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1.
Cont Lens Anterior Eye ; 47(2): 102131, 2024 Apr.
Article En | MEDLINE | ID: mdl-38403480

PURPOSE: To investigate the influence of corneal parameters on the treatment zone area (TZA) after Corneal Refractive Therapy (CRT) with a 5.0-mm back optical zone diameter (BOZD) were worn and to compare changes in the axial length (AL) with traditional 6.0-mm BOZD lenses. METHODS: This retrospective study involved 146 subjects (7-12 years) who wore orthokeratology (ortho-K) lenses for one year: 86 subjects were treated with CRT 5.0-mm lenses, and 60 subjects were treated with CRT 6.0-mm lenses. The TZA was measured after one year of ortho-K treatment. Both TZA and AL elongation after wearing the two kinds of lenses was compared. The parameters were recorded in the CRT 5.0 group: flat K, steep K, corneal toricity, e value, and anterior corneal elevation values at the 3-, 4-, and 5-mm chords along the principal meridians of the superior, inferior, nasal, and temporal sides. The relationships between these data and the TZA were analyzed. RESULTS: The TZA was 12.90 ± 5.15 mm2 and 20.61 ± 4.54 mm2, and the AL elongation was 0.15 ± 0.18 mm and 0.26 ± 0.18 mm in the CRT 5.0 group and the CRT 6.0 group, respectively (all p < 0.001). The one-year AL elongation was significantly associated with initial age and the TZA (r =  - 0.394, 0.393; all p < 0.001) in the CRT 5.0 group. The following corneal parameters were found to have statistically significant correlations with the TZA: the e value, difference in corneal elevation (nasal-temporal at the 3-, 4-, and 5-mm chord), and the absolute value of elevation difference (nasal-temporal at the 3- and 4-mm chord and inferior-superior at the 3-, 4-, and 5-mm chord). The e value was the only relevant factor for the TZA by multiple regression analysis (unstandardized ß = 14.219, p = 0.008). In the CRT 6.0 group, the one-year AL elongation was statistically significantly associated only with initial age (r =  - 0.605, p = 0.005), but not with the TZA (p = 0.161). CONCLUSIONS: A smaller TZA induced by a smaller BOZD may be beneficial for retarding AL elongation in children undergoing ortho-K treatment. The morphology and eccentricity of the cornea may show effects on the TZA.


Contact Lenses , Myopia , Orthokeratologic Procedures , Child , Humans , Corneal Topography , Retrospective Studies , Myopia/therapy , Cornea , Refraction, Ocular , Axial Length, Eye
2.
Cont Lens Anterior Eye ; 47(2): 102122, 2024 Apr.
Article En | MEDLINE | ID: mdl-38220497

PURPOSE: To compare the efficiency of orthokeratology (OK) and defocus-incorporated multiple segment (DIMS) lenses in myopia control in children. METHODS: This prospective study involved 540 subjects (7-14 years) categorized into three groups: DIMS lenses (180 cases), OK lenses (180 cases), or single-vision spectacles (SVS) (180 cases). After a one-year follow-up, changes in axial length (AL) and differences among the groups were analyzed. The subjects were further divided into a low myopia degree subgroup (LM, -1.50 D ≤ SE ≤ -0.50 D), a moderate myopia degree subgroup (MM, -3.00 D ≤ SE < -1.50 D), and a high myopia degree subgroup (HM, -5.00 D ≤ SE < -3.00 D). A one-way ANOVA and multiple linear regression analysis were used to compare AL elongation and the factors influencing the different groups. RESULTS: A total of 496 (92 %) subjects completed the study. The mean AL change in the OK lenses, DIMS lenses, and SVS were 0.20±0.18 mm, 0.30±0.22 mm, and 0.38±0.19 mm, respectively (P < 0.001). In the LM subgroup, the OK and DIMS groups showed similar AL changes, but both exhibited slower changes than the SVS group (P = 0.001). In the MM and HM subgroups, the OK lens performed the shortest AL elongation compared with the DIMS lenses and SVS (P < 0.001). Multiple regression analysis showed that the AL change was associated with age (ß = -0.038 and P = 0.005), initial AL (ß = -0.010 and P = 0.011), initial SE (ß = 0.028 and P = 0.007), and interventions using OK lenses (ß = -0.172 and P = 0.020) and DIMS lenses (ß = -0.089 and P = 0.020). CONCLUSION: Over a one-year treatment period, OK and DIMS lenses can significantly retard AL elongation compared with SVS. In addition, the OK lenses were more effective than the DIMS lenses in controlling AL in patients with higher degrees of myopia.


