Spatial distribution and ecological risk assessment of short and medium chain chlorinated paraffins in water and sediments of river Ravi, Pakistan.

Short (SCCPs) and medium (MCCPs) chain chlorinated paraffins being the emerging organic pollutants have raised serious concerns due to their widespread use and related human health risks. However, their occurrence in aquatic bodies like rivers and associated damage to ecological integrity is yet unknown in some regions of the world. The current study is the first ever assessment of SCCPs and MCCPs in sediment and water of river Ravi, Pakistan. Spatial occurrence and associated ecological risks were investigated from sediments (n = 16) and composite water samples (n = 8) collected at eight locations along the stretch of river Ravi. The concentrations of SCCPs and MCCPs varied from below limit of detection (

Racial disparities in mitral valve surgery: A statewide analysis.

OBJECTIVE: Racial disparities in health care have come to the forefront. We hypothesized that Black race was associated with worse preoperative risk, lower repair rates, and worse outcomes among patients who underwent mitral valve surgery. METHODS: All patients who underwent mitral valve repair or replacement with or without coronary artery bypass grafting from 2011 to 2020 in a statewide collaborative database were stratified into 3 racial groups, White, Black, and other. Preoperative characteristics, procedure type, and outcomes were evaluated. RESULTS: A total of 9074 mitral valve operations were performed at 33 centers (Black 1009 [11.1%], White 7862 [86.6%]). Preoperative combined Society of Thoracic Surgeons morbidity and mortality was higher for Black patients (Black 32%, White 22%, other 23%, [P < .001]) because of a greater proportion of diabetes, hypertension, and chronic lung disease. White patients were more likely to undergo mitral repair (White 66%, Black 53.3%, other 57%; P < .001). Operative mortality was similar across racial groups (White 3.7%, Black 4.6%, other 4.5%; P = .36). After adjusting for preoperative factors, mitral etiology, and hospitals, race was not associated with mitral valve repair, complications, or mortality, but Black patients had higher odds of extended care facility utilization and readmission. CONCLUSIONS: Contrary to our hypothesis, there was no difference in the odds of repair or operative mortality across races after accounting for risk and etiology. However, Black patients were more likely to be readmitted after discharge. These findings support a greater focus on reducing disparities in mitral valve surgery.

Pesticide exposure in New Zealand school-aged children: Urinary concentrations of biomarkers and assessment of determinants.

This study aimed to assess pesticide exposure and its determinants in children aged 5-14 years. Urine samples (n = 953) were collected from 501 participating children living in urban areas (participant n = 300), rural areas but not on a farm (n = 76), and living on a farm (n = 125). The majority provided two samples, one in the high and one in the low spraying season. Information on diet, lifestyle, and demographic factors was collected by questionnaire. Urine was analysed for 20 pesticide biomarkers by GC-MS/MS and LC-MS/MS. Nine analytes were detected in > 80% of samples, including six organophosphate insecticide metabolites (DMP, DMTP, DEP, DETP, TCPy, PNP), two pyrethroid insecticide metabolites (3-PBA, trans-DCCA), and one herbicide (2,4-D). The highest concentration was measured for TCPy (median 13 µg/g creatinine), a metabolite of chlorpyrifos and triclopyr, followed by DMP (11 µg/g) and DMTP (3.7 µg/g). Urine metabolite levels were generally similar or low compared to those reported for other countries, while relatively high for TCPy and pyrethroid metabolites. Living on a farm was associated with higher TCPy levels during the high spray season. Living in rural areas, dog ownership and in-home pest control were associated with higher levels of pyrethroid metabolites. Urinary concentrations of several pesticide metabolites were higher during the low spraying season, possibly due to consumption of imported fruits and vegetables. Organic fruit consumption was not associated with lower urine concentrations, but consumption of organic food other than fruit or vegetables was associated with lower concentrations of TCPy in the high spray season. In conclusion, compared to other countries such as the U.S., New Zealand children had relatively high exposures to chlorpyrifos/triclopyr and pyrethroids. Factors associated with exposure included age, season, area of residence, diet, in-home pest control, and pets.

