BACKGROUND Icariin(ICA)is a natural compound derived from Epimedium that has shown promise in treating colorectal cancer(CRC)by reducing inflammation,inducing apoptosis,and limiting tumor progression.AIM To elucidate ...BACKGROUND Icariin(ICA)is a natural compound derived from Epimedium that has shown promise in treating colorectal cancer(CRC)by reducing inflammation,inducing apoptosis,and limiting tumor progression.AIM To elucidate the specific mechanisms underlying its therapeutic effects on this malignancy.METHODS We examined the impact of different ICA concentrations on the biological behavior of CRC cells in vitro.We also assessed the protein expression of SMAD4,CX-C motif chemokine ligand 1(CXCL1),and CXCL8,as well as epithelial-mesenchymal transition(EMT)-related signaling molecules,and the mRNA expression of proinflammatory factors.To further explore ICA’s mechanisms in CRC treatment,we introduced small interfering SMAD4 and its negative control group.In CRC cells,we evaluated proliferation,apoptosis,invasion,migration,EMT,and the recruitment of tumor-associated neutrophils(TANs).Moreover,we investigated the role of the CXCL8-C-X-C motif chemokine receptor 2(CXCR2)axis in the recruitment of ICA-affected TANs.In vivo,we preliminarily assessed the therapeutic efficacy of ICA against CRC.In ICA-treated mice,we measured tumor size,histological morphology,apoptosis,and neutrophil infiltration.Additionally,we analyzed the expression of SMAD4,CXCL1,CXCL8,CXCR2,EMT,and proteins related to migration.RESULTS Our findings indicate that ICA attenuated CRC cell proliferation,invasion,and migration,while suppressing TAN recruitment and promoting apoptosis in a concentration-dependent manner.When small interfering SMAD4 was introduced,the anticancer effects of ICA were diminished.Furthermore,disruption of the CXCL8-CXCR2 axis reduced neutrophil recruitment.We found that ICA inhibited tumor growth,improved tumor histology and morphology,alleviated CD66b+neutrophil infiltration,and inhibited EMT in mice with subcutaneous CRC tumors.In addition,ICA appeared to enhance SMAD4 protein expression while suppressing CXCL8 and CXCR2 expression in both in vivo and in vitro experiments.CONCLUSION ICA impedes the recruitment of TANs primarily through SMAD4-mediated modulation of the CXCL8-CXCR2 axis,thereby suppressing EMT and other pro-metastatic programs in CRC.展开更多
Objective:Multiple programmed cell death(PCD)pathways have been individually reported to be triggered by cisplatin,but whether and how they are co-regulated remains unclear.In this study,we comprehensively investigate...Objective:Multiple programmed cell death(PCD)pathways have been individually reported to be triggered by cisplatin,but whether and how they are co-regulated remains unclear.In this study,we comprehensively investigate the spectrum of cisplatin-induced PCD.Methods:We employed integrated in vitro and in vivo models including human cancer cell lines,a Cal27 xenograft mouse model,and paired clinical specimens from an oral squamous cell carcinoma patient receiving neoadjuvant cisplatin-based chemotherapy.A comprehensive methodological suite-encompassing cell death assays,Western blotting,Hematoxylin and eosin staining,immunofluorescence,Cyclic multiplexed tissue staining,and pathway-specific pharmacological inhibitors was utilized to dissect the activation of apoptosis,necroptosis,pyroptosis,and ferroptosis.Results:Cisplatin simultaneously upregulates markers of PCD pathways(including apoptosis,necroptosis,pyroptosis,and ferroptosis)in a dose-or time-dependent manner.Pharmacological inhibition or genetic knockdown of key genes in each pathway significantly reduced cytotoxicity.confirming their functional roles.Notably,indicators of key pro-inflammatory death modalities,pyroptosis and ferroptosis,were prominently co-upregulated in both xenograft tumors and clinical patient samples,suggesting that these two forms of PCD may represent the predominant death forms in cisplatin-induced tumor cell death.Conclusion:Cisplatin induces the coordinated activation of multiple cell death programs within a unified framework.Prominent engagement of immunogenic cell death pathways,particularly pyroptosis and ferroptosis,provides a mechanistic basis for the clinically observed synergy between cisplatin and immune checkpoint blockade therapy.展开更多
Gastric cancer(GC)remains one of the most common cancers and leading causes of cancer deaths globally1with 60.0%of cases and 56.6%of deaths occurring in East Asia.South Korea and Japan have conducted nationwide GC scr...Gastric cancer(GC)remains one of the most common cancers and leading causes of cancer deaths globally1with 60.0%of cases and 56.6%of deaths occurring in East Asia.South Korea and Japan have conducted nationwide GC screening programs for decades but with essential differences in strategies,organization,and coverage2.展开更多
Instrumental and expert assessments were used to assess the effect of massage on facial skin blood perfusion,as well as the effects of the long-term use of the two skin health programs on the water content of the stra...Instrumental and expert assessments were used to assess the effect of massage on facial skin blood perfusion,as well as the effects of the long-term use of the two skin health programs on the water content of the stratum corneum,F4,L*,dermal and epidermal thickness and density,facial wrinkles,and so on.Sixty healthy Chinese women were selected as the study subjects,which were subsequently divided into G1 non-massage group and G2 massage group.The results show that massage can increase the blood perfusion of facial skin.Group G2 solution is found to be more effective in improving the skin structural barrier(epidermal density),skin elasticity,firmness(dermal thickness)and forehead wrinkles.展开更多
Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replacement(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasin...Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replacement(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasingly older,have comorbidities,and frailty.TAVR cardiac rehabilitation(CR)programs significantly improve both functional capacity and quality of life of patients.However,there are no guidelines on how to carry out them and few elderly patients are referred to CR.Furthermore,mortality in women who undergo TAVR is higher than in men and even fewer are referred to CR programs.Multidisciplinary patient care,including comorbidities and frailty,is essential.It is necessary to ensure exquisite continuity of care during TAVR,CR,and the rest of the patient's life.Telerehabilitation could be an option in some lower-risk patients to include more patients in CR programs after TAVR,given the high demand.This article reviews the evidence on why CR should be performed in post-TAVR patients and proposes a practical and novel approach to the care process and the recommended aspects and components of the CR program.展开更多
