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Novel nonsteroidal mineralocorticoid receptor antagonists (MRAs) are noted for their potential cardiorenal benefits for patients with type 2 diabetes mellitus and chronic kidney diseases; however, the effect of this regimen on renal outcomes remains uncertain.We performed a systematic review and meta-analysis of nonsteroidal MRAs focusing primarily on renal outcomes and safety in randomized, controlled trials. The MEDLINE, Embase, and Cochrane databases were systemically searched for trials published through April 2022. We included randomized, controlled trials assessing the effects of nonsteroidal MRAs on renal outcomes, as well as cardiovascular disease (CVD) effects in patients with chronic kidney disease (CKD). Summary estimates of risk ratios (RRs) reductions were calculated with a random-effects model. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. This study is registered with PROSPERO under number CRD42022335464.In total, 11 trials and 1 pooled analysis including a total of 17,517 participants were enrolled. Nonsteroidal MRAs reduced renal composite endpoints by 17 % [HR = 0.83, 95 % (0.75, 0.91); low quality] with 16 % in kidney failure (high quality), 23 % in ESRD (high quality), 20 % in eGFR decreased to less than 15 mL/min/1.73 mNonsteroidal MRAs had a statistically beneficial effect on reducing the risk of the composite kidney outcome, the composite of cardiovascular outcomes, and all-cause mortality. Nonsteroidal MRAs were also associated with benefits of proteinuria remission and blood pressure lowering. Although these findings provided positive evidence for the use of nonsteroidal MRAs for cardiorenal protection in patients with or without CKD, the quality of this evidence is potentially uncertain.

The development of renewable energy is of great significance to relieve the pressure on the energy supply and promote the low-carbon operation of the power system. However, the volatility of renewable energy, especially wind and solar energy, has a great impact on the safe and reliable operation of the power system. If we want to introduce renewable energy and ensure the safe and reliable operation of the power system, it is necessary for the power system to provide enough flexibility. Northwest China is rich in natural resources and an important area of power supply in China, which also faces the problem of insufficient flexibility. Therefore, based on the power system development and natural conditions in northwest China, this paper studies the key factors affecting the flexibility of the power system when renewable energy accounts for a large proportion, and proposes measures to improve the flexibility of the power system by using the power system optimization tool Flextool developed by IRENA.

Background and objectives Several clinical practice guidelines noted the potential benefits of urate-lowering therapy on cardiovascular disease and CKD progression; however, the effect of this regimen remains uncertain. In this systematic review, we aimed to evaluate the efficacy of urate-lowering therapy on major adverse cardiovascular events, all-cause mortality, kidney failure events, BP, and GFR. Design, setting, participants, & measurements We systematically searched MEDLINE, Embase, and the Cochrane databases for trials published through July 2020. We included prospective, randomized, controlled trials assessing the effects of urate-lowering therapy for at least 6 months on cardiovascular or kidney outcomes. Relevant information was extracted into a spreadsheet by two authors independently. Treatment effects were summarized using random effects meta-analysis. Results We identified 28 trials including a total of 6458 participants with 506 major adverse cardiovascular events and 266 kidney failure events. Overall urate-lowering therapy did not show benefits on major adverse cardiovascular events (risk ratio, 0.93; 95% confidence interval, 0.74 to 1.18) and all-cause mortality (risk ratio, 1.04; 95% confidence interval, 0.78 to 1.39) or kidney failure (risk ratio, 0.97; 95% confidence interval, 0.61 to 1.54). Nevertheless, urate-lowering therapy attenuated the decline in the slope of GFR (weighted mean difference, 1.18 ml/min per 1.73 m2 per year; 95% confidence interval, 0.44 to 1.91) and lowered the mean BP (systolic BP: weighted mean difference, −3.45 mm Hg; 95% confidence interval, −6.10 to −0.80; diastolic BP: weighted mean difference, −2.02 mm Hg; 95% confidence interval, −3.25 to −0.78). There was no significant difference (risk ratio, 1.01; 95% confidence interval, 0.94 to 1.08) in the risk of adverse events between the participants receiving urate-lowering therapy and the control group. Conclusions Urate-lowering therapy did not produce benefits on the clinical outcomes, including major adverse cardiovascular events, all-cause mortality, and kidney failure. Thus, there is insufficient evidence to support urate lowering in patients to improve kidney and cardiovascular outcomes.