Pollution characteristics and health risk assessment of PM2.5-bound arsenic: a 7-year observation in the urban area of Jinan, China.

The aim of the study was to analyze the temporal trends, pollution sources, and carcinogenic health risks associated with PM2.5-bound arsenic (As). A total of 588 PM2.5 samples were collected in Jinan during January 2014-December 2020. The content and distribution characteristics were determined for As and Al in PM2.5, and the pollution sources were identified based on enrichment factors (EFs). The health risk of inhalation exposure to As was estimated using the risk assessment methods recommended by the United States Environmental Protection Agency (US EPA). The annual average concentration of As in PM2.5 was 4.5-17.5 ng m-3, which was 0.8-2.9 times higher than the limit ruled by the European Union and China's Ambient Air Quality Standards (6 ng m-3). From 2014 to 2020, the As concentration gradually decreased from 17.5 to 4.9 ng m-3. After 2017, the concentration was close to the level required by the atmospheric quality standard (6 ng m-3). The PM2.5 and arsenic concentrations in the heating season were significantly higher than those in the non-heating season. The EF of As ranged from 144 to 607, which was higher than 10. The cancer risk of As in PM2.5 decreased to the lowest values (heating season 1.0 × 10-5 and non-heating season 7.1 × 10-6, respectively) in 2019. As in Jinan mainly came from anthropogenic pollution. The level of As pollution has been significantly reduced in recent years, but there is still a high risk of carcinogenesis. Air pollution control strategies and guidelines need to be implemented in urban areas, especially during the heating season in winter and spring.

Preliminary Assessment of a Postural Synergy-Based Exoskeleton for Post-Stroke Upper Limb Rehabilitation.

Upper limb exoskeletons have drawn significant attention in neurorehabilitation because of the anthropomorphic mechanical structure analogous to human anatomy. Whereas, the training movements are typically unorganized because most exoskeletons ignore the natural movement characteristic of human upper limbs, particularly inter-joint postural synergy. This paper introduces a newly developed exoskeleton (Armule) for upper limb rehabilitation with a postural synergy design concept, which can reproduce activities of daily living (ADL) motion with the characteristics of human natural movements. The semitransparent active control strategy with the interactive force guidance and visual feedback ensured the active participation of users. Eight participants with hemiplegia due to a first-ever, unilateral stroke were recruited and included. They participated in exoskeleton therapy sessions for 4 weeks, with passive/active training under trajectories and postures with the characteristics of human natural movements. The primary outcome was the Fugl-Meyer Assessment for Upper Extremities (FMA-UE). The secondary outcomes were the Action Research Arm Test(ARAT), modified Barthel Index (mBI), and metric measured with the exoskeleton After the 4-weeks intervention, all subjects showed significant improvements in the following clinical measures: the FMA-UE (difference, 11.50 points, p = 0.002), the ARAT (difference, 7.75 points ), and the mBI (difference, 17.50 points, p = 0.003 ) score. Besides, all subjects showed significant improvements in kinematic and interaction force metrics measured with the exoskeleton. These preliminary results demonstrate that the Armule exoskeleton could improve individuals' motor control and ADL function after stroke, which might be associated with kinematic and interaction force optimization and postural synergy modification during functional tasks.

Determinants of Value in Coronary Artery Bypass Grafting.

