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1.
Sci Rep ; 14(1): 13197, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851848

RESUMO

New urbanization (NU) and ecological welfare performance (EWP) play pivotal roles in achieving sustainable urban development, with both emphasizing social equity and environmental management. Exploring the coordinated relationship between EWP and NU is invaluable for understanding the symbiotic interplay between humans and nature. We constructed a framework to elucidate the coupling mechanism of EWP and NU from the perspective of systems theory. We quantified the levels of NU and EWP utilizing the entropy weighting method and the super-efficient SBM method, respectively. Furthermore, we assessed the degree of coupling coordination between the two using the coupling coordination degree model (CCDM). Spatial and temporal evolution analysis was conducted, and factors influencing the degree of coupling coordination between EWP and NU were explored through a spatial-temporal geographically-weighted regression model (GTWR). The results indicate: (1) During the study period, the average annual increase in EWP in the study area was 2.59%, with a narrowing relative gap between cities. Conversely, the average annual increase in the level of NU was 7.6%, with demographic and economic dimensions carrying the highest weights. (2) The type of coupling coordination between EWP and NU transitions from basic coordination to moderate coordination, with the development of EWP lagging behind that of NU. (3) City size demonstrates a positive yet diminishing trend on the coupling coordination level, with economic development exerting the greatest influence and exhibiting a "V" trend, while the impact of green technology innovation diminishes negatively. Additionally, regional disparities are significant, with city size exhibiting a negative impact in areas of high population density and low economic levels, and green technology innovation showing notable polarization characteristics in core cities. These findings serve as a foundation for fostering coordinated ecological development amid the rapid urbanization process of the Chengdu-Chongqing Economic Circle.

2.
J Environ Manage ; 362: 121348, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38824891

RESUMO

Heterotrophic-sulfur autotrophic denitrification (HAD) has been proposed to be a prospective nitrogen removal process. In this work, the potential of fermentation liquid (FL) from waste-activated sludge (WAS) as the electron donor for denitrification in the HAD system was explored and compared with other conventional carbon sources. Results showed that when FL was used as a carbon source, over 99% of NO3--N was removed and its removal rate exceeded 14.00 mg N/g MLSS/h, which was significantly higher than that of methanol and propionic acid. The produced sulfate was below the limit value and the emission of N2O was low (1.38% of the NO3--N). Microbial community analysis showed that autotrophic denitrifiers were predominated in the HAD system, in which Thiobacillus (16.4%) was the dominant genus. The economic analysis showed the cost of the FL was 0.062 €/m3, which was 30% lower than that in the group dosed with methanol. Our results demonstrated the FL was a promising carbon source for the HAD system, which could reduce carbon emission and cost, and offer a creative approach for waste-activated sludge resource reuse.


Assuntos
Carbono , Desnitrificação , Fermentação , Nitrogênio , Esgotos , Carbono/metabolismo , Nitrogênio/metabolismo , Eliminação de Resíduos Líquidos/métodos
3.
J Environ Manage ; 360: 121201, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38796870

RESUMO

The explosive growth of China's express delivery industry has greatly increased plastic waste, with low-value plastics not effectively utilized, such as PE packaging bags, which are often not recycled and end up in landfills or incinerators, causing significant resource waste and severe plastic pollution. A gate -to- grave life cycle assessment was adopted to assess the impacts of express delivery plastic waste (EDPW) management models (S1, landfill; S2, incineration; S3, mechanical pelletization), with Suzhou, China as a case. Results showed that mechanical pelletization, was the most environmentally advantageous, exhibiting a comprehensive environmental impact potential of -215.54 Pt, significantly lower than that of landfill (S1, 78.45 Pt) and incineration (S2, -121.77 Pt). The analysis identified that the end-of-life disposal and sorting stages were the principal contributors to environmental impacts in all three models, with transportation and transfer stages of residual waste having minimal effects. In terms of all environmental impact categories, human carcinogenic toxicity (HTc) emerged as the most significant contributor in all three scenarios. Specifically, S1 exhibited the most detrimental effect on human health, while S2 and S3 showed positive environmental impacts. Based on these findings, it is recommended that the application and innovation in mechanical recycling technologies be enhanced, the promotion of the eco-friendly transformation of packaging materials be pursued, and a sustainable express delivery packaging recycling management system be established. These strategies are essential for achieving more eco-friendly management of EDPW, reducing its environmental pollution, and moving towards more sustainable express delivery management practices.


