Risk of bleeding with dental implant surgery in patients on anticoagulant or antiplatelet drugs: a systematic review and meta-analysis.

INTRODUCTION: A large number of patients under oral anticoagulant (OAC) or antiplatelet (AP) therapy require dental implantation. We systematically reviewed evidence on the risk of bleeding after implant placement with continued OAC or AP therapy. METHODS: PubMed, Embase and CENTRAL were searched for studies comparing bleeding outcomes after implant placement between OAC/AP therapy vs. controls or OAC vs. AP therapy. RESULTS: Seven studies were included. Pooled analysis showed no significant difference in the risk of bleeding with continued OAC therapy vs. control (RR 1.81 95% confidence interval [CI] 0.70, 4.63 I2 = 14% p = .22). Subgroup analysis depending on the type of OAC showed there was a non-significant tendency of increased risk of bleeding with Vitamin K antagonists (VKAs) (RR 3.42 95% CI 1.00, 11.67 I2 = 23% p = .05) but not with direct oral anticoagulants (DOACs) (RR 1.67 95% CI 0.49, 5.70 I2 = 0% p = .41). Limited data suggest an increased risk of bleeding with OAC as compared to AP (RR 0.08 95% CI 0.01, 0.76 I2 = 0% p = .03). CONCLUSIONS: Continuation of OAC therapy in patients undergoing implant surgery does not increase the risk of bleeding provided local haemostatic measures are used. The indirect comparison suggests bleeding tendency may be higher with VKAs as compared to DOAC.

Effects of diabetes/hyperglycemia on peri-implant biomarkers and clinical and radiographic outcomes in patients with dental implant restorations: A systematic review and meta-analysis.

OBJECTIVE: The objective of this study is to systematically analyze the effects of diabetes mellitus/hyperglycemia (DM/HG) on peri-implant biomarkers and clinical and radiographic outcomes in patients undergoing implant treatment. MATERIALS AND METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched up to March 2022. Studies reporting on peri-implant biomarkers, and clinical and radiographic outcomes in patients with different glycemic status levels (HbA1c) were included. Several analyses were conducted, such as meta-analysis, sensitivity analysis, dose-response meta-analysis (DRMA), and robust error meta-regression (REMR). RESULTS: A total of 10 studies and 634 participants were included for analysis, with a maximum follow-up of six years in function. The level of advanced glycation end products (AGEs) in peri-implant crevicular fluid (PICF) was significantly higher in the DM/HG group than in the healthy group (p < .01). Subgroup analyses showed that a set of negative regulators of bone metabolism (including IL-6, TNF-α, IL-8, and RANKL) were significantly higher in the DM/HG group (p = .01). Implant survival rate (100%) was not compromised in patients with an HbA1c level less than 10%. Outcomes of implant stability quotient (ISQ) values, bleeding on probing rate (BOP%), probing depth (PD), and marginal bone loss (MBL) in the DM/HG group were significantly worse than those in the healthy group (p = .04, <0.01, 0.01, <0.01, respectively). DRMA results showed AGE accumulation in PICF, PD, and MBL worsened in a dose-response dependent manner with elevated HbA1c levels (<6%, 6-8%, >8%; p = .04, 0.02, <0.01, respectively). CONCLUSIONS: DM/HG can upregulate negative regulators of bone metabolism and compromise peri-implant health. In addition, there are dose-response relationships between HbA1c levels and AGE accumulation in PICF, PD, and MBL.

How to reconcile land use conflicts in mega urban agglomeration? A scenario-based study in the Beijing-Tianjin-Hebei region, China.

With the development of global urbanization, land use conflicts have become one of the major issues hindering sustainable land use and human-environment coordination in urbanized areas. In this context, reconciliation of land use conflicts requires urgent attention. By taking the Beijing-Tianjin-Hebei (BTH) urban agglomeration as a case study area, the spatial comprehensive conflict index (SCCI) was constructed to identify and evaluate land use conflicts. Besides, the impacts of rapid urbanization and terrain restriction on land use conflicts were also explored using the coupling coordination degree (CCD) model and terrain index, respectively. Then, the Dyna-CLUE model was adopted to simulate land use conflicts under three adaptive scenarios in 2030. Results show that: (1) During 2000-2015, land use conflicts in the BTH region demonstrated an overall mitigating trend, and their spatial patterns remained relatively stable, characterized by significant cluster and belt agglomeration. (2) Land use conflicts were significantly intensified in areas experiencing rapid urban-rural transformation and terrain transition, and two typical conflict zones were identified, i.e. the urban-rural interface of the Beijing-Tianjin region and the terrain transition area located in the Taihang Mountains, Yan Mountains and Bashang Plateau. (3) In 2030, land use conflicts in the BTH region manifest overall mitigation under the ecological security (ES) scenario, while demonstrating an intensifying trend under the business as usual (BAU) scenario and cropland protection (CP) scenario. Based on simulation results, land use spatial optimization modes at county level for the BTH region were formulated. In face of increasingly prominent land use conflicts globally, this study will provide a scientific reference for policymaking in pursuit of sustainable land use management for the BTH region and urban agglomerations in other parts of the world.

