To explore the impact of partial centralization on supply chain performance,this study constructs a two-period game model of a closed-loop supply chain involving a manufacturer and an online retail platform participat...To explore the impact of partial centralization on supply chain performance,this study constructs a two-period game model of a closed-loop supply chain involving a manufacturer and an online retail platform participating in the trade-in strategy.Through mathematical modeling and numerical simulation methods,the optimal decisions were analyzed under conditions where the manufacturer partially owns the retail platform’s partial equity.This study finds that partial centralization yields the highest profits,followed by full centralization,with decentralized decisions yielding the lowest profits.Moderate centralization enhances overall profits by optimizing incentive mechanisms,whereas excessive ownership concentration reduces the flexibility of the retail platform,leading to a decline in profits.Additionally,product durability and trade-in subsidy significantly influence supply chain profitability:high-durability products reduce renewal frequency,while trade-in subsidy effectively stimulates consumer demand and increase overall profits.This study provides theoretical support and practical guidance for companies implementing the trade-in strategy.展开更多
Objective:Limited evidence is available regarding the associations of centralization with gastric cancer patients’quality of care in high surgical volume settings.The current study aimed to explore the effects of hos...Objective:Limited evidence is available regarding the associations of centralization with gastric cancer patients’quality of care in high surgical volume settings.The current study aimed to explore the effects of hospital volume and the Herfindahl-Hirschman index(HHI)on in-hospital mortality,total cost,and length of stay for Chinese gastrectomy patients in a nationwide database.Methods:We extracted data on gastrectomy for gastric cancer from the Hospital Quality Monitoring System Database between 2013 and 2018.Hospital volume was divided into 4 quartiles:low(1-83 cases per year),medium(84-238 cases),high(239-579 cases),and very high(580-1,193 cases).The HHI was divided into 3 categories:highly concentrated(>2,500),moderately concentrated(1,500-2,500),and unconcentrated(<1,500).We used mixed-effects models to analyze the data while accounting for data clustering.Results:We analyzed 125,683 patients in 515 institutions.In the multivariable analyses,hospital volume was significantly associated with in-hospital mortality[medium vs.low:odds ratio(OR)=0.61,95%confidence interval(95%CI)=0.43-0.84,P=0.003;high:OR=0.57,95%CI=0.38-0.87,P=0.009;and very high:OR=0.33,95%CI=0.18-0.61,P<0.001)and length of stay(high vs.low:β=-0.036,95%CI=-0.071--0.002,P=0.039)but not with total cost.Hospitals located in unconcentrated provinces had higher in-hospital mortality(OR=1.52,95%CI=1.03-2.26,P=0.036)and longer lengths of stay(β=0.024,95%CI=0.001-0.047,P=0.041)than hospitals located in highly concentrated provinces.Conclusions:Centralization of gastrectomy,measured by hospital volume and the HHI,was associated with decreased in-hospital mortality and shortened length of stay without increasing total cost.These results support the strategy of centralizing gastrectomy in high-volume settings.展开更多
The As-level topology is a hotspot of the recent reseaches. We can understand the centralization of the network clearly by researching the evolvement trend of the Internet macroscopic topology. The massive data we use...The As-level topology is a hotspot of the recent reseaches. We can understand the centralization of the network clearly by researching the evolvement trend of the Internet macroscopic topology. The massive data we use in this paper is from CAIDA (The Cooperative Association for Internet Data Analysis) Skitter project. And the time span of the data is from July, 2001 to January, 2008. This paper introduces the background of the AS-level topology at first, then carries out the evolvement of degree, core and layer. It is believed that the influence of the top-degree nodes on the other nodes decreases and the centralization of network is going to fall off with the decrease of the core. And the nucleus status of network declines.展开更多
Objective:To uncover the impact of centralization of COVID-19 and perceived control of COVID-19 on society during the pandemic.Methods:We recruited a total of 1041 people in this cross-sectional study.The data were co...Objective:To uncover the impact of centralization of COVID-19 and perceived control of COVID-19 on society during the pandemic.Methods:We recruited a total of 1041 people in this cross-sectional study.The data were collected using a questionnaire booklet covering demographics,a COVID-19-related information form,the Centrality of Event Scale,and the Perception of Control of COVID-19 Scale.We utilized independent samples t-test,chi-square test,and one-way analysis of variance to analyze the data.Results:1041 questionnaires were collected and no questionnaire were excluded from our study.Slightly more than half of the participants(51.2%)stated that social isolation impaired public mental health,while 30.1%reported adverse impacts of the pandemic on their sleep quality.Participants with changes to their sleep patterns were found to centralize COVID-19 more.Moreover,measures against COVID-19 and constant announcements of the daily number of cases in the media brought both positive and negative effects on people and further contributed to the participants’centralization of COVID-19.Individuals with low centralization scores were concluded to perceive COVID-19 as a minor disease.Healthcare professionals without a relative diagnosed with COVID-19 and those satisfied with treatment opportunities had a higher perceived control of COVID-19,while those who were not interested in statistical data on COVID-19 and who had difficulty complying with the rules had a lower perceived control of COVID-19.Besides,poorer perceived control of COVID-19 was found to adversely affect sleep quality.Furthermore,healthcare professionals scored higher on the inevitability subscale of the Perception of Control of COVID-19 Scale.Finally,among the participants,most COVID-19 survivors thought COVID-19 to be an avoidable disease.Conclusion:In addition to its physical impacts,COVID-19 adversely impacts on mental health,and these effects are closely linked to a society’s centralization of COVID-19 and perceived control of COVID-19.展开更多