Background Over 180 000 coronary artery bypass grafting (CABG) procedures are performed annually, accounting for $7 to $10 billion in episode expenditures. Assessing tradeoffs between spending and quality contributing to value during 90-day episodes has not been conducted but is essential for success in bundled reimbursement models. We, therefore, identified determinants of variability in hospital 90-day episode value for CABG. Methods Medicare and private payor admissions for isolated CABG from 2014 to 2016 were retrospectively linked to clinical registry data for 33 nonfederal hospitals in Michigan. Hospital composite risk-adjusted complication rates (≥1 National Quality Forum-endorsed, Society of Thoracic Surgeons measure: deep sternal wound infection, renal failure, prolonged ventilation >24 hours, stroke, re-exploration, and operative mortality) and 90-day risk-adjusted, price-standardized episode payments were used to categorize hospitals by value by defining the intersection between complications and spending. Results Among 2573 total patients, those at low- versus high-value hospitals had a higher percentage of prolonged length of stay >14 days (9.3% versus 2.4%, P=0.006), prolonged ventilation (17.6% versus 4.8%, P<0.001), and operative mortality (4.8% versus 0.6%, P=0.001). Mean total episode payments were $51 509 at low-compared with $45 526 at high-value hospitals (P<0.001), driven by higher readmission ($3675 versus $2177, P=0.005), professional ($7462 versus $6090, P<0.001), postacute care ($7315 versus $5947, P=0.031), and index hospitalization payments ($33 474 versus $30 800, P<0.001). Among patients not experiencing a complication or 30-day readmission (1923/2573, 74.7%), low-value hospitals had higher inpatient evaluation and management payments ($1405 versus $752, P<0.001) and higher utilization of inpatient rehabilitation (7% versus 2%, P<0.001), but lower utilization of home health (66% versus 73%, P=0.016) and emergency department services (13% versus 17%, P=0.034). Conclusions To succeed in emerging bundled reimbursement programs for CABG, hospitals and physicians should identify strategies to minimize complications while optimizing inpatient evaluation and management spending and use of inpatient rehabilitation, home health, and emergency department services.

Pollution characteristics and chronic health risk assessment of metals and metalloids in ambient PM2.5 in Licheng District, Jinan, China.

PM2.5 samples were collected at the Wangsheren primary school site in Licheng District of Jinan, China, during 2016. Eleven metals and metalloids including Al, As, Be, Cd, Cr, Hg, Mn, Ni, Pb, Sb and Se in PM2.5 were measured by inductively coupled plasma-mass spectroscopy. The annual average mass concentration of PM2.5 was found to be 88.7 µg m-3. The highest PM2.5 concentrations were obtained during the heating seasons of winter and spring. The concentrations of metals and metalloids in PM2.5 were in a descending order of Al, Pb, Mn, As, Se, Cr, Sb, Ni, Cd, Hg and Be. The enrichment factors showed that Pb, Mn, As, Se, Cr, Sb, Ni, Cd, Hg originated from anthropogenic sources. Factor analysis indicated that the main sources of the metals were coal combustion dust, soil dust, metallurgical industry, brake abrasion of vehicles and other mixed sources. Coal combustion dust was the primary source of metal pollution in PM2.5. Non-carcinogenic risks associated with exposure through the respiratory system were between 6.30 × 10-4 and 7.62 × 10-1, which were lower than the safe limit (1). The carcinogenic risks of Cr, As and Cd were 3.17 × 10-5, 1.52 × 10-5, 2.22 × 10-6, respectively, which were higher than the precautionary criterion (10-6/year). This study indicates that the air pollution of PM2.5 is of public health concern in Licheng District of Jinan, particularly related to potential carcinogenic metals of As, Cr and Cd. Intervention action is needed to reduce the emission sources of these elements, especially coal combustion in winter heating season.

Inaugural Readmission Penalties for Total Hip and Total Knee Arthroplasty Procedures Under the Hospital Readmissions Reduction Program.

