Associations of centralization with health care quality for gastric cancer patients receiving gastrectomy in China

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.

AS-Level Internet Macroscopic Topology Centralization Evolvement Analysis

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.

Centralization and perceived control of COVID-19 during the pandemic:A cross-sectional study

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.

Local government centralization and corporate ESG performance:Evidence from China’s county-to-district reform

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.

Study on Concept of Centralization and Decentralization Group Decision Making

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.

The future of artificial hibernation medicine:protection of nerves and organs after spinal cord injury

Spinal cord injury is a serious disease of the central nervous system involving irreversible nerve injury and various organ system injuries.At present,no effective clinical treatment exists.As one of the artificial hibernation techniques,mild hypothermia has preliminarily confirmed its clinical effect on spinal cord injury.However,its technical defects and barriers,along with serious clinical side effects,restrict its clinical application for spinal cord injury.Artificial hibernation is a futureoriented disruptive technology for human life support.It involves endogenous hibernation inducers and hibernation-related central neuromodulation that activate particular neurons,reduce the central constant temperature setting point,disrupt the normal constant body temperature,make the body adapt"to the external cold environment,and reduce the physiological resistance to cold stimulation.Thus,studying the artificial hibernation mechanism may help develop new treatment strategies more suitable for clinical use than the cooling method of mild hypothermia technology.This review introduces artificial hibernation technologies,including mild hypothermia technology,hibernation inducers,and hibernation-related central neuromodulation technology.It summarizes the relevant research on hypothermia and hibernation for organ and nerve protection.These studies show that artificial hibernation technologies have therapeutic significance on nerve injury after spinal co rd injury through inflammatory inhibition,immunosuppression,oxidative defense,and possible central protection.It also promotes the repair and protection of res pirato ry and digestive,cardiovascular,locomoto r,urinary,and endocrine systems.This review provides new insights for the clinical treatment of nerve and multiple organ protection after spinal cord injury thanks to artificial hibernation.At present,artificial hibernation technology is not mature,and research fa ces various challenges.Neve rtheless,the effort is wo rthwhile for the future development of medicine.

Advantages of nanocarriers for basic research in the field of traumatic brain injury

A major challenge for the efficient treatment of traumatic brain injury is the need for therapeutic molecules to cross the blood-brain barrier to enter and accumulate in brain tissue.To overcome this problem,researchers have begun to focus on nanocarriers and other brain-targeting drug delivery systems.In this review,we summarize the epidemiology,basic pathophysiology,current clinical treatment,the establishment of models,and the evaluation indicators that are commonly used for traumatic brain injury.We also report the current status of traumatic brain injury when treated with nanocarriers such as liposomes and vesicles.Nanocarriers can overcome a variety of key biological barriers,improve drug bioavailability,increase intracellular penetration and retention time,achieve drug enrichment,control drug release,and achieve brain-targeting drug delivery.However,the application of nanocarriers remains in the basic research stage and has yet to be fully translated to the clinic.

Role of CD36 in central nervous system diseases

CD36 is a highly glycosylated integral membrane protein that belongs to the scavenger receptor class B family and regulates the pathological progress of metabolic diseases.CD36 was recently found to be widely expressed in various cell types in the nervous system,including endothelial cells,pericytes,astrocytes,and microglia.CD36 mediates a number of regulatory processes,such as endothelial dysfunction,oxidative stress,mitochondrial dysfunction,and inflammatory responses,which are involved in many central nervous system diseases,such as stroke,Alzheimer’s disease,Parkinson’s disease,and spinal cord injury.CD36 antagonists can suppress CD36 expression or prevent CD36 binding to its ligand,thereby achieving inhibition of CD36-mediated pathways or functions.Here,we reviewed the mechanisms of action of CD36 antagonists,such as Salvianolic acid B,tanshinone IIA,curcumin,sulfosuccinimidyl oleate,antioxidants,and small-molecule compounds.Moreover,we predicted the structures of binding sites between CD36 and antagonists.These sites can provide targets for more efficient and safer CD36 antagonists for the treatment of central nervous system diseases.

