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Health system reform is considered a tough issue worldwide. Great efforts have been made toward health system building and strengthening. However, it is still unclear which health system is appropriate for different countries. This study aimed to systematically compare the characteristics of the establishment periods between eighty-eight counties of National Health Service (NHS) and Social Health Insurance (SHI).
Forty-eight NHS countries and forty SHI countries with data availability were selected. The establishment years of current health systems and other eighteen indicators in economics, society, population and health during establishment periods were collected. Comparison between NHS and SHI was conducted by descriptive analysis of every indicator.
Most NHS countries were established during the cold war, while SHI had been set up since the cold war ended. The median of gross domestic product (GDP) per capita, urbanization rate and aging rate of SHI were USD 1535 in current dollars, 58.2 percent and 9.8 percent, respectively; compared with USD 1387, 41.2 percent and 4.7 percent, respectively of NHS. NHS countries had a smaller total population, lower mortality rate and elderly dependency ratio, while the birth rate and children's dependency ratio were higher. SHI countries showed a higher life expectancy and lower mortality rate in infants and children. NHS countries spent less in total health expenditure and a lower proportion of GDP. The median health expenditure per capita of SHI and NHS were USD 188 and USD 131 in current dollars, respectively. There was little difference among maternal mortality rates, and public and private health expenditure proportions.
NHS and SHI countries had different characteristics during the health system establishment periods. NHS was established earlier than SHI overall, so that SHI revealed higher levels in economic and social development. Health outcomes of NHS countries were slightly lower than SHI ones, while health expenditure was more in SHI countries. Specific social, economic, demographic and health conditions should be considered when countries are building their own health systems.
Previous studies in China showed large sex differences in childhood overweight and obesity (OW/OB) rates. However, limited research has examined the cause of these sex differences. The present study aimed to examine individual and parental/familial factors associated with sex differences in childhood OW/OB rates in China.
Variables associated with child weight status, beliefs and behaviours, and obesity-related parenting practices were selected to examine their sex differences and association with a sex difference in child OW/OB outcomes using logistic regression analysis.
Cross-sectional data analysis using the 2011 China Health and Nutrition Survey.
Children aged 6–17 years (n 1544) and their parents.
Overall child OW/OB prevalence was 16·8 %. Adolescent boys (AB; 12–17 years) were about twice as likely to be overweight/obese as adolescent girls (AG; 15·5 v. 8·4 %, P<0·05). AB more likely had energy intake exceeding recommendations, self-perceived underweight, underestimated their body weight and were satisfied with their physical activity level than AG. AG more likely practised weight-loss management through diet and self-perceived overweight than AB. Mothers more likely identified AG’s weight accurately but underestimated AB’s weight. Stronger associations with risk of childhood OW/OB were found in boys than girls in dieting to lose weight (OR=6·7 in boys v. 2·6 in girls) and combined maternal and child perception of the child’s overweight (OR=35·4 in boys v. 14·2 in girls).
Large sex differences in childhood obesity may be related to the sex disparities in weight-related beliefs and behaviours among children and their parents in China.
The novel visible-light-responsive direct solid-state Z-scheme g-C3N4/BiOI heterojunction has been synthesized successfully by means of a solid phase calcination method and used for the degradation of microcystin-LR (MC-LR). The layered g-C3N4 disperses on the surface of BiOI microspheres. The samples are characterized by FESEM, HRTEM, XRD, FT-IR, UV-vis spectroscopy, XPS, BET, PL, and Mott–Sckottky. The photocatalytic activity and photodegradation mechanism of the as-prepared g-C3N4/BiOI microsphere photocatalysts are conducted under visible light irradiation using MC-LR as the target pollutant. The g-C3N4/BiOI material exhibits superior photocatalytic performance when compared with pure BiOI, the possible reason is the efficient separation of photogenerated carriers at the interface between g-C3N4 and BiOI. The heterostructure is responsible for the improved separation efficiency of photogenerated electron–hole pairs and thus the higher photocatalytic activity. The possible photocatalytic mechanism is proposed based on relative band positions of these two semiconductors.