Background Liver cancer is among the top five causes of cancer death in 90 countries,with China accounting for a substantial proportion of the global burden.This study aimed to analyse the national liver cancer polici...Background Liver cancer is among the top five causes of cancer death in 90 countries,with China accounting for a substantial proportion of the global burden.This study aimed to analyse the national liver cancer policies and programs in China.Methods This study applied a documentary research method using the systematic READ approach.Six national official websites and one public policy database were searched.The document analysis was based on the WHO Health System's Six Building Blocks and the WHO's four modules of cancer control(prevention,early detection,diagnosis and treatment,and palliative care).Results A total of 74 liver cancer-related policies and 8 programs published from 1 January 1984 to 31 March 2025 were included in this study.The analysis revealed that liver cancer management in China mainly focused on Medical products and Technologies(n=46,62.16%),and Service Delivery(n=34,45.95%)within the WHO health system building blocks.When it came to WHO cancer control four modules,most policies(n=39,52.70%)targeted Diagnosis and Treatment of liver cancer,followed by Prevention of liver cancer(n=33,44.59%).Additionally,8 national programs were implemented to improve the prevention,diagnosis,and treatment of liver cancer.Before 2019,the emphasis of liver cancer prevention was primarily on hepatitis prevention and control.However,since 2020,the national-level programs aimed at preventing and controlling liver cancer emphasizing patient education and treatment for high-risk groups.Conclusions China's liver cancer control mainly focused heavily on prevention,diagnosis and treatment modules with special focus on medical products and technology,as well as service delivery.Currently,less attention has been given to the detection and palliative care of survivors.The control of liver cancer in China still requires further strengthening of the health system for implementation.Considering the continual increase in the burden of liver cancer,it is imperative for future efforts to develop a comprehensive national liver cancer strategy.展开更多
Curriculum is to provide learning paths to become the citizen of their communities,countries,and of the world.Indian Knowledge System established to promote interdisciplinary research for its traditional knowledge of ...Curriculum is to provide learning paths to become the citizen of their communities,countries,and of the world.Indian Knowledge System established to promote interdisciplinary research for its traditional knowledge of various domains for societal applications and to make India Self Reliant.As per National Education Policy 2020 recommendations UGC developed a new CCFUP.The CCFUP main objectives are to give equal emphasis on all disciplines for integration of general and vocational education.It aims at community learning and all-round development to meet cutting-edge entrepreneurship development and startups ecosystem to bring ethical,emotional balanced sustainable society and peaceful quality life.This paper intended to reveal the importance of Curriculum Design for Entrepreneurship development in the light of Sustainable Development Goals(SDGs).Objectives of CCFUP are capacity to extrapolate applications in unfamiliar contexts to generate solutions to specific problems in real life citations rather than replicate curriculum content knowledge.Outcome based education aims to achieve expected results.Universities and schools should become a facilitator for creating entrepreneurs through support of banking and marketing systems.Under Graduate Education Curriculum with Accessible,Accountable,Affordable,Quality,Equity education envisages to produce scientific,creative,and service-oriented intellectuals.Current challenges for human beings are global warming,climate change,antisocial trafficking,drugs,terrorism,poverty,intolerance,etc.Having to deal with such complex issues proper Education Policy is required for scientific insight and knowledge intensive enterprise.Research findings applicable for decisions to decision makers and lab to land and relevance of evidence analysis enable them to apply for evaluation of policies and claims.展开更多
Background Supplementation of choline chloride in culture medium programs the preimplantation bovine embryo to increase weaning weight of the resultant calf.Here,it was hypothesized that similar programming actions of...Background Supplementation of choline chloride in culture medium programs the preimplantation bovine embryo to increase weaning weight of the resultant calf.Here,it was hypothesized that similar programming actions of choline can be induced by feeding rumen-protected choline(RPC)to beef cows during the periconceptional period.Results A preliminary experiment was conducted to determine changes in circulating concentrations of choline and its metabolites after RPC supplementation.Suckled beef cows were individually fed 0,30,60,and 90 g of RPC(i.e.,0,8.6,17.3 and 25.9 g choline chloride)and blood samples were collected at random times after feeding.There were no differences in plasma concentrations of choline or its metabolites between groups.In the second experiment,effects of feeding 60 g/d RPC from d-1 to 7 relative to timed artificial insemination were examined for suckled beef cows.Feeding RPC did not affect pregnancy or calving rates,pregnancy losses,plasma concentrations of pregnancy-associated glycoproteins,gestation length or calf birth weight.Calves from RPC fed dams were lighter than control calves at~118 days of age(range 75–150;age included in the statistical model)and at weaning at~248 days of age.There was no effect of treatment on hip height at~118 days of age although there was a trend for RPC calves to be shorter at weaning.Weight/height ratio was lower for RPC than control at both 118 and 248 days of age.Treatment did not affect testis weight at~118 days of age.Conclusions Supplementation of RPC during the periconceptional period programmed development to alter calf phenotype in the postnatal period.The net result,reduced body weight,was the opposite of the phenotype caused by the addition of choline to embryo culture medium.展开更多
Objectives:The objective of this study was to examine communication effectiveness(CE)in conjunction with participant satisfaction in a multicultural fitness program.Methods:Adults from a fitness program site with part...Objectives:The objective of this study was to examine communication effectiveness(CE)in conjunction with participant satisfaction in a multicultural fitness program.Methods:Adults from a fitness program site with participant diversity and multicultural backgrounds were selected and asked to complete a three-part Fitness CE Evaluation Scale questionnaire:CE Questionnaire and Customer Satisfaction(CS)Scale plus a short demographic survey.A sample of 95 participants was recruited from a Midwest Functional 45 Fitness Training Program site in the U.S.A.Multivariate Analysis of Variance(MANOVA)tests were conducted for CE and CS variable vectors.Results:The results showed that there were significant main effects on CE and CS for nationality(p=0.001;p<0.001)and language(p=0.006;p<0.001),but no effect for participation frequency,respectively;there were also significant main effects on CS for gender(p=0.006)and membership type(p=0.019).Univariate tests revealed that domestics and/or first language participants scored significantly higher on reactionto strangers(p=0.001;p=0.001),uncertainty(p<0.001;p<0.001),facilities/services(p<0.001;p<0.001),individual/psychological factor(p=0.009;p=0.034),relaxation(p=0.018;p=0.021),social factor(p<0.001;p=0.002),and health/fitness(p<0.001;p=0.001),respectively.Conclusions:Being highly aware of fitness participants’uncertainty and reaction to strangers can help multicultural fitness program managers or trainers improve their communication effectiveness,which will continue improving their customers’satisfaction.展开更多