STUDY ON THE CENTRALIZATION STRATEGY OF THE BLOOD ALLOCATION AMONG DIFFERENT DEPARTMENTS WITHIN A HOSPITAL

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.

Geochronology and Geochemistry of the Xingxingxia Triassic A-type Granites in Central Tianshan,NW China:Petrogenesis and Tectonic Implications

The Triassic granitoids in Central Tianshan play a key role in determining the petrogenesis and tectonic evolution on the southern margin of the Central Asian orogenic belt.In this study,we present SHRIMP zircon U-Pb ages,Hf isotopic and geochemical data on the Xingxingxia biotite granite,amazonite granite and granitic pegmatite in Central Tianshan,NW China.Zircon U-Pb dating yielded formation ages of 242 Ma for the biotite granite and 240 Ma for the amazonite granite.These granitoid rocks have high K_(2)O with low MgO and CaO contents.They are enriched in Nb,Ta,Hf and Y,while being depleted in Ba and Sr,showing flat HREE patterns and negative Eu anomalies.They have typical A-type granite geochemical signatures with high Ga/A_(1)(8–13)and TFeO/(TFeO+MgO)ratios,showing an A_(2) affinity for biotite granite and an A_(1) affinity for amazonite granite and granitic pegmatite.Zircon ε_(Hf)(t)values of the granitoids are 0.45–2.66,with Hf model ages of 0.99–1.17 Ga.This suggests that these A-type granites originated from partial melting of the lower crust.We propose that Xingxingxia Triassic A-type granites formed under lithospheric extension from post-orogenic to anorogenic intraplate settings and NE-trending regional strike-slip fault-controlled magma emplacement in the upper crust.

Petroleum geological characteristics and exploration targets of the oil-rich sags in the Central and West African Rift System

Based on seismic,drilling,and source rock analysis data,the petroleum geological characteristics and future exploration direction of the oil-rich sags in the Central and West African Rift System(CWARS)are discussed.The study shows that the Central African Rift System mainly develops high-quality lacustrine source rocks in the Lower Cretaceous,and the West African Rift System mainly develops high-quality terrigenous organic matter-rich marine source rocks in the Upper Cretaceous,and the two types of source rocks provide a material basis for the enrichment of oil and gas in the CWARS.Multiple sets of reservoir rocks including fractured basement and three sets of regional cap rocks in the Lower Cretaceous,the Upper Cretaceous,and the Paleogene are developed in the CWARS.Since the Late Mesozoic,due to the geodynamic factors including the dextral strike-slip movement of the Central African Shear Zone,the basins in different directions of the CWARS differ in terms of rifting stages,intervals of regional cap rocks,trap types and accumulation models.The NE-SW trending basins have mainly preserved one stage of rifting in the Early Cretaceous,with regional cap rocks developed in the Lower Cretaceous strata,forming traps of reverse anticlines,flower-shaped structures and basement buried hill,and two types of hydrocarbon accumulation models of"source and reservoir in the same formation,and accumulation inside source rocks"and"up-source and down-reservoir,and accumulation below source rocks".The NW–SE basins are characterized by multiple rifting stages superimposition,with the development of regional cap rocks in the Upper Cretaceous and Paleogene,forming traps of draping anticlines,faulted anticlines,antithetic fault blocks and the accumulation model of"down-source and up-reservoir,and accumulation above source rocks".The combination of reservoir and cap rocks inside source rocks of basins with multiple superimposed rifting stages,as well as the lithologic reservoirs and the shale oil inside source rocks of strong inversion basins are important fields for future exploration in basins of the CWARS.

