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JMIR Public Health and Surveillance May 2024The fragmentation of the medical insurance system is a major challenge to achieving health equity. In response to this problem, the Chinese government is pushing to...
Evidence From the China Family Panel Studies Survey on the Effect of Integrating the Basic Medical Insurance System for Urban and Rural Residents on the Health Equity of Residents: Difference-in-Differences Analysis.
BACKGROUND
The fragmentation of the medical insurance system is a major challenge to achieving health equity. In response to this problem, the Chinese government is pushing to establish the unified Urban and Rural Resident Basic Medical Insurance (URRBMI) system by integrating the New Rural Cooperative Medical Scheme and the Urban Resident Basic Medical Insurance. By the end of 2020, URRBMI had been implemented almost entirely across China. Has URRBMI integration promoted health equity for urban and rural residents?
OBJECTIVE
This study aims to examine the effect of URRBMI integration on the health level of residents and whether the integration can contribute to reducing health disparities and promoting health equity.
METHODS
We used the staggered difference-in-differences method based on the China Family Panel Studies survey from 2014 to 2018. Our study had a nationally representative sample of 27,408 individuals from 98 cities. We chose self-rated health as the measurement of health status. In order to more accurately discern whether the sample was covered by URRBMI, we obtained the exact integration time of URRBMI according to the official documents issued by local governments. Finally, we grouped the sample by urban and rural areas, regions, and household income to examine the impact of the integration on health equity.
RESULTS
We found that overall, the URRBMI integration has improved the health level of Chinese residents (B=0.066, 95% CI 0.014-0.123; P=.01). In terms of health equity, the results showed that first, the integration has improved the health level of rural residents (B=0.070, 95% CI 0.012-0.128; P=.02), residents in western China (B=0.159, 95% CI 0.064-0.255; P<.001), and lower-middle-income groups (B=0.113, 95% CI 0.004-0.222, P=.04), so the integration has played a certain role in narrowing the health gap between urban and rural areas, different regions, and different income levels. Through further mechanism analysis, we found that the URRBMI integration reduced health inequity in China by facilitating access to higher-rated hospitals and increasing reimbursement rates for medical expenses. However, the integration did not improve the health of the central region and low-income groups, and the lack of access to health care for low-income groups was not effectively reduced.
CONCLUSIONS
The role of URRBMI integration in promoting health equity among urban and rural residents was significant (P=.02), but in different regions and income groups, it was limited. Focusing on the rational allocation of medical resources between regions and increasing the policy tilt toward low-income groups could help improve the equity of health insurance integration.
Topics: Humans; China; Rural Population; Urban Population; Insurance, Health; Health Equity; Female; Male; Adult; Middle Aged; Surveys and Questionnaires
PubMed: 38815256
DOI: 10.2196/50622 -
Heliyon May 2024Nepal is one of the pioneers of hydropower development among Asian countries. The plethora of fast-flowing rivers provides immense potential for hydropower generation....
Nepal is one of the pioneers of hydropower development among Asian countries. The plethora of fast-flowing rivers provides immense potential for hydropower generation. However, Nepal still lacks a clear blueprint for the overall development and management of this sector. This paper aims to review the evolution of hydropower development, future prospects and roadblocks to hydropower development. With the growing energy demands projected to reach as high as 41,264.82 Gigawatt hours (GWh) in 2030 and 115,294.4 GWh in 2040 under different scenarios, this paper highlights the huge prospects the sector holds. It also proposes a focus on storage-type hydropower plants and concepts of energy banking to address the incipient condition of seasonal energy mismatch in the country, which has developed a condition of energy shortage during the winter and energy surplus during the monsoon. Moreover, projected changes in hydro-climatic extremes under the climate change scenarios is likely to affect water availability and subsequently the energy production in the majority of hydropower projects. Thus, this review can serve as a guideline to help understand the current scenario and make rational decisions and policies for the future management of the hydropower sector of the country.
PubMed: 38813230
DOI: 10.1016/j.heliyon.2024.e31139 -
Heliyon May 2024We analysed herding behaviour in the recent pandemic and conflict. We employed the cross-sectional dispersion of daily stock returns to estimate herding's intensity in...
