Search Results (2,170)

Objectives: Patients with rare diseases in China face extremely high medical expenses. The current coverage framework remains inadequate in terms of coverage depth and proactive risk control, underscoring an urgent need for institutional reform. Methods: This study employs a policy content analysis approach to review the current landscape of rare disease protection in China. Drawing on risk management theory and the health capital model, it constructs an analytical framework to examine potential institutional reforms through the lens of risk response pathways and the efficiency of health investment. Results: The findings reveal that basic medical insurance (BMI) provides limited financial protection for patients with rare diseases. Among China’s 31 provincial-level administrative centers, 24 have set general outpatient reimbursement ceilings under the urban and rural resident basic medical insurance (URRBMI) at 1000 RMB or less. In comparison, 24 cities have set outpatient reimbursement limits under the urban employee basic medical insurance (UEBMI) at 6000 RMB or less. The security system relies predominantly on the BMI, while supplementary mechanisms have failed to provide effective support or continuity in coverage. Current policies are generally reactive, with coverage typically triggered only after a confirmed diagnosis and often lacking early intervention or preventive strategies. Conclusions: China’s rare disease security system urgently requires structural improvements in coverage depth and proactive risk management. The proposed Dedicated Insurance Scheme for Rare Diseases (DISRD) presents a feasible and sustainable model for China’s multi-tiered system of securing rare diseases. It provides valuable institutional insights for other countries and regions seeking to build public health systems with proactive risk control capabilities. Full article

Background: Fungicide resistance is one of the major factors threatening social and ecological sustainability. Many issues associated with the evolutionary processes and mechanisms of fungicide resistance in pathogens remain poorly understood, and better knowledge of these issues through experimentally observing the rise and fall of the resistance is critical for the development of effective management strategies to ensure food security and ecological health. Methods: An experimental evolution approach was used to continuously acclimate a series of Phytophthora infestans populations under different mancozeb conditions for 400 consecutive days. Results: We found that P. infestans developed mancozeb resistance after 200 days of acclimation. This resistance was associated with ABC transporters and endocytic proteins. Potentially due to fitness costs associated with aggressiveness, mancozeb resistance was reversible. And the pathogen exhibited comparable rates of resistance gain during acclimation and resistance loss during the reversal experiment. Conclusions: Our results suggest that this pathogen may also develop resistance to mancozeb. However, this type of resistance may not be persistent, implying the fungicides concerned could be reused in practice. These results provide new insights into the evolution of fungicide resistance and sustainable plant disease chemical management based on the fungicide dose chosen beyond that of potato blight, warranting further study on the resistance target gene. Full article

Against the backdrop of carbon reduction and sustainable development, cities play a central role in carbon emissions. These emissions are interconnected through economic, demographic, technological, and other factors, forming a complex network. This study investigates the structural characteristics and driving factors of carbon emission linkages among Chinese cities, with the aim of providing theoretical support and practical guidance for the development of sound regional carbon reduction policies. An improved gravity model was used to measure both the presence and intensity of linkages between cities. Social Network Analysis (SNA) was applied to examine network features such as density, centrality, and hierarchical structure. In addition, the Quadratic Assignment Procedure (QAP) was employed to test the effects of geographical proximity, economic disparities, demographic differences, and technological gaps on carbon emission linkages. Based on these methods, the study constructs the Chinese Carbon Emission Correlation Network (CECN), which shows high connectivity, a clear hierarchical structure, and a strengthened role of core cities. Cities with extensive linkages are mainly located in the eastern coastal region and political centers, forming a spatial pattern with stronger connections in the east than in the west, and more along the coast than inland. The network can also be divided into five distinct sub-groups. Moreover, geographical proximity, population differences, economic affluence, and technological disparities were found to significantly shape the spatial correlation of carbon emissions. These findings offer valuable guidance for designing targeted carbon reduction policies, which are essential for fostering regional coordination and advancing sustainable urban development. Full article