Importance: The Hospital Readmissions Reduction Program (HRRP) is a Centers for Medicare and Medicaid Services policy that levies hospital reimbursement penalties based on excess readmissions of patients with 4 medical conditions and 3 surgical procedures. A greater understanding of factors associated with the 3 surgical reimbursement penalties is needed for clinicians in surgical practice. Objective: To investigate the first year of HRRP readmission penalties applied to 2 surgical procedures-elective total hip arthroplasty (THA) and total knee arthroplasty (TKA)-in the context of hospital and patient characteristics. Design, Setting, and Participants: Fiscal year 2015 HRRP penalization data from Hospital Compare were linked with the American Hospital Association Annual Survey and with the Healthcare Cost and Utilization Project State Inpatient Database for hospitals in the state of Florida. By using a case-control framework, those hospitals were separated based on HRRP penalty severity, as measured with the HRRP THA and TKA excess readmission ratio, and compared according to orthopedic volume as well as hospital-level and patient-level characteristics. The first year of HRRP readmission penalties applied to surgery in Florida Medicare subsection (d) hospitals was examined, identifying 60 663 Medicare patients who underwent elective THA or TKA in 143 Florida hospitals. The data analysis was conducted from February 2016 to January 2017. Exposures: Annual hospital THA and TKA volume, other hospital-level characteristics, and patient factors used in HRRP risk adjustment. Main Outcomes and Measures: The HRRP penalties with HRRP excess readmission ratios were measured, and their association with annual THA and TKA volume, a common measure of surgical quality, was evaluated. The HRRP penalties for surgical care according to hospital and readmitted patient characteristics were then examined. Results: Among 143 Florida hospitals, 2991 of 60 663 Medicare patients (4.9%) who underwent THA or TKA were readmitted within 30 days. Annual hospital arthroplasty volume seemed to follow an inverse association with both unadjusted readmission rates (r = -0.16, P = .06) and HRRP risk-adjusted readmission penalties (r = -0.12, P = .14), but these associations were not statistically significant. Other hospital characteristics and readmitted patient characteristics were similar across HRRP orthopedic penalty severity. Conclusions and Relevance: This study's findings suggest that higher-volume hospitals had less severe, but not significantly different, rates of readmission and HRRP penalties, without systematic differences across readmitted patients.

Development of a questionnaire-based insecticide exposure assessment method and comparison with urinary insecticide biomarkers in young Australian children.

Environmental and behavioural factors assessed via an online questionnaire were compared to insecticide metabolite concentrations in urine collected from 61 children from South East Queensland, Australia. Metabolite concentrations (µg/L urine) were transformed using the natural logarithm prior to regression analysis and adjusted for age and creatinine. A significant dietary association was reported for vegetable intake and 3-phenoxybenzoic acid (3-PBA) (ß: 1.47 for top quartile of intake versus bottom quartile of intake 95% CI: 0.36, 2.57). Intake of vegetables and fruit were also positively associated with sum non-specific organophosphate metabolites (Æ©nsOP). Æ©nsOP concentrations were lower when fruits and vegetables were always or almost always washed prior to cooking or eating (ß: -0.69 95% CI: -1.25, -0.12). In multivariable modelling 3-PBA concentrations were also associated with hand-washing frequency (ß: 1.69 95% CI: 0.76, 2.61 for <1 day versus > 3 day), presence of a dog in the home (ß: 0.73 95% CI: 0.07, 1.38), frequency of pest-spray use in the summer months (ß: 0.88 95% CI: 0.22, 1.54 weekly versus less than weekly) and season (ß: 0.88 95% CI: 0.32, 1.44 for spring/summer versus winter/autumn). This is the first study in Australia to report dietary, behavioural and environmental factors associated with biomarkers of insecticide exposure in young children.

Chlorinated paraffins in indoor dust from Australia: Levels, congener patterns and preliminary assessment of human exposure.

