Distinct Clinicopathological Features and Prognostic Values of High-, Low-, or Non-Expressing HER2 Status in Colorectal Cancer.

The encouraging effects of HER2-ADC in patients with HER2-low expression cancers indicated the classical classifications based on positive and negative HER2 might no longer be suitable. However, the biology and prognosis of colorectal cancer patients with different HER2 expression status were still not clear. This is a multi-center retrospective study that included patients with histologically confirmed colorectal cancer and determined HER2 status who received radical surgical resection. HER2 immunohistochemistry (IHC) 1+ and IHC 2+ groups were combined and defined as a HER2-low group because of the concordance of clinicopathological characteristics. As compared with the HER2-high group, both the HER2-zero and the HER2-low group had less tumor with perineural invasion (14.3%, 13.1% vs. 31.6%, p = 0.001 and p < 0.001), less stage III disease (41.8%, 39.9% vs. 56.1%, p = 0.044 and p = 0.022), more RAS/BRAF mutation (52.1%, 49.9% vs. 19.5%, p < 0.001 and p < 0.001) and better disease-free survival (DFS) (3y-DFS rate of 78.7%, 82.4% vs. 59.3%, p < 0.001 and p < 0.001). Multivariate analysis and propensity score matching also revealed that HER2-high expression was an independent prognostic factor of DFS. In conclusion, our study revealed that HER2-low colorectal cancer tumors are close to HER2-zero tumors, but different from HER2-high tumors. The routine examination of HER2 IHC is needed in early-stage colorectal cancer.

Coupling coordination degree for urban green growth between public demand and government supply in urban agglomeration: A case study from China.

The public demand for urban green growth (UGG) varies greatly due to climate conditions, resource endowments, geographical location; thus, understanding the coupling relationship between public demand and government supply is important to optimize government investment. This paper aims to evaluate the coupling coordination of UGG between public demand and government supply. An index system consisting of six aspects, including environment, society, economy, population, production and life, was used to evaluate the government supply. Meanwhile, citizens' demand was measured by the satisfaction for the six aspects. The coupling coordination degree model (CCDM) was established to analyze the government supply and public demand for UGG, and it was tested in the case of Shandong Peninsula urban agglomeration in China. The results indicated that citizens of Shandong Peninsula are basically satisfied, and the satisfaction for the environment, population and life is higher than the average value. From 2015 to 2019, the government supply level shows a trend of rising first and then declining, of which environment has been always at a high level for the five years. The coupling coordination degree of UGG shows the supply and demand in different cities of urban agglomerations is unbalanced, and the overall value of the eastern coast is higher than that of the western inland area. Moreover, the concept of relative satisfaction was put forwards, which is of great significance for regional policy. To improve UGG for a city, determining optimization objectives base on their evaluation results of coupling coordination degree and relative satisfaction is important, as well as the possible external reasons for the low coupling coordination degree.

Ensuring food security with lower environmental costs under intensive agricultural land use patterns: A case study from China.

Rapid population growth and environmental deterioration make ensuring food security with lower environmental costs fundamental to realizing sustainable development in China and other developing countries. The conceptual framework used in this paper integrates the major consequences of intensive agricultural land use and the diverse objectives of policymakers and farmers. It also offers an operational approach, based on farmers' diverse performance in grain production and farmland productivity, to assess food production and environmental impacts under foci-differentiated scenarios. Using data from farmer household surveys, soil surveys, land use images, and statistical yearbooks, this approach was tested using a regional case in China. The results indicate that, among all farmer types, the medium-scale farmers had a better comprehensive performance for grain production for yield, fertilizer and pesticide inputs, labor productivity, and sustainability. Therefore, grain yields can be increased and environmental costs reduced simultaneously through the use of policy instruments that encourage the transformation of trapped farmers into medium-scale farmers and balancing the proportion of single and double cropped rice. In addition, and in order to reduce grain losses caused by natural disasters and to prevent environmental degradation, robust policy measures should be developed to avoid the currently predominant cropping patterns that erode biodiversity.

Assessing the impacts of the changes in farming systems on food security and environmental sustainability of a Chinese rural region under different policy scenarios: an agent-based model.