Myopia , Orthokeratologic Procedures , Child , Humans , Refraction, Ocular , Prospective Studies , Myopia/diagnosis , Myopia/therapy , Eyeglasses , Axial Length, Eye
3.
Heliyon ; 9(10): e21141, 2023 Oct.
Article En | MEDLINE | ID: mdl-37916102

Limited research has focused on the psychological pain among older people and factors associated with psychological distress in older adults also remain to be evaluated. This study aims to examine the status and correlates of psychological pain among older people from urban and rural areas in China. This cross-sectional study analyzed data from 4312 samples which extracted from the dataset of China's Health-Related Quality of Life Survey for Older Adults 2018. Psychological pain was assessed by the Chinese version of the Psychache Scale (PAS). Multiple linear regression models were established to examine the associations between demographic characteristics and psychological pain. The average score of PAS among older people was 41.79 ± 14.52, and the average score of PAS among urban older people was higher than rural ones in this study. For rural older people, age (B ≥ 80 = 2.55), gender (B Female = 1.27), educational level (B Primary school = 1.63; B ≥ Middle school = 0.27), smoking (B yes = 0.83), number of chronic diseases (B ≥ 2 = 3.19) and personal social capital (B BRC = 0.27) were positively related to psychological pain, while family per-capita annual income (B15,000-30,000 = -2.52; B > 30,000 = -3.44), living arrangement (B With spouse = -3.40; B With children = -2.89; B Others = -3.82) and personal social capital (B BOC = -0.36) were negatively associated with psychological pain (p < 0.05). Moreover, for urban older people, gender (B Female = 0.98), current occupation (B With occupation = 1.13) and smoking (B yes = 2.14) were positively related to psychological pain, whereas age (B ≥ 80 = -1.45), family per-capita annual income (B > 30,000 = -3.63), living arrangement (B With spouse = -1.31), BMI (Bnormal = -2.62) and personal social capital (B BOC = -0.16) were negatively associated with psychological pain (p < 0.05). The present study sheds light on the worrying state of psychological pain experienced by Chinese older people. The results suggest that targeted interventions and social support, should be taken to alleviate the psychological pain among older people, especially urban older people.

4.
Materials (Basel) ; 16(22)2023 Nov 16.
Article En | MEDLINE | ID: mdl-38005114

The high-cycle bending fatigue experiment is one of the most important necessary steps in guiding the crankshaft manufacturing process, especially for high-power engines. In this paper, an accelerated method was proposed to shorten the time period of this experiment. First, the loading period was quickened through the prediction of the residual fatigue life based on the unscented Kalman filtering algorithm approach and the crack growth speed. Then, the accuracy of the predictions was improved obviously based on the modified training section based on the theory of fracture mechanics. Finally, the fatigue limit load analysis result was proposed based on the predicted fatigue life and the modified SAFL (statistical analysis for the fatigue limit) method. The main conclusion proposed from this paper is that compared with the conventional training sections, the modified training sections based on the theory of fracture mechanics can obviously improve the accuracy of the remaining fatigue life prediction results, which makes this approach more suitable for the application. In addition, compared with the system's inherent natural frequency, the fatigue crack can save the experiment time more effectively and thus is superior to the former factor as the failure criterion parameter.

6.
PLoS One ; 18(9): e0291135, 2023.
Article En | MEDLINE | ID: mdl-37699021

In modern engineering application, enough high cycle bending fatigue strength is the necessary factor to provide the basic safety security for the application of the crankshaft in automobile engines (both diesel and gasoline types). At present, this parameter is usually obtained through the standard bending fatigue experiment process, which is time consuming and expensive. In this paper, a new accelerated crankshaft bending fatigue experiment was proposed step by step. First the loading procedure was quickened through the prediction of the residual fatigue life based on the UKF (unscented Kalman filtering algorithm). Then the accuracy of the predictions was improved based on the modified sampling range and the theory of fracture mechanics. Finally the statistical analysis method of the fatigue limit load was performed based on the above predictions. The main conclusion of this paper is that the proposed accelerated bending fatigue experiment can save more than 30% of the bending fatigue experiment period and provide nearly the same fatigue limit load analysis result. In addition, compared with the particle filtering algorithm method, the modified UKF can provide much higher accuracy in predicting the residual bending fatigue life of the crankshaft, which makes this method more superior to be applied in actual engineering.


