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Nonmodal Clinical Decision Support And Antimicrobial Restriction Effects On Rates Of Fluoroquinolone Use In Uncomplicated Infections, L R. Gunn, R Tunney, K E. Kelly 2018 Campbell University

Nonmodal Clinical Decision Support And Antimicrobial Restriction Effects On Rates Of Fluoroquinolone Use In Uncomplicated Infections, L R. Gunn, R Tunney, K E. Kelly

Pharmacy Practice

No abstract provided.


Metabolism Of Primaquine In Normal Human Volunteers: Investigation Of Phase I And Phase Ii Metabolites From Plasma And Urine Using Ultra-High Performance Liquid Chromatography-Quadrupole Time-Of-Flight Mass Spectrometry, B. Avula, B. L. Tekwani, N. D. Chaurasiya, P. S. Fasinu, N. D. Nanayakkara, H. B. Herath, Y. H. Wang, J. Y. Bae, S. I. Khan, M. A. Elsohly, J. D. McChesney 2018 Campbell University

Metabolism Of Primaquine In Normal Human Volunteers: Investigation Of Phase I And Phase Ii Metabolites From Plasma And Urine Using Ultra-High Performance Liquid Chromatography-Quadrupole Time-Of-Flight Mass Spectrometry, B. Avula, B. L. Tekwani, N. D. Chaurasiya, P. S. Fasinu, N. D. Nanayakkara, H. B. Herath, Y. H. Wang, J. Y. Bae, S. I. Khan, M. A. Elsohly, J. D. Mcchesney

Pharmaceutical Sciences

No abstract provided.


Kinetics And Inhibition Studies Of The L205r Mutant Of Camp-Dependent Protein Kinase Involved In Cushing’S Syndrome, Nicole M. Luzi, Charles E. Lyons, Darrell L. Peterson, Keith C. Ellis 2018 Virginia Commonwealth University

Kinetics And Inhibition Studies Of The L205r Mutant Of Camp-Dependent Protein Kinase Involved In Cushing’S Syndrome, Nicole M. Luzi, Charles E. Lyons, Darrell L. Peterson, Keith C. Ellis

Medicinal Chemistry Publications

Overproduction of cortisol by the hypothalamus–pituitary–adrenal hormone system results in the clinical disorder known as Cushing's syndrome. Genomics studies have identified a key mutation (L205R) in the α‐isoform of the catalytic subunit of cAMP‐dependent protein kinase (PKACα) in adrenal adenomas of patients with adrenocorticotropic hormone‐independent Cushing's syndrome. Here, we conducted kinetics and inhibition studies on the L205R‐PKACα mutant. We have found that the L205R mutation affects the kinetics of both Kemptide and ATP as substrates, decreasing the catalytic efficiency (kcat/KM) for each substrate by 12‐fold and 4.5‐fold, respectively. We have also determined the IC …


Reduction Of Endothelial Nitric Oxide Increases The Adhesiveness Of Constitutive Endothelial Membrane Icam-1 Through Src-Mediated Phosphorylation, Feng Gao, Brandon P. Lucke-Wold, Xiang Li, Aric F. Logsdon, Li-Chong Xu, Sulei Xu, Kyle B. LaPenna, Huaqi Wang, M.A. Hassan Talukder, Christopher A. Siedlecki, Jason D. Huber, Charles L. Rosen, Pingnian He 2018 Pennsylvania State University

Reduction Of Endothelial Nitric Oxide Increases The Adhesiveness Of Constitutive Endothelial Membrane Icam-1 Through Src-Mediated Phosphorylation, Feng Gao, Brandon P. Lucke-Wold, Xiang Li, Aric F. Logsdon, Li-Chong Xu, Sulei Xu, Kyle B. Lapenna, Huaqi Wang, M.A. Hassan Talukder, Christopher A. Siedlecki, Jason D. Huber, Charles L. Rosen, Pingnian He

Faculty & Staff Scholarship

Nitric oxide (NO) is a known anti-adhesive molecule that prevents platelet aggregation and leukocyte adhesion to endothelial cells (ECs). The mechanism has been attributed to its role in the regulation of adhesion molecules on leukocytes and the adhesive properties of platelets. Our previous study conducted in rat venules found that reduction of EC basal NO synthesis caused EC ICAM-1-mediated firm adhesion of leukocytes within 10–30min. This quick response occurred in the absence of alterations of adhesion molecules on leukocytes and also opposes the classical pattern of ICAM-1-mediated leukocyte adhesion that requires protein synthesis and occurs hours after stimulation. The objective …


