For the performance improvement of microbial fuel cells (MFCs), the anode becomes a breakthrough point due to its influence on bacterial attachment and extracellular electron transfer (EET). On other level, carbon materials possess the following features: low cost, rich natural abundance, good thermal and chemical stability, as well as tunable surface properties and spatial structure.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
The construction of an optimized electrolyte system compatible with layered transition metal (TM) oxides is of great importance to advanced sodium‐ion batteries (SIBs). Herein, a low‐cost iron‐containing manganese‐based layered cathode material of Na0.67Ni0.15Fe0.2Mn0.65O2 (N‐NFM) is prepared through an improved coprecipitation method. Then, the chemical properties of interfaces between the N‐NFM cathode and organic liquid electrolytes based on NaClO4 and NaPF6 are investigated, respectively. Results show that the cathode electrolyte interphase (CEI) film formed in the NaPF6‐based electrolyte is dense and uniform, which inhibits the dissolution of TM ions effectively and provides a low energy barrier for the transport of Na+. Apart from that the CEI film formed in the NaClO4‐based electrolyte contains more organic but less inorganic compounds, resulting in an increase in impedance. In addition, it is believed that the stability of the CEI film is susceptible to the perchlorate with strong oxidizing property. In this role, a small part of the CEI film falls from the cathode surface, accelerating the dissolution of TM ions and leading to the reactivation of electrolyte decomposition.
ObjectiveTo assess the quality of primary healthcare (PHC) for patients with diabetes in China from 2011 to 2015.SettingThis study analysed data on 1006, 1472 and 1771 participants with diabetes who were surveyed in 2011, 2013 and 2015, respectively, in the China Health and Retirement Longitudinal Study, a nationally representative survey conducted in 29 provinces of China.Outcome measuresThe study measured the proportions of patients with diabetes who received diabetes-related health education, examinations and treatments, as well as the hospital admission rate due to diabetes of these patients. Multilevel logistic regression was used to adjust sociodemographic variables.ResultsAccording to the multivariate analysis, the proportion of patients who received diabetes-related health education decreased significantly (OR=0.74, 95% CI 0.61 to 0.90), and the proportion of those receiving examinations and treatments remained unchanged from 2011 to 2015. Diabetes-related hospitalisation increased from 4.01% in 2011 to 6.08% in 2013 (OR=1.47, 95% CI 0.97 to 2.22), and recurrent hospitalisations increased from 18.87% in 2011 to 28.45% in 2015 (OR=1.78, 95% CI 1.44 to 2.20). The proportions of patients with diabetes-related and recurrent hospitalisations in western China were higher than those in the east (OR=1.80, 95% CI 1.13 to 2.87; OR=1.92, 95% CI 1.50 to 2.45).ConclusionsNationally, the analysis of patient-reported process and outcome indicators cannot confirm that the quality of PHC has improved in China during 2011–2015. Regional disparities in primary diabetes care require urgent resource allocation to western China. Establishing a national quality registry for PHC, which transparently reports outcomes by region and social-economic position, is essential for countries sharing the challenge of improving both quality and equity of PHC.
To study the microscopic production mechanism of corner residual oil after polymer flooding, microscopic visualization oil displacement technology and COMSOL finite element numerical simulation methods were used. The influence of the viscosity and interfacial tension of the oil displacement system after polymer flooding on the movement mechanism of the corner residual oil was studied. The results show that by increasing the viscosity of the polymer, a portion of the microscopic remaining oil in the corner of the oil-wet property can be moved whereas that in the corner of the water-wet property cannot be moved at all. To move the microscopic remaining oil in the corners with water-wet properties after polymer flooding, the viscosity of the displacement fluid or the displacement speed must be increased by 100–1000 times. Decreasing the interfacial tension of the oil displacement system changed the wettability of the corner residual oil, thus increasing the wetting angle. When the interfacial tension level reached 10−2 mN/m, the degree of movement of the remaining oil in the corner reached a maximum. If the interfacial tension is reduced, the degree of production of the residual oil in the corner does not change significantly. The microscopic production mechanism of the corner residual oil after polymer flooding expands the scope of the displacement streamlines in the corner.
Background
One of the important ways to reduce medical costs and improve quality of care is to enable physicians to provide standard medical services according to clinical guidelines, and the medical payment system is a significant means of guiding the behaviour of health service providers. This study aims to investigate whether the diagnosis-related group (DRG) payment system can improve the consistency of health services.
Method
Inpatients with three types of disease—chronic obstructive pulmonary disease (COPD), acute myocardial infarction (AMI) and cerebral infarction (CI)—were enrolled from 25 county-level hospitals in a DRG pilot city in China. Inpatients from hospitals that implemented DRG payment were selected as the intervention group, and similar inpatient cases from hospitals that still implemented fee-for-services (FFS) payment were designated as the control group. A propensity matching score (PSM) was used for data matching to control for age, gender and disease severity. The variation of hospitalization expenditures and their trends before and after implementation of the DRG policy were described by using these matched samples.
Results
After DRG implementation, the standard deviation (SD) of hospitalization expenditures in the COPD, AMI and CI intervention groups decreased by 11094 yuan, 4833 yuan and 425 yuan, respectively, which were 5972, 2484, and 2938 yuan more than that in the control group. In each year after DRG implementation, the interquartile range (IQR) of hospitalization expenditures was smaller in DRG group than that in FFS group. In most years, the degree of variation in costs of the intervention group decreased more than that of the control group. The medians of hospitalization expenditures of the intervention groups were lower than the fixed cost, while most medians of the control groups were higher than the fixed cost.
Conclusion
A comparison of patients with similar demographics and disease characteristics revealed that patients in the DRG group experienced a smaller degree of variation in hospitalization expenditures, and indicated the expenditures had a tendency to become progressively more concentrated over time. It is suggested that DRG system can promote better consistency in health services and reduce medical costs.
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