Established during the long years of revolutionary struggle and the founding of the People＇s Republic of China （PRC）, the Communist Party of China（CPC）-led decision-making system has a historical rationality. Bef...Established during the long years of revolutionary struggle and the founding of the People＇s Republic of China （PRC）, the Communist Party of China（CPC）-led decision-making system has a historical rationality. Before China＇s reform and opening-up was implemented in 1978, the decision-making system highlighted centralization which led to disadvantages such as non-existent specialized division of functions, a low level of institutionalization, heavy reliance on experience, an enclosed decision-making mode and non-existent self-correction mechanisms. These disadvantages were institutional factors which ultimately caused the historic tragedy of ＂ Cultural Revolution. ＂After the reform and opening-up, the decision-making structure, mode and mechanism were reformed in order to promote scientific, democratic and law-based decisions. History has shown that the reform has successfully overcome various challenges brought about by China＇s rapidly changing economy and society. From the perspective of political development, the reform has promoted several transitions： from individual controlled decision-making system to a more democratic decision-making process, from being empirical to scientifically-based, from highly centralized decision-making organizations to decentralized one, from an enclosed mode to an open mode, from passive to active participation in the decision-making process and from a non-institutionalized to an institutionalized system. Therefore, the CPC-led open decision-making model based on science and laws and participated by other parties has taken an initial shape.展开更多
Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-y...Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality.展开更多
The paper extracts the concept of Centralization Group Decision Making(CGDM) and Decentralization Group Decision Making(DGDM) from management systems on bases of studies on Informational Centralization Process(ICP) an...The paper extracts the concept of Centralization Group Decision Making(CGDM) and Decentralization Group Decision Making(DGDM) from management systems on bases of studies on Informational Centralization Process(ICP) and Informational Decentralization Process(IDP), then the similarities and differences between CGDM and DGDM are presented. Further, the taxonomy of CGDM and DGDM is researched.展开更多
Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain met...Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain metabolites but also contribute to antigen delivery and immune cell activation. The advent of novel genomic technologies has enabled rapid progress in the characterization of myeloid and lymphoid cells and their interactions with meningeal lymphatic vessels within the central nervous system. In this review, we provide an overview of the multifaceted roles of meningeal lymphatic vessels within the context of the central nervous system immune network, highlighting recent discoveries on the immunological niche provided by meningeal lymphatic vessels. Furthermore, we delve into the mechanisms of crosstalk between meningeal lymphatic vessels and immune cells in the central nervous system under both homeostatic conditions and neurodegenerative diseases, discussing how these interactions shape the pathological outcomes. Regulation of meningeal lymphatic vessel function and structure can influence lymphatic drainage, cerebrospinal fluid-borne immune modulators, and immune cell populations in aging and neurodegenerative disorders, thereby playing a key role in shaping meningeal and brain parenchyma immunity.展开更多
Copper is a transition metal and an essential element for the organism,as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs,including the central ne...Copper is a transition metal and an essential element for the organism,as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs,including the central nervous system.Central copper dysregulations have been evidenced in two genetic disorders characterized by mutations in the copper-ATPases ATP7A and ATP7B,Menkes disease and Wilson’s disease,respectively,and also in multifactorial neurological disorders such as Alzheimer’s disease,Parkinson’s disease,amyotrophic lateral sclerosis,and multiple sclerosis.This review summarizes current knowledge about the role of copper in central nervous system physiology and pathology,reports about unbalances in copper levels and/or distribution under disease,describes relevant animal models for human disorders where copper metabolism genes are dysregulated,and discusses relevant therapeutic approaches modulating copper availability.Overall,alterations in copper metabolism may contribute to the etiology of central nervous system disorders and represent relevant therapeutic targets to restore tissue homeostasis.展开更多
Peripheral nerve injury is a common neurological condition that often leads to severe functional limitations and disabilities.Research on the pathogenesis of peripheral nerve injury has focused on pathological changes...Peripheral nerve injury is a common neurological condition that often leads to severe functional limitations and disabilities.Research on the pathogenesis of peripheral nerve injury has focused on pathological changes at individual injury sites,neglecting multilevel pathological analysis of the overall nervous system and target organs.This has led to restrictions on current therapeutic approaches.In this paper,we first summarize the potential mechanisms of peripheral nerve injury from a holistic perspective,covering the central nervous system,peripheral nervous system,and target organs.After peripheral nerve injury,the cortical plasticity of the brain is altered due to damage to and regeneration of peripheral nerves;changes such as neuronal apoptosis and axonal demyelination occur in the spinal cord.The nerve will undergo axonal regeneration,activation of Schwann cells,inflammatory response,and vascular system regeneration at the injury site.Corresponding damage to target organs can occur,including skeletal muscle atrophy and sensory receptor disruption.We then provide a brief review of the research advances in therapeutic approaches to peripheral nerve injury.The main current treatments are conducted passively and include physical factor rehabilitation,pharmacological treatments,cell-based therapies,and physical exercise.However,most treatments only partially address the problem and cannot complete the systematic recovery of the entire central nervous system-peripheral nervous system-target organ pathway.Therefore,we should further explore multilevel treatment options that produce effective,long-lasting results,perhaps requiring a combination of passive(traditional)and active(novel)treatment methods to stimulate rehabilitation at the central-peripheral-target organ levels to achieve better functional recovery.展开更多
Transforming growth factor-beta 1(TGF-β1)has been extensively studied for its pleiotropic effects on central nervous system diseases.The neuroprotective or neurotoxic effects of TGF-β1 in specific brain areas may de...Transforming growth factor-beta 1(TGF-β1)has been extensively studied for its pleiotropic effects on central nervous system diseases.The neuroprotective or neurotoxic effects of TGF-β1 in specific brain areas may depend on the pathological process and cell types involved.Voltage-gated sodium channels(VGSCs)are essential ion channels for the generation of action potentials in neurons,and are involved in various neuroexcitation-related diseases.However,the effects of TGF-β1 on the functional properties of VGSCs and firing properties in cortical neurons remain unclear.In this study,we investigated the effects of TGF-β1 on VGSC function and firing properties in primary cortical neurons from mice.We found that TGF-β1 increased VGSC current density in a dose-and time-dependent manner,which was attributable to the upregulation of Nav1.3 expression.Increased VGSC current density and Nav1.3 expression were significantly abolished by preincubation with inhibitors of mitogen-activated protein kinase kinase(PD98059),p38 mitogen-activated protein kinase(SB203580),and Jun NH2-terminal kinase 1/2 inhibitor(SP600125).Interestingly,TGF-β1 significantly increased the firing threshold of action potentials but did not change their firing rate in cortical neurons.These findings suggest that TGF-β1 can increase Nav1.3 expression through activation of the ERK1/2-JNK-MAPK pathway,which leads to a decrease in the firing threshold of action potentials in cortical neurons under pathological conditions.Thus,this contributes to the occurrence and progression of neuroexcitatory-related diseases of the central nervous system.展开更多