Prescription Drug Abuse, Jiaxi Tian 2018 Augustana College, Rock Island Illinois

Prescription Drug Abuse, Jiaxi Tian

Global Issues in Public Health

Prescription drug abuse is an action that portrayed as misuse or overuse of prescription drugs. It is a prevalent problem all over the world. U.S is a particular country that has drug abuse as a serious problem has several different causes of the drug abuse. In the U.S., most prescription drugs are pain killers. The outcomes of drug abuse vary but may lead to death.


Group Ii Innate Lymphoid Cells And Microvascular Dysfunction From Pulmonary Titanium Dioxide Nanoparticle Exposure, Alaeddin Bashir Abukabda, Carroll Rolland McBride, Thomas Paul Batchelor, William Travis Goldsmith, Elizabeth Compton Bowdridge, Krista Lee Garner, Sherri Friend, Timothy Robert Nurkiewicz 2018 West Virginia University

Group Ii Innate Lymphoid Cells And Microvascular Dysfunction From Pulmonary Titanium Dioxide Nanoparticle Exposure, Alaeddin Bashir Abukabda, Carroll Rolland Mcbride, Thomas Paul Batchelor, William Travis Goldsmith, Elizabeth Compton Bowdridge, Krista Lee Garner, Sherri Friend, Timothy Robert Nurkiewicz

Faculty & Staff Scholarship

Background: The cardiovascular effects of pulmonary exposure to engineered nanomaterials (ENM) are poorly understood, and the reproductive consequences are even less understood. Inflammation remains the most frequently explored mechanism of ENM toxicity. However, the key mediators and steps between lung exposure and uterine health remain to be fully defined. The purpose of this study was to determine the uterine inflammatory and vascular effects of pulmonary exposure to titanium dioxide nanoparticles (nano-TiO2). We hypothesized that pulmonary nano-TiO2 exposure initiates a Th2 inflammatory response mediated by Group II innate lymphoid cells (ILC2), which may be associated with an impairment in uterine microvascular …


Exposure To Mild Blast Forces Induces Neuropathological Effects, Neurophysiological Deficits And Biochemical Changes, Adan Hernandez, Chunfeng Tan, Florian Plattner, Aric F. Logsdon, Karine Pozo, Mohammad A. Yousuf, Tanvir Singh, Ryan C. Turner, Brandon P. Luke-Wold, Jason D. Huber, Charles L. Rosen, James A. Bibb 2018 University of Texas Southwestern Medical Center

Exposure To Mild Blast Forces Induces Neuropathological Effects, Neurophysiological Deficits And Biochemical Changes, Adan Hernandez, Chunfeng Tan, Florian Plattner, Aric F. Logsdon, Karine Pozo, Mohammad A. Yousuf, Tanvir Singh, Ryan C. Turner, Brandon P. Luke-Wold, Jason D. Huber, Charles L. Rosen, James A. Bibb

Faculty & Staff Scholarship

Direct or indirect exposure to an explosion can induce traumatic brain injury (TBI) of various severity levels. Primary TBI from blast exposure is commonly characterized by internal injuries, such as vascular damage, neuronal injury, and contusion, without external injuries. Current animal models of blast-induced TBI (bTBI) have helped to understand the deleterious effects of moderate to severe blast forces. However, the neurological effects of mild blast forces remain poorly characterized. Here, we investigated the effects caused by mild blast forces combining neuropathological, histological, biochemical and neurophysiological analysis. For this purpose, we employed a rodent blast TBI model with blast forces …


Experimental Intravascular Hemolysis Induces Hemodynamic And Pathological Pulmonary Hypertension: Association With Accelerated Purine Metabolism, Victor P. Bilan, Frank Schneider, Enrico M. Novelli, Eric E. Kelley, Sruti Shiva, Mark T. Gladwin, Edwin K. Jackson, Stevan P. Tofovic 2018 University of Pittsburgh

Experimental Intravascular Hemolysis Induces Hemodynamic And Pathological Pulmonary Hypertension: Association With Accelerated Purine Metabolism, Victor P. Bilan, Frank Schneider, Enrico M. Novelli, Eric E. Kelley, Sruti Shiva, Mark T. Gladwin, Edwin K. Jackson, Stevan P. Tofovic

