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1.
Epilepsia Open ; 6(2): 323-330, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34033247

RESUMO

OBJECTIVE: Epilepsy is a chronic neurological disease that is characterized by seizures. Seizure episodes, stigma, and high medical costs associated with this condition caused significant psychological distress. This study aimed to evaluate epidemiological characteristics and treatment status of epilepsy in individuals existing in the tropical rural areas of Hainan Province of China. METHODS: A household survey on epilepsy was conducted among the rural population of Chengmai County, Danzhou City, Baoting Autonomous County (Li and Miao nationalities), and Dingan County in Hainan Province, China. A screening questionnaire based on the standard screening questionnaires of the World Health Organization (WHO) was designed and a screening instrument of International Community-based Epilepsy Research Group was used. Individuals suspected or previously diagnosed with epilepsy were reexamined by an experienced neurologist. Further clinical data were collected from subjects with confirmed diagnosis of epilepsy. RESULTS: This study included 16 676 subjects with 8827 men (52.93%) and 7849 women (47.07%). Majority of the study subjects included were of Han Chinese (N = 13 145, 78.83%), and the remaining were of Li minority ethnicity. The incidence of epilepsy was 0.24 per 1000, and the total prevalence of active epilepsy was 2.33 per 1000. The prevalence of epilepsy in the Han and Li nationalities was 3.27 and 2.27 per 1000, respectively, which was shown to be higher in people aged ≥ 60. The initial onset of epilepsy tended to trigger among children aged between 0 and 9 years old. Initial assessment revealed that the treatment gap for active epilepsy was 58.97%, and stroke is shown as the most common cause of symptomatic epilepsy. SIGNIFICANCE: The prevalence and incidence of epilepsy in tropical rural areas of Hainan Province were close to those of the earlier findings that are reported in other regions of China and lower than those remaining in the tropical areas around the world. There exists a huge treatment gap for active epilepsy, which indicates an urgent need for a rational intervention strategy.

2.
Inquiry ; 58: 469580211009667, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33870745

RESUMO

Studies globally have provided substantial evidence that PHC could conduct doctor-visiting behaviors, control medical expense, and improve population health. This study aimed to map how family doctor (FD) in Shanghai achieved gate-keeper goals including health management, medical expense control, and conducting ordered doctor-visiting behavior. A total of 2754 and 1995 valid questionnaires were collected in 2013 and 2016 respectively in Shanghai. The data were analyzed using structural equation modeling (SEM). Invariance analysis was also performed for 2 waves of data. We found that the coefficient of cognition on health management (ß5 = 0.26, P < .05) was larger than that of signing with FD (ß4 = 0.06, P < .05). SEM model also showed that first-contact at community health service center (CHSC) had a positive effect on health management (ß6 = 0.30, P < .05), and the latter also affected health management results positively (ß8 = 0.39, P < .05), suggesting that the path for FD was through first-contact and health management. Besides, the gate-keeper role of medical expense control was significant through the first-contact (ß10 = -0.12, P < .05) mediation rather than health management (ß9 = 0.03, P > .05). The model fit was acceptable (RMSEA = 0.033). A "cognition-behavior-outcomes (health and medical expense)" path of FD's gate-keeper role was found. It is necessary to consolidate FD contracted services rather than reimbursement discount the latter of which is proved to be unsustainable.