Drug delivery systems(DDS)have recently emerged as a promising approach for the unique advantages of drug protection and targeted delivery.However,the access of nanoparticles/drugs to the central nervous system(CNS)re...Drug delivery systems(DDS)have recently emerged as a promising approach for the unique advantages of drug protection and targeted delivery.However,the access of nanoparticles/drugs to the central nervous system(CNS)remains a challenge mainly due to the obstruction from brain barriers.Immune cells infiltrating the CNS in the pathological state have inspired the development of strategies for CNS foundation drug delivery.Herein,we outline the three major brain barriers in the CNS and the mechanisms by which immune cells migrate across the blood–brain barrier.We subsequently review biomimetic strategies utilizing immune cell-based nanoparticles for the delivery of nanoparticles/drugs to the CNS,as well as recent progress in rationally engineering immune cell-based DDS for CNS diseases.Finally,we discuss the challenges and opportunities of immune cell-based DDS in CNS diseases to promote their clinical development.展开更多
By far, the researches on how to distribute blood products among different departments in hospital have not been further studied, though the problem of blood shortage and wastage that caused by improper blood allocati...By far, the researches on how to distribute blood products among different departments in hospital have not been further studied, though the problem of blood shortage and wastage that caused by improper blood allocation is severe, which may endanger patient＇s lives and impose considerable costs on hospitals. In order to solve this problem, this paper mainly studies on how to distribute the blood items among different departments within a hospital and investigates the allocation approach with the novel management method by centralizing the inventory of several different departments. By integrating the blood inventory requirements of some departments, the hospital could reduce the rate of blood shortage and wastage effectively, release the pressure of the occupancy of resources and reduce the bullwhip effect of blood products. This paper illustrates the centralization principle in hospital and formulates the mixed integer programming model to work out the optimal allocation network scheme and the optimal inventory setting for every department. And the results of the numerical example demonstrate that this centralization method could considerably reduce blood shortage and wastage in hospital by about 72% and 90% respectively. Furthermore, it could decrease the total cost by about 108,540 RMB a month on blood supply chain management in the hospital and improve the effect of some certain surgeries by transfusing the fresh blood to patients.展开更多
As a city–county consolidation with Chinese characteristics,China’s countyto-district(CtD)reform transfers a county’s autonomy to a city,thereby strengthening the administrative,decision-making,fiscal and other pow...As a city–county consolidation with Chinese characteristics,China’s countyto-district(CtD)reform transfers a county’s autonomy to a city,thereby strengthening the administrative,decision-making,fiscal and other powers of the prefecture-level municipal government,which effectively enables the centralization of local governments.Based on this exogenous quasi-natural experiment,we use a difference-in-differences(DID)approach to empirically examine the impact of prefecture-level municipal government centralization on companies’ESG performance.The results show that municipal government centralization can significantly promote corporate ESG performance,which represents environmental protection,social responsibility and corporate governance behavior.The mechanism analysis also shows that the CtD reform can address market segmentation,alleviate policy uncertainty and reduce rentseeking,which further improves ESG performance.展开更多
The impact of heavy reduction on dendritic morphology was explored by combining experimental research and numerical simulation in metallurgy,including a detailed three-dimensional(3D)analysis and reconstruction of den...The impact of heavy reduction on dendritic morphology was explored by combining experimental research and numerical simulation in metallurgy,including a detailed three-dimensional(3D)analysis and reconstruction of dendritic solidification structures.Combining scanning electron microscopy and energy-dispersive scanning analysis and ANSYS simulation,the high-precision image processing software Mimics Research was utilized to conduct the extraction of dendritic morphologies.Reverse engineering software NX Imageware was employed for the 3D reconstruction of two-dimensional dendritic morphologies,restoring the dendritic characteristics in three-dimensional space.The results demonstrate that in a two-dimensional plane,dendrites connect with each other to form irregularly shaped“ring-like”structures.These dendrites have a thickness greater than 0.1 mm along the Z-axis direction,leading to the envelopment of molten steel by dendrites in a 3D space of at least 0.1 mm.This results in obstructed flow,confirming the“bridging”of dendrites in three-dimensional space,resulting in a tendency for central segregation.Dense and dispersed tiny dendrites,under the influence of heat flow direction,interconnect and continuously grow,gradually forming primary and secondary dendrites in three-dimensional space.After the completion of dendritic solidification and growth,these microdendrites appear dense and dispersed on the two-dimensional plane,providing the nuclei for the formation of new dendrites.When reduction occurs at a solid fraction of 0.46,there is a noticeable decrease in dendritic spacing,resulting in improved central segregation.展开更多
