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•We estimate China domestic air passenger market's CO2 emissions in 2007 and 2014.•We assess the change of air route networks and emission features focused on regional disparity.•Applying decomposition method to identify the driving forces of estimated CO2 emissions.•Noteworthy offset to increasing CO2 emissions is indicated from modal split changes.

This paper reviews the changes in cross-strait aviation policies that have occurred since 2009 and assesses the effects of those changes on tourism flows, focusing on the routes served by charter flights. This study is unique because it explores the linkage between aviation and tourism policies in a newly established market. Based on three distinct sets of time series data from 2009 to 2015, various statistics and vector autoregression methods are applied to examine the impacts of the changes on tourism as well as the relationships among scheduled services, charter services, and tourism flows. Our main findings are as follows: First, the changes have promoted scheduled services constantly and aggressively, which contributed to the transformation of cross-strait tourism into a thriving business. Second, through regulation, the changes have created a policy framework for charter flight business. Third, charter flights have become a supplement to scheduled flights in the tourism market. Our contribution is threefold. First, our study contributes to the literature on the effect of aviation policy regimes on the tourism market with respect to charter operations. Second, it provides practical guidance for regions with similar situations, such as the Korean Peninsula. Third, it has crucial policy implications for regulators and governments and provides advice for airlines in the cross-strait market.

Radical surgical resection represents the only hope of cure for pancreatic neuroendocrine tumor (PanNET). Adjuvant therapy is rarely used because there is no evidence to distinguish patients with high recurrence risk. Here we investigated the recurrence feature of resected PanNET and established a novel risk stratification to predict its recurrence. We analyzed 505 PanNET patients who underwent R0 resection at our institute from January 2004 through May 2015. The median follow-up was 71months (range: 12months-143months), 129 patients (25.5%) experienced recurrence with median disease-free survival (mDFS) of 19months. Restricted cubic spline (RCS) functions revealed a positive, linear relationship between Ki-67 index and recurrence. Multivariate analysis showed T stage, N stage, insulinoma and Ki-67 index were independent predictors of recurrence (P

Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus (T1DM). We found that the incidence of DKA was 55.5 per 1000 person-years in US commercially insured patients with T1DM; age-sex-standardized incidence decreased at an average annual rate of 6.1% in 2018–2019 after a steady increase since 2011.

Purpose Dronedarone may increase digoxin plasma levels through inhibition of P-glycoprotein. Using real-world data, we evaluated the risk of digitalis intoxication in concomitant users of dronedarone and digoxin compared digoxin-alone users. Methods We used the Clinformatics DataMart, a US claims database, to identify adult patients with atrial fibrillation (AF) or atrial flutter (AFL) who concomitantly used dronedarone and digoxin and those who used digoxin alone between July 2009 and March 2016. Digitalis intoxication during follow-up until March 2016 was ascertained using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). Adjusted hazard ratios (HR) for digitalis intoxication in concomitant users versus users of digoxin alone were estimated, controlling for age, sex, cohort entry year, number of medical encounters for AF or AFL, history of congestive heart failure, diabetes, hypertension, stroke, myocardial infarction, renal failure, use of drugs interacting with digoxin, and digoxin dose. Findings Overall, 524 concomitant users and 32,459 users of digoxin alone were identified, among which 3 and 301 events of digitalis intoxication occurred during follow-up, respectively. Incidence rates were 17.25 and 9.17 cases per 1000 person-years, respectively. The adjusted HR for digitalis intoxication in concomitant users versus users of digoxin alone was 1.56 (95% CI, 0.50-4.88; P = 0.45). When digitalis intoxication was defined by ICD-9-CM and ICD-10-CM codes accompanied by laboratory testing for digoxin/digitoxin or hospitalization within 30 days, no events occurred in the concomitant users and 40 events occurred in the users of digoxin alone (incidence rate of 1.22 cases per 1000 person-years). Implications Concomitant use of dronedarone and digoxin was uncommon in this study, and no significant increase in the risk of digitalis intoxication with concomitant use was found.