3.
J Oleo Sci ; 70(5): 685-696, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33840662

RESUMO

The lipid metabolism disorder is the key role of Nonalcoholic fatty liver disease (NAFLD). Selenoprotein P plays an important role in the pathological process of lipid accumulation. Coix lacryma-jboi seed oil (CLSO) is an active component extracted from Coix lacryma-jobi seed (CLS) which has been found to be effective of reducing blood fat and antioxidative. But the effect and mechanism of CLSO on NAFLD are not clear. The aim of this study was to explore the therapeutic effect and mechanism of CLSO in the treatment of NAFLD. Our result showed that CLSO decreased the liver/body weight ratio, lowered the total cholesterol (TC) and triacylglycerol (TG), and elevated the high density lipoprotein (HDL) in serum. CLSO reduced the lipid deposition in the liver of NAFLD rats. In addition, CLSO could bring down the abnormal expression of superoxide dismutase (SOD) and malondialdehyde (MDA). Moreover, CLSO significantly declined the liver apolipoprotein E (apoE), apolipoprotein E receptor (apoER) and selenoprotein P 1 (SePP1) expression. In vivo, CLSO decreased the lipid droplets and TG level, reduced the protein expression of SePP1, apoER, phosphor-adenosine 5'-monophosphate (AMP)-activated protein kinase (p-AMPK) in the cytoplasm of HepG2 cells induced by oleic acid and palmitic acid (OP). At the same time, lipid accumulation was observed in the Sepp1 high expression cells induced by endoplasmic reticulum (ER) activator tunicamycin (Tm). CLSO could identically reduce the protein expression of SePP1, apoER, p-AMPK in the cytoplasm of HepG2 cells induced by Tm. This result not only proved the CLSO had therapeutic effect on NAFLD, but also confirmed its mechanism associated with degrading the phosphorylation of adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) which led to the decrease of the expression SePP1/apoER2 in order to reduce lipid accumulation. The study suggests CLSO has great medicinal value in treating NAFLD besides its edibility.

4.
Medicine (Baltimore) ; 100(12): e24804, 2021 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-33761640

RESUMO

RATIONALE: The etiology of non-immune hydrops fetalis is complex, and its prognosis is poor. One of its main causes is anemia. There are few reports on hydrops fetalis due to anemia caused by hereditary spherocytosis (HS), especially regarding its occurrence in the neonatal period. Thus, we report on a case of neonatal HS caused by a new SPTB gene mutation that was characterized by hydrops fetalis. PATIENT CONCERNS: A neonate with intrauterine hydrops fetalis showed severe hyperbilirubinemia and anemia, reticulocytosis, and hepatosplenomegaly. Laboratory examination findings were normal. DIAGNOSES: Gene sequencing of the patient and his parents showed a de novo frameshift mutation in the patient's SPTB gene. Ultimately, the patient was diagnosed with HS. INTERVENTIONS: Exchange and red blood cell transfusions were performed in the neonatal period. OUTCOMES: The child was discharged from the hospital 14 days postnatal because his hemoglobin and bilirubin levels were stable. Red blood cell transfusion was performed once in infancy; however, no further red blood cell transfusions were required within 2 years of age. LESSONS: Hydrops fetalis can be a manifestation of HS. Genetic detection can help confirm the diagnosis of suspected neonatal HS undocumented by other laboratory examinations.


Assuntos
Hidropisia Fetal/genética , Espectrina/genética , Esferocitose Hereditária/diagnóstico , Análise Mutacional de DNA , Transfusão de Eritrócitos , Mutação da Fase de Leitura , Hemoglobinas/análise , Humanos , Hidropisia Fetal/sangue , Hidropisia Fetal/terapia , Recém-Nascido , Masculino , Esferocitose Hereditária/complicações , Esferocitose Hereditária/genética , Esferocitose Hereditária/terapia , Resultado do Tratamento
5.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(3): 242-247, 2021 Mar.
Artigo em Chinês | MEDLINE | ID: mdl-33691916