Research Design , Stress, Mechanical , Humans , Algorithms , Automobiles , Engineering
7.
BMJ Open ; 13(9): e073226, 2023 09 29.
Article En | MEDLINE | ID: mdl-37775296

OBJECTIVES: Workplace violence (WPV) against healthcare workers (HCWs) is a global issue. Our research aimed to elucidate the status and associated factors of WPV among front-line/non-front-line HCWs during the COVID-19 pandemic. DESIGN: This cross-sectional study was conducted among HCWs in Hangzhou City through multistage sampling from December 2020 to January 2021. PARTICIPANTS: This study included 14 909 valid samples (N=3748 front-line HCWs and N=11 161 non-front-line HCWs). PRIMARY AND SECONDARY OUTCOME MEASURES: We assessed the WPV status by Chinese version of WPV questionnaire. Binary logistic regression model was established to examine the associated factors of front-line/non-front-line HCWs experiencing WPV. RESULTS: The total WPV prevalence equalled 37.25% for front-line HCWs and 27.73% for non-front-line HCWs. Among front-line HCWs, females were less likely to experience WPV (OR 0.837, 95% CI 0.710 to 0.988), while individuals who were undergraduate (OR 1.251, 95% CI 1.061 to 1.541) and had higher professional title (intermediate: OR 1.475, 95% CI 1.227 to 1.772; advanced: OR 1.693, 95% CI 1.294 to 2.216) were more likely to suffer from WPV; for non-front-line HCWs, individuals who aged over 50 years old (OR 0.721, 95% CI 0.563 to 0.969), had worked between 10 and 19 years (OR 0.847, 95% CI 0.749 to 0.958) and worked in the non-graded hospital (OR 0.714, 95% CI 0.614 to 0.832) had less chance to experience WPV, while individuals who had higher educational level (undergraduate: OR 1.323, 95% CI 1.179 to 1.484; ≥graduate: OR 1.519, 95% CI 1.217 to 1.895), were nurse (OR 1.142, 95% CI 1.031 to 1.265), and had higher professional title (intermediate: OR 1.458, 95% CI 1.297 to 638; advanced: OR 1.928, 95% CI 1.607 to 2.313) were more inclined to suffer from WPV (p all<0.05). CONCLUSIONS: This study indicates that the prevalence of WPV among front-line HCWs is significantly higher than among non-front-line HCWs. Policy-makers should prioritise COVID-19 front-line HCWs, especially those with high educational levels and professional titles.


COVID-19 , Workplace Violence , Female , Humans , Middle Aged , Cross-Sectional Studies , COVID-19/epidemiology , Pandemics , Health Personnel , Surveys and Questionnaires , China/epidemiology , Workplace , Prevalence
8.
BMC Psychiatry ; 23(1): 476, 2023 06 29.
Article En | MEDLINE | ID: mdl-37380993

BACKGROUND: The poor relationship between doctors and patients is a long-standing, global problem. However, current interventions tend to focus on the training of physicians, while patient-targeted interventions still need to be improved. Considering that patients play a significant role in outpatient consultations, we developed a protocol to assess the effectiveness of the Patient Oriented Four Habits Model (POFHM) in improving doctor-patient relationships. METHODS: A cross-sectional incomplete stepped-wedge cluster randomized trial design will be conducted in 8 primary healthcare institutions (PHCs). Following phase I of "usual care" as control measures for each PHC, either a patient- or doctor-only intervention will be implemented in phase II. In phase III, both patients and doctors will be involved in the intervention. This study will be conducted simultaneously in Nanling County and West Lake District. The primary outcomes will be evaluated after patients complete their visit: (1) patient literacy, (2) sense of control and (3) quality of doctor-patient communication. Finally, a mixed-effects model and subgroup analysis will be used to evaluate the effectiveness of the interventions. DISCUSSION: Fostering good consultation habits for the patient is a potentially effective strategy to improve the quality of doctor-patient communication. This study evaluates the implementation process and develops a rigorous quality control manual using a theoretical domain framework under the collective culture of China. The results of this trial will provide substantial evidence of the effectiveness of patient-oriented interventions. The POFHM can benefit the PHCs and provide a reference for countries and regions where medical resources are scarce and collectivist cultures dominate. TRIAL REGISTRATION: AsPredicted #107,282 on Sep 18, 2022; https://aspredicted.org/QST_MHW.


