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
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
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
Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microgl...Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.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
Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’...Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’s disease.In this review,we summarize the changes in short-chain fatty acid levels and the abundance of short-chain fatty acid-producing bacteria in various samples from patients with Parkinson’s disease,highlighting the critical role of gut homeostasis imbalance in the pathogenesis and progression of the disease.Focusing on the nervous system,we discuss the molecular mechanisms by which short-chain fatty acids influence the homeostasis of both the enteric nervous system and the central nervous system.We identify key processes,including the activation of G protein-coupled receptors and the inhibition of histone deacetylases by short-chain fatty acids.Importantly,structural or functional disruptions in the enteric nervous system mediated by these fatty acids may lead to abnormalα-synuclein expression and gastrointestinal dysmotility,which could serve as an initiating event in Parkinson’s disease.Furthermore,we propose that short-chain fatty acids help establish communication between the enteric nervous system and the central nervous system via the vagal nerve,immune circulation,and endocrine signaling.This communication may shed light on their potential role in the transmission ofα-synuclein from the gut to the brain.Finally,we elucidate novel treatment strategies for Parkinson’s disease that target short-chain fatty acids and examine the challenges associated with translating short-chain fatty acid-based therapies into clinical practice.In conclusion,this review emphasizes the pivotal role of short-chain fatty acids in regulating gut-brain axis integrity and their significance in the pathogenesis of Parkinson’s disease from the perspective of the nervous system.Moreover,it highlights the potential value of short-chain fatty acids in early intervention for Parkinson’s disease.Future research into the molecular mechanisms of short-chain fatty acids and their synergistic interactions with other gut metabolites is likely to advance the clinical translation of innovative short-chain fatty acid-based therapies for Parkinson’s disease.展开更多
Regenerative capacity of the central nervous system(CNS)is unevenly distributed among vertebrates.While most mammalian species including humans elicit limited repair following CNS injury or disease,highly regenerative...Regenerative capacity of the central nervous system(CNS)is unevenly distributed among vertebrates.While most mammalian species including humans elicit limited repair following CNS injury or disease,highly regenerative vertebrates including urodele amphibians and teleost fish spontaneously reverse CNS damage.Teletost zebrafish(danio rerio)are tropical freshwater fish that proved to be an excellent vertebrate model of successful CNS regeneration.Differential neuronal,glial,and immune injury responses underlie disparate injury outcomes between highly regenerative zebrafish and poorly regenerative mammals.This article describes complications associated with neuronal repair following spinal cord injury(SCI)in poorly regenerative mammals and highlights intersecting modes of plasticity and regeneration in highly regenerative zebrafish(Figures 1 and 2).Comparative approaches evaluating immunoglial SCI responses were recently reviewed elsewhere(Reyes and Mokalled,2024).展开更多
The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzh...The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzheimer's or Parkinson's disease)or traumatic injuries(such as spinal cord lesions).In the last 20 years,the field has made significant progress in unlocking axon regrowth.展开更多
Central nervous system(CNS) axons fail to regenerate following brain or spinal cord injury(SCI),which typically leads to permanent neurological deficits.Peripheral nervous system axons,howeve r,can regenerate followin...Central nervous system(CNS) axons fail to regenerate following brain or spinal cord injury(SCI),which typically leads to permanent neurological deficits.Peripheral nervous system axons,howeve r,can regenerate following injury.Understanding the mechanisms that underlie this difference is key to developing treatments for CNS neurological diseases and injuries characterized by axonal damage.To initiate repair after peripheral nerve injury,dorsal root ganglion(DRG) neurons mobilize a pro-regenerative gene expression program,which facilitates axon outgrowth.展开更多
Synapses are key structures involved in transmitting information in the nervous system,and their functions rely on the regulation of various lipids.Lipids play important roles in synapse formation,neurotransmitter rel...Synapses are key structures involved in transmitting information in the nervous system,and their functions rely on the regulation of various lipids.Lipids play important roles in synapse formation,neurotransmitter release,and signal transmission,and dysregulation of lipid metabolism is closely associated with various neurodegenerative diseases.The complex roles of lipids in synaptic function and neurological diseases have recently garnered increasing attention,but their specific mechanisms remain to be fully understood.This review aims to explore how lipids regulate synaptic activity in the central nervous system,focusing on their roles in synapse formation,neurotransmitter release,and signal transmission.Additionally,it discusses the mechanisms by which glial cells modulate synaptic function through lipid regulation.This