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BACKGROUND: Understanding the relationship between human evolution and environmental changes is the key to lifting the veil on human origin. The hypothesis that environmental changes triggered the divergence of humans from apes (ca. 9.3-6.5 million years ago, Ma) has been poorly tested because of limited continuous environmental data from fossil localities. Lufengpithecus (12.5-6.0 Ma) found on the southeastern margin of the Tibetan Plateau (SEMTP) across the ape-human split provides a good chance for testing this hypothesis. RESULTS: Here, we reconstructed the habitats of L. keiyuanensis (12.5-11.6 Ma) with comprehensive vegetation, climate, and potential food web data by palaeobotanical evidence, together with other multidisciplinary data and partly tested the environment-driven hypothesis by revealing the living conditions of Lufengpithecus. CONCLUSION: A detailed comparison of hominoids on different continents reveals their behaviour and fate divergence across the ape-human split against the background of global climate change, i.e., the stable living conditions of SEMTP not only provided a so-called 'refuge' for arboreal Lufengpithecus but also acted as a 'double-edged sword', preventing their further evolution while vegetation shifts in East Africa probably stimulated the emergence of human bipedalism, and the intense climatic changes in Europe possibly prevented those hominoids from surviving that time interval. Our findings provide interesting insight into the environmental impacts on the behavioural evolution of hominoids.
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Hominidae , Condições Sociais , Animais , Humanos , Filogenia , Ásia Oriental , Fósseis , Evolução BiológicaRESUMO
BACKGROUND: To analyze the association of serum Asprosin concentrations with heart failure (HF). METHODS: A total of 103 patients with HF were included in the HF group, and 103 patients with health checkups were included in the non-HF group. The serum Asprosin levels of the two groups were measured, and relevant clinical data were collected for statistical analysis. RESULTS: Compared with the non-HF group, the serum Asprosin concentration was significantly higher in the HF group, and the difference was statistically significant (P < 0.001). According to the serum Asprosin levels, we divided all the subjects into three quartiles. We found that the prevalence of HF increased with increasing serum Asprosin levels in the three groups (P < 0.001). Serum Asprosin levels were positively correlated with NT-ProBNP (P < 0.05) and negatively correlated with LVEF (P < 0.001). Dichotomous logistic regression analysis found Asprosin and age to be independent risk factors for HF (OR = 1.010, 95% CI: 1.003-1.018; OR = 1.058, 95% CI:1.004-1.665, respectively). Combining Asprosin and NT-proBNP indicators to draw ROC curves can improve the specificity and sensitivity of HF diagnosis. CONCLUSIONS: Serum Asprosin levels were significantly elevated in HF patients. The serum Asprosin level is an independent risk factor for HF, and the combined detection of Asprosin and NT-proBNP levels can improve the accuracy of HF diagnosis.
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Insuficiência Cardíaca , Humanos , Insuficiência Cardíaca/diagnóstico , Curva ROC , Fatores de Risco , Peptídeo Natriurético Encefálico , Fragmentos de Peptídeos , BiomarcadoresRESUMO
RATIONALE: Nitrogen (N) isotopic ratios (δ15 N values) of plants are primarily determined by the δ15 N values of their N sources. Metallic nutrients affect plant N uptake. However, there is little knowledge of the relationships between leaf δ15 N values and leaf metallic nutrients. The δ15 N values are often lower in soil nitrate (NO3 - ) than in ammonium (NH4 + ) due to large isotopic fractionation during nitrification. Plants acquire more NO3 - than NH4 + when accumulating high potassium (K), calcium (Ca) and magnesium (Mg) to maintain charge balance. In addition, plants that absorb more NO3 - than NH4 + increase the soil pH and decrease the availability of iron (Fe), manganese (Mn) and zinc (Zn). We therefore hypothesized that leaf δ15 N values correlate negatively with K, Ca and Mg contents, while positively with Fe, Mn and Zn contents. METHODS: Leaves of non-N-fixing plants were sampled across an approx. 6000 km transect in China and their δ15 N values and metallic nutrient content were determined using elemental analyzer/isotope ratio mass spectrometry. RESULTS: Inconsistent with the hypothesis, leaf δ15 N values correlated positively with leaf K, Ca and Mg, indicating higher δ15 N values of soil NO3 - than NH4 + . Higher δ15 N values of soil NO3 - revealed stronger denitrification than nitrification in the study regions because isotopic fractionation occurs during both processes. Leaf δ15 N values correlated negatively with Fe, relating to decreases in soil Fe availability, which might be attributed to oxidation of Fe2+ to Fe3+ supplying electrons for denitrification, while greater uptake of NO3 - than NH4 + of plants increases soil pH. Leaf δ15 N values correlated positively with Zn and did not correlate with Mn. These observed relationships between leaf δ15 N values and metallic nutrients, except Mn, were independent of vegetation or soil types. CONCLUSIONS: This study has enriched our knowledge of associations between metallic nutrients and N cycling in plant-soil systems, especially for the roles of Fe in soil N transformations and K, Ca and Mg in plant N uptake.