In order to confirm the genetic relationship between the Yellow Sea and East China Sea populations of mantis shrimps Oratosquilla oratoria, fragments of mitochondrial DNA COI gene samples were analysed. A total of 212 individuals from nine localities in the East China Sea and Yellow Sea were collected and 108 haplotypes were detected. Neighbour-joining analysis revealed a complete genetic break between the Yellow Sea and East China Sea, which was consistent with the previous mtDNA 16S rRNA. Pleistocene isolation and the current physical barrier were responsible for the complete genetic break between the East China Sea and Yellow Sea. Furthermore, local adaptation in the COI gene may also be contributed to by the genetic differentiation between the populations of the Yellow Sea and East China. The different Ka/Ks ratios between the two clades may reflect different selection pressures and local adaptation on the fragment of COI gene.
Pristine graphene has low thermoelectric performance due to its ultra-high thermal conductivity and a low Seebeck coefficient, the latter of which results from the zero-band gap of graphene. To improve the thermoelectric performance of graphene-based materials, various methods have been proposed to open a band gap in graphene. Graphene antidot lattices is one of the most effective methods to reach this goal by patterning periodic nano- or sub-1-nm pores (antidots) across graphene. In high-porosity graphene antidot lattices, charge carriers mainly flow through the narrow necks between pores, forming a comparable case as graphene nanoribbons. This will open a geometry-dependent band gap and dramatically increase the Seebeck coefficient. The antidots also strongly scatter phonons, leading to a dramatically reduced lattice thermal conductivity to further enhance the thermoelectric performance. In computations, the thermoelectric figure of merit of a graphene antidot lattices was predicted to be around 1.0 at 300 K but experimental validation is still required. The electrical conductivity and Seebeck coefficient of graphene antidot lattices on various substrates including SiO2, SiC and hexagonal boron nitride were measured. The antidots were drilled with a focused ion beam or reactive ion etching.
Glacier surface melting can be described using energy-balance models. We conducted a surface energy budget experiment to quantify surface energy fluxes and to identify factors affecting glacial melt in the ablation zone of Laohugou glacier No. 12, western Qilian mountains. The surface energy budget was calculated based on data from an automatic weather station, and turbulent fluxes calculated using the bulk-aerodynamic approach were corrected using measurements from an eddy-covariance system. Simulated mass balances were validated by stake observations. Net shortwave radiation was the primary component of the surface energy balance (126Wm–2), followed by sensible heat flux. Net longwave radiation (–45Wm–2) and latent heat flux (–12.8 Wm–2) represented heat sinks. The bulk-aerodynamic method underestimated sensible and latent heat fluxes by 3.4 and 1.2 W m–2, respectively. The simulated total mass balance of –1703mmw.e. exceeded the observed total by 90 mm w.e. Daily positive accumulated temperature and low albedo were the main factors accelerating glacier melt. An uncertainty assessment showed that mass balance was very sensitive to albedo and varied by 36% when albedo changed by 0.1.
We examined the in vitro developmental competence of parthenogenetic activation (PA) oocytes activated by an electric pulse (EP) and treated with various concentrations of AZD5438 for 4 h. Treatment with 10 µM AZD5438 for 4 h significantly improved the blastocyst formation rate of PA oocytes in comparison with 0, 20, or 50 µM AZD5438 treatment (46.4% vs. 34.5%, 32.3%, and 24.0%, respectively; P < 0.05). The blastocyst formation rate was higher in the group treated with AZD5438 for 4 h than in the groups treated with AZD5438 for 2 or 6 h (42.8% vs. 38.6% and 37.2%, respectively; P > 0.05). Furthermore, 66.67% of blastocysts derived from these AZD5438-treated PA oocytes had a diploid karyotype. The blastocyst formation rate of PA and somatic cell nuclear transfer (SCNT) embryos was similar between oocytes activated by an EP and treated with 2 mM 6-dimethylaminopurine for 4 h and those activated by an EP and treated with 10 µM AZD5438 for 4 h (11.11% vs. 13.40%, P > 0.05). In addition, the level of maturation-promoting factor (MPF) was significantly decreased in oocytes activated by an EP and treated with 10 µM AZD5438 for 4 h. Finally, the mRNA expression levels of apoptosis-related genes (Bax and Bcl-2) and pluripotency-related genes (Oct4, Nanog, and Sox2) were checked by RT-PCR; however, there were no differences between the AZD5438-treated and non-treated control groups. Our results demonstrate that porcine oocyte activation via an EP in combination with AZD5438 treatment can lead to a high blastocyst formation rate in PA and SCNT experiments.
