Finding flaws in the spatial distribution of health workforce and its influential factors: An empirical analysis based on Chinese provincial panel data, 2010–2019

BackgroundThe maldistributions of the health workforce showed great inconsistency when singly measured by population quantity or geographic area in China. Meanwhile, earlier studies mainly employed traditional econometric approaches to investigate determinants for the health workforce, which ignored spillover effects of influential factors on neighboring regions. Therefore, we aimed to analyze health workforce allocation in China from demographic and geographic perspectives simultaneously and then explore the spatial pattern and determinants for health workforce allocation taking account of the spillover effect.MethodsThe health resource density index (HRDI) equals the geometric mean of health resources per 1,000 persons and per square kilometer. First, the HRDI of licensed physicians (HRDI_P) and registered nurses (HRDI_N) was calculated for descriptive analysis. Then, global and local Moran's I indices were employed to explore the spatial features and aggregation clusters of the health workforce. Finally, four types of independent variables were selected: supportive resources (bed density and government health expenditure), healthcare need (proportion of the elderly population), socioeconomic factors (urbanization rate and GDP per capita), and sociocultural factors (education expenditure per pupil and park green area per capita), and then the spatial panel econometric model was used to assess direct associations and intra-region spillover effects between independent variables and HRDI_P and HRDI_N.ResultsGlobal Moran's I index of HRDI_P and HRDI_N increased from 0.2136 (P = 0.0070) to 0.2316 (P = 0.0050), and from 0.1645 (P = 0.0120) to 0.2022 (P = 0.0080), respectively. Local Moran's I suggested spatial aggregation clusters of HRDI_P and HRDI_N. For HRDI_P, bed density, government health expenditure, and GDP had significantly positive associations with local HRDI_P, while the proportion of the elderly population and education expenditure showed opposite spillover effects. More precisely, a 1% increase in the proportion of the elderly population would lead to a 0.4098% increase in HRDI_P of neighboring provinces, while a 1% increase in education expenditure leads to a 0.2688% decline in neighboring HRDI_P. For HRDI_N, the urbanization rate, bed density, and government health expenditure exerted significantly positive impacted local HRDI_N. In addition, the spillover effect was more evident in the urbanization rate, with a 1% increase in the urbanization rate relating to 0.9080% growth of HRDI_N of surrounding provinces. Negative spillover effects of education expenditure, government health expenditure, and elderly proportion were observed in neighboring HRDI_N.ConclusionThere were substantial spatial disparities in health workforce distribution in China; moreover, the health workforce showed positive spatial agglomeration with a strengthening tendency in the last decade. In addition, supportive resources, healthcare needs, and socioeconomic and sociocultural factors would affect the health labor configuration not only in a given province but also in its nearby provinces

The impact of electroacupuncture on anxiety-like behavior and gut microbiome in a mouse model of chronic restraint stress

IntroductionElectroacupuncture (EA) is a beneficial physiotherapy approach for addressing neuropsychiatric disorders. Nevertheless, the impact of EA on the gut microbiome in relation to anxiety disorders remains poorly understood.MethodsTo address this gap, we conducted a study using a chronic restraint stress (CRS) mouse model to investigate the anti-anxiety outcome of EA and its influence on gut microbiota. Our research involved behavioral tests and comprehensive sequencing of full-length 16S rRNA microbiomes.ResultsOur findings revealed that CRS led to significant anxiety-like behaviors and an imbalance in the gut microbiota. Specifically, we identified 13 species that exhibited changes associated with anxiety-like behaviors. Furthermore, EA partially alleviated both behaviors related to anxiety and the dysbiosis induced by CRS.DiscussionIn summary, this study sheds light on the alterations in gut microbiota species resulting from CRS treatment and brings new light into the connection between EA’s anti-anxiety effects and the gut microbiota

Research Progress of Each Cell Signaling Pathway in Renal Interstitial Fibrosis and Anti-Fibrotic Intervention Countermeasures

Interstitial fibrosis is a common pathological feature of various progressive renal diseases, andthis result is mainly caused with the activation of renal interstitial innate cells (fibroblasts, pericytes, immune cells, mesenchymal stem cells, etc.) and the massive expression and deposition of extracellular matrix（ECM）. According to statistics,chronic kidney disease and interstitial renal fibrosis affect half of the world's adults over the age of 70 and 10% of the population.Although there are currently no drugs or other means to halt this process, as more and more key players affecting fibrosis are identified, this provides new research directions for anti-fibrotic therapy. In this review, we highlight the relationship between renal interstitial lamina propria and the progression of interstitial fibrosis and describe new advances in anti-fibrotic strategies.Finally,we hope to provide new ideas for the treatment of interstitial renal fibrosis

Sufentanil for carboprost-induced adverse reactions during cesarean delivery under combined spinal-epidural anesthesia