Assuntos
Incineração , Plásticos , Reciclagem , Instalações de Eliminação de Resíduos , Gerenciamento de Resíduos , China , Gerenciamento de Resíduos/métodos , Eliminação de Resíduos/métodos , Humanos
4.
Sci Total Environ ; 928: 172429, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38621531

RESUMO

Adsorbable organic halogen (AOX) represents the total amount of halogenated organics that can be adsorbed on activated carbon (AC) from samples. Measuring AOX is crucial for assessing water quality, and any erroneous estimation of AOX risks misleading decision-makers. This study demonstrated two overlooked factors that may introduce biases to AOX measurement. The first one relates to impurities in the gas transfer tubes of AOX combustion system and in the pressurized gas of AOX separation system, which resulted in significant fluctuations and high blank values (8.5-118.0 µg-Cl/L). The solutions of above issues are to warming up the combustor for several runs and replacing the pressurized air with argon gas in the separator, which could drop the blank AOX values to 9.1-10.0 µg-Cl/L. The second one involves coexisting chloride ion (Cl-) during AOX analysis, which interfered with AOX measurements (T. test, p < 0.05) even at low concentration levels (e.g., 10 mg/L Cl- in samples with 100 µg-Cl/L p-chlorophenol). Results show that AC captured 0.02-0.11 % of Cl-, resulting in 17.7-24.5 µg-Cl/L AOX responses in control samples containing 15-130 mg/L Cl- only. Furthermore, a significant mass imbalance of Cl- (3.58-8.39 %) during analysis process suggests a potential impact of residual Cl- on subsequent samples. By comparing synthetic and actual waters, samples with low dissolved organic carbon (DOC) were more susceptible to interference from Cl- on AOX measurement than those with high DOC. These findings underscore the pressing need to optimize existing AOX methods or develop alternative analytical methods to ensure accurate water quality assessment.

5.
Medicine (Baltimore) ; 103(14): e37589, 2024 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-38579090

RESUMO

BACKGROUND: Chronic gouty arthritis, a prevalent metabolic disorder, has prompted interest in the role of diet and lifestyle in its management. This study examines alkaline water as a non-pharmacological adjunct to traditional medicine, hypothesizing its positive effects on uric acid levels and gout symptoms. METHODS: In this research, 400 chronic arthritis patients from Guangdong Hydropower Hospital (September 2021-September 2023) were randomly assigned to groups receiving varying concentrations of alkaline water alongside conventional Western medicine, or Western medicine alone. A 1-year follow-up involved assessments using visual analogue scales, joint swelling scores, functional assessment scales, and biochemical markers (serum uric acid, creatinine, urea nitrogen) for comprehensive evaluation. RESULTS: Pain relief: High-concentration alkaline water significantly reduced VAS pain scores posttreatment (P < .05). Joint swelling: Greatest improvement observed in high-concentration group (P < .001). Daily activity capability: Notable enhancements in daily activity scores in experimental groups (P < .05). Range of joint motion: All groups showed significant improvement posttreatment (P < .05). Inflammatory markers: Experimental groups experienced a notable decrease in C-reactive protein, especially in the low concentration group (P < .001). Erythrocyte sedimentation rate decreases were marginal and not statistically significant (P > .05). Interleukin-1ß and tumor necrosis factor-α levels significantly decreased, particularly in the low concentration group. Serum uric acid levels: Significant reduction in serum uric acid observed in all alkaline water groups (P < .05), contrasting with the control group. CONCLUSION: Alkaline water, particularly at high concentrations, effectively alleviated pain, reduced joint swelling, enhanced daily activities, and improved joint motion in chronic gouty arthritis treatment. It significantly reduced key inflammatory markers (C-reactive protein, interleukin-1ß, tumor necrosis factor-α) and serum uric acid levels, suggesting its potential as a valuable adjunct in gout management. The limited impact on erythrocyte sedimentation rate warrants further investigation.