review shows that within the central nervous system,lipids are essential components of the cell membrane bilayer,playing critical roles in synaptic structure and function.They regulate presynaptic vesicular trafficking,postsynaptic signaling pathways,and glial-neuronal interactions.Cholesterol maintains membrane fluidity and promotes the formation of lipid rafts.Glycerophospholipids contribute to the structural integrity of synaptic membranes and are involved in the release of synaptic vesicles.Sphingolipids interact with synaptic receptors through various mechanisms to regulate their activity and are also involved in cellular processes such as inflammation and apoptosis.Fatty acids are vital for energy metabolism and the synthesis of signaling molecules.Abnormalities in lipid metabolism may lead to impairments in synaptic function,affecting information transmission between neurons and the overall health of the nervous system.Therapeutic strategies targeting lipid metabolism,particularly through cholesterol modulation,show promise for treating these conditions.In neurodegenerative diseases such as Alzheimer’s disease,Parkinson disease,and amyotrophic lateral sclerosis,dysregulation of lipid metabolism is closely linked to synaptic dysfunction.Therefore,lipids are not only key molecules in neural regeneration and synaptic repair but may also contribute to neurodegenerative pathology when metabolic dysregulation occurs.Further research is needed to elucidate the specific mechanisms linking lipid metabolism to synaptic dysfunction and to develop targeted lipid therapies for neurological diseases.展开更多
The mechanistic target of rapamycin(m TOR) is a serine/threonine kinase that plays a pivotal role in cellular growth, proliferation, survival, and metabolism. In the central nervous system(CNS), the mTOR pathway regul...The mechanistic target of rapamycin(m TOR) is a serine/threonine kinase that plays a pivotal role in cellular growth, proliferation, survival, and metabolism. In the central nervous system(CNS), the mTOR pathway regulates diverse aspects of neural development and function. Genetic mutations within the m TOR pathway lead to severe neurodevelopmental disorders, collectively known as “mTORopathies”(Crino, 2020). Dysfunctions of m TOR, including both its hyperactivation and hypoactivation, have also been implicated in a wide spectrum of other neurodevelopmental and neurodegenerative conditions, highlighting its importance in CNS health.展开更多
Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases....Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases.A highly versatile cell type,microglia have been shown to fulfill a multitude of critical roles in the central nervous system,including facilitating neurogenesis and myelination,pruning synapses,removing debris and waste,modulating neuronal activity,supporting the blood-brain barrier,repairing tissue damage,and surveilling against microbial invasions under physiological conditions(Prinz et al.,2021;Paolicelli et al.,2022).展开更多
Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neu...Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.展开更多
AIM:To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion(CRVO)with macular edema(ME).METHODS:Optical coherence tomography angiology(OCT...AIM:To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion(CRVO)with macular edema(ME).METHODS:Optical coherence tomography angiology(OCTA)parameters,including optic disc vessel density(VD;including whole-disc VD,intra-disc VD,and peripapillary VD),superficial/deep capillary plexus(SCP/DCP)VD,and central macular thickness(CMT)were analyzed.Additional assessments included best-corrected visual acuity(BCVA)via Early Treatment Diabetic Retinopathy Study(ETDRS)chart and hemorheological profiling.CRVO patients received monthly intravitreal ranibizumab injections for three consecutive months.Pre-and post-treatment parameters were statistically compared.RESULTS:The study comprised 60 CRVO-ME patients(28 males;32 females),aged 50-78y(mean 63.3±7.6y)and 60 age-/sex-matched healthy controls.As compared with participants exhibiting normal funduscopic findings,CRVO patients demonstrated significantly elevated levels of low-shear-rate whole blood viscosity(LSR-WBV),high-shearrate whole blood viscosity(HSR-WBV),and aggregation index(AI,all P<0.05).In CRVO-affected eyes,vertical cupto-disc(C/D)ratio and optic cup volume were significantly smaller,whereas retinal nerve fiber layer(RNFL)thickness was significantly greater,compared to both unaffected contralateral eyes and normal control eyes(all P<0.05).Following treatment,VD of the entire optic disc(P<0.05),intra-disc VD(P<0.05),and peripapillary VD(P<0.05)all increased significantly relative to baseline.CMT decreased significantly(P<0.05),whereas macular SCP-VD and macular DCP-VD showed non-significant slight reductions(P>0.05).At baseline,BCVA of CRVO eyes correlated with whole-disc VD(r=-0.276,P=0.033),intra-disc VD(r=-0.342,P=0.009),and peripapillary VD(r=-0.335,P=0.007),with intra-disc VD demonstrating the strongest association.Besides,BCVA improvement,after the treatment,correlated positively with whole-disc VD(r=0.342,P=0.008)and intradisc VD(r=0.396,P=0.002).CONCLUSION:Optic disc blood perfusion is more closely associated with visual acuity than macular perfusion,suggesting intra-disc VD may serve as a potential biomarker for monitoring visual acuity changes in CRVO.Multiple ranibizumab injections significantly improve optic disc perfusion but may have exerted detrimental effects on the macula.CRVO patients shows higher hemorheological parameters than those with normal fundi.Reduced vertical C/D ratio and optic cup volume may be linked to CRVO incidence,potentially acting as susceptibility factors.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.