Marsh wetland degradation and shrub expansion, driven by human activities and climate change, can impact carbon, nitrogen, and sulfur cycles by soil microorganisms. There is a paucity of systematic and in-depth research on the impact of shrub expansion in temperate wetlands on soil element cycles, which is a pressing scientific issue that demands resolution. This study used metagenomic sequencing and soil analysis methods to investigate the impact of shrub expansion in the Sanjiang Plain wetlands on carbon, nitrogen, and sulfur cycles in temperate wetland soils, as well as on functional microbial communities. Shrub expansion significantly altered soil carbon, nitrogen, and sulfur cycle processes and the composition (β diversity) of associated functional microbial communities, despite minimal changes in overall α diversity. Significant shifts occurred in the abundance of cycle pathways and related functional genes. Ammonia nitrogen, moisture, and total phosphorus were identified as the primary factors influencing these cycles and the functional microbial communities. Changes in the abundance of specific cycling pathways following shrub expansion are key drivers of functional community structure transformation. These changes may significantly reduce the long-term carbon sequestration potential of wetlands and affect regional climate feedback by altering greenhouse gas fluxes. The findings provide a theoretical basis for managing shrub expansion and assessing wetland function. Full article

African Swine Fever (ASF) reached the island of Borneo at the end of 2020. The first mortalities were recorded in wild bearded pigs (Sus barbatus) in Sabah, north-east Borneo. The virus then began to spread across the island but due to COVID-19 lockdowns the spread was difficult to monitor on the ground. With the urgent need to track this epidemic, and in the absence of traditional monitoring, the Babi Hutan Project was launched in April 2021 to gather data on pig sightings using citizen science. Any sightings of bearded pigs were requested via the website, social media and a WhatsApp hotline. Here we bring together the data from this project and other online sources to show how the virus spread across almost the entire island within a one-year period. The speed of spread appeared to increase with time following an exponential model: we estimate an average speed of spread of 0.89 km/day after 100 days since the first observation and at 4.28 km/day after 400 days. Our key recommendations are: that existing hunting bans on bearded pigs remain in place; that urgent biosecurity measures should be put in place if outbreaks occur in areas with backyard (domestic) pigs; that surviving pigs are tested for resistance; that the disease dynamics are modelled and that the International Union for Conservation of Nature (IUCN) urgently re-evaluates the bearded pig’s status. Full article

With the increasing global demand for sustainable building materials, coal gangue, as a potential supplementary cementitious material (SCM), has attracted widespread attention. Coal gangue is primarily composed of clay minerals, among which the kaolinite content can significantly enhance its cementitious properties after activation. However, there are various grades of coal gangues, which restrain their application, especially for the low kaolinite content coal gangue. This paper investigates the feasibility of using iron-rich coal gangue with low kaolinite content as a cement substitute through high-temperature activation treatment. In the current study, activated coal gangue replaced cement clinker at proportions of 10%, 15%, and 20%, which was further mixed with limestone powder to form a new cementitious material system. The mechanical attributes of the systems were assessed using compressive strength and microhardness tests. The influence of hydration products and microstructural changes on system performance was further explored through electrochemical impedance spectroscopy (EIS) and quantitative X-ray diffraction (XRD) analysis. The findings suggest that a well-balanced addition of coal gangue can effectively substitute for cement clinker, thereby enhancing both the mechanical properties and microstructure of the systems. These results demonstrate that through appropriate activation treatments, coal gangue can be utilized as an effective SCM. While traditional SCMs like fly ash (FA) and ground granulated blast-furnace slag (GGBFS) have near-zero allocated carbon footprints, their global supply is diminishing and increasingly unreliable. In contrast, our approach valorizes a vast industrial waste stream, aligning with circular economy principles and offering a scalable, sustainable, and low-carbon alternative for the construction industry. Full article

