Annual Rate Research Articles

Which aspects of education are health protective? a life course examination of early education and adulthood cardiometabolic health in the 30-year study of early child care and Youth Development (SECCYD)

BackgroundPast research describes robust associations between education and health, yet findings have generally been limited to the examination of education as the number of years of education or educational attainment. Little is known about the specific features or processes underpinning education that are health protective. The objective of the current study was to address this gap by examining specific aspects of early education pertaining to student characteristics and experiences, as well as features of the classroom environment, in predicting cardiometabolic health in adulthood.MethodsSubjects were 1364 participants in the NICHD Study of Early Child Care and Youth Development (SECCYD, 1991–2009) and recent SECCYD 30-year follow-up, the Study of Health in Early and Adult Life (SHINE, 2018–2022). Models examined individual education indicators (student social skills, student-teacher relationship quality, and classroom emotional and instructional quality in the period of elementary school and student academic performance between ages 54 months and 15 years) in relation to a composite of cardiometabolic risk in adulthood (ages 26–31), reflecting central adiposity, blood pressure, insulin resistance, inflammation, and dyslipidemia. Models were adjusted for key explanatory factors including socio-demographics, infant characteristics, parental socioeconomic status (SES), and child health status. Follow-up analyses were performed to test potential mediators of early education effects on adult health, including adult SES (educational attainment, household income) and health behaviors (diet quality, activity level, sleep duration, smoking).ResultsIn adjusted models, results showed greater student social skills, indexed by a mean of annual teacher ratings between kindergarten and 6th grade, predicted lower cardiometabolic risk in adulthood (β=-0.009, p <.05). In follow-up analyses, results showed the protective effect of student social skills on cardiometabolic risk may be mediated by adult income (β=-0.0014, p <.05) and diet quality (β=-0.0031, p <.05). Effects of the other early education indicators were non-significant (ps > 0.05).ConclusionsFindings point to the potential significance of early student social competence as a link to long-term health, possibly via the acquisition of resources needed for the maintenance of health, as well as through engagement in health behaviors supporting healthy eating. However, more research is needed to replicate these findings and to elaborate on the role of early student social competence and the pathways explaining its effects on cardiometabolic health in adulthood.

Trends in Cognitive Function Before and After Diabetes Onset: The China Health and Retirement Longitudinal Study.

Individuals with prevalent diabetes were known to have a higher risk of dementia and lower cognitive function. However, trends of cognitive function before diabetes and in the short term after new-onset diabetes remain unclear. This study included participants without baseline diabetes from the China Health and Retirement Longitudinal Study. Cognitive tests were conducted at baseline (wave 1) and at least one time from wave 2 (2013) to wave 4 (2018). Cognitive function was assessed using a global cognition score which was the summary measure of 4 cognitive tests. A linear mixed model was constructed to fit the trends in cognitive function before and after diabetes onset and the trends among nondiabetes. The threshold of statistical significance was p < 0.05. During the 7-year follow-up, 1,207 (9.7% of 12,422, 59.1 ± 8.6 years, 39.9% male participants) participants developed new-onset diabetes. The cognitive function of both the without diabetes group and the diabetes group declined annually during the follow-up. The annual decline rate of the diabetes group before diabetes onset was similar to that of the without diabetes group during the whole follow-up period. After diabetes onset, participants experienced statistically significant faster cognitive declines in global cognition (-0.023 SD/year; 95% CI -0.043 to -0.004; p = 0.019) and visuospatial abilities test (-0.036 SD/year; -0.061 to -0.011; p = 0.004), but not in tests of episodic memory (-0.018 SD/year; -0.041 to 0.004; p = 0.116), attention and calculation (-0.017 SD/year; -0.037 to 0.003; p = 0.090), or orientation (0.001 SD/year; -0.018 to 0.020; p = 0.894), compared with the cognitive slope before diabetes. In subgroup analysis, compared with those who developed diabetes between 45-54 years, those developing diabetes older (55-64 years, p for interaction = 0.701; 65-74 years, p for interaction = 0.996) did not demonstrate different rates of global cognitive decline after diabetes. Individuals experienced faster rate of cognitive decline in a few years after diabetes onset, but not during the prediabetes period. Age did not modify the effect of diabetes on postdiabetes cognitive decline. Efforts in eliminating the adverse impacts on cognition should be started on diagnosis of diabetes.