Background: Among numerous health benefits, sports participation has been shown to reduce the risk of overweight and obesity in children and adolescents. Schools represent an ideal environment for increasing sports p...Background: Among numerous health benefits, sports participation has been shown to reduce the risk of overweight and obesity in children and adolescents. Schools represent an ideal environment for increasing sports participation, but it is unclear how access and choice influence participation and whether characteristics of the school sports program differentially influence boys' and girls' participation. The purpose of this study was to evaluate the characteristics of high school athletic programs and determine the extent to which these characteristics influenced boys' and girls' sports team participation. Methods: Longitudinal telephone surveys were conducted with 1244 New Hampshire and Vermont students. Students self-reported their sports team participation at baseline (elementary school) and follow-up (high school). High school personnel were surveyed to assess sports oppor- tunities, which were defined for this analysis as the number of sports offered per 100 students (i.e., choice) and the percent of sports offered that did not restrict the number of players (i.e., access). Results: Approximately 70% of children participated on at least one sports team, including 73% of boys and 66% of girls. We detected sta- tistically significant interactions between sex and two school opportunity variables: 1) the number of sports offered per 100 students (i.e., choice) and 2) the percent of sports offered that did not restrict the number of players (i.e., access). After controlling for children's baseline sports participation and other covariates, boys were more likely to play on at least one sports team per year if their school did not restrict participation in the most popular sports (relative risk, RR = 1.12, p 〈 0.01); in contrast, girls were more likely to play on at least one sports team per year if their school offered a wider variety of sports (RR = 1.47, p 〈 0.001). Conclusion: Sports participation has previously been shown to confer a number of health benefits; as such, school sports programs may be an important, effective, and underused target for public health efforts, including obesity prevention programs. Efforts to increase physical activity among youth should consider both access and choice in school athletic programs. Schools may need to use different strategies to increase sports participation in boys and girls.展开更多
Selection and use of molecular markers for evaluation of DNA polymorphism in plants are couple of the most important approaches in the field of molecular genetics.The assessment of genetic diversity using morphologica...Selection and use of molecular markers for evaluation of DNA polymorphism in plants are couple of the most important approaches in the field of molecular genetics.The assessment of genetic diversity using morphological markers is not sufficient due to little differentiating traits among the species,genera or their individuals.Morphological markers are not only highly influenced by environmental factors but skilled assessment is also prerequisite to find the variations in plant genetic resources.Therefore,molecular markers are considered as efficient tools for detailed DNA based characterization of fruit crops.Molecular markers provide new directions to the efforts of plant breeders particularly in genetic variability,gene tags,gene localization,taxonomy,genetic diversity,phylogenetic analysis and also play an important role to decrease the time required for development of new and excellent cultivars.The success of molecular markers technology in genetic improvement programs depends on the close relationship among the plant breeders,biotechnologists,skilled manpower and good financial support.The present review describes application and success of molecular markers technology used for genetic improvement in different fruit crops.展开更多
Since deep-sea gas hydrate-bearing sediments were drilled for the first time in the Blake Ridge in 1970,gas hydrates have been discovered at 53 drill sites in the continental margins of global oceans with internationa...Since deep-sea gas hydrate-bearing sediments were drilled for the first time in the Blake Ridge in 1970,gas hydrates have been discovered at 53 drill sites in the continental margins of global oceans with international scientific ocean drilling(DSDP/ODP/IODP Programs).As a result,massive amounts of geophysical well-logging data have been accumulated,which provide critical information for understanding the in-situ properties of gas hydrates and their host sediments.Gas hydrates have such physical and chemical properties as non-conductivity,low density,high acoustic velocity,and high hydrogen content,which form the basis of identifying gas hydrate reservoirs and predicting their distribution by well-logging data.A series of well-logging evaluation methods have been proposed to estimate gas hydrate saturation of sediments,including Archie equation,combined methods of density and nuclear magnetic resonance well logging,various forms of three-phase acoustic wave equations,and elastic wave velocity simulations based on different rock physical models.The distribution of gas hydrates is highly heterogeneous,which is mainly manifested in the selectivity of hydrate occurrence to the lithology of host sediments and to the nucleation sites within a host sediment of the same lithology.The scientific-ocean-drilling well logging data have also been preliminarily used for evaluating the heterogeneity of gas hydrate distribution and inferring the growth habit of gas hydrates in host sediments.Nevertheless,there still exist some problems.The formation models used in logging evaluation are in general oversimplified,in which only two or three stratal components are involved.The application of high-resolution logging while-drilling(LWD)data remains limited.Log interpretation is not closely integrated with core geology.Therefore,joint inversion of lithologic components,porosity and gas hydrate saturation based on more complex formation models,together with the applications of high-resolution LWD logging data and core calibration,may represent an important direction in future welllogging evaluation of gas hydrate reservoirs.展开更多
BACKGROUND Sleep problems are particularly prevalent in people with depression or anxiety disorder.Although mindfulness has been suggested as an important component in alleviating insomnia,no comprehensive review and ...BACKGROUND Sleep problems are particularly prevalent in people with depression or anxiety disorder.Although mindfulness has been suggested as an important component in alleviating insomnia,no comprehensive review and meta-analysis has been conducted to evaluate the effects of different mindfulness-based intervention(MBI)programs on sleep among people with depression or anxiety disorder.AIM To compare the effects of different MBI programs on sleep among people with depression or anxiety disorder.METHODS Related publications in Embase,Medline,PubMed and PsycINFO databases were systematically searched from January 2010 to June 2020 for randomised controlled trials.Data were synthesized using a random-effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder.The fixed-effects model was used when heterogeneity was negligible,and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences(SMDs)and 95%confidence intervals(CIs).RESULTS We identified 397 articles,of which 10 randomised controlled trials,involving a total of 541 participants,were included in the meta-analysis.Studies of internet mindfulness meditation intervention(IMMI),mindfulness meditation(MM),mindfulness-based cognitive therapy(MBCT),mindfulness-based stress reduction(MBSR)and mindfulness-based touch therapy(MBTT)met the inclusion criteria.The greatest effect sizes are reported in favour of MBTT,with SMDs of-1.138(95%CI:-1.937 to-0.340;P=0.005),followed by-1.003(95%CI:-1.645 to-0.360;P=0.002)for MBCT.SMDs of-0.618(95%CI:-0.980 to-0.257;P=0.001)and-0.551(95%CI:-0.842 to-0.260;P<0.0001)were reported for IMMI and MBSR in the pooling trials,respectively.Significant effects on sleep problem improvement are shown in all reviewed MBI programs,except MM,for which the effect size was shown to be nonsignificant.CONCLUSION All MBI programs(MBTT,MBCT,IMMI and MBSR),except MM,are effective options to improve sleep problems among people with depression or anxiety disorder.展开更多
