全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

Challenges and opportunities for battery health estimation:Bridging laboratory research and real-world applications

Addressing climate change demands a significant shift away from fossil fuels,with sectors like electricity and transportation relying heavily on renewable energy.Integral to this transition are energy storage systems,notably lithium-ion batteries.Over time,these batteries degrade,affecting their efficiency and posing safety risks.Monitoring and predicting battery aging is essential,especially estimating its state of health(SOH).Various SOH estimation methods exist,from traditional model-based approaches to machine learning approaches.

Alexa,let's train now!——A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging

Background:There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging.Consequently,the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions.In this context,digital and home-based physical training interventions might be a promising alternative to center-based intervention programs.Thus,this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance.Methods:In this pre-registered systematic review(PROSPERO;ID:CRD42022320031),5 electronic databases(PubMed,Web of Science,Psyclnfo,SPORTDiscus,and Cochrane Library)were searched by 2 independent researchers(FH and PT)to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults.The systematic literature search yielded 8258 records(extra17 records from other sources),of which 27 controlled trials were considered relevant.Two reviewers(FH and PT)independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise(TESTEX scale).Results:Of the 27 reviewed studies,15 reported positive effects on cognitive and motor-cognitive outcomes(i.e.,performance improvements in measures of executive functions,working memory,and choice stepping reaction test),and a considerable heterogeneity concerning study-related,population-related,and intervention-related characteristics was noticed.A more detailed analysis suggests that,in particular,interventions using online classes and technology-based exercise devices(i.e.,step-based exergames)can improve cognitive performance in healthy older adults.Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence(≤85%)and monitoring of the level of regular physical activity in the control group.Conclusion:The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall,though there is limited evidence that specific types of digital and home-based physical training interventions(e.g.,online classes and step-based exergames)can be an effective strategy for improving cognitive performance in older adults.However,due to the limited number of available studies,future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

A Blockchain and CP-ABE Based Access Control Scheme with Fine-Grained Revocation of Attributes in Cloud Health

The Access control scheme is an effective method to protect user data privacy.The access control scheme based on blockchain and ciphertext policy attribute encryption(CP–ABE)can solve the problems of single—point of failure and lack of trust in the centralized system.However,it also brings new problems to the health information in the cloud storage environment,such as attribute leakage,low consensus efficiency,complex permission updates,and so on.This paper proposes an access control scheme with fine-grained attribute revocation,keyword search,and traceability of the attribute private key distribution process.Blockchain technology tracks the authorization of attribute private keys.The credit scoring method improves the Raft protocol in consensus efficiency.Besides,the interplanetary file system(IPFS)addresses the capacity deficit of blockchain.Under the premise of hiding policy,the research proposes a fine-grained access control method based on users,user attributes,and file structure.It optimizes the data-sharing mode.At the same time,Proxy Re-Encryption(PRE)technology is used to update the access rights.The proposed scheme proved to be secure.Comparative analysis and experimental results show that the proposed scheme has higher efficiency and more functions.It can meet the needs of medical institutions.

Report on Cardiovascular Health and Diseases in China 2023:An Updated Summary

Since 1990,China has made considerable progress in resolving the problem of“treatment difficulty”of cardiovascular diseases(CVD).The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors,and this situation is further worsened due to the accelerated aging population in China.CVD remains one of the greatest threats to the health of Chinese residents.In terms of the proportions of disease mortality among urban and rural residents in China,CVD has persistently ranked first.In 2021,CVD accounted for 48.98%and 47.35%of deaths in rural and urban areas,respectively.Two out of every five deaths can be attributed to CVD.To implement a national policy“focusing on the primary health institute and emphasizing prevention”and truly achieve a shift of CVD prevention and treatment from hospitals to communities,the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the“Report on Cardiovascular Health and Diseases in China”annually since 2005.The 2024 report is established based on representative,published,and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys,randomized controlled clinical trials,large sample registry studies,and typical community prevention and treatment cases,along with data from some projects undertaken by the National Center for Cardiovascular Diseases.These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

The First China Sports and Health Conference was Held in Beijing

On May 27,2023,the first China Sports and Health Conference was successfully held in Beijing,which was hosted by the Chinese Preventive Medicine Association(CMPA)and organized by the Capital University of Physical Education and Sports(Beijing Institute for International Olympic Studies)and the Sports and Health Branch of the CMPA.

