[Spatial-temporal Evolution and Driving Factors Analysis of Ecological Environment Quality in Daihai Basin based on AWRSEI].

Watersheds are an important ecological security barrier and social and economic development area. In order to evaluate the ecological environment quality of arid and semi-arid watersheds more objectively and accurately, based on the remote sensing ecological index (RSEI), the salinity index was introduced to construct a remote sensing ecological index (AWRSEI) suitable for arid and semi-arid watersheds, and the Daihai watershed was taken as an example to analyze its applicability. Based on the AWRSEI model, four phases of Landsat TM/OLI composite images were used to quantitatively evaluate the ecological and environmental quality of the Daihai Basin from 2001 to 2020. The spatio-temporal evolution of the ecological and environmental quality of the Daihai Basin was analyzed using the coefficient of variation and spatial autocorrelation, and the cause analysis and driving factor explanation power analysis were carried out using geographic detectors. The results showed that:① the average correlation coefficient between AWRSEI and various ecological factors was 0.860, which was more representative than that of a single index component. The load positive and negative values and ranking of the first principal component were consistent with those of RSEI, the contribution rate of eigenvalues was 3.69% higher than those of RSEI, and the evaluation results were closer to the real surface conditions, which is suitable for the ecological environment quality assessment of arid watersheds. ② The annual average of the AWRSEI index in the Daihai Basin from 2001 to 2020 was 0.427, which indicated a poor ecological environment quality basis. During the study period, the average of AWRSEI showed a fluctuating trend and reached the highest value of 0.502 in 2020. The overall ecological environment quality improved significantly, the deterioration area decreased by 20.51%, and the improvement area increased by 12.71%. In terms of spatial distribution, the ecological environment quality of forest land in the southern and northwestern high-altitude areas of the Daihai Basin was good, whereas that in the northern and southern mid-altitude areas was poor, and that in the northern area was better than that in the southern area. ③ The average variation coefficient of AWRSEI in the Daihai Basin was 0.280, the ecological environment quality was stable, and the overall change fluctuation was small; the high fluctuation was mainly concentrated in the southern part of the lake and the residential area. There was a significant spatial autocorrelation in the ecological environment quality of the Daihai Basin, and the high-high agglomeration area was mainly distributed in the forest area at high altitude and the cultivated land area at low altitude. Low-low concentration areas were scattered in the middle altitude area. ④ The improvement of the ecological environment in Daihai Basin from 2001 to 2020 was mainly due to the increase in NDVI and the decrease in NDBSI and NDSI. NDVI and NDBSI were the combination with the strongest interaction and the strongest interpretation of the ecological environment. Land use was the dominant factor of AWRSEI and had the strongest explanatory power. The combination of land use and meteorological factors was the strongest interaction, and the relationship between each driving factor was enhanced.

Anti-inflammatory response-based risk assessment in acute type A aortic dissection: A national multicenter cohort study.

Background: Early identification of patients at high risk of operative mortality is important for acute type A aortic dissection (TAAD). We aimed to investigate whether patients with distinct risk stratifications respond differently to anti-inflammatory pharmacotherapy. Methods: From 13 cardiovascular hospitals, 3110 surgically repaired TAAD patients were randomly divided into a training set (70%) and a test set (30%) to develop and validate a risk model to predict operative mortality using extreme gradient boosting. Performance was measured by the area under the receiver operating characteristic curve (AUC). Subgroup analyses were performed by risk stratifications (low versus middle-high risk) and anti-inflammatory pharmacotherapy (absence versus presence of ulinastatin use). Results: A simplified risk model was developed for predicting operative mortality, consisting of the top ten features of importance: platelet-leukocyte ratio, D-dimer, activated partial thromboplastin time, urea nitrogen, glucose, lactate, base excess, hemoglobin, albumin, and creatine kinase-MB, which displayed a superior discrimination ability (AUC: 0.943, 95 % CI 0.928-0.958 and 0.884, 95 % CI 0.836-0.932) in the derivation and validation cohorts, respectively. Ulinastatin use was not associated with decreased risk of operative mortality among each risk stratification, however, ulinastatin use was associated with a shorter mechanical ventilation duration among patients with middle-high risk (defined as risk probability >5.0 %) (ß -1.6 h, 95 % CI [-3.1, -0.1] hours; P = 0.048). Conclusion: This risk model reflecting inflammatory, coagulation, and metabolic pathways achieved acceptable predictive performances of operative mortality following TAAD surgery, which will contribute to individualized anti-inflammatory pharmacotherapy.