Exploring the eco-efficiency of cultivated land utilization and its influencing factors in China's Yangtze River Economic Belt, 2001-2018.

Rapid urbanization in China has worsened the sustainable utilization of limited cultivated land resources, which seriously threatens food security and ecological security. To realize maximum benefits and minimize environmental pollution, the eco-efficiency of cultivated land utilization (ECLU) is becoming a vital indicator in weighing the rationality of regional land use. However, conceptualization of the ECLU remains lacking, while assessments of this indicator are still incomplete. This lack of information may inhibit planning guideline for the sustainable development of cultivated land resources. Thus, this study attempts to fill this gap by customizing a new conceptual index system for the ECLU and measuring it using the slack-based measure with undesirable output (SBM-Undesirable) model in the Yangtze River Economic Belt (YREB) during the period 2001-2018. Spatial econometric models were used to further analyze the influencing factors of the ECLU. The average ECLU value in the YREB declined from 2001 to 2004, and then rapidly trended upward in 2005-2018. The lower reaches had the highest efficiency, followed by the middle and upper reaches, with respective values of 0.494, 0.628, and 0.683. The spatial-temporal pattern of the ECLU reveals that the number of areas with low and medium-low efficiency decreased gradually, while the number of areas with medium-high and high efficiency increased continuously. The magnitude and direction of influencing factors indicates that socioeconomic development level, agricultural science and technology investments, carbon emission reducing, and agricultural pollution control could effectively improve the ECLU. These findings have important implications for promoting high-efficient, low-carbon utilization of cultivated land resources and sustainable regional development in China.

Assessment and analysis of agricultural non-point source pollution loads in China: 1978-2017.

China's successful agriculture development has resulted in public concerned environmental problems. However, continuous and detailed data about Chinese agricultural non-point source pollution (ANPSP) loads are lacking. To assess and analyze Chinese ANPSP loads from 1978 to 2017, an inventory analysis was performed, and a socioeconomic and spatiotemporal analysis in the scale of provinces was conducted. The results showed that the pollution loads of chemical oxygen demand (COD), total nitrogen (TN) and total phosphorus (TP) increased by 91.0%, 196.2% and 244.1%, respectively, and their variation underwent a free development stage, reform promotion stage, market regulation stage and policy incentive stage. The results of the pollution source analysis showed that over the past 40 years, the total percent contribution to COD by livestock and poultry breeding (LPB) and rural household waste (RHW) accounted for 83.1%-96.6%, the total percent contribution to TN by mineral fertilizers (MF) and LPB accounted for 72.3%-80.8%, and the total percent contribution to TP by LPB, RHW and MF accounted for 69.1%-88.6%. In addition, Shandong, Guangdong, Sichuan, and Henan were the top producers of ANPSP loads, and their COD, TN, and TP loads accounted for approximately 32%, 30%, and 35% of the national totals, respectively. The discharge intensity of COD, TN and TP decreased by 79.2%, 67.8%, and 62.6%, respectively. The discharge intensity exhibited a phasic feature that aligned with the national economic plan in the temporal scale and was closely related to the agricultural conditions in the spatial scale.

Antitumor activity of recombinant RGD-IFN-α2a-core fusion protein in vitro.