Variation in Muskox (Ovibos moschatus) Guard Hair Growth Rates: Implications for Measuring Chronological Biomarkers.

Segmental analyses of hair may be useful for measuring biomarkers over several seasons to years from a single sample. To attribute hair segments to specific time periods, a known chronological marker, or a hair growth rate, is needed. We examined guard hair growth rates of captive muskoxen (Ovibos moschatus) in Fairbanks, Alaska, USA. We sought to determine if a general growth rate could be applied across muskox populations, thus facilitating the use of segmental analyses for various biomarkers. We used archived samples from 16 muskoxen that had guard hairs sampled at six, 14, and 30 wk after shaving. We measured the lengths of 10 guard hairs per sample, calculated weekly and annual growth rates, and then fitted linear mixed-effects models to assess the effect of different covariates on hair growth rate. The period in which hair had been grown had a significant effect (P<0.05) on growth rate. Extrapolated annual hair growth rates were 277±40 mm/yr (weeks 0-6), 248±47 mm/yr (weeks 7-14), and 165±36 mm/yr (weeks 15-30), with an overall average rate of 210±14 mm/yr. These rates were significantly faster than those of free-ranging Greenland muskoxen-78 mm/yr as measured by stable isotope analyses-and varied intra-annually. This suggests that a universal growth rate cannot be generalized across muskox populations and time.

RESEARCH ON THE IMPACT OF GREEN FINANCE ON GREEN TECHNOLOGY INNOVATION

The green technology innovation of enterprises cannot succeed without the support of capital. Financing constraints are the bottleneck of green technology innovation activities carried out by enterprises. In this regard, the government has adopted green finance-related policies, and the financial institutions have supported more efficient green technology innovation in enterprises with financial instruments like green credit and green bonds. This article, with the starting point of green finance, the study object of financial data of A-share listed companies from 2016 to 2021, and the mediator of financing constraints, studies the impact of green finance on green technology innovation through finding the correlation between enterprises’ annual ESG rating and financing constraints. This study finds: the impact of green finance on green technology innovation is positive; financing constraints are the mediator between green finance and green technology innovation; and there is a negative correlation between enterprises’ ESG management performance and their financing constraints.&#x0D; On account of the conclusion of this article, the suggestions are as follows: it is necessary for the government to design the development framework of the green economy in a top-down way and to encourage financial institutions and enterprises to work together in terms of green innovation; financial institutions should actively practice the philosophy of green development and broaden the supporting channels of green finance; and enterprises need to focus on the philosophy of ESG development in order to gain more support for green investment capital.

Reduced pertussis disease severity in infants following the introduction of pertussis vaccination of pregnant women in Spain, 2015–2019

BackgroundMaternal pertussis vaccination during the third trimester of pregnancy was implemented in 2015 in Spain, reaching a national coverage of 84% in 2019. In this ecological study, we investigated whether there was a change in the disease severity for pertussis in infants upon introduction of prenatal pertussis vaccination. MethodsWe performed a time-trend analysis of infant pertussis hospitalizations during 2005–2019 in Spain using national register data. Annual hospitalization rates per 100,000 population and the mean length of hospitalization were calculated for infants < 3 months of age (target group benefiting from the prenatal vaccination) and a reference group aged 3–11 months. We compared overall rates and annual percent changes of the above variables in both groups for the time period before (2005–2014) and after vaccination introduction (2015–2019), using segmented Poisson regression. ResultsDuring the pre-vaccination period, infants aged 0–2 months had a 5-times higher rate of pertussis hospitalization and spent on average 50 % longer in hospital than the reference group. After the maternal vaccination introduction, the hospitalization rate decreased more rapidly in infants aged 0–2 months than in infants aged 3–11 months: annual reduction of 34 % (95 % CI: 31–38) versus 26 % (95 % CI: 21–31) in the hospitalization rate and 13 % (95 % CI: 11–15) versus 6 % (95 % CI: 2–9) in the mean hospital stay, respectively. In 2019, the mean hospital stay for pertussis was about 4.5 days in both groups. ConclusionsMaternal pertussis vaccination in Spain led to a reduction in disease severity in the target group as compared to older infants, highlighting the need for increased efforts on educating healthcare professionals on the importance of maternal vaccinations.

