The Effect of Hospital Vertical Integration on Health Care Quality in China

The rapid growth of hospital integration activities in China has made it critical to understand whether integration in health care markets enhanced or damaged quality. The purpose of this study is to analyze the effect of hospital integration on health care quality in Shanghai. Using difference-in-difference analysis, the authors analyze cure rate and length of stay for gastric ulcer patients. The data indicates that hospital integration has positive impact on cure rate 4 years after integration at the 10% significant, but has no significant impact on length of stay. The authors also discuss the implications of these findings and offer directions for future research

Absence of metallicity and bias-dependent resistivity in low-carrier-density EuCd2As2

EuCd2As2 was theoretically predicted to be a minimal model of Weyl semimetals with a single pair of Weyl points in the ferromagnet state. However, the heavily p-doped EuCd2As2 crystals in previous experiments prevent direct identification of the semimetal hypothesis. Here we present a comprehensive magneto-transport study of high-quality EuCd2As2 crystals with ultralow bulk carrier density (10^13 cm-3). In contrast to the general expectation of a Weyl semimetal phase, EuCd2As2 shows insulating behavior in both antiferromagnetic and ferromagnetic states as well as surface-dominated conduction from band bending. Moreover, the application of a dc bias current can dramatically modulate the resistance by over one order of magnitude, and induce a periodic resistance oscillation due to the geometric resonance. Such nonlinear transport results from the highly nonequilibrium state induced by electrical field near the band edge. Our results suggest an insulating phase in EuCd2As2 and put a strong constraint on the underlying mechanism of anomalous transport properties in this system.Comment: 13 pages, 4 figure

Soil N-oxide emissions decrease from intensive greenhouse vegetable fields by substituting synthetic N fertilizer with organic and bio-organic fertilizers

In order to reduce soil and environmental quality degradation associated with the use of synthetic nitrogen (N), substituting chemical fertilizer with organic or bio-organic fertilizer has become an increasingly popular option. However, components of this fertilizer strategy related to mitigation of soil N-oxide emissions and maintenance of crop yield remain uncertain. Here, we evaluated the effects of three different fertilizer strategies, with equal amounts of N, on nitrous oxide (N2O) and nitric oxide (NO) emissions, vegetable yield, and yield-scaled N2O and NO emissions under three consecutive cucumber growing seasons. The three treatments were chemical fertilizer (NPK, urea), organic fertilizer (O, composted cattle manure), and bio-organic fertilizer (O + T, O combined with Trichoderma.spp). Results showed that the NPK plot had the highest area-scaled emissions of N2O (13.1 ± 0.48 kg N ha−1 yr−1) and NO (5.01 ± 0.34 kg N ha−1 yr−1), which were 1.3–1.4 and 3.1–3.7 times greater than the O and O + T plots, respectively. The annual direct emission factors for N2O and NO were 2.08% and 0.92% for the NPK plot, which declined to 1.34% and 0.09% in the O plot, and 1.12% and 0.03% in the O + T plot, respectively. The annual vegetable yield was 117 ± 2.9 t ha−1 for NPK plot and 122 ± 2.0 t ha−1 for O + T plot, which was higher than 111 ± 1.7 t ha−1 for O plot. The yield-scaled N2O + NO emissions differed significantly with fertilization treatment, with the lowest value observed in the O + T plot. We attributed the lower soil N-oxide emissions following organic fertilizer application to the slow release of available N and enhanced denitrification caused by the increase of soil dissolved organic carbon and pH. Compared with the use of organic fertilizer alone, the addition of Trichoderma.spp significantly increased the potential denitrification rate but decreased N2O emissions, which may have promoted the reduction of N2O to N2. Therefore, our results suggest that adopting composted organic fertilizer mixtures with microbial inoculants could be a win-win practice to mitigate gaseous N losses and simultaneously improve crop yield in intensively managed vegetable cropping systems

Gut Microbiota, Blood Metabolites, and Left Ventricular Diastolic Dysfunction in Us Hispanics/Latinos

BACKGROUND: Left ventricular diastolic dysfunction (LVDD) is an important precursor of heart failure (HF), but little is known about its relationship with gut dysbiosis and microbial-related metabolites. By leveraging the multi-omics data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a study with population at high burden of LVDD, we aimed to characterize gut microbiota associated with LVDD and identify metabolite signatures of gut dysbiosis and incident LVDD. RESULTS: We included up to 1996 Hispanic/Latino adults (mean age: 59.4 years; 67.1% female) with comprehensive echocardiography assessments, gut microbiome, and blood metabolome data. LVDD was defined through a composite criterion involving tissue Doppler assessment and left atrial volume index measurements. Among 1996 participants, 916 (45.9%) had prevalent LVDD, and 212 out of 594 participants without LVDD at baseline developed incident LVDD over a median 4.3 years of follow-up. Using multivariable-adjusted analysis of compositions of microbiomes (ANCOM-II) method, we identified 7 out of 512 dominant gut bacterial species (prevalence \u3e 20%) associated with prevalent LVDD (FDR-q \u3c 0.1), with inverse associations being found for Intestinimonas_massiliensis, Clostridium_phoceensis, and Bacteroide_coprocola and positive associations for Gardnerella_vaginali, Acidaminococcus_fermentans, Pseudomonas_aeruginosa, and Necropsobacter_massiliensis. Using multivariable adjusted linear regression, 220 out of 669 circulating metabolites with detection rate \u3e 75% were associated with the identified LVDD-related bacterial species (FDR-q \u3c 0.1), with the majority being linked to Intestinimonas_massiliensis, Clostridium_phoceensis, and Acidaminococcus_fermentans. Furthermore, 46 of these bacteria-associated metabolites, mostly glycerophospholipids, secondary bile acids, and amino acids, were associated with prevalent LVDD (FDR-q \u3c 0.1), 21 of which were associated with incident LVDD (relative risk ranging from 0.81 [p = 0.001, for guanidinoacetate] to 1.25 [p = 9 × 10 CONCLUSION: In this study of US Hispanics/Latinos, we identified multiple gut bacteria and related metabolites linked to LVDD, suggesting their potential roles in this preclinical HF entity. Video Abstract

