Yingluo Yang

The obesity epidemic is not only impairing the health of millions of Americans but also giving rise to billions of added dollars in health care spending. Climbing rates of obesity over the past decades are one of the predominant determinants behind the surging progression of health care expenses in the United States. Moreover, the less fit and less productive U.S. workforce has gradually eroded the nation’s industrial competitiveness. Since the early 1970s, adult obesity rates have doubled and childhood obesity rates have more than tripled, while health expenditures have risen two percentage points faster than the Gross Domestic Product, burgeoning from 8.8 percent in 1980 to a projected 17.9 percent in 2011. Studies analyze that greater than a quarter of America’s health care expenses are attributed to obesity. The stunning growth in obesity has been imputed for 20 to 30 percent of the increase in health care costs since the late 1970s. If the proportion of obese population had stayed unchanged, then health care expenditures in America would be approximately 10 percent less on a per capita average than they are today.

The drive for cost-effective use of medical interventions has advantages, but can also be challenging in the context of end-of-life palliative treatments. A quality-adjusted life-year (QALY) provides a common currency to assess the extent of the benefits gained from a variety of interventions in terms of health-related quality of life and survival for the patient. However, since it is in the nature of end-of-life palliative care that the benefits it brings to its patients are of short duration, it fares poorly under a policy of QALY-maximization. Nevertheless, we argue that the goals of palliative care and QALY are not incompatible, and optimal integration of palliative care into the calculation of QALY may reveal a mechanism to modify considerations of how optimal quality of life can be achieved, even in the face of terminal illness. The use of QALYs in resource allocation means that palliative care will always compete with alternative uses of the same money. More research should be conducted to evaluate choices between palliative care and more aggressive therapies for the terminally ill. However, current limited data show that investing in palliative care makes more sense not only ethically, but also financially

The call for family and medical leave reform in the United States was largely the result of sweeping demographic shifts that occurred in the workforce after the 1950s, coupled with an ever-increasing life expectancy and changing social norms concerning the role of women as caretakers. By the early 1990s, the number of women in the workforce had nearly tripled from 1950. During that same period, life expectancy increased by six years for males and seven for females. Meanwhile, the first wave of the Depression-era generation began to reach the age of retirement. In short, the parents of American workers were living longer and retiring in greater numbers while more women, who were more likely to be informal caregivers, decided to join the workforce. As a result, many families with ill or elder parents began to turn to institutional long-term care.

Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China

Recent developments in the health care industry have precipitated a new wave of interest in expanding the scope of practice for nursing. This is because the Patient Protection and Affordable Care Act, broadly designed to increase access to health insurance, will inevitably result in increased demand for primary care providers. And with compensation for primary care physicians already lagging far behind that of specialists, the role of nurse practitioners is once again receiving increased attention as a viable means by which to ease the pressure for access to health care.But the economics of this trade-off are controversial. On one hand, it sets primary care physicians at odds with specialists; namely, if the ultimate goal is to “bend the cost curve downward,” should specialist compensation be reduced in order to increase spending on primary care?

Used appropriately, reliance on science distinguishes public health from policymaking driven more by theory and opinion and enhances trust in public health interventions. Evidence-based vaccine policymaking aims to control communicable disease by urging decision makers to base policies on the best available evidence rather than politics or personal views. The results of this approach, such as smallpox eradication, have been dramatic. Historically, mandatory childhood vaccination has been perhaps the most successful evidence-based tool in combating many epidemics. Philosophically, vaccination mandates correspond to the legal system’s dual role in codifying what society deems undesirable behavior and declaring beneficial social norms and values consistent with understandings of the social contract. Despite their effectiveness and philosophical grounding, vaccination mandates present serious legal and ethical questions. Public health policymakers have a continuing responsibility to rely on evidence not only as a basis for generating policy, but also for evaluating and improving elements of its legal design.

As we journey into the fourth year of the COVID-19 pandemic, a majority of Americans express relief at a “return to normal,” experience pandemic fatigue, or embrace the idea of living with COVID-19 in much the same way we live with the seasonal flu. But transition to a new phase of life with SARS-CoV-2 does not diminish the importance of vaccination. The US Centers for Disease Control and the Food and Drug Administration recently recommended another round of booster dose for persons age 5 and up, or an initial series for those not previously vaccinated, with an updated bivalent formula that protects against both the original virus strain and Omicron subvariants that are now the dominant source of infection. By most accounts most of the population has been or will become infected with SARS-CoV-2. Suboptimal uptake of the COVID-19 vaccines among the approximately 25 million adolescents in the United States is a significant obstacle to population coverage, public health, and the health and well-being of adolescents. A major cause of low adolescent uptake is parental vaccine hesitancy. This article discusses parental vaccine hesitancy and argues that permitting independent adolescent consent to COVID-19 vaccination should be an ethical and policy priority as we continue to confront the threat of Omicron and other variants of the coronavirus. We discuss the central role of the pediatric healthcare team in caring for adolescent patients who disagree with their parents about vaccination.

