Cost-effectiveness of different intervention strategies of human immunodeficiency virus in Zhejiang, China: a Model Study From 2023 to 2052.

OBJECTIVE: :Mass screening for human immunodeficiency virus (HIV) and preexposure prophylaxis (PrEP) may be effective measures for reducing the probability of HIV transmission. Our study aimed to determine the cost-effectiveness of preliminary screening in the general population, PrEP for HIV-negative spouses in serodiscordant couples, or both approaches in Zhejiang Province. DESIGN: :From a policy-maker's perspective, a Markov model was constructed to compare 4 strategies over a 30-year horizon. METHODS: :In the Markov model, the implementation intensities of the strategies varied from 50% to 100%. Different strategies were evaluated by the reduction of unfavorable clinical outcomes, saved life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratios (ICERs), and net monetary benefits (NMBs). RESULTS: :The PrEP-Screening strategy reduced the most unfavorable clinical outcomes and saved the most LYs and QALYs from 2023 to 2052. It always gained the maximum QALYs and NMB, while its ICER was always lower than the willingness-to-pay (WTP). The NMB of the PrEP-Screening strategy gradually increased as the implementation intensity increased. CONCLUSIONS: :With adequate manpower and policies, we suggest implementing the PrEP-Screening strategy in Zhejiang Province, suggesting that the broader the population coverage of the strategy, the better. In addition, the PrEP strategy is an alternative.

Exploration for the Priority of HIV Intervention: Modelling Health Impact and Cost-Effectiveness - Six Cities, Eastern China, 2019-2028.

Introduction: In order to enhance the effectiveness of resource allocation, regions must tailor their responses to their specific epidemiological and economic situations. Methods: Utilizing Spectrum software, we projected the cost-effectiveness of 10 chosen HIV interventions in six cities in eastern China from 2019 to 2028. We assessed three scenarios - Base, Achievable, and Idealized - for each city. The analysis included the projected number of HIV infections and deaths averted, as well as the incremental cost-effectiveness ratios for each intervention in the six cities. Results: In Shijiazhuang, Wuxi, Yantai, and Zhenjiang, cities with initially low antiretroviral therapy (ART) coverage, ART showed significant effectiveness, especially for males. Conversely, in Foshan and Ningbo, where ART coverage was notably high, oral pre-exposure prophylaxis (PrEP) for men who have sex with men (MSM) proved effective in the Idealized scenario. MSM outreach, ART for males, and ART for females demonstrated cost-effectiveness across all six cities in both Achievable and Idealized scenarios at the predefined thresholds for each city. Discussion: Maintaining an appropriate coverage rate for outreach to MSM can lead to cost-effectiveness. In cities with low ART coverage, scaling up ART remains a crucial intervention. In regions with high ART coverage, consideration may be given to the utilization of oral PrEP for MSM individuals, requiring budget allocation.

Assessment of lumbar disc herniation-impaired gait by using IMU data fusion method.

The inertial motion unit (IMU) is an effective tool for monitoring and assessing gait impairment in patients with lumbar disc herniation(LDH). However, the current clinical assessment methods for LDH gait focus on patients' subjective scoring indicators and lack the assessment of kinematic ability; at the same time, individual differences in the motor function degradation of the healthy and affected lower limbs of LDH patients are also ignored. To solve this problem, we propose an LDH gait feature model based on multi-source adaptive Kalman data fusion of acceleration and angular velocity. The gait phase is segmented by using an adaptive Kalman data fusion algorithm to estimate the attitude angle, and obtaining gait events through a zero-velocity update technique and a peak detection algorithm. Two IMUs were used to analyze the gait characteristics of lumbar disc patients and healthy gait people, including 12 gait characteristics such as gait spatiotemporal parameters, kinematic parameters, gait variability and stability. Statistical methods were used to analyze the characteristic model and verify the biological differences between the healthy affected side of LDH and healthy subjects. Finally, feature engineering and machine learning technology were used to identify the gait pattern of inertial movement units in patients with lumbar intervertebral disc disease, and achieved a classification accuracy of 95.50%, providing an effective gait feature set and method for clinical evaluation of LDH.

Physiological Characteristics and Transcriptomic Responses of Pinus yunnanensis Lateral Branching to Different Shading Environments.