The ALMA-QUARKS survey: -- I. Survey description and data reduction

This paper presents an overview of the QUARKS survey, which stands for `Querying Underlying mechanisms of massive star formation with ALMA-Resolved gas Kinematics and Structures'. The QUARKS survey is observing 139 massive clumps covered by 156 pointings at ALMA Band 6 ($\lambda\sim$ 1.3 mm). In conjunction with data obtained from the ALMA-ATOMS survey at Band 3 ($\lambda\sim$ 3 mm), QUARKS aims to carry out an unbiased statistical investigation of massive star formation process within protoclusters down to a scale of 1000 au. This overview paper describes the observations and data reduction of the QUARKS survey, and gives a first look at an exemplar source, the mini-starburst Sgr B2(M). The wide-bandwidth (7.5 GHz) and high-angular-resolution (~0.3 arcsec) observations of the QUARKS survey allow to resolve much more compact cores than could be done by the ATOMS survey, and to detect previously unrevealed fainter filamentary structures. The spectral windows cover transitions of species including CO, SO, N$_2$D$^+$, SiO, H$_{30}\alpha$, H$_2$CO, CH$_3$CN and many other complex organic molecules, tracing gas components with different temperatures and spatial extents. QUARKS aims to deepen our understanding of several scientific topics of massive star formation, such as the mass transport within protoclusters by (hub-)filamentary structures, the existence of massive starless cores, the physical and chemical properties of dense cores within protoclusters, and the feedback from already formed high-mass young protostars.Comment: 9 figures, 4 tables, accepted by RA

Genetic Variation of Promoter Sequence Modulates XBP1 Expression and Genetic Risk for Vitiligo

Our previous genome-wide linkage analysis identified a susceptibility locus for generalized vitiligo on 22q12. To search for susceptibility genes within the locus, we investigated a biological candidate gene, X-box binding protein 1(XBP1). First, we sequenced all the exons, exon-intron boundaries as well as some 5′ and 3′ flanking sequences of XBP1 in 319 cases and 294 controls of Chinese Hans. Of the 8 common variants identified, the significant association was observed at rs2269577 (p_trend = 0.007, OR = 1.36, 95% CI = 1.09–1.71), a putative regulatory polymorphism within the promoter region of XBP1. We then sequenced the variant in an additional 365 cases and 404 controls and found supporting evidence for the association (p_trend = 0.008, OR = 1.31, 95% CI = 1.07–1.59). To further validate the association, we genotyped the variant in another independent sample of 1,402 cases and 1,288 controls, including 94 parent-child trios, and confirmed the association by both case-control analysis (p_trend = 0.003, OR = 1.18, 95% CI = 1.06–1.32) and the family-based transmission disequilibrium test (TDT, p = 0.005, OR = 1.93, 95% CI = 1.21–3.07). The analysis of the combined 2,086 cases and 1,986 controls provided highly significant evidence for the association (p_trend = 2.94×10−6, OR = 1.23, 95% CI = 1.13–1.35). Furthermore, we also found suggestive epistatic effect between rs2269577 and HLA-DRB1*07 allele on the development of vitiligo (p = 0.033). Our subsequent functional study showed that the risk-associated C allele of rs2269577 had a stronger promoter activity than the non-risk G allele, and there was an elevated expression of XBP1 in the lesional skins of patients carrying the risk-associated C allele. Therefore, our study has demonstrated that the transcriptional modulation of XBP1 expression by a germ-line regulatory polymorphism has an impact on the development of vitiligo

X-chromosome and kidney function:evidence from a multi-trait genetic analysis of 908,697 individuals reveals sex-specific and sex-differential findings in genes regulated by androgen response elements

X-chromosomal genetic variants are understudied but can yield valuable insights into sexually dimorphic human traits and diseases. We performed a sex-stratified cross-ancestry X-chromosome-wide association meta-analysis of seven kidney-related traits (n = 908,697), identifying 23 loci genome-wide significantly associated with two of the traits: 7 for uric acid and 16 for estimated glomerular filtration rate (eGFR), including four novel eGFR loci containing the functionally plausible prioritized genes ACSL4, CLDN2, TSPAN6 and the female-specific DRP2. Further, we identified five novel sex-interactions, comprising male-specific effects at FAM9B and AR/EDA2R, and three sex-differential findings with larger genetic effect sizes in males at DCAF12L1 and MST4 and larger effect sizes in females at HPRT1. All prioritized genes in loci showing significant sex-interactions were located next to androgen response elements (ARE). Five ARE genes showed sex-differential expressions. This study contributes new insights into sex-dimorphisms of kidney traits along with new prioritized gene targets for further molecular research.</p