Environmental quality assessment and spatial spillover effects of three urban agglomerations in China: A Meta-EBM approach.

The new development form of urban agglomeration has greatly promoted economic and social progress in recent years, but it is also facing severe environmental pollution problems. Understanding the status quo of environmental efficiency in urban agglomerations and its leading driving forces is an important prerequisite for formulating energy conservation and emission reduction policies. This research uses the Meta Epsilon Based Measure (Meta-EBM) model to measure the environmental emission efficiency of the Beijing-Tianjin-Hebei（BTH）, Yangtze River Delta (YRD) and Pearl River Delta (PRD) urban agglomerations in China from 2014 to 2018 so as to improve on the inability of traditional Data Envelopment Analysis (DEA) to combine linear and non-linear characteristics, and employs Moran's I index and spatial econometric methods to analyze their spatial dependence and main driving factors. The results demonstrate that the overall environmental efficiency of the three major urban agglomerations in the five years from 2014 to 2018 presents a wave-like development and then tends to be flat. The itemized efficiency of economic outputs has maintained a relatively high level with the environmental output index exhibiting the best efficiency for industrial wastewater, followed by industrial sulfur dioxide (SO2). The scores of the two indicators for inhalable fine particle emissions (PM2.5) and industrial smoke and dust in each urban agglomeration are not ideal, and there are obvious differences between regions. Among them, YRD and PRD are relatively inferior. From the perspective of spatial spillover effects, various indicators show diverse characteristics at different development stages of the regions. Population and Normalized Difference Vegetation Index (NDVI) have a positive effect on environmental efficiency, while both Gross Domestic Product (GDP) per capita and transportation tend to show greater negative effects on regional environmental optimization. This study proposes countermeasures as follows. Each urban agglomeration should set up measures suitable to local conditions and give full play to their location advantages. They can also use space radiation to promote sector economic development and optimize urban environmental benefits.

Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand (TRAIL): A Novel Biomarker for Prognostic Assessment and Risk Stratification of Acute Pulmonary Embolism.

BACKGROUND: Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is associated with poor prognosis in cardiovascular diseases. However, the predictive value of TRAIL for the short-term outcome and risk stratification of acute pulmonary embolism (PE) remains unknown. METHODS: This study prospectively included 151 normotensive patients with acute PE. The study outcome was a composite of 30-day adverse events, defined as PE-related death, shock, mechanical ventilation, cardiopulmonary resuscitation, and major bleeding. RESULTS: Overall, nine of 151 (6.0%) patients experienced 30-day adverse composite events. Multivariable logistic regression showed that TRAIL was an independent predictor of study outcome (OR 0.19 per SD; 95% CI 0.04-0.90). An ROC curve revealed that TRAIL's area under the curve (AUC) was 0.83 (95% CI 0.76-0.88). The optimal cut-off value for TRAIL was 18 pg/mL, with a sensitivity, specificity, negative predictive value, positive predictive value, positive likelihood ratio, and negative likelihood ratio of 89%, 69%, 99%, 15%, 2.87, and 0.16, respectively. Compared with the risk stratification algorithm outlined in the 2019 ESC guidelines, our biomarker-based risk stratification strategy (combining TRAIL and hs-cTnI) has a similar risk classification effect. CONCLUSION: Reduced plasma TRAIL levels predict short-term adverse events in normotensive patients with acute PE. The combination of the 2019 ESC algorithm and TRAIL aids risk stratification in normotensive patients with acute PE.

Challenges and Special Aspects of Pulmonary Hypertension in Middle- to Low-Income Regions: JACC State-of-the-Art Review.

Challenges and special aspects related to the management and prognosis of pulmonary hypertension (PH) in middle- to low-income regions (MLIRs) range from late presentation to comorbidities, lack of resources and expertise, cost, and rare options of lung transplantation. Expert consensus recommendations addressing the specific challenges for prevention and therapy of PH in MLIRs with limited resources have been lacking. To date, 6 MLIR-PH registries containing mostly adult patients with PH exist. Importantly, the global prevalence of PH is much higher in MLIRs compared with high-income regions: group 2 PH (left heart disease), pulmonary arterial hypertension associated with unrepaired congenital heart disease, human immunodeficiency virus, or schistosomiasis are highly prevalent. This consensus statement provides selective, tailored modifications to the current PH guidelines to address the specific challenges faced in MLIRs, resulting in the first pragmatic and cost-effective consensus recommendations for PH care providers, patients, and their families.

[Analysis of assessment results of malaria elimination in Suzhou City].