Shifting the Paradigm:A Fresh Look at Physical Activity Frequency and Its Impact on Mental Health,Life Satisfaction,and Self-Rated Health in Adolescents

As adolescent mental health problems are becoming a more serious issue globally,this paper explores the relationship of physical activity in adolescents and its frequency on mental health as well as examines the mediating effects of life satisfaction and self-rated health in order to provide a reference for the promotion of mental health in adolescents.A sample of 3578 Chinese high school students completed questionnaires assessing their mental health,physical activity frequency,life satisfaction,and self-rated health.The mean SCL-90 value for adolescents was found to be 1.629%,and 24.73%of adolescents had varying degrees of mental health issue.Increased physical activity frequency is positively associated with improved mental health(p<0.001).Additionally,life satisfaction and self-rated health were found to play significant mediating roles in the relationship between physical activity frequency and mental health.Specifically,low-frequency physical activity had the most pronounced mediating effect on mental health through life satisfaction,while high-frequency physical activity exerted the most significant mediating effect on mental health through self-rated health.These findings underscore the importance of promoting physical activity among adolescents and highlight the distinct pathways through which physical activity frequency can influence mental health outcomes.Further research is needed to explore these relationships in diverse populations and settings,as well as to develop targeted intervention.

Public satisfaction with the quality of First Health Facility Services in Indonesia: Does sociodemographic matter?

Objective:To investigate individual characteristics related to satisfaction with the quality of First Health Facility Services(FHFS)in Indonesia.Methods:This cross-sectional study analyzes national representation data.Meanwhile,the study involved 9846 representative respondents in 2019.Respondent’s satisfaction with FHFS based on the five dimensions of service quality(SERVQUAL)is a dependent variable.Independent variables consist of sex,marital status,age,education,employment,insurance ownership,and economics.The study used multivariate logistic regression to explain the relationship between individual characteristics and FSHS quality.Results:77.3%Respondents were satisfied with FHFS,with the highest order of satisfaction dimensions being assurance(59.4%),empathy(57.3%),reliability(53.6%),responsiveness(52.7%),and then tangibility(49.1%).Multivariate logistic analysis showed that divorce was 1.48 more likely than never-married to be satisfied(95%CI 1.17-1.87).Employees were 0.77 less likely than the unemployed to get satisfied(95%CI 0.70-0.86).Respondents with higher education was 0.82 less likely than those with primary education to be satisfied(95%CI 0.67-0.99).Meanwhile,respondents who had government-run insurance were 1.61 more likely than uninsured to be satisfied(95%CI 1.42-1.80).Moreover,the rich were 0.82 less likely than the poor to get satisfied(95%CI 0.73-0.92).Conclusions:Community satisfaction with FHFS is generally high,though some areas could be improved.Demographic factors are still strongly related to satisfaction ratings.The government can assess the quality of services in accordance with standards and disseminate information about service standards for primary facilities to all levels of society,ensuring that service satisfaction is rated as good by all groups.

Effect of health education based on information-motivationbehavioral skills model on patients with unilateral vestibular dysfunction

