Factors associated with patients' healthcare-seeking behavior and related clinical outcomes under China's hierarchical healthcare delivery system.

Introduction: The hierarchical healthcare delivery system is an important measure to improve the allocation of medical resources and promote equitable distribution of basic medical and health services. It is one of the key factors in the success or failure of China's medical reform. This study aims to analyze the factors influencing patients' healthcare-seeking behaviors, including socioeconomic and clinical outcomes, under China's hierarchical healthcare delivery system, and to provide potential solutions. Methods: Patients receiving outpatient treatment in the past 14 days and inpatient care in the past 1 year were investigated. The multivariate logistic regression was used to analyze the influencing factors of patient's medical treatment behavior selection, and to compare whether the clinical outcomes of primary medical institutions and grade A hospitals are the same. Results: Nine thousand and ninety-eight person-times were included in the study. Of these, 4,538 patients were outpatients, 68.27% of patients were treated in primary medical institutions; 4,560 patients were hospitalized, 58.53% chose to be hospitalized in grade A hospitals. Provinces and cities, urban and rural areas, occupation, education level, medical insurance type, income, whether there are comorbid diseases, and doctors' medical behavior are the factors affecting the choice of medical treatment behavior. Patients who choose primary medical institutions and grade A hospitals have different control levels and control rate for the blood pressure, blood lipids, blood glucose. Conclusion: Under the hierarchical diagnosis and treatment system, the patients' choice of hospital is mainly affected by their level of education, medical insurance types, and the inpatients are also affected by whether there are comorbid conditions. Clinical outcomes of choosing different levels of hospitals were different.

A Multivariate analysis on evoked components of Chinese semantic congruity: an OP-MEG study with EEG.

The application of wearable magnetoencephalography using optically-pumped magnetometers has drawn extensive attention in the field of neuroscience. Electroencephalogram system can cover the whole head and reflect the overall activity of a large number of neurons. The efficacy of optically-pumped magnetometer in detecting event-related components can be validated through electroencephalogram results. Multivariate pattern analysis is capable of tracking the evolution of neurocognitive processes over time. In this paper, we adopted a classical Chinese semantic congruity paradigm and separately collected electroencephalogram and optically-pumped magnetometer signals. Then, we verified the consistency of optically-pumped magnetometer and electroencephalogram in detecting N400 using mutual information index. Multivariate pattern analysis revealed the difference in decoding performance of these two modalities, which can be further validated by dynamic/stable coding analysis on the temporal generalization matrix. The results from searchlight analysis provided a neural basis for this dissimilarity at the magnetoencephalography source level and the electroencephalogram sensor level. This study opens a new avenue for investigating the brain's coding patterns using wearable magnetoencephalography and reveals the differences in sensitivity between the two modalities in reflecting neuron representation patterns.

OPM-MEG Measuring Phase Synchronization on Source Time Series: Application in Rhythmic Median Nerve Stimulation.

The magnetoencephalogram (MEG) based on array optically pumped magnetometers (OPMs) has the potential of replacing conventional cryogenic superconducting quantum interference device. Phase synchronization is a common method for measuring brain oscillations and functional connectivity. Verifying the feasibility and fidelity of OPM-MEG in measuring phase synchronization will help its widespread application in the study of aforementioned neural mechanisms. The analysis method on source-level time series can weaken the influence of instantaneous field spread effect. In this paper, the OPM-MEG was used for measuring the evoked responses of 20Hz rhythmic and arrhythmic median nerve stimulation, and the inter-trial phase synchronization (ITPS) and inter-reginal phase synchronization (IRPS) of primary somatosensory cortex (SI) and secondary somatosensory cortex (SII) were analysed. The results find that under rhythmic condition, the evoked responses of SI and SII show continuous oscillations and the effect of resetting phase. The values of ITPS and IRPS significantly increase at the stimulation frequency of 20Hz and its harmonic of 40Hz, whereas the arrhythmic stimulation does not exhibit this phenomenon. Moreover, in the initial stage of stimulation, the ITPS and IRPS values are significantly higher at Mu rhythm in the rhythmic condition compared to arrhythmic. In conclusion, the results demonstrate the ability of OPM-MEG in measuring phase pattern and functional connectivity on source-level, and may also prove beneficial for the study on the mechanism of rhythmic stimulation therapy for rehabilitation.

Dissipation Behavior and Dietary Risk Assessment of Thiamethoxam, Pyraclostrobin, and Their Metabolites in Home-Style Pickled Cowpea.