Background: The pathophysiology of epilepsy is characterized by increased neuronal activity due to an excess of the excitatory neurotransmitter glutamate and a deficiency in the inhibitory neurotransmitter gamma–aminobutyric acid (GABA). Epilepsy presents with seizures, neuronal loss, and hyperactivity in the subthalamic nucleus (STN). Astrocytes play a crucial role by absorbing extracellular glutamate through glutamate transporter–1 (GLT–1), thereby reducing neuronal excitation. Upregulating the expression of astrocytic GLT–1 is a promising therapeutic strategy for epilepsy. Sulbactam (SUL), a β–lactam antibiotic, has been demonstrated to exert neuroprotective effects by upregulating GLT–1 expression. Objectives: This study investigated the impact of SUL on neuronal and behavioral changes in epilepsy by using a pentylenetetrazol (PTZ)-induced rat model of epilepsy. Methods: Rats were treated with saline, SUL (50 and 150 mg/kg), or a combination of SUL and the GLT–1 blocker dihydrokainate (DHK) for 20 days. Subsequently, behavioral tasks were conducted to assess recognition, anxiety, and memory. Results: Histological analyses revealed that SUL ameliorated neuronal deficits, increased astrocytic GLT–1 expression, and reduced hyperactivity in the STN. Additionally, SUL promoted astrocyte proliferation, indicating a new dimension of its neuroprotective properties. However, the beneficial effects of SUL were prevented by DHK. Conclusions: This pioneering study highlights multiple benefits of SUL, including seizure suppression, increased GLT–1 expression, and astrocyte proliferation, underscoring its high potential as a treatment for epilepsy. Full article

Both feeling and thought operate largely through a process of associations. Some of these are learned; some seem to be transcultural. In Western art it has long been assumed that certain arrangement of sounds, shapes, and colors evoke particular emotions and ideas. Rudolph Otto applies this idea also to the experience of the “Holy,” the “mysterium tremendum et fascinans.” This is a unique experience, irreducible to any other. However, there is a “law of associations” by which aesthetic and moral experiences evoke the “numinous” by a kind of analogy. Otto’s analysis raises the question whether there is in fact a specific experience of “the holy.” Is religious consciousness a sui generis experience, or is it rather an interpretation of experience? Is Otto’s notion of the numinous tied to a particular stage of religion? Post-Kantian transcendental theology proposes that “depth” or “limit” experiences are implicit in consciousness, and provide the basis for a variety of associations with the ultimate mystery of existence. The divine is anticipated as infinite transcendence that is at the same time radical immanence. The implicit intentionality of the divine can be implicit or can be formulated at different levels as feeling, image, concept, and transcendental intentionality. The “sacred” is an aesthetic construct signifying heightened awareness of the mystery. Sacred spaces are places consecrated to such awareness; they can be constructed in response to various aspects of communal awareness. All such aesthetic mediations of the sacred have an ambiguous relation to religious conversion. Full article

Against the backdrop of green and sustainable development, green innovation has become a central issue of concern for both society and academia. Based on regional innovation system and network theories, this study conceptualizes the urban knowledge base as a network structure rather than a simple collection of isolated knowledge elements. Using green patent licensing data, a multi-layer network is constructed, and the Exponential Random Graph Model (ERGM) is employed to examine the impact of urban knowledge network structures on city-level innovation diffusion. The study finds that in the green ICT field, cities’ deep embedding in knowledge networks weakens their ability to absorb external innovations, while broad embedding facilitates the introduction of external innovations. In the green transportation field, deep embedding in knowledge networks enhances the absorption of external innovations, whereas broad embedding has no significant effect. In both fields, knowledge combination potential and knowledge uniqueness promote the outward diffusion of local innovations but weaken the inflow of external innovations. This study not only offers theoretical insights into innovation diffusion at the city level but also provides guidance for policymakers in developing targeted urban sustainable development strategies. Full article