Objective: Carboprost plays an important role in managing refractory uterine atony and severe postpartum hemorrhage. However, it is associated with challenging adverse reactions. We aimed to evaluate the clinical effects of low-dose sufentanil on the prevention of adverse events associated with carboprost during cesarean delivery. Study Design: Patients were randomly divided into two groups: a placebo control group (group C, n = 15) that received an intravenous infusion of 1 mL of normal saline 2 min before carboprost and a sufentanil group (group S, n = 15) that received 5 µg of sufentanil. The primary outcome was the incidence of nausea and vomiting following carboprost administration. Results: The incidence of nausea, vomiting, and gastrointestinal discomfort was significantly lower in group S than in group C (P < 0.05). Conclusions: The prophylactic use of low-dose sufentanil reduces the incidence of gastrointestinal side effects caused by carboprost administration during cesarean section

SDSS J013127.34−-032100.1: A newly discovered radio-loud quasar at z=5.18z=5.18 with extremely high luminosity

Only very few z>5 quasars discovered to date are radio-loud, with a radio-to-optical flux ratio (radio-loudness parameter) higher than 10. Here we report the discovery of an optically luminous radio-loud quasar, SDSS J013127.34-032100.1 (J0131-0321 in short), at z=5.18+-0.01 using the Lijiang 2.4m and Magellan telescopes. J0131-0321 has a spectral energy distribution consistent with that of radio-loud quasars. With an i-band magnitude of 18.47 and radio flux density of 33 mJy, its radio-loudness parameter is ~100. The optical and near-infrared spectra taken by Magellan enable us to estimate its bolometric luminosity to be L_bol ~ 1.1E48 erg/s, approximately 4.5 times greater than that of the most distant quasar known to date. The black hole mass of J0131-0321 is estimated to be 2.7E9 solar masses, with an uncertainty up to 0.4 dex. Detailed physical properties of this high-redshift, radio-loud, potentially super-Eddington quasar can be probed in the future with more dedicated and intensive follow-up observations using multi-wavelength facilities.Comment: 5 pages, 3 figures, accepted to ApJ

The puzzle of excessive non-DDˉD\bar D component of the inclusive ψ(3770)\psi(3770) decay and the long-distant contribution

In this letter we suggest that the obvious discrepancy between theoretical prediction on the $\mathrm{non}-D\bar D$ decays of $\psi(3770)$ and data is to be alleviated by taking final state interaction (FSI) into account. By assuming that $\psi(3770)$ overwhelmingly dissociates into $D\bar D$, then the final state interaction induces a secondary process, we calculate the branching ratios of $\psi(3770)\to D\bar D\to J/\psi\eta, \rho\pi, \omega\eta, K^*K$. Our results show that the branching ratio of $\psi(3770)\to \mathrm{non}-D\bar{D}$ can reach up to $\mathcal{B}_{\mathrm{non}-D\bar{D}}^{FSI}=(0.2\sim1.1)$ while typical parameters $I=0.4$ GeV$^{-2}$ and $\alpha=0.8\sim 1.3$ are adopted. This indicates that the FSI is obviously non-negligible.Comment: 6 pages, 4 figures, 1 tables. More references and discussions added, typos corrected. Accepted by Phys. Lett.

Final State Interactions in D0→K0K0ˉD^0 \to K^0 \bar{K^0}

It is believed that the production rate of $D^0\to K^0\bar K^0$ is almost solely determined by final state interactions (FSI) and hence provides an ideal place to test FSI models. Here we examine model calculations of the contributions from s-channel resonance $f_J(1710)$ and t-channel exchange to the FSI effects in $D^0\to K^0\bar K^0$. The contribution from s-channel $f_0(1710)$ is sma$For the t-channel FSI evaluation, we employ the one-particle-exchange (OPE) model and Regge model respecti$ The results from two methods are roughly consistent with each other and can reproduce the large rate of $D^0\to K^0\bar K^0$ reasonably well$Comment: Latex, 16 pages, with 2 figure

The physical constraints on a new LoBAL QSO at z=4.82

Very few low-ionization broad absorption line (LoBAL) QSOs have been found at high redshifts to date. One high-redshift LoBAL QSO, J0122+1216, was recently discovered at the Lijiang 2.4-m Telescope with an initial redshift determination of 4.76. Aiming to investigate its physical properties, we carried out follow-up observations in the optical and near-IR spectroscopy. Near-IR spectra from UKIRT and P200 confirms that it is a LoBAL, with a new redshift determination of $4.82\pm0.01$ based on the \mgii~ emission-line. The new \mgii~ redshift determination reveals strong blueshifts and asymmetry of the high-ionization emission lines. We estimated a black hole mass of $\sim 2.3\times 10^9 M_\odot$ and Eddington ratio of $\sim 1.0$ according to the empirical \mgii-based single-epoch relation and bolometric correction factor. It is possible that strong outflows are the result of an extreme quasar environment driven by the high Eddington ratio. A lower limit on the outflowing kinetic power ($>0.9\% L_{Edd}$) was derived from both emission and absorption lines, indicating these outflows play a significant role in the feedback process to regulate the growth of its black hole as well as host galaxy evolution.Comment: 12 pages, 10 figures. Accepted for publication in The Astrophysical Journa