Accounting for Greenhouse Gas Emissions in the Agricultural System of China Based on the Life Cycle Assessment Method

Agricultural systems contribute nearly one-third of global anthropogenic GHG emissions and are an important source of GHGs globally. The clarification of the GHG emission pattern from agriculture is of paramount importance in the establishment of an agricultural emission reduction mechanism and the realization of China’s dual-carbon target. Based on the life cycle assessment method (LCA), this paper comprehensively quantifies the greenhouse gas emissions from the agricultural system in China, encompassing rice, wheat, and corn cultivation as well as animal husbandry including cows, horses, donkeys, mules, camels, pigs, and sheep. The analysis covers the period 2000–2020 and examines the spatial distribution, temporal trends, and structural changes in the greenhouse gas emissions within China’s agriculture sector. The main results are as follows: (1) from 2000 to 2020, China witnessed a consistent upward trajectory in its total agricultural GHG emissions, exhibiting an average annual growth rate of 0.73%. Notably, methane (CH4) emissions emerged as the largest contributor, displaying an overall fluctuating pattern. Carbon dioxide (CO2) emissions demonstrated intermittent increases with a noteworthy annual growth rate of 3%, signifying the most rapid expansion within this context. Conversely, nitrous oxide (N2O) emissions experienced decline over the specified period. (2) GHG emissions from cultivation demonstrate an upward trajectory, primarily driven by the CH4 emissions originating from rice cultivation and CO2 resulting from straw incineration. Conversely, GHG emissions stemming from animal husbandry declined, with the primary source being CH4 emissions arising from animal enteric fermentation. Agricultural N2O emissions predominantly arise due to manure management and nitrogen fertilizer application. (3) Agricultural greenhouse gas emissions exhibit significant variations in spatial distribution, gradually concentrating towards the North China Plain, the middle and lower reaches of the Yangtze River, and the northeast. Specifically, agricultural CH4 emissions are progressively concentrated in China’s pivotal rice-growing regions, encompassing the middle and lower reaches of the Yangtze River Plain, as well as livestock breeding areas like Inner Mongolia. Agricultural CO2 emissions primarily concentrate in dryland crop production zones such as North China and Northeast China. Meanwhile, Agricultural N2O emissions predominantly occur in Inner Mongolia and the North China Plain. China’s agricultural greenhouse gas emissions in 2020 show a significant spatial clustering effect, with hotspots primarily concentrated in Shandong, Anhui, Henan, and other regions and cold spots focused in the western and southern areas. The emission patterns of agricultural GHGs are closely intertwined with farming practices, regional development levels, and national policy; hence, tailored measures for emission reduction should be formulated based on specific crop types, livestock categories, agricultural production activities, and regional development characteristics.

Salmonella infections in Denmark from 2013-2022 with focus on serotype distribution, invasiveness, age, sex, and travel exposition.

