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The article examines different approaches to the essence of the concepts of «management», «health care management», etc., based on which the interpretation of the concept of «health care management» is proposed. Conceptualization of the content of the terms «management» and «administration» is of great importance for the development of the conceptual and categorical apparatus not only of the theory of management and science in general, but also of modern branch theories. The variety of approaches is caused by the conditions of functioning of modern management systems in the field of health care, which is caused by the continuation of the reformation of the management system of the industry, the addition of the legal framework, the search for sources of financing, personnel support, and the development of infrastructure in most modern states. The article analyzes the object and subject of health care management as mandatory components of the structure of the health care system. The content of the main functions and methods of management in the field of health care is revealed. The interrelationship of functions and methods depending on the level of management and the applied model of organization of the health care system is analyzed. It is emphasized that the presence of different types of health care models depends not only on the method of financing and management, but also on the conformity of this model to the cultural, economic and social characteristics of the nation and the state. It is indicated that modern states, which continue the process of reforming the health care sector, can use the best practices of each of the presented models to create an effective and accessible system of medical care, capable of responding to modern challenges, with an effective management system. It has been established that the management system of the health care sector should be based on a number of scientific approaches that will allow taking into account all factors of the internal and external environment. It has been proven that the need to form an optimal management system is an important element of transformational processes in the field of health care. Today, the field of health care should be aimed at developing the capacity of health care institutions to meet the established quality standards, offer a favorable environment for the activities of medical workers, and meet the existing needs of citizens.

Abstract Cervical cancer (CCa) patients with lymph node (LN) metastasis face poor prognoses and have limited treatment options. Aberrant N6-methyladenosine (m6A) modification of RNAs are known to promote tumor metastasis, but their role in CCa remains unclear. Our study reveals that HNRNPC, an alternative splicing (AS) factor and m6A reader, increases tumor-related variants through m6A-dependent manner, thereby promoting lymphatic metastasis in CCa. We found that HNRNPC overexpression correlates with lymphatic metastasis and poorer prognoses in CCa patients. Functionally, knocking down HNRNPC markedly inhibited the migration and invasion of several CCa cell lines, while supplementing HNRNPC restored the malignant phenotypes of these cells. Mechanistically, HNRNPC regulates exon skipping of FOXM1 by binding to its m6A-modified motif. Mutating the m6A site on FOXM1 weakened the interaction between HNRNPC and FOXM1 pre-RNA, leading to a reduction in the metastasis-related FOXM1-S variant. In conclusion, our findings demonstrate that m6A-dependent alternative splicing mediated by HNRNPC is essential for lymphatic metastasis in CCa, potentially providing novel clinical markers and therapeutic strategies for patients with advanced CCa.

The rapid development of electric vehicles (EVs) and unmanned aerial vehicles (UAVs) provides new ways for personnel search and material distribution during emergency periods. This paper proposes an EV-UAV joint rescue system, in which the UAVs use the EVs as charging and maintenance base stations to provide various services for the objects to be rescued, and the EVs can use distributed generations to obtain diversified electricity supply, which improves the adaptability and endurance level of the system in emergencies. The coordinated scheduling model of the EV-UAV system is established in the mixed-integer linear programming (MILP) formulation, which considers factors including electricity consumption, electricity replenishment, loading capacity, distribution route, and distribution time window of the EVs and the UAVs. Case studies verify the validity of the model proposed, compare the EV-UAV and ground vehicle (GV)-UAV rescue systems, and illustrate the technical characteristics and application potential of the EV-UAV system in emergency assistance.

