Impacts of pilot carbon emission trading policies on urban environmental pollution: Evidence from China.

The trading of carbon emissions is a crucial regulatory method to address environmental pollution issues. This study takes China's carbon emission trading pilot policy established in 2013 as a quasi-natural experiment and uses the DID model to empirically test the urban panel data from 2006 to 2019. The results show that the carbon emission trading pilot policy can effectively reduce urban environmental pollution, and this effect is more noticeable in mid-western cities, northern cities, cities with fewer resources, and large-scale cities. In addition, to address the urban environmental pollution problem through this policy, the government is encouraged to raise its environmental protection awareness and put more effort into the innovation of technology. In general, this study uses carbon emission trading policies from China to confirm that market-based incentive environmental regulation tools can effectively reduce environmental pollution in urban areas. These findings can provide more theoretical support and empirical evidence for the government to use mechanisms of the market to effectively solve pollution problems, improve ecological environment quality, and accelerate the realization of green economy.

Large Ascending Aortic Pseudoaneurysm with Focal Dissection after Coronary Artery Bypass Surgery.

Background There are many known complications that occur after surgical revascularization for patients with significant left main coronary artery disease. Case Description This case report highlights the preoperative workup, surgical approach, and postoperative management of a patient who presents with an aortic pseudoaneurysm and dissection 2 years after the index CABG. Conclusion The development of an aortic pseudoaneurysm in combination with an ascending aortic dissection after prior coronary artery bypass grafting (CABG) is a rare compilation of complications that has scarcely been reported in the literature.

How to implement a clinical robotic mitral valve surgery program.

Minimally invasive, specifically, robot-assisted mitral valve surgery has evolved as a method to intervene on mitral valve disease without a median sternotomy while providing the advantages of excellent visualization and allowing for precise technical movements in a small space with the goal to decrease surgical invasiveness, post-operative pain, and hospital length of stay. As patient interest in minimally invasive cardiac procedures become more prevalent and patients seek the opportunity to undergo robotic valve surgery, institutions worldwide are exploring the potential of establishing a robotic mitral valve surgery program. While robust existing experience in open surgical mitral valve repair, careful patient selection, a dedicated team, and institution support are fundamental factors to implement a new robotic mitral valve surgery program, we believe that simulation team training prior to transitioning to live cases is also crucial and should be incorporated to establish a successful mitral valve surgery program.

Six Sigma Methodology and Postoperative Information Reporting: A Multidisciplinary Quality Improvement Study With Interrupted Time-Series Regression.

OBJECTIVE: The postoperative handover is often compromised by reporting inconsistencies between different specialties. We describe a multidisciplinary quality improvement initiative to improve postoperative information reporting. DESIGN: A quality improvement project with interrupted time-series data collection was undertaken in the postanesthesia care unit between January 2015 and August 2015. We utilized Six Sigma methodology to engage multispecialty stakeholders in identifying deficiencies in the existing postoperative handover process in January 2015. A standardized handover process including a checklist and electronic handover note was implemented within a postanesthesia care unit in June 2015. Direct observations of handovers were conducted to determine reporting accuracy, handover duration, and specialty representative attendance. Segmented linear and logistic regression analyses were used for interrupted time-series data. SETTING: Single postanesthesia care unit at an academic tertiary referral center. PARTICIPANTS: Physician trainees in anesthesia (n = 82) and surgical subspecialties (n = 139), certified registered nurse anesthetists (n = 57), and recovery room registered nurses (n = 139). RESULTS: Cumulative handover scores increased by 18.3 points in the postimplementation period (n = 70) when compared to preimplementation handovers (n = 69), a finding which remained statistically significant after adjusting for preintervention time trends (difference 16 points; 95% confidence intervals 3-31; p = 0.021). No statistically significant difference in handover duration was seen between cohorts (6.8 minutes vs 6.1 minutes, difference 0.5 minutes; 95% confidence intervals -2.8 to 3.7; p = 0.78). Three years postimplementation, there was consistent use of a modified electronic handover note and surgical subspecialty attendance during handover. CONCLUSIONS: A standardized handover process was associated with improved information reporting among different surgical disciplines without significantly lengthening handover duration.

An electronic handoff tool to facilitate transfer of care from anesthesia to nursing in intensive care units.

Checklists are commonly used to structure the communication process between anesthesia nursing healthcare providers during the transfer of care, or handoff, of a patient after surgery. However, intraoperative information is often recalled from memory leading to omission of critical data or incomplete information exchange during the patient handoff. We describe the implementation of an electronic anesthesia information transfer tool (T2) for use in the handover of intubated patients to the intensive care unit. A pilot observational study auditing handovers against a pre-existing checklist was performed to evaluate information reporting and attendee participation. There was a modest improvement in information reporting on part of the anesthesia provider, as well as team discussions regarding the current hemodynamic status of the patient. While T2 was well-received, further evaluation of the tool in different handover settings can clarify its potential for decreasing adverse communication-related events.

Respiratory and Swallowing Outcomes Based on Aneurysm Location in 360 Patients with Subarachnoid Hemorrhage.