To analyze the nationwide incidence of Salmonella infections in Denmark from 2013 to 2022. Confirmed cases of Salmonella enterica subsp. enterica were examined using the National Register of Enteric Pathogens during 2013-2022. Proportions, incidence rates (IR), relative risk (RR), and 95% confidence intervals (CI) were calculated toassess differences in serotypes, invasiveness, age, sex, and travel exposure. We identified 9,944 Danish Salmonella enterica subsp. enterica cases, with an average annual incidence rate of 16.9 per 100,000 inhabitants, declining during the COVID-19 pandemic. Typhoidal cases totaled 206, with an average annual IR of 0.35 per 100,000 inhabitants. Enteric fever patients had a median age of 24years (IQR:17-36). Leading non-typhoid Salmonella (NTS) serotypes were S. Enteritidis (26.4%), monophasic S. Typhimurium (16.5%), and S. Typhimurium (13.5%). Median age for NTS cases was 42 (IQR: 18-62), with even sex distribution, and a third reported travel prior to onset of disease. The overall percentage of invasive NTS (iNTS) infection was 8.1% (CI: 7.6-8.7). Eleven serotypes were associated with higher invasiveness, with S. Dublin and S. Panama having the highest invasiveness with age and sex-adjusted RR of 7.31 (CI: 6.35-8.43) and 5.42 (CI: 3.42-8.60), respectively, compared to all other NTS serotypes. Increased age was associated with higher RR for iNTS infection. During the decade, there was a limited number of typhoidal cases. The dominant NTS serotypes were S. Enteritidis and monophasic S. Typhimurium, whereas S. Dublin and S. Panama exhibited the highest invasive potential.

Evaluation and model to achieve sex parity in cataract surgical coverage in Theni district, India

Background/aimsTo propose an approach to determine the target ratio of cataract surgical rates (CSRs) of female to male subpopulations to increase sex parity in cataract surgical coverage (CSC), based on...

Estimating the slip rate in the North Tabriz Fault using focal mechanism data and GPS velocity field

Abstract This study delves into slip distribution on the North Tabriz Fault (NTF), a critical aspect of seismic hazard analysis due to its proximity to the Tabriz metropolis. The study operates within a uniform elastic half-space, maintaining constant values for fault geometry and regional rheological parameters throughout the research. To calculate strain boundary conditions, permanent and periodic global positioning system (GPS) data from the northwest region were utilized. The fault was constrained perpendicularly while allowing tangential movement, facilitating the determination of its annual slip rate using the boundary element method, with the Okada analytical model serving as the fundamental solution. The findings underscore the intricate relationship between the fault’s slip rate and boundary conditions, revealing a predominant right-lateral strike-slip motion. The study offers two slip rate assessments, obtained through earthquake focal mechanisms and GPS velocity data, yielding values of 5 and 5.5 mm / year {\rm{mm}}/{\rm{year}} , respectively. Importantly, the alignment of these calculated slip rates with paleo-seismological data underscores the credibility of the results generated via the boundary element method, distinguishing it as a reliable approach when compared to other numerical and analytical techniques. This research provides valuable insights into the behavior and slip dynamics of the NTF, which is pivotal for assessing seismic risks.

Traumatic spinal cord injury: A four-year study in Puerto Rico

Objective Assess the occurrence of traumatic spinal cord injury (TSCI) in Puerto Rico, a geographically delimited territory. Design Retrospective review of data from all encounters with ICD-10-CM codes S12-14, S22-24, S32-34, G82.2 and G82.5 for years 2019-2022. Setting Puerto Rico Trauma Hospital. Outcome measures Patient (sex, age) and injury characteristics (neurological level, mechanism of injury, severity score, length of stay, mortality, and disposition). Results Annual incidence rates did not change over time with an increasing trend among older adults (P = 0.08). Median age was 44 yrs and 85% were men. The most frequent neurological level was thoracic (P = 0.03). Falls were the most common mechanism and was associated with age (P < 0.0001). In-hospital mortality was 24.8%, higher (P = 0.05) in 2020-2021. Median length of stay was 26 days, higher (P = 0.014) in 2020-2021. An increase (P < 0.001) over time in discharges to inpatient rehabilitation was observed. The SARS-CoV-2 lockdown resulted in fewer and older patients; more cervical injuries and falls; longer length of stay, and higher in-hospital mortality. Conclusion The risk of TSCI in Puerto Rico was 74% lower than in the United States. The incidence of TSCI in older adults in Puerto Rico appears to be on the rise due to falls. Preventive strategies should include fall prevention education and social interventions to decrease motor vehicle accidents and firearm violence. Disasters such as the COVID-19 pandemic, can change demographic trends in TSCI. Trauma centers should consider implementing a physiatry consult service to improve patient disposition.