China has abundant resources of hot dry rocks.However,due to the fact that the evaluation methods for favorable areas are mainly qualitative,and the evaluation indicators and standards are inconsistent,which restrict ...China has abundant resources of hot dry rocks.However,due to the fact that the evaluation methods for favorable areas are mainly qualitative,and the evaluation indicators and standards are inconsistent,which restrict the evaluation efficiency and exploration process of dry hot rocks.This paper is based on the understanding of the geologic features and genesis mechanisms of hot dry rocks in China and abroad.By integrating the main controlling factors of hot dry rock formation,and using index grading and quantification,the fuzzy hierarchical comprehensive method is applied to establish an evaluation system and standards for favorable areas of hot dry rocks.The evaluation system is based on four indicators:heat source,thermal channel,thermal reservoir and cap rock.It includes 11 evaluation parameters,including time of magmatic/volcanic activity,depth of molten mass or magma chamber,distribution of discordogenic faults,burial depth of thermal reservoir,cap rock type and thickness,surface thermal anomaly,heat flow,geothermal gradient,Moho depth,Curie depth,Earthquake magnitude and focal depth.Each parameter is divided into 3 levels.Applying this evaluation system to assess hot dry rock in central Inner Mongolia revealed that Class I favorable zones cover approximately 494 km^(2),while Class II favorable zones span about 5.7×10^(4) km^(2).The Jirgalangtu Sag and Honghaershute Sag in the Erlian Basin,along with Reshuitang Town in Keshiketeng Banner,Reshui Town in Ningcheng County,and Reshuitang Town in Aohan Banner of Chifeng City,are identified as Class I favorable zones for hot dry rock resources.These areas are characterized by high-temperature subsurface molten bodies or magma chambers serving as high-quality heat sources,shallow thermal reservoir depths,and overlying thick sedimentary rock layers acting as caprock.The establishment and application of the evaluation system for favorable areas of hot dry rock are expected to provide new approaches and scientific basis for guiding the practice of selecting hot dry rock areas in China.展开更多
BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carri...BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications.A combination of group psychological nursing and physical mo-vement care significantly mitigates the risk of venous thrombosis and improves psychological well-being,and enhances motor function,underscoring its clinical importance.AIM To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.METHODS Sixty-five GC patients with PICC,admitted from January 2022 to January 2023,were randomly divided into two groups using the lottery method:A control group(n=35,routine nursing)and an observation group(n=30,routine nursing plus psychological nursing and physical movement nursing).Both groups re-ceived continuous care for 2 weeks.Pre-nursing and post-nursing data on psycho-logical state,physical function,chemotherapy-related thrombosis incidence,and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.RESULTS After nursing,both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores,with the observation group performing better(P<0.05).The Functional Comprehensive Assessment score for the observation group after nursing was(65.42±2.35)points,lower than the control group’s(62.19±4.33)points(P<0.05).Although no significant difference was observed in the incidence of venous thrombosis between the two groups(χ2=0.815,P=0.367),the observation group had lower incidence.Both groups showed decreased Revised Piper Fatigue Scale scores,with the observation group scoring lower(P<0.05).CONCLUSION Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk,improves psychological well-being,cancer-related fatigue,and physical function,making it highly promotable.展开更多
The development of neurodegenerative diseases is closely related to the disruption of central nervous system homeostasis.Microglia,as innate immune cells,play important roles in the maintenance of central nervous syst...The development of neurodegenerative diseases is closely related to the disruption of central nervous system homeostasis.Microglia,as innate immune cells,play important roles in the maintenance of central nervous system homeostasis,injury response,and neurodegenerative diseases.Lactate has been considered a metabolic waste product,but recent studies are revealing ever more of the physiological functions of lactate.Lactylation is an important pathway in lactate function and is involved in glycolysis-related functions,macrophage polarization,neuromodulation,and angiogenesis and has also been implicated in the development of various diseases.This review provides an overview of the lactate metabolic and homeostatic regulatory processes involved in microglia lactylation,histone versus non-histone lactylation,and therapeutic approaches targeting lactate.Finally,we summarize the current research on microglia lactylation in central nervous system diseases.A deeper understanding of the metabolic regulatory mechanisms of microglia lactylation will provide more options for the treatment of central nervous system diseases.展开更多
Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play p...Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement.Mammalian sperm-associated antigen 17(SPAG17)encodes a conserved axonemal protein of cilia and flagella,forming part of the C1a projection of the central apparatus,with functions related to ciliary/flagellar motility,skeletal growth,and male fertility.This study investigated two novel homozygous SPAG17 mutations(M1:NM_206996.2,c.829+1G>T,p.Asp212_Glu276del;and M2:c.2120del,p.Leu707*)identified in four infertile patients from two consanguineous Pakistani families.These patients displayed the MMAF phenotype confirmed by Papanicolaou staining and scanning electron microscopy assays of spermatozoa.Quantitative real-time polymerase chain reaction(PCR)of patients’spermatozoa also revealed a significant decrease in SPAG17 mRNA expression,and immunofluorescence staining showed the absence of SPAG17 protein signals along the flagella.However,no apparent ciliary-related symptoms or skeletal malformations were observed in the chest X-rays of any of the patients.Transmission electron microscopy of axoneme cross-sections from the patients showed incomplete C1a projection and a higher frequency of missing microtubule doublets 1 and 9 compared with those from fertile controls.Immunofluorescence staining and Western blot analyses of spermatogenesis-associated protein 17(SPATA17),a component of the C1a projection,and sperm-associated antigen 6(SPAG6),a marker of the spring layer,revealed disrupted expression of both proteins in the patients’spermatozoa.Altogether,these findings demonstrated that SPAG17 maintains the integrity of spermatozoal flagellar axoneme,expanding the phenotypic spectrum of SPAG17 mutations in humans.展开更多
文摘To explore the impact of partial centralization on supply chain performance,this study constructs a two-period game model of a closed-loop supply chain involving a manufacturer and an online retail platform participating in the trade-in strategy.Through mathematical modeling and numerical simulation methods,the optimal decisions were analyzed under conditions where the manufacturer partially owns the retail platform’s partial equity.This study finds that partial centralization yields the highest profits,followed by full centralization,with decentralized decisions yielding the lowest profits.Moderate centralization enhances overall profits by optimizing incentive mechanisms,whereas excessive ownership concentration reduces the flexibility of the retail platform,leading to a decline in profits.Additionally,product durability and trade-in subsidy significantly influence supply chain profitability:high-durability products reduce renewal frequency,while trade-in subsidy effectively stimulates consumer demand and increase overall profits.This study provides theoretical support and practical guidance for companies implementing the trade-in strategy.
