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1.
ACS Appl Mater Interfaces ; 15(2): 3433-3441, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36596273

RESUMO

Lack of solution processability is the main bottleneck in research progression and commercialization of conducting polymers. The current strategy of employing a water-soluble dopant (such as PEDOT:PSS) is not feasible with organic solvents, thus limiting compatibility on hydrophobic surfaces, such as three-dimensional (3D) printable thermoplastics. In this article, we utilize a colloidal dispersion of PEDOT particles to overcome this limitation and formulate an organic paint demonstrating conformal coating on 3D-printed objects. We start with synthesizing PEDOT particles that possess a low electrical resistance (gap resistance of 4.2 ± 0.5 Ω/mm). A particle-based organic paint is formulated and applied via brush painting. Coated objects show a surface resistance of 1 kΩ/cm, comparable to an object printed by commercial conductive filaments. The coating enables the fabrication of pH and strain sensors. Highly conductive PEDOT particles also absorb light strongly, especially in the near-infrared (NIR) range due to the high concentration of charge carriers on the polymer's conjugated backbones (i.e., polarons and bipolarons). PEDOT converts light to heat efficiently, resulting in a superior photothermal activity that is demonstrated by the flash ignition of a particle-impregnated cotton ball. Consequently, painted 3D prints are highly effective in converting NIR light to heat, and a 5 s exposure to a NIR laser (808 nm, 0.8 mW/cm2) leads to a record high-temperature increase (194.5 °C) among PEDOT-based coatings.

2.
ACS Appl Mater Interfaces ; 14(25): 28604-28614, 2022 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-35726703

RESUMO

Impedance-matched acoustic materials were developed to improve ultrasound penetration through the aberration layer. The traditional ultrasound layer matching material is called a couplant, which can only enhance ultrasound transmission to soft biological media such as the cartilage and muscle but cannot penetrate hard media such as the bone. Here, we propose a phase-modulated complementary acoustic metamaterial based on the principle of impedance matching, which enables ultrasound to penetrate the bone, and use the equivalent parameter technology of acoustic metamaterials for parameter design. Ultrasonic layer adjustment is performed through 3D printing and corrects bone aberrations. Several configurations were investigated through numerical simulations and experiments in non-reflecting tanks. Specifically, the bone matching layer can be optimally designed for a specific bone thickness and a specific operating frequency of the ultrasound probe, thereby amplifying the ultrasound to penetrate the matching layer and bone. The experimental and simulation results show that the proposed acoustic metamaterial can improve the transmission efficiency of ultrasound through the aberration layer.


Assuntos
Acústica , Transdutores , Simulação por Computador , Impedância Elétrica , Ultrassonografia/métodos
3.
BMJ Open ; 12(2): e054713, 2022 02 16.
Artigo em Inglês | MEDLINE | ID: mdl-35173004

RESUMO

INTRODUCTION: Little is known about the impact of the government's efforts in having novel anticancer medicines covered by the public health insurance system in China. This study targeted the above policy implemented in Fujian province in 2017, analysed the policy impact on the medical expenditure of cancer treatment and patient affordability based on the clinical data of Fujian provincial medical centre. METHODS: The study included 253 human epidermal growth factor receptor 2-positive patients with breast cancer who completed at least one course of trastuzumab treatment extracted from the hospital health information system of the provincial medical centre of Fujian. We adopted the propensity score-matching method to mimic a quasi-experimental design to estimate the impact of the public health insurance coverage policy on all the indicated patients with a before-after comparison of the total breast cancer-associated direct medical expenditures for a standard course of treatment or maintenance treatment and the proportionate patient out-of-pocket (OOP) expenditure based on the real clinical data. RESULTS: We found evidence of an association between the public health insurance coverage of novel breast cancer medication and the reductions of the medical expenditure by US$18661.02 (95% CI 13 836.57 to 28 201.45), and the proportionate patient OOP expenditure by 24% (95% CI0.20 to 0.27). The medical expenditure and the proportionate patient OOP expenditure might be generally reduced. CONCLUSIONS: The coverage of innovative antibreast cancer medicines by the public health insurance was found to be associated with a reduction of the medical expenditure and share of patient OOP expenditure for cancer treatment of the indicated patients. Patients with lower ability-to-pay did not benefit well from the coverage policy. To maximise the welfare of the public health insurance coverage of novel anticancer medication, the study called for strengthened health insurance benefit packages of the rural patient and the patient enrolled in the urban and rural resident health insurance programme, who might have lower ability-to-pay and need more support from the public security system.


