Multi-objective ecological restoration priority in China: Cost-benefit optimization in different ecological performance regimes based on planetary boundaries.

In the context of the "United Nations Decade on Ecosystem Restoration", optimizing spatiotemporal arrangements for ecological restoration is an important approach to enhancing overall socioecological benefits for sustainable development. However, against the background of ecological degradation caused by the human use of most natural resources at levels that have approached or exceeded the safe and sustainable boundaries of ecosystems, it is key to explain how to optimize ecological restoration by classified management and optimal total benefits. In response to these issues, we combined spatial heterogeneity and temporal dynamics at the national scale in China to construct five ecological performance regimes defined by indicators that use planetary boundaries and ecological pressures which served as the basis for prioritizing ecological restoration areas and implementing zoning control. By integrating habitat conservation, biodiversity, water supply, and restoration cost constraints, seven ecological restoration scenarios were simulated to optimize the spatial layout of ecological restoration projects (ERPs). The results indicated that the provinces with unsustainable freshwater use, climate change, and land use accounted for more than 25%, 66.7%, and 25%, respectively, of the total area. Only 30% of the provinces experienced a decrease in environmental pressure. Based on the ecological performance regimes, ERP sites spanning the past 20 years were identified, and more than 50% of the priority areas were clustered in regime areas with increased ecological stress. As the restoration area targets doubled (40%) from the baseline (20%), a multi-objective scenario presents a trade-off between expanded ERPs in areas with highly beneficial effects and minimal restoration costs. In conclusion, a reasonable classification and management regime is the basis for targeted restoration. Coordinating multiple objectives and costs in ecological restoration is the key to maximizing socio-ecological benefits. Our study offered new perspectives on systematic and sustainable planning for ecological restoration.

Resilience assessment of the nitrogen flow system in food production and consumption for sustainable development on the Qinghai-Tibet Plateau.

A robust and resilient nitrogen (N) flow system can effectively ensure consistent food production and consumption activities while preserving environmental quality. In this study, we constructed an indicator system to evaluate N flow system resilience including food production and consumption, at the county scale on the Qinghai-Tibet Plateau (QTP) from 1998 to 2018. The subsystem coupling coordination degree (CCD) and the effect of N losses on N flow system resilience were subsequently explored. The results indicated that despite the overall N flow system resilience remaining low and exhibiting spatiotemporal disparities from 1998 to 2018, over 90 % of the counties experienced improvements. High resilience areas (>0.15) were mainly concentrated in some counties in Sichuan Province, where N losses were positively correlated with system resilience. The level of resilience depended on agricultural and livestock development, and the CCD of subsystems was also high (>0.5) in this region, with the most balanced environmental and socioeconomic development. The low system resilience areas were concentrated in the eastern part of the QTP, where human activities caused substantial disturbances. The fragmentation of the agro-pastoral system coupled with the low system resilience of the food production and driving pressure subsystems led to low CCD between subsystems. In contrast, the western regions, characterized by a stable food production system, high food self-sufficiency, and weak dependence on external systems, showed a higher degree of system resilience and resistance. Our findings provide a reference for N resource management and policy formulation for food production and consumption in the agricultural and pastoral areas of the QTP.

The hospital management practices in Chinese county hospitals and its association with quality of care, efficiency and finance.

