Development of a Risk Assessment Model for Predicting Red Blood Cell Transfusion in Neonatal Patients.

BACKGROUND: The goal was to develop a risk assessment model for predicting red blood cell (RBC) transfusion in neonatal patients to assist hospital blood supply departments in providing small portions of RBCs to those requiring RBC transfusion on time. METHODS: Clinical information was collected from 1,201 children admitted to the neonatal unit. Clinical factors associated with predicting RBC transfusion were screened, and prediction models were developed using stepwise and multifactorial logistic regression analyses, followed by the evaluation of prediction models using receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA). RESULTS: Overall, 81 neonatal patients were transfused with RBCs, and the variables of gestational age at birth, age < 1 month, receipt of mechanical ventilation, and infant anemia were included in the final prediction model. The area under the curve of the prediction model was 0.936 (0.921 - 0.949), which was significantly higher than that of the individual indicators of gestational age at birth, age at admission < 1 month, receipt of mechanical ventilation, and infant anemia (p < 0.001). DCA showed a standardized net benefit for the possible risk of infant RBC transfusion at 0.1 - 1.0. CONCLUSIONS: We developed a risk assessment model to predict the risk of RBC transfusion in neonatal patients that can effectively assess the risk of RBC transfusion in children.

[Temporal-spatial Distribution and Health Risk Assessment of Heavy Metals in the Surface Water of Ningbo].

A total of 120 surface water samples were collected from industrial and commercial districts of Ningbo, China in the wet and dry seasons. The concentrations of six heavy metals (Cd, Cr, Ni, Pb, Zn, and Fe) in the samples were measured, the temporal-spatial distribution characteristics of the six heavy metals were analyzed, and Pearson correlation coefficients of the six heavy metals were calculated. Combined with the temporal-spatial distribution characteristics and Pearson correlation coefficients of the six heavy metals, the main pollution sources of the two districts were analyzed, respectively. The risk of heavy metals in surface water to the exposed population was evaluated by calculating the health risk index and carcinogenic risk index. The results showed that the pollution characteristics of heavy metals in the surface water of Ningbo industrial district and commercial district differed greatly in different seasons. In the industrial district, the orders of the average concentration of heavy metals in the wet season and dry season were Fe>Zn>Ni>Pb>Cr>Cd and Fe>Zn>Cr>Ni>Pb>Cd, respectively. The concentrations of Cr, Cd, and Pb in the wet and dry seasons exceeded the class Ⅳ recommended values, following the degrees of Cr>Cd>>Pb and Pb>Cr=Cd, respectively. Sewage containing heavy metals was one of the major pollution sources. In the commercial district, the average concentrations of heavy metals in the wet season and dry season were in the order of Fe>Pb>Ni>Zn>Cd>Cr and Fe>Pb>Ni>Zn>Cr=Cd, respectively. The concentrations of Cd and Pb in the wet season exceeded the corresponding levels (class Ⅳ), and the degree followed Cd>Pb. Only Pb exceeded the standard in the dry season, with the exceeding standard rate of 60%. Road pollution containing heavy metals was the major pollution source, and heavy metals entered surface water mostly with surface runoff and precipitation. The carcinogenic risk posed by heavy metals in the surface water of the Ningbo industrial district and commercial district was very high, and the carcinogenic risk in the commercial district was much higher than that in the industrial district. The main carcinogen was Cr. Compared to the research results of the research group in 2015, the pollution degree of heavy metals has been greatly reduced. In the future, we still need to give adequate attention to the prevention and control of heavy metal pollution in surface water in Ningbo.

Genetic characteristics of an amikacin-resistant Brucella abortus strain first isolated from Marmota himalayana.

Brucella spp. are facultative intracellular pathogens that can persistently colonize animal host cells and cause zoonotic brucellosis. Brucellosis affects public health and safety and even affects economic development. Our lab found that a Brucella strain isolated from Marmota himalayana exhibited amikacin resistance. To annotate and analyze the potential resistance genes in this strain, we utilized sequencing platforms in this study and cloned potential resistance genes. The findings showed that the isolated strain belonged to B. abortus biovar 1 and was similar to B. abortus 2308. The isolate had amikacin resistance genes encoding aminoglycoside 3'-phosphotransferase. Based on the results of genome analysis, the isolated strain may have obtained amikacin resistance genes from Salmonella spp. through Tn3 family transposons. Notably, this study establishes a foundation for further research on the resistance mechanism of Brucella spp. and provides data that may be useful for the prevention and control of drug-resistant Brucella strains.

Road freight emission in China: From supply chain perspective.

