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85, 0.930, and 0.95,respectively. Regression results showed that an increase in the population less than 14years of age, assets, nurse-patient ratio and bed occupancy rate could increase medical centers' efficiency. The rate of emergency return within 3-day and patient self-pay revenues were associated significantly with reduced hospital efficiency (p < 0.05). The result also showed that the foundation owns medical center has the highest efficiency than other ownership hospitals.

The study results provide information for hospital managers to consider ways they could adjust available resources to achieve high efficiency.

The study results provide information for hospital managers to consider ways they could adjust available resources to achieve high efficiency.

Ensuring access to healthcare is a complex, multi-dimensional health challenge. Since the inception of the coronavirus pandemic, this challenge is more pressing. Some dimensions of access are difficult to quantify, namely characteristics that influence healthcare services to be both acceptable and appropriate. These link to a patient's acceptance of services that they are to receive and ensuring appropriate fit between services and a patient's specific healthcare needs. These dimensions of access are particularly evident in rural health systems where additional structural barriers make accessing healthcare more difficult. Thus, it is important to examine healthcare access barriers in rural-specific areas to understand their origin and implications for resolution.

We used qualitative methods and a convenience sample of healthcare providers who currently practice in the rural US state of Montana. Our sample included 12 healthcare providers from diverse training backgrounds and specialties. All were decisionust be monitored to improve patient experiences and outcomes for rural Americans.

Complex trauma is a significant public health issue with detrimental health, interpersonal and psychological impacts, which can impede client recovery and result in multiple representations. 'Trauma Informed Practice' (TIP) is an evidence-based model which ensures safe and effective services for clients and staff. This study examines health professional's use of TIP, and the motivators, enablers and barriers to implementation in a multidisciplinary setting.

A mixed methods study with 24 front-line clinicians and managers within a community health setting in Australia. A purpose designed, expert validated TIP checklist was completed, followed by semi-structured focus groups. Survey data was reported using descriptive statistics. Focus group data was digitally recorded, transcribed and thematically analysed.

Ten key factors were identified motivating, restricting or enabling TIP implementation. Seven were organisational factors including supportive and informed management, flexibility of service models, lanisational needs are to be effectively met.

Providing TIP is essential for ensuring optimum client outcomes for trauma survivors and for maintaining workforce wellbeing. Although the increasing uptake to TIP is evident within the health setting, further attention is required to address the tension between service models focused on efficiently servicing whole populations and those attuned to effectively meeting the needs of high risk groups. A complex strategy to unite therapeutic and managerial goals is necessary if client, professional and organisational needs are to be effectively met.

The seminar-case learning (SCL) method is a case-oriented teaching model, with teachers and students as the main body of teaching, characterized by communication, interaction, and mutual inspiration. This study explored the effects of the SCL method versus traditional lecture-based learning (LBL) in the statistics curriculum for undergraduate students majoring in preventive medicine. Research questions were 1) whether the scores of students in the experimental group (the SCL model) were higher than those in the control group (the LBL model); 2) whether the students' satisfaction in the experimental group was better than that in the control group; and 3) whether the self-report benefit of students in the experimental group was better than that in the control group.

We conducted a two-armed cluster-randomized education intervention trial in practice teaching of health statistics among undergraduates majoring in preventive medicine. Two administrative classes (classes 1-4 and classes 5-8) were divided into tthan that in the control group (P < 0.05).

As an effective method of high-quality education, the SCL model is worthy of further promotion in the practice teaching of preventive medicine.

As an effective method of high-quality education, the SCL model is worthy of further promotion in the practice teaching of preventive medicine.

A better understanding of how the care of acute leukemia patients is managed in the last days of life would help clinicians and health policy makers improve the quality of end-of-life care. This study aimed (i) to describe the intensity of end-of-life care among patients with acute leukemia who died in the hospital (2017-2018) and (ii) to identify the factors associated with the intensity of end-of-life care.

This was a retrospective cohort study of decedents based on data from the French national hospital database. The population included patients with acute leukemia who died during a hospital stay between 2017 and 2018, in a palliative care situation (code palliative care Z515 and-or being in a inpatient palliative care support bed during the 3 months preceding death). Intensity end-of-life care was assessed using two endpoints High intensive end-of-life (HI-EOL intensive care unit admission, emergency department admission, acute care hospitalization, intravenous chemotherapy) care and most invasive endy end-of-life care, such as the access to palliative care and specialized cancer center care management, may help to improve end-of-life care quality.

Fluoride iontophoresis (FI) is a non-invasive method for the transfer of fluoride ions under electrical pressure into dental hard tissue. This study aimed to determine the effect of FI on the seal ability of self-etch adhesive in human dentin using dentin permeability test and scanning electron microscopy (SEM).