BACKGROUND Vestibular dysfunction(VH)is a common concomitant symptom of late peri-pheral vestibular lesions,which can be trauma,poisoning,infection,heredity,and neurodegeneration,but about 50%of the causes are unknown.The study uses the information-motivation-behavioral skills(IMB)model for health education,effectively improve the quality of life,increase their self-confidence,reduce anxiety and depression,and effectively improve the psychological state of patients.AIM To explore the effect of health education based on the IMB model on the degree of vertigo,disability,anxiety and depression in patients with unilateral vestibular hypofunction.METHODS The clinical data of 80 patients with unilateral vestibular hypofunction from January 2019 to December 2021 were selected as the retrospective research objects,and they were divided into the control group and the observation group with 40 cases in each group according to different nursing methods.Among them,the control group was given routine nursing health education and guidance,and the observation group was given health education and guidance based on the IMB model.The changes in self-efficacy,anxiety and depression,and quality of life of patients with unilateral VH were compared between the two groups.RESULTS There was no significant difference in General Self-Efficacy Scale(GSES)scale scores between the two groups of patients before nursing(P>0.05),which was comparable;after nursing,the GSES scale scores of the two groups were higher than those before nursing.The nursing group was higher than the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the scores of Hospital Anxiety and Depression Scale(HADS)and anxiety and depression subscales between the two groups before nursing(P>0.05).After nursing,the HADS score,anxiety,and depression subscale scores of the two groups of patients were lower than those before nursing,and the nursing group was lower than the control group,and the difference was statistically significant(P<0.05).After nursing,the Dizziness Handicap Inventory(DHI)scale and DHI-P,DHI-E and DHI-F scores in the two groups were decreased,and the scores in the nursing group were lower than those in the control group,and the difference was statistically significant(P<0.05).CONCLUSION Health education based on the IMB model can effectively improve patients'quality of life,increase self-efficacy of patients with unilateral vestibular hypofunction,enhance patients'confidence,enable patients to resume normal work and life as soon as possible,reduce patients'anxiety and depression,and effectively improve patients'psychological status.

Mental health in the virtual world:Challenges and opportunities in the metaverse era

Current rates of mental illness are worrisome.Mental illness mainly affects females and younger age groups.The use of the internet to deliver mental health care has been growing since 2020 and includes the implementation of novel mental health treatments using virtual reality,augmented reality,and artificial intelligence.A new three dimensional digital environment,known as the metaverse,has emerged as the next version of the Internet.Artificial intelligence,augmented reality,and virtual reality will create fully immersive,experiential,and interactive online environments in the metaverse.People will use a unique avatar to do anything they do in their“real”lives,including seeking and receiving mental health care.In this opinion review,we reflect on how the metaverse could reshape how we deliver mental health treatment,its opportunities,and its challenges.

Parental Educational Expectations,Academic Pressure,and Adolescent Mental Health:An Empirical Study Based on CEPS Survey Data

Background:This study aimed to investigate the relationship between parental educational expectations and adolescent mental health problems,with academic pressure as a moderating variable.Methods:This study was based on the baseline data of the China Education Panel Survey,which was collected within one school year during 2013–2014.It included 19,958 samples from seventh and ninth graders,who ranged from 11 to 18 years old.After removing missing values and conducting relevant data processing,the effective sample size for analysis was 16344.The OLS(Ordinary Least Squares)multiple linear regression analysis was used to examine the relationship between parental educational expectations,academic pressure,and adolescents’mental health problems.In addition,we established an interaction term between parents’educational expectations and academic pressure to investigate the moderating effect of academic stress.Results:The study found that adolescents whose parents had high educational expectations reported less mental health problems.(β=−0.195;p<0.001).Additionally,adolescents who had high academic pressure reported more mental health problems.(β=0.649;p<0.001).Furthermore,the study found that academic pressure had a significant moderating effect on the relationship between parental educational expectations and adolescents’mental health problems(β=0.082;p<0.001).Conclusion:Parental educational expectations had a close relationship with adolescents’mental health problems,and academic pressure moderated this relationship.For those adolescents with high levels of academic pressure,the association between high parental educational expectations and mental health problems became stronger.On the contrary,for those adolescents with low levels of academic pressure,the association between high parental educational expectations and mental health problems became weaker.These findings shed new light on how parental educational expectations affected adolescent mental health problems and had significant implications for their healthy development.