Central Asia revealed as a key area in evolution of Eremurus (Asphodelaceae)

Eremurus was described at the beginning of the 19th century.However,due to limited sampling and the small number of gene markers to date,its phylogeny and evolution are largely unknown.In this study,we analyzed plastomes from 27 species belonging to 2 subgenera and 3 sections of Eremurus,which are found in Central Asia(its center of diversity)and China.We also analyzed nuclear DNA ITS of 33 species,encompassing all subgenera and sections of the genus in Central Asia,southwest Asia and China.Our findings revealed that the genus was monophyletic,although both subgenera Eremurus and Henningia were found to be paraphyletic.Both plastome and nrDNA-based phylogenetic trees had three clades that did not reflect the current taxonomy of the genus.Our biogeographical and time-calibrated trees suggest that Eremurus originated in the ancient Tethyan area in the second half of the Eocene.Diversification of Eremurus occurred from the early Oligocene to the late Miocene.Paratethys Sea retreat and several orogenetic events,such as the progressive uplift of the Qinghai-Tibet Plateau and surrounding mountain belts(Altai,Pamir,Tian Shan),caused serious topographic and climate(aridification)changes in Central Asia that may have triggered a split of clades and speciation.In this transformed Central Asia,speciation proceeded rapidly driven mainly by vicariance caused by numerous mountain chains and specialization to a variety of climatic,topographic and soil conditions that exist in this region.

The Global Energy and Water Exchanges(GEWEX)Project in Central Asia:The Case for a Regional Hydroclimate Project

Central Asia consists of the former Soviet Republics,Kazakhstan,Kyrgyz Republic,Tajikistan,Turkmenistan,and Uzbekistan.The region’s climate is continental,mostly semi-arid to arid.Agriculture is a significant part of the region’s economy.By its nature of intensive water use,agriculture is extremely vulnerable to climate change.Population growth and irrigation development have significantly increased the demand for water in the region.Major climate change issues include melting glaciers and a shrinking snowpack,which are the foundation of the region’s water resources,and a changing precipitation regime.Most glaciers are located in Kyrgyzstan and Tajikistan,leading to transboundary water resource issues.Summer already has extremely high temperatures.Analyses indicate that Central Asia has been warming and precipitation might be increasing.The warming is expected to increase,but its spatial and temporal distribution depends upon specific global scenarios.Projections of future precipitation show significant uncertainties in type,amount,and distribution.Regional Hydroclimate Projects(RHPs)are an approach to studying these issues.Initial steps to develop an RHP began in 2021 with a widely distributed online survey about these climate issues.It was followed up with an online workshop and then,in 2023,an in-person workshop,held in Tashkent,Uzbekistan.Priorities for the Global Energy and Water Exchanges(GEWEX)project for the region include both observations and modeling,as well as development of better and additional precipitation observations,all of which are topics for the next workshop.A well-designed RHP should lead to reductions in critical climate uncertainties in policy-relevant timeframes that can influence decisions on necessary investments in climate adaptation.

Assessment of Wet Season Precipitation in the Central United States by the Regional Climate Simulation of the WRFG Member in NARCCAP and Its Relationship with Large-Scale Circulation Biases

Assessment of past-climate simulations of regional climate models(RCMs)is important for understanding the reliability of RCMs when used to project future regional climate.Here,we assess the performance and discuss possible causes of biases in a WRF-based RCM with a grid spacing of 50 km,named WRFG,from the North American Regional Climate Change Assessment Program(NARCCAP)in simulating wet season precipitation over the Central United States for a period when observational data are available.The RCM reproduces key features of the precipitation distribution characteristics during late spring to early summer,although it tends to underestimate the magnitude of precipitation.This dry bias is partially due to the model’s lack of skill in simulating nocturnal precipitation related to the lack of eastward propagating convective systems in the simulation.Inaccuracy in reproducing large-scale circulation and environmental conditions is another contributing factor.The too weak simulated pressure gradient between the Rocky Mountains and the Gulf of Mexico results in weaker southerly winds in between,leading to a reduction of warm moist air transport from the Gulf to the Central Great Plains.The simulated low-level horizontal convergence fields are less favorable for upward motion than in the NARR and hence,for the development of moist convection as well.Therefore,a careful examination of an RCM’s deficiencies and the identification of the source of errors are important when using the RCM to project precipitation changes in future climate scenarios.