Habits , Physician-Patient Relations , Humans , Cross-Sectional Studies , Outpatients , Community Health Services , Randomized Controlled Trials as Topic
9.
Front Psychiatry ; 14: 1173755, 2023.
Article En | MEDLINE | ID: mdl-37151975

Background: With the aging population in East Asia, the prevalence of dementia and the need for patient care is increasing. Family caregivers of people with dementia are at risk of physical and mental health problems. Filial piety culture regulates relationships within East Asian families and effects the well-being and behavior of dementia family caregivers (CGs). Objective: To systematically assess the experience of East Asian dementia caregivers in filial culture. Methods: Electronic databases, including MEDLINE, APA PsycINFO, CINAHL (via EBSCOhost), Web of Science, and Cochrane Library, were searched for relevant studies up to July 2021. Only original articles were included. Results: Thirteen eligible studies were included, of which eight were qualitative and five were quantitative. Meta-analysis showed a negative association (r = -0.18, 95%CI [-0.28, -0.08]) between filial culture and caregiver burden. The quantitative studies identified four themes related to dementia caregivers' experiences: (1) Recognition and understanding of filial piety as part of cultural identity, (2) Role transitions- from child to CG, (3) Filial piety's constraints on CGs; (4) CGs' self-compassion through changing cultural norms of filial practice. Conclusion: Filial culture influences the whole process behind caregiving for East Asian dementia caregivers. At the same time, cultural transition has also brought about new connotations and practices to filial culture.

10.
Acta Radiol ; 64(5): 1919-1926, 2023 May.
Article En | MEDLINE | ID: mdl-36775984

BACKGROUND: The effect of different computed tomography (CT) scanning methods of the shoulder on image quality is uncertain. PURPOSE: To compare the effect of different methods of CT scanning of the right shoulder on image quality and radiation dose. MATERIAL AND METHODS: A total of 30 adults were divided into five groups. Group A received scans centered on the body's long axis, a scout direction of 0° + 90°, and automatic tube current modulation (ATCM). The other four groups (B, C, D, E) received isocenter scans centered on the shoulder with different scout directions (B and C: 0° + 90°, D: 0°, E: 0° + 270°) and tube currents (B: 420 mA; C, D, E: ATCM). The volume CT dose index (CTDIvol), dose-length product (DLP), image objective noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were compared. Three subjective measures were also compared (noise, stripe artifacts, diagnostic confidence). RESULTS: The five groups differed significantly in all subjective and objective indexes. The CTDIvol and DLP decreased in the order of groups C, A, B, E, and D; the differences between groups A and B were not significant (P > 0.05). Groups B, C, and E had better SNR and CNR than groups A and D (P < 0.01). Subjective evaluations indicated group D was worse than groups B, C, and E (P < 0.05). CONCLUSION: In the ATCM system that uses the last scout view, CT of the shoulder should use isocenter scanning with the lateral scout view when the tube is away from the long axis of the body as the last execution direction.


Shoulder , Tomography, X-Ray Computed , Adult , Humans , Radiation Dosage , Tomography, X-Ray Computed/methods , Signal-To-Noise Ratio , Radiographic Image Interpretation, Computer-Assisted/methods
11.
J Neurosci ; 43(9): 1456-1474, 2023 03 01.
Article En | MEDLINE | ID: mdl-36653190