基金supported by Beijing Scholar Project 20182024(No.B00033)。
文摘Objective:Limited evidence is available regarding the associations of centralization with gastric cancer patients’quality of care in high surgical volume settings.The current study aimed to explore the effects of hospital volume and the Herfindahl-Hirschman index(HHI)on in-hospital mortality,total cost,and length of stay for Chinese gastrectomy patients in a nationwide database.Methods:We extracted data on gastrectomy for gastric cancer from the Hospital Quality Monitoring System Database between 2013 and 2018.Hospital volume was divided into 4 quartiles:low(1-83 cases per year),medium(84-238 cases),high(239-579 cases),and very high(580-1,193 cases).The HHI was divided into 3 categories:highly concentrated(>2,500),moderately concentrated(1,500-2,500),and unconcentrated(<1,500).We used mixed-effects models to analyze the data while accounting for data clustering.Results:We analyzed 125,683 patients in 515 institutions.In the multivariable analyses,hospital volume was significantly associated with in-hospital mortality[medium vs.low:odds ratio(OR)=0.61,95%confidence interval(95%CI)=0.43-0.84,P=0.003;high:OR=0.57,95%CI=0.38-0.87,P=0.009;and very high:OR=0.33,95%CI=0.18-0.61,P<0.001)and length of stay(high vs.low:β=-0.036,95%CI=-0.071--0.002,P=0.039)but not with total cost.Hospitals located in unconcentrated provinces had higher in-hospital mortality(OR=1.52,95%CI=1.03-2.26,P=0.036)and longer lengths of stay(β=0.024,95%CI=0.001-0.047,P=0.041)than hospitals located in highly concentrated provinces.Conclusions:Centralization of gastrectomy,measured by hospital volume and the HHI,was associated with decreased in-hospital mortality and shortened length of stay without increasing total cost.These results support the strategy of centralizing gastrectomy in high-volume settings.
文摘The As-level topology is a hotspot of the recent reseaches. We can understand the centralization of the network clearly by researching the evolvement trend of the Internet macroscopic topology. The massive data we use in this paper is from CAIDA (The Cooperative Association for Internet Data Analysis) Skitter project. And the time span of the data is from July, 2001 to January, 2008. This paper introduces the background of the AS-level topology at first, then carries out the evolvement of degree, core and layer. It is believed that the influence of the top-degree nodes on the other nodes decreases and the centralization of network is going to fall off with the decrease of the core. And the nucleus status of network declines.
文摘Objective:To uncover the impact of centralization of COVID-19 and perceived control of COVID-19 on society during the pandemic.Methods:We recruited a total of 1041 people in this cross-sectional study.The data were collected using a questionnaire booklet covering demographics,a COVID-19-related information form,the Centrality of Event Scale,and the Perception of Control of COVID-19 Scale.We utilized independent samples t-test,chi-square test,and one-way analysis of variance to analyze the data.Results:1041 questionnaires were collected and no questionnaire were excluded from our study.Slightly more than half of the participants(51.2%)stated that social isolation impaired public mental health,while 30.1%reported adverse impacts of the pandemic on their sleep quality.Participants with changes to their sleep patterns were found to centralize COVID-19 more.Moreover,measures against COVID-19 and constant announcements of the daily number of cases in the media brought both positive and negative effects on people and further contributed to the participants’centralization of COVID-19.Individuals with low centralization scores were concluded to perceive COVID-19 as a minor disease.Healthcare professionals without a relative diagnosed with COVID-19 and those satisfied with treatment opportunities had a higher perceived control of COVID-19,while those who were not interested in statistical data on COVID-19 and who had difficulty complying with the rules had a lower perceived control of COVID-19.Besides,poorer perceived control of COVID-19 was found to adversely affect sleep quality.Furthermore,healthcare professionals scored higher on the inevitability subscale of the Perception of Control of COVID-19 Scale.Finally,among the participants,most COVID-19 survivors thought COVID-19 to be an avoidable disease.Conclusion:In addition to its physical impacts,COVID-19 adversely impacts on mental health,and these effects are closely linked to a society’s centralization of COVID-19 and perceived control of COVID-19.
文摘Established during the long years of revolutionary struggle and the founding of the People＇s Republic of China （PRC）, the Communist Party of China（CPC）-led decision-making system has a historical rationality. Before China＇s reform and opening-up was implemented in 1978, the decision-making system highlighted centralization which led to disadvantages such as non-existent specialized division of functions, a low level of institutionalization, heavy reliance on experience, an enclosed decision-making mode and non-existent self-correction mechanisms. These disadvantages were institutional factors which ultimately caused the historic tragedy of ＂ Cultural Revolution. ＂After the reform and opening-up, the decision-making structure, mode and mechanism were reformed in order to promote scientific, democratic and law-based decisions. History has shown that the reform has successfully overcome various challenges brought about by China＇s rapidly changing economy and society. From the perspective of political development, the reform has promoted several transitions： from individual controlled decision-making system to a more democratic decision-making process, from being empirical to scientifically-based, from highly centralized decision-making organizations to decentralized one, from an enclosed mode to an open mode, from passive to active participation in the decision-making process and from a non-institutionalized to an institutionalized system. Therefore, the CPC-led open decision-making model based on science and laws and participated by other parties has taken an initial shape.