Many Chinese cities have completed barrier-free transportation infrastructures system but always ignore its efficiency. The study purpose of this research is to find out some community planning method to improve the effect of bus and metro barrier-free transportation system in China. Filed survey are research methods used. Taking Chengdu as the study area, researchers carried out a large scale filed survey to study the current bus and metro barrier-free systems. Through relevant literature research, then find people physically challenged to check whether these infrastructure meet their really need. Finally, based on considerable empirical evidence, the findings can be generalized to suggest five issues relevant to the creation of ‘enabling’ or more accessible city environments for all. Overall, this study provides academic support and empirical analysis for what was ignored in urban transportation planning (UTP) process owing to efficiency first principle.

The Civil Aviation Administration of China (CAAC) started to open commercial airlines sector to private, collective and foreign capitals in 2004. From 2004 to 2007, 14 airlines were given approval to operate domestic passenger flights, which brought researchers a vital chance to investigate the performance of local state-owned airlines or private airlines in aviation sector. The study purposes of this paper are (1) to review the development process of these newly established airlines, and (2) to examine their air-route networks’ change patterns. The results show that, generally, the airlines have been re-constructing its air-route networks over those years. High-speed rail (HSR) operation is one of key elements to explain the change patterns. The study results are useful for aviation policy makers, airlines stockholders, and capitals interested in Chinese aviation market.

• This study explores the effects of charter promotions on international tourism in Japan.

Low-carbon urban development is a hot spot of global concerns for fighting against climate change for China, transportation sector has a significant contribution to urban CO 2 emissions, while the emissions are still increasing. Transit-Oriented Development (TOD) strategies provide a novel approach for urban planners to facilitate the urban carbon mitigation from transportation sector in long-term. While TOD strategies are emerging cases, they are merely qualitatively discussed in China, lacking practical indicators and quantitative verification for supporting the real urban plan. With such circumstance, this study aims to conduct an empirical and quantitative study on the applications of TOD strategy in Shanghai based on Exploratory Spatial Data Analysis (ESDA) and the updating data. Firstly, the changes of urban morphology were quantitatively analyzed by spatial cluster analysis, which reveals the layer structure changes and residents migration at about 1 km accuracy. Secondly, accessibility was selected as an indicator for urban transportation and estimated by method based on Time Cost Weighted Distance. Finally, the effectiveness of TOD was investigated by evaluating the integration between population and transportation accessibility with Geographic Weighted Regression model. Results highlight that TOD can effectively improve the transportation network with higher accessibility and lower urban carbon emissions. The outcomes of this study provide critical insights to the recent practice in Shanghai, as well as the practical guidance to low carbon urban planning in developing countries.

Pancreatic cancer is an aggressive and devastating disease that is characterized by uncontrolled progression, invasiveness and resistance to conventional treatment. In the past decades, much effort has been given to cancer genetics and pathological classification of this disease. Our previous study has uncovered a subgroup of patients with poor outcome, which is characterized by serum signature of CEA(+)/CA125(+)/CA19-9 ≥ 1000 U/mL; however, the underlying biology mechanism remains poorly understood. By using high-throughput screening analysis, we analyzed gene expression signature in highly malignant patients with serum markers of CEA(+)/CA125(+)/CA19-9 ≥ 1000 U/mL. Multiple differentially expressed genes were identified, many of which were closely related with cancer metabolic changes. Treatment of pancreatic cancer cell lines PANC-1 with transforming growth factor-β (TGF-β), which was commonly used to induce metastasis, has uncovered that the glycolytic process and antioxidant response was up-regulated upon TGF-β stimulation. These results were consistent with the high-throughput screening analysis. Subsequent analysis indicated that among glycolytic genes, aldolase A (ALDOA) increased the most significantly upon TGF-β treatment. Further in vitro and in vivo results demonstrated that ALDOA was associated with proliferation and metastasis of pancreatic cancer cells. Moreover, ALDOA predicted poor prognosis of pancreatic cancer, partially due to its role in E-cadherin expression regulation, and the results were further validated by analysis of the correlation between ALDOA and E-cadherin expression in pancreatic cancer tissue samples. Mechanistically, the role of ALDOA in pancreatic cancer might attribute to its regulation of c-Myc, HIF1α and NRF2 (Nuclear Factor, Erythroid 2-Like 2), which were key regulators of glycolysis and antioxidant response control.