The fuzziness of the traditional multiaxial fatigue prediction model is discussed and the fuzzy theory is applied into fatigue reliability analysis. The fuzzy linear regression analysis method is used to determine the fuzzy coefficients in the multiaxial stress–life equation under a small sample condition, and the corresponding multiaxial fatigue probabilistic stress–life curve is calculated with different confidence levels.
Retreatment of tuberculosis (TB) often fails in China, yet the risk factors associated with the failure remain unclear. To identify risk factors for the treatment failure of retreated pulmonary tuberculosis (PTB) patients, we analyzed the data of 395 retreated PTB patients who received retreatment between July 2009 and July 2011 in China. PTB patients were categorized into ‘success’ and ‘failure’ groups by their treatment outcome. Univariable and multivariable logistic regression were used to evaluate the association between treatment outcome and socio-demographic as well as clinical factors. We also created an optimized risk score model to evaluate the predictive values of these risk factors on treatment failure. Of 395 patients, 99 (25·1%) were diagnosed as retreatment failure. Our results showed that risk factors associated with treatment failure included drug resistance, low education level, low body mass index (<18·5), long duration of previous treatment (>6 months), standard treatment regimen, retreatment type, positive culture result after 2 months of treatment, and the place where the first medicine was taken. An Optimized Framingham risk model was then used to calculate the risk scores of these factors. Place where first medicine was taken (temporary living places) received a score of 6, which was highest among all the factors. The predicted probability of treatment failure increases as risk score increases. Ten out of 359 patients had a risk score >9, which corresponded to an estimated probability of treatment failure >70%. In conclusion, we have identified multiple clinical and socio-demographic factors that are associated with treatment failure of retreated PTB patients. We also created an optimized risk score model that was effective in predicting the retreatment failure. These results provide novel insights for the prognosis and improvement of treatment for retreated PTB patients.
To evaluate the effects of different anthropogenic activities on zooplankton and the pelagic ecosystem, we conducted seasonal cruises in 2010 to assess spatial heterogeneity among the mesozooplankton communities of Xiangshan Bay, a subtropical semi-enclosed bay in China. The evaluation included five different areas: a kelp farm, an oyster farm, a fish farm, the thermal discharge area of a power plant, and an artificial reef, and we aimed to identify whether anthropogenic activities dominated spatial variation in the mesozooplankton communities. The results demonstrated clear spatial heterogeneity among the mesozooplankton communities of the studied areas, dominantly driven by natural hydrographic properties, except in the area near the thermal discharge outlet of the power station. In the outlet area, thermal shock caused by the discharge influenced the mesozooplankton community by decreasing abundance and biomass throughout the four seasons, even causing a shift in the dominant species near the outlet during summer from Acartia pacifica to eurythermal and warm water taxa. Unique features of the mesozooplankton community in the oyster farm may be due to the combined effects of oyster culture and the natural environment in the branch harbour. However, kelp and fish culture, and the construction of an artificial reef did not exert any obvious influence on the mesozooplankton communities up to 2010, probably because of the small scale of the aquaculture and a time lag in the rehabilitation effects of the artificial reef. Thus, our results suggested that the dominant factors influencing spatial variations of mesozooplankton communities in Xiangshan Bay were still the natural hydrographic properties, but the thermal discharge was an anthropogenic activity that changed the pelagic ecosystem, and should be supervised.
