bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of the Effect of Rural Residents Serious Illness Medical Insurance on Relieving the Economic Burden of Rural Residents in China:A Case Study in Jinzhai County
Authors: Li Yang , Duan Guangfeng , Xiong Linping 
Published: February 2020

Abstract
Background

In 2003, China established a New Rural Cooperative Medical System(NRCMS) for rural residents, which had alleviated the burden of medical expenses of rural residents, but the reimbursement for high medical was insufficient. Therefore, China had gradually established a Serious Illness Insurance System (SIMIS) on the basis of NRCMS. After the payment of NRCMS, patients who met the requirements of SIMIS policy would be given a second payment to further alleviate the economic burden of patients with high medical expenses in rural areas. The purpose of this study is to analyze the effect of the implementation of SIMIS on alleviating the economic burden of rural residents in Jinzhai County.

Methods

Based on the inpatient reimbursement data of NRCMS in Jinzhai County, Anhui Province from 2013 to 2016. We adopt descriptive and regression discontinuity (RD) method to analyze the payment effect of SIMIS. The RD analysis object (n = 7353) was the patients whose annual serious illness expenses were between CNY 10,000 and CNY 30,000, and the descriptive analysis object (n = 2720) was the patients compensated by SIMIS.

Results

The results of RD showed that the actual medical insurance payment proportion (AMIPP) increased by about 2.5% (lwald = 0.025, P < 0.01), inside medical insurance self-payment proportion (IMSPP) increased by about 2% (lwald = 0.020, P < 0.10), outside medical insurance self-payment proportion (OMISPP) decreased by about 1.6% (lwald = -0.016, P < 0.05). The descriptive results showed that the serious illness patients mostly chose to go to hospital outside the county. The annual average number of hospitalizations was 3.64. The reimbursement mainly came from the NRCMS. The payment amount of SIMIS was relatively small, and the out of pocket medical expenses were still high.

Conclusion

The medical technology level of Jinzhai County could not meet the needs of seriously illness patients, the number of beneficiaries of SIMIS was small, and the ability to relieve the burden of medical expenses of rural residents was insufficient. The high out of pocket expenses increased the possibility that people with good economic conditions could enjoy the reimbursement of SIMIS, resulting in inequity.
Transcriptomic and anatomic profiling reveal germination process of different wheat varieties in response to waterlogging stress
Authors: Shen Changwei , Yuan Jingping , Qiao Hong , Wang Zijuan , Liu Yuanhai , Ren Xiujuan , Wang Fei , Liu Xing , Zhang Ying , Chen Xiling , Ou Xingqi 
Published: February 2020

Abstract
Background Waterlogging is one of the most serious abiotic stresses affecting wheat-growing regions in China. There are considerable differences in waterlogging tolerance among different wheat varieties, and the mechanisms governing the waterlogging tolerance of wheat seeds during germination have not been elucidated. Methods To reveal the adaptability of wheat to waterlogging stress during germination, we analysed the germination rate and anatomical structure of three wheat seeds, ‘Zhoumai 22’(ZM22), ‘Bainong 207’(BN207) and ‘Bainong 607’(BN607). At the same time, Illumina sequencing technology was used to determine the transcriptome of these three wheat varieties during germination. Results The results showed that there was no significant difference between the germination rate of BN607 after 3 days of waterlogging treatment and that of the control seeds. However, under waterlogging stress, the degree of emulsification and degradation of endosperm cells was higher than that of the control treatment, and amyloplasts in endosperm were significantly reduced. Transcriptomic data were obtained from seed samples (a total of 18 samples) of three wheat varieties under the waterlogging and control treatments. A total of 2775 differentially expressed genes (DEGs) were identified by comprehensive analysis. In addition, by analysing the correlation between the expression levels of DEGs and seed germination rates in three wheat varieties under waterlogging stress, it was found that the relative expression levels of 563 and 398 genes were positively and negatively correlated with the germination rate of wheat seeds, respectively. The GO and KEGG analyses found that the difference in waterlogging tolerance of the three wheat varieties was related to the abundance of key genes involved in the glycolysis pathway, the starch and sucrose metabolism pathway, and the lactose metabolism pathway. The alcohol dehydrogenase (ADH) gene in the endosperm of BN607 was immediately induced after short-term waterlogging, and the energy provided by the glycolysis pathway enabled the seeds of BN607 to germinate as early as possible, while the expression of the AP2/ERF transcription factor was upregulated to further enhance its waterlogging tolerance. Conclusions Taken together, the results of this study help to elucidate the mechanisms by which different wheat varieties respond to waterlogging stress during germination.
Telemedical care improves quality of life in patients with schizophrenia and bipolar disorder. Results of a randomized controlled trial
Authors: Stentzel Ulrike , Berg Neeltje van den , Strobel Lara N. , Schulte Josephine , Langosch Jens M. , Hoffmann Wolfgang , Grabe Hans J. 
Published: February 2020