INTRODUCTION: Aneurysmal subarachnoid hemorrhage (aSAH) may result in abnormal respiratory and swallowing function. We analyzed factors that may influence long-term respiratory and swallowing function in aSAH patients and compared patients with anterior and posterior aneurysm locations. METHODS: We retrospectively reviewed 360 consecutive aSAH patients. We recorded location of the aneurysm and respiratory indices on admission, in-hospital adverse respiratory events, and the need for tracheostomy (for respiratory failure) or percutaneous endoscopic gastrostomy (PEG) tube (for prolonged dysphagia). Respiratory and swallowing function was also reviewed at 1 year and at most recent clinical follow-up. RESULTS: Aneurysms consisted of 293 described as anterior circulation (81.4%) and 67 described as posterior circulation (18.6%), including 31 patients with basilar artery aneurysms and 16 with posterior inferior cerebellar artery (PICA) aneurysms. There were no differences in oxygen saturation or PaO2:FiO2 ratio on admission, though patients with PICA aneurysms presented significantly more commonly with endotracheal intubation. PICA aneurysm patients had higher rates of tracheostomy and PEG tube dependence at 1 year in univariate analysis. Higher Hunt-Hess grade was a predictor of pneumonia and prolonged intubation, whereas older age and prolonged hospitalization were predictors of PEG placement in multivariate analysis. CONCLUSIONS: Ruptured anterior and posterior circulation aneurysms have similar rates of in-hospital respiratory and swallowing dysfunction. There was a higher rate of swallowing dysfunction in the posterior circulation aneurysm group compared with the anterior group at most recent follow-up (12% vs. 2%, P = 0.035). Patients with PICA aneurysms demonstrated higher rates of tracheostomy and PEG, though the latter did not achieve statistical significance.

[Study on the relationship between body mass index and risk factors of chronic diseases of Beijing urban residences].

UNLABELLED: This study aimed to analysis the relationship among body mass index (BMI) and waist circumference (WC) with chronic diseases risk factors--serum total cholesterol (TC), triglyceridaemia(TG), high density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), systolic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of chronic diseases. The data was collected from 1995 to 1998 in the study of community base integrated intervention of non-communicable chronic diseases. RESULTS: The prevalence of overweight and obesity in male was 41.7% and 14.6%, in female was 32.0% and 20.4% in this population, respectively. BMI and WC had significant positive relationship with TC, TG, SBP and DBP but negative with HDL-C and HDL-C/TC. WC had significant positive relation with FBG. The prevalence of dyslipidaemia hypertension and diabetes were significantly increased in overweight and obese groups. For early prevention, we have to pay more attention to the population with BMI > 24.0 kg/m2, they had increased risk factors of non-communicable chronic diseases.

[Study on the oxidative injury of ECV304 cell induced by homocysteine].

The mechanism of homocysteine-induced oxidative injury on ECV304 cell line, a spontaneously transformed immortal human endothelial cell line, was studied. ECV304 cells were incubated with different levels of Hcy (0.05-2.00 mmol/L) for 12 hours. The activity of major anti-oxidative enzymes and the generation of reactive oxidative species (ROS) were measured by chromatometry and fluorochromy. The results showed that Hcy could induce obvious oxidative injury on ECV304 even at low level (0.05-0.10 mmol/L). The level of MDA was increased and the active oxygen was generated in the cells. The activities of anti-oxidative enzymes (SOD and GSH-Px) except the activity of CAT were decreased in the cells. It was concluded that Hcy may induce oxidative injury on EVC304 cell line through increasing the levels of ROS and inhibiting the activities of anti-oxidative enzymes.

Effects of red palm oil on serum lipids and plasma carotenoids level in Chinese male adults.

OBJECTIVE: Effects of red palm oil on major plasma carotenoids, tocopherol, retinol and serum lipids were evaluated when used in Chinese diet. METHODS: Red palm oil group (RPO) composed of 20 male subjects(aged 18-32) and soybean oil group (SBO) composed of 22 male subjects (aged 18-32). Dietary fat provided about 28% of total calories, and the test oil accounted for about 60% of total dietary fat. In the 3 weeks of pretest period, diets were prepared with soybean oil, and then in the next 6 weeks subjects in each group consumed the diet prepared by test oil. RESULTS: Plasma alpha-carotene, beta-carotene and lycopene concentration of RPO group significantly increased at the time of interim (21 days) and of the end (42 days) (P < 0.05), and alpha-tocopherol concentration significantly increased at the time of the end (42 days) in this study. Though Chinese plasma retinol level was relatively low when compared with that of Westerners, red palm oil diet showed no significant effect on adult Chinese plasma retinol level. Serum concentration of total cholesterol, triglyceride, high density lipoprotein cholesterol, apolipoprotein AI and apolipoprotein B of all subjects showed no significant changes in RPO group during the study. CONCLUSIONS: The data in our study suggest that red palm oil is a good source of carotenoids and vitamin E when used in Chinese diet preparation, and it can significantly increase plasma concentration of alpha-carotene, beta-carotene, lycopene and alpha-tocopherol.

[Influence of calcium content among different calcium agents on absorbing and bone density of rats].

To identify the influence of different calcium contents among different calcium agents on absorbing and born density of rats, wistar rats are fed with diet containing different contents of calcium of different calcium agents. 3-day calcium metabolization experiment is carried out in the fourth week and atomic absorption spectrophotometry is applied to measure the calcium content of their dejecta and to estimate apparent absorptivity. Rats are killed in the twelfth week, and their thighbones are peeled. the results show that there is significant difference of the apparent absorptivity with different calcium intake. With the same content of calcium from nine kinds of calcium agents, the absorptivity is not significant different with an exception of those of active calcium, milk powder and oatmeal. Born density from the group of rats, which fed with diet with low level, middle level or high level of calcium, is obviously higher than that of rats fed with basic diet (P < 0.05). Born density of thighbone of the group of rats, which fed with diet with middle or high level of calcium content is not significantly different compared with that of rats fed with diet with calcium carbonate. The absorptivity of calcium is related with calcium content in diet. The effect of absorptivity of calcium agents tested is affirmative, but there is no difference of their effect in comparison with the calcium carbonate.