Summary Fragmentation in social health insurance schemes is an important factor for inequitable access to health care and financial protection for people covered by different health insurance schemes ...in China. To fulfil its commitment of universal health coverage by 2020, the Chinese Government needs to prioritise addressing this issue. After analysing the situation of fragmentation, this Review summarises efforts to consolidate health insurance schemes both in China and internationally. Rural migrants, elderly people, and those with non-communicable diseases in China will greatly benefit from consolidation of the existing health insurance schemes with extended funding pools, thereby narrowing the disparities among health insurance schemes in fund level and benefit package. Political commitments, institutional innovations, and a feasible implementation plan are the major elements needed for success in consolidation. Achievement of universal health coverage in China needs systemic strategies including consolidation of the social health insurance schemes.
AbstractObjectiveTo evaluate the association between intakes of refined grains, whole grains, and white rice with cardiovascular disease, total mortality, blood lipids, and blood pressure in the ...Prospective Urban and Rural Epidemiology (PURE) study.DesignProspective cohort study.SettingPURE study in 21 countries.Participants148 858 participants with median follow-up of 9.5 years.ExposuresCountry specific validated food frequency questionnaires were used to assess intakes of refined grains, whole grains, and white rice.Main outcome measureComposite of mortality or major cardiovascular events (defined as death from cardiovascular causes, non-fatal myocardial infarction, stroke, or heart failure). Hazard ratios were estimated for associations of grain intakes with mortality, major cardiovascular events, and their composite by using multivariable Cox frailty models with random intercepts to account for clustering by centre.ResultsAnalyses were based on 137 130 participants after exclusion of those with baseline cardiovascular disease. During follow-up, 9.2% (n=12 668) of these participants had a composite outcome event. The highest category of intake of refined grains (≥350 g/day or about 7 servings/day) was associated with higher risk of total mortality (hazard ratio 1.27, 95% confidence interval 1.11 to 1.46; P for trend=0.004), major cardiovascular disease events (1.33, 1.16 to 1.52; P for trend<0.001), and their composite (1.28, 1.15 to 1.42; P for trend<0.001) compared with the lowest category of intake (<50 g/day). Higher intakes of refined grains were associated with higher systolic blood pressure. No significant associations were found between intakes of whole grains or white rice and health outcomes.ConclusionHigh intake of refined grains was associated with higher risk of mortality and major cardiovascular disease events. Globally, lower consumption of refined grains should be considered.
An m-dimensional vectorial inverse nodal Sturm-Liouville problem with eigenparameter-dependent boundary conditions is studied. We show that if there exists an infinite sequence ynj,rx,λnj,r2j=1∞ of ...eigenfunctions which are all vectorial functions of type (CZ), then the potential matrix Qx and A are simultaneously diagonalizable by the same unitary matrix U. Subsequently, some multiplicity results of eigenvalues are obtained.
This work reports on the toxicity of CuO nanoparticles (NPs) to maize (Zea mays L.) and their transport and redistribution in the plant. CuO NPs (100 mg L–1) had no effect on germination, but ...inhibited the growth of maize seedlings; in comparison the dissolved Cu2+ ions and CuO bulk particles had no obvious effect on maize growth. CuO NPs were present in xylem sap as examined by transmission electron microscopy (TEM) and energy dispersive spectroscopy (EDS), showing that CuO NPs were transported from roots to shoots via xylem. Split-root experiments and high-resolution TEM observation further showed that CuO NPs could translocate from shoots back to roots via phloem. During this translocation, CuO NPs could be reduced from Cu (II) to Cu (I). To our knowledge, this is the first report of root–shoot–root redistribution of CuO NPs within maize. The current study provides direct evidence for the bioaccumulation and biotransformation of CuO NPs (20–40 nm) in maize, which has significant implications on the potential risk of NPs and food safety.