In this study, the fate of two pesticides commonly used on cowpeas, thiamethoxam and pyraclostrobin, during the preparation of home-made pickled cowpeas was investigated using an improved QuEChERS method combined with UHPLC-MS/MS. Although pesticide residues were primarily distributed on cowpea samples, some were transferred to brine. The dissipation half-life of thiamethoxam on cowpea samples was significantly shorter than that of pyraclostrobin due to thiamethoxam's higher water solubility. Thiamethoxam demonstrated a half-life of 5.12 ± 0.66 days, whereas pyraclostrobin exhibited a longer half-life of 71.46 ± 7.87 days. In addition, the degradation half-lives of these two pesticides in the whole system (cowpea and brine) were 45.01 ± 4.99 and 70.51 ± 5.91 days, respectively. This result indicates that the pickling did not effectively promote the degradation of thiamethoxam and pyraclostrobin. The metabolite clothianidin of thiamethoxam was not produced throughout the pickling process, but the metabolite BF 500-3 of pyraclostrobin was detected in cowpea samples. The detection rates for thiamethoxam, pyraclostrobin, and BF 500-3 in the 20 market samples were 10%, 70%, and 45%, respectively. However, the risk quotient analysis indicated that the risk of dietary intake of thiamethoxam and pyraclostrobin in pickled cowpeas by Chinese consumers was negligible.

Structural, rheological, and gelling characteristics of starch-based materials in context to 3D food printing applications in precision nutrition.

Starch-based materials have viscoelasticity, viscous film-forming, dough pseudoplasticity, and rheological properties, which possess the structural characteristics (crystal structure, double helix structure, and layered structure) suitable for three-dimensional (3D) food printing inks. 3D food printing technology has significant advantages in customizing personalized and precise nutrition, expanding the range of ingredients, designing unique food appearances, and simplifying the food supply chain. Precision nutrition aims to consider individual nutritional needs and individual differences, which include special food product design and personalized precise nutrition, thus expanding future food resources, then simplifying the food supply chain, and attracting extensive attention in food industry. Different types of starch-based materials with different structures and rheological properties meet different 3D food printing technology requirements. Starch-based materials suitable for 3D food printing technology can accurately deliver and release active substances or drugs. These active substances or drugs have certain regulatory effects on the gut microbiome and diabetes, so as to maintain personalized and accurate nutrition.

Xenon-lamp simulated sunlight-induced photolysis of pyriclobenzuron in water: Kinetics, degradation pathways, and identification of photolysis products.

Pyriclobenzuron 1(PBU) is a novel molluscicide developed to control Pomacea canaliculate, and little information on its environmental fate has been published. In this study, the photolysis of PBU in an aqueous environment was simulated using a xenon lamp. Results showed that the photolysis of PBU in water followed first-order kinetics, exhibiting a t0.5 of 95.1 h and 83.6 h in Milli-Q water and river water, respectively. Two main photolysis products 2(PPs) were detected by HPLC-UV and identified by UPLC-Q/TOF MS, which were formed via the hydroxylation and photocatalytic hydro-dehalogenation of PBU, respectively. The initial relative abundance of photolysis product 1 3(PP-1) in Milli-Q water was 1.55 times higher than that in river water. PP-1 was detected at 26.5 % and 76.8 % of the maximum relative abundance in the river water and Milli-Q water after 720 h, respectively. Photolysis product 2 4(PP-2) was stable in water because of its weak hydrophilicity. The PP-2 detected after 720 h in Milli-Q water and river water was 93.7 % and 93.5 % of the maximum relative abundance, respectively. Finally, ECOSAR software was used to evaluate the acute aquatic toxicity of PBU and its PPs, revealing that the PPs had lower toxicity levels to non-target aquatic organisms.

Optimization of Signal Space Separation for Optically Pumped Magnetometer in Magnetoencephalography.

Magnetoencephalography (MEG) is a noninvasive functional neuroimaging modality but highly susceptible to environmental interference. Signal space separation (SSS) is a method for improving the SNR to separate the MEG signals from external interference. The origin and truncation values of SSS significantly affect the SSS performance. The origin value fluctuates with respect to the helmet array, and determining the truncation values using the traversal method is time-consuming; thus, this method is inappropriate for optically pumped magnetometer (OPM) systems with flexible array designs. Herein, an automatic optimization method for the SSS parameters is proposed. Virtual sources are set inside and outside the brain to simulate the signals of interest and interference, respectively, via forward model, with the sensor array as prior information. The objective function is determined as the error between the signals from simulated sources inside the brain and the SSS reconstructed signals; thus, the optimized parameters are solved inversely by minimizing the objective function. To validate the proposed method, a simulation analysis and MEG auditory-evoked experiments were conducted. For an OPM sensor array, this method can precisely determine the optimized origin and truncation values of the SSS simultaneously, and the auditory-evoked component, for example, N100, can be accurately located in the temporal cortex. The proposed optimization procedure outperforms the traditional method with regard to the computation time and accuracy, simplifying the SSS process in signal preprocessing and enhancing the performance of SSS denoising.