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Metais , Isótopos de Nitrogênio , Folhas de Planta , China , Espectrometria de Massas , Metais/análise , Metais/metabolismo , Isótopos de Nitrogênio/análise , Isótopos de Nitrogênio/metabolismo , Nutrientes/análise , Nutrientes/metabolismo , Folhas de Planta/química , Folhas de Planta/metabolismoRESUMO
BACKGROUND: Limited clinical studies describe the pharmacodynamics of fosfomycin (FOS), tigecycline (TGC) and colistin methanesulfonate (CMS) in combination against KPC-producing Klebsiella pneumoniae (KPC-Kp). Population pharmacokinetic models were used in our study. Monte Carlo simulation was conducted to calculate probability of target attainment (PTA) and cumulative fraction of response (CFR) of each agent alone and in combination against KPC-Kp in patients with normal or decreased renal function. RESULTS: The simulated regimen of FOS 6 g q8h reached ≥90% PTA against a MIC of 64 mg/L in patients with normal renal function. For patients with renal impairment, FOS 4 g q8h could provide sufficient antimicrobial coverage against a MIC of 128 mg/L. And increasing the daily dose could result to the cut-off value to 256 mg/L in decreased renal function. For TGC, conventional dosing regimens failed to reach 90% PTA against a MIC of 2 mg/L. Higher loading and daily doses (TGC 200/400 mg loading doses followed by 100 mg q12h/200 mg q24h) were needed. For CMS, none achieved 90% PTA against a MIC of 2 mg/L in normal renal function. Against KPC-Kp, the regimens of 200/400 mg loading dose followed by 100 q12h /200 mg q24h achieved > 80% CFRs regardless of renal function, followed by CMS 9 million IU loading dose followed by 4.5/3 million IU q12h in combination with FOS 8 g q8h (CFR 75-91%). CONCLUSIONS: The use of a loading dose and high daily dose of TGC and CMS in combination with FOS can provide sufficient antimicrobial coverage against critically ill patients infected with KPC-Kp.
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Antibacterianos/farmacocinética , Rim/fisiopatologia , Infecções por Klebsiella/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Enterobacteriáceas Resistentes a Carbapenêmicos/efeitos dos fármacos , Colistina/farmacocinética , Colistina/uso terapêutico , Estado Terminal , Feminino , Fosfomicina/farmacocinética , Fosfomicina/uso terapêutico , Humanos , Testes de Função Renal , Klebsiella pneumoniae/efeitos dos fármacos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Método de Monte Carlo , Tigeciclina/farmacocinética , Tigeciclina/uso terapêuticoRESUMO
Humic substances (HS) are redox-active and can function as organic terminal electron acceptors in anaerobic microbial respiration, which plays a relevant role on suppressing the emissions of methane (CH4) in anoxic systems. However, it is unclear whether or not there is an inherent link between suppression of CH4 emissions by HS and warming temperature. In this study, we assess the effects of HS additions on CH4 production in paddy and wetland soils and their responses to increasing temperature by incubation experiments. We show that the intensity of HS to suppress CH4 production under anoxic condition is positively associated with the temperature, which may be due to the fact that the activities of enzymes involved in methanogenesis have lower temperature sensitivity than those involved in microbial HS reduction, and that the methanogenesis process is less susceptible to increasing temperature compared to the microbial HS reduction process. The hypothetical increase in the effectiveness of pH alteration and HS toxicity caused by warming may be also responsible for the increased inhibition of CH4 production by HS addition in response to increasing temperature. Our findings highlight the increasingly important role of HS in suppressing CH4 production in anoxic ecosystems in a future warmer world.