RESUMO

OBJECTIVE: To study the perinatal complications of late preterm twins (LPTs) versus early term twins (ETTs). METHODS: A retrospective analysis was performed for the complications of 246 LPTs, 496 ETTs, and their mothers. The risk factors for late preterm birth were analyzed. According to gestational age, the twins were divided into five groups: 34-34+6 weeks (n=44), 35-35+6 weeks (n=70), 36-36+6 weeks (n=132), 37-37+6 weeks (n=390), and 38-38+6 weeks (n=106). The perinatal complications were compared between groups. RESULTS: Maternal hypertension, maternal thrombocytopenia, placenta previa, and premature rupture of membranes were independent risk factors for late preterm birth in twins (P < 0.05). The LPT group had higher incidence rates of respiratory diseases, feeding intolerance, and hypoglycemia than the ETT group (P < 0.05). The 34-34+6 weeks group had a higher incidence rate of neonatal asphyxia than the 37-37+6 weeks and 38-38+6 weeks groups; and had a higher incidence rate of septicemia than 36-36+6 weeks group (P < 0.0045). The 34-34+6 weeks and 35-35+6 weeks groups had higher incidence rates of neonatal respiratory distress syndrome, neonatal apnea, and anemia than the other three groups; and had higher incidence rates of neonatal pneumonia, hypoglycemia and septicemia than the 37-37+6 weeks and 38-38+6 weeks groups (P < 0.0045). The 35-35+6 weeks group had a higher incidence rate of feeding intolerance than the 36-36+6 weeks, 37-37+6 weeks, and 38-38+6 weeks groups (P < 0.0045). The 36-36+6 weeks group had a lower incidence rate of hypoglycemia than the 34-34+6 weeks group and a higher incidence rate of hypoglycemia than the 37-37+6 weeks group (P < 0.0045). CONCLUSIONS: Compared with ETTs, LPTs have an increased incidence of perinatal complications. The incidence of perinatal complications is associated with gestational ages in the LPTs and ETTs.


Assuntos
Nascimento Prematuro , Síndrome do Desconforto Respiratório do Recém-Nascido , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Gravidez , Estudos Retrospectivos , Gêmeos
6.
Environ Sci Technol ; 55(8): 5496-5505, 2021 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-33764760

RESUMO

This paper showcases the suitability of an environmentally extended input-output framework to provide macroeconomic analyses of an expanding bioeconomy to allow for adequate evaluation of its benefits and trade-offs. It also exemplifies the framework's applicability to provide early design stage evaluations of emerging technologies expected to contribute to a future bioeconomy. Here, it is used to compare the current United States (U.S.) bioeconomy to a hypothetical future containing additional cellulosic ethanol produced from two near-commercial pathways. We find that the substitution of gasoline with cellulosic ethanol is expected to yield socioeconomic net benefits, including job growth and value added, and a net reduction in global warming potential and nonrenewable energy use. The substitution fares comparable to or worse than that for other environmental impact categories including human toxicity and eutrophication potentials. We recommend that further technology advancement and commercialization efforts focus on reducing these unintended consequences through improved system design and innovation. The framework is seen as complementary to process-based technoeconomic and life cycle assessments as it utilizes related data to describe specific supply chains while providing analyses of individual products and portfolios thereof at an industrial scale and in the context of the U.S. economy.


Assuntos
Biocombustíveis , Gasolina , Etanol , Humanos , Indústrias , Fatores Socioeconômicos , Estados Unidos
7.
Proc Natl Acad Sci U S A ; 118(13)2021 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-33723013

RESUMO

With the increasing demand for net-zero sustainable aviation fuels (SAF), new conversion technologies are needed to process waste feedstocks and meet carbon reduction and cost targets. Wet waste is a low-cost, prevalent feedstock with the energy potential to displace over 20% of US jet fuel consumption; however, its complexity and high moisture typically relegates its use to methane production from anaerobic digestion. To overcome this, methanogenesis can be arrested during fermentation to instead produce C2 to C8 volatile fatty acids (VFA) for catalytic upgrading to SAF. Here, we evaluate the catalytic conversion of food waste-derived VFAs to produce n-paraffin SAF for near-term use as a 10 vol% blend for ASTM "Fast Track" qualification and produce a highly branched, isoparaffin VFA-SAF to increase the renewable blend limit. VFA ketonization models assessed the carbon chain length distributions suitable for each VFA-SAF conversion pathway, and food waste-derived VFA ketonization was demonstrated for >100 h of time on stream at approximately theoretical yield. Fuel property blending models and experimental testing determined normal paraffin VFA-SAF meets 10 vol% fuel specifications for "Fast Track." Synergistic blending with isoparaffin VFA-SAF increased the blend limit to 70 vol% by addressing flashpoint and viscosity constraints, with sooting 34% lower than fossil jet. Techno-economic analysis evaluated the major catalytic process cost-drivers, determining the minimum fuel selling price as a function of VFA production costs. Life cycle analysis determined that if food waste is diverted from landfills to avoid methane emissions, VFA-SAF could enable up to 165% reduction in greenhouse gas emissions relative to fossil jet.