Abstract
Background Schizophrenia and bipolar disorder are serious psychiatric disorders with a high disease burden, a high number of years of life lived with disability and a high risk for relapses and re-hospitalizations. Besides, both diseases are often accompanied with a reduced quality of life. A low level of quality of life is one predictor for relapses. This study examines whether a telemedical care program can improve quality of life. Methods Post stationary t elem e di c a l c a re of patients with severe psychiatric disorders” (Tecla) is a prospective controlled randomized intervention trial to implement and evaluate a telemedical care concept for patients with schizophrenia and bipolar disorder. Participants were randomized to an intervention or a control group. The intervention group received telemedical care including regular, individualized telephone calls and SMS-messages. The quality of life was measured with the German version of the WHOQOL-BREF. Effects of telemedicine on quality of life after 6 months were analyzed using t-tests to compare the intervention with the control group. Participants also evaluated the telemedical care program based on a short standardized interview. Results 118 participants were recruited, thereof 57.6% men (n = 68). Participants were on average 43 years old (SD) 13). The IG showed higher QoL scores as the control group (CG) 6 months after baseline for the WHOQOL total sum score (t-test (CI) 93.1 (92.4-93.8) vs 89.7 (88.8-90.6), p < 0.0001) and for 4 of 5 domains: Global 62.0 (60.9-63.0) vs. 56.8 (55.6-58.1), p < 0.0001; Physical health 63.8 (63.0-64.7) vs. 59.6 (58.5-60.6), p < 0.0001; Psychological 60.9 (60.0-61.9) vs. 56.4 (55.1-57.6), p < 0.0001; Environment 70.8 (70.1-71.6) vs. 67.5 (66.7-68.3), p < 0.0001. Conclusion The Tecla telemedical care concept has improved the quality of life in patients with severe psychiatric disorders. It provides for a low-threshold and well suitable component in psychiatric treatment.
Neuronal Lipoprotein Lipase Deficiency alters Neuronal Function and Hepatic Metabolism
Authors: Bruce Kimberley , Wang Hong , Dobrinskikh Evgenia , Rudenko Ivan A , Gao Hong , Libby Andrew E , Gorkhali Sachi , Yu Tian , Zsombok Andrea , Eckel Robert H 
Published: February 2020

Abstract
Background: The autonomic regulation of hepatic metabolism offers a novel target for the treatment of non-alcoholic fatty liver disease (NAFLD). However, the molecular characteristics of neurons that regulate the brain-liver axis remain unclear. Since mice lacking neuronal lipoprotein lipase (LPL) develop perturbations in neuronal lipid-sensing and systemic energy balance, we reasoned that LPL may be a component of pre-autonomic neurons involved in the regulation of hepatic metabolism. Methods: Measures of glucose homeostasis in mice homozygous (NEXLPL-/-) and heterozygous (NEXLPL+/-) for neuronal LPL deficiency were compared to that of WT mice. A detailed analysis of hepatic glucose and lipid metabolism was also determined in NEXLPL+/- at 6-18 mo. To determine the effect of neuronal LPL deficiency on neuronal physiology, liver-related neurons were identified in the paraventricular nucleus (PVN) of the hypothalamus using the transsynaptic retrograde tracer PRV-152. In addition, we used Fluorescence Lifetime Imaging Microscopy (FLIM) as a novel method to visualize changes in neuronal metabolism following LPL-depletion directly in the PVN. Results: Here we show that despite obesity, mice with reduced neuronal LPL also show improved glucose tolerance and reduced hepatic lipid accumulation with aging, concomitant with reduced hepatic lipogenic gene expression (e.g. SCD1 and FADS2). Retroviral tracing and patch clamp studies revealed reduced inhibitory post-synaptic currents in liver-related neurons lacking LPL. Quantification of the free versus bound Nicotinamide Adenine Dinucleotide (NADH) and Flavin Adenine Dinucleotide (FAD), revealed that LPL loss resulted in altered substrate utilization characterized by increased glucose utilization and TCA cycle flux. These findings were recapitulated by analysis of global metabolites from hypothalamic cell lines either deficient in, or over-expressing, LPL. Conclusions: Our data suggest that LPL is a novel feature of liver–related preautonomic neurons in the PVN. Moreover, LPL loss is sufficient to alter neuronal metabolism and function, leading to changes in systemic glucose metabolism including improved hepatic function with age.
Night sleep duration and risk of each lipid profile abnormality in a Chinese population: a prospective cohort study
Authors: Song Qiaofeng , Liu Xiaoxue , Zhou Wenhua , Wu Shouling , wang xizhu 
Published: February 2020