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Substâncias Húmicas , Metano , Áreas Alagadas , Solo , Microbiologia do SoloRESUMO
The electron transfer capacities (ETCs) of soil humic substances (HSs) are linked to the type and abundance of redox-active functional moieties in their structure. Natural temperature can affect the chemical structure of natural organic matter by regulating their oxidative transformation and degradation in soil. However, it is unclear if there is a direct correlation between ETC of soil HS and mean annual temperature. In this study, we assess the response of the electron-accepting and -donating capacities (EAC and EDC) of soil HSs to temperature by analyzing HSs extracted from soil set along glacial-interglacial cycles through loess-palaeosol sequences and along natural temperature gradients through latitude and altitude transects. We show that the EAC and EDC of soil HSs increase and decrease, respectively, with increasing temperature. Increased temperature facilitates the prevalence of oxidative degradation and transformation of HS in soils, thus potentially promoting the preferentially oxidative degradation of phenol moieties of HS or the oxidative transformation of electron-donating phenol moieties to electron-accepting quinone moieties in the HS structure. Consequently, the EAC and EDC of HSs in soil increase and decrease, respectively. The results of this study could help to understand biogeochemical processes, wherein the redox functionality of soil organic matter is involved in the context of increasing temperature.
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Substâncias Húmicas , Solo/química , Elétrons , Oxirredução , TemperaturaRESUMO
This paper presents a surgical optical navigation system with non-invasive, real-time, and positioning characteristics for open surgical procedure. The design was based on the principle of near-infrared fluorescence molecular imaging. The in vivo fluorescence excitation technology, multi-channel spectral camera technology and image fusion software technology were used. Visible and near-infrared light ring LED excitation source, multi-channel band pass filters, spectral camera 2 CCD optical sensor technology and computer systems were integrated, and, as a result, a new surgical optical navigation system was successfully developed. When the near-infrared fluorescence was injected, the system could display anatomical images of the tissue surface and near-infrared fluorescent functional images of surgical field simultaneously. The system can identify the lymphatic vessels, lymph node, tumor edge which doctor cannot find out with naked eye intra-operatively. Our research will guide effectively the surgeon to remove the tumor tissue to improve significantly the success rate of surgery. The technologies have obtained a national patent, with patent No. ZI. 2011 1 0292374. 1.
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Imagem Óptica , Cirurgia Assistida por Computador , Sistemas Computacionais , Fluorescência , Humanos , Raios Infravermelhos , Linfonodos , Neoplasias , SoftwareRESUMO
Soil organic carbon (SOC) plays a vital role in improving soil quality and alleviating global warming. Understanding the dynamic changes in SOC is crucial for its accumulation induced by compost application in agroecosystem. In this study, soil samples were collected from three treatments: high-rate bio-compost (BioMh), low-rate bio-compost (BioMl), and control (CK, no fertilization) during 2002-2020 in a wheat-maize double cropping system in North China. The soils were separated into three functional fractions, i.e., coarse particle organic matter (cPOM, >250 µm), microaggregates (µAgg, 53-250 µm) and mineral-associated organic matter (MAOM, < 53 µm), and the associated SOC contents were determined. During 1993-2002, SOC contents in bulk soil significantly increased with the duration in the BioMh and BioMl plots. However, there was no significant correlation between SOC content and duration during 2002-2020. These results suggested that compost application positively improved SOC sequestration, while the duration of SOC sequestration (i.e., the longevity of increased SOC with time) under compost inputs maintained only 9 years. Moreover, there was a significant increase in mean annual SOC contents in bulk soil with compost application rate during 2002-2020, indicating that carbon saturation did not occur. Additionally, the SOC contents in the cPOM fraction increased with time (p < 0.01), but the corresponding µAgg and MAOM associated SOC was insignificant (p > 0.05). The MAOM fraction exhibited no additional carbon accumulation with expanding compost application, confirming a hierarchical carbon saturation in these fractions. We concluded that soils under wheat-maize double cropping system in North China have greater potential to sequester C through additional compost inputs, despite showing hierarchical saturation behavior in the non-protected coarse particulate fraction.