Metabolic reprogramming of the inflammatory response in the nervous system:the crossover between inflammation and metabolism

Metabolism is a fundamental process by which biochemicals are broken down to produce energy(catabolism) or used to build macromolecules(anabolism). Metabolism has received renewed attention as a mechanism that generates molecules that modulate multiple cellular responses. This was first identified in cancer cells as the Warburg effect, but it is also present in immunocompetent cells. Studies have revealed a bidirectional influence of cellular metabolism and immune cell function, highlighting the significance of metabolic reprogramming in immune cell activation and effector functions. Metabolic processes such as glycolysis, oxidative phosphorylation, and fatty acid oxidation have been shown to undergo dynamic changes during immune cell response, facilitating the energetic and biosynthetic demands. This review aims to provide a better understanding of the metabolic reprogramming that occurs in different immune cells upon activation, with a special focus on central nervous system disorders. Understanding the metabolic changes of the immune response not only provides insights into the fundamental mechanisms that regulate immune cell function but also opens new approaches for therapeutic strategies aimed at manipulating the immune system.

Crosstalk among mitophagy,pyroptosis,ferroptosis,and necroptosis in central nervous system injuries

Central nervous system injuries have a high rate of resulting in disability and mortality;however,at present,effective treatments are lacking.Programmed cell death,which is a genetically determined fo rm of active and ordered cell death with many types,has recently attra cted increasing attention due to its functions in determining the fate of cell survival.A growing number of studies have suggested that programmed cell death is involved in central nervous system injuries and plays an important role in the progression of brain damage.In this review,we provide an ove rview of the role of programmed cell death in central nervous system injuries,including the pathways involved in mitophagy,pyroptosis,ferroptosis,and necroptosis,and the underlying mechanisms by which mitophagy regulates pyroptosis,ferroptosis,and necro ptosis.We also discuss the new direction of therapeutic strategies to rgeting mitophagy for the treatment of central nervous system injuries,with the aim to determine the connection between programmed cell death and central nervous system injuries and to identify new therapies to modulate programmed cell death following central nervous system injury.In conclusion,based on these properties and effects,interventions targeting programmed cell death could be developed as potential therapeutic agents for central nervous system injury patients.

End-group modulation of phenazine based non-fullerene acceptors for efficient organic solar cells with high open-circuit voltage

Phenazine-based non-fullerene acceptors(NFAs)have demonstrated great potential in improving the power conversion efficiency(PCE)of organic solar cells(OSCs).Halogenation is known to be an effective strategy for increasing optical absorption,refining energy levels,and improving molecular packing in organic semiconductors.Herein,a series of NFAs(Pz IC-4H,Pz IC-4F,Pz IC-4Cl,Pz IC-2Br)with phenazine as the central core and with/without halogen-substituted(dicyanomethylidene)-indan-1-one(IC)as the electron-accepting end group were synthesized,and the effect of end group matched phenazine central unit on the photovoltaic performance was systematically studied.Synergetic photophysical and morphological analyses revealed that the PM6:Pz IC-4F blend involves efficient exciton dissociation,higher charge collection and transfer rates,better crystallinity,and optimal phase separation.Therefore,OSCs based on PM6:Pz IC-4F as the active layer exhibited a PCE of 16.48%with an open circuit voltage(Voc)and energy loss of 0.880 V and 0.53 e V,respectively.Accordingly,this work demonstrated a promising approach by designing phenazine-based NFAs for achieving high-performance OSCs.

Microglia lactylation in relation to central nervous system diseases

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.

April-September minimum temperature reconstruction based on Sabina tibetica ring-width chronology in the central eastern Tibetan Plateau,China

Minimum temperatures have remarkable impacts on tree growth at high-elevation sites on the Tibetan Plateau,but the shortage of long-term and high-resolution paleoclimate records inhibits understanding of recent minimum temperature anomalies.In this study,a warm season(April–September)reconstruction is presented for the past 467 years(1550–2016)based on Sabina tibetica ring-width chronology on the Lianbaoyeze Mountain of the central eastern Tibetan Plateau.Eight warm periods and eight cold periods were identified.Long-term minimum temperature variations revealed a high degree of coherence with nearby reconstructions.Spatial correlations between our reconstruction and global sea surface temperatures suggest that warm season minimum temperature anomalies in the central eastern Tibetan Plateau were strongly influenced by large-scale ocean atmospheric circulations,such as the El Ni?o-Southern Oscillation and the Atlantic Multidecadal Oscillation.