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Purpose: This study presents a rare case of avulsion fracture of the anterior inferior iliac spine, typically occurring in adolescents engaged in physical activities. The purpose of this study is to emphasize the diagnostic challenges and conservative treatment options available for this condition. Method: We describe the case of a 14-year-old healthy adolescent who suffered from an avulsion fracture following pelvic trauma after participating in a short-distance sprint. Initial physical examination and X-ray imaging were inconclusive, showing no apparent fractures. Due to parental refusal of a Computerized Tomography (CT) scan by concerns over the potential risks associated with radiation exposure, a diagnostic ultrasound was performed, which confirmed the presence of an avulsion fracture at the anterior inferior iliac spine. Results: The ultrasound findings led to a conservative treatment approach, involving rest, and unloading of the affected limb. Follow-up assessments indicated significant pain relief within four weeks and enabled the resumption of partial physical activity after six months. Conclusion: This case highlights the utility of ultrasound as an effective alternative diagnostic tool in situations where CT scans are not permissible. Additionally, it demonstrates that conservative management can be successful in treating avulsion fractures of the anterior inferior iliac spine in adolescents, leading to satisfactory recovery and return to activity.
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Combatting climate change depends on demand-side mitigation strategies related to food, which is in turn contingent on explicit estimation and management of dish-level emissions. Here, on the basis of a bottom-up integrated emissions framework, we first estimate the greenhouse gas emissions of 540 dishes from 36 cuisines using data from over 800,488 restaurants in China's provincial capital cities. By mining residents' dietary preferences, we then design various dietary change strategies to explicitly link food emissions to the Paris Agreement pledges. The results show that China's food system greenhouse gas emissions were approximately 4.64 GtCO2eq in 2020, accounting for 37% of total emissions, with average per-dish emissions of 8.44 kgCO2eq. Current emission patterns of food consumption in China may not be consistent with the attainment of the 1.5 °C and 2 °C climate targets, but transitioning towards low-emission cuisines and dishes could change that by reducing emissions by 38-69%.
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Mudança Climática , Gases de Efeito Estufa , China , Gases de Efeito Estufa/análise , Humanos , Restaurantes , Efeito Estufa/prevenção & controle , Paris , DietaRESUMO
Differences in progress across sustainable development goals (SDGs) are widespread globally; meanwhile, the rising call for prioritizing specific SDGs may exacerbate such gaps. Nevertheless, how these progress differences would influence global sustainable development has been long neglected. Here, we present the first quantitative assessment of SDGs' progress differences globally by adopting the SDGs progress evenness index. Our results highlight that the uneven progress across SDGs has been a hindrance to sustainable development because (1) it is strongly associated with many public health risks (e.g., air pollution), social inequalities (e.g., gender inequality, modern slavery, wealth gap), and a reduction in life expectancy; (2) it is also associated with deforestation and habitat loss in terrestrial and marine ecosystems, increasing the challenges related to biodiversity conservation; (3) most countries with low average SDGs performance show lower progress evenness, which further hinders their fulfillment of SDGs; and (4) many countries with high average SDGs performance also showcase stagnation or even retrogression in progress evenness, which is partly ascribed to the antagonism between climate actions and other goals. These findings highlight that while setting SDGs priorities may be more realistic under the constraints of multiple global stressors, caution must be exercised to avoid new problems from intensifying uneven progress across goals. Moreover, our study reveals that the urgent needs regarding SDGs of different regions seem complementary, emphasizing that regional collaborations (e.g., demand-oriented carbon trading between SDGs poorly performed and well-performed countries) may promote sustainable development achievements at the global scale.
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Offshore carbon emissions from the international shipping trade are significant contributors to climate change. Based on the complex shipping trade networks, offshore carbon emissions are correlated rather than independent, and allocating responsibility for reducing emissions does not depend solely on the amount but on linkages. We use the global container shipping data covering more than 98% of routes from 2015 to 2020 to calculate the offshore carbon emissions from shipping. Subsequently, we construct an offshore carbon emissions network based on the shipping routes and emissions to identify the evolutionary tendency of network and clarify emissions reduction responsibilities by considering equity and efficiency. We discover that global offshore carbon emissions present a complicated network structure dominated by developed countries and large economies. Countries on the same continent or within the same economic organizations have closer and more frequent carbon correlations. Greater responsibilities should be allocated to countries who are at the center of the network.