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Compostagem , Solo , Carbono/análise , Agricultura/métodos , Zea mays , Triticum , China , Sequestro de Carbono , Fertilizantes/análiseRESUMO
Background: The clinical characteristics and risk factors of infusion reactions (IRs) are inadequately described in clinical practice due to underreported cases. In the present study, we reported the current status of IRs based on an in-hospital pharmacovigilance database of a tertiary care hospital. Methods: Our study conducted a retrospective analysis of drug-induced IRs recorded at an in-hospital pharmacovigilance center between January 2015 to December 2019. The descriptive statistical analysis encompassed main causative agents, clinical manifestations, organ/system involvement and outcome. The severity of IRs was assessed with reference to the CTCAE version 5.0 criteria and we investigated risk factors associated with severe IRs. Results: During the study period, a total of 505 cases of inpatient drug-induced IRs were detected, of which 79.2% (400 cases) were classified as general IRs and 20.8% (105 cases) were categorized as severe IRs. The primary drugs responsible for these reactions were antibiotics (23%, 116 cases), with piperacillin sodium-sulbactam sodium being the most prevalent, followed by antineoplastic agents (18.4%, 93 cases) and traditional Chinese medicine injections (TCMIs) (12.9%, 65 cases). The administration of cefoperazone - sulbactam, mannatide, Shenqi Fuzheng, elemene, and diterpene ginkgolides meglumine resulted in a higher incidence of critical IRs. Among all cases of IRs, 43.2%, 41.2%, and 23.4% showed signs and symptoms of circulation, skin mucosa, and respiratory organs/systems, respectively. 9.1% of cases experienced systemic damage, while 7.1% and 5.9% of cases reported neurological and gastrointestinal related adverse reactions, respectively. The multivariate analysis revealed that alcohol consumption (OR = 2.389%, 95% CI 1.141-5.002, p = 0.021), age over 65 (OR = 1.814%, 95% CI 1.052-3.127, p = 0.032) and the utilization of contrast media (OR = 4.072%, 95% CI 1.903-8.713, p < 0.001) were identified as risk factors for the development of severe IRs. Conclusion: Understanding the clinical characteristics of IRs helps to implement effective pharmaceutical monitoring and appropriate preventive measures for susceptible populations with risk factors.
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Background: Perceived delays in cancer drug approvals have been a major concern for policymakers in China. Policies have been implemented to accelerate the launch of new cancer drugs and indications. This study aimed to assess similarities and differences between China and the United States in the approvals, timing, and clinical benefit evidence of cancer drug indications between 2001 and 2020. Methods: This study retrospectively identified all cancer drugs and indications approved in both China and the United States from January 1st, 2001 to December 31, 2020, and described differences in approval times as well as in submission and review times. Information on the availability of overall survival benefit evidence by December 31, 2020, was collected. Univariate and multiple logistic regression analyses were used to assess whether evidence of benefit and other factors affected the propensity and timing of approvals of cancer drug indications in China. Findings: Between 2001 and 2020, 229 indications corresponding to 145 cancer drugs approved in the United States were identified. Of those, 80 indications (34.9%) were also approved in China by the end of 2020. Cancer drug indications were approved in China at a median of 1273.5 days after approval in the United States. The median submission and review time differences for cancer drug indications in China were 1198.0 days and 180.0 days respectively. Submission time differences accounted for most of the approval time differences (p < 0.001). Indications supported by overall survival benefit evidence had shorter median review time differences (145.0 days) than those without such evidence (235.0 days, p = 0.008). Indications with overall survival benefit evidence were 3.94 times more likely to be approved in China compared to those without such evidence (p = 0.001), controlling for approval year, cancer type, and the prevalence of cancer by site. Interpretation: FDA-approved cancer drug indications demonstrating a survival benefit were more likely to receive approvals in China with shorter regulatory review times compared to indications without such evidence. Given that manufacturer submission times were the main driver of cancer drug approval times in China, factors influencing submission timing should be explored. Funding: No funding.
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Versatile printing of polymers, metals, and composites always calls for simple, economic approaches. Here we present an approach to three-dimensional (3D) printing of polymeric, metallic, and composite materials at room conditions, based on the polymeric vapor-induced phase separation (VIPS) process. During VIPS 3D printing (VIPS-3DP), a dissolved polymer-based ink is deposited in an environment where nebulized non-solvent is present, inducing the low-volatility solvent to be extracted from the filament in a controllable manner due to its higher chemical affinity with the non-solvent used. The polymeric phase is hardened in situ as a result of the induced phase separation process. The low volatility of the solvent enables its reclamation after the printing process, significantly reducing its environmental footprint. We first demonstrate the use of VIPS-3DP for polymer printing, showcasing its potential in printing intricate structures. We further extend VIPS-3DP to the deposition of polymer-based metallic inks or composite powder-laden polymeric inks, which become metallic parts or composites after a thermal cycle is applied. Furthermore, spatially tunable porous structures and functionally graded parts are printed by using the printing path to set the inter-filament porosity as well as an inorganic space-holder as an intra-filament porogen.