Assuntos
Artrite Gotosa , Gota , Humanos , Artrite Gotosa/tratamento farmacológico , Ácido Úrico , Fator de Necrose Tumoral alfa/metabolismo , Proteína C-Reativa , Interleucina-1beta/metabolismo , Gota/tratamento farmacológico , Dor , Água
6.
Digit Health ; 10: 20552076231207582, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38425654

RESUMO

Purpose: Color fundus photography is widely used in clinical and screening settings for eye diseases. Poor image quality greatly affects the reliability of further evaluation and diagnosis. In this study, we developed an automated assessment module for color fundus photography image quality assessment using deep learning. Methods: A total of 55,931 color fundus photography images from multiple centers in Shanghai and the public database were collected and annotated as training, validation, and testing data sets. The pre-diagnosis image quality assessment module based on the multi-task deep neural network was designed. The detailed criterion of color fundus photography image quality including three subcategories with three levels of grading was applied to improve precision and objectivity. The auxiliary tasks such as the localization of the optic nerve head and macula, the classification of laterality, and the field of view were also included to assist the quality assessment. Finally, we validated our module internally and externally by evaluating the area under the receiver operating characteristic curve, sensitivity, specificity, accuracy, and quadratic weighted Kappa. Results: The "Location" subcategory achieved area under the receiver operating characteristic curves of 0.991, 0.920, and 0.946 for the three grades, respectively. The "Clarity" subcategory achieved area under the receiver operating characteristic curves of 0.980, 0.917, and 0.954 for the three grades, respectively. The "Artifact" subcategory achieved area under the receiver operating characteristic curves of 0.976, 0.952, and 0.986 for the three grades, respectively. The accuracy and Kappa of overall quality reach 88.15% and 89.70%, respectively, on the internal set. These two indicators on the external set were 86.63% and 88.55%, respectively, which were very close to that of the internal set. Conclusions: This work showed that our deep module was able to evaluate the color fundus photography image quality using more detailed three subcategories with three grade criteria. The promising results on both internal and external validation indicated the strength and generalizability of our module.

7.
Bioresour Technol ; 397: 130508, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38431057

RESUMO

C. pyrenoidosa, a species of microalgae, has been recognized as a viable protein source for human consumption. The primary challenges in this context are the development of an efficient extraction process and the valorization of the resultant waste streams. This study, situated within the paradigm of circular economy, presents an innovative extraction approach that achieved a protein extraction efficiency of 62 %. The extracted protein exhibited remarkable oil-water emulsifying performances, such as uniform morphology with high creaming stability, suggesting a sustainable alternative to conventional emulsifiers. Additionally, hydrothermal liquefaction technique was employed for converting the residual biomass and waste solution from the extraction process into biocrude. A biocrude yield exceeding 40 wt%, characterized by a carbon content of 73 % and a higher heating value of 36 MJ/kg, were obtained. These findings demonstrate the promising potential of microalgae biorefinery, which is significant for paving toward circular economy and zero-waste society.


Assuntos
Chlorella , Microalgas , Humanos , Microalgas/metabolismo , Biocombustíveis , Carbono/metabolismo , Proteínas/metabolismo , Biomassa
8.
BMC Public Health ; 24(1): 917, 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38549088

RESUMO

INTRODUCTION: The term "health poverty trap" describes a vicious cycle in which developing countries or regions become trapped in low levels of health and poverty during the process of modernization. Although significant progress has been made in alleviating poverty in China, there is still a need to further enhance the living conditions of its impoverished population. METHODS: This research utilizes the data of the three national representative panel surveys from 2014 to 2020. The primary objective is to gain a better understanding of the intricate relationship between health and poverty. To examine the self-reinforcing effects of the cumulative cycle between health and poverty, we employ unconditional quantile regression analysis. RESULT: The low-income group exhibits lower overall health status compared to the average level. Economic constraints partially hinder the ability of low-income individuals to access healthcare resources, thereby reinforcing the cyclical relationship between health and poverty. Additionally, the unique psychological and behavioral preferences of individuals in health poverty act as indirect factors that further strengthen this cycle. Health poverty individuals can generate endogenous force to escape the "health poverty trap" by enhancing their confidence levels and digital literacy. CONCLUSIONS: The research examines the coexistence of health gradients and economic inequality among Chinese residents. Additionally, the study explores the endogenous force mechanism of escaping the health poverty trap from psychological and behavioral perspectives. This research also offers insights into optimizing government poverty alleviation programs to effectively address this issue.