8.
Glob Chang Biol ; 27(11): 2561-2579, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33666308

RESUMO

A quantitative understanding of physiological thermal responses is vital for forecasting species distributional shifts in response to climate change. Many studies have focused on metabolic rate as a global metric for analyzing the sublethal effects of changing environments on physiology. Thermal performance curves (TPCs) have been suggested as a viable analytical framework, but standard TPCs may not fully capture physiological responses, due in part to failure to consider the process of metabolic depression. We derived a model based on the nonlinear regression of biological temperature-dependent rate processes and built a heart rate data set for 26 species of intertidal molluscs distributed from 33°S to ~40°N. We then calculated physiological thermal performance limits with continuous heating using T 1 / 2 H , the temperature at which heart rate is decreased to 50% of the maximal rate, as a more realistic measure of upper thermal limits. Results indicate that heat-induced metabolic depression of cardiac performance is a common adaptive response that allows tolerance of harsh environments. Furthermore, our model accounted for the high inter-individual variability in the shape of cardiac TPCs. We then used these TPCs to calculate physiological thermal safety margins (pTSM), the difference between the maximal operative temperature (95th percentile of field temperatures) and T 1 / 2 H of each individual. Using pTSMs, we developed a physiological species distribution model (pSDM) to forecast future geographic distributions. pSDM results indicate that climate-induced species range shifts are potentially less severe than predicted by a simple correlative SDM. Species with metabolic depression below the optimum temperature will be more thermal resistant at their warm trailing edges. High intraspecific variability further suggests that models based on species-level vulnerability to environmental change may be problematic. This multi-scale, mechanistic understanding that incorporates metabolic depression and inter-individual variability in thermal response enables better predictions about the relationship between thermal stress and species distributions.


Assuntos
Termotolerância , Adaptação Fisiológica , Mudança Climática , Temperatura Alta , Temperatura
9.
Food Res Int ; 142: 110205, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33773680

RESUMO

A long shelf life for fresh meat products is very important both to processors, retailers and consumers. In this work, the effect of repeat acid spraying on the shelf life of vacuum skin-packaged (VSP) chilled beef, as well as the quality and microbial community dynamics was evaluated. Carcasses were sprayed with 300 ppm peroxyacetic acid (PA) or 3% lactic acid (LA) three times during the chilling process, or one more time of LA spray before packaging (LLA). Quality, sensory attributes and microbial load of VSP beef during 32 days of storage at 4 °C were evaluated. The results showed that quality and sensory scores decreased over time for all treatments, but LLA treated samples were still above the rejection threshold at the end of the storage period. Moreover, the total volatile basic nitrogen value and the total viable counts were 15.0 mg/100 g and 7.2 log CFU/g for the control group, while acid treated groups remained below these two values until the end of the storage period. In particular LLA treated beef steaks exhibited the best preservation potential even at the end of storage. This is attributed to the reduction of Proteobacteria in LLA beef steaks shown by the bacterial diversity analysis via high-throughput sequencing, as well as the lower counts of B. thermosphacta and Enterobacteriaceae during storage. This indicates that LLA treatment has the potential to achieve a shelf life extension of VSP steaks without impacting on quality.