OBJECTIVE: To analyze the assessment results of malaria elimination in Suzhou City, so as to provide references for consolidating the results of malaria elimination in the city. METHODS: According to "Jiangsu Province Malaria Evaluation and Assessment Implementation Plan (2014 Edition)" and "Jiangsu City Malaria Evaluation Implementation Regulations (2015 Edition)", the assessment of the county-level cities and districts under the jurisdiction of Suzhou City was conducted. After the assessment, the municipal level assessment and evaluation were carried out, and one district was randomly selected for the assessment of malaria elimination review. RESULTS: The assessment score of malaria elimination in Suzhou City was 98.6 points. Wujiang District was randomly selected for review assessment, and the review score was 95.8 points. According to the 85 points attainment criteria specified by the national assessment, Suzhou City met the requirement of malaria elimination. CONCLUSIONS: Suzhou City has passed the inspection certification of malaria elimination in Jiangsu Province. However, the post-elimination malaria monitoring should be continued to consolidate the achievements.

[Key points of poverty alleviation of Chinese herbal medicine industry and classification of recommended Chinese herbal medicines].

To build a well-off society in an all-round way, eliminate poverty, improve people's livelihood and improve the level of social and economic development in poverty-stricken areas is the frontier issues of the government and science and technology workers at all levels. Chinese herbal medicine is the strategic resource of the people's livelihood, Chinese herbal medicine cultivation is an important part of China's rural poor population income. As most of the production of Chinese herbal medicine by the biological characteristics of their own and the interaction of natural ecological environment factors, showing a strong regional character.the Ministry of Traditional Chinese Medicine and the State Council Poverty Alleviation Office and other five departments jointly issued the "China Herbal Industry Poverty Alleviation Action Plan (2017-2020)", according to local conditions of guidance and planning of Chinese herbal medicine production practice, promote Chinese herbal medicine industry poverty alleviation related work In this paper, based on the relevant data of poverty-stricken areas, this paper divides the areas with priority to the poverty alleviation conditions of Chinese herbal medicine industry, and analyzes and catalogs the list of Chinese herbal medicines grown in poverty-stricken areas at the macro level. The results show that there are at least 10% of the poor counties in the counties where the poverty-stricken counties and the concentrated areas are concentrated in the poverty-stricken areas. There is already a good base of Chinese herbal medicine industry, which is the key priority area for poverty alleviation of Chinese herbal medicine industry. Poverty-stricken counties, with a certain degree of development of Chinese medicine industry poverty alleviation conditions, the need to strengthen the relevant work to expand the foundation and capacity of Chinese herbal medicine industry poverty alleviation; 37% of poor counties to develop Chinese medicine industry, the basic conditions of poverty alleviation. It is suggested that: prioritized priorities, counties that have a good foundation for Chinese herbal medicine industry will implement the "Poverty Alleviation Action Plan for Chinese Herbal Medicine Industry" through nearly 100 counties with priority development.

[Relationships between urbanization and water resource utilization in Dongting Lake District of South-central China].

By using analytic hierarchy process and entropy method, the evaluation index system and the response relationship model of comprehensive development level of urbanization and comprehensive development and utilization potential of water resources in Dongting Lake District were constructed, with the key affecting factors, their change characteristics, and response characteristics from 2001 to 2010 analyzed. During the study period, the Dongting Lake District was undergoing a rapid development of urbanization, and at a scale expansion stage. The economic and social development level was lagged behind the population and area increase, and the quality and efficiency of urbanization were still needed to be improved. With the advance of urbanization, the water consumption increased yearly, and the water resources utilization efficiency and management level improved steadily. However, the background condition of water resources and their development and utilization level were more affected by hydrological environment rather than urbanization. To a certain extent, the development of urbanization in 2001, 2002, 2005, 2006, 2007, 2009 was slowed down by the shortage of water resources. At present, Dongting Lake region was confronted with the dual task of improving the level and quality of urbanization, and hence, it would be necessary to reform the traditional epitaxial expansion of urbanization and to enhance the water resource support capability.

Assessment of atherosclerotic plaques in the rabbit abdominal aorta with interleukin-8 monoclonal antibody-targeted ultrasound microbubbles.

In this study, we aimed to prepare a neovascularization-relevant inflammatory cytokine-targeted ultrasound contrast agent and apply it in the ultrasound imaging of atherosclerotic plaque. An interleukin-8 (IL-8) monoclonal antibody was conjugated to SonoVue microbubbles using the N-succinimidyl-3-(2-pyridyldithio)propionate cross-linking method. Then, a prepared IL-8-targeted contrast agent was used for contrast-enhanced ultrasound (CEU) to detect rabbit abdominal aorta atherosclerotic plaque and to investigate the imaging characteristics of atherosclerotic plaque with the contrast agent. We found that an IL-8 monoclonal antibody can be successfully coupled to SonoVue microbubbles with stable biological characteristics. CEU with this IL-8-targeted contrast agent can increase the atherosclerotic plaque detection sensitivity, with stronger echo, so that three more plaques were detected compared with using non-targeted SonoVue microbubbles. Thus, an inflammatory cytokine-targeting ultrasound contrast agent carrying IL-8 monoclonal antibody can provide unique advantages for researching the characteristics of atherosclerotic plaque.

