Determinants and action paths of transboundary water pollution collaborative governance: A case study of the Yangtze River Basin, China.

With rapid economic growth, the issue of water pollution has become increasingly prominent, and there is a consensus that river basin management systems and cross-regional management coordination mechanisms need improving. In this study, 171 transboundary sections of the Yangtze River Basin were matched with the data of 57 cities to construct panel data from 2015 to 2021. Based on the four-dimensional framework of environment-determination-process-resources, the dynamic qualitative comparative analysis (QCA) method is used to identify the key influencing factors and action paths of water pollution collaborative governance effects. The results show that a single antecedent condition is not necessary to achieve efficient collaborative governance effects, and only the "number of collaborative governance" and "scale of collaboration" conditions played important roles. There are five paths that can achieve efficient collaborative governance effects: economy-oriented, ecology-oriented, technology-oriented, government-oriented, and all-oriented. Additionally, heterogeneous results show that the impact of the regional governance intention on efficient collaborative governance effect is limited in the middle and upstream sections of the Yangtze River Basin, while the downstream sections are more dependent on the basic condition of the basin. The results can help promote effective cross-regional collaboration in the Yangtze River Basin, provide scientific basis for regions to formulate targeted governance measures, and provide models for governance in other regions.

Peptidoglycan Recognition Protein 1 Attenuates Atherosclerosis by Suppressing Endothelial Cell Adhesion.

ABSTRACT: Peptidoglycan recognition protein 1 (PGLYRP1) has long been believed to play an important role in infectious and immune diseases. We hypothesized that it might be involved in the pathophysiology of atherosclerotic diseases, which are regarded as chronic inflammatory diseases. Serum PGLYRP1 concentrations were measured in 240 patients with coronary artery disease (CAD) and 209 age-matched and gender-matched individuals with normal coronary arteries using enzyme-linked immunosorbent assay. The expression of PGLYRP1 in atherosclerotic plaques was quantified using western blotting and immunostaining. ApoE-/- mice, fed a high-fat diet, were randomly given intraperitoneal injections of saline or recombinant PGLYRP1 protein for 12 weeks. The effects of PGLYRP1 on human umbilical vein endothelial cells were investigated by western blotting. Higher concentrations of PGLYRP1 were significantly associated with a higher risk of CAD. The odd ratio for upper quartile versus lower quartile was 2.24 (95% confidence interval: 1.21-4.13) after adjustment for sex, age, smoking, body mass index, lipid profile, blood pressure, fasting glucose, and estimated glomerular filtration rate. PGLYRP1 was highly expressed in murine atherosclerotic plaques. Recombinant PGLYRP1 protein alleviated the progress of atherosclerosis in vivo and reduced the expression of endothelial cells' adhesion molecules in vitro. In conclusion, our study suggested that PGLYRP1 is upregulated in patients with CAD and atherosclerotic plaques. PGLYRP1 may participate in the pathophysiological process of atherosclerosis.

Advances in clinical trials on perioperative immune checkpoint inhibitors for resectable non-small cell lung cancer: A comprehensive review.

The reduction in lung cancer mortality rates over the past decade can be partially ascribed to advancements in immunotherapy. Immune checkpoint inhibitors (ICIs) have transformed the therapeutic landscape for advanced non-small cell lung cancer (NSCLC) and have recently been evaluated in multiple clinical trials to confirm their safety and efficacy in the neoadjuvant, adjuvant and perioperative settings for patients with resectable NSCLC. The Food and Drug Administration (FDA) has granted approval for adjuvant atezolizumab following platinum-doublet chemotherapy, neoadjuvant nivolumab and platinum-doublet chemotherapy, adjuvant pembrolizumab after platinum-doublet chemotherapy, and neoadjuvant/adjuvant pembrolizumab for resectable NSCLC, with potential forthcoming approvals for additional agents or indications. Novel data, approvals, and emerging research findings are dramatically shifting the accepted standards of care over just a few years. Despite these advances, the optimal application of these treatments is not entirely straightforward. This article summarizes the biological rationale for immunotherapy and the important clinical trials regarding perioperative ICIs. We also further outline the controversies and future directions to better guide the individualized treatment of NSCLC patients.

P2Y12 inhibitor monotherapy and dual antiplatelet therapy after percutaneous coronary intervention: An updated meta-analysis of randomized trials.

INTRODUCTION: Long-term dual antiplatelet therapy (DAPT) has substantially reduced the risk of post-percutaneous coronary intervention (PCI) myocardial infarction and stent thrombosis at the expense of major bleeding. We hypothesized that a short-term DAPT followed by extended P2Y12 inhibitor monotherapy might be appropriate for patients with both high ischemic and bleeding risks. MATERIALS AND METHODS: We searched the databases: Pubmed, EMBASE, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov to identify randomized trials assessing the antiplatelet strategies after PCI. The primary safety endpoint was Bleeding Academic Research Consortium (BARC) type 3 or 5 bleeding. The efficacy outcome was a composite of all-cause mortality/cardiovascular disease (CVD) death, myocardial infarction, or stroke. A random-effect model was used to calculate the pooled hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: We identified 5 randomized trials comparing P2Y12 inhibitor monotherapy with standard DAPT (12 months) (16,057 versus 16,088). P2Y12 inhibitor monotherapy following short-term DAPT (1 to 3 months) significantly reduced the risk of BARC type 3 or 5 bleeding compared to standard DAPT (pooled HR: 0.63, 95%CI: 0.46-0.86). The difference between P2Y12 inhibitor monotherapy and standard DAPT in reducing the composite CVD outcomes was not statistically significant (HR: 0.88, 95%CI: 0.77-1.01). CONCLUSIONS: P2Y12 inhibitor monotherapy might be an effective strategy for lowering severe bleeding complications and simultaneously preserving the ischemic benefit in patients receiving PCI.