Genome-wide expression analysis of LACS gene family implies GhLACS25 functional responding to salt stress in cotton.

BACKGROUND: Long-chain acyl-coenzyme A synthetase (LACS) is a type of acylating enzyme with AMP-binding, playing an important role in the growth, development, and stress response processes of plants. RESULTS: The research team identified different numbers of LACS in four cotton species (Gossypium hirsutum, Gossypium barbadense, Gossypium raimondii, and Gossypium arboreum). By analyzing the structure and evolutionary characteristics of the LACS, the GhLACS were divided into six subgroups, and a chromosome distribution map of the family members was drawn, providing a basis for further research classification and positioning. Promoter cis-acting element analysis showed that most GhLACS contain plant hormones (GA, MeJA) or non-biological stress-related cis-elements. The expression patterns of GhLACS under salt stress treatment were analyzed, and the results showed that GhLACS may significantly participate in salt stress response through different mechanisms. The research team selected 12 GhLACSs responsive to salt stress for tissue expression analysis and found that these genes are expressed in different tissues. CONCLUSIONS: There is a certain diversity of LACS among different cotton species. Analysis of promoter cis-acting elements suggests that GhLACS may be involved in regulating plant growth, development and stress response processes. GhLACS25 was selected for in-depth study, which confirmed its significant role in salt stress response through virus-induced gene silencing (VIGS) and induced expression in yeast cells.

Plant polyphenol surfactant construction with strong surface activity and chelation properties as efficient decontamination of UO22+ on cotton fabric.

Chemically synthesized surfactants have promising applications in the treatment of uranium, however, their hazardous environmental effects, non-biodegradability, and numerous drawbacks prevent them from being widely used in practice. Herein, we successfully synthesized a green chelating and foaming integrated surfactant (BTBS) by Mannich reaction and acylation of bayberry tannin for the effective removal of UO22+ from aqueous environments or solid surfaces. The as-prepared surfactant was systematically characterized by FT-IR, showing that the hydrophobic groups were successfully grafted onto tannin. The modified material showed better foaming and emulsifying properties, which proved this method could improve the amphiphilicity of tannin. Moreover, for the first time, a foam fractionation method in conjunction with a tannin-based surfactant was applied for UO22+ removal from water. This surfactant was used as a co-surfactant and could readily remove 90 % of UO22+ (20 mg L-1) from water. The removal of UO22+ could be completed in a short time (30 min), and the maximum adsorption capacity was determined as 175.9 mg g-1. This surfactant can also be used for efficient decontamination of uranium-contaminated cotton cloth with a high removal rate of 94.55 %. In addition, the mechanism studies show that the adsorption of BTBS for UO22+ can be mainly attributed to a chelating mechanism between UO22+ and the adjacent phenolic hydroxyls. The novel biomass-derived BTBS with advantages such as high capture capacity, environmental friendliness, and cost-effectiveness suggests that it plays an important role in the remediation of radionuclide pollution.

Serum basic fibroblast growth factor and interleukin-1ß predict the effect of first-line chemotherapy in patients with advanced gastric cancer.

BACKGROUND: The incidence and mortality rates of gastric cancer in China are the second-highest in the world, and most patients with gastric cancer lose their chance of surgery by the time of their diagnosis. AIM: To explore the predictive potential of serum basic fibroblast growth factor and interleukin-1ß levels for the effect of first-line chemotherapy in patients with advanced gastric cancer. METHODS: From the gastric cancer patients admitted to our hospital from May 2019 to April 2023, 84 patients were selected and randomly and equally assigned to the experimental or control group. The FLOT group received the FLOT chemotherapy regimen (composed of oxaliplatin + calcium folinate + fluorouracil + paclitaxel), while the SOX group received the SOX chemotherapy regimen (composed of oxaliplatin + tiga capsules). The clinical efficacy, tumor marker levels, adverse reactions, and survival rates of the two groups were compared 7 days after the end of the relevant treatments. RESULTS: The target effective rate of the FLOT group was 54.76%, which was much higher than that of the SOX group (33.33%; P < 0.05). After treatment, both the groups demonstrated lower levels of cancer antigen (CEA), carbohydrate antigen 199 (CA199), and peptide tissue antigen (TPS). For several patients before treatment (P < 0.05). Third and fourth grades. In terms of adverse reactions, the level of white blood cells in both the groups was lower. Moreover, the incidence of hand-foot skin reactions in these two study groups was lower (P < 0.05), while those of peripheral neuritis, vomiting, diarrhea, and abnormal liver function were significant (P < 0.05). No statistically significant difference was noted between the two groups (P < 0.05). The 1-year survival rate was higher in the FLOT group (P < 0.05). CONCLUSION: The FLOT regimen was effective in reducing the serum CEA, CA199, and TPS levels as well as in improving the 1-year survival rate of patients with good tolerability, making it worthy of clinical promotion and application.

