Associations between Extending Access to Primary Care and Emergency Department Visits: A Difference-In-Differences Analysis

BackgroundHealth services across the world increasingly face pressures on the use of expensive hospital services. Better organisation and delivery of primary care has the potential to manage demand and reduce costs for hospital services, but routine primary care services are not open during evenings and weekends.Extended access (evening and weekend opening) is hypothesized to reduce pressure on hospital services from emergency department visits. However, the existing evidence-base is weak, largely focused on emergency out-of-hours services, and analysed using a before-and after-methodology without effective comparators.ConclusionsThe study found that extending access was associated with a reduction in emergency department visits in the first 12 months. The results of the research have already informed the decision by National Health Service England to extend primary care access across Greater Manchester from 2016. However, further evidence is needed to understand whether extending primary care access is cost-effective and sustainable.     

在实验动物水平通过恢复和改善胰岛β细胞功能的糖尿病治疗新进展

糖尿病是一个世界性问题,在中国就有超过1.3亿人患有糖尿病.糖尿病主要分为1型糖尿病和2型糖尿病.遗憾的是,糖尿病至今尚未达成有效的预防和治愈手段.但是,近年来的一系列突破性的研究成果,让我们看到了治愈糖尿病的希望.在这里我们回顾了目前关于1型糖尿病和2型糖尿病可能的治愈途径的研究进展.这些途径包括胰岛移植和1型糖尿病...     

Evolution of spore release mechanisms in the saprolegniaceae (Oomycetes): evidence from a phylogenetic analysis of internal transcribed spacer sequences

Classical studies on spore release within the Saprolegniaceae (Oomycetes) led to the proposition that different mechanisms of sporangial emptying represent steps in an evolutionary transition series. We have reevaluated this idea in a phylogenetic framework using internal transcribed spacer sequences of four genera. These data were compared with the response to osmotic stress exhibited by each taxon. Saprolegnia emerges as the most basal genus, sister to Achlya, Thraustotheca, and Dictyuchus. Achlya and Thraustotheca are most closely related, while Dictyuchus appears to have evolved along a separate evolutionary lineage. The resulting phylogenetic framework is consistent with the idea that the mechanism of sporangial emptying exhibited by Saprolegnia represents the plesiomorphic condition from which the other mechanisms were derived independently. These alternative mechanisms of spore release may have resulted from a small number of mutations that inhibited axonemal development and altered the temporal and spatial expression of lytic enzymes that degrade the sporangial wall. Copyright 1998 Academic Press.     

外源DNA在体内的吸收与降解

外源ＤＮＡ在动物体内的吸收与降解研究已经受到了关注[1、2 ] 。由于基因治疗与ＤＮＡ疫苗的飞速发展 ,经常要通过一定的方式将外源的ＤＮＡ导入到动物体 ,然而对于它们的吸收与降解机制到目前为止仍然不是十分清楚。用基因治疗疾病时 ,须解决外源基因在动物体内的吸收与降解问题 ,尤其是大量外源ＤＮＡ质粒在动物体内的吸收与降解问题。外源ＤＮＡ的吸收与降解研究已成为一个热点 ,目前主要集中在肠胃道吸收降解和细胞吸收降解两个方面。1 .外源ＤＮＡ在肠胃道中的吸收与降解最有可能让外源ＤＮＡ进入动物体的就是肠胃道 ,在每天的进食中 …     

Prediction of enzyme function based on 3D templates of evolutionarily important amino acids

Background  

Structural genomics projects such as the Protein Structure Initiative (PSI) yield many new structures, but often these have no known molecular functions. One approach to recover this information is to use 3D templates – structure-function motifs that consist of a few functionally critical amino acids and may suggest functional similarity when geometrically matched to other structures. Since experimentally determined functional sites are not common enough to define 3D templates on a large scale, this work tests a computational strategy to select relevant residues for 3D templates.     