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The impact of climate change on economic inequality has attracted increasing attention from both government and academia. Here, we present a protocol for estimating both the impact of climate change on economic growth and economic growth inequality under multiple climate policies. We describe steps for constructing an uncertainty analysis framework, collecting and pre-processing data, and estimating the climate-economic response. We then detail procedures of predicting climate policy impact and calculating inter-country economic growth inequality. For complete details on the use and execution of this protocol, please refer to Tang et al. (2023).1.
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Mudança Climática , Desenvolvimento Econômico , PolíticasRESUMO
Studies have shown that the soaring demand for air conditioners in recent years is closely related to the worsening global warming; however, little evidence has been provided for China. This study uses weekly data of 343 Chinese cities to investigate how air conditioner sales respond to climate variability. We detected a U-shaped relationship between air-conditioning and temperature. An additional day with average temperature above 30°C increases weekly sales by 16.2%. Heterogeneity analysis shows that the adoption of air-conditioning is different for south and north China. By combining our estimates with shared socioeconomic pathway scenarios, we project China's mid-century air conditioner sales and the resulting electricity demand. Under the fossil-fueled development scenario, air conditioner sales in the Pearl River Delta would rise by 71% (65.7%-87.6%) in summer. On average, the per capita electricity demand for air-conditioning will surge by 28% (23.2%-35.4%) in China by mid-century.
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Understanding the implications of global climate governance is critical for achieving sustainable economic development, given that the economic impacts of climate change and policies are disproportionately distributed across regions. We estimate the updated damage functions and construct an uncertainty analysis framework to assess whether stringent climate policies entail economic benefits in terms of growth and inequality. The findings show that although climate policies slow the pace of economic growth, the benefits of avoided damage may overweight policy costs in the long run. Moreover, pursuing the 1.5°C goal slows economic catch-up of poor countries in the short to medium term relative to 2°C, but improves global inequality in the long run. This situation may, however, change when moving to a fast-growing and fossil-fueled world, in which inequalities gradually decline but start to rise after 2065. This study highlights the importance of synergizing the stringent 1.5°C goal with economic inequality alleviation.
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Regional trade agreements (RTAs) have been widely adopted to facilitate international trade and cross-border investment and promote economic development. However, ex ante measurements of the environmental effects of RTAs to date have not been well conducted. Here, we estimate the CO2 emissions burdens of the Regional Comprehensive Economic Partnership (RCEP) after evaluating its economic effects. We find that trade among RCEP member countries will increase significantly and economic output will expand with the reduction of regional tariffs. However, the results show that complete tariff elimination among RCEP members would increase the yearly global CO2 emissions from fuel combustion by about 3.1%, doubling the annual average growth rate of global CO2 emissions in the last decade. The emissions in some developing members will surge. In the longer run, the burdens can be lessened to some extent by the technological spillover effects of deeper trade liberalization. We stress that technological advancement and more effective climate policies are urgently required to avoid undermining international efforts to reduce global emissions.
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Low-expansion alloys are of great importance and can be used for the development of new aerospace materials. Herein, we report diverse rare earth quasicrystal alloys fabricated by the vacuum suction casting process. The effects of the addition of cerium (Ce) on the microstructure, thermal expansion properties and microhardness of the Al-Cu-Fe alloy were systematically investigated. This study discovered the tiny Al-Cu-Fe-Ce microstructure. A uniform distribution could be achieved after Ce addition amount is elevated. At the Ce addition amount of 1 at%, the lowest alloy thermal expansion coefficient was obtained. The alloy exhibited the maximum microhardness under these conditions. The microhardness of alloys containing 1 at% of Ce was approximately 2.4 times higher than the microhardness exhibited by alloys devoid of Ce additives. The coefficient of thermal expansion decreases by approximately 20%. The use of the suction casting process and the addition of an appropriate amount of Ce can potentially help design and develop Al-Cu-Fe-Ce alloys.