COVID-19 Pandemic Impact on Mental Health in First Year Secondary School Students

Confinement was a helpful measure to avoid virus propagation, but social isolation and the massive closure of face-to face activities in educational institutions, impacted negatively in mental health of students, it increased stress and anxiety in adolescents, affecting their communication skills in this significant step of interpersonal relationships, and the search for their identity. The lockdown in addition to stress and anxiety triggered fear emotions, frustration, worrying and anger, as well as changes in driving energy, diminishing interest and desires. This work aimed to analyze the impact on mental health in first year secondary school adolescents after the COVID-19 pandemic lockdown. Method: Qualitative and phenomenological research, 25 students of first year from a public secondary school of Mexico’s metropolitan area participated in the study;they were girls and boys 12 - 13 years old. Data collection was through a semi-structured interview, testimonials and anecdotes, in two hour sessions, along a week;research team recorded the interviews, testimonials and anecdotes. A signed informed consent was obtained from school authorities, parents and the assent of students. Obtained qualitative data were analyzed according to De Souza Minayo. Results: Four categories emerged with sub-categories. Category 1: Anxiety crisis, sub-categories 1.1. In overcrowded places, 1.2. To speak in public, 1.3. Facing interpersonal relationships with peers. Category 2: Impaired self-concept, sub-categories 2.1. Deficient self-perception, 2.2 Continuous disqualification and 2.3. Deficient personal objectivity. Category 3: Emotions handling, and sub-categories 3.1 Deficient identification of emotions, 3.2 Deficient handling of emotions, 3.3 Maximized emotions. Category 4: Coping strategies, and sub-categories 4.1 Deficient coping strategies, 4.2 Self-injuries, 4.3 Solitude. Conclusion: In early adolescence and in the post-pandemic context tools to face them are insufficient to develop social skills and coping strategies. Lockdown interrupted their socialization process, and their relationships with peers made them anxious and led them to risk behaviors. In this context alternatives to develop significant learning are needed, based on adolescents’ self-awareness highlighting adaptation, communication, emotional intelligence, creative problem solving and resilience skills.

A concept analysis of vicarious resilience in mental health nursing

Objective:The introduction of the vicarious resilience concept in psychology and mental health nursing literature is a highly promising advancement.By utilizing this novel concept,experts in various domains can enhance their comprehension of how to foster resilience in individuals by observing and learning from the resilience of others.This concept analysis aims to elucidate the concept of vicarious resilience in mental health nursing by defining its related attributes,antecedents,and consequences.Methods:Walker and Avant’s strategy for concept analysis method was used.This review specifically examined mental health nurse providers.A comprehensive literature search was performed in the PubMed,Medline,the Cochrane Library,and CINAHL databases.The inclusion criterion was Englishlanguage documents on vicarious resilience within mental health nursing.Results:A total of 24 articles were included.The concept’s attributes were empathy,hope,resourcefulness,awareness,and spirituality.Antecedents were associated with listening to patients’trauma narratives,self-care,self-awareness,and support from colleagues.Consequences were enhanced well-being,changes in life goals,adaptation,personal growth,and increased personal resilience.Currently,there is only one tool in the empirical reference.Conclusion:Interpreting the concept of vicarious resilience in mental health nursing and determining its characteristics can be utilized to design nursing interventions to develop vicarious resilience and enhance the quality of care in mental health facilities.

Effects of methionine supplementation in a reduced protein diet on growth performance, oxidative status, intestinal health, oocyst shedding, and methionine and folate metabolism in broilers under Eimeria challenge