Elevated factor XI is associated with recurrent left ventricular thrombus of unknown origin.

Elevated factor XI (FXI) has been shown to predispose to thromboembolism. We investigated whether it is associated with left ventricular thrombus (LVT) formation, its recurrence and subsequent thromboembolic events. In 54 patients with prior LVT of unknown origin, who stopped anticoagulation and 54 controls, we determined FXI, along with plasma clot permeability (Ks ), fibrinolysis time (CLT), endogenous thrombin potential (ETP), von Willebrand factor (vWF) and fibrinolysis proteins. During follow-up, the primary endpoint involving the recurrence of LVT a symptomatic ischemic stroke or systemic embolism was recorded. Elevated (>120%) FXI levels were more often observed in LVT patients when compared to the control group (14 [25.9%] vs. 6 [11.1%], p = .048) in association with the presence of active FXI. FXI correlated with age (r = .406, p = .002), Ks (r = -.542, p < .001) and CLT (r = .406, p = .002), also after adjustment for age, but not with ETP, vWF or fibrinolysis proteins. During follow-up of 77.6 ± 18.5 months the primary endpoint occurred in 17 (31.5%) LVT patients, including 11 (20.4%) recurrent LVT, and in 4 (7.4%) controls (annual incidence rate 4.9% vs. 1.1%, respectively; p = .002). On multivariate logistic regression analysis, elevated FXI was independently associated with the primary endpoint (OR 1.18; 95% CI 1.09-1.28). Elevated FXI in association with a prothrombotic state characterizes patients with prior LVT of unknown origin and predisposes to its recurrence and/or ischemic stroke during follow-up. It might be speculated that the measurement of FXI helps identify patients who could benefit from prolonged anticoagulation and FXI inhibitors in the future.

Spatial-temporal evolution and driving factors of rural resilience in the urban agglomerations in the middle reaches of the Yangtze River, China.

How to maintain the balanced stability and resilient development of rural systems is an important issue that needs urgent attention in the field of sustainable rural development at present. In this paper, the entropy method, spatial autocorrelation model, and Geodetector were used to explore the rural resilience level, spatial distribution characteristics, and driving factors of 31 cities in the urban agglomerations in the middle reaches of the Yangtze River (UAMRYR), and to put forward corresponding policy suggestions. The results are as follows: (1) From 2005 to 2020, rural resilience in the UAMRYR showed an upward trend with an average annual growth rate of 8.26%. The ranking of the three major urban agglomerations is Changsha-Zhuzhou-Xiangtan urban agglomerations > Wuhan urban agglomerations > Poyang Lake urban agglomerations. (2) During the study period, the spatial distribution of rural resilience gradually developed from a negative correlation to a strong positive correlation and generally showed the characteristics of high in the west and low in the east. (3) The urbanization rate, the size and structure of the economy, the difference in consumption and income between urban and rural areas, the local fiscal revenue, and the number of village committees are the key factors affecting the level of rural resilience. On this basis, we proposed policy recommendations to improve the economic, social, and ecological resilience of rural areas in the UAMRYR. The findings of this paper are expected to provide insights into the policy formulation of China's rural revitalization strategy.