Improvement of amphipathic properties with molecular structure unfolding and activation of cottonseed protein as ultra stable and safe emulsifier by deamidation.

By-product cottonseed proteins are excellent options for numerous applications due to their superior properties and lower cost. However, its complex folded structure and large molecular weight lead to lower reactivity and insufficient amphiphilicity. Cottonseed protein isolate (CPI) is less-soluble in water. Therefore, we improved the amphiphilicity of CPI with associated hydrolysis, molecular structure unfolding, and activation by alkaline-induced deamidation (at 24, 36, and 72 h) and produced three cottonseed protein hydrolysates CPH 24, 36, and 72. FTIR/UV-CD measurements confirmed the conformational changes and conversion of the structural content. Particle size decreased 2503.4-771.8 nm, while surface hydrophobicity (133.5-326.7), carboxyl content (1.13 × 10Ö¾3-2.09 × 10Ö¾3), and flexibility increased, signifying hydrolysis, unfolding, and amphiphilicity improvement. Longer deamidation (CPH 72) exhibited the best properties, its prepared emulsions were long-term stable under all the environmental stresses without visible phase separation after at least 40 days of storage except at pH 4. Compared to CPI, it had smaller droplets (939.3-264.9 nm) and larger absolute ζ-potential (-26.5 to -58.0 mV). From the in-vitro cytotoxicity test, deamidated CPI is extremely safer than commonly used synthetic surfactants. This research provides a new method for producing multifunctional emulsifiers from CPI, which could be utilized in the development of functional foods/non-foods.

Lint percentage and boll weight QTLs in three excellent upland cotton (Gossypium hirsutum): ZR014121, CCRI60, and EZ60.

BACKGROUND: Upland cotton (Gossypium hirsutum L.) is the most economically important species in the cotton genus (Gossypium spp.). Enhancing the cotton yield is a major goal in cotton breeding programs. Lint percentage (LP) and boll weight (BW) are the two most important components of cotton lint yield. The identification of stable and effective quantitative trait loci (QTLs) will aid the molecular breeding of cotton cultivars with high yield. RESULTS: Genotyping by target sequencing (GBTS) and genome-wide association study (GWAS) with 3VmrMLM were used to identify LP and BW related QTLs from two recombinant inbred line (RIL) populations derived from high lint yield and fiber quality lines (ZR014121, CCRI60 and EZ60). The average call rate of a single locus was 94.35%, and the average call rate of an individual was 92.10% in GBTS. A total of 100 QTLs were identified; 22 of them were overlapping with the reported QTLs, and 78 were novel QTLs. Of the 100 QTLs, 51 QTLs were for LP, and they explained 0.29-9.96% of the phenotypic variation; 49 QTLs were for BW, and they explained 0.41-6.31% of the phenotypic variation. One QTL (qBW-E-A10-1, qBW-C-A10-1) was identified in both populations. Six key QTLs were identified in multiple-environments; three were for LP, and three were for BW. A total of 108 candidate genes were identified in the regions of the six key QTLs. Several candidate genes were positively related to the developments of LP and BW, such as genes involved in gene transcription, protein synthesis, calcium signaling, carbon metabolism, and biosynthesis of secondary metabolites. Seven major candidate genes were predicted to form a co-expression network. Six significantly highly expressed candidate genes of the six QTLs after anthesis were the key genes regulating LP and BW and affecting cotton yield formation. CONCLUSIONS: A total of 100 stable QTLs for LP and BW in upland cotton were identified in this study; these QTLs could be used in cotton molecular breeding programs. Putative candidate genes of the six key QTLs were identified; this result provided clues for future studies on the mechanisms of LP and BW developments.