In order to improve environment and relieve poverty, China has launched a series of major ecological engineering programs since the 1980 s. These include the Natural Forest Conservation Program, the Sloping Cropland C...In order to improve environment and relieve poverty, China has launched a series of major ecological engineering programs since the 1980 s. These include the Natural Forest Conservation Program, the Sloping Cropland Conversion Program, the Desertification Combating Program, and the Protection Forest System Construction Program. There is a growing need to quantify the contributions of these programs to regional carbon stocks.However, the lack of widely accepted, robust methods is one of the key obstacles to quantification. The objective of this study was to review existing methods for quantifying regional carbon stocks and then recommend suitable ones for the Chinese ecological engineering programs. We expect that the recommended methods can be applied to elsewhere in the world where there are similar characteristics and objectives.展开更多
Fuzzing is an effective technique to find security bugs in programs by quickly exploring the input space of programs.To further discover vulnerabilities hidden in deep execution paths,the hybrid fuzzing combines fuzzi...Fuzzing is an effective technique to find security bugs in programs by quickly exploring the input space of programs.To further discover vulnerabilities hidden in deep execution paths,the hybrid fuzzing combines fuzzing and concolic execution for going through complex branch conditions.In general,we observe that the execution path which comes across more and complex basic blocks may have a higher chance of containing a security bug.Based on this observation,we propose a hybrid fuzzing method assisted by static analysis for binary programs.The basic idea of our method is to prioritize seed inputs according to the complexity of their associated execution paths.For this purpose,we utilize static analysis to evaluate the complexity of each basic block and employ the hardware trace mechanism to dynamically extract the execution path for calculating the seed inputs’weights.The key advantage of our method is that our system can test binary programs efficiently by using the hardware trace and hybrid fuzzing.To evaluate the effectiveness of our method,we design and implement a prototype system,namely SHFuzz.The evaluation results show SHFuzz discovers more unique crashes on several real-world applications and the LAVA-M dataset when compared to the previous solutions.展开更多
This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a nat...This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a national level population health screening program for diabetes related eye diseases,targeting the rapidly increasing number of adults in the country with diabetes.In the second example,the AI assisted screening is done shortly after a person is admitted to one of the public hospitals to identify which inpatients—especially which elderly patients with complex conditions—have a high risk of being readmitted as an inpatient multiple times in the months following discharge.Ways in which healthcare needs and the clinical operations context influenced the approach to designing or deploying the AI systems are highlighted,illustrating the multiplicity of factors that shape the requirements for successful large‐scale deployments of AI systems that are deeply embedded within clinical workflows.In the first example,the choice was made to use the system in a semi‐automated(vs.fully automated)mode as this was assessed to be more cost‐effective,though still offering substantial productivity improvement.In the second example,machine learning algorithm design and model execution trade-offs were made that prioritized key aspects of patient engagement and inclusion over higher levels of predictive accuracy.The article concludes with several lessons learned related to deploying AI systems within healthcare settings,and also lists several other AI efforts already in deployment and in the pipeline for Singapore's public healthcare system.展开更多
Background:Although there is broad consensus around the need to accelerate progress towards universal health coverage(UHC)in Sub-Saharan Africa,the financing strategies for achieving it are still unclear.We sought to ...Background:Although there is broad consensus around the need to accelerate progress towards universal health coverage(UHC)in Sub-Saharan Africa,the financing strategies for achieving it are still unclear.We sought to leverage the lessons learned in financing HIV programs over the past two decades to inform efforts to advance the universal health coverage agenda in the East African Community.Methods:We conducted a literature review of studies reporting financing mechanisms for HIV programs between 2004 and 2014.This review is further underpinned by evidence from a mixed-methods study entailing a survey of 195 health facilities across Uganda supplemented with 18 semi-structured interviews with HIV service managers.Results:Our data shows that there are six broad HIV financing strategies with potential for application to the universal health coverage agenda in the East African Community(EAC);i)Bi-lateral and multi-lateral funding vehicles:The establishment of HIV-specific global financing vehicles such as PEPFAR and The Global Fund heralded an era of unprecedented levels of international funding of up to$500 billion over the past two decades ii)Eliciting private sector contribution to HIV funding:The private sector’s financial contribution to HIV services was leveraged through innovative engagement and collaborative interventions iii)Private sector-led alternative HIV financing mechanisms:The introduction of‘VIP’HIV clinics,special‘HIV insurance’schemes and the rise of private philanthropic aid were important alternatives to the traditional sources of funding iv)Commodity social marketing:Commodity social marketing campaigns led to an increase in condom use among low-income earners v)The use of vouchers:Issuing of HIV-test vouchers to the poor was an important demand-side financing approach vi)Earmark HIV taxes:Several countries in Africa have introduced‘special HIV’taxes to boost domestic HIV funding.Conclusions:The lessons learned from financing HIV programs suggest that a hybrid of funding strategies are advisable in the quest to achieve UHC in EAC partner states.The contribution of the private sector is indispensable and can be enhanced through targeted interventions towards UHC goals.展开更多
AIM:To identify a possible role of home echocardiography for monitoring chronic heart failure(CHF)patients.METHODS:We prospectively investigated 118 patients hospitalized during the last year for CHF who could not eas...AIM:To identify a possible role of home echocardiography for monitoring chronic heart failure(CHF)patients.METHODS:We prospectively investigated 118 patients hospitalized during the last year for CHF who could not easily reach the pertaining District Healthcare Center.The patients were followed up with 2 home management programs:one including clinical and electrocardiographic evaluations and also periodic home echocardiographic examinations(group A),the other including clinical and electrocardiographic evaluations only(group B).RESULTS:At the end of the 18-mo follow-up no significant differences were observed between the 2 groups as regards the primary endpoint:rehospitalization occurred in 4 patients of the group A and in 6 patients of the group B;major cardiovascular events occurred in 2 and in 3 patients,respectively.No significant differences were observed with respect to the secondary endpoints:one vascular event appeared in both the groups,3 cardiovascular deaths occurred in group A and 2 in group B.No significant differences were observed between the 2 groups as regards the composite endpoint of death plus hospitalization.CONCLUSION:Home echocardiography for monitoring of CHF patients does not improve the cardiovascular endpoints.In our CHF patients,a low incidence of vascular events was observed.展开更多