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.
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 Natural Science Foundation of Yunnan Province,No.202401AS070086(to ZW)the National Key Research and Development Program of China,No.2018YFA0801403(to ZW)+1 种基金Yunnan Science and Technology Talent and Platform Plan,No.202105AC160041(to ZW)the Natural Science Foundation of China,No.31960120(to ZW)。
文摘Traumatic brain injury can be categorized into primary and secondary injuries.Secondary injuries are the main cause of disability following traumatic brain injury,which involves a complex multicellular cascade.Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury.In this article,we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury.We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia.We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia,such as the Toll-like receptor 4/nuclear factor-kappa B,mitogen-activated protein kinase,Janus kinase/signal transducer and activator of transcription,phosphoinositide 3-kinase/protein kinase B,Notch,and high mobility group box 1 pathways,can alleviate the inflammatory response triggered by microglia in traumatic brain injury,thereby exerting neuroprotective effects.We also reviewed the strategies developed on the basis of these pathways,such as drug and cell replacement therapies.Drugs that modulate inflammatory factors,such as rosuvastatin,have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury.Mesenchymal stem cells possess anti-inflammatory properties,and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury.Additionally,advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials,genetic engineering,and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models.However,numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed.In the future,new technologies,such as single-cell RNA sequencing and transcriptome analysis,can facilitate further experimental studies.Moreover,research involving non-human primates can help translate these treatment strategies to clinical practice.
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 the National Key R&D Program of China,No.2021YFC2501200(to PC).
文摘Short-chain fatty acids,metabolites produced by the fermentation of dietary fiber by gut microbiota,have garnered significant attention due to their correlation with neurodegenerative diseases,particularly Parkinson’s disease.In this review,we summarize the changes in short-chain fatty acid levels and the abundance of short-chain fatty acid-producing bacteria in various samples from patients with Parkinson’s disease,highlighting the critical role of gut homeostasis imbalance in the pathogenesis and progression of the disease.Focusing on the nervous system,we discuss the molecular mechanisms by which short-chain fatty acids influence the homeostasis of both the enteric nervous system and the central nervous system.We identify key processes,including the activation of G protein-coupled receptors and the inhibition of histone deacetylases by short-chain fatty acids.Importantly,structural or functional disruptions in the enteric nervous system mediated by these fatty acids may lead to abnormalα-synuclein expression and gastrointestinal dysmotility,which could serve as an initiating event in Parkinson’s disease.Furthermore,we propose that short-chain fatty acids help establish communication between the enteric nervous system and the central nervous system via the vagal nerve,immune circulation,and endocrine signaling.This communication may shed light on their potential role in the transmission ofα-synuclein from the gut to the brain.Finally,we elucidate novel treatment strategies for Parkinson’s disease that target short-chain fatty acids and examine the challenges associated with translating short-chain fatty acid-based therapies into clinical practice.In conclusion,this review emphasizes the pivotal role of short-chain fatty acids in regulating gut-brain axis integrity and their significance in the pathogenesis of Parkinson’s disease from the perspective of the nervous system.Moreover,it highlights the potential value of short-chain fatty acids in early intervention for Parkinson’s disease.Future research into the molecular mechanisms of short-chain fatty acids and their synergistic interactions with other gut metabolites is likely to advance the clinical translation of innovative short-chain fatty acid-based therapies for Parkinson’s disease.
文摘Regenerative capacity of the central nervous system(CNS)is unevenly distributed among vertebrates.While most mammalian species including humans elicit limited repair following CNS injury or disease,highly regenerative vertebrates including urodele amphibians and teleost fish spontaneously reverse CNS damage.Teletost zebrafish(danio rerio)are tropical freshwater fish that proved to be an excellent vertebrate model of successful CNS regeneration.Differential neuronal,glial,and immune injury responses underlie disparate injury outcomes between highly regenerative zebrafish and poorly regenerative mammals.This article describes complications associated with neuronal repair following spinal cord injury(SCI)in poorly regenerative mammals and highlights intersecting modes of plasticity and regeneration in highly regenerative zebrafish(Figures 1 and 2).Comparative approaches evaluating immunoglial SCI responses were recently reviewed elsewhere(Reyes and Mokalled,2024).