Cadmium, zinc, and copper leaching rates determined in large monolith lysimeters

Soil mass balances are used to assess the risk of trace metals that are inadvertently applied with fertilizers into agroecosystems. The accuracy of such balances is limited by leaching rates, as they are difficult to measure. Here, we used monolith lysimeters to precisely determine Cd, Cu, and Zn leaching rates in 2021 and 2022. The large lysimeters (n = 12, 1 m diameter, 1.35 m depth) included one soil type (cambisol, weakly acidic) and distinct cropping systems with three experimental replicates. Stable isotope tracers were applied to determine the direct transfer of these trace metals from the soil surface into the seepage water. The annual leaching rates ranged from 0.04 to 0.30 for Cd, 2.65 to 11.7 for Cu, and 7.27 to 39.0 g (ha a)−1 for Zn. These leaching rates were up to four times higher in the year with several heavy rain periods compared to the dry year. Monthly resolved data revealed that distinct climatic conditions in combination with crop development have a strong impact on trace metal leaching rates. In contrast, fertilization strategy (e.g., conventional vs. organic) had a minor effect on leaching rates. Trace metal leaching rates were up to 10 times smaller than fertilizer inputs and had therefore a minor impact on soil mass balances. This was further confirmed with isotope source tracing that showed that only small fractions of Cd, Cu, and Zn were directly transferred from the soil surface to the leached seepage water within two years (< 0.07 %). A comparison with models that predict Cd leaching rates in the EU suggests that the models overestimate the Cd soil output with seepage water. Hence, monolith lysimeters can help to refine leaching models and thereby also soil mass balances that are used to assess the risk of trace metals inputs with fertilizers.

Epidemiological characteristics of diarrheagenic Escherichia coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai, 2014-2021

Objective: To understand the epidemiological characteristics of diarrheagenic Escherichia (E. ) coli infection in infectious diarrhea outpatients aged 15 years and older in Shanghai and provide evidence for the development of disease control strategies. Methods: Based on multistage systematic sampling, diarrhea surveillance was conducted in 22 sentinel hospitals in Shanghai, the information about cases' demographic, clinical, and epidemiological characteristics were collected. Stool samples were collected for the detection and typing of diarrheagenic E. coli by local centers for disease control and prevention. The positive rate of diarrheagenic E. coli in different populations and seasons from 2014 to 2021 were analyzed. Statistical analysis was conducted by using χ2 test. Results: In 15 185 diarrhea cases, 8.05% (1 222/15 185) were positive for diarrheagenic E. coli. The positive rate was higher in men (8.74%, 684/7 824) than in women (7.31%, 538/7 361). The positive rate was highest in age group 15-29 years (9.14%, 335/3 665) and the annual positive rate was highest in 2021 (10.21%, 83/813), the differences were all significant (P<0.05). In the 1 264 strains of diarrheagenic E. coli analyzed through PCR, enterotoxingenic E. coli was the most frequently identified pathogen (50.24%, 635/1 264), followed by enteroadhesive E. coli (27.93%, 353/1 264), and enteropathogenic E. coli (21.36%, 270/1 264). The positive rate of diarrheagenic E. coli showed obvious seasonality with peak in summer (13.92%, 774/5 562) (χ2=495.73, P<0.001). Conclusions: Diarrheagenic E. coli has become a prominent pathogen in infectious diarrhea cases in Shanghai, the disease can occur all the year round with incidence peak during summer and autumn. Predominant subtypes included enterotoxingenic E. coli, enteroadhesive E. coli and enteropathogenic E. coli. Targeted prevention and control strategies are needed for diarrheagenic E. coli-induced infectious diarrhea in different age groups, seasons and for different types of infections.

Assessing Carbon Emissions from Animal Husbandry in China: Trends, Regional Variations and Mitigation Strategies

The intensification of land use and the accelerated integration of three industries (agricultural production, agricultural product processing industry, and agricultural product market service industry) in China have resulted in the continuous expansion of animal husbandry and its industrial chain. This phenomenon has led to a rise in greenhouse gas (GHG) emissions from livestock farming, intensifying climate change and placing strain on worldwide environmental conservation efforts. Life cycle assessment (LCA) was utilized to evaluate carbon emissions from China’s animal husbandry sector from 2012 to 2021. Additionally, the logarithmic mean divisia index (LMDI) decomposition method was employed to examine and elucidate the influential impacts of five factors on carbon emissions. These factors included the efficiency of animal husbandry production, the structure of the agricultural industry, per capita agricultural production income, urbanization, and the total population. The results reveal the following: (1) From 2012 to 2021, China’s animal husbandry sector witnessed a marginal increase in cumulative carbon emissions from 287.74 million tons to 294.73 million tons, with an annual growth rate of 0.42%. (2) Emission contributions were categorized as follows: the production stage (149.61 million tons), the transportation stage (145.07 million tons), and the processing stage (0.05 million tons). (3) The primary factor contributing to the rise in carbon emissions from animal husbandry from 2012 to 2021 was the per capita agricultural production income factor (A3), alongside a notable impact from the total population factor (A5).