Land use/cover changes (LULC) are complicated and regionally diverse. When mining regional patterns, the use of a spatial relationship that is determined without considering the spatial correlation...

BACKGROUND: Sepsis has always been a challenge in pediatric intensive care unit (PICU) with poor prognosis. In order to evaluate the effect between routine continuous renal replacement therapy (CRRT) and high-volume hemofiltration (HVHF) in children with sepsis, we performed out this prospective, randomized, controlled, open-label trial. METHODS: Forty-seven children with sepsis were enrolled from January 2015 to December 2016. Twenty-two patients in Control group received routine CRRT and 25 patients in HVHF group received HVHF within 6 hours after the diagnosis of sepsis. The oxygenation index, serum creatinine, urea, lactate, inflammatory cytokines (IL-6, IL-10, and TNF-α), pediatric risk of mortality III (PRISM III) and 28-day mortality rate were collected and compared. RESULTS: The oxygenation index in HVHF group and Control group was significantly increased at 48 hours (P0.05). CONCLUSIONS: HVHF might be an effective treatment for children with sepsis.

Assessing heat-related health risks is important for sustainable urban development. Although fine-scale information (e.g., at the community/neighborhood or city block level) is ideal for identifying and mitigating these risks, previous studies have preferred to work at the administrative unit level. High-resolution Local Climate Zone (LCZ) maps, i.e., maps of urban “zones” with different microclimates, could help to standardize the analyzing units. In this study, we proposed an LCZ-based risk assessment approach for this purpose. First, an LCZ map of the study site (Changzhou, China) was generated using multisource big data and machine-learning techniques. Next, Crichton's Risk Triangle framework, based on the hazard-exposure-vulnerability risk components, was employed to estimate heat-related health risks. Finally, the relationship between LCZ types and heat-related health risk levels was quantitatively analyzed in detail. The results indicated that at least 60% of LCZ1-5 (compact high-/mid-/low-rise, open high-/mid-rise areas) were designated as high-risk areas, while heat hazard mitigation and climate adaptation strategies in urban planning would benefit more from LCZ 6 (open low-rise). This study, based on the LCZ concept, shows the risk difference at the community level, and can be used for informing and implementing area-level urban planning strategies. It could contribute to global heat-related health risk analysis, since the LCZ is a globally consistent system for urban microclimate analysis.

The synthesis of nano-sized alloys of Pt and rare earth (RE) metal catalysts has been a huge challenge due to a significantly large standard reduction potential difference of Pt and RE metals and the high synthesis temperature. Pt

In some cases, because of the complex internal structure of the machines, the positions of the vibration sensors are far away from the rolling bearings, such as in an aeroengine, causing the fault features to become extremely weak, which brings great challenge to the detection of rolling bearings. To address this problem, an integrated detection method is proposed. First, a method named MEDL is proposed to determine the optimal filter length in minimum entropy deconvolution (MED) to enhance the periodic fault impulse component in the weak signal, which accuracy is 1. After that, the MEDL is combined with variational mode decomposition (VMD) and autocorrelation to extract fault features from strong background noise. A series of fault simulation experiments for rolling bearings were conducted by using an aeroengine rotor experimental rig with casing. The results verify that the accuracy of the integrated detection method is 100 % in different measuring points, speeds and fault types. At the same time, it compared with spectral kurtosis (SK) and empirical wavelet transform (EWT). It proves that the integrated detection method is more robust in extracting the weak fault characteristic of rolling bearings from the casing signals effectively.