Faculty & Staff Scholarship

Pulmonary hypertension (PH) is emerging as a serious complication associated with hemolytic disorders, and plexiform lesions (PXL) have been reported in patients with sickle cell disease (SCD). We hypothesized that repetitive hemolysis per se induces PH and angioproliferative vasculopathy and evaluated a new mechanism for hemolysis-associated PH (HA-PH) that involves the release of adenosine deaminase (ADA) and purine nucleoside phosphorylase (PNP) from erythrocytes. In healthy rats, repetitive admin- istration of hemolyzed autologous blood (HAB) for 10 days produced reversible pulmonary parenchymal injury and vascular remodeling and PH. Moreover, the combination of a single dose of Sugen-5416 (SU, 200mg/kg) and 10-day …


Inhibition Of Phosphodiesterase-4 Reverses Aβ-Induced Memory Impairment By Regulation Of Hpa Axis Related Camp Signaling, Ying Xu, Naping Zhu, Wen Xu, Han Ye, Kaiping Liu, Feiyan Wu, Meixi Zhang, Yun Ding, Chong Zhang, Hanting Zhang, James O'Donnell, Jiangchun Pan 2018 Wenzhou Medical University & University of Buffalo

Inhibition Of Phosphodiesterase-4 Reverses Aβ-Induced Memory Impairment By Regulation Of Hpa Axis Related Camp Signaling, Ying Xu, Naping Zhu, Wen Xu, Han Ye, Kaiping Liu, Feiyan Wu, Meixi Zhang, Yun Ding, Chong Zhang, Hanting Zhang, James O'Donnell, Jiangchun Pan

Faculty & Staff Scholarship

Beta amyloid peptides (Aβ) are found to be associated with dysfunction of hypothalamic-pituitary-adrenal axis (HPA axis) that leads to memory and cognitive deficits in patients with Alzheimer’s disease (AD). Phosphodiesterase 4 (PDE4) inhibitors increase the intracellular cAMP activities, which may ameliorate cognitive deficits associated with AD. However, it remains unclear whether PDE4-mediated reversal of cognitive impairment in mouse model of AD is related to HPA axis and downstream cAMP-dependent pathway. The present study investigated the effects of PDE4 inhibitor rolipram on Aβ1-42-induced cognitive dysfunction and its underlying mechanisms. The step-down passive avoidance (PA) and Morris water-maze (MWM) tests were conducted …


Incineration Of Nanoclay Composites Leads To Byproducts With Reduced Cellular Reactivity, Alixandra Wagner, Andrew P. White, Man Chio Tang, Sushant Agarwal, Todd A. Stueckle, Yon Rojanasakul, Rakesh K. Gupta, Carasela Zoica Dinu 2018 West Virginia University

Incineration Of Nanoclay Composites Leads To Byproducts With Reduced Cellular Reactivity, Alixandra Wagner, Andrew P. White, Man Chio Tang, Sushant Agarwal, Todd A. Stueckle, Yon Rojanasakul, Rakesh K. Gupta, Carasela Zoica Dinu

Faculty & Staff Scholarship

Addition of nanoclays into a polymer matrix leads to nanocomposites with enhanced properties to be used in plastics for food packaging applications. Because of the plastics’ high stored energy value, such nanocomposites make good candidates for disposal via municipal solid waste plants. However, upon disposal, increased concerns related to nanocomposites’ byproducts potential toxicity arise, especially considering that such byproducts could escape disposal filters to cause inhalation hazards. Herein, we investigated the effects that byproducts of a polymer polylactic acid-based nanocomposite containing a functionalized montmorillonite nanoclay (Cloisite 30B) could pose to human lung epithelial cells, used as a model for inhalation …


Fasudil In Combination With Bone Marrow Stromal Cells (Bmscs) Attenuates Alzheimer’S Disease-Related Changes Through The Regulation Of The Peripheral Immune System, Jiezhong Yu, Yuqing Yan, Qingfang Gu, Gajendra Kumar, Hongqiang Yu, Yijin Zhao, Chunyun Liu, Ye Gao, Zhi Chai, Jasleen Chumber, Bao-Guo Xiao, Guang-Xian Zhang, Han-Ting Zhang, Yuqiang Jiang, Cun-Gen Ma 2018 Shanxi Datong University & Institute of Genetics and Development Biology