A nested Stackelberg game among a provider of a product,a sender(existing customer),and a receiver(new customer)is developed to explore the optimal referral reward programs(RRPs)for innovative offerings.The results in...A nested Stackelberg game among a provider of a product,a sender(existing customer),and a receiver(new customer)is developed to explore the optimal referral reward programs(RRPs)for innovative offerings.The results indicate that the provider should forsake RRPs and purely rely on customers'organic word-of-mouth communication under certain conditions.In particular,when the innovativeness of the referred product is extremely high,the provider should forsake RRPs completely,even though few customers will make organic referrals for the product.When the innovativeness is on other levels,the provider should make optimal RRPs decision depending on both the sender's persuasion effectiveness and the tie-strength between the two customers.Moreover,the optimal rewards increase with the innovativeness of the referred product when the provider opts to use RRPs.These results seem contrary to the existing empirical finding to some extent,and it is due to the high referral cost for making a successful referral for the high innovative offerings.展开更多
摘要BACKGROUND Icariin(ICA)is a natural compound derived from Epimedium that has shown promise in treating colorectal cancer(CRC)by reducing inflammation,inducing apoptosis,and limiting tumor progression.AIM To elucidate the specific mechanisms underlying its therapeutic effects on this malignancy.METHODS We examined the impact of different ICA concentrations on the biological behavior of CRC cells in vitro.We also assessed the protein expression of SMAD4,CX-C motif chemokine ligand 1(CXCL1),and CXCL8,as well as epithelial-mesenchymal transition(EMT)-related signaling molecules,and the mRNA expression of proinflammatory factors.To further explore ICA’s mechanisms in CRC treatment,we introduced small interfering SMAD4 and its negative control group.In CRC cells,we evaluated proliferation,apoptosis,invasion,migration,EMT,and the recruitment of tumor-associated neutrophils(TANs).Moreover,we investigated the role of the CXCL8-C-X-C motif chemokine receptor 2(CXCR2)axis in the recruitment of ICA-affected TANs.In vivo,we preliminarily assessed the therapeutic efficacy of ICA against CRC.In ICA-treated mice,we measured tumor size,histological morphology,apoptosis,and neutrophil infiltration.Additionally,we analyzed the expression of SMAD4,CXCL1,CXCL8,CXCR2,EMT,and proteins related to migration.RESULTS Our findings indicate that ICA attenuated CRC cell proliferation,invasion,and migration,while suppressing TAN recruitment and promoting apoptosis in a concentration-dependent manner.When small interfering SMAD4 was introduced,the anticancer effects of ICA were diminished.Furthermore,disruption of the CXCL8-CXCR2 axis reduced neutrophil recruitment.We found that ICA inhibited tumor growth,improved tumor histology and morphology,alleviated CD66b+neutrophil infiltration,and inhibited EMT in mice with subcutaneous CRC tumors.In addition,ICA appeared to enhance SMAD4 protein expression while suppressing CXCL8 and CXCR2 expression in both in vivo and in vitro experiments.CONCLUSION ICA impedes the recruitment of TANs primarily through SMAD4-mediated modulation of the CXCL8-CXCR2 axis,thereby suppressing EMT and other pro-metastatic programs in CRC.
基金supported by the grants of the National Natural Science Foundations of China(NSFCGrant Nos.82170971,82373187,82273165)+2 种基金the Sichuan Science and Technology Program(Grant Nos.2025NSFJQ0062 and 2024YFFK0293)the Scientific Research Foundation of the West China Hospital of Stomatology,Sichuan University(RD-03-202110)the Special Funding for the State Key Laboratory of Oral Diseases,Sichuan University(SKLOD-2025KP009).
摘要Objective:Multiple programmed cell death(PCD)pathways have been individually reported to be triggered by cisplatin,but whether and how they are co-regulated remains unclear.In this study,we comprehensively investigate the spectrum of cisplatin-induced PCD.Methods:We employed integrated in vitro and in vivo models including human cancer cell lines,a Cal27 xenograft mouse model,and paired clinical specimens from an oral squamous cell carcinoma patient receiving neoadjuvant cisplatin-based chemotherapy.A comprehensive methodological suite-encompassing cell death assays,Western blotting,Hematoxylin and eosin staining,immunofluorescence,Cyclic multiplexed tissue staining,and pathway-specific pharmacological inhibitors was utilized to dissect the activation of apoptosis,necroptosis,pyroptosis,and ferroptosis.Results:Cisplatin simultaneously upregulates markers of PCD pathways(including apoptosis,necroptosis,pyroptosis,and ferroptosis)in a dose-or time-dependent manner.Pharmacological inhibition or genetic knockdown of key genes in each pathway significantly reduced cytotoxicity.confirming their functional roles.Notably,indicators of key pro-inflammatory death modalities,pyroptosis and ferroptosis,were prominently co-upregulated in both xenograft tumors and clinical patient samples,suggesting that these two forms of PCD may represent the predominant death forms in cisplatin-induced tumor cell death.Conclusion:Cisplatin induces the coordinated activation of multiple cell death programs within a unified framework.Prominent engagement of immunogenic cell death pathways,particularly pyroptosis and ferroptosis,provides a mechanistic basis for the clinically observed synergy between cisplatin and immune checkpoint blockade therapy.
基金supported by grants from the Shanghai Key Disciplines of Public Health(2023-2025)for New Threeyear Action Plan(Grant Nos.GWVI-11.1-22 and GWVI-11.1-23)the Fudan School of Public Health-Jiading CDC key disciplines for the high-quality development of public health(Grant No.GWGZLXK-2023-02)the Fudan Undergraduate Research Opportunities Program(Grant No.FDUROP-24647)。
摘要Gastric cancer(GC)remains one of the most common cancers and leading causes of cancer deaths globally1with 60.0%of cases and 56.6%of deaths occurring in East Asia.South Korea and Japan have conducted nationwide GC screening programs for decades but with essential differences in strategies,organization,and coverage2.
摘要Instrumental and expert assessments were used to assess the effect of massage on facial skin blood perfusion,as well as the effects of the long-term use of the two skin health programs on the water content of the stratum corneum,F4,L*,dermal and epidermal thickness and density,facial wrinkles,and so on.Sixty healthy Chinese women were selected as the study subjects,which were subsequently divided into G1 non-massage group and G2 massage group.The results show that massage can increase the blood perfusion of facial skin.Group G2 solution is found to be more effective in improving the skin structural barrier(epidermal density),skin elasticity,firmness(dermal thickness)and forehead wrinkles.
摘要Severe aortic stenosis has increased exponentially as a result of the aging of the population.Transcatheter aortic valve replacement(TAVR)procedures increase by 20%-30%per year in Spain.Referred patients are increasingly older,have comorbidities,and frailty.TAVR cardiac rehabilitation(CR)programs significantly improve both functional capacity and quality of life of patients.However,there are no guidelines on how to carry out them and few elderly patients are referred to CR.Furthermore,mortality in women who undergo TAVR is higher than in men and even fewer are referred to CR programs.Multidisciplinary patient care,including comorbidities and frailty,is essential.It is necessary to ensure exquisite continuity of care during TAVR,CR,and the rest of the patient's life.Telerehabilitation could be an option in some lower-risk patients to include more patients in CR programs after TAVR,given the high demand.This article reviews the evidence on why CR should be performed in post-TAVR patients and proposes a practical and novel approach to the care process and the recommended aspects and components of the CR program.
基金supported by the funding of the University of Macao(MYRGGRG2023-00059-ICMS)the Science and Technology Development Fund,Macao SAR(File No.0014/2023/AKP).