BACKGROUND: County hospitals as the backbone of the China's healthcare system are providing services for over 70% of the total population. However, the hospital management practice (HMP) and its links with quality of care, efficiency and finance in these hospitals are unknown. METHODS: We did two cross-sectional surveys of HMP in 2013 and 2015 among 101 county hospitals across rural China. Three managing roles (hospital director, director of medical affairs office and director of cardiology) and a cardiologist were invited to the surveys. A novel HMP rating scale, with 100 as full score, was used to measure the HMP in 17 indicators under four dimensions (target, operation, performance, and talent management) for each hospital. We analyzed the association of HMP score with variables on quality of care, efficiency and finance using linear mixed models with and without adjustment for potential confounders. FINDINGS: A total of 95 hospitals participated in at least one survey and were included in the analysis. The overall mean HMP score varied dramatically across the hospitals and 84% of them scored less than 60. The dimension mean HMP score was 38.6 (target), 56.4 (operation), 53.2 (performance) and 55.7 (talent), respectively. The pattern of indicator mean HMP score, however, was almost identical between hospitals with high and low overall HMP score, showing the same 'strength' (staff satisfaction, staff performance appraisal, 'hard wares', patient-centered services, etc.) and 'weakness' (target balance, target setting, continuous quality improvement, penalties on staff with dissatisfied performance, etc.). The associations of overall mean HMP score with quality of care and efficiency variables and cost per hospitalization was not statistically significant. The statistical significance in the association with hospital annual total income disappeared after adjusting for region, teaching status, number of competitors, number of staff and number of beds in use. CONCLUSION: The HMP in Chinese county hospitals scores low in general and was not significantly associated with hospital care quality, efficiency and finance. The current healthcare reform in China should address the micro level issues in hospital management practices.

Distribution, sources, and ecological risk assessment of polycyclic aromatic hydrocarbons in the water and suspended sediments from the middle and lower reaches of the Yangtze River, China.

Samples were collected from the middle and lower reaches of the Yangtze River, China, to study the concentrations, distributions, and compositions of 16 US-EPA priority polycyclic aromatic hydrocarbons (PAHs) in water and suspended particulate matter (SPM). We also evaluated sources of the PAHs and their potential toxicity. Total concentrations of the PAHs (ΣPAHs) in water ranged from 17.33 to 77.12 ng L(-1), and in SPM, the levels ranged from 595.91 to 2473.74 ng g(-1). Total concentrations of seven carcinogenic PAHs (ΣCPAHs) ranged from 7.63 to 13.02 ng L(-1) in water and 276.55 to 1216.89 ng g(-1) in SPM. PAH levels in water samples were relatively low, and those in the lower reaches were higher than in the middle reaches. SPM samples had higher levels of PAHs, especially in the lower reaches and in Dongting Lake and Poyang Lake. Principal component analysis (PCA) with multiple linear regression analysis (MLR) was performed to quantitatively characterize the PAH sources. Two factors and their contributions were identified from water samples. Coal and wood combustion accounted for 74.1 % of the PAHs, and petroleum emissions explained 25.9 % of the PAHs. Three source factors were identified from SPM samples: these were vehicular emissions (46.3 % of PAHs), wood and coal combustion (40.4 % of PAHs), and petrogenic sources (13.3 %). Ecological risk assessment indicated that a moderate undesirable impact will be caused by PAHs, and some control measures and remedial actions should be conducted.

[Source Apportionment and Ecological Risk Assessment of Polycyclic Aromatic Hydrocarbons in Surface Water from Yangtze River, China: Based on PMF Model].

To study the features and ecological risk of PAHs in surface water from Yangtze River, 19 water samples were collected from the main stream and branch of Yangtze River in August 2015. Solid phase extraction method was used to extract PAHs, and the concentrations of the 16 priority PAHs were determined using GC-MS. The results indicated that the concentration of total PAHs (∑PAHs) in the surface water ranged from 17.7-110 ng·L-1 with an average value of 42.6 ng·L-1. The predominant PAHs in the water were PAHs with 2-3 rings, accounting for 67.7% of ∑PAHs. The results of molecular diagnostic ratios indicated that the origin of PAHs was mostly combustion sources, including fossil fuel and biomass combustion. PMF model was used to quantitatively acquire the source contribution of PAHs, which indicated that four sources were identified and their contribution rates were respectively biomass and coal combustion (40.1%), petroleum source (19.6%), traffic source (17.5%) and coke oven source (22.8%). The results of ecological risk assessment indicated that PAHs with 2-3 rings had a relatively high risk level, and Wujiang station and lower reach had a relatively high risk level based on risk quotient. Overall, the ecological risk of PAHs in the Yangtze River was at a relatively low level.