We analysed herding behaviour in the recent pandemic and conflict. We employed the cross-sectional dispersion of daily stock returns to estimate herding's intensity in the Saudi stock market. We conducted all analyses for the entire sample and four sub-samples. Additionally, we investigate the existence of the asymmetry in the investors' responses; whether there are differences between up and down markets and between high-volatility and low-volatility days. We found that herding did not occur in the pre-COVID-19, occurred in the during-COVID-19, disappeared in the post-COVID-19 and did not occur during the Russia-Ukraine conflict. Robustness checks confirm our finding that herding manifested in the during-COVID-19 period. Additionally, no difference exists between bearish and bullish or high-and low-volatility days, pushing aside the asymmetry in the investors' responses. This study may raise investors' awareness of their cognitive bias's influence on their decisions, improving market efficiency by increasing the rationality of investors' decisions.
PubMed: 38813195
DOI: 10.1016/j.heliyon.2024.e31382 -
Heliyon May 2024In this novel research, S-scheme AgCrO/g-CN heterojunctions were generated by sonochemical hybridization of different compositions of AgCrO nanoparticles...
In this novel research, S-scheme AgCrO/g-CN heterojunctions were generated by sonochemical hybridization of different compositions of AgCrO nanoparticles [E = +2.21 eV] and g-CN sheets [E = -1.3 eV] for destructing RhB dye under artificial solar radiation. The as-synthesized nanocomposites were subjected to X-ray diffraction [XRD], diffuse reflectance spectrum [DRS], X-ray photoelectron spectroscopy [XPS], N-adsorption-desorption isotherm, photoluminescence [PL] and high resolution transmission electron microscope [HRTEM] analysis to explore the interfacial interactions between g-CN sheets and AgCrO nanoparticles. Spherical AgCrO nanoparticles deposited homogeneously on the wrinkles points of g-CN sheets at nearly equidistant from each other facilitating the uniform absorption of solar radiations. The absorbability of solar radiations was enhanced by introducing 20 wt % AgCrO on g-CN sheets. The surface area of g-CN sheets was reduced from 37.5 to 16.4 m/g and PL signal intensity diminished by 80 % implying the successful interfacial interaction between AgCrO nanoparticles and g-CN sheets. The photocatalytic performance of heterojunctions containing 20 % AgCrO and 80 % g-CN destructed 96 % of RhB dye compared with 60 and 33 % removal on the surface of pristine g-CN sheets and AgCrO, respectively. Benzoquinone and ammonium oxalate are strongly scavenged the dye decomposition revealing the strong influence of valence band holes of AgCrO and superoxide radicals in destructing RhB dye under solar radiations. S-scheme charge transportation mechanism was suggested rather than type II heterojunction on the light of scavenger trapping experiments results and PL spectrum of terephthalic acid. Overall, this research work illustrated the manipulation of novel S-scheme heterojunction with efficient redox power for destructing various organic pollutants persisted in water resources.
PubMed: 38813157
DOI: 10.1016/j.heliyon.2024.e31221 -
Frontiers in Immunology 2024To be viable therapeutics, antibodies must be tolerated by the human immune system. Rational approaches to reduce the risk of unwanted immunogenicity involve maximizing... (Review)
Review
To be viable therapeutics, antibodies must be tolerated by the human immune system. Rational approaches to reduce the risk of unwanted immunogenicity involve maximizing the 'humanness' of the candidate drug. However, despite the emergence of new discovery technologies, many of which start from entirely human gene fragments, most antibody therapeutics continue to be derived from non-human sources with concomitant humanization to increase their human compatibility. Early experimental humanization strategies that focus on CDR loop grafting onto human frameworks have been critical to the dominance of this discovery route but do not consider the context of each antibody sequence, impacting their success rate. Other challenges include the simultaneous optimization of other drug-like properties alongside humanness and the humanization of fundamentally non-human modalities such as nanobodies. Significant efforts have been made to develop methodologies able to address these issues, most recently incorporating machine learning techniques. Here, we outline these recent advancements in antibody and nanobody humanization, focusing on computational strategies that make use of the increasing volume of sequence and structural data available and the validation of these tools. We highlight that structural distinctions between antibodies and nanobodies make the application of antibody-focused tools to nanobody humanization non-trivial. Furthermore, we discuss the effects of humanizing mutations on other essential drug-like properties such as binding affinity and developability, and methods that aim to tackle this multi-parameter optimization problem.