RNA N6-methyladenosine (m6A) modification is involved in diverse biological processes. However, its role in spinal cord injury (SCI) is poorly understood. The m6A level increases in injured spinal cord, and METTL3, which is the core subunit of methyltransferase complex, is upregulated in reactive astrocytes and further stabilized by the USP1/UAF1 complex after SCI. The USP1/UAF1 complex specifically binds to and subsequently removes K48-linked ubiquitination of the METTL3 protein to maintain its stability after SCI. Moreover, conditional knockout of astrocytic METTL3 in both sexes of mice significantly suppressed reactive astrogliosis after SCI, thus resulting in widespread infiltration of inflammatory cells, aggravated neuronal loss, hampered axonal regeneration, and impaired functional recovery. Mechanistically, the YAP1 transcript was identified as a potential target of METTL3 in astrocytes. METTL3 could selectively methylate the 3'-UTR region of the YAP1 transcript, which subsequently maintains its stability in an IGF2BP2-dependent manner. In vivo, YAP1 overexpression by adeno-associated virus injection remarkably contributed to reactive astrogliosis and partly reversed the detrimental effects of METTL3 knockout on functional recovery after SCI. Furthermore, we found that the methyltransferase activity of METTL3 plays an essential role in reactive astrogliosis and motor repair, whereas METTL3 mutant without methyltransferase function failed to promote functional recovery after SCI. Our study reveals the previously unreported role of METTL3-mediated m6A modification in SCI and might provide a potential therapy for SCI.SIGNIFICANCE STATEMENT Spinal cord injury is a devastating trauma of the CNS involving motor and sensory impairments. However, epigenetic modification in spinal cord injury is still unclear. Here, we propose an m6A regulation effect of astrocytic METTL3 following spinal cord injury, and we further characterize its underlying mechanism, which might provide promising strategies for spinal cord injury treatment.


Gliosis , Spinal Cord Injuries , Animals , Female , Male , Mice , Astrocytes/metabolism , Gliosis/metabolism , Inflammation/metabolism , Methyltransferases/metabolism , Methyltransferases/pharmacology , RNA, Messenger/metabolism , Spinal Cord/metabolism
12.
Front Nutr ; 9: 995729, 2022.
Article En | MEDLINE | ID: mdl-36570148

Background: Lower health-related quality of life (HRQoL) can result in adverse effects on the health of older people. This study aims to explore the relationship between personal social capital (PSC) and HRQoL among Chinese elderly people from rural-and-urban perspective. Materials and methods: 4,802 samples were included from China's health-related quality of life Survey for Older Adults 2018 (CHRQLS-OA 2018). The PSC, including bonding and bridging social capital (BOC and BRC), was measured by the Chinese version of the Personal Social Capital Scale (PSCS-16). The HRQoL was evaluated by the European Five Dimensions Questionnaire (EQ-5D-3L). Linear and Tobit regression models were conducted to examine the relationship between PSC and HRQoL. Results: The BOC and BRC of rural older people were significantly lower than those of urban older people. Pain/discomfort and anxiety/depression were the most significant health problems affecting the older samples. In the five dimensions, the proportion of rural older people with problems was higher than that of urban older people. Among rural older people, BOC was significantly related to self-rated health and EQ-5D utility index (p < 0.05); while BRC was insignificantly associated with self-rated health (p > 0.05) but related to EQ-5D utility index (p < 0.05). Both BOC and BRC were significantly correlated with self-rated health and EQ-5D utility index (p < 0.05) among urban older people. Conclusion: Our study reveals older people's worrying PSC and HRQoL status. The relationship between PSC and HRQoL suggested that more social support and care of intimates should be encouraged to increase the PSC of older people, especially rural older people.

13.
BMC Ophthalmol ; 22(1): 455, 2022 Nov 28.
Article En | MEDLINE | ID: mdl-36443679

BACKGROUND: Corneal neovascularization (CNV) is an important disease that causes blindness. Secretogranin III (Scg3) has emerged as a new influencing factor of neovascularization. This study analyzed the Scg3 antibody's inhibitory effect on CNV and and explored its preliminary mechanism. METHODS: Human umbilical vein endothelial cells (HUVECs) were treated with Scg3 and anti-Scg3. Cell proliferation, wound healing migration and tube formation assays were performed. Healthy adult New Zealand rabbits were randomly selected to be alkali burned and establish the corneal neovascularization (CNV) model. The rabbits were randomly divided into 3 groups (the high concentration group, low concentration group and control group). Different doses of anti-Scg3 and PBS were administered to the rabbits. Clinical examinations, immunostaining, quantitative real-time polymerase chain reaction (qPCR) and western blotting analyses were performed postoperatively. RESULTS: In the in vitro study, the Scg3 antibody mixture inhibited Scg3-induced endothelial cell proliferation and angiogenesis. In the in vivo study, significant CNV was observed in the control group. Confocal microscopy also revealed considerable active neovascularization in the control group. There was no obvious CNV growth in the high concentration group. Additionally, CD31, LYVE1 and CD45 expression was significantly inhibited after treatment with a high concentration of Scg3 antibody. The qPCR and western blotting analyses revealed that the levels of ERK in the low concentration group and high concentration group were higher than those in the control group at 7 days and 14 days. The levels of VEGF in the control group were significantly increased compared with those in the high concentration group. In all three groups, the levels of Akt were not significantly different at any time point. CONCLUSION: The expression of Scg3 could affect the growth of HUVECs in vitro. Treatment with a high concentration (0.5 µg/mL) of Scg3 antibody reduced the inflammatory response and inhibited the growth of corneal neovascularization after corneal alkali burn injury in rabbits. The MEK/ERK pathway might play an important role in the inhibitory effect of anti-Scg3.


