An approach for post‐market monitoring of potential environmental effects of Bt‐maize expressing Cry1Ab on natural enemies

Post‐market monitoring (PMM) consistent with Swiss and European Union legislation should ensure the detection and prevention of adverse effects on the environment possibly deriving from commercial cultivation of genetically modified (GM) crops. Insect‐resistant GM crops (such as Bt‐maize) raise particular questions regarding disturbances of biological control functions provided by beneficial insects such as predators and parasitoids (so‐called natural enemies). Consensus among regulators, scientists and the agricultural biotech industry on appropriate PMM plans allowing the detection and possibly prevention of such adverse effects is still lacking. The aims of this study were to identify the necessity for PMM of Bt‐maize expressing Cry1Ab on natural enemies and to develop an appropriate PMM plan. The approach chosen consisted in determining what type of monitoring is most appropriate to address potential effects of Bt‐maize on natural enemies during commercial cultivation. This included identifying whether there remain substantial scientific uncertainties that would support case‐specific monitoring. Existing pre‐market risk assessment data indicate that Bt‐maize (Cry1Ab) comprises a negligible risk for disturbances in biological control functions of natural enemies. As a consequence, a faunistic monitoring of specific groups of natural enemies is not considered an appropriate approach to detect failures in biological control functions. Alternatively, an approach is proposed that consists in indirectly analysing biological control functions by surveying outbreaks of maize herbivores. Unusual herbivore outbreaks could indicate failures in biological control functions of natural enemies. Data could be collected via questionnaires addressed to farmers growing Bt‐maize. Significant correlations between unusual occurrences of specific maize herbivores and the cultivation of Bt‐maize would subsequently need specific studies to determine possible causalities in more detail. The here proposed approach has the advantage of covering different natural enemy groups. It represents a cost‐effective strategy to obtain scientifically sound data as a basis for regulatory decision‐making.     

银川市职工基本医疗保险总额预付制实施效果分析

目的 了解银川市定点医疗机构总额预付制的实施效果,在此基础上探究总额预付制下不同方式下医保基金的控制与管理。方法 采用定性分析与定量分析相结合的方法,采用SPSS软件对数据进行分析,采用病例组合方法进行改进方法研究。结果 银川市总额预付制实施后费用控制效果不明显,次均费用等指标呈现上升趋势,同时也发现实施方案中存在一些问题。结论 针对总额预付实施方案中出现的问题,提出以病例组合平均费用作为总预付方案,控制费用的同时合理利用医疗资源,促进病人合理分流。     

Alteration of tubuliform silk gland cytoarchitecture with the reproductive cycle of the Western black widow spider,Latrodectus hesperus

The protein synthetic and secretory activity of spider tubuliform glands is known to be coordinated with the reproductive stage of the spider. For spiders that produce multiple egg cases, such as the black widow Latrodectus hesperus, this means that the cells that make up the tubuliform gland cycle from minimal to maximal silk protein synthesis and exocytosis as the spider transitions from early vitellogenesis to a gravid state and back. The impact of these transitions on the cells that form the tubuliform gland has yet to be characterized. The entire tubuliform gland undergoes an elastic deformation, doubling in size in response to the accumulation and depletion of egg case silk proteins within its lumen. Similarly, the diversity and organization of organelles within the cytoplasm of the secretory epithelial cells that make up the wall of the tubuliform gland change with the reproductive stage of the spider. Progression of a spider from early to late vitellogenesis is accompanied by decondensed nucleoli and distention of the rough endoplasmic reticulum, markers of protein synthetic activity. The presumed silk proteins that fill the lumen of the tubuliform gland of a gravid spider include a fibrous matrix with homogeneous spherical inclusions. These components are also present within the cytoplasm of the cell; however, only the fibrous material appears to be enclosed by membranous organelles. Transition of the tubuliform gland from peak silk synthesis back to a quiescent state is marked by the appearance of multivesicular bodies and organelles resembling phagophores and autophagosomes, suggestive of a role for autophagy in the process of recovery. The reproducible cellular dynamics of the tubuliform silk gland of the black widow spider makes it a potential model system for study of the regulation of silk gene expression, endomembrane transport, and exocytosis of silk proteins and autophagy.     