Assuntos
Antineoplásicos , Neoplasias da Mama , Antineoplásicos/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , China , Custos e Análise de Custo , Feminino , Gastos em Saúde , Hospitais , Humanos , Cobertura do Seguro , Seguro Saúde , Pontuação de Propensão , Saúde Pública , Projetos de Pesquisa
4.
ACS Cent Sci ; 7(10): 1668-1675, 2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34729410

RESUMO

Atmospheric pollution demands the development of solar-driven photocatalytic technologies for the conversion of CO2 into a fuel; state-of-the-art cocatalyst systems demonstrate conversion efficiencies currently unattainable by a single catalyst. Here, we upend the status quo demonstrating that the nanofibrillar conducting polymer poly(3,4-ethylenedioxythiophene) (PEDOT) is a record-breaking single catalyst for the photoreduction of CO2 to CO. This high catalytic efficiency stems from a highly conductive nanofibrillar structure that significantly enhances surface area, CO2 adsorption and light absorption. Moreover, the polymer's band gap is optimized via chemical doping/dedoping treatments using hydrochloric acid, ammonia hydroxide, and hydrazine. The hydrazine-treated PEDOT catalyst exhibits 100% CO yield under a stable regime (>10 h) with a maximum rate of CO evolution (3000 µmol gcat -1 h-1) that is 2 orders of magnitude higher than the top performing single catalyst and surpassed only by three other cocatalyst systems. Nanofibrillar PEDOT provides a new direction for designing the next generation of high-efficiency photoreduction catalysts.

5.
BMC Health Serv Res ; 21(1): 856, 2021 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-34419013

RESUMO

BACKGROUND: China started to cover novel medicines for the treatment of major cancers, such as trastuzumab for breast cancer by the government health insurance programs since 2016. Limited data have been published on the use of cancer medications and little is known about how government health insurance coverage of novel anti-cancer medicines benefited patients in the real world. This study aimed to generate evidence to inform the health security authorities to optimize the government health insurance coverage of novel anti-cancer medicines as a more inclusive and equal policy, through which each of the needed patient can get access to the novel anti-cancer medicines regardless of the ability to pay. METHODS: The study targeted one of the government health insurance newly covered novel medicines for breast cancer and the breast cancer patients. The analyses were based on the data collected from one tertiary public hospital in Fujian province of China. We conducted interrupted time series analysis with a segmented regression model and multivariate analyses with a binary logistic regression model to analyze the impact of the government health insurance coverage on medicines utilization and the determinants of patient's medication choice. RESULTS: The average proportion of patients who initiated medication with novel medicines increased from 37.4% before the government health insurance coverage to 69.2% afterwards. Such an increase was observed in all patient sub-groups. The monthly proportion of patients who initiated medication with novel medicines increased sharply by 18.3 % (95 %CI,10.4-34.0 %, p = 0.01) in September 2017, the afterwards trend continuously increased (95 %CI,1.03-3.60, p = 0.02). The critical determinants of patient's medication choice were mostly connected with the patient's health insurance benefits packages. CONCLUSIONS: The government health insurance coverage of novel anti-breast-cancer medicines benefited the patients generally. The utilization of novel medicines such as trastuzumab continuously increased. The insurance coverage benefited well the patients in the high-risk age groups. However, rural patients, patients enrolled in the "resident program", and patients from low-income residential areas and non-local patients benefited less from this policy. Improving the benefits package of the low-income patients and the "resident program" beneficiary would be of considerable significance for a more inclusive and equal health insurance coverage of novel anti-cancer medicines.