Assuntos
Embalagem de Alimentos , Microbiota , Animais , Bovinos , Ácido Láctico , Ácido Peracético/farmacologia , Vácuo
10.
Nefrologia (Engl Ed) ; 2021 Mar 26.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33781579

RESUMO

BACKGROUND: Ubiquitin-52 amino acid fusion protein (UbA52) is an important factor in the pathogenesis of diabetic kidney disease (DKD) and has been suggested a potential marker in the disease. However, whether upregulation of UbA52 marks early kidney injury in T2DM mellitus (T2DM) patients remains unclear. In this study, we examine the diagnostic value of UbA52 as a biomarker in predicting early diabetic kidney disease (DKD) in T2DM patients. METHODS: We used two-step ELISA to test UbA52 level in urine of 3 defined patient groups. Samples from T2DM patients without albuminuria or diabetic retinopathy (DM-WNP; n=30), T2DM patients with albuminuria and diabetic retinopathy, excluding other renal diseases clinically (DM-NP; n=30) and healthy controls (n=30) were analyzed. Spearman's correlation analysis and multiple linear regression model were used to analyze the correlation of urinary UbA52 level with laboratory results regarding kidney function. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic value of UbA52 in predicting T2DM and early DKD. RESULTS: Urinary UbA52 level in DM-NP group was 1.75 times and 2.71 times higher than in DN-WNP (p=0.004) and normal control group (p<0.001), respectively. The level of urinary UbA52 correlated significantly with serum creatinine (r=0.468, p<0.001), GFR (r=-0.300, p=0.004) and proteinuria (r=0.484, p<0.001). Multiple linear regression analysis showed that proteinuria level was independently associated with urinary UbA52 level (ß=0.833, p<0.001). The area under the ROC of urinary UbA52 in diagnosing T2DM and DKD was 0.751 and 0.755, respectively. CONCLUSION: The level of urinary UbA52 increased significantly in T2DM patients with DKD. The level of proteinuria is independently associated with urinary UbA52 level. Urinary UbA52 could serve as an early marker in the diagnosis of DKD. ClinicalTrials.gov Identifier: NCT02204280.

11.
BMC Infect Dis ; 21(1): 147, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546633

RESUMO

BACKGROUND: Coronavirus disease 2019(COVID-19) has spread worldwide. The present study aimed to characterize the clinical features and outcomes of imported COVID-19 patients with high body mass index (BMI) and the independent association of BMI with disease severity. METHODS: In this retrospective cohort study, 455 imported COVID-19 patients were admitted and discharged in Zhejiang province by February 28, 2020. Epidemiological, demographic, clinical, laboratory, radiological, treatment, and outcome data were collected, analyzed and compared between patients with BMI ≥ 24and < 24. RESULTS: A total of 268 patients had BMI < 24, and 187 patients had BMI ≥ 24. Those with high BMI were mostly men, had a smoking history, fever, cough, and sputum than those with BMI < 24. A large number of patients with BMI ≥ 24 were diagnosed as severe/critical types. Some biochemical indicators were significantly elevated in patients with BMI ≥ 24. Also, acute liver injury was the most common complication in these patients. The median days from illness onset to severe acute respiratory syndrome coronavirus 2 detection, duration of hospitalization, and days from illness onset to discharge were significantly longer in patients with BMI ≥ 24 than those with BMI < 24. High BMI, exposure to Wuhan, any coexisting medical condition, high temperature, C-reactive protein (CRP), and increased lactate dehydrogenase (LDH) were independent risk factors for severe/critical COVID-19. After adjusting for age, sex and above factors, BMI was still independently associated with progression to severe/critical illness (P = 0.0040). Hemoglobin, alanine aminotransferase (ALT), CRP, and serum creatinine (Scr) were independent risk factors associated with high BMI. CONCLUSIONS: Contrasted with the imported COVID-19 patients with BMI < 24, high proportion of COVID-19 patients with BMI ≥ 24 in our study, especially those with elevated CRP and LDH, developed to severe type, with longer hospitalization duration and anti-virus course. Thus, high BMI is a risk factor for the progression and prognosis of imported COVID-19.