Assuntos
Pobreza , Mudança Social , Humanos , Fatores Socioeconômicos , China , Dinâmica Populacional
9.
Int Wound J ; 21(3): e14743, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38420721

RESUMO

Emergency craniotomy in patients with traumatic brain injury poses a significant risk for surgical site infections (SSIs). Understanding the risk factors and pathogenic characteristics of SSIs in this context is crucial for improving outcomes. This comprehensive retrospective analysis spanned from February 2020 to February 2023 at our institution. We included 25 patients with SSIs post-emergency craniotomy and a control group of 50 patients without SSIs. Data on various potential risk factors were collected, including demographic information, preoperative conditions, and intraoperative details. The BACT/ALERT3D Automated Bacterial Culture and Detection System was utilized for rapid bacterial pathogen identification. Statistical analyses included univariate and multivariate logistic regression to identify significant risk factors for SSIs. The study identified Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus as the most prevalent pathogens in SSIs. Significant risk factors for SSIs included the lack of preoperative antibiotic use, postoperative drainage tube placement, diabetes mellitus, and the incorporation of invasive procedures, all of which showed a significant association with SSIs in the univariate analysis. The multivariate analysis further highlighted the protective effect of preoperative antibiotics and the increased risks associated with anaemia, diabetes mellitus, postoperative drainage tube placement, and the incorporation of invasive procedures. Our research underscores the critical role of factors like insufficient preoperative antibiotics, postoperative drainage, invasive techniques, anaemia, and diabetes mellitus in elevating the risk of surgical site infections in traumatic brain injury patients undergoing emergency craniotomy. Enhanced focus on these areas is essential for improving surgical outcomes.


Assuntos
Anemia , Lesões Encefálicas Traumáticas , Diabetes Mellitus , Humanos , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/diagnóstico , Fatores de Risco , Craniotomia/efeitos adversos , Antibacterianos/uso terapêutico , Medição de Risco , Lesões Encefálicas Traumáticas/complicações
10.
J Environ Manage ; 354: 120369, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38373374

RESUMO

With rapid urbanization, balancing urban ecological infrastructure (UEI) construction and residents' ecological demands (RED) has become an imperative but challenging issue for sustainable development. This study develops an integrated framework to systematically prioritize UEI implementation based on localized RED and government policies. We incorporate the Kano model and quality function deployment (QFD) approach to quantify the complex associations between various resident needs and existing policies. Taking Chengdu City as a case study, resident surveys and policy reviews are conducted to construct the demand-policy linkage matrix and determine the importance of UEI tasks. Results reveal that, (1) flood control capacity is most prioritized by RED, followed by wetland area and less PM2.5, while cultural service demands rank lower; (2) Forest coverage, green space development, wetland construction and park construction emerge as priority UEI implementation tasks that can maximize fulfilling RED. This novel framework enables adaptive customization of UEI planning for different cities through configurable modeling. It provides a valuable decision support tool that enables optimizing or improving the prioritization of UEI implementation tasks based on residents' preferences. The research results have important reference value for the prioritization of UEI implementation tasks.


Assuntos
Urbanização , Áreas Alagadas , Nigéria , Cidades , Desenvolvimento Sustentável , China , Ecossistema , Conservação dos Recursos Naturais
11.
Environ Sci Pollut Res Int ; 31(16): 23568-23578, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38421543

RESUMO

Shallow urban lakes are naturally vulnerable to ecosystem degradation. Rapid urbanization in recent decades has led to a variety of aquatic problems such as eutrophication, algal blooms, and biodiversity loss, increasing the risk to lake-wide ecological sustainability. Instead of a simple binary assessment of ecological risk, holistic evaluation frameworks that consider multiple stressors and receptors can provide a more comprehensive assessment of overall ecological risk. In this study, we analyzed a combined dataset of government statistics, remote sensing images, and 1 year of field measurements to develop an index system for urban lake ecological risk assessment based on the pressure-state-response (PSR) framework. We used the developed ecological safety index (ESI) system to evaluate the ecological risk for three urban lakes in Jiangsu Province, China: Lake Yangcheng-LYC, Lake Changdang-LCD, and Lake Tashan-LTS. LYC and LTS were classified as "mostly safe" and "generally recognized as safe," respectively, while LCD was assessed as having "potential ecological risk." Our data suggest that socioeconomic pressure and aquatic health are the two main factors affecting the ecological risk in both LYC and LCD. The ecological risk of LTS could be improved more effectively if regional management plans are well implemented. Our study highlights the pressure of external wastewater loading, low forest-grassland coverage, and lake shoreline damage on the three selected urban lakes. The findings of this study can inform watershed management for lake ecosystem restoration and environmental sustainability.