Interferon (IFN) regulates immune responses and antitumor activity. Arginine-glycine-aspartic acid (RGD) peptides can specifically bind to integrin αvß3, a transmembrane receptor that is highly expressed on the surface of various cancer cells. In this study, we expressed recombinant RGD-IFN-α2a-core fusion proteins and assessed their antitumor activity in vitro. Two RGD-IFN-α2a-core fusion proteins and a negative control protein were expressed in vitro. These two RGD-IFN-α2a-core fusion proteins could bind the tumor cell surface specifically and did not bind to normal cells. RGD-IFN-α2a-core fusion protein treatment of tumor cells significantly reduced cell viability and induced apoptosis in a dose-dependent manner. At the 'mRNA' level, both proteins could upregulate CASP3 expression. These data indicate that both laboratory-engineered RGD-IFN-α2a-core fusion proteins could bind the surface of tumor cells and induce apoptosis in vitro. Further studies will investigate the in-vivo antitumor activities of the RGD-IFN-α2a-core fusion proteins.

Intermediate-volatility aromatic hydrocarbons from the rubber products industry in China.

As key components of intermediate-volatility organic compounds (IVOCs), intermediate-volatility aromatic hydrocarbons (IAHs) are important precursors of ozone and secondary organic aerosol (SOA). Rubber products (RP) industry has significant influence on ozone and SOA formation, yet few studies are available to characterize their emissions of IAHs. Here we conducted measurements of IAHs emitted from rubber products (RP) factories in China. Tens of C10-C12 IAH species were identified with C10H14-AH (such as tetramethyl benzene) and naphthalene (C10H8) as the dominant species, accounting for 57.0 % - 100.0 % of total IAHs emissions. On average, IAHs showed higher concentrations (1.1 × 102-1.2 × 103 µg m-3) in mixing, extrusion, painting, crushing, and grinding processes than those (8.2-14 µg m-3) in vulcanization and gumming processes as well as warehouse. Moreover, IAHs concentrations were 1.3-1.7 times of volatile aromatic hydrocarbons (VAHs; C6-C9 aromatics) in the emissions from mixing, extrusion, crushing and grinding processes. The average IAHs to volatile organic compounds (VOCs) ratios also showed relatively higher values (0.1-0.7) in these processes, which were significantly higher than those of 0.01-0.03 observed in other industries, and even comparable to the IVOCs to VOCs ratio of 0.2 used for estimating solvent-related emission. The ozone and SOA formation potential values of IAHs were 1.1-2.6 times and 0.9-3.9 times those of VAHs, respectively, and were 0.5-1.0 times and 0.9-1.9 times those of total VOCs in emissions of mixing, extrusion, crushing, and grinding processes of the RP industry. The total emission of IAHs was estimated to be 115.8 Gg from the RP industry in China, which could account for 64.5 % of total IAH emissions from all industrial sectors. This study further suggests that the RP industry might be an important emission source of IAHs with substantially higher ozone and SOA formation potentials.

Spatial-temporal evolution of agricultural ecological risks in China in recent 40 years.

Excessive use of agricultural chemicals and unreasonable utilization of agricultural wastes have led to severe agricultural non-point source pollution (ANPSP) problems in China. Based on the agricultural pollution loads and pollution control strength, the ecological risk index (ERI) was constructed and was used to explore the spatial-temporal pattern of agricultural ecological risks in China during 1978-2017. The findings indicated that Chinese agricultural ERI was gradually increased from 0.031 to 0.348 in 1978-2017, which has the same phased change characteristics as the succession of agricultural policies. At present, the ecological risk grade of ANPSP was present in the stair-step distribution characteristics of "high in the east and south and low in the west and north" as a whole. Southern China, as the main producing area of aquatic products, had the higher ecological risks. Northeastern China, the Huang-Huai-Hai Area, and the middle and lower reaches of the Yangtze River, as the grain-producing bases, had moderate ecological risks, but Southwestern China and Northwestern China with the poor agricultural production conditions had the lower ecological risks. It evidently showed that the ecological risk problems faced by the high-quality development of Chinese agricultural industrialization are increasingly severe.

Talin2 regulates invasion of human breast cancer MDA-MB-231 cells via alteration of the tumor microenvironment.