Pinus yunnanensis is an important component of China's economic development and forest ecosystems. The growth of P. yunnanensis seedlings experienced a slow growth phase, which led to a long seedling cultivation period. However, asexual reproduction can ensure the stable inheritance of the superior traits of the mother tree and also shorten the breeding cycle. The quantity and quality of branching significantly impact the cutting reproduction of P. yunnanensis, and a shaded environment affects lateral branching growth, development, and photosynthesis. Nonetheless, the physiological characteristics and the level of the transcriptome that underlie the growth of lateral branches of P. yunnanensis under shade conditions are still unclear. In our experiment, we subjected annual P. yunnanensis seedlings to varying shade intensities (0%, 25%, 50%, 75%) and studied the effects of shading on growth, physiological and biochemical changes, and gene expression in branching. Results from this study show that shading reduces biomass production by inhibiting the branching ability of P. yunnanensis seedlings. Due to the regulatory and protective roles of osmotically active substances against environmental stress, the contents of soluble sugars, soluble proteins, photosynthetic pigments, and enzyme activities exhibit varying responses to different shading treatments. Under shading treatment, the contents of phytohormones were altered. Additionally, genes associated with phytohormone signaling and photosynthetic pathways exhibited differential expression. This study established a theoretical foundation for shading regulation of P. yunnanensis lateral branch growth and provides scientific evidence for the management of cutting orchards.

Global burdens of nasopharyngeal carcinoma in children and young adults and predictions to 2040.

OBJECTIVES: To investigate the epidemiological trend for nasopharyngeal carcinoma among children and young adults and the disease burden they caused. MATERIALS AND METHODS: Data were collected from the Global Burden of Disease (GBD) study 2019. A comprehensive analysis was performed, with age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), disability-adjusted life-years (DALYs) and estimated annual percentage changes (EAPC). And decomposition and frontier analyses were done. Future trends were predicted using Bayesian age-period-cohort model. RESULTS: Globally, there were decreases in the ASIR (EAPC -0.175, 95 % confidence interval [CI]: -0.352 to 0.002), ASMR (EAPC -2.681, 95 % CI: -2.937 to -2.424), and age-standardized DALYs rates (EAPC -2.643, 95 % CI: -2.895 to -2.391). However, the ASIR for males in global (EAPC 0.454, 95 % CI: 0.302 to 0.606), Asia (EAPC 0.782, 95 % CI: 0.610 to 0.954) and America (EAPC 0.448, 95 % CI: 0.379 to 0.517), as well as females in European (EAPC 0.595, 95 % CI: 0.479 to 0.712) and American (EAPC 0.369, 95 % CI: 0.324 to 0.415), showed an increasing trend. The future ASIR per 100,000 will likely show a slight upward trend in 2020 to 2040 (increased from 0.254 to 0.284), particularly among females (increased from 0.177 to 0.206), and a continued decline in ASMR for both sexes (decreased from 0.070 to 0.061). CONCLUSIONS: Globally, NPC in children and young adults remains a major public health issue, with the global distribution and magnitude of the burden varies markedly, highlighting the need to formulate regional and population-based policies for primary prevention.

Percutaneous left atrial appendage occlusion and risk of stroke, hospitalized bleeding and death in Medicare beneficiaries.

PURPOSE: Among patients with atrial fibrillation (AF), a nonpharmacologic option (e.g., percutaneous left atrial appendage occlusion [LAAO]) is needed for patients with oral anticoagulant (OAC) contraindications. Among beneficiaries in the Medicare fee-for-service coverage 20% sample databases (2015-18) who had AF and an elevated CHA2DS2-VASc score, we assessed the association between percutaneous LAAO versus OAC use and risk of stroke, hospitalized bleeding, and death. METHODS: Patients undergoing percutaneous LAAO were matched to up to five OAC users by sex, age, date of enrollment, index date, CHA2DS2-VASc score, and HAS-BLED score. Overall, 17 156 patients with AF (2905 with percutaneous LAAO) were matched (average ± SD 78 ± 6 years, 44% female). Cox proportional hazards model were used. RESULTS: Median follow-up was 10.3 months. After multivariable adjustments, no significant difference for risk of stroke or death was noted when patients with percutaneous LAAO were compared with OAC users (HRs [95% CIs]: 1.14 [0.86-1.52], 0.98 [0.86-1.10]). There was a 2.94-fold (95% CI: 2.50-3.45) increased risk for hospitalized bleeding for percutaneous LAAO compared with OAC use. Among patients 65 to <78 years old, those undergoing percutaneous LAAO had higher risk of stroke compared with OAC users. No association was present in those ≥78 years. CONCLUSION: In this analysis of real-world AF patients, percutaneous LAAO versus OAC use was associated with similar risk of death, nonsignificantly elevated risk of stroke, and an elevated risk of bleeding in the post-procedural period. Overall, these results support results of randomized trials that percutaneous LAAO may be an alternative to OAC use for patients with contraindications.