Corneal Injuries , Corneal Neovascularization , Eye Burns , Adult , Rabbits , Humans , Animals , Corneal Neovascularization/drug therapy , Endothelial Cells , Neovascularization, Pathologic , Eye Burns/chemically induced , Alkalies
14.
Patient Prefer Adherence ; 16: 2483-2496, 2022.
Article En | MEDLINE | ID: mdl-36105658

Purpose: There are few studies on the intervention of the doctor-patient relationship (DPR) from patients' perspective, because of lacking appropriate measurement instruments for the effect of the patient interveqntion. Understanding the status of patients' literacy (the ability to initiatively obtain, read, and analyze health-related materials, make appropriate decisions, reduce risks of health-related problems) and developing the patients' literacy scale (PLS) align with the interests of patients, doctors, and researchers. Patients and Methods: This study was conducted in two stages: item building and item refinement. A total of 303 subjects were recruited from the outpatient hall in three hospitals with different levels in Hangzhou city, China. Twenty patients and seven experts determined the face and content validity, respectively. The construct validity, convergent, discriminant validity, and known-group validity of the scale were examined by exploratory and confirmatory factor analysis (EFA and CFA). Internal consistency, including Cronbach's alpha, McDonald's ω, split-half reliability, and composite reliability (CR), was also tested. Results: The EFA of PLS showed that Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was 0.787, and Bartlett's Test of Sphericity showed a significance of p < 0.001. The extracted four-factor (patient activation, knowledge, attitudes, practice) model explained 61.266% of the total variance. For the overall PLS, the Cronbach's alpha, McDonald's ω and split-half reliability coefficient were 0.815, 0.838 and 0.720, respectively. The CFA showed the goodness of fit (RMSEA = 0.065, CMIN/DF = 1.635, GFI = 0.900, CFI = 0.905, TLI = 0.909). The CR of each factor in this scale was 0.740, 0.732, 0.630, and 0.749, respectively. Conclusion: This study showed that the PLS was valid and reliable to measure the patients' literacy (PL). The 15-item PLS can help not only measure PL but also be used as a standard and advocacy target for patients' behavioral model which can further improve the DPR.

15.
Reprod Health ; 19(1): 85, 2022 Mar 31.
Article En | MEDLINE | ID: mdl-35361252

BACKGROUND: Maternal and child health (MCH) hospitals play an essential role in providing MCH services in China, while the supply has become increasingly challenging in the past decade, especially among secondary MCH hospitals. In this study we aimed to evaluate the technical efficiency (TE) of secondary MCH hospitals in Hubei province (China) to generate evidence-based decision-making for efficiency improvement. METHODS: The data were collected from the Department of Maternal and Child Health of Health Commission of Hubei Province in 2019. A total of 59 out of 74 secondary MCH hospitals were included as our study sample. Four input indicators (number of health professionals, number of beds, number of equipment with value greater than 10,000 RMB Yuan, building area for hospital operations) and three output indicators (number of total diagnostic patients, number of discharged patients, and number of birth deliveries) were selected based on previous literature. TE scores of the sample hospitals were estimated by using Bootstrap-Data Envelopment Analysis (Bootstrap-DEA). RESULTS: After bias-correction with Bootstrap-DEA model, the average TE score of the MCH hospitals was 0.673. 20 (33.89%) MCH hospitals had TE scores below the average. No MCH hospitals achieved excellent efficiency; 16 (27.11%) MCH hospitals reached good efficiency; and 26 (44.06%) MCH hospitals fell into poor and failing efficiency. Besides, 17 MCH hospitals had TE scores of 1 before bias-corrections, while none of them reached 1 after bias correction. CONCLUSIONS: Significant capacity variations existed among the secondary MCH hospitals in terms of input and output indicators and their overall TE was low in Hubei of China. For better improvement, the secondary MCH hospitals in Hubei need to improve their internal management and strengthen the construction of their information systems. A series of policy supports are needed from the health and insurance administrations to optimize health resources. Third-party performance evaluation can be piloted to improve efficiency and overall performance of the MCH hospitals. The policy recommendations we raise for MCH hospitals in Hubei can be worth learning for some low- and middle- income countries.