Assuntos
Governo , Cobertura do Seguro , China , Hospitais , Humanos , Estudos Retrospectivos
6.
ACS Appl Mater Interfaces ; 13(29): 34671-34678, 2021 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-34101409

RESUMO

Atmospheric water harvesting is a promising technology for alleviating global water scarcity. Current water sorption materials efficiently capture water vapor from ubiquitous air; however, they are difficult to scale up due to high costs, complex device engineering, and intensive energy consumption. Fired red brick, a low-cost masonry construction material, holds the potential for developing large-scale functional architectures. Here, we utilize fired red brick for atmospheric water harvesting by integrating a microtubular coating of the conducting polymer PEDOT within its inorganic microstructure. This microtubular polymer coating affords hygroscopicity and high surface area for water nucleation, enables capillary forces to promote water transport, and enhances the water harvesting efficiency. Our brick composite achieves a maximum water vapor uptake of ∼200 wt % versus polymer mass at 95% relative humidity, decreasing to ∼15 wt % at 40% relative humidity. Facile water release is demonstrated via thermal, electrical, and illuminative heating. This proof-of-concept study demonstrates the potential of masonry construction materials for large-scale atmospheric water harvesting.

7.
Phys Chem Chem Phys ; 23(23): 13011-13022, 2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34095927

RESUMO

Organometallic halide perovskite (MAPPbBr3), Rust-based Vapor Phase Polymerization (RVPP)-PEDOT hole transporting layers and (RVPP-PEDOT)/MAPPbBr3 dual-layer, deposited on fluorine doped tin oxide glass were studied at room temperature using steady-state absorption, time-resolved photoluminescence imaging and femtosecond time-resolved absorption spectroscopy. Application of these techniques in conjunction with diverse excitation intensities allowed determination of various optoelectronic properties of the perovskite film and the time constant of the hole extraction process. Spectral reconstruction of the bandedge absorption spectrum using Elliot's formula enabled separation of the exciton band. The binding energy of the exciton was determined to be 19 meV and the bandgap energy of the perovskite film was 2.37 eV. Subsequent time-resolved photoluminescence studies of the perovskite film performed using a very weak excitation intensity followed by a global analysis of the data revealed monomolecular recombination dynamics of charge carriers occurring with an amplitude weighted lifetime of 3.2 ns. Femtosecond time-resolved transient absorption of the film performed after excitation intensity spanning a range of over two orders of magnitude enabled determining the rate constant of bimolecular recombination and was found to be 2.6 × 10-10 cm3 s-1. Application of numerous high intensity excitations enabled observation of band filling effect and application of the Burstein-Moss model allowed to determine the reduced effective mass of photoexcited electron-hole pair in MAPPbBr3 film to be 0.19 rest mass of the electron. Finally, application of transient absorption on RVPP-PEDOT/MAPPbBr3 enabled determination of a 0.4 ps time constant for the MAPPbBr3-to-PEDOT hole extraction process.

8.
ACS Nano ; 15(4): 7799-7810, 2021 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-33819007

RESUMO

Increasing capacitance and energy density is a major challenge in developing supercapacitors for flexible portable electronics. A thick electrode with a high mass loading of active electronic material leads to high areal capacitance; however, the higher the loading, the higher the mechanical stiffness and ion diffusion resistance, thereby hampering development of flexible supercapacitors. Here, we show a chemical strategy that leads to a hierarchical electrode structure producing devices with both an exceedingly high areal capacitance and superior flexibility. We utilize α-Fe2O3 particles as an oxidant precursor for controlling oxidative radical polymerization of the conducting polymer poly(3,4-ethylenedioxythiophene) (PEDOT) from the vapor phase. Our approach impregnates carbon cloth with α-Fe2O3 particles prior to monomer vapor exposure, resulting in state-of-the-art flexible nanofibrillar PEDOT supercapacitors possessing high areal capacitance (2243 mF/cm2 for two-electrode vs 6210 mF/cm2 for three-electrode) and high areal energy density (412 µWh/cm2).