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Achieving the carbon neutrality in China has great impact on alleviating global warming. Compost application, an important measure to promote soil organic carbon (SOC) sequestration, has been practiced in China since 2015. However, it is still unclear how much carbon can be fixed by cropland soil under compost application in the whole China. China has pledged to strive for the goal of carbon neutrality by 2060, which brought two issues: whether compost application can consistently promote SOC sequestration until 2060, and how much contribution it can make to the carbon neutrality. In the present study, we analyzed the results from 93 literatures to determine the SOC sequestration under compost application in the different agricultural divisions of China. Results showed that there were regional differences in the effect of compost application on SOC sequestration. The annual SOC sequestration in Northern China (NC) and Gansu + Xinjiang (GX) was significantly high than other regions. In addition, the annual SOC sequestration was negatively related to the duration of the experiment, while the accumulative SOC sequestration during the experimental period increased with the increase of the duration. According to our results, the total SOC sequestration in topsoil of Chinese cropland was 85 Tg C year-1 under compost application, which will make a 4.4% contribution to carbon neutrality during 2021-2060. In conclusion, cropland soil in China can still sequester carbon for more than 35 years under compost application. Thus, abidingly promoting compost application in China is crucial to accomplishing the carbon neutrality goal.
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Carbono , Compostagem , Agricultura/métodos , Carbono/análise , Sequestro de Carbono , China , Produtos Agrícolas , SoloRESUMO
The carbon, nitrogen and water cycles of terrestrial ecosystems are important biogeochemical cycles. Addressing the relationship of leaf nitrogen (N) and carbon isotope discrimination (Δ) will enhance the understanding of the links between these three cycles in plant leaves because Δ can reflect time-integrated leaf-level water-use efficiency (WUE) over the period when the leaf material is produced. Previous studies have paid considerable attention to the relationship. However, these studies have not effectively eliminated the interference of environmental factors, inter-species, and inter-individual differences in this relationship, so new research is necessary. To minimize these interferences, the present work explored the relationship at the three levels of community, population, and plant individual. Three patterns of positive, negative and no relationship were observed across communities, populations, and individuals, which is dependent on environmental conditions, species, and plant individuals. The results strongly suggested that there is no general pattern for the relationship between leaf N and Δ. Furthermore, the results indicated that there is often no coupling between leaf-level long-term WUE and leaf N in the metabolic process of carbon, N and water in leaves. The main reason for the lack of this relationship is that most plants do not invest large amounts of nitrogen into photosynthesis. In addition, the present study also observed that, for most plant species, leaf N was not related to photosynthetic rate, and that variations in photosynthetic rates are mainly driven by stomatal conductance.
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Nitrogen (N) and phosphorus (P) are two crucial limiting mineral elements for terrestrial plants. Although the leaf N:P ratio is extensively used to indicate plant nutrient limitations, the critical N:P ratios cannot be universally applied. Some investigations have suggested that leaf nitrogen isotopes (δ15N) can provide another proxy for nutrient limitations along with the N:P ratio, but the negative relationships between N:P and δ15N were mainly limited to fertilization experiments. It will obviously benefit the study of the nature of nutrient limitations if the relationship could be explained more generally. We analyzed leaf δ15N, N, and P contents across a northeast-southwest transect in China. Leaf δ15N was weakly negatively correlated with leaf N:P ratios for all plants, while there was no correlation between them for various plant groups, including different growth forms, genera, and species across the entire N:P range. This suggests that the use of leaf δ15N in indicating the shift of nutrient limitations across the whole N:P range still requires more validated field investigations. Notably, negative relationships between δ15N and N:P hold for plants with N:P ratios between 10 and 20 but not for plants with N:P ratios lower than 10 or higher than 20. That is, changes in leaf δ15N along with the N:P ratio of plants that are co-limited by N and P can exhibit variations in plant nutrient limitations, whereas plants that are strictly limited by N and P cannot. Moreover, these relationships are not altered by vegetation type, soil type, MAP, or MAT, indicating that the use of leaf δ15N in reflecting shifts in nutrient limitations, depending on the plant nutrient limitation range, is general. We examined the relationships between leaf δ15N and the N:P ratio across an extensive transect, providing references for the widespread use of leaf δ15N in reflecting shifts in nutrient limitation.
