Invasive assessment of coronary microvascular dysfunction and cardiovascular outcomes across the full spectrum of CHD: a meta-analysis.

INTRODUCTION AND OBJECTIVES: Coronary microvascular dysfunction (CMD) is highly prevalent and is recognized as an important clinical entity in patients with coronary heart disease (CHD). Nevertheless, the association of CMD with adverse cardiovascular events in the spectrum of CHD has not been systemically quantified. METHODS: We searched electronic databases for studies on patients with CHD in whom coronary microvascular function was measured invasively, and clinical events were recorded. The primary endpoint was major adverse cardiac events (MACE), and the secondary endpoint was all-cause death. Estimates of effect were calculated using a random-effects model from published risk ratios. RESULTS: We included 27 studies with 11 404 patients. Patients with CMD assessed by invasive methods had a higher risk of MACE (RR, 2.18; 95%CI, 1.80-2.64; P<.01) and all-cause death (RR, 1.88; 95%CI, 1.55-2.27; P<.01) than those without CMD. There was no significant difference in the impact of CMD on MACE (interaction P value=.95) among different invasive measurement modalities. The magnitude of risk of CMD assessed by invasive measurements for MACE was greater in acute coronary syndrome patients (RR, 2.84, 95%CI, 2.26-3.57; P<.01) than in chronic coronary syndrome patients (RR, 1.77, 95%CI, 1.44-2.18; P<.01) (interaction P value<.01). CONCLUSIONS: CMD based on invasive measurements was associated with a high incidence of MACE and all-cause death in patients with CHD. The magnitude of risk for cardiovascular events in CMD as assessed by invasive measurements was similar among different methods but varied among CHD populations.

An integrated approach to prioritizing ecological restoration of abandoned mine lands based on cost-benefit analysis.

How to increase the usable land area by adhering to environmentally friendly ecological restoration of mines with limited funds is a challenge that many cities are currently facing. Cost-benefit analysis (CBA) can provide efficient and effective restoration decisions for abandoned mine land (AML) ecological restoration with limited financial resources. Thus, this study proposes an integrated approach for coupling ecological benefits and restoration costs, including hotspots/coldspots analysis based on five ecosystem services (ESs), landscape connectivity analysis based on graph theory model, hidden costs, and project implementation costs to prioritize AML restoration. The study was conducted on 54 abandoned mine lands (AMLs) in Chaoyang city, the ecological security barrier of China's northern sand prevention belt (NSPB). The comprehensive analysis prioritized the restoration of AMLs into four levels, of which 9 mines were in priority I, where restoration was recommended as a priority, and 22 mines were in priority II, where restoration could be carried out within the affordability of funds. In addition, our model indicates areas with high ecological benefits, in which the ecological source area (7423.66 km2) and the ecosystem service hotspots area (2028.44 km2) are mostly distributed in the southwestern part of Chaoyang city, the two mountain ranges of Songling mountain and Nuruerhu mountain. This study provides scientific spatial guidance to ensure that the AMLs realizes effective restoration and management.

Exploring Spatially Explicit Changes in Carbon Budgets of Global River Basins during the 20th Century.

Rivers play an important role in the global carbon (C) cycle. However, it remains unknown how long-term river C fluxes change because of climate, land-use, and other environmental changes. Here, we investigated the spatiotemporal variations in global freshwater C cycling in the 20th century using the mechanistic IMAGE-Dynamic Global Nutrient Model extended with the Dynamic In-Stream Chemistry Carbon module (DISC-CARBON) that couples river basin hydrology, environmental conditions, and C delivery with C flows from headwaters to mouths. The results show heterogeneous spatial distribution of dissolved inorganic carbon (DIC) concentrations in global inland waters with the lowest concentrations in the tropics and highest concentrations in the Arctic and semiarid and arid regions. Dissolved organic carbon (DOC) concentrations are less than 10 mg C/L in most global inland waters and are generally high in high-latitude basins. Increasing global C inputs, burial, and CO2 emissions reported in the literature are confirmed by DISC-CARBON. Global river C export to oceans has been stable around 0.9 Pg yr-1. The long-term changes and spatial patterns of concentrations and fluxes of different C forms in the global river network unfold the combined influence of the lithology, climate, and hydrology of river basins, terrestrial and biological C sources, in-stream C transformations, and human interferences such as damming.