Impact of digital finance on energy-based carbon intensity: Evidence from mediating effects perspective.

This research measures energy-based carbon intensity based on energy consumption of 30 Chinese provinces and investigates the impact of digital finance. First, the baseline results were examined through panel data model. Second, we reveal the "black box" system of digital finance and energy-based carbon intensity through mediating effects model. Third, by employed panel quantile regression model, we examine the heterogeneity of the effects of various factors under different carbon intensity quantile. The main quantitative results are as follows: (1) Digital finance shows significant sustainable effect, and its growth of 1% will reduce the carbon intensity by about 0.092%. (2) The intermediary effects of technological innovation and energy structure are -0.0663 and 0.007, respectively, accounting for 41.88% and 19.36% of the total effects. Both are significant transmission mechanisms. (3) When the carbon intensity in >0.9 quantile, digital finance shows a positive coefficient. On the contrary, the coefficient at <0.75 quantile is negative and its absolute value increases with the decrease of quantile. It shows that with the reduction of carbon intensity, the positive impact of digital finance gradually increases. (4) In the eastern, central and western regions, a 1% increase in digital finance will reduce the carbon intensity by 0.147%, 0.096% and 0.089% respectively. This research provides a reference for regional governments to use digital finance tools to promote sustainable development.

A new insight to characterize immunomodulation based on hepatopancreatic transcriptome and humoral immune factor analysis of the Cherax quadricarinatus infected with Aeromonas veronii.

Cherax quadricarinatus is a type of large freshwater crayfish that is characterized by rapid growth and formidable adaptability. It has also been widely cultured and studied as a model organism. Aeromonas veronii is the dominant pathogen in aquatic environments and the primary threat to aquaculture's economic stability. To better understand the interactions between C. quadricarinatus and A. veronii, high-throughput RNA sequencing of the C. quadricarinatus hepatopancreas was carried out on a control group, susceptible group (6 h after infection), and resistant group (48 h after infection). A total of 65,850,929 genes were obtained. Compared with the control group, 2616 genes were up-regulated and 1551 genes were down-regulated in the susceptible group; while 1488 genes were up-regulated and 1712 genes were down-regulated in the resistant group. GO and KEGG analysis showed that these differentially expressed genes (DEGs) were associated with multiple immune pathways, including Toll-like receptors (TLRs), antigen processing and presentation, NOD-like receptor signaling pathway, phagosome, lysosome, JAK-STAT signaling pathway. qRT-PCR showed that infection by A. veronii changed the expression pattern of the serine proteinase inhibitor (SPI), crustacean hyperglycemic hormone (CHH), anti-lipopolysaccharide factor (ALF), and extracellular copper/zinc superoxide dismutase (SOD1), all of which were significantly higher than in the control group up to 48 h after infection. In addition, detection of superoxide dismutase (SOD), catalase (CAT), lysozyme (LZM), and phenoloxidase (PO) activity, as well as ceruloplasmin (CP) concentration at different times after infection showed diverse trends. Furthermore, pathological sections obtained 24 h after infection show lesions on the hepatopancreas and intestinal tissues caused by A. veronii. The results of this study provide a foundation for analyzing the immune mechanism of C. quadricarinatus infected with A. veronii at the transcriptional level and a theoretical basis for screening disease-resistant individuals to ensure healthy economic development of the aquatic industry.

Do patients benefit more from robot assisted approach than conventional laparoscopic distal pancreatectomy? A meta-analysis of perioperative and economic outcomes.