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Nitrogênio , Fósforo , Folhas de Planta , Plantas , China , Ecossistema , Nitrogênio/análise , Isótopos de Nitrogênio , Fósforo/análise , Folhas de Planta/química , SoloRESUMO
The photoexcited charge separation efficiency of photocatalysts is generally considered as the key factor for enhancement of their photocatalytic activity, and sometimes, their photoabsorption capability and interfacial reaction kinetics play a key part, but the role of interfacial affinity of photocatalysts with substrates was rarely researched systematically. Herein, nitrogen vacancy-modified polymeric carbon nitride porous nanotubes (PCNpts) were simply synthesized, using tartaric acid as a crosslinking and corrosion agent, and exhibit a remarkable increment in surface area, wettability, photoabsorption and charge separation capability, and photocatalytic activity in water splitting to produce H2, but, interestingly, exhibit substrate-dependent variation of photoactivity in contaminant degradation, compared with bulk PCN. More interestingly, the interfacial affinity of PCNpts and PCN with contaminants and H2O, rather than photoabsorption and charge separation capability, is confirmed to dominate their photoactivity.
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Understanding the water use efficiency (WUE) and adaptation strategies of plants in high-temperature and rainy areas is essential under global climate change. The leaf carbon content (LCC) and intrinsic WUE of 424 plant samples (from 312 plant species) on Hainan Island were measured to examine their relationship with geographical and climatic factors in herbs, trees, vines and ferns. The LCC ranged from 306.30 to 559.20 mg g-1, with an average of 418.85 mg g-1, and decreased with increasing mean annual temperature (MAT). The range of intrinsic WUE was 8.61 to 123.39 µmol mol-1 with an average value of 60.66 µmol mol-1. The intrinsic WUE decreased with increasing altitude and relative humidity (RH) and wind speed (WS), but increased with increasing latitude, MAT and rainy season temperature (RST), indicating that geographical and climatic factors affect the intrinsic WUE. Stepwise regression suggested that in tropical regions with high temperature and humidity, the change in plant intrinsic WUE was mainly driven by WS. In addition, the main factors affecting the intrinsic WUE of different plant functional types of plants are unique, implying that plants of different plant functional types have distinctive adaptive strategies to environmental change. The present study may provide an insight in water management in tropical rainforest.
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BACKGROUND: Psittacosis is a relatively uncommon cause of community-acquired pneumonia, often leading to diagnostic difficulty. METHODS: A retrospective study was conducted on the clinical features of psittacosis patients in China. Forty-six cases of Chlamydophila psittaci infection with atypical pneumonia of varying severity in the last two years were described retrospectively. RESULTS: Fever, relative bradycardia, and other systemic upsets were the main clinical presentation. The most common radiographic abnormality was segmental or lobar shadowing or consolidation. The total white cell counts were usually normal or slightly increased. The concentration of creatine kinase, C reactive protein, and lactic dehydrogenase increased, while albumin decreased remarkably. These cases exhibited good recovery after being treated with tetracycline or quinolone antibiotics. CONCLUSION: These features may help differentiate psittacosis from other traditional bacterial pneumonia. However, they do not provide a definitive diagnosis. Psittacosis diagnosis must perform the whole-genome sequencing for Chlamydophila psittaci in respiratory, blood, or sputum specimens. Increased awareness of psittacosis can shorten diagnostic delays and improve patient outcomes.