Background This study investigated effects of different methionine(Met)supplementation levels in a reduced protein diet on growth performance,intestinal health,and different physiological parameters in broilers under Eimeria challenge.A total of 600 fourteen-day-old Cobb500 male broilers were challenged with E.maxima,E.tenella,and E.acervulina,and randomly allocated in a 2×5 factorial arrangement.Birds received normal protein diets(20%crude protein,NCP)or reduced protein diets(17%crude protein,LCP),containing 2.8,4.4,6.0,7.6,and 9.2 g/kg of Met.Results On 6 and 9 days post inoculation(DPI),increasing Met level linearly improved the growth performance(P<0.05).Total oocyst shedding linearly increased as Met level increased(P<0.05).Duodenal villus height(VH):crypt depth(CD)in the LCP groups were higher on 6 DPI(P<0.01)while lower on 9 DPI(P<0.05)compared to the NCP groups.Jejunal CD and duodenal VH:CD changed quadratically as Met level increased(P<0.05).On 6 DPI,liver glutathione(GSH)and glutathione disulfide(GSSG)linearly increased as Met level increased(P<0.05).On 9 DPI,GSSG quadratically increased,whereas GSH:GSSG quadratically decreased as Met levels increased(P<0.05).The expression of amino acid transporters linearly decreased as Met level increased(P<0.05).The expression of zonula occludens 2 and claudin-1 linearly increased on 6 DPI whereas decreased on 9 DPI as Met level increased(P<0.05).The expressions of cytokines were lower in the LCP groups than the NCP groups(P<0.05).Interaction effects were found for the expression of IL-10 and TNFαon 6 DPI(P<0.05),where it only changed quadratically in the NCP group as Met level increased.The expression of Met and folate metabolism genes were lower in the LCP groups than the NCP groups on 9 DPI(P<0.05).The expression of these genes linearly or quadratically decreased as Met level increased(P<0.05).Conclusion These results revealed the regulatory roles of Met in different physiological parameters including oxidative status,intestinal health,and nutrient metabolism in birds fed reduced protein diet and challenged with Eimeria.

Health Systems Strengthening to Tackle the Global Burden of Pediatric and Congenital Heart Disease: A Diagonal Approach

1 Background Congenital heart disease(CHD)is the most common major congenital anomaly,affecting approximately one in every 100 live births[1].Among congenital anomalies,66%of preventable deaths are due to CHD,and 58%of the avertable morbidity and mortality due to congenital anomalies would result from scaling congenital heart surgery services[2].Every year,nearly 300,000 children and adults die from CHD,the majority of whom live in low-and middle-income countries(LMICs)[3].Approximately 49%of all individuals with CHD will require surgical or interventional care at some point in their lifetime[4];as a result of advances in access to and the delivery of such services,over 95%of children born with CHD in high-income countries now live into adulthood[3].Here,adults have surpassed children in the number of CHD cases at a ratio of 2:1[5].

Understanding the eff ect of recreational drug use on bone health and musculoskeletal disease in the establishment of pain regimens

BACKGROUND:The widespread use of recreational drugs has raised concerns regarding their eff ects on various organ systems.The use of cannabis and opioids in chronic pain management increases their prevalence among patients with musculoskeletal conditions whose bone health may already be compromised.This article aims to review the pathophysiology and toxic eff ects of recreational drug use on musculoskeletal health to establish appropriate pain regimens for patients with substance use.METHODS:Medical literature published from 1970 until 2022 was identifi ed utilizing MEDLINE/PubMed and the Cochrane Library.In addition to the databases,references were obtained through the use of reference lists of published articles identifi ed by the aforementioned databases.The initial search terms included opioids,inhalants,hallucinogens,cannabis,stimulants,and bone health.There were no methodological limitations in relation to the initial acquisition and analysis of data.RESULTS:A total of 55 research articles were included in this review.Cannabis,stimulants,opioids,and inhalants impact bone maintenance,specifically osteoblast and osteoclast activity,as well as impede hormone production.These substances inhibit bone remodeling and development,manifesting as lower bone mineral density and increased fracture risk in chronic users.CONCLUSION:Although the current literature suggests a deleterious effect of recreational drugs on bone health and musculoskeletal disease,further research is warranted to evaluate the clinical effects of long-term substance use.The evaluation of such effects will aid in establishing appropriate pain regimens,as well as appropriate screening and treatment plans for recreational drug users.

