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Background: Although abnormal functional activities or connectivities in individuals with autism spectrum disorders (ASD) have been reported, yet, there is still lack of consistent findings of altered functional activities or connectivities and its associated genetic basis for ASD. Methods: Here, we aimed to identify consistent brain functional alterations and the biological genetic mechanisms in children and adults with ASD using a large sample of resting-state functional magnetic resonance imaging data from the Autism Brain Image Data Exchange dataset (ABIDE). Multi-site based meta-analyses were first employed and identified abnormal brain activity, local and global functional connectivities primarily localizing in frontal-temporal-occipital regions and default mode network (DMN) in individuals with ASD. Results: The significant correlations between the aberrant brain regions and clinical phenotypes related to social functions in ASD were found. Importantly, brain-wide transcriptome-neuroimaging spatial association analyses and the follow-up enrichment, tissue-specific expression, and protein-protein interaction analyses were conducted and identified the underlying cellular and molecular mechanisms of ASD. Conclusions: Collectively, our findings link molecular and functional changes in ASD and provide new evidence for neuropathology and a potential precious treatment target for ASD.

Background: Hospitals are an essential part of the health care system. The purpose of this study is to evaluate the equity and service efficiency of health resource allocation in the hospital service system of 31 provinces (municipalities directly under the central government and autonomous regions) in mainland China from 2017 to 2021, and to analyze the influencing factors of hospital service efficiency to provide a reference for rational allocation of hospital health resources and improvement of hospital service efficiency. Methods: Equity of allocation of hospital health resources in mainland China was evaluated in three dimensions using the Gini coefficient and Lorenz curve. Hospital service efficiency was calculated by output-oriented super efficiency slack-based model-data envelopment analysis (SE-SBM-DEA) model and DEA-based Malmquist total factor productivity index (MTFP), and the influencing factors of hospital service efficiency were analyzed by panel data regression. Results: The number of hospitals in mainland China grew from 31056 to 36570 between 2017 and 21st. The equity ranking of the dimensions of hospital health resource allocation was Demographic > Economic > Geographic. However, the curvature of the demographic and economic dimensions is smaller compared to the curvature of the Lorenz curve for the geographic dimension. The demographic dimension has the lowest average Gini coefficient (0.167), followed by the economic (0.295) and the geographical (0.616). The 2017-2021 MTFP results show that none of the DMU efficiency values exceed 1. SE-SBM-DEA results show 15 DMUs in 2021 with total factor productivity above 1. The five-year average efficiency values ranked West (0.851) > East (0.834) > Central (0.673); Five influential factors identified by panel data regression analysis, Among them, X1(The proportion of urban population), X3(The percentage of illiterate population to total aged 15 and over) and X10(The proportion of the volume of medical service in primary medical facilities) have a positive relationship with hospital service efficiency, and X5(The level of per capital outpatient and emergency treatment expenditure) and X8(The proportion of hospital personnel) have a negative relationship with hospital service efficiency. Conclusion: After five years of development, the hospital service system in mainland China has grown significantly in number and size, but there are still differences in the allocation of hospital health resources between the East and the West, and intra-regional differences remain large. The overall level of efficiency in hospital services over the last five years was poor, with the West overtaking the East as the region with the highest five-year average. The regression model verified the effect of some factors on hospital service efficiency, and the effect of disadvantaged groups on hospital service efficiency was not significant (P>0.05).

Background General practitioners (GP) are the gatekeepers of residents' health, and 2021 is the 10th year of the establishment of the GP system in China. This study aims to assess the equity and trends of GP allocation in China from 2012–2021, summarize the efforts and progress of GPs in China during the decade, and predict the development trend of GPs in mainland China in the next five years to provide a reference for regional health planning and rational allocation of GPs in China. Methods Data from 2012 to 2021 on GPs in 22 provinces, 5 autonomous regions, and 4 municipalities directly under the central government in mainland China (excluding Hong Kong, Macao, and Taiwan) are collected by us. Gini coefficient, Lorenz curve and health resource agglomeration degree (HRAD) were used to analyze the equity of the allocation of GPs in China from different dimensions, and a Grey forecasting model was used to forecast the number of GPs in 2022–2026. Results The number of GPs in mainland China increased from 109,794 to 434,868 from 2012–2021, with 3.08 GPs per 10,000 people. The Gini coefficient of GPs allocation by population in China decreased from 0.312 to 0.147 from 2012–2021, while the Gini coefficient of geographic dimension remained between 0.7 ~ 0.75. Compared with the degree of curvature of the Lorentz curve in the geographic dimension, the degree of curvature of the population and economic dimension were smaller. In 2021, the HRAD in the Eastern region was 4.618, and the Central region was 1.493, with different degrees of imbalance among regions, and the HRAD/PAD in the Eastern, Central and Western regions were 1.196, 0.880 and 0.821, respectively. GPs in the Eastern region is still concentrated, while the Central and Western regions were at a similar level, and GPs were more scarce. The Grey forecasting model predicts that the number of GPs in mainland China will reach about 720,000 in 2026, and the number of GPs per 10,000 people will reach 4.9. Conclusion After a decade of development, the number of GPs in China has increased significantly. It has reached the goal of the GP system when it was first established. However, the equity of the geographical dimension, both in terms of Gini coefficient and HRAD, has great differences between different regions, and at a low level. The Western region has the problem of insufficient GP allocation in both population and geographical dimension. In the future, the number of GPs in China will continue to grow rapidly with the support of policies. The "2030" goal, proposed in 2018, is expected to be achieved by 2026. But due to certain factors (such as COVID-19), the actual situation may be different from the predicted results.