Assessment of Welfare in Transhumance Yak Hybrids (Chauris) in the Lower Himalayan Region of Nepal

In order to develop a yak/chauri-specific welfare assessment protocol, we sent a set of 31 potential welfare measures to 120 Nepalese experts and asked them to identify the measures that they thought would be useful and propose additional useful measures. Eighty-three experts responded, with 13 measures being identified by &gt;50% of respondents as likely to be useful. These thirteen measures plus one new measure (hematology) were included in an assessment protocol that was tested in the second phase of this study in five chauri herds in two districts in northern Nepal. Animal-based evaluations along with sampling for mastitis, intestinal parasites, and hematology were undertaken during or just after morning milking. Resource- and record-based measures were assessed through structured interviews, with verifications on-site where possible. No chauris exhibited poor body conditions, skin injuries, significant locomotion issues, or significant subclinical mastitis. Fecal testing suggested a high prevalence of intestinal parasites at the herd level, while blood testing suggested no evidence of hematological abnormalities. However, for both results, we need more data to use these effectively as measures of welfare. The resource-based assessment revealed significant challenges across all resources, and veterinary services were reported as being inadequate. A high estimated annual mortality rate (10–21%) needs further investigation. This protocol provided a useful start towards developing a welfare assessment protocol for yak/chauri and identified issues that need addressing to optimize chauri welfare.

New Drug for Management of Severe Uncontrolled Asthma: Tezepelumab

Abstract: Tezepelumab is a first-in-class human IgG2λ monoclonal antibody used to treat severe, uncontrolled asthma. Tezepelumab acts by hindering the action of thymic stromal lymphopoietin (TSLP), an epithelial-derived cytokine that triggers an immunological response by binding to TSLP and thereby preventing its binding with the TSLP receptor complex. TSLP has a critical role in Th2 immunity and plays an important role in the pathogenesis of asthma because it stimulates the production of Th2-associated inflammatory mediators, such as interleukin-4, interleukin-5, interleukin-9, and interleukin-13. It is the first biologic with no phenotypic or biomarker restrictions that has been approved for use in severe asthma. Tezepelumab is indicated in severe, uncontrolled asthma patients due to its safety, tolerability, and efficacy. Adults with severe, uncontrolled asthma experienced considerably lower annualised asthma exacerbation rates (AAERs) when administered with tezepelumab compared to a placebo. These preliminary results indicated that the TSLP-induced release of T2 inflammatory mediators may be reduced, and the sustained inhibition was maintained over a 52-week treatment period. In this review, we have summarised various phase III clinical trials and the mechanism of action of tezepelumab in severe, uncontrolled asthma.

Evaluation Research on Energy-Saving Retrofitting of Roofs of Traditional Wood-Structured Dwellings Based on the Continuation of Historical Features: A Case Study of Guangdu Village No. 280 Dwelling in Zhejiang

China has numerous traditional wooden dwellings located in regions with hot summers and cold winters. The historic dwellings lack proper thermal insulation and have excessive energy consumption in the building structure, failing to suit the needs of modern people. Hence, it is crucial to enhance their energy efficiency through essential actions. Roofs, being the fifth side of the building envelope, are frequently neglected when it comes to enhancing their insulating capabilities. The study aimed to implement energy-efficient roof alterations while preserving the historical features of traditional structures. This study focuses on enhancing the energy efficiency of a traditional wood-structured dwelling in Guangdu Village, Zhejiang Province, China, by installing composite thermal insulation panels on the interior of the roof using an easy restoration approach. The actual risk of condensation and the impact of retrofit processes on historical features determine the choice and limitations of energy-saving retrofit materials and methods. This study evaluates the transformation using two indicators: energy efficiency and economic feasibility. The numerical simulation results indicate that traditional dwellings have an annual energy savings rate of 16.66% and an investment payback period of 7.25 years. This study demonstrates the feasibility of energy-saving roof renovation measures for these traditional wood-structured dwellings. The measures improve energy efficiency and are affordable for residents. This study can offer technical suggestions for enhancing the energy efficiency of traditional wood-structured dwellings.