Investigation of the nutritional and functional roles of a combinational use of xylanase and β-glucanase on intestinal health and growth of nursery pigs

Background Xylanase andβ-glucanase combination(XG)hydrolyzes soluble non-starch polysaccharides that are anti-nutritional compounds.This study aimed to evaluate the effects of increasing levels of XG on intestinal health and growth performance of nursery pigs.Methods Forty pigs(6.5±0.4 kg)were assigned to 5 dietary treatments and fed for 35 d in 3 phases(11,9,and 15 d,respectively).Basal diets mainly included corn,soybean meal,and corn distiller's dried grains with solubles,contained phytase(750 FTU/kg),and were supplemented with 5 levels of XG at(1)0,(2)280 TXU/kg xylanase and 125 TGU/kgβ-glucanase,(3)560 and 250,(4)840 and 375,or(5)1,120 and 500,respectively.Growth performance was measured.On d 35,all pigs were euthanized and jejunal mucosa,jejunal digesta,jejunal tissues,and ileal digesta were collected to determine the effects of increasing XG levels and XG intake on intestinal health.Results Increasing XG intake tended to quadratically decrease(P=0.059)viscosity of jejunal digesta(min:1.74 m Pa·s at 751/335(TXU/TGU)/kg).Increasing levels of XG quadratically decreased(P<0.05)Prevotellaceae(min:0.6%at 630/281(TXU/TGU)/kg)in the jejunal mucosa.Increasing XG intake quadratically increased(P<0.05)Lactobacillaceae(max:40.3%at 608/271(TXU/TGU)/kg)in the jejunal mucosa.Increasing XG intake quadratically decreased(P<0.05)Helicobacteraceae(min:1.6%at 560/250(TXU/TGU)/kg)in the jejunal mucosa.Increasing levels of XG tended to linearly decrease(P=0.073)jejunal Ig G and tended to quadratically increase(P=0.085)jejunal villus height to crypt depth ratio(max:2.62 at 560/250(TXU/TGU)/kg).Increasing XG intake tended to linearly increase the apparent ileal digestibility of dry matter(P=0.087)and ether extract(P=0.065).Increasing XG intake linearly increased(P<0.05)average daily gain.Conclusions A combinational use of xylanase andβ-glucanase would hydrolyze the non-starch polysaccharides fractions,positively modulating the jejunal mucosa-associated microbiota.Increased intake of these enzyme combination possibly reduced digesta viscosity and humoral immune response in the jejunum resulting in improved intestinal structure,and ileal digestibility of nutrients,and finally improving growth of nursery pigs.The beneficial effects were maximized at a combination of 550 to 800 TXU/kg xylanase and 250 to 360 TGU/kgβ-glucanase.

Charting the course:India's health expenditure projections for 2035

Objectives Understanding past trends and forecasting future changes in health spending is vital for planning and reducing reliance on out-of-pocket(OOP)expenses.The current study analyzed health expenditure patterns in India and forecasted future trends and patterns until 2035.Methods Data on health expenditure in India from 2000 to 2019 was collected from the Organisation for Economic Co-operation and Development(OECD)iLibrary and National Health Accounts 2019 databases.Gross domestic product(GDP)data from the World Bank was also utilized.Descriptive statistics analyzed the composition and pattern,while the exponential smoothing model forecasted future health expenditures.Results The findings revealed that expenditure made by OOP is the primary health financing source,followed by government and pre-paid private spending.The percentage of GDP allocated to total health expenditure remains stable,while the per capita health expenditure fluctuates.Variations in expenditure among states are observed,with Karnataka relying heavily on pre-paid private coverage.Future projections suggest a decline in per capita and total health expenditure as a share of GDP,with a slight increase in the government’s share.Pre-paid private expenditure per capita and OOP health expenditure as a share of the total is projected to remain relatively constant but still high in absolute terms.Conclusion The study highlights variations in health spending in India,characterized by high OOP spending,limited public coverage,and a need for investments,and reforms to improve healthcare access and equity.

