Patients who survive critical illness commonly suffer cognitive impairments. We aimed to study the effects of cognitive intervention to treat the long-term impairments observed among different populations of intensive care unit (ICU) survivors. The results showed that the intervention significantly suppressed the deterioration of cognitive function in these patients. Medical and neurological ICU survivors were more susceptible than post-anaesthesia ICU patients to severe cognitive damage. In the former, the deterioration of impairments can be slowed by cognitive intervention. In comparison, intervention exerted significantly positive effects on the recovery of the cognitive functions of post-anaesthesia care unit patients. Furthermore, young populations were more likely than older populations to recover from acute cognitive impairments, and the impairment observed among the older population seemed to be multi-factorial and irreversible.

Breast cancer is the most common cancer worldwide. JWA is a microtubule-associated protein that has been identified as a tumor suppressor, and its downregulation in tumors is an independent adverse prognostic factor. The objective of this study was to explore the expression, regulation, and mechanism of JWA in trastuzumab-resistant breast cancers. In this study, we found that JWA expression was lower in trastuzumab-resistant breast cancers than that in trastuzumab-sensitive breast cancers. Furthermore, it was confirmed that overexpression of JWA inhibited proliferation and promoted apoptosis in trastuzumab-resistant breast cancers both in vitro and in vivo. In addition, the low expression of JWA in trastuzumab-resistant breast cancers is associated with a poor prognosis. Combining RNA-sequence datasets and next-generation sequencing, it was found that JWA negatively regulated CDK12, and was involved in the G1-to-S transition of the cell cycle. It has been reported that CDK12 drives breast cancer initiation and induces trastuzumab resistance. Taken together, high expression of JWA could inhibit the growth of trastuzumab-resistant breast cancer, and JWA is a potential predictive marker for trastuzumab resistance. In addition, targeted therapy with JWA may be a novel therapeutic strategy to improve the survival rate of trastuzumab-resistant breast cancer.

Purpose: The increasing global burden of cancer has become a significant challenge for public health. The Chinese government introduced the National Drug Price Negotiation (NDPN) policy with the goal of lowering the prices of innovative drugs and enhancing their accessibility. This study aims to evaluate the impact of the 2021 NDPN policy on the availability, utilization, and cost of anticancer medicines in China. Methods: Data was gathered from 1519 hospitals between April 2021 and December 2022, with a focus on eight anticancer drugs affected by the 2021 NDPN policy. The availability, Defined Daily Doses (DDDs), and cost per Defined Daily Dose (DDDc) before and after the intervention were evaluated through interrupted time series analysis. Results: The NDPN policy resulted in a substantial 5.10% increase in the availability of anticancer drugs (p < 0.001). Utilization also experienced a significant surge, with an immediate increase of 11,254.36 DDDs (p < 0.001) and a monthly increase of 1208.28 DDDs (p < 0.001) following policy implementation. The DDDc decreased by US$ 111.00 (p < 0.001) immediately after the policy. Disparities in regional drug utilization were evident, with higher usage in the eastern region. Conclusion: The 2021 NDPN policy has notably enhanced the availability and utilization of anticancer medications in China while reducing their cost, in line with the policy’s objectives. However, continuous monitoring is essential to ensure sustained access and to tackle regional disparities in drug utilization.

Against the background of the worldwide spread of the COVID-19 pandemic, due to the lack of effective collaborative incentive mechanisms, issues of dislocation and incoordination have emerged in the public health emergency management system (PES) globally. Nevertheless, the available research rarely touches upon the incentive mechanism design for the collaborative management of PES. To alleviate these inefficiency operations problems with PES, three game-theoretical decision models, including a decentralized decision model without public governance policy incentive (GPI), a decentralized decision model with GPI, and a collaborative decision model with GPI, were developed and analyzed to explore and design the incentive mechanism of PES. Furthermore, the corresponding numerical and sensitivity analyses were conducted to validate the modelling results in the article. The research results show that: (1) the collaborative decision scenario with GPI performs best, and the decentralized decision scenario with GPI performs second-best regarding the equilibrium emergency management efforts (EMEs) and utilities in all the decision scenarios; (2) an incentive mechanism of the “carrot + Stick” can effectively enhance the collaborative management of public health emergencies and its governance-driven operational performance/efficiency; (3) strengthening the performance assessment of emergency management for relevant government departments is beneficial in improving the overall emergency management efficiency of the PES; (4) reducing the cost of EMEs and enhancing the effectiveness of EMEs are conducive to improving the overall emergency management efficiency of the PES. This research provides a novel framework for designing an effective incentive mechanism to overcome the incoordination impacts and achieve collaborative operations across the PES.

BACKGROUND:This randomized, controlled trial was designed to assess whether acupuncture plus an oral administration of Chinese herbal medicine provides greater relief of symptoms than oral administration of Chinese herbal medicine alone for treatment...