The effect of HLA disparity on clinical outcome after HLA-haploidentical blood and marrow transplantation.

The relative importance of various human leukocyte antigen (HLA) loci has not been established for unmanipulated HLA-mismatched/haploidentical transplantation. To address this question, we analyzed the impact of HLA-A, HLA-B, HLA-DRB1, HLA-DRB3, HLA-DRB4, and HLA-DRB5 on the outcome of HLA-haploidentical transplantation. Four hundred and eighty-one donor-recipient pairs were fully typed before transplantation. In univariate analysis, HLA-B mismatch not only demonstrated significant adverse effects on acute graft-versus-host disease (GVHD) and transplant-related mortality but also was associated with reduced overall survival and leukemia-free survival (LFS). In multivariate analysis, HLA-B mismatch remained the independent risk factor for acute GVHD and transplant-related mortality. The high risk of disease and the female donor were found to be significant factors for reduced overall survival and LFS. Furthermore, multiple mismatch of the HLA locus was found to have no synergistic adverse effect on outcomes. Our results suggest that prospective matching of patients and donors for HLA-B antigen in the unshared HLA haplotype is warranted for HLA-mismatched/haploidentical transplantation.

Quantitative assessment of hematopoietic chimerism by quantitative real-time polymerase chain reaction of sequence polymorphism systems after hematopoietic stem cell transplantation.

BACKGROUND: Analysis of changes in recipient and donor hematopoietic cell origin is extremely useful to monitor the effect of hematopoietic stem cell transplantation (HSCT) and sequential adoptive immunotherapy by donor lymphocyte infusions. We developed a sensitive, reliable and rapid real-time PCR method based on sequence polymorphism systems to quantitatively assess the hematopoietic chimerism after HSCT. METHODS: A panel of 29 selected sequence polymorphism (SP) markers was screened by real-time PCR in 101 HSCT patients with leukemia and other hematological diseases. The chimerism kinetics of bone marrow samples of 8 HSCT patients in remission and relapse situations were followed longitudinally. RESULTS: Recipient genotype discrimination was possible in 97.0% (98 of 101) with a mean number of 2.5 (1-7) informative markers per recipient/donor pair. Using serial dilutions of plasmids containing specific SP markers, the linear correlation (r) of 0.99, the slope between -3.2 and -3.7 and the sensitivity of 0.1% were proved reproducible. By this method, it was possible to very accurately detect autologous signals in the range from 0.1% to 30%. The accuracy of the method in the very important range of autologous signals below 5% was extraordinarily high (standard deviation <1.85%), which might significantly improve detection accuracy of changes in autologous signals early in the post-transplantation course of follow-up. The main advantage of the real-time PCR method over short tandem repeat PCR chimerism assays is the absence of PCR competition and plateau biases, with demonstrated greater sensitivity and linearity. Finally, we prospectively analyzed bone marrow samples of 8 patients who received allografts and presented the chimerism kinetics of remission and relapse situations that illustrated the sensitivity level and the promising clinical application of this method. CONCLUSION: This SP-based real-time PCR assay provides a rapid, sensitive, and accurate quantitative assessment of mixed chimerism that can be useful in predicting graft rejection and early relapse.

[A field assessment on the risk factors of musculoskeletal disorders].

OBJECTIVE: To investigate the usability of quick exposure check (Quick Exposure Check, QEC) for the field assessment of occupational musculoskeletal disorder risk factors. METHOD: In the shipyard and automobile manufacturing plants, QEC was used to observe the operations among workers with different jobs and to assess the work loads of workers. On the basis of results, the reliability of QEC was evaluated, and the correlation between QEC scores and morbidities of musculoskeletal disorders in workers was analyzed. RESULTS: The inter-observer reliability (ICC) was in the range from 0.737 to 1.000, and intra-observer reliability (Spearman coefficient) was from 0.605 to 1.000. The order of exposure levels to risk factors of workers engaged in different jobs (QEC scores) in the shipyard factory was plumbers > assemblers > welders; The order of exposure levels to risk factors of workers engaged in different jobs (QEC scores) in the automobile factory was welders > punching workers > machinists > casters > assemblers. In different body parts, the exposure level at back and neck parts was the highest and the exposure level at the shoulder and wrist parts was the second. The regression analysis between QEC scores of body parts and the morbidities of musculoskeletal disorders showed that there was a good correlation between exposure levels and morbidities, the coefficients (r(2)) at the shoulder, wrist, and back (static work) were 0.670, 0.740 and 0.958, respectively (P < 0.05). CONCLUSION: The QEC method is suitable and reliable as demonstrated by the field assessment on the exposure to risk factors in shipyard and automobile workers, and its results is correlated closely to the disease prevalence.