基金supported by ANR(ANR-21CE16-0008-01)ANR(ANR-21-CE16-0008-02 and ANR-23CE52-0007)+1 种基金UNADEV(A22018CS)(to HN)UNADEV(A22020CS)(to SB)。
文摘The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzheimer's or Parkinson's disease)or traumatic injuries(such as spinal cord lesions).In the last 20 years,the field has made significant progress in unlocking axon regrowth.
基金supported by the Canada Foundation for Innovation (Project#44220)the Natural Sciences and Engineering Research Council of Canada (RGPIN-2024-03986)+3 种基金the Michael Smith Foundation for Health Research BCthe financial support of Health Canada,through the Canada Brain Research Fund,an innovative partnership between the Government of Canada (through Health Canada),Brain Canada Foundationthe Azrieli Foundationsupported by a Canadian Institutes of Health Research (CIHR) Canada Graduate Scholarship–Master’s Award。
文摘Central nervous system(CNS) axons fail to regenerate following brain or spinal cord injury(SCI),which typically leads to permanent neurological deficits.Peripheral nervous system axons,howeve r,can regenerate following injury.Understanding the mechanisms that underlie this difference is key to developing treatments for CNS neurological diseases and injuries characterized by axonal damage.To initiate repair after peripheral nerve injury,dorsal root ganglion(DRG) neurons mobilize a pro-regenerative gene expression program,which facilitates axon outgrowth.
基金supported by the National Natural Science Foundation of China,No.82201568(to QQ)Capital’s Funds for Health Improvement and Research,No.2024-2-1031(to QQ)Beijing Nova Program,No.20240484566(to QQ).
文摘Synapses are key structures involved in transmitting information in the nervous system,and their functions rely on the regulation of various lipids.Lipids play important roles in synapse formation,neurotransmitter release,and signal transmission,and dysregulation of lipid metabolism is closely associated with various neurodegenerative diseases.The complex roles of lipids in synaptic function and neurological diseases have recently garnered increasing attention,but their specific mechanisms remain to be fully understood.This review aims to explore how lipids regulate synaptic activity in the central nervous system,focusing on their roles in synapse formation,neurotransmitter release,and signal transmission.Additionally,it discusses the mechanisms by which glial cells modulate synaptic function through lipid regulation.This review shows that within the central nervous system,lipids are essential components of the cell membrane bilayer,playing critical roles in synaptic structure and function.They regulate presynaptic vesicular trafficking,postsynaptic signaling pathways,and glial-neuronal interactions.Cholesterol maintains membrane fluidity and promotes the formation of lipid rafts.Glycerophospholipids contribute to the structural integrity of synaptic membranes and are involved in the release of synaptic vesicles.Sphingolipids interact with synaptic receptors through various mechanisms to regulate their activity and are also involved in cellular processes such as inflammation and apoptosis.Fatty acids are vital for energy metabolism and the synthesis of signaling molecules.Abnormalities in lipid metabolism may lead to impairments in synaptic function,affecting information transmission between neurons and the overall health of the nervous system.Therapeutic strategies targeting lipid metabolism,particularly through cholesterol modulation,show promise for treating these conditions.In neurodegenerative diseases such as Alzheimer’s disease,Parkinson disease,and amyotrophic lateral sclerosis,dysregulation of lipid metabolism is closely linked to synaptic dysfunction.Therefore,lipids are not only key molecules in neural regeneration and synaptic repair but may also contribute to neurodegenerative pathology when metabolic dysregulation occurs.Further research is needed to elucidate the specific mechanisms linking lipid metabolism to synaptic dysfunction and to develop targeted lipid therapies for neurological diseases.
基金supported by grants from Simons Foundation (SFARI 479754),CIHR (PJT-180565)the Scottish Rite Charitable Foundation of Canada (to YL)funding from the Canada Research Chairs program。
文摘The mechanistic target of rapamycin(m TOR) is a serine/threonine kinase that plays a pivotal role in cellular growth, proliferation, survival, and metabolism. In the central nervous system(CNS), the mTOR pathway regulates diverse aspects of neural development and function. Genetic mutations within the m TOR pathway lead to severe neurodevelopmental disorders, collectively known as “mTORopathies”(Crino, 2020). Dysfunctions of m TOR, including both its hyperactivation and hypoactivation, have also been implicated in a wide spectrum of other neurodevelopmental and neurodegenerative conditions, highlighting its importance in CNS health.