Social poverty indicators with school bullying victimization: evidence from the global school-based student health survey (GSHS).

BACKGROUND: School bullying is prevalent in children and adolescents. Bullying victims are seen higher risk of negative psychological outcomes. Previously published studies suggested that social indicators may pose significant influence on bullying victimization. However, the association between social poverty and bullying victimization has not been exclusively discussed. METHODS: In this cross-sectional study, we analyzed the association between 6 commonly used social poverty indicators (Poverty Headcount Ratio, PHR; Poverty Gap, PG; Squared Poverty Gap, SPG; monthly household per capita income, PCI; Watts' Poverty Index, WPI; the Gini Index, Gini) and the prevalence of school bullying at country level by using the Global school-based Student Health Survey (GSHS) database. RESULTS: Altogether 16 countries were included into the final analysis, with school bullying victimization prevalence ranged from 12.9 to 47.5%. Bubble plots revealed statistically significant associations between the three indicators measuring absolute poverty level (PHR, PCI, WPI) and bullying victimization. Subsequently performed principal component regression indicated that, for all types of bullying victimization, the increase of absolute poverty level was related to elevated prevalence rates, and the association was particularly strong for verbal bullying victimization. CONCLUSIONS: Our study results may suggest that absolute social poverty is an important parameter for constructing and implementing school bullying victimization intervention strategies and measures.

Validation of a Zio XT Patch Accelerometer for the Objective Assessment of Physical Activity in the Atherosclerosis Risk in Communities (ARIC) Study.

BACKGROUND: Combination devices to monitor heart rate/rhythms and physical activity are becoming increasingly popular in research and clinical settings. The Zio XT Patch (iRhythm Technologies, San Francisco, CA, USA) is US Food and Drug Administration (FDA)-approved for monitoring heart rhythms, but the validity of its accelerometer for assessing physical activity is unknown. OBJECTIVE: To validate the accelerometer in the Zio XT Patch for measuring physical activity against the widely-used ActiGraph GT3X. METHODS: The Zio XT and ActiGraph wGT3X-BT (Actigraph, Pensacola, FL, USA) were worn simultaneously in two separately-funded ancillary studies to Visit 6 of the Atherosclerosis Risk in Communities (ARIC) Study (2016-2017). Zio XT was worn on the chest and ActiGraph was worn on the hip. Raw accelerometer data were summarized using mean absolute deviation (MAD) for six different epoch lengths (1-min, 5-min, 10-min, 30-min, 1-h, and 2-h). Participants who had ≥3 days of at least 10 h of valid data between 7 a.m-11 p.m were included. Agreement of epoch-level MAD between the two devices was evaluated using correlation and mean squared error (MSE). RESULTS: Among 257 participants (average age: 78.5 ± 4.7 years; 59.1% female), there were strong correlations between MAD values from Zio XT and ActiGraph (average r: 1-min: 0.66, 5-min: 0.90, 10-min: 0.93, 30-min: 0.93, 1-h: 0.89, 2-h: 0.82), with relatively low error values (Average MSE × 106: 1-min: 349.37 g, 5-min: 86.25 g, 10-min: 56.80 g, 30-min: 45.46 g, 1-h: 52.56 g, 2-h: 54.58 g). CONCLUSIONS: These findings suggest that Zio XT accelerometry is valid for measuring duration, frequency, and intensity of physical activity within time epochs of 5-min to 2-h.