9.
Front Pharmacol ; 12: 778940, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34992534

RESUMO

Objectives: This study took Fuzhou city as a case, described how the public health insurance coverage policy in 2016 of novel anti-lung cancer medicines benefited patients, and who benefited the most from the policy in China. Methods: This was a retrospective study based on health insurance claim data with a longitudinal analysis of the level and trend changes of the monthly number of patients to initiate treatment with the novel targeted anti-lung cancer medicines gefitinib and icotinib before and after health insurance coverage. The study also conducted a multivariate linear regression analysis to predict the potential determinants of the share of patient out-of-pocket (OOP) expenditure for lung cancer treatment with the study medicines. Results: The monthly number of the insured patients in Fuzhou who initiated the treatment with the studied novel targeted anti-lung cancer medication abruptly increased by 26 in the month of the health insurance coverage (95% CI: 14-37, p < 0.01) and kept at an increasing level afterward (p < 0.01). By controlling the other factors, the shares of OOP expenditure for lung cancer treatment of the patients who were formal employee program enrollees not entitled to government-funded supplementary health insurance coverage and resident program enrollees were 18.3% (95% CI: 14.1-22.6) and 26.7% (95% CI: 21.0-32.4) higher than that of the patients who were formal employee program enrollees with government-funded supplementary health insurance coverage. Conclusion: The public health insurance coverage of novel anti-lung cancer medicines benefited patients generally. To enable that patients benefit from this policy more equally and thoroughly, in order to achieve the policy goal of not to leave anyone behind, it is necessary to strengthen the benefits package of the resident program and to optimize the current financing mechanism of the public health insurance system.

10.
Nat Commun ; 11(1): 3882, 2020 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-32782258

RESUMO

Fired brick is a universal building material, produced by thousand-year-old technology, that throughout history has seldom served any other purpose. Here, we develop a scalable, cost-effective and versatile chemical synthesis using a fired brick to control oxidative radical polymerization and deposition of a nanofibrillar coating of the conducting polymer poly(3,4-ethylenedioxythiophene) (PEDOT). A fired brick's open microstructure, mechanical robustness and ~8 wt% α-Fe2O3 content afford an ideal substrate for developing electrochemical PEDOT electrodes and stationary supercapacitors that readily stack into modules. Five-minute epoxy serves as a waterproof case enabling the operation of our supercapacitors while submerged underwater and a gel electrolyte extends cycling stability to 10,000 cycles with ~90% capacitance retention.

11.
Eur J Clin Pharmacol ; 76(4): 501-506, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31912188

RESUMO

PURPOSE: To systematically compare the efficacy and safety of sufentanil versus fentanyl for pain relief in labor involving combined spinal-epidural analgesia (CSEA), a systematic review and meta-analysis of randomized controlled trials targeting parturients requesting labor analgesia was conducted. METHODS: The primary outcome measure was visual analog scale scores assessed at 10, 15, 30, and 60 min after intrathecal injection. Secondary outcomes included duration of spinal analgesia, incidence of side effects in parturients, and neonatal Apgar scores. RESULTS: Twelve randomized controlled trials, including data from 881 patients fulfilled the inclusion criteria. No clinically meaningful differences in pain reduction after intrathecal injection were found between the two analgesics. Sufentanil extended the duration of spinal analgesia by 25.40 min (95% CI 21.82 to 28.98 min; p < 0.00001) compared with fentanyl. The risk for pruritus, nausea, and vomiting among parturients was 82% for those using sufentanil (relative risk 0.82 [95% CI 0.67-0.99]; p = 0.04) and 48% for those using fentanyl (relative risk 0.48 [95% CI 0.29-0.80]; p = 0.005). Both the synthesis results and sensitivity analysis demonstrated no differences in the risk for respiratory depression between parturients using sufentanil versus fentanyl. The neonates in sufentanil group exhibited higher Apgar scores than the fentanyl group 5 min after delivery (weighted mean difference 0.10 [95% CI 0.05-0.16]; p = 0.0002). CONCLUSION: Existing evidence suggests that compared with fentanyl, sufentanil used for analgesia in combined spinal-epidural during labor is more effective in extending the duration of spinal analgesia, and may be safer for the infant. There was overall low clinical and statistical heterogeneity among the included studies. For all outcomes, variations caused by heterogeneity across trials were acceptable. Thus the findings of this meta-analysis may provide additional evidence for future clinical practices of pain relief in labor involving CSEA. Stronger evidence supporting this conclusion will require data from more high-quality and multicenter randomized controlled trials.