Soil desertification control is a global challenge, and the barrenness of sandy soil limits the growth of plants. To enhance the vegetation growth capacity of sandy soils, the preparation of soil amendments and the experiment of improving desertified soil were conducted. The soil amendment is prepared by mixing polyacrylamide (2.7%), biochar (16.2%), sodium bentonite (16.2%), straw fibers (5.4%), corn straw (2.7%), sheep manure organic fertilizer (54.1%), and composite microbial agents (2.7%). The laboratory experiment was conducted to investigate the effects of varying rates (0, 1.5%, 3%, 4.5%, 6%) of composite soil amendments on the properties of sandy soil and the Lolium perenne L. with a growth period of 30–60 days. The results indicated that the application of composite amendments at different rates maintained the soil pH between 7.0 and 7.5, increased the electrical conductivity, and significantly improved the soil moisture content, soil organic carbon (SOC), total nitrogen (TN), and total phosphorus contents. Under the condition of 3% amendment, the soil TN content increased from 0.74 to 1.83 g·kg⁻¹. The composite amendments remarkably promoted L. perenne growth, as evidenced by increased plant height, dry weight, and nitrogen and phosphorus nutrient content, while the SOC content increased by 1–4 times. The application of composite amendments, prepared by mixing materials such as biochar, organic fertilizer, crop straw, microbial agents, bentonite, and water-retaining agents, enhanced the physicochemical properties of sandy soil and promoted L. perenne growth, and 3% was the most suitable application rate. These findings are expected to advance desertification-controlling technologies and enhance soil carbon sequestration capacity. Full article

Autologous platelet-rich plasma (PRP) has emerged as a promising regenerative therapy in various medical fields, including the treatment of stress urinary incontinence (SUI) in women. PRP promotes regeneration by delivering a concentrated dose of platelets to damaged tissues, triggering healing mechanisms such as hemostasis, revascularization, and connective tissue regeneration through the release of growth factors. Despite evidence supporting the short- and medium-term benefits of PRP, its long-term efficacy remains unclear, largely due to the limited duration of follow-up in existing studies. Furthermore, the lack of standardized protocols for both preparation and administration of PRP poses a significant challenge to accurately assessing and comparing its sustained therapeutic outcomes. This literature review utilized comprehensive searches of PubMed and Google Scholar databases to analyze current evidence regarding PRP’s role in managing SUI in women. SUI, often resulting from weakened pubo-urethral ligament or intrinsic sphincter dysfunction due to childbirth, aging, or hormonal changes, significantly impacts quality of life. PRP offers a safe, minimally invasive, and cost-effective treatment option; however, further large-scale, well-designed studies are necessary to define optimal protocols and confirm long-term benefits. Advancing understanding of PRP therapy could substantially improve clinical management and patient quality of life in SUI. Full article

Brucella infection is associated with an increased risk of adverse obstetric outcomes in humans and animals. Decidualization, a process involving structural and functional changes in endometrial stromal cells, is essential for proper trophoblast implantation and placental development. Trophoblasts’ migration and their ability to invade the decidua and to undergo tubulogenesis, critical for proper implantation and placental development, are normally promoted by decidual cells. We evaluated whether Brucella infection of human endometrial stromal cells (T-HESC cell line) affects their ability to decidualize and to promote trophoblast functions. Infection of T-HESC cells with either B. abortus, B. suis, or B. melitensis resulted in deficient decidualization (as revealed by reduced prolactin levels) and an increased production of proinflammatory chemokines (C-X-C motif chemokine ligand 8 -CXCL8- and C-C motif chemokine ligand 2 -CCL2-) as compared to uninfected cells subjected to decidualization stimuli. In addition, conditioned media (CM) from infected decidualized T-HESC induced an inflammatory response (CXCL8, CCL2 and interleukin-6 -IL-6) in human trophoblasts (Swan-71 cell line) but reduced their ability to produce progesterone. Trophoblasts preincubated with this CM also had reduced migration, invasion, and tubulogenesis capacities, and this impairment was mediated, at least in part, by CXCL8 and CCL2. Moreover, infection of decidual stromal cells impaired the adhesion and spreading of blastocyst-like spheroids formed by Swan-71 cells. Brucella infection also affected the chemotactic capacity of decidual stromal cells for trophoblasts. Overall, these results suggest that Brucella infection of endometrial stromal cells impairs key processes required for successful implantation and placental development. Full article