Are adult thoracic patient education materials designed with patients in mind?

OBJECTIVE: Patients are increasingly using the internet to obtain health care information. US News and World Report Best Hospital rankings received more than 103 million views in 2021. Considering 21% of thoracic surgery patients are minorities, 27.9% are in the bottom quartile of household income, and 70% have Medicare/Medicaid or no insurance, online patient educational materials (PEMs) should be accessible and written at a level easily understood by majority of patients. We performed a comprehensive analysis of readability of websites containing patient-centered resources across all adult thoracic surgery areas. METHODS: Online PEMs on thoracic surgical procedures were collected from top 50 hospitals for pulmonology and lung surgery ranked by US News and World Report Best Hospital as of December 1, 2021. Text pertaining to thoracic surgical procedures was collected and divided into 4 procedural genres: esophageal, lung, transplant procedures, and other. Texts were analyzed using OleanderSoftware's Readability Suite through the Raygor readability test. RESULTS: Three hundred seventy-two articles met criteria for analysis. Websites were difficult to read; mean (standard deviation) readability score for all content required a 13.9 (3.6) grade level for comprehension. The mean (standard deviation) readability for esophageal, lung, lung transplant, and other surgeries were 14.5 (3.6), 13.1 (3.6), 11.5 (3.9), and 13.4 (3.7), respectively. CONCLUSIONS: Online PEMs required at least a college reading level to comprehend, well exceeding the sixth-grade level recommended by the American Medical Association. As digital health becomes increasingly relevant, improving the readability of online PEMs in adult cardiac surgery will facilitate equitable access to high-quality care.

An Automatic Remote Health Risk Assessment system based on LSTM for elderly.

To address the challenges posed by the aging process, we designed and validated an LSTM-based automatic remote health risk assessment system for the elderly. This system consists of a wireless physiological parameter sensing unit, a vital sign prediction unit and a pre-defined risk scoring criteria unit. The vital sign prediction module is composed of five 5-input-1-output neural networks based on the LSTM architecture, which are responsible for predicting the vital signs collected by wireless sensors, including: systolic blood pressure (SBP), pulse rate (PR), respiratory rate (RR), temperature (TEMP), and oxygen saturation (SPO2). The pre-defined health risk scoring criteria is a simplified version of the National Early Warning Score (NEWS), which is responsible for calculating the risk level based on the predicted values. This allows the care team to respond to the medical needs of the elderly in a timely manner. Through experiments, our system can achieve a risk identification accuracy of 74% and MAEs of the predicted values for each parameter are in an acceptable range. Our results suggest that an automated remote health risk assessment system for the elderly using deep learning could be a viable new strategy for home-based monitoring systems.

How enlightened self-interest guided global vaccine sharing benefits all: A modeling study.

Background: Despite consensus that vaccines play an important role in combatting the global spread of infectious diseases, vaccine inequity is still a prevalent issue due to a deep-seated mentality of self-priority. We aimed to evaluate the existence and possible outcomes of a more equitable global vaccine distribution and explore a concrete incentive mechanism that promotes vaccine equity. Methods: We designed a metapopulation epidemiological model that simultaneously considers global vaccine distribution and human mobility, which we then calibrated by the number of infections and real-world vaccination records during the coronavirus disease 2019 (COVID-19) pandemic from March 2020 to July 2021. We explored the possibility of the enlightened self-interest incentive mechanism, which comprises improving one's own epidemic outcomes by sharing vaccines with other countries, by evaluating the number of infections and deaths under various vaccine sharing strategies using the proposed model. To understand how these strategies affect the national interests, we distinguished imported from local cases for further cost-benefit analyses that rationalise the enlightened self-interest incentive mechanism behind vaccine sharing. Results: The proposed model accurately reproduces the real-world cumulative infections for both global and regional epidemics (R2>0.990), which can support the following evaluations of different vaccine sharing strategies: High-income countries can reduce 16.7 (95% confidence interval (CI) = 8.4-24.9, P < 0.001) million infection cases and 82.0 (95% CI = 76.6-87.4, P < 0.001) thousand deaths on average by more actively sharing vaccines in an enlightened self-interest manner, where the reduced internationally imported cases outweigh the threat from increased local infections. Such vaccine sharing strategies can also reduce 4.3 (95% CI = 1.2-7.5, P < 0.01) million infections and 7.0 (95% CI = 5.7-8.3, P < 0.001) thousand deaths in middle- and low-income countries, effectively benefiting the whole global population. Lastly, the more equitable vaccine distribution could help largely reduce the global mobility reduction needed for pandemic control. Conclusions: The incentive mechanism of enlightened self-interest we explored here could motivate vaccine equity by realigning the national interest to more equitable vaccine distributions. The positive results could promote multilateral collaborations in global vaccine redistribution and reconcile conflicted national interests, which could in turn benefit the global population.