The talin proteins are a key component of the extracellular matrix-integrin-cytoskeleton system, and our previous study suggested that talin2 contributes to the tumor invasion and metastasis processes regulated by the tumor microenvironment. In the present study, the specific effects of talin2 on the invasive ability of breast cancer cells, as well as the underlying mechanism, were investigated by creating two MDA-MB-231 cell lines with stable talin2 knockdown by specific RNA interference. Initially, it was confirmed that the expression levels of talin2 in human breast cancer tissues were upregulated compared with in normal adjacent tissues. Subsequently, invasion and wound healing assays revealed that depletion of talin2 in MDA-MB-231 cells decreased their migratory and invasive abilities. Western blot analysis demonstrated that knockdown of talin2 in MDA-MB-231 cells caused marked downregulation of the tumor microenvironment markers hypoxia-inducible factor 1α, phosphorylated ribosomal protein S6 kinase, phosphorylated protein kinase B and phosphorylated mechanistic target of rapamycin. Furthermore, knockdown of talin2 decreased the basal contents of glucose and lactic acid in the breast cancer cell line. In conclusion, the findings of the present study demonstrated that talin2 knockdown may inhibit the invasive ability of human breast cancer MDA-MB-23l cells via alterations in the tumor microenvironment.

A novel and efficient synthetic route to perfluoroisobutyronitrile from perfluoroisobutyryl acid.

A novel synthetic route to perfluoroisobutyronitrile from perfluoroisobutyryl acid which has mild conditions and low toxicity is described. This study introduces detailed synthetic protocols and characterization including GC-MS, 13C NMR and 19F NMR spectroscopy of perfluoroisobutyryl acid, perfluoroisobutyryl chloride, perfluoroisobutyl amide and perfluoroisobutyronitrile. Besides, this route is superior to the established patent and shows potential application in high voltage electrical equipment.

Real time analysis of lead-containing atmospheric particles in Beijing during springtime by single particle aerosol mass spectrometry.

Using a single particle aerosol mass spectrometer (SPAMS), the chemical composition and size distributions of lead (Pb)-containing particles with diameter from 0.1 µm to 2.0 µm in Beijing were analyzed in the spring of 2011 during clear, hazy, and dusty days. Based on mass spectral features of particles, cluster analysis was applied to Pb-containing particles, and six major classes were acquired consisting of K-rich, carboneous, Fe-rich, dust, Pb-rich, and Cl-rich particles. Pb-containing particles accounted for 4.2-5.3%, 21.8-22.7%, and 3.2% of total particle number during clear, hazy and dusty days, respectively. K-rich particles are a major contribution to Pb-containing particles, varying from 30.8% to 82.1% of total number of Pb-containing particles, lowest during dusty days and highest during hazy days. The results reflect that the chemical composition and amount of Pb-containing particles has been affected by meteorological conditions as well as the emissions of natural and anthropogenic sources. K-rich particles and carbonaceous particles could be mainly assigned to the emissions of coal combustion. Other classes of Pb-containing particles may be associated with metallurgical processes, coal combustion, dust, and waste incineration etc. In addition, Pb-containing particles during dusty days were first time studied by SPAMS. This method could provide a powerful tool for monitoring and controlling of Pb pollution in real time.

Development of a time-resolved fluoroimmunoassay of CFP-10 for rapid diagnosis of tuberculous pleural effusion.

Tuberculous pleural effusion is the second most common form of extrapulmonary tuberculosis, which is very difficult to rapidly distinguish from malignant pleural effusion in the clinical setting. A time-resolved fluoroimmunoassay (TRF) of CFP-10, a low molecular weight protein secreted by pathogenic Mycobacterium tuberculosis, was developed to differentiate tuberculous pleural effusion from malignant one. The measuring range was 0.3-187.5 ng/ml with the dose-response coefficient of 0.9998 and detection limit of 0.036 ng/ml. The intra-assay and inter-assay coefficients of variation were 3.6-9.2% and 10.0-12.4%, respectively. The concentration of CFP-10 in malignant pleural effusion was less than 0.8 ng/ml. The negative predictive value was 93.1% in malignant pleural effusion (n = 247) while the positive predictive value was 83.0% in tuberculous pleural effusion (n = 235). Moreover, there was a statistically significant difference in the CFP-10 concentration of pleural effusion between the groups before and after clinical therapy of tuberculosis (P < 0.001, n = 81). In addition, the stability of the diagnostic reagents lasted at least 1 year at 4 °C. Therefore, the TRF of CFP-10 may be used for the rapid diagnosis of tuberculous pleural effusion and further monitoring the clinical therapeutic efficacy of tuberculosis.

[Land layout for lake tourism based on ecological restraint].