文摘Objective: To evaluate the organizational model of a perinatal network and its relevance in a resource-limited country. Methodology: This was a mixed prospective qualitative and quantitative study conducted over a 2-year period, from January 1, 2022, to December 31, 2023. This study took place in Senegal, a country with limited resources and a weakness of hyperspecialized medical technical resources. There was no policy for the management of fetal malformations. The qualitative part was carried out through overt participant observation. The human resources and the organization of the perinatal network were described. For the quantitative part, all fetuses managed during the study period were included. The studied parameters related to neonatal care and outcomes. Qualitative variables were described using dispersion parameters, and quantitative variables were described using proportions. Results: The perinatal network includes several specialists across six hospitals. Of these hospitals, only one provided emergency pediatric surgery. The network included highly specialized human resources in prenatal diagnosis, congenital heart defects, pediatric surgery, anesthesia, and other medical specialties in perinatology. Advanced ultrasound was centralized by an obstetrician. The team decided on the follow-up methods, timing, and mode of delivery. The newborn was immediately transferred to the appropriate specialty. Over the 2-year period, 201 fetuses were managed. The rate of cesarean delivery was 76.3%. Neonatal mortality was 51.4%. Discussion: Centralizing care improves the quality of prenatal diagnosis and management of congenital defects. Mortality remains high when emergency surgery is not well available. This mortality is also due to the lack of a single center offering all perinatal care and so, the transfer of newborns. The cesarean rate increases due to underlying conditions and organizational factors. Conclusion: Public policies should prioritize the centralization of care for congenital disorders to reduce the costs of disability and mortality.
基金This work is supported by National Natural Science Foundation of China (79870 0 71)
文摘The paper extracts the concept of Centralization Group Decision Making(CGDM) and Decentralization Group Decision Making(DGDM) from management systems on bases of studies on Informational Centralization Process(ICP) and Informational Decentralization Process(IDP), then the similarities and differences between CGDM and DGDM are presented. Further, the taxonomy of CGDM and DGDM is researched.
基金supported by the National Natural Science Foundation of China, No.82274616the Key Laboratory Project for General Universities in Guangdong Province, No.2019KSYS005Guangdong Province Science and Technology Plan International Cooperation Project, No.2020A0505100052 (all to QW)。
文摘Meningeal lymphatic vessels form a relationship between the nervous system and periphery, which is relevant in both health and disease. Meningeal lymphatic vessels not only play a key role in the drainage of brain metabolites but also contribute to antigen delivery and immune cell activation. The advent of novel genomic technologies has enabled rapid progress in the characterization of myeloid and lymphoid cells and their interactions with meningeal lymphatic vessels within the central nervous system. In this review, we provide an overview of the multifaceted roles of meningeal lymphatic vessels within the context of the central nervous system immune network, highlighting recent discoveries on the immunological niche provided by meningeal lymphatic vessels. Furthermore, we delve into the mechanisms of crosstalk between meningeal lymphatic vessels and immune cells in the central nervous system under both homeostatic conditions and neurodegenerative diseases, discussing how these interactions shape the pathological outcomes. Regulation of meningeal lymphatic vessel function and structure can influence lymphatic drainage, cerebrospinal fluid-borne immune modulators, and immune cell populations in aging and neurodegenerative disorders, thereby playing a key role in shaping meningeal and brain parenchyma immunity.
文摘Copper is a transition metal and an essential element for the organism,as alterations in its homeostasis leading to metal accumulation or deficiency have pathological effects in several organs,including the central nervous system.Central copper dysregulations have been evidenced in two genetic disorders characterized by mutations in the copper-ATPases ATP7A and ATP7B,Menkes disease and Wilson’s disease,respectively,and also in multifactorial neurological disorders such as Alzheimer’s disease,Parkinson’s disease,amyotrophic lateral sclerosis,and multiple sclerosis.This review summarizes current knowledge about the role of copper in central nervous system physiology and pathology,reports about unbalances in copper levels and/or distribution under disease,describes relevant animal models for human disorders where copper metabolism genes are dysregulated,and discusses relevant therapeutic approaches modulating copper availability.Overall,alterations in copper metabolism may contribute to the etiology of central nervous system disorders and represent relevant therapeutic targets to restore tissue homeostasis.
基金supported by grants from the Natural Science Foundation of Tianjin(General Program),Nos.23JCYBJC01390(to RL),22JCYBJC00220(to XC),and 22JCYBJC00210(to QL).
文摘Peripheral nerve injury is a common neurological condition that often leads to severe functional limitations and disabilities.Research on the pathogenesis of peripheral nerve injury has focused on pathological changes at individual injury sites,neglecting multilevel pathological analysis of the overall nervous system and target organs.This has led to restrictions on current therapeutic approaches.In this paper,we first summarize the potential mechanisms of peripheral nerve injury from a holistic perspective,covering the central nervous system,peripheral nervous system,and target organs.After peripheral nerve injury,the cortical plasticity of the brain is altered due to damage to and regeneration of peripheral nerves;changes such as neuronal apoptosis and axonal demyelination occur in the spinal cord.The nerve will undergo axonal regeneration,activation of Schwann cells,inflammatory response,and vascular system regeneration at the injury site.Corresponding damage to target organs can occur,including skeletal muscle atrophy and sensory receptor disruption.We then provide a brief review of the research advances in therapeutic approaches to peripheral nerve injury.The main current treatments are conducted passively and include physical factor rehabilitation,pharmacological treatments,cell-based therapies,and physical exercise.However,most treatments only partially address the problem and cannot complete the systematic recovery of the entire central nervous system-peripheral nervous system-target organ pathway.Therefore,we should further explore multilevel treatment options that produce effective,long-lasting results,perhaps requiring a combination of passive(traditional)and active(novel)treatment methods to stimulate rehabilitation at the central-peripheral-target organ levels to achieve better functional recovery.
基金supported by the Natural Science Foundation of Guangdong Province,Nos.2019A1515010649(to WC),2022A1515012044(to JS)the China Postdoctoral Science Foundation,No.2018M633091(to JS).