Chlorinated paraffins (CPs) are a group of polychlorinated n-alkanes with high production volumes. Until now, there are only limited data on the levels of CPs in the environment, especially in the indoor environment. In this study, dust samples were collected from 44 indoor environments, including 27 private houses, 10 offices, and 7 vehicles. Short-, medium-, and long-chain CPs were detected in all dust samples. The median concentration of ∑CPs (C10-C21) was 57, 160 and 290 µg/g, in houses, offices, and vehicles, respectively. Medium-chain CPs were the dominant group, on average accounting for 86% of ∑CPs. Cl6 and Cl8 groups had the highest contributions to ∑CPs across all the different microenvironments, while C13 and C14 were the predominant groups of SCCPs and MCCPs. Median exposure to ∑CPs via indoor dust were estimated at 80 ng/kg/day and 620 µg/kg/day for Australian adults and toddlers respectively. The daily intake of CPs via dust, in the worse scenario, was still 2-3 orders of magnitudes lower than the reference doses based on neoplastic effects.

Organophosphate and brominated flame retardants in Australian indoor environments: Levels, sources, and preliminary assessment of human exposure.

Concentrations of nine organophosphate flame retardants (OPFRs) and eight polybrominated diphenyl ethers (PBDEs) were measured in samples of indoor dust (n = 85) and air (n = 45) from Australian houses, offices, hotels, and transportation (buses, trains, and aircraft). All target compounds were detected in indoor dust and air samples. Median ∑9OPFRs concentrations were 40 µg/g in dust and 44 ng/m3 in indoor air, while median ∑8PBDEs concentrations were 2.1 µg/g and 0.049 ng/m3. Concentrations of FRs were higher in rooms that contained carpet, air conditioners, and various electronic items. Estimated daily intakes in adults are 14000 pg/kg body weight/day and 330 pg/kg body weight/day for ∑9OPFRs and ∑8PBDEs, respectively. Our results suggest that for the volatile FRs such as tris(2-chloroethyl) phosphate (TCEP) and TCIPP, inhalation is expected to be the more important intake pathway compared to dust ingestion and dermal contact.

Variation in readmission expenditures after high-risk surgery.

BACKGROUND: The Hospital Readmissions Reduction Program reduces payments to hospitals with excess readmissions for three common medical conditions and recently extended its readmission program to surgical patients. We sought to investigate readmission intensity as measured by readmission cost for high-risk surgeries and examine predictors of higher readmission costs. MATERIALS AND METHODS: We used the Healthcare Cost and Utilization Project's State Inpatient Database to perform a retrospective cohort study of patients undergoing major chest (aortic valve replacement, coronary artery bypass grafting, lung resection) and major abdominal (abdominal aortic aneurysm repair [open approach], cystectomy, esophagectomy, pancreatectomy) surgery in 2009 and 2010. We fit a multivariable logistic regression model with generalized estimation equations to examine patient and index admission factors associated with readmission costs. RESULTS: The 30-d readmission rate was 16% for major chest and 22% for major abdominal surgery (P < 0.001). Discharge to a skilled nursing facility was associated with higher readmission costs for both chest (odds ratio [OR]: 1.99; 95% confidence interval [CI]: 1.60-2.48) and abdominal surgeries (OR: 1.86; 95% CI: 1.24-2.78). Comorbidities, length of stay, and receipt of blood or imaging was associated with higher readmission costs for chest surgery patients. Readmission >3 wk after discharge was associated with lower costs among abdominal surgery patients. CONCLUSIONS: Readmissions after high-risk surgery are common, affecting about one in six patients. Predictors of higher readmission costs differ among major chest and abdominal surgeries. Better identifying patients susceptible to higher readmission costs may inform future interventions to either reduce the intensity of these readmissions or eliminate them altogether.

A Cost-Effectiveness Analysis of Plasmodium falciparum Malaria Elimination in Hainan Province, 2002-2012.