Assuntos
/epidemiologia , Adulto , Índice de Massa Corporal , China/epidemiologia , Estudos de Coortes , Progressão da Doença , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Fatores de Risco
12.
J Orthop Surg Res ; 16(1): 126, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33568164

RESUMO

BACKGROUND: This study was conducted with the aim to compare the effect of posterior condyle offset (PCO) changes on knee joint function of patients following total knee replacement (TKR). METHODS: Electronic and manual searches were performed in the PubMed, Embase, and Cochrane Library databases from inception to September 2019. Network meta-analysis combined direct and indirect evidence to assess the weighted mean difference (WMD) and surface under the cumulative ranking curves (SUCRA) of different PCO changes (PCO ≤ - 2 mm, - 2 mm < PCO < 0 mm, 0 mm ≤ PCO < 2 mm and PCO ≥ 2 mm) on knee joint function after TKR. Then 103 OA patients undergoing unilateral TKR were included and the effect of PCO on the postoperative knee function was examined. RESULTS: Totally, 5 cohort studies meeting the inclusion criteria were enrolled in this analysis. The results of meta-analysis showed that patients with 0 mm ≤ PCO < 2 mm after TKR had a better recovery of joint function (flexion contracture: 28.67%; KS functional score: 78.67%; KS knee score: 75.00%) than the remaining three groups. However, the knee flexion (77.00%) of patients with PCO ≤ - 2 mm after TKR was superior to the other three groups. Retrospective study also revealed a significant correlation between PCO changes and the flexion contracture, further flexion and KS functional score of patients after TKR, in which each functional knee score of patients with 0 mm ≤ PCO < 2 mm was better than the others. CONCLUSION: These findings suggest a close correlation between PCO magnitude and knee joint function after TKR and that 0 mm ≤ PCO < 2 mm is superior to other changes for joint function after TKR.

13.
Meat Sci ; 174: 108416, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33388717

RESUMO

The objective was to evaluate the effect of packaging conditions on bacteriological and biochemical changes in beef steaks classified here, as normal ultimate pH (pHu; 5.40-5.79), intermediate pHu (5.80-6.09) or high pHu (≥ 6.10). Steaks were packaged in vacuum packaging (VP) and modified atmosphere packaging with high oxygen (HiO2-MAP) or carbon monoxide (CO-MAP). Headspace, bacterial counts, total volatile basic nitrogen, pH, purge loss, surface color, lipid oxidation, and sensory attributes were monitored over a 14-day storage period at 2 °C. HiO2-MAP and CO-MAP of high pHu steaks resulted in a bright red color even when observed to be spoilt. Reduced purge loss and lipid oxidation, as well as increased sensory acceptability were observed for steaks with elevated pHu. Higher pHu was also accompanied by an acceleration of microbial proliferation. Of all packaging types investigated, CO-MAP exerted the best preservation, regardless of pHu and based on its antibacterial and antioxidant properties.

14.
Cancer Immunol Immunother ; 70(7): 1841-1851, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33388997

RESUMO

Previously we reported that administration of IgG could inhibit tumor progression in mouse models. At the same time, we also found that some IgGs have glycosylation modifications on their Fab fragments, which may have different biological functions than non-glycosylated IgG. In this study, we employed mouse tumor models to explore the roles of two different forms of IgG, i.e. Fab-glycosylated and Fab-non-glycosylated IgG, in tumor progression. The two types of IgGs were separated with ConA absorption which could react with glycan on the Fab arm but could not access glycan on the Fc fragment. In addition, we performed cytokine array, ELISA, western blotting, immunocytochemistry and other techniques to investigate the possible mechanisms of the actions of Fab-glycosylated IgG in the models. We found that Fab-glycosylated IgG, unlike Fab-non-glycosylated IgG, did not inhibit tumor growth and metastasis in the model. On the contrary, Fab-glycosylated IgG may bind to antigen-bound IgG molecules and macrophages through the glycosidic chain on the Fab fragment to affect antigen-antibody binding and macrophage polarization, which are likely to help tumor cells to evade the immune surveillance. A new mechanism of immune evasion with Fab-glycosylated IgG playing a significant role was proposed.