Refereed/Peer-reviewed This paper examines China's LCC market and assesses the network development patterns from a geographical perspective. Overall, a nationwide LCC network has been formed with each individual LCC focusing on their own markets with limited overlap to avoid cut-throat competition. Spring Airlines has developed an advanced network supported by its core bases including Shanghai in East China, Shijiazhuang in North China, Shenyang in Northeast China and Shenzhen in South China. China United has developed a network radiating from Beijing. West Air and Lucky Air seem to be developing a hub-and-spoke network that contributes to the tourism industry in West China. The LCC network is affected by seasonal variations, especially for the routes to tourism destinations such as Haikou, Sanya and Xiamen. Hub cities, however, experience less seasonal impact. This research also finds that routes between 600 and 1800 km account for a large proportion of the LCC markets. Aviation policy, local government's subsidization and the expansion of the high-speed rail network have helped shape the landscape of China's LCC sector. usc

Pancreatic cancer is currently one of the deadliest solid malignancies and pancreatic ductal adenocarcinoma (PDAC) is the most common type of pancreatic cancer. In the past decade, diagnostics and surgical techniques for PDAC have been evolving steadily; however, clinical outcomes of patients with PDAC have shown little, if any, improvement. Subgroup classification based on accurate prediction of prognosis in patients with pancreatic cancer is important for treatment selection and clinical decision-making. The traditional method to evaluate prognosis relies on the TNM staging system, but it may not reflect the true status of every patient due to individual biological differences. Metabolomics is a field of study that involves the identification and quantification of metabolites present in a biological system. Analysis of metabolic differences between cancerous and noncancerous tissues can provide novel insights into tumor biology that are closely associated with disease prognosis and diagnosis. Therefore, evaluation of metabolic tumor burden may improve the accuracy of the clinical decision-making process, thereby facilitating optimization of the treatment strategies for pancreatic cancer.

Recent aviation deregulation is producing structural changes within leisure industries in many parts of the world. This paper reviews the development of low cost carriers (LCCs) and assesses its effects on both of domestic and international charter markets in Japan since 2007. Furthermore, this paper analyzes the effect of scheduled services deregulation on international tourism to Japanese regional areas in relation to charter services. The results suggest that in the domestic market, LCC operations have seldom impacted charter traffic due to the differences in target markets and routes. In the international market, LCCs launched scheduled services to Japan but mainly on high demand routes. The deregulation of scheduled services led to a passenger shift from charters to newly scheduled flights and a concentration of tourist arrivals in regional centres. It also led to a decline in international tourist arrivals in some remote destinations. This paper indicates a current trend in which charter business is still an important sector in aviation and leisure markets.

Since 2007, Japan has deregulated charter operations to promote outbound tourism. This study investigated changes since deregulation in the spatial patterns of charter departure airports and traffic volume to major destinations. Furthermore, this study analyzed the effects of new entrant airlines on charter network evolution. For the purposes of this paper, charter supply data has been analyzed and case studies of a short-haul route from Japan to Korea, a medium-haul route to Pacific resorts, and a long-haul route to Europe have been conducted. The results suggest that deregulation has resulted in a concentration of charter departures at airports located in the Tokyo metropolitan area, and has had a variety of effects on charter traffic to major destinations. In particular, during the process of deregulation, the role of airlines has been shifted from carriers offering charter services under the requirement of tour operators to a market leader which controls the charter flows.