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Chlamydophila psittaci , Pneumonia Bacteriana , Psitacose , Humanos , Psitacose/diagnóstico , Psitacose/tratamento farmacológico , Estudos Retrospectivos , População do Leste Asiático , Pneumonia Bacteriana/microbiologia , Antibacterianos/uso terapêuticoRESUMO
BACKGROUND: China's National Reimbursement Drug List (NRDL) has become the primary route for drug reimbursement in China. More recently, the authority has made pharmacoeconomic evaluation an integral part of the application for NRDL inclusion. The underlying financial conflict of interests (FCOI) of pharmacoeconomic evaluations, however, has the potential to influence evidence generated and thus subsequent decision-making yet remains poorly understood. METHODS: We searched for studies published between January 2012 and January 2022 on the 174 drugs added to the 2017-2020 NRDLs after successful negotiation. We categorised the study's FCOI status into no funding, industry funding, non-profit funding and multiple fundings based on authors' disclosure and assessed the reporting quality of included studies using the Consolidated Health Economic Evaluation Reporting Standards 2022 checklist. We compiled descriptive statistics of funding types and study outcomes using t-tests and χ2 tests and conducted multivariate regression analysis. RESULTS: We identified 378 records and our final sample included 92 pharmacoeconomic evaluations, among which 69.6% were conducted with at least one funding source. More than half (57.6%) of the evaluations reached favourable conclusions towards the intervention drug and 12.6% reached a dominant result of the intervention drug over the comparison from model simulation. The reporting quality of included studies ranged from 19 to 25 (on a scale of 28), with an average of 22.3. The statistical tests indicated that industry-funded studies were significantly more likely to conclude that the intervention therapy was economical (p<0.01) and had a significantly higher proportion of resulting target drug economically dominated the comparison drug (p<0.05). CONCLUSION: The study revealed that FCOI bias is common in published pharmacoeconomic evaluations conducted in Chinese settings and could significantly influence the study's economical results and conclusions through various mechanisms. Multifaceted efforts are needed to improve transparency, comparability and reporting standardisation.
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Farmacoeconomia , Negociação , Humanos , Custos de Medicamentos , Análise Custo-Benefício , ChinaRESUMO
This study assesses plants' adaptation to the elevated atmospheric CO(2) concentrations (c(a)) using 83 tree-ring δ(13)C series from the mid- to high-latitudes of the northern hemisphere. We found that the variation of Δ with the atmospheric CO(2) concentration is nonlinear and that the range of Δ change is relatively small. After 1950, the mean increase in Δ is 0.43, corresponding to the average coefficient of Δ-c(a) relationship to be about 0.006/ ppmv CO(2). In contrast to the changes in Δ, intercellular CO(2) concentration (c(i)) and intrinsic water-use efficiency (W(i)) both increase linearly with c(a). For the past two and a half centuries, changes in the intercellular CO(2) concentration (c(i)) and intrinsic water-use efficiency (W(i)) are, on average, both about 30%, while the mean change of the c(i)/c(a) ratio is 3%. Most changes have occurred after 1950. W(i) responds to c(a) linearly with sensitivities ranging from 0.06 to 0.6 µmol CO(2)/mmol H(2)O ppmv(-1), and an average 0.33 µmol CO(2)/mmol H(2)O ppmv(-1) during the past 50 years. Statistical analysis shows that the increase in c(a) accounts for 98% of the W(i) variation. The remaining small variance is explained by altitude and temperature. Trees at higher elevations show slightly higher increase in W(i), and they are also more sensitive to the CO(2) increase than trees at lower altitudes. Trees growing at low temperature environments are slightly more sensitive to CO(2) increase than those at higher temperature sites. No significant relationship between precipitation and plants' W(i) response to the atmospheric CO(2) increase is found with these data. Although the temperature and altitude both impact the W(i) response to elevated CO(2), the size of the impact is physically small and can be omitted from ecological models.
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Atmosfera , Dióxido de Carbono/metabolismo , Plantas/metabolismo , Água/metabolismo , Dióxido de Carbono/análiseRESUMO
How climate warming affected terrestrial ecosystems received considerable attention. Soil micronutrients play a vital role in regulating the growth of all living organisms and thus make a significant contribution to plant production. However, the responses of soil micronutrients to climate warming still remained unclear. While soil sampling along a temperature gradient could reveal the long-term influence of climate warming on soil nutrient dynamics, the variations of soil micronutrients with temperature might be interfered by the effect of precipitation due to the collinearity between temperature and precipitation. Moreover, changes in soil micronutrients over broad geographical scale could be affected by soil texture. Hence, this study conducted a soil investigation across a temperature transect along the 400 mm isohyet in northern China to examine the responses of soil micronutrients to changing temperature and soil texture when the effect of precipitation was minimized. We observed that soil copper (Cu), manganese (Mn) and zinc (Zn) contents all decreased along the temperature gradient. Soil Cu, Mn and Zn contents were positively correlated with soil clay and silt contents and negatively correlated with soil sand content. Temperature and soil texture together accounted for 72.0 % of the variations in soil micronutrient contents. Temperature and soil texture individually explained 10.4 % and 48.0 %, and their shared variation explained 13.6 % of the variations in soil micronutrient contents. Moreover, soil parent material also exerted an effect on soil micronutrient contents. Our results suggested that climate warming might cause a decrease in soil micronutrient contents.