Fasudil In Combination With Bone Marrow Stromal Cells (Bmscs) Attenuates Alzheimer’S Disease-Related Changes Through The Regulation Of The Peripheral Immune System, Jiezhong Yu, Yuqing Yan, Qingfang Gu, Gajendra Kumar, Hongqiang Yu, Yijin Zhao, Chunyun Liu, Ye Gao, Zhi Chai, Jasleen Chumber, Bao-Guo Xiao, Guang-Xian Zhang, Han-Ting Zhang, Yuqiang Jiang, Cun-Gen Ma

Faculty & Staff Scholarship

Alzheimer’s disease (AD) is a chronic progressive neurodegenerative disease. Its mechanism is still not clear. Majority of research focused on the central nervous system (CNS) changes, while few studies emphasize on peripheral immune system modulation. Our study aimed to investigate the regulation of the peripheral immune system and its relationship to the severity of the disease after treatment in an AD model of APPswe/PSEN1dE9 transgenic (APP/PS1 Tg) mice. APP/PS1 Tg mice (8 months old) were treated with the ROCK-II inhibitor 1-(5-isoquinolinesulfonyl)- homo-piperazine (Fasudil) (intraperitoneal (i.p.) injections, 25 mg/kg/day), bone marrow stromal cells (BMSCs; caudal vein injections, 1 × 106 BMSCs …


In Utero Gene Expression In The Slc39a8(Neo/Neo) Knockdown Mouse, Jing Chen, Marina Galvez-Peralta, Xiang Zhang, Jingyuan Deng, Zijuan Liu, Daniel W. Nebert 2018 Cincinnati Children's Hospital Medical Center

In Utero Gene Expression In The Slc39a8(Neo/Neo) Knockdown Mouse, Jing Chen, Marina Galvez-Peralta, Xiang Zhang, Jingyuan Deng, Zijuan Liu, Daniel W. Nebert

Faculty & Staff Scholarship

Slc39a8 encodes ZIP8, a divalent cation/bicarbonate symporter expressed in pluripotent mouse embryonic stem cells, and therefore ubiquitous in adult tissues; ZIP8 influxes Zn2+, Mn2+ and Fe2+. Slc39a8(neo/neo) knockdown mice exhibit 10–15% of wild-type ZIP8 mRNA and protein levels, and show pleiotropic phenotype of stunted growth, neonatal lethality, multi-organ dysmorphogenesis, and dysregulated hematopoiesis manifested as severe anemia. Herein we performed RNA-seq analysis of gestational day (GD)13.5 yolk sac and placenta, and GD16.5 liver, kidney, lung, heart and cerebellum,comparing Slc39a8(neo/neo) with Slc39a8(+/+) wild-type. Meta-data analysis of differentially- expressed genes revealed 29 unique genes from all tissues — having enriched GO categories associated …


Wdr5 Supports Colon Cancer Cells By Promoting Methylation Of H3k4 And Suppressing Dna Damage, Beth K. Neilsen, Binita Chakraborty, Jamie L. McCall, Danielle E. Frodyma, Richard L. Sleightholm, Kurt W. Fisher, Robert E. Lewis 2018 University of Nebraska

Wdr5 Supports Colon Cancer Cells By Promoting Methylation Of H3k4 And Suppressing Dna Damage, Beth K. Neilsen, Binita Chakraborty, Jamie L. Mccall, Danielle E. Frodyma, Richard L. Sleightholm, Kurt W. Fisher, Robert E. Lewis

Faculty & Staff Scholarship

Background: KMT2/MLL proteins are commonly overexpressed or mutated in cancer and have been shown to support cancer maintenance. These proteins are responsible for methylating histone 3 at lysine 4 and promoting transcription and DNA synthesis; however, they are inactive outside of a multi-protein complex that requires WDR5. WDR5 has been implicated in cancer for its role in the COMPASS complex and its interaction with Myc; however, the role of WDR5 in colon cancer has not yet been elucidated.