Modern interpretation of the traditional application of Shihu - A comprehensive review on phytochemistry and pharmacology progress of Dendrobium officinale.

ETHNOPHARMACOLOGICAL RELEVANCE: The traditional Chinese medicine (TCM) "Shihu" has a long history of medicinal use in China from some species of Dendrobium. D. officinale is a major source of "Shihu" and is widely cultivated in south of China and listed separately as "Tiepi Shihu" by the Chinese Pharmacopoeia in now time. Traditionally, D. officinale has been widely used in daily health care and the treatment of diabetes and gastrointestinal diseases. AIM OF THIS REVIEW: In order to better develop and utilize D. officinale, we conducted this systematic review of previous studies, showed clear structure of all isolates from D. officinale together with pharmacological progress, hoping to provide references for further research and utilization. In addition, specific display of the chemical components and the research progress of related activities can help to better understand the traditional records and modern pharmaceutical applications of the plant medicine. MATERIALS AND METHODS: Information on phytochemistry and pharmacological studies of D. officinale was collected from various scientific databases including Web of Science, SciFinder, ACS, Springer, Scopus, PubMed, ScienceDirect, Google Scholar and CNKI. RESULTS: More than 180 compounds isolated from D. officinale, including bibenzyls, phenols, phenylpropanoids, lignans, flavonoids and polysaccharides are listed in this review. Furthermore, modern pharmacological researches such as hypoglycemia, immune regulation, antioxidant, cardiovascular regulation and gastrointestinal protection are summarized. CONCLUSION: Based on the summary of the research work of D. officinale, we systematically show the chemical composition of the plant, and concluded the relationship of those composition with plant habitat together with the relationship between the structure of chemical components and pharmacological activity. Moreover, we suggest that some of small molecule compounds could also be quality control of D. officinale besides polysaccharides.

Improvement of plant tolerance to drought stress by cotton tubby-like protein 30 through stomatal movement regulation.

INTRODUCTION: Cotton is a vital industrial crop that is gradually shifting to planting in arid areas. However, tubby-like proteins (TULPs) involved in plant response to various stresses are rarely reported in cotton. The present study exhibited that GhTULP30 transcription in cotton was induced by drought stress. OBJECTIVE: The present study demonstrated the improvement of plant tolerance to drought stress by GhTULP30 through regulation of stomatal movement. METHODS: GhTULP30 response to drought and salt stress was preliminarily confirmed by qRT-PCR and yeast stress experiments. Ectopic expression in Arabidopsis and endogenous gene silencing in cotton were used to determine stomatal movement. Yeast two-hybrid and spilt-luciferase were used to screen the interacting proteins. RESULTS: Ectopic expression of GhTULP30 in yeast markedly improved yeast cell tolerance to salt and drought. Overexpression of GhTULP30 made Arabidopsis seeds more resistant to drought and salt stress during seed germination and increased the stomata closing speed of the plant under drought stress conditions. Silencing of GhTULP30 in cotton by virus-induced gene silencing (VIGS) technology slowed down the closure speed of stomata under drought stress and decreased the length and width of the stomata. The trypan blue and diaminobenzidine staining exhibited the severity of leaf cell necrosis of GhTULP30-silenced plants. Additionally, the contents of proline, malondialdehyde, and catalase of GhTULP30-silenced plants exhibited significant variations, with obvious leaf wilting. Protein interaction experiments exhibited the interaction of GhTULP30 with GhSKP1B and GhXERICO. CONCLUSION: GhTULP30 participates in plant response to drought stress. The present study provides a reference and direction for further exploration of TULP functions in cotton plants.

Sensitization of Mn2+ luminescence via efficient energy transfer to suit the application of high color rendering WLEDs.