Abstract
Background To explore the associations between sleep duration and abnormalities in each serum lipid level in a Chinese population. Methods A prospective study was conducted with 33,817 participants from the general Chinese population. Sleep duration was categorized as ≤5, 6, 7, 8 or ≥9 h. Each lipid profile abnormality was defined according to the Chinese Guidelines for the Prevention and Treatment of Dyslipidemia in Adults. The Cox proportional hazards model was used to assess these associations. Results Compared with a seven-hour sleep duration, longer sleep duration was significantly associated with high low-density lipoprotein cholesterol (LDL-C) (HR: 1.18; 95% CI: 1.10–1.17) in fully adjusted models. And a longer sleep duration was significantly associated with low high-density lipoprotein cholesterol (HDL-C) levels (HR: 1.22; 95% CI: 1.19–1.35). In subgroup analyses, the positive association between long sleep duration and high LDL-C and low HDL-C levels in men and in the different age groups were more pronounced than the association in women. No significant interactions were observed in the association between sleep duration and each abnormal serum lipid level by sex/age in the study population(p- interaction>0.05). Conclusions These findings suggest that longer sleep duration is associated with high LDL-C and low HDL-C levels among the Chinese population.
Genetic evidence for imported malaria and local transmission in Richard Toll, Senegal
Authors: Daniels Rachel F. , Schaffner Stephen F. , Dieye Yakou , Dieng Gnagna , Hainsworth Michael , Fall Fatou B. , Diouf Coumba Ndoffene , Ndiop Medoune , Cissé Moustapha , Gueye Alioune Badara , Sarr Oumar , Guinot Philippe , Deme Awa B. , Bei Amy K. , Sy Mouhamad , Thwing Julie , MacInnis Bronwyn , Earle Duncan , Guinovart Caterina , Sene Doudou , Hartl Daniel L. , Ndiaye Daouda , Steketee Richard W. , Wirth Dyann F. , Volkman Sarah K. 
Published: February 2020

Abstract
Background: Malaria elimination efforts can be undermined by imported malaria infections. Imported infections are classified based on travel history.Methods: We applied a genetic strategy to better understand the contribution of imported infections and to test for local transmission in the very low prevalence region of Richard Toll, Senegal.Results: Genetic relatedness analysis, based upon molecular barcode genotyping data derived from diagnostic material, provided evidence for both imported infections and ongoing local transmission in Richard Toll. Evidence for imported malaria included finding that a large proportion of Richard Toll parasites were genetically related to parasites from Thiès, Senegal, a region of moderate transmission with extensive available genotyping data. Evidence for ongoing local transmission included finding parasites of identical genotype that persisted across multiple transmission seasons as well as enrichment of highly related infections within the households of non-travelers compared to travelers.Conclusions: These data indicate that, while a large number of infections may have been imported, there remains ongoing local malaria transmission in Richard Toll. These proof-of-concept findings underscore the value of genetic data to identify parasite relatedness and patterns of transmission to inform optimal intervention selection and placement. This work was supported by the Bill & Melinda Gates Foundation, Grant Number OPP1156051
Epac ameliorates tubulointerstitial inflammation in diabetic nephropathy via C/EBPβ/SOCS3/STAT3 pathway
Authors: Yang Wenxia , Zhang Shumin , Wang Huafen , Liu Yifei , Liu Jialu , Sun Lin , Xiao Li 
Published: February 2020