文摘Transforming growth factor-beta 1(TGF-β1)has been extensively studied for its pleiotropic effects on central nervous system diseases.The neuroprotective or neurotoxic effects of TGF-β1 in specific brain areas may depend on the pathological process and cell types involved.Voltage-gated sodium channels(VGSCs)are essential ion channels for the generation of action potentials in neurons,and are involved in various neuroexcitation-related diseases.However,the effects of TGF-β1 on the functional properties of VGSCs and firing properties in cortical neurons remain unclear.In this study,we investigated the effects of TGF-β1 on VGSC function and firing properties in primary cortical neurons from mice.We found that TGF-β1 increased VGSC current density in a dose-and time-dependent manner,which was attributable to the upregulation of Nav1.3 expression.Increased VGSC current density and Nav1.3 expression were significantly abolished by preincubation with inhibitors of mitogen-activated protein kinase kinase(PD98059),p38 mitogen-activated protein kinase(SB203580),and Jun NH2-terminal kinase 1/2 inhibitor(SP600125).Interestingly,TGF-β1 significantly increased the firing threshold of action potentials but did not change their firing rate in cortical neurons.These findings suggest that TGF-β1 can increase Nav1.3 expression through activation of the ERK1/2-JNK-MAPK pathway,which leads to a decrease in the firing threshold of action potentials in cortical neurons under pathological conditions.Thus,this contributes to the occurrence and progression of neuroexcitatory-related diseases of the central nervous system.
基金supported by the National Natural Science Foundation of China(82204634,82174047,81622051)the Zhejiang Provincial Natural Science Foundation of China(LQ22H280010)the Foundation of Zhejiang Chinese Medical University(2021ZR03).
文摘Drug delivery systems(DDS)have recently emerged as a promising approach for the unique advantages of drug protection and targeted delivery.However,the access of nanoparticles/drugs to the central nervous system(CNS)remains a challenge mainly due to the obstruction from brain barriers.Immune cells infiltrating the CNS in the pathological state have inspired the development of strategies for CNS foundation drug delivery.Herein,we outline the three major brain barriers in the CNS and the mechanisms by which immune cells migrate across the blood–brain barrier.We subsequently review biomimetic strategies utilizing immune cell-based nanoparticles for the delivery of nanoparticles/drugs to the CNS,as well as recent progress in rationally engineering immune cell-based DDS for CNS diseases.Finally,we discuss the challenges and opportunities of immune cell-based DDS in CNS diseases to promote their clinical development.
文摘By far, the researches on how to distribute blood products among different departments in hospital have not been further studied, though the problem of blood shortage and wastage that caused by improper blood allocation is severe, which may endanger patient＇s lives and impose considerable costs on hospitals. In order to solve this problem, this paper mainly studies on how to distribute the blood items among different departments within a hospital and investigates the allocation approach with the novel management method by centralizing the inventory of several different departments. By integrating the blood inventory requirements of some departments, the hospital could reduce the rate of blood shortage and wastage effectively, release the pressure of the occupancy of resources and reduce the bullwhip effect of blood products. This paper illustrates the centralization principle in hospital and formulates the mixed integer programming model to work out the optimal allocation network scheme and the optimal inventory setting for every department. And the results of the numerical example demonstrate that this centralization method could considerably reduce blood shortage and wastage in hospital by about 72% and 90% respectively. Furthermore, it could decrease the total cost by about 108,540 RMB a month on blood supply chain management in the hospital and improve the effect of some certain surgeries by transfusing the fresh blood to patients.
基金supported by the National Natural Science Foundation of China(Grant No.T2293773 and No.T2293770).
文摘As a city–county consolidation with Chinese characteristics,China’s countyto-district(CtD)reform transfers a county’s autonomy to a city,thereby strengthening the administrative,decision-making,fiscal and other powers of the prefecture-level municipal government,which effectively enables the centralization of local governments.Based on this exogenous quasi-natural experiment,we use a difference-in-differences(DID)approach to empirically examine the impact of prefecture-level municipal government centralization on companies’ESG performance.The results show that municipal government centralization can significantly promote corporate ESG performance,which represents environmental protection,social responsibility and corporate governance behavior.The mechanism analysis also shows that the CtD reform can address market segmentation,alleviate policy uncertainty and reduce rentseeking,which further improves ESG performance.
基金supported by Open Foundation of the State Key Laboratory of Refractories and Metallurgy(No.G201711)the National Natural Science Foundation of China(Nos.52104317 and 51874001).
文摘The impact of heavy reduction on dendritic morphology was explored by combining experimental research and numerical simulation in metallurgy,including a detailed three-dimensional(3D)analysis and reconstruction of dendritic solidification structures.Combining scanning electron microscopy and energy-dispersive scanning analysis and ANSYS simulation,the high-precision image processing software Mimics Research was utilized to conduct the extraction of dendritic morphologies.Reverse engineering software NX Imageware was employed for the 3D reconstruction of two-dimensional dendritic morphologies,restoring the dendritic characteristics in three-dimensional space.The results demonstrate that in a two-dimensional plane,dendrites connect with each other to form irregularly shaped“ring-like”structures.These dendrites have a thickness greater than 0.1 mm along the Z-axis direction,leading to the envelopment of molten steel by dendrites in a 3D space of at least 0.1 mm.This results in obstructed flow,confirming the“bridging”of dendrites in three-dimensional space,resulting in a tendency for central segregation.Dense and dispersed tiny dendrites,under the influence of heat flow direction,interconnect and continuously grow,gradually forming primary and secondary dendrites in three-dimensional space.After the completion of dendritic solidification and growth,these microdendrites appear dense and dispersed on the two-dimensional plane,providing the nuclei for the formation of new dendrites.When reduction occurs at a solid fraction of 0.46,there is a noticeable decrease in dendritic spacing,resulting in improved central segregation.
基金Supported by PetroChina Prospective and Basic Technological Project(2022DJ5503).