摘要Background Liver cancer is among the top five causes of cancer death in 90 countries,with China accounting for a substantial proportion of the global burden.This study aimed to analyse the national liver cancer policies and programs in China.Methods This study applied a documentary research method using the systematic READ approach.Six national official websites and one public policy database were searched.The document analysis was based on the WHO Health System's Six Building Blocks and the WHO's four modules of cancer control(prevention,early detection,diagnosis and treatment,and palliative care).Results A total of 74 liver cancer-related policies and 8 programs published from 1 January 1984 to 31 March 2025 were included in this study.The analysis revealed that liver cancer management in China mainly focused on Medical products and Technologies(n=46,62.16%),and Service Delivery(n=34,45.95%)within the WHO health system building blocks.When it came to WHO cancer control four modules,most policies(n=39,52.70%)targeted Diagnosis and Treatment of liver cancer,followed by Prevention of liver cancer(n=33,44.59%).Additionally,8 national programs were implemented to improve the prevention,diagnosis,and treatment of liver cancer.Before 2019,the emphasis of liver cancer prevention was primarily on hepatitis prevention and control.However,since 2020,the national-level programs aimed at preventing and controlling liver cancer emphasizing patient education and treatment for high-risk groups.Conclusions China's liver cancer control mainly focused heavily on prevention,diagnosis and treatment modules with special focus on medical products and technology,as well as service delivery.Currently,less attention has been given to the detection and palliative care of survivors.The control of liver cancer in China still requires further strengthening of the health system for implementation.Considering the continual increase in the burden of liver cancer,it is imperative for future efforts to develop a comprehensive national liver cancer strategy.
摘要Curriculum is to provide learning paths to become the citizen of their communities,countries,and of the world.Indian Knowledge System established to promote interdisciplinary research for its traditional knowledge of various domains for societal applications and to make India Self Reliant.As per National Education Policy 2020 recommendations UGC developed a new CCFUP.The CCFUP main objectives are to give equal emphasis on all disciplines for integration of general and vocational education.It aims at community learning and all-round development to meet cutting-edge entrepreneurship development and startups ecosystem to bring ethical,emotional balanced sustainable society and peaceful quality life.This paper intended to reveal the importance of Curriculum Design for Entrepreneurship development in the light of Sustainable Development Goals(SDGs).Objectives of CCFUP are capacity to extrapolate applications in unfamiliar contexts to generate solutions to specific problems in real life citations rather than replicate curriculum content knowledge.Outcome based education aims to achieve expected results.Universities and schools should become a facilitator for creating entrepreneurs through support of banking and marketing systems.Under Graduate Education Curriculum with Accessible,Accountable,Affordable,Quality,Equity education envisages to produce scientific,creative,and service-oriented intellectuals.Current challenges for human beings are global warming,climate change,antisocial trafficking,drugs,terrorism,poverty,intolerance,etc.Having to deal with such complex issues proper Education Policy is required for scientific insight and knowledge intensive enterprise.Research findings applicable for decisions to decision makers and lab to land and relevance of evidence analysis enable them to apply for evaluation of policies and claims.
基金supported by the L.E.“Red”Larson Endowment and grants number 2020-67015-30821 and 2023-67015-40730 from the Agriculture and Food Research Initiative of USDA-NIFAsupported by the Higher Education Commission of Pakistan。
摘要Background Supplementation of choline chloride in culture medium programs the preimplantation bovine embryo to increase weaning weight of the resultant calf.Here,it was hypothesized that similar programming actions of choline can be induced by feeding rumen-protected choline(RPC)to beef cows during the periconceptional period.Results A preliminary experiment was conducted to determine changes in circulating concentrations of choline and its metabolites after RPC supplementation.Suckled beef cows were individually fed 0,30,60,and 90 g of RPC(i.e.,0,8.6,17.3 and 25.9 g choline chloride)and blood samples were collected at random times after feeding.There were no differences in plasma concentrations of choline or its metabolites between groups.In the second experiment,effects of feeding 60 g/d RPC from d-1 to 7 relative to timed artificial insemination were examined for suckled beef cows.Feeding RPC did not affect pregnancy or calving rates,pregnancy losses,plasma concentrations of pregnancy-associated glycoproteins,gestation length or calf birth weight.Calves from RPC fed dams were lighter than control calves at~118 days of age(range 75–150;age included in the statistical model)and at weaning at~248 days of age.There was no effect of treatment on hip height at~118 days of age although there was a trend for RPC calves to be shorter at weaning.Weight/height ratio was lower for RPC than control at both 118 and 248 days of age.Treatment did not affect testis weight at~118 days of age.Conclusions Supplementation of RPC during the periconceptional period programmed development to alter calf phenotype in the postnatal period.The net result,reduced body weight,was the opposite of the phenotype caused by the addition of choline to embryo culture medium.
基金funded by Department of Education of Guangdong Province(NO.2022GXJK239,2024SQXX_025)Guangzhou Sport University(NO.XGQN202410).
摘要Objectives:The objective of this study was to examine communication effectiveness(CE)in conjunction with participant satisfaction in a multicultural fitness program.Methods:Adults from a fitness program site with participant diversity and multicultural backgrounds were selected and asked to complete a three-part Fitness CE Evaluation Scale questionnaire:CE Questionnaire and Customer Satisfaction(CS)Scale plus a short demographic survey.A sample of 95 participants was recruited from a Midwest Functional 45 Fitness Training Program site in the U.S.A.Multivariate Analysis of Variance(MANOVA)tests were conducted for CE and CS variable vectors.Results:The results showed that there were significant main effects on CE and CS for nationality(p=0.001;p<0.001)and language(p=0.006;p<0.001),but no effect for participation frequency,respectively;there were also significant main effects on CS for gender(p=0.006)and membership type(p=0.019).Univariate tests revealed that domestics and/or first language participants scored significantly higher on reactionto strangers(p=0.001;p=0.001),uncertainty(p<0.001;p<0.001),facilities/services(p<0.001;p<0.001),individual/psychological factor(p=0.009;p=0.034),relaxation(p=0.018;p=0.021),social factor(p<0.001;p=0.002),and health/fitness(p<0.001;p=0.001),respectively.Conclusions:Being highly aware of fitness participants’uncertainty and reaction to strangers can help multicultural fitness program managers or trainers improve their communication effectiveness,which will continue improving their customers’satisfaction.