Ethical Implications of Case‐Based Payment in China: A Systematic Analysis

How health care providers are paid affects how medicine is practiced. It is thus important to assess provider payment models not only from the economic perspective but also from the ethical perspective. China recently started to reform the provider payment model in the health care system from fee‐for‐service to case‐based payment. This paper aims to examine this transition from an ethical perspective. We collected empirical studies on the impact of case‐based payment in the Chinese health care system and applied a systematic ethical matrix that integrates clinical ethics and public health ethics to analyze the empirical findings. We identified eleven prominent ethical issues related to case‐based payment. Some ethical problems of case‐based payment in China are comparable to ethical problems of managed care and diagnosis related groups in high‐income countries. However, in this paper we discuss in greater detail four specific ethical issues in the Chinese context: professionalism, the patient‐physician relationship, access to care and patient autonomy. Based on the analysis, we cautiously infer that case‐based payment is currently more ethically acceptable than fee‐for‐service in the context of China, mainly because it seems to lower financial barriers to access care. Nonetheless, it will be difficult to justify the implementation of case‐based payment if no additional measures are taken to monitor and minimize its existing negative ethical implications.     

A Test of Diversity–Productivity Models in Natural,Degraded, and Restored Wet Prairies

Conceptual restoration models depict strong correlations between structure and function, with both decreasing as an ecosystem is degraded and increasing during restoration. We evaluated the “linear” and “asymptotic” models by measuring diversity and annual net primary productivity (NPP) within four states of a southern Wisconsin floodplain: a remnant (unplowed) wet prairie, two degraded sites (soybean field and invaded prairie), and a restored prairie. Neither model fit our data for aboveground (ANPP), belowground (BNPP), or total (TNPP) productivity. ANPP declined as species richness increased (r = 0.998, df = 2), with highest values for soybeans (1,024 g/m²; two species in 30 0.25‐m² plots) and invaded prairie (937 g/m²; nine species, 99% cover of Phalaris arundinacea), intermediate for restored prairie (712 g/m²; 28 species), and lowest for diverse remnant prairie (571 g/m²; 36 species). In contrast, BNPP was lowest for soybeans (225 g/m²) and highest for remnant prairie (571 g/m²). TNPP in restored prairie (990 g/m²) matched that of the remnant (1,147 g/m²) within 7 years, but root:shoot NPP ratios were quite different (0.39 and 0.99, respectively). Overall, results suggest that the relationship between species diversity and productivity can differ with the component measured (ANPP, BNPP, or TNPP) and that diversity does not ensure high productivity. Because measuring ANPP does not fully test ecosystem‐function theory, we recommend assessing BNPP and additional ecosystem processes in future attempts to determine whether adding species will restore more function to degraded ecosystems.     

北京市2010年手足口病死亡病例流行病学及临床特征分析

目的:通过描述2010年北京市手足口病死亡病例的流行病学特点和临床特点,分析手足口病重症病例发生死亡的危险因素,为防制手足口病,减少手足口病的死亡提供科学依据。方法:采用现况描述及病例对照研究的方法,对2010年北京市手足口病死亡病例的特点进行分析。结果:2010年北京市共报告18例手足口病死亡病例,88.9%分布在5-8月份;死亡病例的男女比例为3.5:1;年龄均小于4岁;流动人口聚集区的死亡病例较多;散居儿童及外地户籍儿童比例高,分别为83.3%和94.4%。死亡病例均出现出疹、发热及神经精神系统症状,整体精神状况,呼吸功能指标以及循环系统受累明显。与重症痊愈病例相比,感染EV71型病毒是发生死亡的危险因素(x2=4.774,P=0.029)。结论:手足口病死亡病例分布与重症病例分布基本一致。应对流动人口聚集地区的4岁以下婴幼儿重症病例进行重点防控。