Exploitation of lignocellulosic-based biomass biorefinery: A critical review of renewable bioresource, sustainability and economic views.

Urbanization has driven the demand for fossil fuels, however, the overly exploited resource has caused severe damage on environmental pollution. Biorefining using abundant lignocellulosic biomass is an emerging strategy to replace traditional fossil fuels. Value-added lignin biomass reduces the waste pollution in the environment and provides a green path of conversion to obtain renewable resources. The technology is designed to produce biofuels, biomaterials and value-added products from lignocellulosic biomass. In the biorefinery process, the pretreatment step is required to reduce the recalcitrant structure of lignocellulose biomass and improve the enzymatic digestion. There is still a gap in the full and deep understanding of the biorefinery process including the pretreatment process, thus it is necessary to provide optimized and adapted biorefinery solutions to cope with the conversion process in different biorefineries to further provide efficiency in industrial applications. Current research progress on value-added applications of lignocellulosic biomass still stagnates at the biofuel phase, and there is a lack of comprehensive discussion of emerging potential applications. This review article explores the advantages, disadvantages and properties of pretreatment methods including physical, chemical, physico-chemical and biological pretreatment methods. Value-added bioproducts produced from lignocellulosic biomass were comprehensively evaluated in terms of encompassing biochemical products , cosmetics, pharmaceuticals, potent functional materials from cellulose and lignin, waste management alternatives, multifunctional carbon materials and eco-friendly products. This review article critically identifies research-related to sustainability of lignocellulosic biomass to promote the development of green chemistry and to facilitate the refinement of high-value, environmentally-friendly materials. In addition, to align commercialized practice of lignocellulosic biomass application towards the 21st century, this paper provides a comprehensive analysis of lignocellulosic biomass biorefining and the utilization of biorefinery green technologies is further analyzed as being considered sustainable, including having potential benefits in terms of environmental, economic and social impacts. This facilitates sustainability options for biorefinery processes by providing policy makers with intuitive evaluation and guidance.

Network-level pavement maintenance and rehabilitation decision-making with the optimized annual budget.

Maintenance and rehabilitation (M&R) is necessary to keep pavement networks in good condition. Due to the capital intensity, M&R funding is always insufficient. The annual budget, determining the available funding, is a critical criterion when planning M&R treatments. However, its values are often given, and the determination of the values is seldom discussed. To fill the gap, this paper focuses on both the determination of annual budgets and the budget allocations, and therefore enhances the network-level decision-making on M&R by developing a Multi-Objective Optimization (MOO) method. This method does not only optimize and trade off the annual budgets and their consequences, but also allocates the funding across the entire network through generating the optimized M&R decisions. According to a case study with 50 segments, the developed method successfully and effectively identified non-linear discrete relationship between the minimized annual budgets and the maximized M&R benefits subject to all the constraints, and generated the optimized annual budget allocation for each M&R decision. The achievements of this paper can be used to enhance the efficiency of M&R decisions and contribute to informed pavement management.

The Impact of Congenital Cardiac Surgery Fellowship on Training and Practice.