To avoid the decrease and deterioration of lake wetlands and the other ecological issues such as lake water pollution that were caused by the unreasonable exploration of lake tourism, a land layout for the tourism development of Liangzi Lake with the priority of ecological security pattern was proposed, based on the minimal cumulative resistance model and by using GIS technology. The study area was divided into four ecological function zones, i. e., core protection zone, ecological buffer zone, ecotone zone, and human activity zone. The core protection zone was the landscape region of ecological source. In the protection zone, new tourism land was forbidden to be increased, and some of the existing fundamental tourism facilities should be removed while some of them should be upgraded. The ecological buffer zone was the landscape region with resistance value ranged from 0 to 4562. In the buffer zone, expansion of tourism land should be forbidden, the existing tourism land should be downsized, and human activities should be isolated from ecological source by converting the human environment to the natural environment as far as possible. The ecotone zone was the landscape region with resistance value ranged from 4562 to 30797. In this zone, the existing tourism land was distributed in patches, tourism land could be expanded properly, and the lake forestry ecological tourism should be developed widely. The human activity zone was the landscape region with resistance value ranged from 30797 to 97334, which would be the key area for the land layout of lake tourism. It was suggested that the land layout for tourism with the priority of landscape ecological security pattern would be the best choice for the lake sustainable development.

[Preparation and characterization of reference samples of Mycobacterium tuberculosis culture filtrate protein-10 for time-resolved fluoroimmunoassay].

OBJECTIVE: To prepare reference samples of Mycobacterium tuberculosis culture filtrate protein-10 (CFP-10) and CFP10-streptavidin fusion proteins (CFP10/SA) for time-resolved fluoroimmunoassay (TRFIA). METHODS: The CFP10 gene was amplified by PCR from Mycobacterium tuberculosis strain H37Rv and cloned into pET24b, pET24b-streptavidin (SA) or pET21a-SA expression vectors. The recombinant proteins CFP10, CFP10-SA and SA-CFP10 were expressed in Rosetta cells, purified via nickel affinity chromatography and refolded by dialysis. The sensitivity and stability of the resultant proteins as reference samples were evaluated by double-antibody sandwich TRFIA. RESULTS: CFP10-SA and SA-CFP10 fusion proteins were expressed as inclusion bodies, whereas CFP10 was expressed in a soluble form. The resultant purity of the 3 recombinant proteins all exceeded 95%. TRFIA results showed that CFP-SA fusion protein possessed the best sensitivity (0.02 µg/L) and stability. CONCLUSION: The reference samples of CFP10 for TRFIA detection have been successfully prepared and can be used in the development of a diagnostic kit for Mycobacterium tuberculosis.

Evaluation of medical treatment for peripheral arterial disease in Chinese high-risk patients.

BACKGROUND: Peripheral arterial disease (PAD) is an important manifestation of systemic atherosclerosis and is associated with elevated cardiovascular morbidity and mortality. The aim of the present study was to evaluate the use of antiplatelet agents, statins and angiotensin-converting enzyme inhibitors (ACEI) in Chinese high-risk cardiovascular (CV) patients with PAD, with an emphasis on the need for aggressive medical management of all atherosclerotic manifestations. METHODS AND RESULTS: Medical records from 5,263 Chinese patients at high risk of CV were evaluated for the use of antiplatelet agents, statins and ACEI in patients with and without PAD. PAD was defined as an ankle-brachial index (ABI)<0.9 in either leg. Multivariable logistic regression analyses were performed to compare medication use in the 2 groups. A total of 5,254 patients were analyzed (52.9% male, mean age 67.3 years). The prevalence of PAD in the total patient group was 25.4%; 22.5% of them had PAD only. Overall, 5.7% had PAD only, 19.6% had PAD and coronary heart disease (CHD) or stroke or diabetes, 7.7% had CHD only, 12.6% had stroke only, and 13.6% had diabetes only. The 28.9% subjects having none of PAD, CHD, stroke or diabetes were used as the reference group. Only 65%, 37% and 47% of all patients received antiplatelet agents, statins and ACEI, respectively. Antiplatelets, statins, ACEI and all 3 medications were used less frequently in PAD only patients (58.1%, 35.9, 53.5% and 21.6%) vs CHD only (90.9%, 74.5%, 70.6% and 55.9%, p<0.001). All 3 proven efficacious therapies were prescribed for only 56% of patients with CHD only, 8% with stroke only, 13% with diabetes only and 21% with PAD only. CONCLUSION: PAD is prevalent in Chinese high-risk CV patients, equivalent to CHD, but these patients receive less intensive treatment than those with CHD. Programs to improve CV risk reduction in these high-risk patients are needed.