Objective To explore the changes in serum levels of growth differentiation factor 11 （GDF11） and cell division cycle 42 （Cdc42） in maintenance hemodialysis （MHD） elders and examine their correlations with events and occurrence of major adverse cardiovascular events （MACE）. Methods From June 2019 to June 2021, 164 MHD elders were selected as observation subjects （hemodialysis group） while 150 ESRD elders undergoing no hemodialysis during the same period as non-hemodialysis group. And 148 healthy elders receiving physical examinations were designated as control group. According to whether or not MACE occurred within 2 years, they were assigned into two groups of non-MACE （n = 92） and MACE （n = 72）. Enzyme-linked immunosorbent assay （ELISA） was utilized for determining serum levels of GDF11 and Cdc42. Multivariate Logistic regression was applied for examining the influencing factors of 2-year MACE and receiver operating characteristic （ROC） curve for determining the predictive value of GDF11 and Cdc42 levels for MACE. Results As compared with control, non-hemodialysis and hemodialysis groups, serum level of GDF11 [（640.38 ± 137.55）vs（851.56 ± 215.61），（785.27 ± 174.62）μg/L]declined obviously in hemodialysis group （t = 10.414, P＜0.001） while Cdc42 level rose sharply [（57.22 ± 11.34） vs （35.61 ± 10.25）, （43.58 ± 10.72） μg/L] （t = 17.589, P＜0.001）. Cdc42 levels [（65.31 ± 21.22） vs （50.89 ± 15.56） μg/L] were obviously higher in MACE group than those in non-MACE group. GDF11 level [（576.56 ± 125.71） vs （690.33 ± 159.84） μg/L] was obviously lower than that in non-MACE group and the differences were statistically significant （P＜0.05）. AUC of GDF11/Cdc42 level and their combined prediction for MACE was 0.762, 0.794 and 0.868 respectively. The value of combined prediction was better than that of individual prediction （Z = 3.183, 3.047; P = 0.002, 0.002）. Conclusion In MHD elders, lower serum level of GDF11 and higher level of Cdc42 are correlated closely with the occurrence of MACE. GDF11 and Cdc42 may be used as markers for managing and assessing ESRD MHD elders.

Abstract The mechanism by which aging induces aortic aneurysm and dissection (AAD) remains unclear. A total of 430 participants were recruited for the screening of differentially expressed plasma microRNAs (miRNAs). We found that miR-1204 is significantly increased in both the plasma and aorta of elder patients with AAD and is positively correlated with age. Cell senescence induces the expression of miR-1204 through p53 interaction with plasmacytoma variant translocation 1, and miR-1204 induces vascular smooth muscle cell (VSMC) senescence to form a positive feedback loop. Furthermore, miR-1204 aggravates angiotensin II-induced AAD formation, and inhibition of miR-1204 attenuates β-aminopropionitrile monofumarate-induced AAD development in mice. Mechanistically, miR-1204 directly targets myosin light chain kinase (MYLK), leading to the acquisition of a senescence-associated secretory phenotype (SASP) by VSMCs and loss of their contractile phenotype. MYLK overexpression reverses miR-1204-induced VSMC senescence, SASP and contractile phenotypic changes, and the decrease of transforming growth factor-β signaling pathway. Our findings suggest that aging aggravates AAD via the miR-1204-MYLK signaling axis.

Microtus fortis is known as a non-susceptible animal host of S. japonicum. A better understanding of this animal immune defense mechanism during the early stage of infection may offer an alternative route for vaccine development or therapy. Here, we analyzed the whole blood transcriptome of M. fortis using next-generation sequencing (NGS) to identify immune genes of biological relevance that might be involved in the mechanism of its resistance. The blood samples were collected from uninfected animals (control group) and infected animals at different time points (3, 7, 10 and 14 days post-infection). We identified 5310 sequences as unigenes and successfully annotated 4636 of them. The immune response was more intense at 10 dpi. The upregulated genes at this time point were mainly activated in the TNF and NF-kappa B signaling pathways, Th1, Th2and Th17 cell differentiation as well as cytokine-cytokine receptor interaction. Based on the differentially expressed genes analysis, we report that the IF27L2B, RETN, PGRP, IFI35, TYROBP, S100A8, S100A11, CD162, CD88, CYBA, and LBP could play important roles in the mechanism of M. fortis resistance.