Freight emissions management has entered the deep-water zone. This study evaluated road freight emissions from supply chain perspective using China's 2007, 2010 and 2012 multiregional input-output table. For the first time, we quantified road freight emission based on sectors in China. Heavy industries, mining, agriculture and light industry contributed 71%,14%, 12% and 3% of total NOx emissions in 2012 from production perspective. Construction was the largest consumption sector (43%) responsible for road freight emission from consumption perspective. Upstream transport and final product transport emitted 3.04 Tg (80%) and 0.77 Tg (20%) NOx in 2012. Huge disparities of road freight emissions flows and allocation patterns were found across provinces in China in terms of resource endowments, geographical position and economic development. The road freight emission increased rapidly from 2007 to 2012, and economic growth effect outpaced emission control effect caused by emission standard upgrade and thus dominated the emission growth. The production structure and consumption pattern changes also promoted the emission growth. It is thus important to mitigate freight emissions with different strategies based on a certain sector's freight emissions features from the whole supply chain.

Induced defense and its cost in two bryophyte species.

PREMISE: Current knowledge about defense strategies in plants under herbivore pressure is predominantly based on vascular plants. Bryophytes are rarely consumed by herbivores since they have ample secondary metabolites. However, it is unknown whether bryophytes have induced defenses against herbivory and whether there is a trade-off between growth and defense in bryophytes. METHODS: In an experiment with two peatland bryophytes, Sphagnum magellanicum Brid. and S. fuscum (Schimp.) H. Klinggr., two kinds of herbivory, clipping with scissors and grazing by mealworms (Tenebrio molitor L.) were simulated. At the end of the experiment, we measured growth traits, carbon-based defense compounds (total phenolics and cellulose) and storage compounds (total nonstructural carbohydrates) of these two Sphagnum species. RESULTS: Grazing but not clipping increased total phenolics and C:N ratio and reduced biomass production and height increment. A negative relationship between biomass production and total phenolics was found in S. magellanicum but not in S. fuscum, indicating a growth-defense trade-off that is species-specific. Grazing reduced the sugar starch content of S. magellanicum and the sugar of S. fuscum. Either clipping or grazing had no effect on chlorophyll fluorescence (including actual and maximum photochemical efficiency of photosystem II) except that a significant effect of clipping on actual photochemical efficiency in S. fuscum was observed. CONCLUSIONS: Our results suggest that Sphagnum can have induced defense against herbivory and that this defense can come at a cost of growth. These findings advance our knowledge about induced defense in bryophytes, the earliest land plants.

Whole-genome sequencing of rough Brucella melitensis in China provides insights into its genetic features.

Brucella spp. can cause the zoonosis brucellosis, which affects public health and safety and even economic development. B. melitensis has a smooth phenotype, while 28 B. melitensis isolates had a rough phenotype in 2018. In this study, rough phenotype detection and whole genome sequencing methods were used to analyze the genetic features of rough B. melitensis. A drug susceptibility test was also performed. The results showed that the rough B. melitensis strains originated from strains isolated in China rather than from foreign strains. Furthermore, an MS tree showed that 9 complexes to be epidemic in China. For the rough B. melitensis strains, expression of the metabolic function genes varied in the earlier stages of evolution compared to the cellular process and signalling function genes. Expression of some transcriptional regulatory factors also varied in the later stages of evolution, and compared to MFS transporter genes, ABC transporter genes varied in the earlier stages. Moreover, as there was no significant difference in rifampicin, doxycycline and streptomycin susceptibility between the smooth and rough B. melitensis strains, treatment of brucellosis was not affected by strain type. This study provided important information for understanding the genetics and evolution of rough B. melitensis in China.

Inequality of household consumption and air pollution-related deaths in China.

Substantial quantities of air pollution and related health impacts are ultimately attributable to household consumption. However, how consumption pattern affects air pollution impacts remains unclear. Here we show, of the 1.08 (0.74-1.42) million premature deaths due to anthropogenic PM2.5 exposure in China in 2012, 20% are related to household direct emissions through fuel use and 24% are related to household indirect emissions embodied in consumption of goods and services. Income is strongly associated with air pollution-related deaths for urban residents in which health impacts are dominated by indirect emissions. Despite a larger and wealthier urban population, the number of deaths related to rural consumption is higher than that related to urban consumption, largely due to direct emissions from solid fuel combustion in rural China. Our results provide quantitative insight to consumption-based accounting of air pollution and related deaths and may inform more effective and equitable clean air policies in China.

Mercury and arsenic in the surface peat soils of the Changbai Mountains, northeastern China: distribution, environmental controls, sources, and ecological risk assessment.