TIFY transcription factors play crucial regulatory roles in secondary metabolism and stress response. However, the expression patterns of the Cannabis sativa L. TIFY gene family under alkali stress, their involvement in cannabinoid metabolism, and their underlying genetic evolutionary mechanisms remain largely unexplored. In this study, we used bioinformatics approaches to conduct genome-wide identification and functional characterization of the C. sativa TIFY gene family. Fourteen TIFY genes were identified and mapped onto seven chromosomes. These genes were classified into four subfamilies: TIFY, JAZ, ZML, and PPD, with the JAZ subfamily further subdivided into five distinct branches. Collinearity analysis suggested that gene duplication events contributed to the expansion of the TIFY gene family in C. sativa. Weighted gene coexpression network analysis (WGCNA) revealed that CsJAZ2, CsJAZ3, and CsJAZ6 participated in the cannabinoid regulatory network. Cis-element analysis indicated that the promoter regions of TIFY genes were enriched in hormone- and stress-responsive elements. Furthermore, transcriptome and RT-qPCR analyses were conducted to examine gene expression patterns under alkaline stress (the RNA employed in RT-qPCR was extracted from the apical leaves of samples subjected to short-duration alkaline stress treatment). The results showed that CsJAZ5 and CsJAZ6 were downregulated, whereas CsPPD1, CsTIFY1, and CsZML1 were upregulated in response to alkali stress. In summary, CsJAZ5, CsPPD1, and CsTIFY1 may serve as candidate genes for the development of alkali-tolerant cultivars, while CsJAZ2 and CsJAZ3 may be valuable targets for enhancing cannabinoid production. This study provides important molecular insights and a theoretical basis for future research on the evolutionary dynamics and functional roles of TIFY transcription factors, particularly in stress adaptation and cannabinoid metabolism. Full article

This paper addresses the issue of the poor collision avoidance effect of underactuated surface vehicles (USVs) during local path tracking. A virtual ship group control method is suggested by using Freiner coordinates and a model predictive control (MPC) algorithm. We track the planned path using the MPC algorithm according to the known vessel state and build a hierarchical weighted cost function to handle the state of the virtual vessel, to ensure that the vessel avoids obstacles while tracking the path. In addition, the control system incorporates an Extended Kalman Filter (EKF) algorithm to minimize the state estimation error by continuously updating the ship state and providing more accurate state estimation for the system in a timely manner. In order to validate the anti-interference and robustness of the control system, the simulation experiment is carried out with the “Yukun” as the research object by adding the interference of wind and wave of level 6. The outcome shows that the algorithm suggested in this paper can accurately perform the trajectory-tracking task and make collision avoidance decisions under six levels of external interference. Compared with the original MPC algorithm, the improved MPC algorithm reduces the maximum rudder angle output value by 58%, the integral absolute error by 46%, and the root mean square error value by 46%. The improved control algorithm reduces the maximum rudder angle output value by 42% and the maximum rudder angle output value by 10%. The control method provides a new technical choice for trajectory tracking and collision avoidance of USVs in complex marine environments, with a reliable theoretical basis and practical application value. Full article

Urban spatial justice is a critical issue in the context of rapid urbanization. Improving public well-being depends on the efficient use of park green space (PGS) resources. This study evaluates the spatial distribution equity and social equity of PGS in Jinan City, Shandong Province, China, with the aim of optimizing their spatial layout, mitigating poor accessibility due to uneven spatial distribution, and improving the quality of life for all inhabitants. Firstly, based on Sustainable Development Goal 11 (SDG11), we constructed an urban sustainable development index system to quantify residents’ demand levels. The supply level was measured through three dimensions: quantity, quality, and accessibility of PGS utilizing multi-source geospatial data. A coupling coordination degree model (CCDM) was employed to analyze the supply-demand equilibrium. Secondly, Lorenz curves and Gini coefficients were utilized to evaluate the equity of PGS resource distribution to disadvantaged populations. Finally, a k-means clustering algorithm found the best sites for additional parks in low-accessibility regions. The results show that southern areas—that is; those south of the Yellow River—showed greater supply-demand equilibrium than northern ones. With a Gini index for PGS services aimed at vulnerable populations of 0.35, the citywide social level distribution appeared to be relatively balanced. This paper suggests an evaluation technique to support fair resource allocation, establishing a dual-perspective evaluation framework (spatial and social equality) and giving a scientific basis for PGS planning in Jinan. Full article