Previous studies have thoroughly investigated the prevalence and risk factors for completed suicide. In marked contrast is the lack of a better understanding of attempted suicide in the elderly. The aim of this study was to estimate the prevalence of attempted suicide in the elderly and examine the associated factors.
Using a multi-stage cluster sampling approach, a cross-sectional survey of 8,399 elderly house-dwelling residents was conducted in Shanghai, China.
The two-week prevalence of attempted suicide in the elderly was 0.75%. In the bivariate analysis, having no caregivers, depressive, anxiety, sad, fear, obsessive-compulsive and anger symptom, and lower scores on the Barthel Index of Activities of Daily Living and the Lawton Instrumental Activities of Daily Living Scale were significantly associated with an increased risk of attempted suicide in the elderly. In the multivariate analysis, sad and fear symptoms were significantly and independently associated with a higher risk of attempted suicide in the elderly.
The two-week prevalence of attempted suicide in the elderly is relatively high when compared with the annualized or lifetime prevalence reported in China and foreign settings. Elderly individuals with certain mental symptoms should be targeted for suicide prevention and provided with timely mental health support.
Astronomy cloud computing environment is a cyber-Infrastructure for Astronomy Research initiated by Chinese Virtual Observatory (China-VO) under funding support from NDRC (National Development and Reform commission) and CAS (Chinese Academy of Sciences). Based on virtualization technology, astronomy cloud computing environment was designed and implemented by China-VO team. It consists of five distributed nodes across the mainland of China. Astronomer can get compuitng and storage resource in this cloud computing environment. Through this environments, astronomer can easily search and analyze astronomical data collected by different telescopes and data centers , and avoid the large scale dataset transportation.
Choline and betaine are essential nutrients involved in one-carbon metabolism and have been hypothesised to affect breast cancer risk. Functional polymorphisms in genes encoding choline-related one-carbon metabolism enzymes, including phosphatidylethanolamine N-methyltransferase (PEMT), choline dehydrogenase (CHDH) and betaine-homocysteine methyltransferase (BHMT), have important roles in choline metabolism and may thus interact with dietary choline and betaine intake to modify breast cancer risk. This study aimed to investigate the interactive effect of polymorphisms in PEMT, BHMT and CHDH genes with choline/betaine intake on breast cancer risk among Chinese women. This hospital-based case–control study consecutively recruited 570 cases with histologically confirmed breast cancer and 576 age-matched (5-year interval) controls. Choline and betaine intakes were assessed by a validated FFQ, and genotyping was conducted for PEMT rs7946, CHDH rs9001 and BHMT rs3733890. OR and 95 % CI were estimated using unconditional logistic regression. Compared with the highest quartile of choline intake, the lowest intake quartile showed a significant increased risk of breast cancer. The SNP PEMT rs7946, CHDH rs9001 and BHMT rs3733890 had no overall association with breast cancer, but a significant risk reduction was observed among postmenopausal women with AA genotype of BHMT rs3733890 (OR 0·49; 95 % CI 0·25, 0·98). Significant interactions were observed between choline intake and SNP PEMT rs7946 (Pinteraction=0·029) and BHMT rs3733890 (Pinteraction=0·006) in relation to breast cancer risk. Our results suggest that SNP PEMT rs7946 and BHMT rs3733890 may interact with choline intake on breast cancer risk.
We present a scheme of electron beam radiography to dynamically diagnose the high energy density (HED) matter in three orthogonal directions simultaneously based on electron Linear Accelerator. The dynamic target information such as, its profile and density could be obtained through imaging the scattered electron beam passing through the target. Using an electron bunch train with flexible time structure, a very high temporal evolution could be achieved. In this proposed scheme, it is possible to obtain 1010 frames/second in one experimental event, and the temporal resolution can go up to 1 ps, spatial resolution to 1 µm. Successful demonstration of this concept will have a major impact for both future inertial confinement fusion science and HED physics research.