BACKGROUND: In 2007, congenital cardiac surgery became a recognized fellowship by the American Council of Graduate Medical Education (ACGME). Beginning in 2023, the fellowship transitioned from a 1-year to a 2-year program. Our objective is to provide current benchmarks by surveying current training programs and assessing characteristics contributing to career success. METHODS: This was a survey-based study in which tailored questionnaires were distributed to program directors (PDs) and graduates of the ACGME accredited training programs. Data collection included responses to multiple-choice and open-ended questions relevant to didactics, operative training, training center characteristics, mentorship, and employment characteristics. Results were analyzed using summary statistics and subgroup and multivariable analyses. RESULTS: The survey yielded responses from 13 of 15 PDs (86%) and 41 of 101 graduates (41%) from ACGME accredited programs. Perceptions among PDs and graduates were somewhat discordant, with PDs more optimistic than graduates. Of PDs, 77% (n = 10) believed current training adequately prepares fellows and is successful in securing employment for graduates. The responses from graduates demonstrated 30% (n = 12) were dissatisfied with operative experience and 24% (n = 10) with overall training. Being supported during the first 5 years of practice was significantly associated with retention in congenital cardiac surgery and greater practicing case volumes. CONCLUSIONS: Dichotomous views exist between graduates and PDs regarding success in training. Mentorship during the early career was associated with increased case volumes, career satisfaction, and retention in the congenital cardiac surgery field. Educational bodies should incorporate these elements during training and after graduation.

Impact, healthcare utilization and costs of travel-associated mosquito-borne diseases in international travellers: a prospective study.

BACKGROUND: International travellers frequently acquire infectious diseases whilst travelling, yet relatively little is known about the impact and economic burden of these illnesses on travellers. We conducted a prospective exploratory costing study on adult returning travellers with falciparum malaria, dengue, chikungunya or Zika virus. METHODS: Patients were recruited in eight Travel and Tropical Medicine clinics between June 2016 and March 2020 upon travellers' first contact with the health system in their country of residence. The patients were presented with a structured 52-question self-administered questionnaire after full recovery to collect information on patients' healthcare utilization and out-of-pocket costs both in the destination and home country, and about income and other financial losses due to the illness. RESULTS: A total of 134 patients participated in the study (malaria, 66; dengue, 51; chikungunya, 8; Zika virus, 9; all fully recovered; median age 40; range 18-72 years). Prior to travelling, 42% of patients reported procuring medical evacuation insurance. Across the four illnesses, only 7% of patients were hospitalized abroad compared with 61% at home. Similarly, 15% sought ambulatory services whilst abroad compared with 61% at home. The average direct out-of-pocket hospitalization cost in the destination country (USD $2236; range: $108-$5160) was higher than the direct out-of-pocket ambulatory cost in the destination country (USD $327; range: $0-$1560), the direct out-of-pocket hospitalization cost at home (USD $35; range: $0-$120) and the direct out-of-pocket ambulatory costs at home (US$45; range: $0-$192). Respondents with dengue or malaria lost a median of USD $570 (Interquartile range [IQR] 240-1140) and USD $240 (IQR 0-600), respectively, due to their illness, whilst those with chikungunya and Zika virus lost a median of USD $2400 (IQR 1200-3600) and USD $1500 (IQR 510-2625), respectively. CONCLUSION: Travellers often incur significant costs due to travel-acquired diseases. Further research into the economic impact of these diseases on travellers should be conducted.

The past, present, and future of sleep quality assessment and monitoring.

Sleep quality is considered to be an individual's self-satisfaction with all aspects of the sleep experience. Good sleep not only improves a person's physical, mental and daily functional health, but also improves the quality-of-life level to some extent. In contrast, chronic sleep deprivation can increase the risk of diseases such as cardiovascular diseases, metabolic dysfunction and cognitive and emotional dysfunction, and can even lead to increased mortality. The scientific evaluation and monitoring of sleep quality is an important prerequisite for safeguarding and promoting the physiological health of the body. Therefore, we have compiled and reviewed the existing methods and emerging technologies commonly used for subjective and objective evaluation and monitoring of sleep quality, and found that subjective sleep evaluation is suitable for clinical screening and large-scale studies, while objective evaluation results are more intuitive and scientific, and in the comprehensive evaluation of sleep, if we want to get more scientific monitoring results, we should combine subjective and objective monitoring and dynamic monitoring.

Forecasting the carbon emissions in Hubei Province under the background of carbon neutrality: a novel STIRPAT extended model with ridge regression and scenario analysis.