Developing novel luminescent materials with ideal properties is an endless project, urged by growing requirements of advances in energy saving, healthy lighting and environmental friendliness. Herein, a series of ScCaOBO3:Ce3+,Mn2+ phosphors with excellent luminescence properties were synthesized by the high temperature solid state method. X-ray diffraction was applied to analyse the phase composition of the obtained phosphors. The morphology and dopant distribution were observed by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS), respectively. The Rietveld refinements and luminescence spectra indicate that Ce3+ preferentially occupies the Sc3+ site and produces a blue emission band at around 460 nm, which originates from the characteristic 5d-4f transitions, while Mn2+ preferentially occupies the Ca2+ site and emits red light due to its characteristic 4T1(4G)-6A1(6S) transitions. Upon excitation at 354 nm, both Ce3+ and Mn2+ emissions can be obtained and further investigations evidenced that the broad and intense light emission of Mn2+ located in the red spectral region is the result of energy transfer from Ce3+ to Mn2+. Theoretical calculations reveal that the energy transfer process from Ce3+ to Mn2+ is of the resonance type and is governed by electric dipole-dipole interactions. Since the ScCaOBO3:Ce3+,Mn2+ phosphors are capable of producing broadband emissions that widely cover the blue and red spectral regions, the introduction of a green light-emitting phosphor CMA:Tb3+ can conveniently generate high quality white light. Therefore, a white light-emitting diode device with extremely high color rendering indices, Ra = 93.7 and R9 = 91.9, was successfully obtained.

Purification, structural characterization and immunomodulatory activities of a polysaccharide from the fruiting body of Morchella sextelata.

A novel polysaccharide (MSP-1) was isolated from the fruiting body of Morchella sextelata and purified using DEAE-52 and Sephadex G-75. The molecular weight of MSP-1 was 1.17 × 104 Da, as detected by HPLC analysis. The monosaccharide composition of MSP-1 was mannose and glucose at a ratio of 1.00: 1.25. Methylation and NMR results revealed that the backbone of MSP-1 was composed of →4)-ß-D-Manp-(1→, →4)-ß-D-Glcp-(1→, →4)-α-D-Glcp-(1→, and →4, 6)-α-D-Glcp-(1→. SEM images of MSP-1 presented a dense network structure with porous characterizations. The immunomodulatory activities of MSP-1 were evaluated using RAW264.7 cells, and the results showed that MSP-1 promoted proliferative and phagocytic activity and increased the production of NO, TNF-α and IL-6. These results indicated that MSP-1 exhibited significant immunomodulatory activities.

Outbreak of the South American tomato leafminer, Tuta absoluta, in the Chinese mainland: geographic and potential host range expansion.

BACKGROUND: In 2017 Tuta absoluta was identified as an invasive species in China. Due to its rapid geographic expansion and the severe crop damage it causes, T. absoluta poses a serious threat to China's tomato production industry. To determine its geographic distribution and host range, intensive surveys and routine monitoring were conducted across the Chinese mainland between 2018 and 2019. The population colonization coefficient (PCC; ratio of colonized sites and prefectures) and population occurrence index (POI; ratio of infested host species and PCCs) were calculated. RESULTS: In northwestern China, T. absoluta populations established in Xinjiang exhibited a medium PCC value (~0.03). In southwestern China, populations in Yunnan and its five neighboring provinces exhibited high (~0.50 in Yunnan and Guizhou), or low (<0.02 in Guangxi, Sichuan, Hunan, and Chongqing) PCC values. In the Chinese mainland, infestations of four crop plant species (tomato, eggplant, potato, and Chinese lantern) and two wild plant species (black nightshade and Dutch eggplant) were identified; tomatoes were infested in every colonized province. Chinese lantern and Dutch eggplant are potentially novel hosts. Yunnan, Guizhou, and Xinjiang experienced the most serious damage (POI). In southwestern China, observed damage significantly decreased with increased distance from the first discovery site of T. absoluta to the farthest county of an infested province increased. CONCLUSION: T. absoluta populations are well-established and could potentially spread to other regions of China. The present study helps to inform the establishment of better pest management guidelines and strategies in China and tomato-producing regions worldwide. © 2021 Society of Chemical Industry.

Establishment of a risk assessment system for peptic ulcer recurrence and its value in individualized intervention.