Crown roots are the main components of the fibrous root system in rice (Oryza sativa). WOX11, a WUSCHEL-related homeobox gene specifically expressed in the emerging crown root meristem, is a key ...regulator in crown root development. However, the nature of WOX11 function in crown root development has remained elusive. Here, we identified a rice AP2/ERF protein, ERF3, which interacts with WOX11 and was expressed in crown root initials and during crown root growth. Functional analysis revealed that ERF3 was essential for crown root development and acts in auxin- and cytokinin-responsive gene expression. Downregulation of ERF3 in wox11 mutants produced a more severe root phenotype. Also, increased expression of ERF3 could partially complement wox11, indicating that the two genes functioned cooperatively to regulate crown root development. ERF3 and WOX11 shared a common target, the cytokinin-responsive gene RR2. The expression of ERF3 and WOX11 only partially overlapped, underlining a spatio-temporal control of RR2 expression and crown root development. Furthermore, ERF3-regulated RR2 expression was involved in crown root initiation, while the ERF3/WOX11 interaction likely repressed RR2 during crown root elongation. These results define a mechanism regulating gene expression involved in cytokinin signaling during different stages of crown root development in rice.
To ensure food safety and avoid infections by Escherichia coli O157:H7 (E. coli O157:H7), we developed a novel fluorescent microsphere (FM)-based immunochromatography assay (FM-ICA). FMs were ...conjugated to anti-E. coli O157:H7 monoclonal antibody (MAb) as an ICA probe, Immunomagnetic beads (IM-beads) were prepared by conjugating functionalized magnetic microspheres with the antibody for enrichment and separation of pathogenic bacteria from complex food matrices. Under selected conditions, a standard curve of FM-ICA measurement of E. coli O157:H7 was developed with a linear range from 3 × 105 to 6 × 107 colony-forming units (CFU)/mL in PBS buffer. The recoveries of intra- and inter assay ranged from 101.64% to 107.03% and 95.62%–110.2% respectively, with CV below 10%. The FM-ICA showed good sensitivity, accuracy and precision. When IM-beads separation plus FM-ICA (IMS-FICA) were used to assay raw food samples, sensitivity was 3 × 103 CFU/mL, a 33-fold improvement compared with FM-ICA only. Moreover, this method had high specificity for E. coli O157:H7 and can be used to assay E. coli O157:H7 in beef, milk and water samples. This assay can be completed within 2 h and has great potential for on-site quantitation of E. coli O157:H7 with simplicity, rapidity, sensitivity, and cost-effectiveness.
•Immunomagnetic beads were prepared for separating and concentrating bacteria.•Fluorescence microspheres as label for immunochromatography assay.•IMS-FICA detection has the sensitivity of 3 × 103 CFU/mL and can be completed within 2 h.
The occurrence of depression is higher in patients with chronic liver disease (CLD) than that in the general population. The mechanism described in previous studies mainly focused on inflammation and ...stress, which not only exists in CLD, but also emerges in common chronic diseases, leaving the specific mechanism unknown. This review was to summarize the prevalence and risk factors of depression in CLD including chronic hepatitis B, chronic hepatitis, alcoholic liver disease, and non-alcoholic fatty liver disease, and to point out the possible underlying mechanism of this potential link. Clarifying the origins of this common comorbidity (depression and CLD) may provide more information to understand both diseases.
•Luteolin alleviated quality deterioration and reduced disease incidence rate of sweet cherry.•Luteolin activated phenylpropanoid metabolic pathway and ameliorated antioxidant capacity.•Luteolin ...suppressed mycelial growth and pathogenicity of Botrytis cinerea and Penicillium expansum.•Luteolin decreased patulin production of P. expansum.