The impact of global greenhouse gas emissions is increasingly serious, and the development of green low-carbon circular economy has become an inevitable trend for the development of all countries in the world. To achieve emission peak and carbon neutrality is the primary goal of energy conservation and emission reduction. As the core province in central China, Hubei Province is under prominent pressure of carbon emission reduction. In this paper, the future development trend of carbon emissions is analyzed, and the emission peak value and carbon peak time in Hubei Province is predicted. Firstly, the generalized Divisia index method (GDIM) model is proposed to determine the main influencing factors of carbon emissions in Hubei Province. Secondly, based on the main influencing factors identified, a novel STIRPAT (Stochastic Impacts by Regression on Population, Affluence, and Technology) extended model with ridge regression is established to predict carbon emissions. Thirdly, the scenario analysis method is used to set the variables of the STIRPAT extended model and to predict the emission peak value and carbon peak time in Hubei Province. The results show that Hubei Province's carbon emissions peaked first in 2025, with a peak value of 361.81 million tons. Finally, according to the prediction results, the corresponding suggestions on carbon emission reduction are provided in three aspects of industrial structure, energy structure, and urbanization, so as to help government establish a green, low-carbon, and circular development economic system and achieve the industry's cleaner production and sustainable development of society.

rFGF4 alleviates lipopolysaccharide-induced acute lung injury by inhibiting the TLR4/NF-κB signaling pathway.

Acute lung injury (ALI) is a serious and common clinical disease. Despite significant progress in ALI treatment, the morbidity and mortality rates remain high. However, no effective drug has been discovered for ALI. FGF4, a member of the FGF family, plays an important role in the regulation of various physiological and pathological processes. Therefore, in the present study, we aimed to study the protective effects of FGF4 against LPS-induced lung injury in vivo and in vitro. We found that rFGF4 treatment improved the lung W/D weight ratio, the survival rate, immune cell infiltration and protein concentrations in mice with LPS-induced ALI. Histological analysis revealed that rFGF4 significantly attenuated lung tissue injury and cell apoptosis. Furthermore, rFGF4 inhibited the activation of the TLR4/NF-κB signaling pathway and the production of pro-inflammatory mediators in LPS-injured lung tissues, murine alveolar macrophages (MH-S) and murine pulmonary epithelial (MLE-12) cells. The results of cell experiments further verified that rFGF4 inhibited the production of inflammatory mediators in MH-S cells and MLE-12 cells by regulating the TLR4/NF-κB signaling pathway. These results revealed that rFGF4 protected lung tissues and inhibited inflammatory mediators in mice with LPS-induced ALI by inhibiting the TLR4/NF-κB signaling pathway in MH-S and MLE-12 cells.

[Risk Assessment and Sources of Heavy Metals in Farmland Soils of Yellow River Irrigation Area of Ningxia].

The farmland environment is directly related to the quality and safety of agricultural products. In order to understand the characteristics and main influencing factors of heavy metals in farmland soil in the Yellow River irrigation area of Ningxia, sampling and monitoring were conducted for five consecutive years from 2017 to 2021, and the distribution characteristics and correlation of heavy metals were analyzed. The pollution status and potential ecological risks of heavy metals were evaluated, and the main sources of heavy metals in farmland were analyzed. The results showed that the average values of Pb, As, Zn, Ni, Cu, Hg, Cr, and Cd in the soil of the Ningxia Yellow River irrigation area were 19.74, 11.67, 66.88, 29.09, 22.55, 0.03, 62.27, and 0.19 mg·kg-1, respectively, which were enriched to some extent compared with the background values of the soil environment in Ningxia. Among them, Hg and Cd had middle- and high-grade ecological risk points; however, none of them exceeded the control value of agricultural land soil pollution risk, and all sampling sites had no high-risk or extremely high-risk levels. The results of source analysis based on positive matrix factorization (PMF) and correlation analysis showed that there were five main sources of heavy metals in farmland soil in the study area: natural sources, mixed sources of industrial and mining activities and the production and life of residents, transportation sources, agricultural production activities sources, and industrial sources, with contribution rates of 26.54%, 25.59%, 22.52%, 15.63%, and 9.72%, respectively. On the whole, the heavy metals in farmland soil in the Ningxia Yellow River irrigation area did not exceed the standard, and there was no high-level ecological risk. The production environment of the farmland soil was good, but the contribution rate of human activities to soil heavy metals was large.