Clinical Analysis and Mental Health Survey of Hemophilia Carriers:a Cross-sectional Study

Objective:Hemophilia carriers(HCs),who are heterozygous for mutations in the clotting factor VIII/clotting factor IX gene(F8 or F9),may have a wide range of clotting factor levels,from very low,similar to afflicted males,to the upper limit of normal,and may experience mental health issues.The purpose of this study was to provide genetic information on mothers of hemophilia patients and to understand the clotting factor activity and phenotype of HCs.Additionally,we aimed to investigate the mental health status of HCs in China.Methods:A total of 127 hemophilia mothers,including 93 hemophilia A(HA)mothers and 34 hemophilia B(HB)mothers,were enrolled in this study.Long distance PCR,multiplex PCR,and Sanger sequencing were used to analyze mutations in F8 or F9.Coagulation factor activity was detected by a one-stage clotting assay.The Symptom Checklist 90(SCL-90,China/Mandarin version)was given to HCs at the same time to assess their mental health.Results:A total of 90.6%of hemophilia mothers were diagnosed genetically as carriers,with inversion in intron 22 and missense mutations being the most common mutation types in HA and HB carriers,respectively.The median clotting factor level in carriers was 0.74 IU/mL(ranging from 0.09 to 1.74 IU/mL)compared with 1.49 IU/mL(ranging from 0.93 to 1.89 IU/mL)in noncarriers,of which 14.3%of HCs had clotting factor levels of 0.40 IU/mL or below.A total of 53.8%(7/13)of HA carriers with low clotting factor levels(less than 0.50 IU/mL)had a history of bleeding,while none of the HB carriers displayed a bleeding phenotype.The total mean score and the global severity index of the SCL-90 for surveyed HCs were 171.00(±60.37)and 1.78(±0.59),respectively.A total of 67.7%of the respondents had psychological symptoms,with obsessive-compulsive disorder being the most prevalent and severe.The pooled estimates of all nine factors were significantly higher than those in the general population(P<0.05).Conclusions:The detection rate of gene mutations in hemophilia mothers was 90.6%,with a median clotting factor level of 0.74 IU/mL,and 14.3%of HCs had a clotting factor level of 0.40 IU/mL or below.A history of bleeding was present in 41.2%of HCs with low clotting factor levels(less than 0.50 IU/mL).Additionally,given the fragile mental health status of HCs in China,it is critical to develop efficient strategies to improve psychological well-being.

Probiotic cocktails accelerate baicalin metabolism in the ileum to modulate intestinal health in broiler chickens

Background Baicalin and probiotic cocktails are promising feed additives with broad application prospects.While probiotic cocktails are known to enhance intestinal health,the potential synergistic impact of combining baicalin with probiotic cocktails on the gut health of broiler chickens remains largely unexplored.Therefore,this study aims to investigate the influence of the combined administration of baicalin and probiotic cocktails on the composition of ileal and cecal microbiota in broiler chickens to elucidate the underlying mechanisms responsible for the healthpromoting effects.Results A total of 3201-day-old male Arbor Acres broilers were divided into 4 groups,each with 8 replicates of 10 chicks per replicate.Over a period of 42 d,the birds were fed a basal diet or the same diet supplemented with 37.5 g/t baicalin(BC),1,000 g/t probiotic cocktails(PC),or a combination of both BC(37.5 g/t)and PC(1,000 g/t).The results demonstrated that BC+PC exhibited positive synergistic effects,enhancing intestinal morphology,immune function,and barrier function.This was evidenced by increased VH/CD ratio,sIgA levels,and upregulated expression of occludin and claudin-1(P<0.05).16S rRNA analysis indicated that PC potentiated the effects of BC,particularly in the ileum,where BC+PC significantly increased theα-diversity of the ileal microbiota,altered itsβ-diversity,and increased the relative abundance of Flavonifractor(P<0.05),a flavonoid-metabolizing bacterium.Furthermore,Flavonifractor positively correlated with chicken ileum crypt depth(P<0.05).While BC+PC had a limited effect on cecal microbiota structure,the PC group had a very similar microbial composition to BC+PC,suggesting that the effect of PC at the distal end of the gut overshadowed those of BC.Conclusions We demonstrated the synergistic enhancement of gut health regulation in broiler chickens by combining baicalin and probiotic cocktails.Probiotic cocktails enhanced the effects of baicalin and accelerated its metabolism in the ileum,thereby influencing the ileal microbiota structure.This study elucidates the interaction mechanism between probiotic cocktails and plant extract additives within the host microbiota.These findings provide compelling evidence for the future development of feed additive combinations.