基金funded by the U.S.National Institute of Environmental Health Sciences(ES014218)the U.S.National Cancer Institute(CA94273)
摘要Background: Among numerous health benefits, sports participation has been shown to reduce the risk of overweight and obesity in children and adolescents. Schools represent an ideal environment for increasing sports participation, but it is unclear how access and choice influence participation and whether characteristics of the school sports program differentially influence boys' and girls' participation. The purpose of this study was to evaluate the characteristics of high school athletic programs and determine the extent to which these characteristics influenced boys' and girls' sports team participation. Methods: Longitudinal telephone surveys were conducted with 1244 New Hampshire and Vermont students. Students self-reported their sports team participation at baseline (elementary school) and follow-up (high school). High school personnel were surveyed to assess sports oppor- tunities, which were defined for this analysis as the number of sports offered per 100 students (i.e., choice) and the percent of sports offered that did not restrict the number of players (i.e., access). Results: Approximately 70% of children participated on at least one sports team, including 73% of boys and 66% of girls. We detected sta- tistically significant interactions between sex and two school opportunity variables: 1) the number of sports offered per 100 students (i.e., choice) and 2) the percent of sports offered that did not restrict the number of players (i.e., access). After controlling for children's baseline sports participation and other covariates, boys were more likely to play on at least one sports team per year if their school did not restrict participation in the most popular sports (relative risk, RR = 1.12, p 〈 0.01); in contrast, girls were more likely to play on at least one sports team per year if their school offered a wider variety of sports (RR = 1.47, p 〈 0.001). Conclusion: Sports participation has previously been shown to confer a number of health benefits; as such, school sports programs may be an important, effective, and underused target for public health efforts, including obesity prevention programs. Efforts to increase physical activity among youth should consider both access and choice in school athletic programs. Schools may need to use different strategies to increase sports participation in boys and girls.
摘要Selection and use of molecular markers for evaluation of DNA polymorphism in plants are couple of the most important approaches in the field of molecular genetics.The assessment of genetic diversity using morphological markers is not sufficient due to little differentiating traits among the species,genera or their individuals.Morphological markers are not only highly influenced by environmental factors but skilled assessment is also prerequisite to find the variations in plant genetic resources.Therefore,molecular markers are considered as efficient tools for detailed DNA based characterization of fruit crops.Molecular markers provide new directions to the efforts of plant breeders particularly in genetic variability,gene tags,gene localization,taxonomy,genetic diversity,phylogenetic analysis and also play an important role to decrease the time required for development of new and excellent cultivars.The success of molecular markers technology in genetic improvement programs depends on the close relationship among the plant breeders,biotechnologists,skilled manpower and good financial support.The present review describes application and success of molecular markers technology used for genetic improvement in different fruit crops.
基金Projects funded by the National Natural Science Foundation of China“Turbidites in the Abyssal Plain of the South China Sea and Their Tectonic Implications”(No.41676029)“Gravity Flow Deposits in the Ocean-Continent Transition Zone of the Northern South China Sea”(No.41876049).
摘要Since deep-sea gas hydrate-bearing sediments were drilled for the first time in the Blake Ridge in 1970,gas hydrates have been discovered at 53 drill sites in the continental margins of global oceans with international scientific ocean drilling(DSDP/ODP/IODP Programs).As a result,massive amounts of geophysical well-logging data have been accumulated,which provide critical information for understanding the in-situ properties of gas hydrates and their host sediments.Gas hydrates have such physical and chemical properties as non-conductivity,low density,high acoustic velocity,and high hydrogen content,which form the basis of identifying gas hydrate reservoirs and predicting their distribution by well-logging data.A series of well-logging evaluation methods have been proposed to estimate gas hydrate saturation of sediments,including Archie equation,combined methods of density and nuclear magnetic resonance well logging,various forms of three-phase acoustic wave equations,and elastic wave velocity simulations based on different rock physical models.The distribution of gas hydrates is highly heterogeneous,which is mainly manifested in the selectivity of hydrate occurrence to the lithology of host sediments and to the nucleation sites within a host sediment of the same lithology.The scientific-ocean-drilling well logging data have also been preliminarily used for evaluating the heterogeneity of gas hydrate distribution and inferring the growth habit of gas hydrates in host sediments.Nevertheless,there still exist some problems.The formation models used in logging evaluation are in general oversimplified,in which only two or three stratal components are involved.The application of high-resolution logging while-drilling(LWD)data remains limited.Log interpretation is not closely integrated with core geology.Therefore,joint inversion of lithologic components,porosity and gas hydrate saturation based on more complex formation models,together with the applications of high-resolution LWD logging data and core calibration,may represent an important direction in future welllogging evaluation of gas hydrate reservoirs.
摘要BACKGROUND Sleep problems are particularly prevalent in people with depression or anxiety disorder.Although mindfulness has been suggested as an important component in alleviating insomnia,no comprehensive review and meta-analysis has been conducted to evaluate the effects of different mindfulness-based intervention(MBI)programs on sleep among people with depression or anxiety disorder.AIM To compare the effects of different MBI programs on sleep among people with depression or anxiety disorder.METHODS Related publications in Embase,Medline,PubMed and PsycINFO databases were systematically searched from January 2010 to June 2020 for randomised controlled trials.Data were synthesized using a random-effects or a fixed-effects model to analyse the effects of various MBI programs on sleep problems among people with depression or anxiety disorder.The fixed-effects model was used when heterogeneity was negligible,and the random-effects model was used when heterogeneity was significant to calculate the standardised mean differences(SMDs)and 95%confidence intervals(CIs).RESULTS We identified 397 articles,of which 10 randomised controlled trials,involving a total of 541 participants,were included in the meta-analysis.Studies of internet mindfulness meditation intervention(IMMI),mindfulness meditation(MM),mindfulness-based cognitive therapy(MBCT),mindfulness-based stress reduction(MBSR)and mindfulness-based touch therapy(MBTT)met the inclusion criteria.The greatest effect sizes are reported in favour of MBTT,with SMDs of-1.138(95%CI:-1.937 to-0.340;P=0.005),followed by-1.003(95%CI:-1.645 to-0.360;P=0.002)for MBCT.SMDs of-0.618(95%CI:-0.980 to-0.257;P=0.001)and-0.551(95%CI:-0.842 to-0.260;P<0.0001)were reported for IMMI and MBSR in the pooling trials,respectively.Significant effects on sleep problem improvement are shown in all reviewed MBI programs,except MM,for which the effect size was shown to be nonsignificant.CONCLUSION All MBI programs(MBTT,MBCT,IMMI and MBSR),except MM,are effective options to improve sleep problems among people with depression or anxiety disorder.
基金supported by grants from Strategic Priority Research Program of Chinese Academy of Sciences(No.XDA05060101)Graduate Innovation Project Funding of Jiangxi Province(No.YC2013-S117)+1 种基金Jiangxi Provincial Science and Technology International Cooperation Project(No.09003614)GanPo 555 Talent Project Funding of Jiangxi Province
摘要In order to improve environment and relieve poverty, China has launched a series of major ecological engineering programs since the 1980 s. These include the Natural Forest Conservation Program, the Sloping Cropland Conversion Program, the Desertification Combating Program, and the Protection Forest System Construction Program. There is a growing need to quantify the contributions of these programs to regional carbon stocks.However, the lack of widely accepted, robust methods is one of the key obstacles to quantification. The objective of this study was to review existing methods for quantifying regional carbon stocks and then recommend suitable ones for the Chinese ecological engineering programs. We expect that the recommended methods can be applied to elsewhere in the world where there are similar characteristics and objectives.