Topics: Humans; Single-Domain Antibodies; Animals; Computational Biology; Antibodies
PubMed: 38812514
DOI: 10.3389/fimmu.2024.1399438 -
Journal of Nanobiotechnology May 2024Discrepancies in the utilization of reactive oxygen species (ROS) between cancer cells and their normal counterparts constitute a pivotal juncture for the precise...
BACKGROUND
Discrepancies in the utilization of reactive oxygen species (ROS) between cancer cells and their normal counterparts constitute a pivotal juncture for the precise treatment of cancer, delineating a noteworthy trajectory in the field of targeted therapies. This phenomenon is particularly conspicuous in the domain of nano-drug precision treatment. Despite substantial strides in employing nanoparticles to disrupt ROS for cancer therapy, current strategies continue to grapple with challenges pertaining to efficacy and specificity. One of the primary hurdles lies in the elevated levels of intracellular glutathione (GSH). Presently, predominant methods to mitigate intracellular GSH involve inhibiting its synthesis or promoting GSH efflux. However, a conspicuous gap remains in the absence of a strategy capable of directly and efficiently clearing GSH.
METHODS
We initially elucidated the chemical mechanism underpinning oridonin, a diminutive pharmacological agent demonstrated to perturb reactive oxygen species, through its covalent interaction with glutathione. Subsequently, we employed the incorporation of maleimide-liposomes, renowned for their capacity to disrupt the ROS delivery system, to ameliorate the drug's water solubility and pharmacokinetics, thereby enhancing its ROS-disruptive efficacy. In a pursuit to further refine the targeting for acute myeloid leukemia (AML), we harnessed the maleic imide and thiol reaction mechanism, facilitating the coupling of Toll-like receptor 2 (TLR2) peptides to the liposomes' surface via maleic imide. This strategic approach offers a novel method for the precise removal of GSH, and its enhancement endeavors are directed towards fortifying the precision and efficacy of the drug's impact on AML targets.
RESULTS
We demonstrated that this peptide-liposome-small molecule machinery targets AML and consequently induces cell apoptosis both in vitro and in vivo through three disparate mechanisms: (I) Oridonin, as a Michael acceptor molecule, inhibits GSH function through covalent bonding, triggering an initial imbalance of oxidative stress. (II) Maleimide further induces GSH exhaustion, aggravating redox imbalance as a complementary augment with oridonin. (III) Peptide targets TLR2, enhances the directivity and enrichment of oridonin within AML cells.
CONCLUSION
The rationally designed nanocomplex provides a ROS drug enhancement and targeted delivery platform, representing a potential solution by disrupting redox balance for AML therapy.
Topics: Diterpenes, Kaurane; Glutathione; Liposomes; Leukemia, Myeloid, Acute; Humans; Reactive Oxygen Species; Animals; Mice; Cell Line, Tumor; Toll-Like Receptor 2; Antineoplastic Agents; Apoptosis
PubMed: 38812031
DOI: 10.1186/s12951-024-02574-6 -
BMC Microbiology May 2024Dairy buffaloes are typically fed a high-forage, low-quality diet with high fiber. These conditions result in an inherent energy and protein inefficiency. In order to...