Assuntos
Ecossistema , Monitoramento Ambiental , Monitoramento Ambiental/métodos , Lagos , Biodiversidade , China , Medição de Risco , Eutrofização
12.
Heliyon ; 10(2): e24745, 2024 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-38298663

RESUMO

Background: Currently, ischemic stroke is the leading cause of death in China. To compare regional differences of ischemic stroke, we analyzed the clinical characteristics of patients with ischemic stroke in four regionally representative hospitals in China. Methods: We conducted a retrospective study at four tertiary hospitals in east China, with regionally representative patients. The associated factors include hypertension, diabetes mellitus, coronary heart disease, hyperlipidemia and a combination of these factors. The standardized ratio (SR), estimated as the observed number divided by the expected number, computed as the sum of predicted probabilities from a multivariable logistic regression model derived using data from all other cities, was used to compare to average levels. Results: A total of 34,707 patients were included. The number of patients increased with age in all four hospitals and patients were predominantly male. The number of ischemic stroke cases with related factors increased with age, except for hyperlipidemia. There was no significant gender difference when multiple related factors existed simultaneously. Coronary heart disease had a more significant impact on ischemic stroke in Qingdao Municipal Hospital and the First Hospital of Qinhuangdao, while hyperlipidemia had a significant influence on ischemic stroke in the First Hospital of Qinhuangdao. Conclusions: At four hospitals in east China, with the increase of age, the risk factors associated with ischemic stroke increased, and the distribution of ischemic stroke-related factors showed regional differences.

13.
ACS Biomater Sci Eng ; 9(12): 6698-6714, 2023 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-37988627

RESUMO

The widespread and escalating emergence of multidrug resistance is now recognized as one of the most severe global threats to human health. To address the urgent issue of drug-resistant bacteria and the limitation of effective clinical treatments, antimicrobial peptides (AMPs) have been developed as promising substituents of conventional antibiotics. In this study, rational design strategies were employed to acquire seven cationic and α-helical engineered peptides based on the original template of Abaecin. After investigation, we found that AC7 (LLRRWKKLFKKIIRWPRPLPNPGH) demonstrated potent and broad-spectrum antimicrobial activity. Additionally, it demonstrated low cytotoxicity and hemolysis while maintaining good stability. Notably, AC7 displays the antibacterial mechanism with superior abilities in cell membrane disruption and potential DNA binding in vitro, as well as effectively disrupting biofilms. Moreover, the murine skin wound model infected with drug-resistant Pseudomonas aeruginosa was employed to evaluate the anti-infective efficacy and therapeutic potential of AC7. It was observed that AC7 displays a remarkable capacity to inhibit wound colonization, reduce levels of inflammatory cytokines (TNF-α) and inflammatory cells (white blood cells (WBC), monocytes (MONO), lymphocytes (LYMPH), neutrophils (GRAN)), promote the levels of IL-10 and VEGF, and enhance wound healing. Overall, these findings demonstrate the potential of AC7 as a viable alternative to traditional antibiotics.


Assuntos
Anti-Infecciosos , Animais , Camundongos , Humanos , Anti-Infecciosos/farmacologia , Antibacterianos/farmacologia , Bactérias , Cicatrização
14.
J Environ Manage ; 348: 119385, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37925981

RESUMO

The Environmental Protection Industry (EPI) has expanded tremendously in response to rising environmental awareness and governmental assistance. EPI development has been hampered by the disordered and unbalanced allocation of production factors caused by the complex and diverse industry mix. In this study, a micro perspective is adopted to dissect the EPI into three departments: technology, manufacturing, and management. A measuring model for determining the misallocation of factors in the EPI is constructed using a three-department Cobb-Douglas production function. The model assesses the effectiveness of factor allocation in China's national and regional EPI while taking into account provincial industrial structures. The findings demonstrate disparate performances between various factors and departments and highlight noteworthy variances in the effectiveness of factor allocation within China's EPI. In particular, capital misallocation is far worse than labor misallocation, with manufacturing misallocation being noticeably worse than other departments. The excessive concentration of factors within the manufacturing department and the severe lack of inputs in the other two departments are mostly to blame for Central and Northwest China's low factor allocation efficiency. Additionally, capital tends to cluster inside the manufacturing department, while labor tends to move toward dominant departments. Finally, relevant policy suggestions are made based on the empirical findings.