Assuntos
Analgesia Epidural/métodos , Analgesia Obstétrica/métodos , Analgésicos Opioides/uso terapêutico , Fentanila/uso terapêutico , Trabalho de Parto/efeitos dos fármacos , Dor/tratamento farmacológico , Sufentanil/uso terapêutico , Analgésicos Opioides/administração & dosagem , Índice de Apgar , Feminino , Fentanila/administração & dosagem , Humanos , Recém-Nascido , Injeções Espinhais , Gravidez , Sufentanil/administração & dosagem
12.
J Pain Symptom Manage ; 59(4): 829-835.e1, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31759032

RESUMO

CONTEXT: The annual consumption of opioid analgesics in the U.S. was more than 10 times the world average, whereas that in China was at a moderate level within Asia but much lower than the worldwide average. The opposite situations of opioid use in the U.S. and China revealed totally different problems in the developed versus developing world, that is, overuse versus underuse of opioids. OBJECTIVES: This study analyzed the clinical consumption, estimated the needs of pain treatment, and evaluated the adequacy of opioid analgesic consumption in mainland China and its seven regions. METHODS: A retrospective analysis of the national and regional consumption of opioid analgesics in mainland China during 2006-2016 was conducted. The adequacy of consumption measure was used to gauge the overall adequacy of opioid analgesic consumption in morphine equivalents (MEs) for the treatment of moderate-to-severe pain in mainland China and compared with international data. Annual per capita consumption was adopted to measure the clinical consumption of opioid analgesics in MEs at a national level and across seven regions of mainland China. Needs of morphine for cancer pain treatment in mainland China and in its seven regions were estimated and compared with the clinical consumption of opioid analgesics in MEs. RESULTS: The adequacy of consumption measure of mainland China ranged from 0.0041 to 0.0088 during 2006-2016, which was less than 1% of that in the reference countries. The poor North East region had only 10.85% of the cancer pain morphine needs fulfilled. The highest fulfillment rate was 36.02% in rich Southern China, which was 25.9% at the national level. CONCLUSION: The clinical consumption of opioid analgesics for the treatment of moderate-to-severe pain in mainland China was far below the international level. The annual per capita of clinical consumption was lower, and the adequacy of cancer pain treatment was poorer in less developed areas. All these findings call for actions to strengthen pain management.


Assuntos
Analgésicos Opioides , Manejo da Dor , Analgésicos/uso terapêutico , Analgésicos Opioides/uso terapêutico , China/epidemiologia , Humanos , Morfina/uso terapêutico , Dor/tratamento farmacológico , Dor/epidemiologia , Estudos Retrospectivos
13.
J Glob Health ; 9(2): 020702, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31673344

RESUMO

METHODS: Using an interrupted time series design, we conducted segmented regression analyses of utilization changes of targeted anti-cancer medicines covered by the provincial government health insurance program during 2013 to 2016 in 69 hospitals with more than 100 beds in Hangzhou, the capital city of Zhejiang province of China. The WHO/Health Action International Project on Medicine Prices and Availability methodology was used to measure patient affordability of the study medicines. RESULTS: In March 2015, the utilization of all study medicines increased by 15.58 (95% CI = 3.86, 27.30, P = 0.01) to 439.14 standard units (95% CI = 311.79, 566.49, P < 0.001). Before covered by government health insurance, the estimated out-of-pocket payment by patient ranged from 3.0 to 13.1 times of the provincial average disposable annual income per capita for urban residents, and 6.2 to 27.3 times for rural residents. Such payments were reduced to 0.6 to 2.1 times for urban residents and 1.8 to 4.4 times for rural population after government health insurance coverage inclusion. During 2015 to 2016, the per capita contribution to Hangzhou catastrophic health insurance program was CNY15 (US$ 2.3), and the reimbursement rate was 70% in Hangzhou city. The cumulative total insurance expenses on six study targeted anticancer medicines accounted for an estimated 53% of the total amount of premiums of the government catastrophic health insurance fund. Sensitivity analyses indicated that this proportion would have changed to 46%, 61% and 69% when changing the per capita contribution to CNY25 (US$ 3.8) and CNY40 (US$ 6.2), and changing the insurance reimbursement rate to 60%, 80 and 90%. CONCLUSION: Government health insurance coverage inclusion significantly increased utilization of the expensive targeted anti-cancer medicines, and improved patient affordability. However, the financial burden of patients is still high, especially for the rural low-income population. Rising utilization and expenditures call for careful monitoring of anti-cancer medicines use, and for strategies to decrease prices to facilitate medicines access and keep the insurance system sustainable.