Child Health , Efficiency, Organizational , Child , China , Health Resources , Hospitals , Humans
17.
Nanomaterials (Basel) ; 11(10)2021 Oct 03.
Article En | MEDLINE | ID: mdl-34685044

In this study, the effects of Cu nanoparticle inclusion on the dynamic responses of single crystal Al during shockwave loading and subsequent spallation processes have been explored by molecular dynamics simulations. At specific impact velocities, the ideal single crystal Al will not produce dislocation and stacking fault structure during shock compression, while Cu inclusion in an Al-Cu nanocomposite will lead to the formation of a regular stacking fault structure. The significant difference of a shock-induced microstructure makes the spall strength of the Al-Cu nanocomposite lower than that of ideal single crystal Al at these specific impact velocities. The analysis of the damage evolution process shows that when piston velocity up ≤ 2.0 km/s, due to the dense defects and high potential energy at the interface between inclusions and matrix, voids will nucleate preferentially at the inclusion interface, and then grow along the interface at a rate of five times faster than other voids in the Al matrix. When up ≥ 2.5 km/s, the Al matrix will shock melt or unloading melt, and micro-spallation occurs; Cu inclusions have no effect on spallation strength, but when Cu inclusions and the Al matrix are not fully diffused, the voids tend to grow and coalescence along the inclusion interface to form a large void.

18.
BMC Ophthalmol ; 21(1): 383, 2021 Oct 27.
Article En | MEDLINE | ID: mdl-34706712

BACKGROUND: Diabetic retinopathy (DR) is one of the most common chronic microvascular complications of diabetes. Many studies have suggested that genetic factors are important in the context of DR. This study evaluated the associations of GWAS (Genome-wide association study) -identified DR-associated SNPs in a Chinese population in Guangxi Province with type 2 diabetes mellitus (T2DM). METHODS: A total of 386 hospitalized T2DM patients without proliferative diabetic retinopathy (PDR) and 316 hospitalized T2DM patients with PDR were included in this case-control study. Four tag SNPs, including rs1800896 in the IL-10 gene, rs2010963 in the VEGFA gene, rs2070600 in the RAGE gene and rs2910164 in the miR-146a gene, were examined using KASP (kompetitive allele specific PCR) genotyping assays. RESULTS: There were no significant differences in the genotype or allele frequencies of the miR-146a polymorphism (rs2910164) between subjects with PDR and those without DR. The TC genotype of rs1800896 was determined to be associated with an increased risk of PDR (the odds ratio (OR) was 2.366, with a 95% confidence interval (CI) ranging from 1.144 to 4.894). The CG genotypes of rs2010963 was associated with an decreased risk of PDR (the OR was 0.588, with a 95% CI ranging from 0.366 to 0.946). Regarding rs2070600, 2 genotypes (TT and CT) were associated with a decreased risk of PDR (the OR of the TT genotype was 0.180, with a 95% CI ranging from 0.037 to 0.872, and the OR of the CT genotype was 0.448, with a 95% CI ranging from 0.266 to 0.753). CONCLUSIONS: The rs1800896 polymorphisms in the IL-10 gene, rs2010963 in the VEGFA gene and rs2070600 in the RAGE gene are associated with the risk of PDR in the Han Chinese population of Guangxi Province. Our findings provide suggestive evidence that these polymorphisms may be involved in the pathogenesis of PDR and should be investigated further.