Assuntos
Conservação dos Recursos Naturais , Desenvolvimento Econômico , Indústrias , Comércio , China
15.
Animals (Basel) ; 13(20)2023 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-37893967

RESUMO

During the process of pork production, the carcasses of pigs are divided and sold, which provides better economic benefits and market competitiveness for pork production than selling the carcass as a whole. Due to the significant cost of post-slaughter phenotypic measurement, the genetic architecture of tenderloin weight (TLNW) and rib weight (RIBW)-important components of pig carcass economic value-remain unknown. In this study, we conducted genome-wide association studies (GWAS) for TLNW and RIBW traits in a population of 431 Duroc × Landrace × Yorkshire (DLY) pigs. In our study, the most significant single nucleotide polymorphism (SNP) associated with TLNW was identified as ASGA0085853 (3.28 Mb) on Sus scrofa chromosome 12 (SSC12), while for RIBW, it was Affx-1115046258 (172.45 Mb) on SSC13. Through haplotype block analysis, we discovered a novel quantitative trait locus (QTL) associated with TLNW, spanning a 5 kb region on SSC12, and a novel RIBW-associated QTL spanning 1.42 Mb on SSC13. Furthermore, we hypothesized that three candidate genes, TIMP2 and EML1, and SMN1, are associated with TLNW and RIBW, respectively. Our research not only addresses the knowledge gap regarding TLNW, but also serves as a valuable reference for studying RIBW. The identified SNP loci strongly associated with TLNW and RIBW may prove useful for marker-assisted selection in pig breeding programs.

16.
Surg Endosc ; 37(10): 7784-7789, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37587239

RESUMO

INTRODUCTION: Previous reports show that over 85% of general surgery residents choose to pursue fellowship training after completing residency. There continues to be an increase interest among general surgery residents in minimally invasive surgery (MIS) fellowship. Moreover, demographic disparities, particularly gender disparities continue to persist among surgical sub-specialties. In this study, we evaluated the gender disparities and practice patterns among graduating MIS fellows. METHODS AND PROCEDURES: MIS fellows were surveyed, and 169 results were received from fellows who completed training in the years: 2010, 2015-2019. Surveys collected were used to create a descriptive analysis of the demographics, practice patterns and job finding measures. Loglinear regression model was performed to assess gender trend variation over training years. RESULTS: Fellows self-reported gender showed 65% male, 30% female, and 5% prefer not to say. The cohort of participants was described as 45.3% white, 5.3% African American, and 6.5% Hispanic or Latino. Further, results showed 87.1% of fellows work in MIS surgery with 91.8% reporting their fellowship experience facilitated their ability to find a job. Most alumni pursue a comprehensive MIS practice. Moreover, the proportion of female fellows increased from 29 to 41%, but this increase over time was not significant using loglinear regressions [p-value = 0.0810, Relative risk = 1.1994 (95% CI 0.9778, 1.4711)]. CONCLUSION: Overall, there is good evidence to support that fellowship training facilitates future career advancements. Further, MIS fellows have differential practice patterns. Finally, females remain underrepresented among the MIS fellows which should call for leadership action to bridge these gaps.


Assuntos
Educação de Pós-Graduação em Medicina , Internato e Residência , Humanos , Masculino , Feminino , Educação de Pós-Graduação em Medicina/métodos , Bolsas de Estudo , Competência Clínica , Inquéritos e Questionários , Procedimentos Cirúrgicos Minimamente Invasivos/educação , Demografia
17.
Surg Obes Relat Dis ; 19(10): 1119-1126, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37328408

RESUMO

BACKGROUND: Bariatric surgery is a common operation, but differences in outcomes between males and females are unknown. OBJECTIVES: To compare the risk of mortality, complications, reintervention, and healthcare utilization after sleeve gastrectomy or gastric bypass using sex as a biologic variable. SETTING: United States. METHODS: Retrospective cohort study of adults undergoing sleeve gastrectomy or gastric bypass from January 1, 2012 to December 31, 2018 using Medicare claims data. We performed a heterogeneity of treatment effect analysis to determine the impact of sleeve gastrectomy versus gastric bypass comparing males to females. The primary outcome was safety (mortality, complications, and reinterventions) up to 5 years after surgery. The secondary outcome was healthcare utilization (hospitalization and emergency department use). RESULTS: Among 95,405 patients the majority (n = 71,348; 74.8%) were female and most (n = 57,008; 59.8%) underwent sleeve gastrectomy. For all patients, compared to gastric bypass, sleeve gastrectomy was associated with a lower risk of complications and reintervention but a higher risk of revision. Compared to gastric bypass, sleeve gastrectomy was associated with a lower risk of mortality for females (adjusted hazard ratio .86, 95% CI .75-.96) but not males. We found no difference in procedure treatment effect by sex for mortality, hospitalization, emergency department use, or overall reintervention when comparing sleeve to gastric bypass. CONCLUSIONS: Females and males have similar outcomes following bariatric surgery. Females have a lower risk of complications but a higher risk of reintervention. Decisions surrounding treatment for this common procedure should be tailored to include a discussion of sex-specific differences in treatment outcome.