15.
BMC Fam Pract ; 22(1): 11, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33419410

RESUMO

BACKGROUND: The family doctor system is a vital part of China's national medical and health system reform. Evidence of the degree of implementation of the family doctor system is required to assist managers and policy makers in Pudong with resource allocation planning. This study analyzed changes in indicators (family doctor team construction, contracted medical services, health management services and so on) over time to evaluate the progress of the family doctor system in Pudong. METHODS: We used a cross-sectional design with an online questionnaire survey to collect 3-year (2013-2016) consecutive data. The online questionnaires were completed by the doctors responsible for information reporting in each community health service center of Pudong. The data were sorted, and the indices calculated and analyzed using descriptive statistics and statistical tests. RESULTS: The proportion of registered general practitioners increased each year, from 50.8% in 2013 to 66.5% in 2016; this difference was statistically significant (P = 0.000). The number of family doctors per 10,000 permanent residents rose each year, from 1.7 in 2013 to 2.1 in 2016. The rate of contracted household residents was 55.7% in 2013 and increased to 71.7% in 2016, with the difference being significant in different years (P = 0.012). Analysis of referral services showed the people times of contracted residents transferring to higher-level hospitals from family doctors increased each year, from 172,734 in 2013 to 341,615 in 2016; differences among different regions were statistically significant for 2013-2016. The rate of health screening for contracted residents also increased each year, with statistically significant differences in different years (P = 0.000). The rate of health assessment interventions for contracted residents rose each year, with statistically significant differences in different years (P = 0.003). CONCLUSIONS: The family doctor signing service in Pudong made headway in general practitioner availability, contract service rate of household residents, and providing health management services. However, problems included family doctor shortages and limited supporting policies, especially in rural and suburban areas compared with urban divisions. Increasing the enrollment rate of family doctors and speeding up the implementation of "contract service fees" are key tasks for the sustainable development of the family doctor system in Pudong.

16.
J Food Prot ; 84(6): 1060-1068, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33508090

RESUMO

ABSTRACT: Beef-based medium beef extract (BE) and standard medium tryptic soy broth (TSB) are used as minimally processed food models to study the effects on Escherichia coli O157:H7 biofilm formation. The effects of temperatures (4, 10, 25, 37, and 42°C), pH values (4.5, 5.0, 5.5, 6.0, 7.0, and 8.0), strain characteristics, and the expression of functional genes on the biofilm formation ability of the bacteria were determined. The three tested E. coli O157:H7 strains produced biofilm in both media. Biofilm formation was greater in BE than in TSB (P < 0.05). The strongest biofilm formation capacity of E. coli O157:H7 was achieved at 37°C and pH 7.0. Biofilm formation was significantly inhibited for three tested strains incubated at 4°C. Biofilm formation ability was correlated with swarming in TSB. Biofilm formation was significantly and positively correlated with autoaggregation or hydrophobicity in BE (P < 0.05). At the initial stage of biofilm formation, the expressions of luxS, sdiA, csgD, csgA, flhC, adrA, and rpoS were significantly higher in BE than in TSB (P < 0.05). At the maturity stage, the expressions of luxS, sdiA, csgD, csgA, flhC, csrA, adrB, adrA, iraM, and rpoS were significantly higher in TSB than in BE (P < 0.05). Such information could help in the development of effective biofilm removal technologies to deal with risks of E. coli O157:H7 biofilms in the beef industry.

17.
Food Microbiol ; 95: 103716, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33397629

RESUMO

To investigate the persistence of acid tolerance response (ATR) and the regulatory mechanism during chilled storage, Salmonella ATCC 14028 and the △phoP mutant were acid adapted and then incubated in meat extract at 4 °C for 24 days as simulated beef storage. The bacterial population, D values and expression of PhoP/PhoQ linked genes of both strains were determined at 6-day intervals. Although a mild suppression effect on the D values of adapted Salmonella was found during the long-time storage in meat extract at 4 °C, the D value of adapted strains was significantly higher than non-adapted strains, indicating the persistence of ATR during the whole aging and distribution of beef posing a threat to food safety. The fact that low temperature inhibits the formation of ATR at the early adapted stage emphasizes the importance of keeping a low-temperature environment during slaughter. An interaction between the acidic adaptation and phoP gene on D values was found and the expression levels of adiA, adiY, cadA and cadB genes was significantly reduced in the △phoP mutant, suggesting that PhoP/Q system plays an important role in the ATR by sensing the pH and regulating lysine and arginine decarboxylation directly or indirectly.