The agent-based modelling (ABM) is commonly used to simulate urban land growth. A key challenge of ABM for the simulation of urban land-use dynamics in support of sustainable urban management is to understand and model how human individuals make and develop their location decisions that then shape urban land-use patterns. To investigate this issue, we focus on modelling the agent learning process in residential location decision-making process, to represent individuals' personal and interpersonal experience learning during their decision-making. We have constructed an extended reinforcement learning model to represent the human agents' learning when they make location decisions. Consequently, we propose and have developed a new agent-based procedure for residential land growth simulation that incorporates an agent learning model, an agent decision-making model, a land use conversion model, and the impacts of urban land zoning and the developers' desires. The proposed procedure was first tested by using hypothetical data. Then the model was used for a simulation of the urban residential land growth in the city of Nanjing, China. By validating the model against empirical data, the results showed that adding agent learning model contributed to the representation of the agent's adaptive location decision-making and the improvement of the model's simulation power to a certain extent. The agent-based procedure with the agent learning model embedded is applicable to studying the formulation of urban development policies and testing the responses of individuals to these policies.

Introduction Diabetic kidney disease (DKD) is a major microvascular complication of diabetes mellitus (DM) and the primary cause of end-stage renal disease. Routine medication might result in adverse effects which limit their usage. Laboratory studies have shown that Xiao Zheng San Jie (XZSJ) granules is effective in reducing the levels of urinary protein and blood creatinine in rats with DKD. Hence, we aim to conduct a clinical trial to determine the efficacy and safety of XZSJ granules among patients with DKD Stage IV, who present with the syndromes of qi deficiency and blood stasis. The purpose of this paper is to report the methodology of this trial.Methods and analysisThis is a randomised, double-blind, placebo-controlled, multi-centre clinical trial. A total of 72 patients with DKD Stage IV who have the syndromes of qi deficiency and blood stasis will be randomly assigned to either intervention or placebo group. In addition to routine medication, the intervention group will be given XZSJ formula (in granules) and the control group will be given placebo for 12-weeks. Data collected at baseline as well as weeks 4, 8 and 12 will be recorded in case report forms and subsequently entered into EpiData 3.1 electronic database. Adverse events will also be documented. Primary outcomes – estimated glomerular filtration rate, urinary albumin-to-creatinine ratio, and serum creatinine – will be assessed after 12 weeks. Ethics and disseminationThis trial has been approved by the Research Ethics Committee of Dongzhimen Hospital (DZMEC-KY-2018-60). Informed consent will be obtained from all participants. Results of this study will be disseminated to the public through academic conferences and peer-reviewed journals.DiscussionThis trial might provide information on an effective method for the treatment of DKD, especially for patients who present with the syndromes of qi deficiency and blood stasis. We hope that this trial will serve as a reference for the conception of high-quality Traditional Chinese Medicine trials in the future, which incorporate syndrome diagnosis into the study design.Trial registration Chinese Clinical Trial Registry, ChiCTR1900021391. Registered 18 February 2018, http://www.chictr.org.cn/showproj.aspx?proj=36106.

Two-dimensional graphitic carbon nitride (g-C3N4, GCN) is considered as one of the promising visible light-responsive photocatalysts for energy storage and environmental remediation. However, the photocatalytic performance of pristine GCN is restricted by the inherent shortcomings of rapid charge carrier recombination and limited absorption of visible light. Vacancy engineering is widely accepted as the auspicious approach for boosting the photocatalytic activity of GCN-based photocatalysts. Herein, a magnesium thermal calcination method has been developed to reconstruct GCN, in which magnesium serves as a carbon etcher for introducing carbon vacancies and pores into GCN (Vc-GCN). The fabricated Vc-GCN demonstrates excellent photocatalytic performances of degrading hazardous 4-chlorophenol under visible light irradiation benefiting from the improved carrier separating and light absorption ability as well as rich reactive sites. The optimal Vc-GCN sample delivers 2.3-fold enhancement from the pristine GCN. The work provides a tactic to prepare GCN photocatalysts with controllable carbon vacancies and for a candidate for the degradation of organic pollutants from the environment.