Methods: WDR5 expression was evaluated using RT-qPCR and western blot analysis. Cell viability and colony forming assays were utilized to evaluate the …


Conformational Switching In The Coiled-Coil Domains Of A Proteasomal Atpase Regulates Substrate Processing, Aaron Snoberger, Evan J. Brettrager, David M. Smith 2018 West Virginia University

Conformational Switching In The Coiled-Coil Domains Of A Proteasomal Atpase Regulates Substrate Processing, Aaron Snoberger, Evan J. Brettrager, David M. Smith

Faculty & Staff Scholarship

Protein degradation in all domains of life requires ATPases that unfold and inject proteins into compartmentalized proteolytic chambers. Proteasomal ATPases in eukaryotes and archaea contain poorly understood N-terminally conserved coiled-coil domains. In this study, we engineer disulfide crosslinks in the coiled-coils of the archaeal proteasomal ATPase (PAN) and report that its three identical coiled-coil domains can adopt three different conforma- tions: (1) in-register and zipped, (2) in-register and partially unzipped, and (3) out-of-register. This conformational heterogeneity conflicts with PAN’s symmetrical OB-coiled-coil crystal structure but resembles the conformational heterogeneity of the 26S proteasomal ATPases’ coiled-coils. Furthermore, we find that one coiled-coil …


Increased Phenacetin Oxidation Upon The L382v Substitution In Cytochrome P450 1a2 Is Associated With Altered Substrate Binding Orientation, Qingbiao Huang, Grazyna D. Szklarz 2018 West Virginia University

Increased Phenacetin Oxidation Upon The L382v Substitution In Cytochrome P450 1a2 Is Associated With Altered Substrate Binding Orientation, Qingbiao Huang, Grazyna D. Szklarz

Faculty & Staff Scholarship

Leucine382 of cytochrome P450 1A2 (CYP1A2) plays an important role in binding and O-dealkylation of phenacetin, with the L382V mutation increasing substrate oxidation (Huang and Szklarz, 2010, Drug Metab. Dispos. 38:1039–1045). This was attributed to altered substrate binding orientation, but no direct experimental evidence had been available. Therefore, in the current studies, we employed nuclear magnetic resonance (NMR) longitudinal (T1) relaxation measurements to investigate phenacetin binding orientations within the active site of CYP1A2 wild type (WT) and mutants. Paramagnetic relaxation time (T1P) for each proton of phenacetin was calculated from the T1 value obtained from the enzymes in ferric and …


A Small Molecule P53 Activator Attenuates Fanconi Anemia Leukemic Stem Cell Proliferation, Wei Du, Xiaoli Li, Andrew F. Wilson, Qishen Pang 2018 West Virginia University

A Small Molecule P53 Activator Attenuates Fanconi Anemia Leukemic Stem Cell Proliferation, Wei Du, Xiaoli Li, Andrew F. Wilson, Qishen Pang

Faculty & Staff Scholarship

Although p53 mutations are common in solid tumors, such mutations are found at a lower frequency in hematologic malignancies. In the genetic disorder Fanconi anemia (FA), p53 has been proposed as an important pathophysiological factor for two important hematologic hallmarks of the disease: bone marrow failure and leukemogenesis. Here we show that low levels of the p53 protein enhance the capacity of leukemic stem cells from FA patients to repopulate immunodeficient mice. Furthermore, boosting p53 protein levels with the use of the small molecule Nutlin-3 reduced leukemia burden in recipient mice. These results demonstrate that the level of p53 protein …


Polypharmacy Among Patients With Diabetes: A Cross-Sectional Retrospective Study In A Tertiary Hospital In Saudi Arabia, Monira Alwhaibi, Bander Balkhi, Tariq M. Alhawassi, Hadeel Alkofide, Nouf Alduhaim, Rawan Alabdulali, Hadeel Drweesh, Ursha Sambamoorthi 2018 King Saud University

Polypharmacy Among Patients With Diabetes: A Cross-Sectional Retrospective Study In A Tertiary Hospital In Saudi Arabia, Monira Alwhaibi, Bander Balkhi, Tariq M. Alhawassi, Hadeel Alkofide, Nouf Alduhaim, Rawan Alabdulali, Hadeel Drweesh, Ursha Sambamoorthi