Abstract As a fundamental property of light, polarization serves as an excellent information encoding carrier, playing significant roles in many optical applications, including liquid crystal displays, polarization imaging, optical computation and encryption. However, conventional polarization information encoding schemes based on Malus’ law usually consider 1D polarization projections on a linear basis, implying that their encoding flexibility is largely limited. Here, we propose a Poincaré sphere (PS) trajectory encoding approach with metasurfaces that leverages a generalized form of Malus’ law governing universal 2D projections between arbitrary elliptical polarization pairs spanning the entire PS. Arbitrary polarization encodings are realized by engineering PS trajectories governed by either arbitrary analytic functions or aligned modulation grids of interest, leading to versatile polarization image transformation functionalities, including histogram stretching, thresholding and image encryption within non-orthogonal PS loci. Our work significantly expands the encoding dimensionality of polarization information, unveiling new opportunities for metasurfaces in polarization optics for both quantum and classical regimes.

Objective: Studies focusing on bone and joint infections (BJIs) in young infants are rare. Some cases of BJI are accompanied by sepsis. This study aimed to identify the clinical and bacteriological features of sepsis in neonates and young infants with BJIs. Methods: Neonates and infants younger than 3 months diagnosed with BJI in the present institution from 2014 to 2021 were retrospectively reviewed. Patient characteristics, clinical data, and outcomes were documented and compared between those with and without sepsis. Results: Twenty-five patients with a mean age of 34.8 days were included. Nine BJI cases had concomitant sepsis (group A), and 16 had BJI without sepsis (group B). Within group A, staphylococcus aureus was the major pathogenic germ (5 cases, of which 4 were of the methicillin-resistant staphylococcus aureus (MRSA) type). There was no statistical difference in male-to-female ratio, age, history of hospitalization, anemia, birth asphyxia, peripheral leukocyte counts, C-reactive protein on admission, and sequelae between groups. Univariate analyses indicated a significant difference in the incidence of septic arthritis (SA) combined with osteomyelitis (OM) (88.9% vs 37.5%), congenital deformities (44.4% vs 0%), and mean duration of symptoms (2.83 days vs 9.21 days) in comparisons between groups A and B. Conclusion: Staphylococcus aureus is the main pathogenic bacteria in BJI cases complicated with sepsis in neonates and young infants. Among infants younger than 3 months diagnosed with BJI, those with concurrent SA and OM, MRSA infection, or congenital deformities are more likely to develop sepsis.

BackgroundStroke is the leading cause of mortality in China, with limited evidence of in-hospital burden obtained from nationwide surveys. We aimed to monitor and track the temporal trends and rural-urban disparities in cerebrovascular risk factors, management and outcomes from 2005 to 2015.MethodsWe used a two-stage random sampling survey to create a nationally representative sample of patients admitted for ischaemic stroke in 2005, 2010 and 2015. We sampled participating hospitals with an economic-geographical region-stratified random-sampling approach first and then obtained patients with a systematic sampling approach. We weighed our survey data to estimate the national-level results and assess changes from 2005 to 2015.ResultsWe analysed 28 277 ischaemic stroke admissions from 189 participating hospitals. From 2005 to 2015, the estimated national hospital admission rate for ischaemic stroke per 100 000 people increased (from 75.9 to 402.7, Ptrend