Association between Increased Risk of Pneumonia with ICS in COPD: A Continuous Variable Analysis of Patient Factors from the IMPACT Study.

Despite the proven benefits of inhaled corticosteroid (ICS)-containing triple therapy for chronic obstructive pulmonary disease (COPD), clinicians limit patient exposure to ICS due to the risk of pneumonia. However, there are multiple factors associated with the risk of pneumonia in patients with COPD. This posthoc analysis of IMPACT trial data aims to set the risks associated with ICS into a context of specific patient-related factors that contribute to the risk of pneumonia. The 52-week, double-blind IMPACT trial randomized patients with symptomatic COPD and ≥1 exacerbation in the prior year 2:2:1 to once-daily fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI), FF/VI or UMEC/VI. Annual rate of on-treatment pneumonias in the intent-to-treat population associated with age, body mass index (BMI), percent predicted forced expiratory volume in 1s (FEV1) and blood eosinophil count (BEC) was evaluated. This analysis revealed that the annual rate of pneumonia showed the lowest risk at the age of 50years. The 95% confidence intervals (CI) between ICS-containing and non-ICS containing treatments diverged in ages > 63years, suggesting a significantly increased ICS-related risk in older patients. In contrast, the annual rate of pneumonia rose in both groups below BMI of 22.5kg/m2, but above that, there was no relationship to pneumonia rate and no differential effect between the two groups. The relationship between BEC and pneumonia was flat up to > 300/µL cells with ICS-containing treatment and then rose. In contrast, the rate of pneumonia with non-ICS containing treatment appeared to increase at a lower level of BEC (~ 200/µL). There was little evidence of a differential effect of older age, lower BMI, lower FEV1 and BEC on the pneumonia rate between ICS-containing and non-ICS containing treatments. This analysis points to the need for a balanced approach to risk versus benefit in the use of ICS-containing treatments in COPD. IMPACT ClinicalTrials.gov number, NCT02164513.

Determination of the minimum soil infiltration rate of sunken green space considering the annual runoff collection ratio, sunken depth and sunken green space area of Hefei city, China.

Sunken green space is one of the urban rainwater collection facilities, which belongs to Low Impact Development (LID) techniques. It plays a key role in the construction of sponge city, and the amount of runoff collection is usually affected by the area of the sunken green space, the infiltration rate of the soil, and the annual runoff collection rate. To determine the minimum soil infiltration rate of sunken green space considering the annual runoff collection ratio of sponge cities, this paper selects a residential district in Hefei city, China, as the case study. Based on 45 years of precipitation data, the designed rainfall corresponding to annual runoff collection ratios of 75%, 80% and 85% is 21.3 mm, 23.4 mm and 27.5 mm, respectively. The characteristics of rainfall infiltration in sunken green space are analyzed by using the water balance model and runoff yield and conflux model. The results reveal that the soil infiltration rate is 1.16×10-4 cm/s~3.88×10-3 cm/s when the sunken depth is 0.1 m~0.3 m and that the ratio of green space area is 5%~25%. The runoff collection of the reconstructed sunken green space is 2.87 times and 1.98 times that of the nonsunken green space and the nonreconstructed sunken green space, respectively. That is to say, under the comprehensive performance of the sunken depth, sunken green space area, the steady soil infiltration rater of the reconstructed sunken green space cannot be less than the value obtained in this paper. Otherwise, the requirements of annual total runoff reduction ratio of the sponge city cannot be met. Therefore, this study provides references for realizing the ratio of annual runoff collection and sponge city construction in similar urban areas. It can also be applied to optimal selection of sunken green space in some sponge city projects.