health consequences and addictive properties of menthol, there is a moral imperative to inform those who use these products. Findings suggest the need for tailored messaging strategies targeted to reach menthol smokers who will be most impacted by a ban, but also have the most to gain from such a policy change.
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Conhecimentos, Atitudes e Prática em Saúde , Política de Saúde , Mentol , Fumantes/psicologia , Fumantes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Percepção , Inquéritos e Questionários , Adulto JovemRESUMO
Based on the generalized Lorenz-Mie theory and the Maxwell stress tensor approach we present the first rigorous full-wave solution of the optical forces acting on spherical microparticles immersed in a two-dimensional vector Airy beam beyond the paraxial approximation. The critical aspect lies in evaluating efficiently and accurately the partial wave expansion coefficients of the incident Airy beam, which are achieved by using the vector angular spectrum representation for a variety of polarizations. The optical field distributions are then simulated to show the self-accelerating and self-healing effects of the Airy beam. The dielectric and gold microparticles are shown to be trapped within the main lobe or the nearby side-lobes mostly by the transverse gradient optical force while driven forward along the parabolic trajectory of the Airy beam by the longitudinal scattering force. It is thus demonstrated theoretically that the vector Airy beam has the capability of precisely transporting both dielectric and metallic microparticles along the prespecified curved paths.