Dairy buffaloes are typically fed a high-forage, low-quality diet with high fiber. These conditions result in an inherent energy and protein inefficiency. In order to make full and rational use of feed resources and improve the production level and breeding efficiency of dairy buffaloes, the effects of various roughages on nutrient digestibility, ruminal fermentation parameters, and microorganisms in dairy buffaloes were studied in this experiment. Three ternary hybrid buffaloes, with an average body weight of 365 ± 22.1 kg, were selected and fitted with permanent rumen fistulas. They were fed six different diets, each consisting of 1 kg concentrate supplement and one of six types of roughage, including alfalfa hay (A diet), oat hay (O diet), whole corn silage (W diet), king grass (K diet), sugarcane shoot silage (S diet), and rice straw hay (R diet) according to an incomplete Latin square design of 3 × 6, respectively. The pre-feeding period of each period was 12 d. From day 13 to 15 was the official experimental period. During the prefeeding period, free feed intake for each roughage was determined, and during the experiment, the roughage was fed at 90% of the voluntary feed intake. Digestion and metabolism tests were carried out using the total manure collection method to determine the feed intake and fecal output of each buffalo, and to collect feed and fecal samples for chemical analysis. On day 15, rumen fluid samples were collected two hours after morning feeding to determine rumen fermentation parameters and bacterial 16 S rRNA high-throughput sequencing was performed. The results showed that DM and OM digestibility were greatest for the W diet and lowest for the S diet. The rumen pH of the O diet was significantly greater than that of the W diet. The concentration of rumen fluid NH-N (mg/dL) increased with increased CP content. The concentration of total volatile fatty acids (mmol/L) in the rumen decreased with increased NDF content but increased with increased NFC content. The relative abundances of Bacteroidetes, Firmicutes, and Spirochaetes were 57.03-74.84%, 14.29-21.86%, and 0.44-1.43% in the different quality roughage groups. Bacteroidetes were mainly Prevotellaceae1 and Rikenellaceae RC_gut_group with relative abundances of 30.17-45.75% and 3.23-7.82%. The relative abundance of Patescibacteria and Spirochaetes decreased with increasing roughage quality. These results provide a theoretical and practical basis for evaluating the nutritional value of dairy buffalo feed, utilizing feed resources, matching rations, feeding scientifically, and protecting animal health.
Topics: Animals; Buffaloes; Rumen; Fermentation; Animal Feed; Bacteria; Dietary Fiber; Silage; Nutrients; Digestion; Diet; RNA, Ribosomal, 16S; Gastrointestinal Microbiome; Female; Fatty Acids, Volatile
PubMed: 38811906
DOI: 10.1186/s12866-024-03342-0 -
PloS One 2024As a new business model, E-commerce brings new changes to the global economy and society. So, can E-commerce development policies promote high-quality agricultural...
As a new business model, E-commerce brings new changes to the global economy and society. So, can E-commerce development policies promote high-quality agricultural development? This article regards the pilot construction of national e-commerce demonstration cities as a quasi-natural experiment for the development of e-commerce. Based on the E-commerce pilot and economic and social development data of national prefecture-level cities from 2004 to 2018, the agricultural total factor productivity calculated by the Fare-Primont index method is used as the characterization of the quality of urban agricultural development, and an empirical model is constructed under the progressive Differences-in-Differences framework. This paper empirically tests the overall impact of E-commerce development on the high-quality development of agriculture and its sources, analyzes the heterogeneity and dynamics of the impact, and investigates the possible impact mechanism. The result shows that from the overall impact and its sources, the development of E-commerce in cities has a positive impact on the high-quality development of agriculture, and the impact is mainly due to its role in promoting technological innovation and economies of scale. From the perspective of heterogeneity, the larger the population size of a city, the more significant the level of e-conomic development or Internet development. From the perspective of the dynamic impact, the positive impact of e-commerce development becomes more significant over time. With the passage of time, the impact of E-commerce on high-quality agricultural development policies shows a trend of first increasing and then decreasing. Overall, this study provides empirical evidence for the rationality and effectiveness of policies and measures related to E-commerce to promote the high-quality development of agriculture.
Topics: Agriculture; China; Cities; Commerce; Humans; Economic Development
PubMed: 38809857
DOI: 10.1371/journal.pone.0299097 -
Microbiology Spectrum May 2024Broad-spectrum ampicillin-resistant and third-generation cephalosporin-resistant Enterobacteriaceae, particularly and that have pathological features in humans, have...