Diabetes Mellitus, Type 2 , Diabetic Retinopathy , Case-Control Studies , China/epidemiology , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/genetics , Diabetic Retinopathy/epidemiology , Diabetic Retinopathy/genetics , Gene Frequency , Genome-Wide Association Study , Genotype , Humans , Polymorphism, Single Nucleotide
19.
ACS Appl Mater Interfaces ; 13(40): 47341-47353, 2021 Oct 13.
Article En | MEDLINE | ID: mdl-34597036

Neuroinflammation following spinal cord injury usually aggravates spinal cord damage. Many inflammatory cytokines are key players in neuroinflammation. Owing largely to the multiplicity of cytokine targets and the complexity of cytokine interactions, it is insufficient to suppress spinal cord damage progression by regulating only one or a few cytokines. Herein, we propose a two-pronged strategy to simultaneously capture the released cytokines and inhibit the synthesis of new ones in a broad-spectrum manner. To achieve this strategy, we designed a core/shell-structured microcomposite, which was composed of a methylprednisolone-incorporated polymer inner core and a biocompatible polydopamine outer shell. Thanks to the inherent adhesive nature of polydopamine, the obtained microcomposite (MP-PLGA@PDA) efficiently neutralized the excessive cytokines in a broad-spectrum manner within 1 day after spinal cord injury. Meanwhile, the controlled release of immunosuppressive methylprednisolone reduced the secretion of new inflammatory cytokines. Benefiting from its efficient and broad-spectrum capability in reducing the level of cytokines, this core/shell-structured microcomposite suppressed the recruitment of macrophages and protected the injured spinal cord, leading to an improved recovery of motor function. Overall, the designed microcomposite successfully achieved the two-pronged strategy in cytokine neutralization, providing an alternative approach to inhibit neuroinflammation in the injured spinal cord.


Anti-Inflammatory Agents/therapeutic use , Delayed-Action Preparations/chemistry , Methylprednisolone/therapeutic use , Microplastics/chemistry , Neuroinflammatory Diseases/drug therapy , Spinal Cord Injuries/drug therapy , Animals , Anti-Inflammatory Agents/pharmacokinetics , Cytokines/metabolism , Indoles/chemistry , Methylprednisolone/pharmacokinetics , Neuroinflammatory Diseases/etiology , Neuroinflammatory Diseases/metabolism , Polylactic Acid-Polyglycolic Acid Copolymer/chemistry , Polymers/chemistry , Rats, Sprague-Dawley , Recovery of Function/drug effects , Spinal Cord/drug effects , Spinal Cord/metabolism , Spinal Cord Injuries/complications , Spinal Cord Injuries/metabolism
20.
J Neuroinflammation ; 18(1): 196, 2021 Sep 12.
Article En | MEDLINE | ID: mdl-34511129

BACKGROUND: Spinal cord injury (SCI) is a severe traumatic disease which causes high disability and mortality rates. The molecular pathological features after spinal cord injury mainly involve the inflammatory response, microglial and neuronal apoptosis, abnormal proliferation of astrocytes, and the formation of glial scars. However, the microenvironmental changes after spinal cord injury are complex, and the interactions between glial cells and nerve cells remain unclear. Small extracellular vesicles (sEVs) may play a key role in cell communication by transporting RNA, proteins, and bioactive lipids between cells. Few studies have examined the intercellular communication of astrocytes through sEVs after SCI. The inflammatory signal released from astrocytes is known to initiate microglial activation, but its effects on neurons after SCI remain to be further clarified. METHODS: Electron microscopy (TEM), nanoparticle tracking analysis (NTA), and western blotting were applied to characterize sEVs. We examined microglial activation and neuronal apoptosis mediated by astrocyte activation in an experimental model of acute spinal cord injury and in cell culture in vitro. RESULTS: Our results indicated that astrocytes activated after spinal cord injury release CCL2, act on microglia and neuronal cells through the sEV pathway, and promote neuronal apoptosis and microglial activation after binding the CCR2. Subsequently, the activated microglia release IL-1ß, which acts on neuronal cells, thereby further aggravating their apoptosis. CONCLUSION: This study elucidates that astrocytes interact with microglia and neurons through the sEV pathway after SCI, enriching the mechanism of CCL2 in neuroinflammation and spinal neurodegeneration, and providing a new theoretical basis of CCL2 as a therapeutic target for SCI.


Extracellular Vesicles , Spinal Cord Injuries , Apoptosis , Astrocytes/metabolism , Chemokine CCL2/metabolism , Extracellular Vesicles/metabolism , Humans , Microglia/metabolism , Neuroinflammatory Diseases , Neurons , Spinal Cord/pathology , Spinal Cord Injuries/metabolism
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