Abstract
Background: Tubulointerstitial inflammation plays a pivotal role in the progression of diabetic nephrology (DN), and tubular cells act as the driving force in the inflammation cascade. The aim of the study is to investigate whether activation of Epac alleviates tubulointerstitial inflammation through SOCS3/JAK/STAT3 pathway under DN. Methods: The kidney morphological changes and the level of oxidative stress were observed in db/db mice treated with Epac agonist (8-pCPT-2’-O-Me-cAMP). The expression of inflammatory cytokines, fibrosis markers, C/EBPβ, SOCS3 and p-STAT3 in renal tissues were assessed. In in vitro study, the changes of above genes and proteins were also detected in human proximal tubular cell line (HK-2) incubated with high glucose (HG) with and without Epac agonist. Overexpression of SOCS3 plasmid, SOCS3 siRNA and C/EBP-β siRNA were employed and the translocation of C/EBP-β and p-STAT3 were observed by immunofluorescence. Macrophage migration assay were detected in Transwell system. Results: In db/db mice, we observed that the expression of MCP-1 was up-regulated in renal tubular cells, which concurrent with increased influx of macrophages, cytokines production (MCP-1, TNF-α, and IL-6), and tubulointerstitial fibrosis. Moreover, we also found that these changes were accompanied by reduced C/EBP-β expression and increased SOCS3 and phosphorylated STAT3 (p-STAT3) expression. However, after treated db/db mice with 8-O-cAMP, an Epac activator, the expression of SOCS3 further up-regulated while other protein expression profile was partially reversed. In vitro , high glucose (30mM, HG) treatment down-regulated C/EBP-β expression while increased SOCS3, p-STAT3 and MCP-1 expression in HK-2 cells; Activation of Epac by 8-O-cAMP further increased the gene and protein expression of SOCS3 while reversed the changes of the other proteins. Mechanistically, under HG ambience, knockdown of C/EBP-β or SOCS3 in HK-2 cells partially blocked the inhibitory effect of Epac activation on MCP-1 expression. Furthermore, 8-O-cAMP treatment enhanced the nuclear-translocation of C/EBP-β and further increased the transcription of SOCS3 gene, which decreased MCP-1 expression through inhibiting the phosphorylation of STAT3 in HK-2 cells. Conclusions: These data indicate that Epac ameliorates tubulointerstitial inflammation in DN at least partially through C/EBPβ/SOCS3/STAT3 pathway. Therefore, Activation of Epac by 8-O-cAMP may be a novel therapeutic strategy for DN.
Key stakeholder experiences of an integrated healthcare pilot in Australia: A thematic analysis
Authors: TRANKLE STEVEN , USHERWOOD TIM , ABBOTT PENELOPE , ROBERTS MARY , CRAMPTON MICHAEL , GIRGIS CHRISTIAN M , RISKALLAH JOHN , CHANG YASHU , SAINI JASPREET , REATH JENNIFER 
Published: February 2020

Abstract
Background In Australia and other developed countries, the prevalence of chronic illness is increasing, as are costs of healthcare, particularly hospital-based care. Integrating healthcare and supporting illness management in the community are seen as a means of preventing illness, improving outcomes and reducing unnecessary hospitalisation. Western Sydney has high rates of diabetes, heart and respiratory diseases and the NSW State Ministry of Health funded a range of key strategies through the Western Sydney Integrated Care Program (WSICP) to integrate care across hospital and community settings for patients with these illnesses. Methods We aimed to explore how different stakeholders experienced the WSICP and investigate their broader perspectives on the care delivered. We administered 125 in-depth interviews in two rounds over 12 months with 83 participants including patients and their carers, care facilitators, hospital specialists and nurses, allied health professionals, general practitioners and primary care nurses, and program managers. Half of the participants (n=42) were interviewed twice. We conducted a thematic analysis on the interview transcripts. Results The key themes related to the set-up and operationalising of WSICP; challenges encountered; and the added value of the program. Implementing the WSICP was a large and time consuming undertaking but challenges including those with staffing and information technology were being addressed. The WSICP was considered to have value in reducing hospital admissions due to improved patient self-management and a focus on prevention, greater communication and collaboration between healthcare providers across health sectors and an increased capacity to manage chronic illness in the primary care setting. Conclusions Patients, carers and health providers experienced the WSICP as an innovative integrated care model and valued its patient centred approach. Long term sustainability of the WSICP will depend on more effectively sharing information including across health sectors to support enhanced collaboration, continuing its suite of strategies and expanding them into other illness areas and locations, and ongoing capacity building of primary health care. Funding reform of the current fee-for-service payment system was recommended to facilitate high quality management of chronic illness in the community.
Mapping the lipid metabolites in follicular fluid from patients with infertility issues across ages
Authors: Zhang Xingxing , Wang Tianqi , Song Jingyan , Deng Jifeng , Sun Zhengao 
Published: February 2020