In this paper, we introduce a high-order accurate constrained transport type finite volume method to solve ideal magnetohydrodynamic equations on two-dimensional triangular meshes. A new divergence-free WENO-based reconstruction method is developed to maintain exactly divergence-free evolution of the numerical magnetic field. In this formulation, the normal component of the magnetic field at each face of a triangle is reconstructed uniquely and with the desired order of accuracy. Additionally, a new weighted flux interpolation approach is also developed to compute the z-component of the electric field at vertices of grid cells. We also present numerical examples to demonstrate the accuracy and robustness of the proposed scheme.
This paper contributes to the regular covers of a complete bipartite graph minus a matching, denoted
, whose fiber-preserving automorphism group acts 2-arc-transitively. All such covers, when the covering transformation group
is either cyclic or
a prime, have been determined in Xu and Du [‘2-arc-transitive cyclic covers of
’, J. Algebraic Combin.39 (2014), 883–902] and Xu et al. [‘2-arc-transitive regular covers of
with the covering transformation group
’, Ars. Math. Contemp.10 (2016), 269–280]. Finally, this paper gives a classification of all such covers for
Phosphatidylinositol-3 kinases (PI3K)-Protein kinase B (Akt)-mammalian target of rapamycin (mTOR) pathway plays an important role in the synthesis and secretion of triacylglycerol. However, the mechanism of PI3K-Akt-mTOR pathway in regulating lipid metabolism of goose liver was poorly understood. The purpose of this study was to determine how PI3K-Akt-mTOR pathway regulating lipid metabolic homeostasis in goose hepatocytes. Goose primary hepatocytes were treated with different PI3K-Akt-mTOR signal inhibitors (LY294002, rapamycin and NVP-BEZ235) for 24 h. The results showed that these inhibitors evidently inhibited PI3K-Akt-mTOR downstream signaling. Meanwhile, these PI3K-Akt-mTOR inhibitors reduced intracellular lipid accumulation, decreased the mRNA expression and protein content of genes involved in the de novo fatty acid synthesis, while increased the transcriptional and protein level of key factors involved in fatty acid oxidation and very low density lipoprotein (VLDL) assembly and secretion. Conclusion: These findings suggested that the reduction of lipids accumulation induced-by inhibiting PI3K-Akt-mTOR pathway was closely linked to the decrease of lipogenesis, the increase of fatty acids oxidation, and the increase of VLDL assembly and secretion in goose hepatocytes.
This paper is devoted to time domain numerical solutions of two-dimensional (2D) material interface problems governed by the transverse magnetic (TM) and transverse electric (TE) Maxwell's equations with discontinuous electromagnetic solutions. Due to the discontinuity in wave solutions across the interface, the usual numerical methods will converge slowly or even fail to converge. This calls for the development of advanced interface treatments for popular Maxwell solvers. We will investigate such interface treatments by considering two typical Maxwell solvers – one based on collocation formulation and another based on Galerkin formulation. To restore the accuracy reduction of the collocation finite-difference time-domain (FDTD) algorithm near an interface, the physical jump conditions relating discontinuous wave solutions on both sides of the interface must be rigorously enforced. For this purpose, a novel matched interface and boundary (MIB) scheme is proposed in this work, in which new jump conditions are derived so that the discontinuous and staggered features of electric and magnetic field components can be accommodated. The resulting MIB time-domain (MIBTD) scheme satisfies the jump conditions locally and suppresses the staircase approximation errors completely over the Yee lattices. In the discontinuous Galerkin time-domain (DGTD) algorithm – a popular GalerkinMaxwell solver, a proper numerical flux can be designed to accurately capture the jumps in the electromagnetic waves across the interface and automatically preserves the discontinuity in the explicit time integration. The DGTD solution to Maxwell interface problems is explored in this work, by considering a nodal based high order discontinuous Galerkin method. In benchmark TM and TE tests with analytical solutions, both MIBTD and DGTD schemes achieve the second order of accuracy in solving circular interfaces. In comparison, the numerical convergence of the MIBTD method is slightly more uniform, while the DGTD method is more flexible and robust.