Piping Plover Chick Foraging,Growth, and Survival in the Great Plains

Abstract: We tested the hypothesis that piping plover (Charadrius melodus) habitat quality and chick survival on the Missouri River, USA, were lower on a cold-water reservoir and downstream from a hypolimnetic (cold-water) release dam with diel water fluctuations (Garrison Dam) than downstream from an epilimnetic dam (Gavins Point Dam). Plovers in adjacent alkali wetlands provided an index to the maximum reproductive potential in the region. Chicks gained weight more rapidly in the alkali wetlands than on epilimnetic and hypolimnetic river reaches. Invertebrate numbers and biomass were higher in the wetlands and epilimnetic reach, but chick survival was lower on the epilimnetic reach. Thus, piping plovers adapted to a variety of prey densities, and other factors, likely predation, reduced survival rates in the epilimnetic reach. Temporal and spatial variability in site quality indices suggests the need for a regional management strategy with different strategies at each site. Managers can minimize effects of local fluctuations in resource abundance and predators by ensuring protection of or creating geographically dispersed habitat. (JOURNAL OF WILDLIFE MANAGEMENT 72(3):682–687; 2008)     

我国奶牛乳房炎致病性金黄色葡萄球菌血清型分布

本试验采用玻片凝集法对从临床型乳房炎病乳中分离获得的56株金黄色葡萄球菌进行血清型分型。结果表明336型占67.9%(38/56),5型占7.1%(4/56),8型占3.6%(2/56)。     

盐度对互花米草枯落物分解释放硅、碳、氮元素的影响

为了研究潮汐湿地盐度对枯落物分解过程中硅、碳、氮元素释放的影响,通过室内模拟不同盐度(0、5、15和30)对互花米草枯落物茎和叶分解释放过程中硅、碳、氮元素的动态变化进行测定。结果表明:(1)互花米草茎和叶枯落物失重率和分解速率均随盐度增加而降低。(2)互花米草茎和叶枯落物分解水体中硅含量均随着盐度升高而增加,并且盐度30处理下,枯落物分解硅释放量显著高于盐度0和5(P0.05)。而分解末期生物硅残留量则随盐度升高而降低。(3)不同盐度处理茎枯落物分解碳释放量无显著差异,但叶枯落物分解碳释放量在盐度5、15和30处理中显著高于淡水(P0.05)。(4)互花米草茎枯落物分解释放到水中的NH_4~+-N含量随着盐度的升高而减少,NO_3~--N含量与之相反。研究单因素盐度对枯落物分解及元素释放的影响,可以为预测潮汐湿地枯落物分解对盐水入侵的响应机制提供参考,为湿地生源要素生物地球化学循环过程研究提供基础依据。     

Structure of the house dust mite allergen Der f 2: implications for function and molecular basis of IgE cross-reactivity

The X-ray structure of the group 2 major allergen from Dermatophagoides farinae (Der f 2) was determined to 1.83 A resolution. The overall Der f 2 structure comprises a single domain of immunoglobulin fold with two anti-parallel beta-sheets. A large hydrophobic cavity is formed in the interior of Der f 2. Structural comparisons to distantly related proteins suggest a role in lipid binding. Immunoglobulin E (IgE) cross-reactivity between group 2 house dust mite major allergens can be explained by conserved surface areas representing IgE binding epitopes.     

Effects of inbreeding and rate of inbreeding in Drosophila melanogaster- Hsp70 expression and fitness

Induction of heat shock proteins (Hsp) is a well-known mechanism through which cells cope with stressful conditions. Hsp are induced by a variety of extrinsic stressors. However, recently intrinsic stressors (aging and inbreeding) have been shown to affect expression of Hsp. Increased homozygosity due to inbreeding may disrupt cellular homeostasis by causing increased expression of recessive deleterious mutations and breakdown of epistatic interactions. We investigated the effect of inbreeding and the rate of inbreeding on the expression of Hsp70, larval heat resistance and fecundity. In Drosophila melanogaster we found that inbred lines (F approximately 0.67) had significantly up-regulated expression of Hsp70, and reduced heat resistance and fecundity as compared with outbred control lines. A significant negative correlation was observed between Hsp70 expression and resistance to an extreme heat stress in inbred lines. We interpreted this as an increased requirement for Hsp70 in the lines suffering most from inbreeding depression. Inbreeding depression for fecundity was reduced with a slower rate of inbreeding compared with a fast rate of inbreeding. Thus, the effectiveness of purging seems to be improved with a slower rate of inbreeding.