© 2015 Elsevier Inc.The breakthrough of induced pluripotent stem cell technology has raised the possibility that patient-specific iPSCs may become a renewable source of autologous cells for cell therapy without the concern of immune rejection. However, the immunogenicity of autologous human iPSC -derived cells is not well understood. Using a humanized mouse model reconstituted with a functional human immune system, we demonstrate that most teratomas formed by autologous integration-free hiPSCs exhibit local infiltration of antigen-specific T cells and associated tissue necrosis, indicating immune rejection of certain hiPSC-derived cells. In this context, autologous hiPSC-derived smooth muscle cells appear to be highly immunogenic, while autologous hiPSC-derived retinal pigment epithelial cells are immune tolerated even in non-ocular locations. This differential immunogenicity is due in part to abnormal expression of immunogenic antigens in hiPSC-derived SMCs, but not in hiPSC-derived RPEs. These findings support the feasibility of developing hiPSC-derived RPEs for treating macular degeneration.

© CERN for the benefit of the ATLAS collaboration 2011.We present first measurements of charged and neutral particle-flow correlations in pp collisions using the ATLAS calorimeters.Data were collected in 2009 and 2010 at centre-of-mass energies of 900 GeV and 7 TeV.Events were selected using a minimum-bias trigger which required a charged particle in scintillation counters on either side of the interaction point.Particle flows, sensitive to the underlying event, are measured using clusters of energy in the ATLAS calorimeters, taking advantage of their fine granularity.No Monte Carlo generator used in this analysis can accurately describe the measurements.The results are independent of those based on charged particles measured by the ATLAS tracking systems and can be used to constrain the parameters of Monte Carlo generators.

© 2016 AIP Publishing LLC.We present evidence for breathing modes in magnetron sputtering plasmas: periodic axial variations of plasma parameters with characteristic frequencies between 10 and 100 kHz. A set of azimuthally distributed probes shows synchronous oscillations of the floating potential. They appear most clearly when considering the intermediate current regime in which the direction of azimuthal spoke motion changes. Breathing oscillations were found to be superimposed on azimuthal spoke motion. Depending on pressure and current, one can also find a regime of chaotic fluctuations and one of stable discharges, the latter at high current. A pressure-current phase diagram for the different situations is proposed.

© 2015 American Chemical Society. We demonstrate straightforward fabrication of highly sensitive biosensor arrays based on field-effect transistors, using an efficient high-throughput, large-area patterning process. Chemical lift-off lithography is used to construct field-effect transistor arrays with high spatial precision suitable for the fabrication of both micrometer- and nanometer-scale devices. Sol-gel processing is used to deposit ultrathin In 2 O 3 films as semiconducting channel layers. The aqueous sol-gel process produces uniform In 2 O 3 coatings with thicknesses of a few nanometers over large areas through simple spin-coating, and only low-temperature thermal annealing of the coatings is required. The ultrathin In 2 O 3 enables construction of highly sensitive and selective biosensors through immobilization of specific aptamers to the channel surface; the ability to detect subnanomolar concentrations of dopamine is demonstrated.

© 2015 Published by John Wiley & Sons Ltd.Soil transplant serves as a proxy to simulate climate changes. Recently, we have shown that southward transplant of black soil and northward transplant of red soil altered soil microbial communities and biogeochemical variables. However, fundamental differences in soil types have prevented direct comparison between southward and northward transplants. To tackle it, herein we report an analysis of microbial communities of Cambisol soil in an agriculture field after 4 years of adaptation to southward and northward soil transplants over large transects. Analysis of bare fallow soils revealed concurrent increase in microbial functional diversity and coarse-scale taxonomic diversity at both transplanted sites, as detected by GeoChip 3.0 and DGGE, respectively. Furthermore, a correlation between microbial functional diversity and taxonomic diversity was detected, which was masked in maize cropped soils. Mean annual temperature, soil moisture, and nitrate showed strong correlations with microbial communities. In addition, abundances of ammonium-oxidizing genes and denitrification genes were correlated with nitrification capacity and NO3--N contents, suggesting that microbial responses to soil transplant could alter microbe-mediated biogeochemical cycle at the ecosystem level. This study proved that microbial responses to southward and northward soil transplants were asymmetric. Microbial responses at the community level to soil transplant can result in altered ecosystem-level biogeochemical cycle.

Digital resurrection technologies use artificial intelligence to recreate the voices, images, and personalities of deceased individuals, raising ethical concerns about memory, identity, and respect for the dignity of the deceased. This paper examines key neuroethical challenges, including mental privacy, cognitive liberty, and the authenticity of AI-generated representations. Rather than framing East-West differences as opposing cultural values, the paper identifies shared ethical concerns expressed through diverse practices. It proposes a cross-cultural governance framework based on universal principles: protecting mental privacy, ensuring faithful representations of identity, and preventing exploitation. Practical mechanisms include digital neural wills, tiered regulation based on technology capabilities, and structured family decision-making. By integrating evidence from neuroscience, law, and cultural studies, this framework aims to ensure that digital resurrection technologies support ethical remembrance rather than commodifying identity. Without proactive governance, these technologies risk distorting how societies remember and honor the deceased.