基金funded by NIH grants HL154720-03S1, AG057587, AG074283, DK122708-03S1, BrightFocus ADR A20183775Brown Foundation 2020 Healthy Aging Initiative (to WC)
文摘Microglia are the macrophages that populate the brain parenchyma.Research in the past decades has identified them as both essential guardians of the brain and significant contributors to various neurological diseases.A highly versatile cell type,microglia have been shown to fulfill a multitude of critical roles in the central nervous system,including facilitating neurogenesis and myelination,pruning synapses,removing debris and waste,modulating neuronal activity,supporting the blood-brain barrier,repairing tissue damage,and surveilling against microbial invasions under physiological conditions(Prinz et al.,2021;Paolicelli et al.,2022).
基金Deutsche Forschungsgemeinschaft(DFG,German Research Foundation),project numbers 324633948 and 409784463(DFG grants Hi 678/9-3 and Hi 678/10-2,FOR2953)to HHBundesministerium für Bildung und Forschung-BMBF,project number 16LW0463K to HT.
文摘Microglia are the resident macrophages of the central nervous system.They act as the first line of defense against pathogens and play essential roles in neuroinflammation and tissue repair after brain insult or in neurodegenerative and demyelinating diseases(Borst et al.,2021).Together with infiltrating monocyte-derived macrophages,microglia also play a critical role for brain tumor development,since immunosuppressive interactions between tumor cells and tumor-associated microglia and macrophages(TAM)are linked to malignant progression.This mechanism is of particular relevance in glioblastoma(GB),the deadliest form of brain cancer with a median overall survival of less than 15 months(Khan et al.,2023).Therefore,targeting microglia and macrophage activation is a promising strategy for therapeutic interference in brain disease.
基金Central High-Level Traditional Chinese Medicine Hospital Project of Eye Hospital China Academy of Chinese Medical Science(No.GSP5-83,No.GSP4-02No.GSP5-06)+1 种基金Supported by National Natural Science Foundation of China(General ProgramNo.82474582).
文摘AIM:To evaluate the therapeutic effects of ranibizumab on optic disc and macular microvascular perfusion in central retinal vein occlusion(CRVO)with macular edema(ME).METHODS:Optical coherence tomography angiology(OCTA)parameters,including optic disc vessel density(VD;including whole-disc VD,intra-disc VD,and peripapillary VD),superficial/deep capillary plexus(SCP/DCP)VD,and central macular thickness(CMT)were analyzed.Additional assessments included best-corrected visual acuity(BCVA)via Early Treatment Diabetic Retinopathy Study(ETDRS)chart and hemorheological profiling.CRVO patients received monthly intravitreal ranibizumab injections for three consecutive months.Pre-and post-treatment parameters were statistically compared.RESULTS:The study comprised 60 CRVO-ME patients(28 males;32 females),aged 50-78y(mean 63.3±7.6y)and 60 age-/sex-matched healthy controls.As compared with participants exhibiting normal funduscopic findings,CRVO patients demonstrated significantly elevated levels of low-shear-rate whole blood viscosity(LSR-WBV),high-shearrate whole blood viscosity(HSR-WBV),and aggregation index(AI,all P<0.05).In CRVO-affected eyes,vertical cupto-disc(C/D)ratio and optic cup volume were significantly smaller,whereas retinal nerve fiber layer(RNFL)thickness was significantly greater,compared to both unaffected contralateral eyes and normal control eyes(all P<0.05).Following treatment,VD of the entire optic disc(P<0.05),intra-disc VD(P<0.05),and peripapillary VD(P<0.05)all increased significantly relative to baseline.CMT decreased significantly(P<0.05),whereas macular SCP-VD and macular DCP-VD showed non-significant slight reductions(P>0.05).At baseline,BCVA of CRVO eyes correlated with whole-disc VD(r=-0.276,P=0.033),intra-disc VD(r=-0.342,P=0.009),and peripapillary VD(r=-0.335,P=0.007),with intra-disc VD demonstrating the strongest association.Besides,BCVA improvement,after the treatment,correlated positively with whole-disc VD(r=0.342,P=0.008)and intradisc VD(r=0.396,P=0.002).CONCLUSION:Optic disc blood perfusion is more closely associated with visual acuity than macular perfusion,suggesting intra-disc VD may serve as a potential biomarker for monitoring visual acuity changes in CRVO.Multiple ranibizumab injections significantly improve optic disc perfusion but may have exerted detrimental effects on the macula.CRVO patients shows higher hemorheological parameters than those with normal fundi.Reduced vertical C/D ratio and optic cup volume may be linked to CRVO incidence,potentially acting as susceptibility factors.