Abstract
Background: Follicular fluid is an important external environment for the growth and development of oocytes. A thorough identification of specific components in follicular fluid can better the existing understand of intracellular signal transduction and reveal potential biomarkers of oocyte health in women undergoing assisted reproductive therapy. To study the biomarkers that affect the development of oocytes, we have adopted a new method of SWATH to MRM( the sequential window acquisition of all theoretical fragment-ion spectra to multiple reaction monitor)metabolomics to provide extensive coverage and excellent quantitative data. This was done to investigate the differences in follicular fluid of patients undergoing in vitro fertilization (IVF) and embryo transfer in different age groups and to further explore the relationship between follicular fluid, age and reproductive function.Method: A combination of Ultra-high-performance liquid chromatography and high resolution mass spectrometry techniques were used to analyze the follicular fluid of 230 patients enrolled for the IVF cycle. The patients were of different ages grouped into two groups:the younger and older patients.The obtained multidimensional chromatographic data were processed by principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA). The charge ratios and mass numbers enabled for the identification of different fragments in the samples. Matching information obtained through database search and the fragment information obtained by fragment ion scan structurally identified substances in the samples. This was used to determine the differential compounds.Results: The quality and quantity of oocytes decline with age. This in caused by changes in follicular fluid metabolites. The main differences were in lipid metabolites. Some were up-regulated : Arachidonate, LysoPC(16:1), LysoPC(20:4) and LysoPC(20:3) while others were down-regulated: LysoPC(18:3) and LysoPC(18:1).Conclusions: Metabolomic analysis of follicular fluid revealed that with the increase in age, several differential metabolites are at play. Among these metabolites, lipid metabolism undergoes significant changes that affect the development of oocytes thus causing reduced fertility in older women. These differential metabolites related to follicular development may provide possible detection and treatment targets for promoting oocyte health, and provide scientific basis for understanding the environment of oocyte development.
Risk Factor Analysis for Anastomotic Leakage after Lower Rectal Cancer Resection: A Retrospective Single-Center Study
Authors: Kinugasa Tetsushi , Nagasu Sachiko , Murotani Kenta , Mizobe Tomoaki , Ochi Takafumi , Isobe Taro , Fujita Fumihiko , Akagi Yoshito 
Published: February 2020

Abstract
Background We investigated the correlation between surgery-related factors and the incidence of leakage after low anterior resection (LAR) for lower rectal cancer. Methods A total of 630 patients underwent colorectal surgery between 2011 and 2014 in our department. Of these, 97 patients (15%) underwent LAR, and are the subjects of this retrospective study. Temporary ileostomy was performed for each patient.Results Anastomotic leakage occurred in 21 patients (21.7%). Univariate analysis showed that operative duration (p=0.0051), transanal hand-sewn anastomosis (p=0.0141), and operation procedure (p=0.0191) were significantly associated with the incidence of leakage. Multivariate analysis showed that underlying disease (p=0.044), transanal hand-sewn anastomosis (p=0.0188), and drain type (p=0.0251) were significantly associated with the incidence of leakage. The propensity score analysis results showed that closed drainage was associated with 6.3 times more postoperative blood loss (mls) in patients experiencing anastomotic leakage compared with open drainage, in the inverse probability of treatment-weighted analysis.Conclusions Our results showed that underlying disease, transanal hand-sewn anastomosis, and the drain type may be risk factors for developing anastomotic leakage after LAR for lower rectal cancer. The notable finding was that the type of drainage was related to the incidence and volume of anastomotic leakage: open drainage was correlated with the incidence of leakage, and closed drainage was correlated with the volume of anastomotic leakage.