OBJECTIVE: To investigate the establishment of a risk assessment system for peptic ulcer (PU) recurrence and implement an individualized intervention for PU patients with a moderate to high recurrence risk to reduce the recurrence of PU in patients with a moderate to high recurrence risk. METHODS: The factors for PU recurrence were collected through consulting the literature, and a risk prediction model for PU recurrence was established using the univariate binary and multivariate multinomial Logistic stepwise regression analysis. According to the model, a total of 235 PU patients were divided into patients with high, moderate and low recurrence risks. A total of 71 PU patients with moderate to high recurrence risks were selected as the study subjects, and further divided into the control group (n=35) and the experimental group (n=36). The control group was not treated with intervention, while the experimental group was treated with individualized intervention. The PU recurrence, adverse emotions and changes of pain degree were assessed in the two groups at 3, 6, 9 and 12 months after intervention. RESULTS: The univariate and multivariate Logistic regression analysis showed that drinking alcohol, smoking, chronic diseases, oral NSAIDS and depression were associated with the recurrence of PU. Individualized intervention improved the recurrence rate, anxiety, depression, pain degree and quality of life of patients with moderate to high PU recurrence risk. CONCLUSION: Drinking alcohol, smoking, chronic diseases, oral NSAIDS and depression were associated with the recurrence of PU. Individualized intervention can improve the quality of prognosis and the recurrence risk of PU in patients, which has positive clinical significance.

Management of a "suspected ward" in a COVID-19 designated hospital in Wuhan.

During December 2019, an outbreak of unexplained pneumonia occurred in Wuhan, Hubei Province. The disease was subsequently named coronavirus disease 2019 (COVID-19) and the causative virus as severe acute respiratory syndrome conronavirus-2 (SARS-CoV-2). Based on experience, it is vital to exclude or diagnose suspected patients as soon as possible to prevent disease spread. Our hospital is a COVID-19 designated hospital in Wuhan. During the epidemic period, there was a reconstruction of the medical facilities to accommodate patients with different disease status. We document the development of "suspected ward," a ward that cared for patients with suspected COVID-19, in a large designated hospital during the COVID-19 outbreak in Wuhan City, China, and explain the suspected ward spatial layout, organization structure, diagnosis, and treatment flow chart of suspected cases. The key characteristics of our "suspected ward" is isolation, triage, fast diagnosis, and rapid referral. Our description of this suspected ward provides a reference for further improvements in the care of patients with suspected disease in emergency medical institutions.

The role of seashell wastes in TiO2/Seashell composites: Photocatalytic degradation of methylene blue dye under sunlight.

This paper proposes a sustainable and facile approach for the synthesis of photocatalysts in which shell waste is used as support material. The synthesized photocatalysts exhibited a significant performance in the mineralization of organic substances under solar irradiation or artificial lighting. Calcined abalone shell with a TiO2 loading of 23.4% led to a significant improvement in optical absorption: the degradation efficiencies of methylene blue (MB) after 140 min under UV light, vis light, UV-vis light, and natural sunlight were 93%, 96%, 100%, and 100%, respectively. Notably, the byproducts obtained after the degradation by commercial P25 TiO2 disappeared with the utilization of shell waste as support material. The Na, Sr, S present in the calcined abalone shell were doped into the substitutional sites of TiO2 and were indispensable to achieve the desired band-gap narrowing and photocatalytic performance; moreover, the Ti and Zn oxides in the calcined abalone shell acted as semiconductors and improved the charge separation efficiency of TiO2. Above all, this paper describes a green synthesis based on the use of waste seashell. This material acts as an excellent photocatalyst support for environmental pollution treatments, leading to the 'control of waste by waste' and opening up new possibilities for shell waste reutilization and sustainable chemistry.

Total Synthesis of Gastrodinol via Photocatalytic 6π Electrocyclization.

The first total synthesis of gastrodinol, an unprecedented poly-p-cresol-substituted natural product with a rearranged and reconstructed C ring moiety, is reported. Our synthesis features a convergent fragment approach. The Sonogashira coupling reaction forges the two segments together to furnish the conjugated ene-yne. Photocatalytic 6π electrocyclization followed by spontaneous aromatization is used to construct the tetrasubstituted B ring at the late stage. Further study shows that gastrodinol exhibits significant cytotoxic activity against five human cancer cell lines in vitro (IC50 2.5-3.8 µM).