Abstract Background Studies have shown that the absolute lymphocyte count (ALC) and the neutrophil-to-lymphocyte ratio (NLR) are related to the outcomes in patients with breast cancer receiving specific chemotherapies. However, the reports have focussed on the initial blood test and there is a lack of evidence or data to support that dynamic changes of ALC or NLR are associated with the patients’ survival outcomes. Methods We retrospectively reviewed electronic medical records from patients with breast cancer treated with eribulin from 2015 to 2019 at our institution. Blood test data were available prior to starting eribulin (baseline), and at 1, 3 and 6 months after initiating eribulin. We classified the patients into ALC and NLR high and low groups using the following cut-offs: 1000/µl for ALC and 3 for NLR. We defined ALC and NLR trends as increasing or decreasing compared with the initial data. We assessed the associations between the ALC and NLR with progression-free survival and overall survival. Results There were 136 patients with breast cancer treated with eribulin. Of these patients, 60 had complete blood tests and follow-up data. Neither a high ALC nor a low baseline NLR was associated with the survival outcome. One month after initiating eribulin treatment, a high ALC and a low NLR were significantly associated with longer progression-free survival (p = 0.044 for each). Three months after initiating eribulin, a high ALC was significantly associated with better overall survival (p = 0.006). A high NLR at 3 or 6 months after initiating eribulin was associated with worse overall survival (p = 0.017 and p = 0.001, respectively). The ALC and NLR trends across times were not associated with survivals. Conclusion We showed that 1, 3 and 6 months after initiating eribulin, a high ALC and a low NLR may be related to the patients’ survival outcomes. The ALC and NLR trends were not associated with survival. Accordingly, we believe patients who maintain a high ALC and a low NLR may have better clinical outcomes after initiating eribulin.

In the field of Multiple Input Multiple Output(MIMO) radar waveform design, how to design an orthogonal waveform with high performance is one of the current hot topics. The Orthogonal Frequency Division Multiplexing - Linear Frequency Modulation(OFDM-LFM) waveform has been widely studied due to its excellent characteristics in many aspects. However, the spatial synthesized signal autocorrelation function of the traditional OFDM-LFM waveform design method has the disadvantage of high grating sidelobes. Based on a detailed analysis of the factors contributing to the high grating sidelobes in traditional OFDM-LFM waveform design methods, in order to meet the requirement that the waveform in the radar system has good properties of correlation, an innovative and effective algorithm for optimizing waveforms has been introduced in this paper. It uses the initial phase and frequency modulation bandwidth as optimization variables simultaneously, with the integrated sidelobe level (ISL) of the waveform as the optimization target. This algorithm aims to solve the waveform optimization problem of the spatial synthesized signals of the traditional frequency-orthogonal linear frequency modulation waveform design method. For the proposed objective function, the alternating direction method of multipliers integrates with the gradient descent algorithm is used to alternately optimize the objective function and the iteration factor is dynamically adjusted based on the gradient descent method. Multiple numerical simulations have verified that the proposed method is superior to the traditional waveform design method in terms of correlation performance while ensuring the orthogonality between signals.

Manufacturing errors (MEs) are unavoidable in product fabrication. The omnipresence of manufacturing errors (MEs) in product engineering necessitates the development of robust optimization methodologies. In this research, a novel approach based on the morphological operations and interval field (MOIF) theory is proposed to address MEs in the discrete-variable-based topology optimization procedures. On the basis of a methodology for deterministic topology optimization (TO) based on the Min-Cut, MOIF introduces morphological operations to generate geometrical variations, while the dimension of the structuring element is dynamically set by the interval field function’s output. The effectiveness of the proposed approach as a powerful tool for accounting for spatially uneven ME in the TOs has been demonstrated.

Since the product contains no carbon-based substances and can be driven by non-carbon-based electricity, electrocatalytic water splitting is considered to be among the most effective strategies for alleviating the energy crisis and environmental pollution. This process helps lower greenhouse gas emissions while also supporting the shift toward renewable energy sources. The anodic oxygen evolution reaction (OER) involves a more complex multi-electron transfer process, which is the principal limiting factor in overall water splitting. Extensive research has demonstrated that the controlled design of effective electrocatalysts can address this limitation. In this study, a previously unreported covalent organic framework material (COF-IM) was synthesized via a post-synthetic modification strategy. Notably, COF-IM contains imidazole nitrogen metal active sites. Transition metal-coordinated COF-IM@Co can function as a highly effective electrocatalyst, exhibiting a lower overpotential (403.8 mV@10 mA cm−2) in alkaline electrolytes, thereby highlighting its potential for practical applications in energy conversion technologies. This study offers new perspectives on the design and synthesis of COFs, while also making substantial contributions to the advancement and application of OER electrocatalysts.