Assuntos
Antineoplásicos/economia , Antineoplásicos/uso terapêutico , Cobertura do Seguro/estatística & dados numéricos , Programas Nacionais de Saúde , China , Custos e Análise de Custo , Humanos , Análise de Séries Temporais Interrompida , Neoplasias/tratamento farmacológico
14.
ACS Appl Mater Interfaces ; 11(50): 47320-47329, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31739664

RESUMO

Current state-of-the-art synthetic strategies produce conducting polymers suffering from low processability and unstable chemical and/or physical properties stifling research and development. Here, we introduce a platform for synthesizing scalable submicron-sized particles of the conducting polymer poly(3,4-ethylenedioxythiophene) (PEDOT). The synthesis is based on a hybrid approach utilizing an aerosol of aqueous oxidant droplets and monomer vapor to engineer a scalable synthetic scheme. This aerosol vapor polymerization technology results in bulk quantities of discrete solid-state submicron particles (750 nm diameter) with the highest reported particle conductivity (330 ± 70 S/cm) so far. Moreover, particles are dispersible in organics and water, obviating the need for surfactants, and remain electrically conductive and doped over a period of months. This enhanced processability and environmental stability enable their incorporation in thermoplastic and cementitious composites for engineering chemoresistive pH and temperature sensors.

15.
BMC Public Health ; 19(1): 824, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31242879

RESUMO

BACKGROUND: Reducing maternal mortality remains a global priority. In 2000, the United Nations Member States pledged to work towards a series of Millennium Development Goals (MDGs), in which the fifth target was to reduce maternal mortality ratio by 75% from 1990 to 2015. The Chinese government introduced Basic Public Health Service project in 2009 to the further improvement of maternal health services and reduction in maternal mortality. China had achieved the goal of MDG5 1 year ahead of the schedule in 2014, but the effects of the project on reducing maternal mortality were rarely evaluated with robust methods. METHODS: We conducted a longitudinal study on maternal mortality ratio by extracting mortality data from the National Maternal Mortality Surveillance System (1991-2016) and maternal health services measures from the China health statistic yearbook (2001-2016). We utilized the segmented linear regression model to assess changes and trends of maternal mortality ratio and maternal health services before and after the introduction of Basic Public Health Service project. Pearson correlation analysis was conducted to measure the strength of association between the maternal mortality ratio and maternal health services. RESULTS: The yearly trend change of national maternal mortality ratio was - 1.76 (p < 0.01) after the introduction of Basic Public Health Service project in 2009, while the yearly trend change of maternal health record establish rate, prenatal examination rate, postpartum visit rate was 0.77 (p < 0.01), 0.61 (p < 0.01) and 0.83 (p < 0.01) separately. The negative correlations were also found between national maternal mortality ratio and prenatal examination rate (r = - 0.95, p < 0.01), maternal health record establish rate (r = - 0.93, p < 0.01) and postpartum visit rate (r = - 0.92, p < 0.01). CONCLUSIONS: The Basic Public Health Service project was found to be associated with the improvements in the maternal health services and reduction in maternal mortality. The design and implementation of the project may serve as a positive example for other developing countries. Continued monitoring and assessment of project effects should be stressed.