In Hainan Province, China, great achievements in elimination of falciparum malaria have been made since 2010. There have been no locally acquired falciparum malaria cases since that time. The cost-effectiveness of elimination of falciparum malaria has been analyzed in Hainan Province. There were 4,422 falciparum malaria cases reported from 2002 to 2012, more cases occurred in males than in females. From 2002 to 2012, a total of 98.5 disability-adjusted life years (DALYs) were reported because of falciparum malaria. Populations in the age ranges of 15-25 and 30-44 years had higher incidences and DALYs than other age groups. From 2002 to 2012, malaria-related costs for salaries of staff, funds from the provincial government, national government, and the GFATM were US$3.02, US$2.24, US$1.44, and US$5.08 million, respectively. An estimated 9,504 falciparum malaria cases were averted during the period 2003-2012. The estimated cost per falciparum malaria case averted was US$116.5. The falciparum malaria elimination program in Hainan was highly effective and successful. However, funding for maintenance is still needed because of imported cases.

[Levels and distribution of the dioxin-like polychlorinated biphenyls (PCBs) in the surface sediment of the Yellow River ].

The levels of DL-PCBs in the surface sediments collected in 15 different sampling sites from the Tibetan Plateau to the Yellow River estuary along the Yellow River were measured using the GC-MS. The concentrations of ∑DL-PCBs ranged from 2. 3 to 14.8 pg.g-1 and the TEQs of DL-PCBs were between 0. 001 4 and 0. 023 1 pgg-1 , with an average of 0. 007 3 pg.g-1. Compared with other domestic and foreign rivers, the DL-PCBs and TEQ levels of the Yellow River were at low levels. The main DL-PCBs congeners in the Yellow River sediments were tetra and penta chlorinated biphenyls. The DL-PCBs congener composition of rural and underdeveloped areas was similar, and there was similar congeners composition between the industry developed areas and the populous areas. Petrochemical industries and hydropower facilities may affect the distribution of DL-PCBs congener in the sediments. A significant correlation between concentrations of DL-PCBs and GDP per capita was found. It indicated that the contamination extent of DL-PCBs in the Yellow River was related with the local economic development, DL-PCBs levels in developed areas were higher than those in remote rural areas.

Upper Yellow River air concentrations of organochlorine pesticides estimated from tree bark, and their relationship with socioeconomic indices.

Organochlorine pesticide (OCP) concentrations in tree bark from the upper Yellow River region were determined. Total OCP concentrations ranged from 2.7 to 82 ng/g dw, with a mean of 20 ng/g dw. Concentrations of total (Σ) DDTs (0.49-37 ng/g dw), HCHs (0.55-4.5 ng/g dw), and HCB (0.1-1.0 ng/g dw) were much higher than the other OCPs and accounted for 89% of the ΣOCP concentrations. p,p'-DDT was the dominant member of the DDT pesticide group and ß-HCH was the dominant HCH isomer. The p,p'-DDT/p,p'-DDE and α-HCH/γ-HCH ratios suggested that there were recent DDT and γ-HCH releases. OCP concentrations in the air were estimated from the tree bark, and the estimated median ΣDDTs, ΣHCHs, and HCB concentrations in the air were 0.09, 0.14, and 0.024 pg/m(3), respectively. The relationship between total OCP concentrations and socioeconomic and natural environment indices were assessed using multiple linear regression analysis, and a regression equation including all these factors was obtained. Population density and tertiary industry were the two dominant factors that appeared to affect OCP concentrations in the upper Yellow River region.

Associations between impulsivity, aggression, and suicide in Chinese college students.