Assuntos
Proteínas de Bactérias/metabolismo , Carne/microbiologia , Salmonella typhimurium/fisiologia , Ácidos/metabolismo , Adaptação Fisiológica , Animais , Proteínas de Bactérias/genética , Bovinos , Regulação Bacteriana da Expressão Gênica
18.
Meat Sci ; 171: 108292, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32896773

RESUMO

Beef rolls for hot pot are usually stored and transported in a frozen state, and the beef color deteriorates quickly. This paper reports on an investigation into the effect of packaging method, freezing temperature and storage time on instrumental color, pH, myoglobin state, lipid oxidation (TBARS) and total volatile basic nitrogen (TVB-N) of beef rolls. It was shown that the color of beef rolls at -18 °C was better than that at -12 °C overall, and the OxyMb% and pH values were higher, while the MetMb% and TBARS were lower with storage at -18 °C. With the extension of storage time, the instrumental color, OxyMb% and pH values of beef rolls decreased. Correspondingly, the MetMb% and TBARS showed an upward trend. However, the TVB-N of all treatments did not exceed the Chinese standard during 180d of storage. The results of this paper provide a number of recommendations for the storage of frozen beef rolls to extend color-shelf life.


Assuntos
Cor , Embalagem de Alimentos/métodos , Congelamento , Produtos da Carne/análise , Animais , Bovinos , Armazenamento de Alimentos/métodos , Concentração de Íons de Hidrogênio , Mioglobina/análise , Nitrogênio/análise , Substâncias Reativas com Ácido Tiobarbitúrico/análise
19.
Meat Sci ; 172: 108320, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33039751

RESUMO

The effect of medium voltage electrical stimulation (ES), prior ageing (0-4 °C, 7 days), and their combination on the decrease of shear force in beef during superchilled storage (-4 °C) for 24 weeks was evaluated, in the context of a high shear force obtained under this storage condition. Both ES and prior ageing significantly reduced the initial Warner-Bratzler shear force, and the combination of ES and prior ageing shortened the storage time needed to reach an acceptable shear force of superchilled beef, which is mainly due to increased myofibrillar degradation as indicated by changes in desmin (P < 0.01, r = 0.35). Additionally, ES and prior ageing did not negatively affect lipid oxidation, total volatile basic nitrogen or water loss of superchilled beef. Consequently, ES combined with ageing for 7 days offered an effective approach for decreasing shear force and ensuring good quality superchilled beef.

20.
Meat Sci ; 172: 108347, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33091723

RESUMO

This study defined the pH threshold for dark cutting beef of Asian consumers using a web-based survey and examined their preferences for beef appearance. Ninety individual images of beef steaks with different pH values were randomly selected to be scored by 4322 respondents. Gender, age and beef eating habits of respondents were found to impact on color preferences. With respondent's visual score of 4 set as the acceptance threshold, linear regression analysis between visual scores and beef instrumental colorimetrics, showed that the acceptance thresholds of instrumental color values were L* ≥ 31.4, a* ≥ 16.4, b* ≥ 6.5, chroma ≥17.4 and hue ≥22.5. These corresponded to pH threshold values of 6.11, 6.20, 6.28, 6.25 and 6.29, respectively. This pH benchmark (6.11 to 6.29) for dark cutters is higher than pH thresholds applied in most countries, indicating that Asian consumers prefer darker meat than expected, however, the likely tenderness of beef with pH's at this level merits consideration.

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