Since China has undergone a series of economic reforms and implemented opening up policies, its farming systems have significantly changed and have dramatically influenced the society, economy, and environment of China. To assess the comprehensive impacts of these changes on food security and environmental sustainability, and establish effective and environment-friendly subsidy policies, this research constructed an agent-based model (ABM). Daligang Town, which is located in the two-season rice region of Southern China, was selected as the case study site. Four different policy scenarios, i.e., "sharply increasing" (SI), "no-increase" (NI), "adjusted-method" (AM), and "trend" (TD) scenarios were investigated from 2015 to 2029. The validation result shows that the relative prediction errors between the simulated and actual values annually ranged from -20 to 20%, indicating the reliability of the proposed model. The scenario analysis revealed that the four scenarios generated different variations in cropping systems, rice yield, and fertilizer and pesticide inputs when the purchase price of rice and the non-agricultural income were assumed to increase annually by 0.1 RMB per kg and 10% per person, respectively. Among the four different policy scenarios in Daligang, the TD scenario was considered the best, because it had a relatively high rice yield, fairly minimal use of fertilizers and pesticides, and a lower level of subsidy. Despite its limitations, ABM could be considered a useful tool in analyzing, exploring, and discussing the comprehensive effects of the changes in farming system on food security and environmental sustainability.

Assessing the effects of rural livelihood transition on non-point source pollution: a coupled ABM-IECM model.

Water pollution caused by anthropogenic activities and driven by changes in rural livelihood strategies in an agricultural system has received increasing attention in recent decades. To simulate the effects of rural household livelihood transition on non-point source (NPS) pollution, a model combining an agent-based model (ABM) and an improved export coefficient model (IECM) was developed. The ABM was adopted to simulate the dynamic process of household livelihood transition, and the IECM was employed to estimate the effects of household livelihood transition on NPS pollution. The coupled model was tested in a small catchment in the Dongting Lake region, China. The simulated results reveal that the transition of household livelihood strategies occurred with the changes in the prices of rice, pig, and labor. Thus, the cropping system, land-use intensity, resident population, and number of pigs changed in the small catchment from 2000 to 2014. As a result of these changes, the total nitrogen load discharged into the river initially increased from 6841.0 kg in 2000 to 8446.3 kg in 2004 and then decreased to 6063.9 kg in 2014. Results also suggest that rural living, livestock, paddy field, and precipitation alternately became the main causes of NPS pollution in the small catchment, and the midstream region of the small catchment was the primary area for NPS pollution from 2000 to 2014. Despite some limitations, the coupled model provides an innovative way to simulate the effects of rural household livelihood transition on NPS pollution with the change of socioeconomic factors, and thereby identify the key factors influencing water pollution to provide valuable suggestions on how agricultural environmental risks can be reduced through the regulation of the behaviors of farming households in the future.

Risk assessment for sustainable food security in China according to integrated food security--taking Dongting Lake area for example.

Integrated food security covers three aspects: food quantity security, food quality security, and sustainable food security. Because sustainable food security requires that food security must be compatible with sustainable development, the risk assessment of sustainable food security is becoming one of the most important issues. This paper mainly focuses on the characteristics of sustainable food security problems in the major grain-producing areas in China. We establish an index system based on land resources and eco-environmental conditions and apply a dynamic assessment method based on status assessments and trend analysis models to overcome the shortcomings of the static evaluation method. Using fuzzy mathematics, the risks are categorized into four grades: negligible risk, low risk, medium risk, and high risk. A case study was conducted in one of China's major grain-producing areas: Dongting Lake area. The results predict that the status of the sustainable food security in the Dongting Lake area is unsatisfactory for the foreseeable future. The number of districts at the medium-risk range will increase from six to ten by 2015 due to increasing population pressure, a decrease in the cultivated area, and a decrease in the effective irrigation area. Therefore, appropriate policies and measures should be put forward to improve it. The results could also provide direct support for an early warning system-which could be used to monitor food security trends or nutritional status so to inform policy makers of impending food shortages-to prevent sustainable food security risk based on some classical systematic methods. This is the first research of sustainable food security in terms of risk assessment, from the perspective of resources and the environment, at the regional scale.