Few studies have examined differences in long-term mortality between coronary artery bypass graft surgery and stenting with drug-eluting stents (DES) for multivessel disease without left main coronary artery stenosis. This study compares the risks of long-term mortality between these 2 procedures during a follow-up of up to 5 years.Patients who underwent isolated bypass surgery (n=13,212) and stenting with DES (n=20,161) between October 2003 and December 2005 in New York State were followed for their vital status through 2008. To control for treatment selection bias, bypass and stenting patients were matched on age, number of diseased coronary vessels, presence of proximal or nonproximal left anterior descending (LAD) artery disease, and propensity of undergoing bypass surgery. Five-year survival rates for the 2 procedures were compared and hazard ratios for death of bypass surgery compared with stenting were obtained.The respective 5-year survival rates in the 8,121 pairs of matched bypass and stenting patients were 80.4% and 73.6% (p0.001), and the risk of death after bypass surgery was 29% lower than for stenting (hazard ratio = 0.71, 95% confidence interval: 0.67 to 0.77, p0.001). Significantly lower risks of death for bypass surgery were observed in patients with LAD artery disease but not in patients without LAD artery disease. Significantly lower risks of death for bypass surgery were also found in all patient subgroups defined by the presence of selected baseline risk factors.Bypass surgery is associated with lower risk of death than stenting with DES for multivessel disease without left main stenosis.

This paper examines the impact of charter services on international tourism in Japan. Particularly, charter flows between Japan and China are analyzed to examine their role in Sino-Japanese tourism. The results show that charters have contributed to geographic spread of tourism destinations in China, and that they meet dispersed and seasonal travel demand from Japanese regions. Scheduled services have not been able to entirely replace charter services, but cause uneven patterns in charter services.

Purpose There are few data on the risk for peripheral neuropathy associated with dronedarone, a newer antiarrhythmic medicine. The objective of this study was to assess whether dronedarone is potentially associated with an increased risk for peripheral neuropathy compared with other antiarrhythmics, including amiodarone, sotalol, flecainide, and propafenone. Methods The MarketScan database was used for identifying patients who were at least 18 years of age, had atrial fibrillation or flutter, and had not been diagnosed with peripheral neuropathy in the 180-day period prior to or on the date of the first prescription of an antiarrhythmic between July 20, 2009, and December 31, 2011. Peripheral neuropathy that occurred during the treatment period for a study drug was ascertained using ICD-9-CM diagnostic codes. For each antiarrhythmic, the incidence rate of peripheral neuropathy was calculated. The adjusted hazard ratio (aHR) for peripheral neuropathy for dronedarone compared with another antiarrhythmic was obtained, with control for age, sex, diabetes mellitus status, and the presence of other comorbidities. Findings The study population included 106,933 patients treated with dronedarone (n = 12,989), amiodarone (n = 45,173), sotalol (n = 22,036), flecainide (n = 14,244), or propafenone (n = 12,491). The incidence rates (per 1000 person–years) of peripheral neuropathy were 1.33 for dronedarone, 2.38 for amiodarone, 1.20 for sotalol, 1.08 for flecainide, and 1.97 for propafenone. The aHRs for peripheral neuropathy for dronedarone relative to other drugs ranged from 0.53 (95% CI, 0.21–1.34) compared with propafenone, to 0.94 (95% CI, 0.38–2.30) compared with sotalol. A new-user analysis showed similar results. Implications The risks for peripheral neuropathy were not significantly different between dronedarone and other antiarrhythmics.