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Sustainable development goals (SDGs) emphasize a holistic achievement instead of cherry-picking a few. However, no assessment has quantitatively considered the evenness among all 17 goals. Here, we propose a systematic method, which first integrates both the evenness and the overall status of all goals, to distinguish the ideal development pathways from the uneven ones and then revisit the development trajectory in China from 2000 to 2015. Our results suggest that, despite the remarkable progress, a bottleneck has occurred in China since 2013 due to the stagnant developments in some SDGs. However, many far-reaching policies in China have been targeting these deficiencies since then, providing a perspective on how a country approaches sustainable development by promoting evenness among all SDGs. Our results also indicate that regions with the slowest progress are the developed provinces, owing to the persistent uneven status of all goals. Our study demonstrates the importance of adopting evenness in assessing and guiding sustainable development.
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PURPOSE: Clinical responses of neoadjuvant chemotherapy (NACT) are associated with prognosis in patients with breast cancer. The selection of suitable variables for the prediction of clinical responses remains controversial. Herein, we developed a predictive model based on ultrasound imaging and clinical indices to identify patients most likely to benefit from NACT. PATIENTS AND METHODS: We recruited a total of 225 consecutive patients who underwent NACT followed by surgery and axillary lymph node dissection at the Sixth Hospital of Ning Bo City of Zhe Jiang Province between January 1, 2018, and March 31, 2021. All patients had been diagnosed with breast cancer following the clinical examination. First, we created a training cohort of patients who underwent NACT+surgery (N=180) to develop a nomogram. We then validated the performance of the nomogram in a validation cohort of patients who underwent NACT+ surgery (N=45). Multivariate logistic regression was then used to identify independent risk factors that were associated with the response to NACT; these were then incorporated into the nomogram. RESULTS: Multivariate logistic regression analysis identified several significant differences as to clinical responses of NACT, including neutrophil-lymphocyte ratio (NLR), body mass index (BMI), pulsatility index (PI), resistance index (RI), blood flow, Ki67, histological type, molecular subtyping, and tumor size. The performance of the nomogram score exhibited a robust C-index of 0.89 (95% confidence interval [CI]: 0.83 to 0.95) in the training cohort and a high C-index of 0.87 (95% CI: 0.81 to 0.93) in the validation cohort. Clinical impact curves showed that the nomogram had a good predictive ability. CONCLUSION: We successfully established an accurate and optimized nomogram incorporated ultrasound imaging and clinical indices that could be used preoperatively to predict clinical responses of NACT. This model can be used to evaluate the risk of clinical responses to NACT and therefore facilitate the choice of personalized therapy.
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As the country with the world's largest coal power capacity, China is launching a national carbon market. How the carbon pricing may contribute to phasing out China's coal power is a great concern. We collect full-sample data set of China's 4540 operating coal plant units and develop a stochastic Monte-Carlo financial model to assess the financial sustainability of the plant operation. Although China's coal plants have long residual technical lifetime, their operations are close to the break-even state. Even with low carbon price of 50 CNY/tCO2 growing at 4%/y and the permits being fully auctioned, the average residual lifetime of all the plants will be reduced by 5.43 years, and the cumulative CO2 emission from 2020 to 2050 will be reduced by 22.73 billion ton. The spatial disparity in the carbon pricing effect is significant, and the western regions are more vulnerable to the carbon pricing risk than the eastern regions.