UNLABELLED
Broad-spectrum ampicillin-resistant and third-generation cephalosporin-resistant Enterobacteriaceae, particularly and that have pathological features in humans, have become a global concern. This study aimed to investigate the prevalence, antimicrobial susceptibility, and molecular genetic features of extended-spectrum beta-lactamase (ESBL)-producing and isolates in Southern Thailand. Between January and August 2021, samples ( = 199) were collected from a tertiary care hospital in Southern Thailand. ESBL and AmpC-lactamase genes were identified using multiplex polymerase chain reaction (PCR). The genetic relationship between ESBL-producing and was determined using the enterobacterial repetitive intergenic consensus (ERIC) polymerase chain reaction. ESBL-producing and isolates were mostly collected from catheter urine samples of infected female patients. The ESBL production prevalence was highest in the medical wards ( = 75, 37.7%), followed by that in surgical wards ( = 64, 32.2%) and operating rooms ( = 19, 9.5%). Antimicrobial susceptibility analysis revealed that all isolates were resistant to ampicillin, cefotaxime, ceftazidime, ceftriaxone, and cefuroxime; 79.4% were resistant to ciprofloxacin; and 64.3% were resistant to trimethoprim-sulfamethoxazole. In ESBL-producing and , ( = 57, 72.2%) and ( = 61, 50.8%) genes were prominent; however, no , , or were found in any of these isolates. Furthermore, only ESBL-producing had co-harbored and genes at 11.6%. The ERIC-PCR pattern of multidrug-resistant ESBL-producing strains demonstrated that the isolates were clonally related (95%). Notably, the presence of multidrug-resistant and extremely resistant ESBL producers was 83.4% and 16.6%, respectively. This study highlights the presence of , , and co-harbored genes in ESBL-producing bacterial isolates from hospitalized patients, which are associated with considerable resistance to beta-lactamase and third-generation cephalosporins.
IMPORTANCE
We advocate for evidence-based guidelines and antimicrobial stewardship programs to encourage rational and appropriate antibiotic use, ultimately reducing the selection pressure for drug-resistant bacteria and lowering the likelihood of ESBL-producing bacterial infections.
PubMed: 38809095
DOI: 10.1128/spectrum.00213-24 -
ACS Applied Nano Materials May 2024Surface-bound molecular motors can drive the collective motion of cytoskeletal filaments in the form of nematic bands and polar flocks in reconstituted gliding assays....
Surface-bound molecular motors can drive the collective motion of cytoskeletal filaments in the form of nematic bands and polar flocks in reconstituted gliding assays. Although these "swarming transitions" are an emergent property of active filament collisions, they can be controlled and guided by tuning the surface chemistry or topography of the substrate. To date, the impact of surface topography on collective motion in active nematics is only partially understood, with most experimental studies focusing on the escape of a single filament from etched channels. Since the late 1990s, significant progress has been made to utilize the nonequilibrium properties of active filaments and create a range of functional nanodevices relevant to biosensing and parallel computation; however, the complexity of these swarming transitions presents a challenge when attempting to increase filament surface concentrations. In this work, we etch shallow, linear trenches into glass substrates to induce the formation of swarming nematic bands and investigate the mechanisms by which surface topography regulates the two-dimensional (2D) collective motion of driven filamentous actin (F-actin). We demonstrate that nematic swarms only appear at intermediate trench spacings and vanish if the trenches are made too narrow, wide, or tortuous. To rationalize these results, we simulate the F-actin as self-propelled, semiflexible chains subject to a soft, spatially modulated potential that encodes the energetic cost of bending a filament along the edge of a trench. In our model, we hypothesize that an individual filament experiences a penalty when its projected end-to-end distance is smaller than the trench spacing ("bending and turning"). However, chains that span the channel width glide above the trenches in a force- and torque-free manner ("crowd-surfing"). Our simulations demonstrate that collections of filaments form nematic bands only at intermediate trench spacings, consistent with our experimental findings.
PubMed: 38808306
DOI: 10.1021/acsanm.4c02020