Objectives We sought to compare outcomes for percutaneous coronary intervention patients undergoing complete revascularization (CR) and incomplete revascularization (IR) in the drug-eluting stent era. Background There have been relatively few studies that have examined the impact of IR in patients undergoing coronary stenting, particularly in the era of drug-eluting stents. Methods New York State9s Percutaneous Coronary Intervention Reporting System was used to identify 11,294 stent patients with multivessel disease undergoing either IR or CR in 39 hospitals between October 1, 2003, and December 31, 2004. These patients were followed through December 31, 2005, and IR patients were subdivided based on the number of IR vessels and presence of a chronic total occlusion. Risk-adjusted mortality and mortality/myocardial infarction (MI) for CR and IR patients were compared at 18 months. Results Incomplete revascularization was performed in a total of 7,795 patients (69.0%). Incomplete revascularization was associated with higher 18-month mortality (adjusted hazard ratio [HR]: 1.23, 95% confidence interval [CI]: 1.04 to 1.45) and higher 18-month MI/mortality (adjusted HR: 1.27, 95% CI: 1.09 to 1.47). The risk-adjusted survival rates for CR and IR were 94.9% and 93.8% (p = 0.01). The risk-adjusted survival/freedom from MI rates were 93.3% and 91.7% (p = 0.002). Patients with 2 diseased vessels unattempted with a total occlusion were at highest risk (adjusted survival HR: 1.44, 95% CI: 1.14 to 1.82, risk-adjusted survival 94.9% vs. 92.9%, p = 0.002; and adjusted survival/freedom from MI: 1.50, 95% CI: 1.21 to 1.86, rates 93.3% vs. 90.3%, p Conclusions Patients undergoing coronary stenting who receive IR experience more adverse outcomes even in the era of drug-eluting stents. This has implications for choice of procedure and post-procedural monitoring.

Objectives Our purpose was to develop a risk score to predict in-hospital mortality for percutaneous coronary intervention (PCI) using a statewide population-based PCI registry. Background Risk scores predicting adverse outcomes after PCI have been developed from a single or a small group of hospitals, and their abilities to be generalized to other patient populations might be affected. Methods A logistic regression model was developed to predict in-hospital mortality for PCI using data from 46,090 procedures performed in 41 hospitals in the New York State Percutaneous Coronary Intervention Reporting System in 2002. A risk score was derived from this model and was validated using 2003 data from New York. Results The risk score included nine significant risk factors (age, gender, hemodynamic state, ejection fraction, pre-procedural myocardial infarction, peripheral arterial disease, congestive heart disease, renal failure, and left main disease) that were consistent with other reports. The point values for risk factors range from 1 to 9, and the total risk score ranges from 0 to 40. The observed and recalibrated predicted risks in 2003 were highly correlated for all PCI patients as well as for those in the higher-risk subgroup who suffered myocardial infarctions within 24 h before the procedure. The total risk score for mortality is strongly associated with complication rates and length of stay in the 2003 PCI data. Conclusions The risk score accurately predicted in-hospital death for PCI procedures using future New York data. Its performance in other patient populations needs to be further studied.

Objectives The purpose of this research was to develop a risk index for in-hospital mortality for coronary artery bypass graft (CABG) surgery. Background Risk indexes for CABG surgery are used to assess patients’ operative risk as well as to profile hospitals and surgeons. None has been developed using data from a population-based region in the U.S. for many years. Methods Data from New York’s Cardiac Surgery Reporting System in 2002 were used to develop a statistical model that predicts mortality and to create a risk index based on a relatively small number of patient risk factors. The fit of the index was tested by applying it to another year (2003) of New York data and testing the correspondence of expected and observed mortality rates for each risk score in the index. Results The risk index contains a total of 10 risk factors (age, female gender, hemodynamic state, ejection fraction, pre-procedural myocardial infarction, chronic obstructive pulmonary disease, calcified ascending aorta, peripheral arterial disease, renal failure, and previous open heart operations). The score possible for each variable ranges from 0 to 5, and total risk scores possible range from 0 to 34. The highest score observed for any patient was 22, and 93% of the patients had scores of 8 or lower. When the risk index was applied to another year of New York data with a considerably lower mortality rate, the C-statistic was 0.782. Conclusions The risk index appears to be a valuable tool for predicting patient risk when applied to another year of New York data. It should now be tested against other risk indexes in a variety of geographical regions.

In this paper a continuous-time stochastic approximation (S.A.) procedure with randomly varying truncations is proposed, and for its convergence to the value to be sought for it is proved that the conditions imposed on the regression function are rather weak and neither the independence of the increment of the error process nor the boundedness of the procedure are required. The convergence rate and the asymptotic properties for a class of measurement errors are also concerned.