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Given the increasing interest in keeping global warming below 1.5°C, a key question is what this would mean for China's emission pathway, energy restructuring, and decarbonization. By conducting a multimodel study, we find that the 1.5°C-consistent goal would require China to reduce its carbon emissions and energy consumption by more than 90 and 39%, respectively, compared with the "no policy" case. Negative emission technologies play an important role in achieving near-zero emissions, with captured carbon accounting on average for 20% of the total reductions in 2050. Our multimodel comparisons reveal large differences in necessary emission reductions across sectors, whereas what is consistent is that the power sector is required to achieve full decarbonization by 2050. The cross-model averages indicate that China's accumulated policy costs may amount to 2.8 to 5.7% of its gross domestic product by 2050, given the 1.5°C warming limit.
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Broke out at the end of 2019, the novel coronavirus pneumonia (COVID-19) has been spreading throughout the world, leading to more than 87 million confirmed infections and 1.88 million fatalities. Motivated by this, we evaluate the economic impacts of COVID-19 outbreak on both national and industrial levels by employing quarterly computable general equilibrium (CGE) model. Our results reveal that the epidemic may lower China's economic growth in 2020 by 3.5%, versus 4.4% for final consumption (relative to baseline). The service industry suffers the most from the outbreak, and the Accommodation-Food-Beverage service, Wholesale-Retail Trade, and Transport-Storage-Post are identified as the most vulnerable sectors, with the negative impact on output reaching as high as 14.6%. When moving to 2021, the hit to economy shrinks to 2% (1.2-2.7%), with industry estimated to be the most affected sector instead. This study indicates that implementing effective measures for preventing and controlling the epidemic and policies for post-disease economic recovery play critical role in curbing the potential economic damage.
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OBJECTIVE: To determine the value of musculoskeletal ultrasound (MSUS) in evaluating the pathological features and inflammatory lesions of rheumatoid finger arthritis. STUDY DESIGN: A comparative study. PLACE AND DURATION OF STUDY: Ningbo No. 6 Hospital, China, from September 2017 to February 2020. METHODOLOGY: Eighty patients with rheumatoid finger arthritis (570 finger joints) were examined by MSUS and MRI. Detection rates of the two methods for diagnosing the pathological features of rheumatoid arthritis, levels of the serum markers rheumatoid factor (RF), etc, were compared. RESULTS: Detection rate of joint effusion by MSUS was higher than MRI (p <0.001). Spearman's correlation analysis showed that synovial blood flow signal grade was positively correlated with serum RF, anti-CCP, ESR, CRP, IL-6, and IL-33 levels (r = 0.853, p <0.001; r = 0.864, p <0.001; r = 0.866, p <0.001; r = 0.846, p <0.001; r = 0.881, p <0.001; and r = 0.873, p <0.001, respectively). Resistive index value of intra-synovial artery in active patients was lower than in define inactive patients (p <0.001). CONCLUSION: Compared to MRI, MSUS has a higher detection rate of joint effusion in RA patients. In the MSUS examination, synovial blood flow signal is positively correlated with RF, Anti-CCP, ESR, CRP, IL-6, and IL-33, and the resistive index of intra-synovial artery is closely related to disease activity. Key Words: Musculoskeletal ultrasound (MSUS), Rheumatoid arthritis (RA), Synovial hyperplasia, Synovial blood flow signal, Serum markers.
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Artrite Reumatoide , Artrite Reumatoide/diagnóstico por imagem , China , Humanos , Imageamento por Ressonância Magnética , Fator Reumatoide , UltrassonografiaRESUMO
This paper aims to examine the worldwide interactions between income inequality and carbon emissions, and the nonlinear threshold roles of globalization, income inequality and economic growth. To fulfill this task, we propose a dynamic panel threshold model with cross-sectional dependence, based on a balance panel data of 92 countries over the period 1991-2015. The results suggest the presence of nonlinear effects of threshold variables, which have asymmetric impacts on the negative relationships between income inequality and carbon emissions. Further, we find that the promotion of globalization significantly contributes to reduce the effect of income unfairness improvement on the increase of carbon emissions, and this similar effect could also be achieved through shrinking income inequality per se and spurring economic growth. We therefore suggest the stakeholders keep working on pushing the reinforced trend of globalization when weighting the trade-offs between income inequality alleviation and carbon emission mitigation.