Faculty & Staff Scholarship

Abstract Patients with diabetes are at high risk for polypharmacy (ie, use of multiple medications) for treatment of diabetes, associated comorbidities and other coexisting conditions. This study aims to estimate the prevalence of polypharmacy and factors associated with polypharmacy among adult patients with diabetes.Methods A cross-sectional retrospective observational study of adults with diabetes, who visited the outpatient clinic of a tertiary teaching hospital in Saudi Arabia, was conducted. Data were extracted from the Electronic Health Record database for a period of 12 months (January– December 2016). Polypharmacy was defined as the cumulative use of five or more medications. Polypharmacy among …


Pseudomonas Aeruginosa Algr Phosphorylation Status Differentially Regulates Pyocyanin And Pyoverdine Production, Alexander S. Little, Yuta Okkotsu, Alexandria A. Reinhart, Heath Damron, Mariette Barbier, Brandon Barrett, Amanda G. Ogledby-Sherrouse, Joanna B. Goldberg, William L. Cody, Michael J. Schurr, Michael L. Vasil 2018 University of Colorado

Pseudomonas Aeruginosa Algr Phosphorylation Status Differentially Regulates Pyocyanin And Pyoverdine Production, Alexander S. Little, Yuta Okkotsu, Alexandria A. Reinhart, Heath Damron, Mariette Barbier, Brandon Barrett, Amanda G. Ogledby-Sherrouse, Joanna B. Goldberg, William L. Cody, Michael J. Schurr, Michael L. Vasil

Faculty & Staff Scholarship

Pseudomonas aeruginosa employs numerous, complex regulatory ele- ments to control expression of its many virulence systems. The P. aeruginosa AlgZR two-component regulatory system controls the expression of several crucial viru- lence phenotypes. We recently determined, through transcriptomic profiling of a PAO1 ΔalgR mutant strain compared to wild-type PAO1, that algZR and hemCD are cotranscribed and show differential iron-dependent gene expression. Previous ex- pression profiling was performed in strains without algR and revealed that AlgR acts as either an activator or repressor, depending on the gene. Thus, examination of P. aeruginosa gene expression from cells locked into different AlgR phosphorylation states …


Theaflavin-3,3′-Digallate Enhances The Inhibitory Effect Of Cisplatin By Regulating The Copper Transporter 1 And Glutathione In Human Ovarian Cancer Cells, Haibo Pan, Eunhye Kim, Gary O. Rankin, Yon Rojanasakul, Youying Tu, Yi Charlie Chen 2018 Zhejiang University & Alderson Broaddus University

Theaflavin-3,3′-Digallate Enhances The Inhibitory Effect Of Cisplatin By Regulating The Copper Transporter 1 And Glutathione In Human Ovarian Cancer Cells, Haibo Pan, Eunhye Kim, Gary O. Rankin, Yon Rojanasakul, Youying Tu, Yi Charlie Chen

Faculty & Staff Scholarship

Ovarian cancer has the highest fatality rate among the gynecologic cancers. The side effects, high relapse rate, and drug resistance lead to low long-term survival rate (less than 40%) of patients with advanced ovarian cancer. Theaflavin-3,3′-digallate (TF3), a black tea polyphenol, showed less cytotoxicity to normal ovarian cells than ovarian cancer cells. We aimed to investigate whether TF3 could potentiate the inhibitory effect of cisplatin against human ovarian cancer cell lines. In the present study, combined treatment with TF3 and cisplatin showed a synergistic cytotoxicity against A2780/CP70 and OVCAR3 cells. Treatment with TF3 could increase the intracellular accumulation of platinum …


Impact Of Universal Medical Insurance System On The Accessibility Of Medical Service Supply And Affordability Of Patients In China, Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin 2018 Huazhong University of Science and Technology

Impact Of Universal Medical Insurance System On The Accessibility Of Medical Service Supply And Affordability Of Patients In China, Xiaolei Xiong, Zhiguo Zhang, Jing Ren, Jie Zhang, Xiaoyun Pan, Liang Zhang, Shiwei Gong, Si Jin

Faculty & Staff Scholarship

Background

China’s universal medical insurance system (UMIS) is designed to promote social fairness through improving access to medical services and reducing out-of-pocket (OOP) costs for all Chinese. However, it is still not known whether UMIS has a significant impact on the accessibility of medical service supply and the affordability, as well as the seeking-care choice, of patients in China.

Methods

Segmented time-series regression analysis, as a powerful statistical method of interrupted time series design, was used to estimate the changes in the quantity and quality of medical service supply before and after the implementation of UMIS. The rates of catastrophic …


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