文摘China has abundant resources of hot dry rocks.However,due to the fact that the evaluation methods for favorable areas are mainly qualitative,and the evaluation indicators and standards are inconsistent,which restrict the evaluation efficiency and exploration process of dry hot rocks.This paper is based on the understanding of the geologic features and genesis mechanisms of hot dry rocks in China and abroad.By integrating the main controlling factors of hot dry rock formation,and using index grading and quantification,the fuzzy hierarchical comprehensive method is applied to establish an evaluation system and standards for favorable areas of hot dry rocks.The evaluation system is based on four indicators:heat source,thermal channel,thermal reservoir and cap rock.It includes 11 evaluation parameters,including time of magmatic/volcanic activity,depth of molten mass or magma chamber,distribution of discordogenic faults,burial depth of thermal reservoir,cap rock type and thickness,surface thermal anomaly,heat flow,geothermal gradient,Moho depth,Curie depth,Earthquake magnitude and focal depth.Each parameter is divided into 3 levels.Applying this evaluation system to assess hot dry rock in central Inner Mongolia revealed that Class I favorable zones cover approximately 494 km^(2),while Class II favorable zones span about 5.7×10^(4) km^(2).The Jirgalangtu Sag and Honghaershute Sag in the Erlian Basin,along with Reshuitang Town in Keshiketeng Banner,Reshui Town in Ningcheng County,and Reshuitang Town in Aohan Banner of Chifeng City,are identified as Class I favorable zones for hot dry rock resources.These areas are characterized by high-temperature subsurface molten bodies or magma chambers serving as high-quality heat sources,shallow thermal reservoir depths,and overlying thick sedimentary rock layers acting as caprock.The establishment and application of the evaluation system for favorable areas of hot dry rock are expected to provide new approaches and scientific basis for guiding the practice of selecting hot dry rock areas in China.
文摘BACKGROUND Long-term chemotherapy for patients with gastric cancer(GC),facilitated by peripherally inserted central catheter(PICC)catheterization,reduces vascular damage and enhances drug delivery efficiency but carries risks of catheter-related complications.A combination of group psychological nursing and physical mo-vement care significantly mitigates the risk of venous thrombosis and improves psychological well-being,and enhances motor function,underscoring its clinical importance.AIM To assess group psychological and physical movement nursing in preventing venous thrombosis in patients with PICC GC.METHODS Sixty-five GC patients with PICC,admitted from January 2022 to January 2023,were randomly divided into two groups using the lottery method:A control group(n=35,routine nursing)and an observation group(n=30,routine nursing plus psychological nursing and physical movement nursing).Both groups re-ceived continuous care for 2 weeks.Pre-nursing and post-nursing data on psycho-logical state,physical function,chemotherapy-related thrombosis incidence,and cancer-related fatigue were analyzed using SPSS 26.0 and GraphPad Prism 8.0.RESULTS After nursing,both groups showed reduced Hamilton Anxiety Scale scores and increased General Perceived Self-Efficacy Scale scores,with the observation group performing better(P<0.05).The Functional Comprehensive Assessment score for the observation group after nursing was(65.42±2.35)points,lower than the control group’s(62.19±4.33)points(P<0.05).Although no significant difference was observed in the incidence of venous thrombosis between the two groups(χ2=0.815,P=0.367),the observation group had lower incidence.Both groups showed decreased Revised Piper Fatigue Scale scores,with the observation group scoring lower(P<0.05).CONCLUSION Group psychological and physical movement nursing for patients with PICC reduces venous thrombosis risk,improves psychological well-being,cancer-related fatigue,and physical function,making it highly promotable.
文摘The development of neurodegenerative diseases is closely related to the disruption of central nervous system homeostasis.Microglia,as innate immune cells,play important roles in the maintenance of central nervous system homeostasis,injury response,and neurodegenerative diseases.Lactate has been considered a metabolic waste product,but recent studies are revealing ever more of the physiological functions of lactate.Lactylation is an important pathway in lactate function and is involved in glycolysis-related functions,macrophage polarization,neuromodulation,and angiogenesis and has also been implicated in the development of various diseases.This review provides an overview of the lactate metabolic and homeostatic regulatory processes involved in microglia lactylation,histone versus non-histone lactylation,and therapeutic approaches targeting lactate.Finally,we summarize the current research on microglia lactylation in central nervous system diseases.A deeper understanding of the metabolic regulatory mechanisms of microglia lactylation will provide more options for the treatment of central nervous system diseases.
基金supported by the National Natural Science Foundation of China(No.82171599 and No.32270901)the National Key Research and Developmental Program of China(2022YFC2702601 and 2022YFA0806303)the Global Select Project(DJKLX-2022010)of the Institute of Health and Medicine,Hefei Comprehensive National Science Center.
文摘Male infertility can result from impaired sperm motility caused by multiple morphological abnormalities of the flagella(MMAF).Distinct projections encircling the central microtubules of the spermatozoal axoneme play pivotal roles in flagellar bending and spermatozoal movement.Mammalian sperm-associated antigen 17(SPAG17)encodes a conserved axonemal protein of cilia and flagella,forming part of the C1a projection of the central apparatus,with functions related to ciliary/flagellar motility,skeletal growth,and male fertility.This study investigated two novel homozygous SPAG17 mutations(M1:NM_206996.2,c.829+1G>T,p.Asp212_Glu276del;and M2:c.2120del,p.Leu707*)identified in four infertile patients from two consanguineous Pakistani families.These patients displayed the MMAF phenotype confirmed by Papanicolaou staining and scanning electron microscopy assays of spermatozoa.Quantitative real-time polymerase chain reaction(PCR)of patients’spermatozoa also revealed a significant decrease in SPAG17 mRNA expression,and immunofluorescence staining showed the absence of SPAG17 protein signals along the flagella.However,no apparent ciliary-related symptoms or skeletal malformations were observed in the chest X-rays of any of the patients.Transmission electron microscopy of axoneme cross-sections from the patients showed incomplete C1a projection and a higher frequency of missing microtubule doublets 1 and 9 compared with those from fertile controls.Immunofluorescence staining and Western blot analyses of spermatogenesis-associated protein 17(SPATA17),a component of the C1a projection,and sperm-associated antigen 6(SPAG6),a marker of the spring layer,revealed disrupted expression of both proteins in the patients’spermatozoa.Altogether,these findings demonstrated that SPAG17 maintains the integrity of spermatozoal flagellar axoneme,expanding the phenotypic spectrum of SPAG17 mutations in humans.