Assuntos
Programas Governamentais , Morte Materna/prevenção & controle , Serviços de Saúde Materna/normas , Mortalidade Materna/tendências , Avaliação de Programas e Projetos de Saúde , United States Public Health Service/normas , China/epidemiologia , Países em Desenvolvimento , Feminino , Governo , Humanos , Análise de Séries Temporais Interrompida , Estudos Longitudinais , Serviços de Saúde Materna/estatística & dados numéricos , Gravidez , Nações Unidas , Estados Unidos
16.
Nanoscale ; 11(25): 12358-12369, 2019 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-31215944

RESUMO

Freestanding, contiguous, and translucent polypyrrole nanonets are prepared within 90 minutes at room temperature in Petri dishes by exposing aqueous oxidant to static pyrrole vapor. The nanonets are 150 nm thick, with variable densities depending on polymerization time. The nanonets maintain a low sheet resistance of 29.1 Ω□-1 at 30% optical transmission, and 423 Ω□-1 at 50% transmission. A mechanism is proposed in which polypyrrole islands serve as nucleation sites for further surface-tension constrained polymerization. The nanonets exhibit a high degree of electrochemical dopability (over 24%). Nets are robust and processable, as evidenced by their ability to drape over 2D and 3D substrates. Large areas of films are manually twisted into highly porous sub-millimeter diameter conductive wires, able to recover their two-dimensional structure upon immersion in solvents. Moreover, nanonets exhibit a high specific capacitance of 518 F g-1 for a 1.2 V potential window. Electrochemical capacitors fabricated with nanonet active electrodes show a high energy density of 9.86 W h kg-1 at 1775 W kg-1 when charged to 0.8 V.

17.
Risk Manag Healthc Policy ; 12: 357-367, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31908552

RESUMO

China's healthcare reform aims to provide affordable and equitable basic healthcare for all by 2020. Access to medicines is an essential part of the healthcare. The efforts of promoting access to medicines have been moving from meeting the needs of the basic healthcare, towards increasingly dedicated resources to offer breakthrough therapies. Looking at access to novel medicines from a health system perspective, and placing the changes China has made into that system context, this paper makes a comprehensive review of the progress of access to novel medicines in China. The review drew on two sources of information, which included desk review of published and grey literature, and key informant interview. Five hurdles were identified which create barriers of access to novel medicines, ranging from regulation and financing of medicines, intellectually property rights protection, and development of innovation capacity, to other health system components. Multiple policies have been implementing in China to remove the multiple access barriers gradually. Universal access to medicines has been moving from towards the basic common conditions to the world breakthrough technologies. We see cause for optimism, but recognize that there is a long way to go. Achieving broader and better access to modern medicines for Chinese patients will require multiple and coordinated government efforts, which would need to target the whole lifecycle regulation of novel medicines with a health system perspective, from balancing IP protection, strengthening R&D and public health, to appropriate regulatory approach and financing mechanism, and to supply chain management, as well as smart use.

18.
ACS Appl Mater Interfaces ; 9(47): 41496-41504, 2017 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-29111644

RESUMO

We introduce a novel condensing vapor phase polymerization (CVPP) strategy for depositing microtubes of the conducting polymer polypyrrole; these serve as one-dimensional hollow microstructures for storing electrochemical energy. In CVPP, water droplets are structure-directing templates for polypyrrole microtubes. Water vapor condensation and polymerization occur simultaneously-conformal coatings of microtubes deposit on porous substrates such as hard carbon fiber paper or glass fiber filter paper. A mechanistic evolution of the microtubular morphology is proposed and tested based on the mass transport of water and monomer vapors as well as on the reaction stoichiometry. A coating of PPy microtubes is characterized by a high reversible capacitance of 342 F g-1 at 5 mV s-1 throughout 5000 cycles of cyclic voltammetry and a low sheet resistance of 70.2 Ω â–¡-1. The open tubular structure is controlled in situ during synthesis and leads to electrodes that exhibit electrochemical stability at high scanning rates up to 250 mV s-1 retaining all stored charge, even after extensive cycling at 25 mV s-1.

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