Assuntos
Produtos Biológicos , Derivação Gástrica , Laparoscopia , Obesidade Mórbida , Adulto , Humanos , Masculino , Feminino , Idoso , Estados Unidos , Derivação Gástrica/efeitos adversos , Derivação Gástrica/métodos , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Medicare , Resultado do Tratamento , Aceitação pelo Paciente de Cuidados de Saúde , Gastrectomia/efeitos adversos , Gastrectomia/métodos , Laparoscopia/métodos
18.
Nat Commun ; 14(1): 3249, 2023 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-37277365

RESUMO

To reduce environmental pollution and reliance on fossil resources, polyethylene terephthalate as the most consumed synthetic polyester needs to be recycled effectively. However, the existing recycling methods cannot process colored or blended polyethylene terephthalate materials for upcycling. Here we report a new efficient method for acetolysis of waste polyethylene terephthalate into terephthalic acid and ethylene glycol diacetate in acetic acid. Since acetic acid can dissolve or decompose other components such as dyes, additives, blends, etc., Terephthalic acid can be crystallized out in a high-purity form. In addition, Ethylene glycol diacetate can be hydrolyzed to ethylene glycol or directly polymerized with terephthalic acid to form polyethylene terephthalate, completing the closed-loop recycling. Life cycle assessment shows that, compared with the existing commercialized chemical recycling methods, acetolysis offers a low-carbon pathway to achieve the full upcycling of waste polyethylene terephthalate.

19.
Resour Policy ; 83: 103687, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37193091

RESUMO

In recent times, industrialized economies have focused more on achieving a sustainable environment while maintaining economic prosperity. However, it is clear from the current research that natural resource exploitation and decentralization substantially affect environmental quality. To experimentally validate such data, the current study examines decentralized economies during the previous three decades (1990-2020). This study discovered the existence of long-term cointegration between carbon emissions, economic growth, revenue decentralization, spending decentralization, natural resources, and human capital using panel data econometric techniques. The findings are based on non-parametric techniques, indicating that economic growth and revenue decentralization are the primary barriers to meeting the COP26 objective. Human capital drives down carbon emissions and contributes to meeting the COP26 objective. On the contrary, decentralization of spending and natural resources has a mixed influence on carbon emissions across quantiles. This report recommends investing in human capital, education, and research & development to speed up COP26's target accomplishment.

20.
Environ Sci Pollut Res Int ; 30(26): 69651-69665, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37142841

RESUMO

In China, the consumption of non-renewable energy increases not only in general economic growth but also in large amounts of carbon dioxide (CO2) emissions which cause disasters and catastrophic damages to the environment. To alleviate environmental pressure, it is neccessary to forecast and model the relationship between energy consumption and CO2 emissions. In this study, a fractional non-linear grey Bernoulli (FANGBM(1,1)) model based on particle swarm optimization is proposed to forecast and model non-renewable energy consumption and CO2 emissions in China. Firstly, based on the FANGBM(1,1) model, non-renewable energy consumption in China is predicted. The comparison results of several competitive models show that the FANGBM(1,1) model has the best predictive performance. Then, the relationship between non-renewable energy consumption and CO2 emissions is modeled. On this basis, China's future CO2 emissions are effectively predicted based on the established model. The forecast results show that the growth trend of China's CO2 emissions will continue to grow to 2035, while the prediction results in different scenarios also show that that the different growth rates of renewable energy share lead to different times to peak CO2 emissions. In the end, relevant suggestions are proposed to support China's dual carbon goals.


Assuntos
Dióxido de Carbono , Energia Renovável , Dióxido de Carbono/análise , Desenvolvimento Econômico , China , Algoritmos , Previsões
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