BACKGROUND: Although there are accumulating data regarding the epidemiology of suicide in China, there are meager data on suicidal ideation and attempts among college students. Interestingly, elevated impulsivity is thought to facilitate the transition from suicidal thoughts to suicidal behavior. Therefore, the objective of this research was to identify the associations between suicide and the personality factors of impulsivity and aggression. METHODS: This study's sampling method employed stratified random cluster sampling. A multi-stage stratified sampling procedure was used to select participants (n = 5,245). We conducted structured interviews regarding a range of socio-demographic characteristics and suicidal morbidity. The Patient Health Questionnaire depression module (PHQ-9) was used to acquire the information about thoughts of being better off dead or hurting themselves in some ways during the past two weeks. The impulsivity symptoms in this study were assessed with the BIS-11-CH (i.e., the Chinese version of the BIS-11), and the Aggressive symptoms were assessed with the BAQ. The statistical package for social science (SPSS) v.13.0 program (SPSS Inc., Chicago, IL, USA) was used for statistical analysis. Socio-demographic variables such as ethnic and gender were compared between groups, through the use of χ2 tests. The nonparametric test (k Independent Sample test, Kruskal-Wallis H) was performed to determine differences between the personality factors of impulsivity and aggression and suicide. RESULTS: In total, 9.1% (n = 479) of the 5,245 students reported they have ever thought about committing suicide; and 1% (n = 51) reported a history of attempted suicide (attempters). The analyses detected significant differences in scores on cognitive impulsivity (p < 0.01), when comparing individuals who only had suicidal ideation and individuals who had attempted suicide. Moreover, significant differences were found between ideators only and attempters on scores of self-oriented attack (p < .001). CONCLUSIONS: Suicidal ideation is prevalent among Chinese university students. Students with high aggression scores were more susceptible to committing suicide. Scores on self-oriented attack and cognitive impulsivity may be important factors for differentially predicting suicide ideation and suicide attempts.

Initial transcatheter thrombolysis for acute superior mesenteric venous thrombosis.

AIM: To determine the optimal initial treatment modality for acute superior mesenteric vein thrombosis (ASMVT) in patients with circumscribed peritonitis. METHODS: A retrospective review was made of the Vascular Surgery Department's medical records to identify adult patients (≥ 18 years old) presenting with circumscribed peritonitis and diagnosed with ASMVT by imaging or endoscopic examination. Patients were selected from the time period between October 2009 and October 2012 to assess the overall performance of a new first-line treatment policy implemented in May 2011 for patients with circumscribed peritonitis, which recommends transcatheter thrombolysis with local anticoagulation and endovascular mechanical thrombectomy. Of the 25 patients selected for study inclusion, 12 had undergone emergency surgical exploration (group 1) and 13 had undergone the initial catheter-directed thrombolysis (group 2). Data extracted from each patient's records for statistical analyses included method of diagnosis, symptoms, etiology and risk factors, thrombus location, initial management, morbidity, mortality, duration and total cost of hospitalization (in Renminbi, RMB), secondary operation, total length of bowel resection, duration of and findings in follow-up, and death/survival. RESULTS: The two treatment groups showed similar rates of morbidity, 30-d mortality, and 1-year survival, as well as similar demographic characteristics, etiology or risk factors, computed tomography characteristics, symptoms, findings of blood testing at admission, complications, secondary operations, and follow-up outcomes. In contrast, the patients who received the initial non-operative treatment of transcatheter thrombolysis had significantly shorter durations of admission to symptom elimination (group 1: 18.25 ± 7.69 d vs group 2: 7.23 ± 2.42 d) and hospital stay (43.00 ± 13.77 d vs 20.46 ± 6.59 d), and early enteral or oral nutrition restoration (20.50 ± 5.13 d vs 8.92 ± 1.89 d), as well as significantly less total length of bowel resection (170.83 ± 61.27 cm vs 29.23 ± 50.24 cm) and lower total cost (200020.4 ± 91505.62 RMB vs 72785.6 ± 21828.16 RMB) (P < 0.05 for all). Statistical analyses suggested that initial transcatheter thrombolysis is correlated with quicker resolution of the thrombus, earlier improvement of symptoms, stimulation of collateral vessel development, reversal of intestinal ischemia, receipt of localizing bowel resection to prevent short bowel syndrome, shorter hospitalization, and lower overall cost of treatment. CONCLUSION: For ASMVT patients with circumscribed peritonitis, early diagnosis is key to survival, and non-operative transcatheter thrombolysis is feasible and effective as an initial treatment.