Structural characterization and hypoglycemic effect via stimulating glucagon-like peptide-1 secretion of two polysaccharides from Dendrobium officinale.

Two polysaccharides, named DOP-1 and DOP-2, with molecular weights of 6.8 kDa and 14.3 kDa, respectively, were isolated and purified from the stems of Dendrobium officinale. Monosaccharide composition, Fourier-transform infrared spectroscopy, methylation, and nuclear magnetic resonance analyses indicated that DOP-1 and DOP-2 may have a backbone consisted of →4)-ß-d-Glcp-(1→, →4)-ß-d-Manp-(1→, →4)-2-O-acetyl-ß-d-Manp-(1→ and →4)-3-O-acetyl-ß-d-Manp-(1→. In vivo assays showed that D. officinale polysaccharides (DOPs) exerted significant hypoglycemic effects accompanying increased serum insulin and glucagon-like peptide-1 (GLP-1) levels in streptozotocin-induced diabetic rats. Further in vitro experiments showed that DOP-induced GLP-1 secretion was inhibited by an intracellular calcium chelator, a Ca2+/calmodulin-dependent protein kinase (CaMK) II inhibitor, a specific calcium-sensing receptor antagonist, and a p38-mitogen-activated protein kinases (MAPK) inhibitor. These results indicated that DOPs may decrease fasting blood sugar levels by stimulating GLP-1 secretion and that intracellular DOP-induced GLP-1 secretion involved the Ca2+/calmodulin/CaMKII and MAPK pathways.

Isolation of wheat mutants with higher grain phenolics to enhance anti-oxidant potential.

Present in many plant foods, biogenic phenolic compounds are important bioactive phytonutrients with high anti-oxidant activity and thereby are praised for their health-promoting properties. However, current food nutrient improvement by high phenolic content in staples is limited by the shortage of genetic resources rich in phenolic compounds. To resolve this obstacle, we developed a non-destructive massive analytical approach to screen wheat phenolic mutants. In grains, multiple mutant lines showed significantly higher contents of flavonoids or cell wall-bound phenolic esters. Moreover, five mutants showed higher anti-oxidant potentials in wall-bound phenolic compounds ranging from 15% to 20%, with the maximal close to natural black wheat. In contrast to black wheat, two mutants accumulated higher phenolic compounds in the endosperm. lrf4 was mapped by BSR to a concentrated genomic region in the short arm of chromosome 1A. The present work represents an efficient high-throughput strategy to increase wheat anti-oxidant potential through traditional mutagenesis.

Marinobacter sp. Stable Hydrous Titanium Oxide-Functionalized Bovine Serum Albumin Nanospheres for Uranium Capture from Spiked Seawater.

A novel nanospherical hydrous titanium oxide adsorbent (hydrous titanium oxide-immobilized bovine serum albumin nanospheres, HTO-BSA-NSs) was prepared by immobilizing HTOs with a manipulated molecular mass and number of active sites for uranium on the surface of BSA-NSs. The adsorption performances of HTO-BSA-NSs were investigated in spiked natural seawater with extra 8 ppm uranium. The results demonstrated that HTO-BSA-NSs are capable of uranium capture from a complex aqueous matrix with a low uranium concentration. Meanwhile, the microbial stability of HTO-BSA-NSs in sterilized natural seawater with Marinobacter sp. was investigated and observed through an optical microscope and TEM, revealing that the wrapped HTOs could protect the BSA-NSs from the decomposition of microorganisms, and the structure and functional groups of HTO-BSA-NSs remain stable compared with the BSA-NSs. In addition, the uranium adsorption mechanism of HTO-BSA-NSs is mainly recognized as dehydrated complexation, which was concluded from characterization analysis, adsorption model fitting, and theoretical calculations based on density functional theory. The remarkable uranium adsorption performance and microbial stability of HTO-BSA-NSs indicated that they have the potential to be a low-cost and environmentally friendly adsorbent for uranium extraction from complex environments such as seawater or uranium-containing industrial wastewater.

Changes in Hospital Referral Patterns to Skilled Nursing Facilities Under the Hospital Readmissions Reduction Program.