BACKGROUND/PURPOSE: Robotic approach has improved the ergonomics of conventional laparoscopic distal pancreatectomy (LDP), but whether patients benefit more from robot assisted distal pancreatectomy (RADP) is still controversial. This meta-analysis aims to compare the perioperative and economic outcomes of RADP with LDP. METHODS: A systematic review of the literature was carried out on PubMed, EMBASE, and the Cochrane Library between January 1990 and March 2017. All eligible studies comparing RADP versus LDP were included. Perioperative and economic outcomes constituted the end points. RESULTS: 13 English studies with 1396 patients were included. Regarding to intraoperative outcomes, RADP was associated with a significant decrease in conversion rate (OR = 0.52; 95%CI: 0.34, 0.78; P = 0.002). Although the spleen-preserving rates were comparable between RADP and LDP, a significant higher splenic vessels conservation rate was observed in the RADP group (OR = 4.71; 95%CI: 1.77, 12.56; P = 0.002). No statistically significant differences were found at operation time, estimated blood loss and blood transfusion rate. Concerning postoperative outcomes, pooled data indicated the overall morbidity, pancreatic fistula and the length of hospital stay did not differ significantly between the RADP and LDP groups. And concerning pathological outcomes, positive margin rate and the number of lymph nodules harvested were comparable between the two groups. The operative cost of RADP was almost double that of LDP (WMD = 2350.2 US dollars; 95%CI: 1165.62, 3534.78; P = 0.0001). CONCLUSION: RADP showed a slight technical advantage. But whether this benefit is worth twofold cost should be considered by patient's individuation.

Impacts of cost containment strategies on pharmaceutical expenditures of the National Health Insurance in Taiwan, 1996-2003.

INTRODUCTION: Pharmaceutical expenditure (PE) of the National Health Insurance (NHI) programme in Taiwan grew from 62.2 billion Taiwan new dollars (NT dollars) in 1996 to NT94.5 dollars billion in 2003.The government has been introducing many strategies to control PE since the inception of NHI including price adjustment based on the prices of international products or existing products (inter-brands comparison), or market price and volume survey; delegation of financial responsibility to regional bureaux; co-payment for outpatient drugs; generic grouping (the reference pricing scheme based on chemical equivalence); a global budget payment system for clinics and hospitals; and reduction in the flat daily payment rate of the drugs for clinics. The aim of this study was to evaluate the impact of these cost containment strategies on the PE of the NHI programme from 1996 to 2003. METHODS: To take the growth and seasonal trends of monthly PE into consideration, Box and Tiao's time-series event intervention analysis based on the Box-Jenkins auto-regressive integrated moving-average model was applied to evaluate the impact of various cost containment strategies on total and subsector (outpatient, inpatient, clinic and hospital sectors) PE. Monthly data of PE of the NHI programme from 1996 to 2003 (the dependent variables) were obtained from the Bureau of the NHI. Drugs prescribed by dentists and Chinese medical doctors at outpatient departments were excluded. RESULTS: After fitting the patterns of time series and controlling for the calendar effect of the Chinese New Year and the severe acute respiratory syndrome outbreak in 2003, three strategies (generic grouping, delegation of financial responsibility and reduction of the flat payment rate of clinics) were significantly associated with a reduction in PE. However, the hospital global budget strategy offset partial savings from these three strategies. Cumulative savings during the study period were estimated to be NT25.442 dollars billion (US0.80 dollars billion). Of all the strategies, generic grouping was the most effective although it had less effect on the clinic subsector. Neither drug co-payment nor price adjustment based on the international or inter-brand price comparison had significant impacts on PE. CONCLUSION: Generic grouping, reduction of the flat payment rate and delegation of financial responsibility were effective in controlling PE. A global budget alone would be unable to control PE without other direct financial incentives. Neither drug co-payment nor brand-specific price adjustment based on prices of international/existing products had a significant impact on PE.

[The application of the integrative management with no blind spot in the cooperative projects for prevention of blindness].

OBJECTIVE: To evaluate the management for donated funds in cooperative projects for prevention of blindness. METHODS: Retrospectively analyze the integrative management with no blind spot in the cooperative projects conducted by the Center of Preventing and Treating Blindness in Anhui Province and the International Organization for Prevention of Blindness from 1992 to 2001. RESULTS: The integrative management such as standardization of fund budget, establishment of inner-controlling system, improvement of inner-management and enhancement of project audit, returning information to donors and obtaining consent were applied in the cooperative projects for prevention of blindness. Therefore, the funds were used reasonably and projects were smoothly accomplished. CONCLUSION: The integrative management with no blind spot is effective for the management of donated funds in the cooperative projects for blindness.