RESUMEN
Anthropogenic emissions of reactive nitrogen (Nr) result in adverse impacts on the ecosystems. Nowhere has that threat been more challenging than in rapidly urbanized China, the world's largest anthropogenic Nr producer. The Nanjing Declaration in 2004 called for global reductions in Nr emissions. To assess China's progress, multisource Nr emissions were evaluated with a quantitative method from 2004 to 2014. The results showed that national Nr emissions had increased with fluctuation over this period, 55-59% of the total Nr emissions were emitted to the atmosphere, and that agricultural production still was the biggest contributor (62-69%). The hotspots were mainly located in the developed and coastal regions that also have high population densities. Urbanization was associated with overall decreases in agricultural Nr emission and increases in industrial and residential Nr emissions. The overall increase in residential Nr emission per capita played a large role in driving the growth of national Nr emission. Continuing urbanization poses a significant challenge to future Nr mitigation for ecosystem sustainability and a range of strategies, covering improvement of N-use efficiency, slowdown of Western China's urbanization, and promotion of low N intensive lifestyle, are proposed that can promote Chinese low-nitrogen development.
RESUMEN
OBJECTIVE: To review the currently available information on atovaquone-proguanil for treatment and prophylaxis of malaria. DATA SOURCES: A MEDLINE search was conducted from 1966 to February 2003 using key phrases Malarone, atovaquone, proguanil, and malaria. Further articles were identified from a manual search of the references of identified articles. STUDY SELECTION AND DATA EXTRACTION: English-language studies with animal and human data evaluating preclinical pharmacology, human studies on pharmacokinetics, and clinical trials were evaluated. Relevant data were extracted from identified articles. DATA SYNTHESIS: Atovaquone-proguanil has been evaluated for treatment of acute, uncomplicated malaria caused by Plasmodium falciparum in 8 clinical trials. In these studies, treatment with atovaquone-proguanil led to a higher (87-100% vs. 72-88%) or equally effective (94-100% vs. 90-100%) cure rate than the comparator antimalarial agents. Atovaquone-proguanil has been evaluated for prophylaxis of malaria in 6 clinical trials. In the 4 placebo-controlled trials for semi-immune residents or nonimmune migrants, the prophylaxis success rates in the atovaquone-proguanil and placebo arms ranged from 98% to 100% and 48% to 82%, respectively. The prophylaxis with success rates were similar among the 2 arms when atovaquone-proguanil was compared with other antimalarial regimens in nonimmune travelers. Atovaquone-proguanil was well tolerated in these clinical trials. CONCLUSIONS: Atovaquone-proguanil is a safe and effective alternative to current recommended regimens for prophylaxis and treatment of malaria.