The potential toxic risk of mercury (Hg) and arsenic (As) in the soils of mining regions and other artificially disturbed lands receives considerable research attention. However, limited investigation has been conducted into the surface soils of natural globally distributed ecosystems, for example peatlands. In this study, we examine the distribution, controlling factors, sources, and potential ecological risks of Hg and As in 96 samples from 42 peatlands in the Changbai Mountains of northeastern China. The results showed that average concentrations (dry weight) of Hg and As at the samples sites were 169.1 ± 0.1 µg kg-1 and 13.0 ± 7.7 mg kg-1, respectively. The distribution of Hg is largely determined by latitude and altitude, while As is controlled more by pH, total organic carbon (TOC), and ratio of TOC and nitrogen (C/N) at the regional scale. Variations in TOC, C/N ratio, and redox conditions contribute to determining the distribution of Hg, while TOC and redox conditions mainly affected the distribution of Arsenic at the local scale. Mercury mostly comes from regional atmospheric wet deposition, whereas elevated concentrations of As are related to local anthropogenic activities. Overall, Hg and As in the peatlands of the Changbai Mountains pose a moderate level of potential risk to ecological health.

Revealing the hidden health costs embodied in Chinese exports.

China emits a considerable amount of air pollutants when producing goods for export. Previous efforts have emphasized the magnitude of export-related emissions; however, their health consequences on the Chinese population have not been quantified. Here, we present an interdisciplinary study to estimate the health impact of export-related air pollution. The results show that export-related emissions elevated the annual mean population weighted PM2.5 by 8.3 µg/m(3) (15% of the total) in 2007, causing 157,000 deaths and accounting for 12% of the total mortality attributable to PM2.5-related air pollution. Compared to the eastern coastal provinces, the inner regions experience much larger export-related health losses relative to their economic production gains, owing to huge inter-regional disparities in export structures and technology levels. A shift away from emission-intensive production structure and export patterns, especially in inner regions, could significantly help improve national exports while alleviating the inter-regional cost-benefit inequality. Our results provide the first quantification of health consequences from air pollution related to Chinese exports. The proposed policy recommendations, based on health burden, economic production gains, and emission analysis, would be helpful to develop more sustainable and effective national and regional export strategies.

Examining air pollution in China using production- and consumption-based emissions accounting approaches.

Two important reasons for China's air pollution are the high emission factors (emission per unit of product) of pollution sources and the high emission intensity (emissions per unit of GDP) of the industrial structure. Therefore, a wide variety of policy measures, including both emission abatement technologies and economic adjustment, must be implemented. To support such measures, this study used the production- and consumption-based emissions accounting approaches to simulate the SO2, NOx, PM2.5, and VOC emissions flows among producers and consumers. This study analyzed the emissions and GDP performance of 36 production sectors. The results showed that the equipment, machinery, and devices manufacturing and construction sectors contributed more than 50% of air pollutant emissions, and most of their products were used for capital formation and export. The service sector had the lowest emission intensities, and its output was mainly consumed by households and the government. In China, the emission intensities of production activities triggered by capital formation and export were approximately twice that of the service sector triggered by final consumption expenditure. This study suggests that China should control air pollution using the following strategies: applying end-of-pipe abatement technologies and using cleaner fuels to further decrease the emission factors associated with rural cooking, electricity generation, and the transportation sector; continuing to limit highly emission-intensive but low value-added exports; developing a plan to reduce construction activities; and increasing the proportion of service GDP in the national economy.

Lifting China's water spell.

China is a country with significant but unevenly distributed water resources. The water stressed North stays in contrast to the water abundant and polluted South defining China's current water environment. In this paper we use the latest available data sets and adopt structural decomposition analysis for the years 1992 to 2007 to investigate the driving forces behind the emerging water crisis in China. We employ four water indicators in China, that is, freshwater consumption, discharge of COD (chemical oxygen demand) in effluent water, cumulative COD and dilution water requirements for cumulative pollution, to investigate the driving forces behind the emerging crisis. The paper finds water intensity improvements can effectively offset annual freshwater consumption and COD discharge driven by per capita GDP growth, but that it had failed to eliminate cumulative pollution in water bodies. Between 1992 and 2007, 225 million tones of COD accumulated in Chinese water bodies, which would require 3.2-8.5 trillion m(3) freshwater, depending on the water quality of the recipient water bodies to dilute pollution to a minimum reusable standard. Cumulative water pollution is a key driver to pollution induced water scarcity across China. In addition, urban household consumption, export of goods and services, and infrastructure investment are the main factors contributing to accumulated water pollution since 2000.