基金the National Key Research and Development Program of China under Grant No.2016QY07X1404National Natural Science Foundation of China(NSFC)under Grant No.61602035 and 61772078+1 种基金Beijing Science and Technology Project under Grant No.Z191100007119010,CCF-NSFOCUS Kun-Peng Scientific Research FoundationOpen Found of Key Laboratory of Network Assessment Technology,Institute of Information Engineering,Chinese Academy of Sciences.
摘要Fuzzing is an effective technique to find security bugs in programs by quickly exploring the input space of programs.To further discover vulnerabilities hidden in deep execution paths,the hybrid fuzzing combines fuzzing and concolic execution for going through complex branch conditions.In general,we observe that the execution path which comes across more and complex basic blocks may have a higher chance of containing a security bug.Based on this observation,we propose a hybrid fuzzing method assisted by static analysis for binary programs.The basic idea of our method is to prioritize seed inputs according to the complexity of their associated execution paths.For this purpose,we utilize static analysis to evaluate the complexity of each basic block and employ the hardware trace mechanism to dynamically extract the execution path for calculating the seed inputs’weights.The key advantage of our method is that our system can test binary programs efficiently by using the hardware trace and hybrid fuzzing.To evaluate the effectiveness of our method,we design and implement a prototype system,namely SHFuzz.The evaluation results show SHFuzz discovers more unique crashes on several real-world applications and the LAVA-M dataset when compared to the previous solutions.
摘要This article explains how two AI systems have been incorporated into the everyday operations of two Singapore public healthcare nation‐wide screening programs.The first example is embedded within the setting of a national level population health screening program for diabetes related eye diseases,targeting the rapidly increasing number of adults in the country with diabetes.In the second example,the AI assisted screening is done shortly after a person is admitted to one of the public hospitals to identify which inpatients—especially which elderly patients with complex conditions—have a high risk of being readmitted as an inpatient multiple times in the months following discharge.Ways in which healthcare needs and the clinical operations context influenced the approach to designing or deploying the AI systems are highlighted,illustrating the multiplicity of factors that shape the requirements for successful large‐scale deployments of AI systems that are deeply embedded within clinical workflows.In the first example,the choice was made to use the system in a semi‐automated(vs.fully automated)mode as this was assessed to be more cost‐effective,though still offering substantial productivity improvement.In the second example,machine learning algorithm design and model execution trade-offs were made that prioritized key aspects of patient engagement and inclusion over higher levels of predictive accuracy.The article concludes with several lessons learned related to deploying AI systems within healthcare settings,and also lists several other AI efforts already in deployment and in the pipeline for Singapore's public healthcare system.
摘要Background:Although there is broad consensus around the need to accelerate progress towards universal health coverage(UHC)in Sub-Saharan Africa,the financing strategies for achieving it are still unclear.We sought to leverage the lessons learned in financing HIV programs over the past two decades to inform efforts to advance the universal health coverage agenda in the East African Community.Methods:We conducted a literature review of studies reporting financing mechanisms for HIV programs between 2004 and 2014.This review is further underpinned by evidence from a mixed-methods study entailing a survey of 195 health facilities across Uganda supplemented with 18 semi-structured interviews with HIV service managers.Results:Our data shows that there are six broad HIV financing strategies with potential for application to the universal health coverage agenda in the East African Community(EAC);i)Bi-lateral and multi-lateral funding vehicles:The establishment of HIV-specific global financing vehicles such as PEPFAR and The Global Fund heralded an era of unprecedented levels of international funding of up to$500 billion over the past two decades ii)Eliciting private sector contribution to HIV funding:The private sector’s financial contribution to HIV services was leveraged through innovative engagement and collaborative interventions iii)Private sector-led alternative HIV financing mechanisms:The introduction of‘VIP’HIV clinics,special‘HIV insurance’schemes and the rise of private philanthropic aid were important alternatives to the traditional sources of funding iv)Commodity social marketing:Commodity social marketing campaigns led to an increase in condom use among low-income earners v)The use of vouchers:Issuing of HIV-test vouchers to the poor was an important demand-side financing approach vi)Earmark HIV taxes:Several countries in Africa have introduced‘special HIV’taxes to boost domestic HIV funding.Conclusions:The lessons learned from financing HIV programs suggest that a hybrid of funding strategies are advisable in the quest to achieve UHC in EAC partner states.The contribution of the private sector is indispensable and can be enhanced through targeted interventions towards UHC goals.
摘要AIM:To identify a possible role of home echocardiography for monitoring chronic heart failure(CHF)patients.METHODS:We prospectively investigated 118 patients hospitalized during the last year for CHF who could not easily reach the pertaining District Healthcare Center.The patients were followed up with 2 home management programs:one including clinical and electrocardiographic evaluations and also periodic home echocardiographic examinations(group A),the other including clinical and electrocardiographic evaluations only(group B).RESULTS:At the end of the 18-mo follow-up no significant differences were observed between the 2 groups as regards the primary endpoint:rehospitalization occurred in 4 patients of the group A and in 6 patients of the group B;major cardiovascular events occurred in 2 and in 3 patients,respectively.No significant differences were observed with respect to the secondary endpoints:one vascular event appeared in both the groups,3 cardiovascular deaths occurred in group A and 2 in group B.No significant differences were observed between the 2 groups as regards the composite endpoint of death plus hospitalization.CONCLUSION:Home echocardiography for monitoring of CHF patients does not improve the cardiovascular endpoints.In our CHF patients,a low incidence of vascular events was observed.
基金The National Social Science Foundation of China(No.17BGL196)。
摘要A nested Stackelberg game among a provider of a product,a sender(existing customer),and a receiver(new customer)is developed to explore the optimal referral reward programs(RRPs)for innovative offerings.The results indicate that the provider should forsake RRPs and purely rely on customers'organic word-of-mouth communication under certain conditions.In particular,when the innovativeness of the referred product is extremely high,the provider should forsake RRPs completely,even though few customers will make organic referrals for the product.When the innovativeness is on other levels,the provider should make optimal RRPs decision depending on both the sender's persuasion effectiveness and the tie-strength between the two customers.Moreover,the optimal rewards increase with the innovativeness of the referred product when the provider opts to use RRPs.These results seem contrary to the existing empirical finding to some extent,and it is due to the high referral cost for making a successful referral for the high innovative offerings.