The experiments were divided into 2 series series 1 was performed on 28 extracted intact third molars and series 2 was performed on 28 extracted carious third molars (ICDAS 4 and 5). In each series, 20 teeth were used for dentin permeability test and 8 teeth were used for SEM study. For dentin permeability test, the specimens were divided into dentin without FI (control) and dentin with FI (experimental) subgroups. Hydraulic conductance (HD) of dentin was measured before and after adhesive treatment, and calculated for the percentage decrease of HD in each subgroup. Two-way ANOVA and Tukey test were used for statistical analysis. SEM study was used to assess the seal ability of self-etch adhesive wever, FI could augment the seal ability of the self-etch adhesive in intact dentin better than that in caries affected dentin.

Hepatitis C virus infection is the main cause of liver ailments across the globe. Several HCV genotypes have been identified in different parts of the world. Effective drugs for combating HCV infections are available but not affordable, particularly to infected individuals from resource-limited countries. Hence, cost-effective drugs need to be developed against important HCV drug targets. As Citrus fruits naturally contain bioactive compounds with antiviral activities, the current study was designed to identify antiviral inhibitors from Citrus fruit extracts against an important drug target, NS3 protease, of HCV genotype 3a which is found predominantly in South Asian countries.

The full-length NS3 protease alone and the NS3 protease domain in fusion with the cognate NS4A cofactor were expressed in Escherichia coli, and purified by chromatographic techniques. Using the purified protein as a drug target, Citrus extracts were evaluated in a FRET assay, and active ingredients, identified using ESI-MS/MS, wereinhibitor of NS3 protease, exhibiting an IC

value of 11.34 ± 3.83µg/mL.

A FRET assay was developed using NS3-NS4A protease, which was successfully utilized for the evaluation of Citrus fruit extracts. Hesperidin, a compound present in the Citrus extracts, was identified as the main flavonoid, which can serve as a cost-effective potent inhibitor of NS3 protease, and could be developed as a drug for antiviral therapy against HCV genotype 3a.

A FRET assay was developed using NS3-NS4A protease, which was successfully utilized for the evaluation of Citrus fruit extracts. Hesperidin, a compound present in the Citrus extracts, was identified as the main flavonoid, which can serve as a cost-effective potent inhibitor of NS3 protease, and could be developed as a drug for antiviral therapy against HCV genotype 3a.

Patients with type 2 diabetes mellitus (T2DM) are susceptible to developing symptomatic peripheral arterial disease (PAD). As a proven vasodilator and antiplatelet agent, the efficiency of Beraprost sodium (BPS) on the prevention of arteries occlusion and stiffness in T2DM patients with PAD has not yet been fully investigated.

From July 2010 to April 2012, 64 Patients enrolled were randomly assigned to the combined therapy group (n=32), which received combination therapy with BPS (60 μg/day) and aspirin (100 mg/day), or to the control group (n=32), which only received aspirin (100 mg/day). After randomization, the patients were followed up at years 0, 1, 2, 3, 4, and 5 with the evaluation of carotid intima-media thickness (CIMT), pulse wave velocity (PWV), inner artery diameter, stenosis rate, and medial arterial calcification (MAC) of lower limb arteries via high-resolution ultrasound measurement. Adverse events were also recorded in each visit.

There was no significant change of the CIMT during the follow-up in both groups when compared to the baseline. Similar results were also observed in the PWV measurement. Significantly increases in the inner artery diameter of the dorsal pedal artery and posterior tibial artery were observed in patients with BPS and aspirin administration during the follow-up. Selleckchem Triparanol Patients in the combined therapy group experienced marked improvement of MAC in the dorsal pedal artery and posterior tibial artery at the end of the follow-up. No significant difference in the adverse events was found between the combined therapy group and the aspirin group.

The combined therapy of BPS and aspirin showed a protective effect on arteries occlusion and stiffness in T2DM patients with PAD, along with a significant improvement of inner artery diameter and MAC in lower limbs.

http//www.chictr.org.cn , ChiCTR-TRC-10000919. Prospectively registered on 2010/06/29.

http//www.chictr.org.cn , ChiCTR-TRC-10000919. Prospectively registered on 2010/06/29.

In regard to central nervous system tumour resection, preserving vital venous structures to avoid devastating consequences such as brain oedema and haemorrhage is important. However, in clinical practice, it is difficult to obtain clear and vivid intraoperative venous visualization and blood flow analyses.

We retrospectively reviewed patients who underwent brain tumour resection with the application of indocyanine green videoangiography (ICG-VA) integrated with FLOW 800 from February 2019 to December 2020 and present our clinical cases to demonstrate the process of venous preservation. Galen, sylvian and superior cerebral veins were included in these cases.

Clear documentation of the veins from different venous groups was obtained via ICG-VA integrated with FLOW 800, which semiquantitatively analysed the flow dynamics. ICG-VA integrated with FLOW 800 enabled us to achieve brain tumour resection without venous injury or obstruction of venous flux.

ICG-VA integrated with FLOW 800 is an available method for venous preservation, although further comparisons between ICG-VA integrated with FLOW 800 and other techniques of intraoperative blood flow monitoring is needed.