BACKGROUND: The Hospital Readmissions Reduction Program (HRRP) penalizes hospitals for higher-than-expected readmission rates. Almost 20% of Medicare fee-for-service (FFS) patients receive postacute care in skilled nursing facilities (SNFs) after hospitalization. SNF patients have high readmission rates. OBJECTIVE: The objective of this study was to investigate the association between changes in hospital referral patterns to SNFs and HRRP penalty pressure. DESIGN: We examined changes in the relationship between penalty pressure and outcomes before versus after HRRP announcement among 2698 hospitals serving 6,936,393 Medicare FFS patients admitted for target conditions: acute myocardial infarction, heart failure, or pneumonia. Hospital-level penalty pressure was the expected penalty rate in the first year of the HRRP multiplied by Medicare discharge share. OUTCOMES: Informal integration measured by the percentage of referrals to hospitals' most referred SNF; formal integration measured by SNF acquisition; readmission-based quality index of the SNFs to which a hospital referred discharged patients; referral rate to any SNF. RESULTS: Hospitals facing the median level of penalty pressure had modest differential increases of 0.3 percentage points in the proportion of referrals to the most referred SNF and a 0.006 SD increase in the average quality index of SNFs referred to. There were no statistically significant differential increases in formal acquisition of SNFs or referral rate to SNF. CONCLUSIONS: HRRP did not prompt substantial changes in hospital referral patterns to SNFs, although readmissions for patients referred to SNF differentially decreased more than for other patients, warranting investigation of other mechanisms underlying readmissions reduction.

Measuring hospital-specific disparities by dual eligibility and race to reduce health inequities.

OBJECTIVE: To propose and evaluate a metric for quantifying hospital-specific disparities in health outcomes that can be used by patients and hospitals. DATA SOURCES/STUDY SETTING: Inpatient admissions for Medicare patients with acute myocardial infarction, heart failure, or pneumonia to all non-federal, short-term, acute care hospitals during 2012-2015. STUDY DESIGN: Building on the current Centers for Medicare and Medicaid Services methodology for calculating risk-standardized readmission rates, we developed models that include a hospital-specific random coefficient for either patient dual eligibility status or African American race. These coefficients quantify the difference in risk-standardized outcomes by dual eligibility and race at a given hospital after accounting for the hospital's patient case mix and proportion of dual eligible or African American patients. We demonstrate this approach and report variation and performance in hospital-specific disparities. PRINCIPAL FINDINGS: Dual eligibility and African American race were associated with higher readmission rates within hospitals for all three conditions. However, this disparity effect varied substantially across hospitals. CONCLUSION: Our models isolate a hospital-specific disparity effect and demonstrate variation in quality of care for different groups of patients across conditions and hospitals. Illuminating within-hospital disparities can incentivize hospitals to reduce inequities in health care quality.

Genomic divergence in cotton germplasm related to maturity and heterosis.

Commercial varieties of upland cotton (Gossypium hirsutum) have undergone extensive breeding for agronomic traits, such as fiber quality, disease resistance, and yield. Cotton breeding programs have widely used Chinese upland cotton source germplasm (CUCSG) with excellent agronomic traits. A better understanding of the genetic diversity and genomic characteristics of these accessions could accelerate the identification of desirable alleles. Here, we analyzed 10,522 high-quality single-nucleotide polymorphisms (SNP) with the CottonSNP63K microarray in 137 cotton accessions (including 12 hybrids of upland cotton). These data were used to investigate the genetic diversity, population structure, and genomic characteristics of each population and the contribution of these loci to heterosis. Three subgroups were identified, in agreement with their known pedigrees, geographical distributions, and times since introduction. For each group, we identified lineage-specific genomic divergence regions, which potentially harbor key alleles that determine the characteristics of each group, such as early maturity-related loci. Investigation of the distribution of heterozygous loci, among 12 commercial cotton hybrids, revealed a potential role for these regions in heterosis. Our study provides insight into the population structure of upland cotton germplasm. Furthermore, the overlap between lineage-specific regions and heterozygous loci, in the high-yield hybrids, suggests a role for these regions in cotton heterosis.