Redox imbalance and fungal infection are major causes for quality deterioration and postharvest decay of fruit. Therefore, it is crucial to activate intrinsic antioxidative capacity and disease responses for fruit quality maintenance. Although plant-derived flavonoids have been reported for health-promoting benefits, their roles in the maintenance of fruit quality remains largely unexplored. Here, we exogenously applied luteolin, a flavonoid substance, and further examined its efficacy in maintaining fruit quality and inhibiting fungal diseases in sweet cherry. The results showed that 100 or 200 mg/L luteolin maintained better organoleptic quality and decreased disease incidence during storage. Biochemical assays revealed that luteolin activated the phenylpropanoid metabolic pathway and improved antioxidative capacity, thereby elevating total anthocyanin and flavonoid contents. Notably, luteolin inhibited mycelial growth of fungal pathogens and reduced patulin yield by Penicillium expansum. Collectively, these results suggest that luteolin is a promising alternative for maintaining better fruit quality and ameliorating disease resistance.
Summary Background China is one of the few Countdown countries to have achieved Millennium Development Goal 5 (75% reduction in maternal mortality ratio between 1990 and 2015). We aimed to examine ...the health systems and contextual factors that might have contributed to the substantial decline in maternal mortality between 1997 and 2014. We chose to focus on western China because poverty, ethnic diversity, and geographical access represent particular challenges to ensuring universal access to maternal care in the region. Methods In this systematic assessment, we used data from national census reports, National Statistical Yearbooks, the National Maternal and Child Health Routine Reporting System, the China National Health Accounts report, and National Health Statistical Yearbooks to describe changes in policies, health financing, health workforce, health infrastructure, coverage of maternal care, and maternal mortality by region between 1997 and 2014. We used a multivariate linear regression model to examine which contextual and health systems factors contributed to the regional variation in maternal mortality ratio in the same period. Using data from a cross-sectional survey in 2011, we also examined equity in access to maternity care in 42 poor counties in western China. Findings Maternal mortality declined by 8·9% per year between 1997 and 2014 (geometric mean ratio for each year 0·91, 95% CI 0·91–0·92). After adjusting for GDP per capita, length of highways, female illiteracy, the number of licensed doctors per 1000 population, and the proportion of ethnic minorities, the maternal mortality ratio was 118% higher in the western region (2·18, 1·44–3·28) and 41% higher in the central region (1·41, 0·99–2·01) than in the eastern region. In the rural western region, the proportion of births in health facilities rose from 41·9% in 1997 to 98·4% in 2014. Underpinning such progress was the Government's strong commitment to long-term strategies to ensure access to delivery care in health facilities—eg, professionalisation of maternity care in large hospitals, effective referral systems for women medically or socially at high risk, and financial subsidies for antenatal and delivery care. However, in the poor western counties, substantial disparity by education level of the mother existed in access to health facility births (44% of illiterate women vs 100% of those with college or higher education), antenatal care (17% vs 69%) had at least four visits), and caesarean section (8% vs 44%). Interpretation Despite remarkable progress in maternal survival in China, substantial disparities remain, especially for the poor, less educated, and ethnic minority groups in remote areas in western China. Whether China's highly medicalised model of maternity care will be an answer for these populations is uncertain. A strategy modelled after China's immunisation programme, whereby care is provided close to the women's homes, might need to be explored, with township hospitals taking a more prominent role. Funding Government of Canada, UNICEF, and the Bill & Melinda Gates Foundation.
Bacterial type III protein secretion systems deliver effector proteins into eukaryotic cells in order to modulate cellular processes. Central to the function of these protein-delivery machines is ...their ability to recognize and secrete substrates in a defined order. Here, we describe a mechanism by which a type III secretion system from the bacterial enteropathogen Salmonella enterica serovar Typhimurium can sort its substrates before secretion. This mechanism involves a cytoplasmic sorting platform that is sequentially loaded with the appropriate secreted proteins. The sequential loading of this platform, facilitated by customized chaperones, ensures the hierarchy in type III protein secretion. Given the presence of these machines in many important pathogens, these findings can serve as the bases for the development of novel antimicrobial strategies.
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