Studies have shown that circular RNAs (circRNAs) have significant potential as novel molecular markers for the diagnosis, treatment, and prognosis of prostate carcinoma (PCa). However, the role and mechanism of circRNA hsa_circ_0102485 in PCa remains unclear.The real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to quantify hsa_circ_0102485 expression in PCa. The potential mechanisms and roles of hsa_circ_0102485 in tumor growth were explored using dual-luciferase-reporter and subcutaneous-xenograft assays, rescue experiments, and immunohistochemical staining. Clinical correlations were assessed by tissue-on-a-chip in-situ hybridization and Fisher's exact test.Hsa_circ_0102485 expression was decreased in PCa, and overexpression of hsa_circ_0102485 suppressed the proliferation, metastasis, invasion, and antiapoptotic abilities of PCa cells. MicroRNA 188-3p (MiR-188-3p) is a direct target of hsa_circ_0102485, and cotransfection of hsa_circ_0102485 in PCa cells overexpressing miR-188-3p inhibited its promotive effects. Hsa_circ_0102485 indirectly promotes the expression of AT-rich interaction domain 5B (ARID5B) and androgen receptor (AR) by sponging miR-188-3p and inhibiting PCa cell growth. Correlation analysis showed that hsa_circ_0102485 expression in PCa was not significantly correlated with the age, International Society of Urologic Pathologists (ISUP) grade, Gleason score, or lymph node metastasis status of PCa patients.Hsa_circ_0102485 plays an inhibitory role in PCa by regulating the Mir-188-3p/ARID5B/AR axis and may be a potential diagnostic biomarker and therapeutic target for PCa that requires further study.

Background IgA nephropathy is the most common glomerular disease and is a common cause of progression to end-stage renal disease in patients with kidney diseases. Proteinuria levels are critical for the prognosis of patients with IgA nephropathy, but many patients are still unable to effectively control their proteinuria levels after receiving RAAS blockers. Antimalarial drugs have shown good efficacy in the treatment of kidney disease in previous studies; however, there have been no strictly designed randomized controlled trials to confirm the clinical efficacy of artesunate for treating IgA nephropathy patients. Therefore, we designed this clinical trial to compare the effect of artesunate versus placebo in patients with IgA nephropathy. Methods This study is a randomized, double-blind, three-group-parallel, placebo-controlled clinical trial. One hundred and twenty eligible IgA nephropathy patients at risk of progression will be randomly divided into the artesunate 100-mg group, artesunate 50-mg group, and placebo group. Changes in proteinuria and renal function will be measured 6 months after the intervention. The levels of Gd-IgA1 and anti-Gd-IgA1 in the patient’s blood will also be tested to explore the possible immune mechanisms. Discussion Clinical evidence supporting artesunate treatment of IgA nephropathy is currently lacking, and we expect that the results of this trial will provide high-quality clinical evidence for artesunate as a treatment option for IgA nephropathy in the future. Trial registration Chinese Clinical Trial Registry ChiCTR2000038104. Registered on 10 September 2020

Background: The mortality prediction scores were widely used in pediatric intensive care units. However, their performances were unclear in Chinese patients and there were also no reports based on large sample sizes in China. This study aims to evaluate the performances of three existing severity assessment scores in predicting PICU mortality and to identify important determinants. Methods: This prospective observational cohort study was carried out in eight multidisciplinary, tertiary-care PICUs of teaching hospitals in China. All eligible patients admitted to the PICUs between Aug 1, 2016, and Jul 31, 2017, were consecutively enrolled, among whom 3,957 were included for analysis. We calculated PCIS, PRISM IV, and PELOD-2 scores based on patient data collected in the first 24 h after PICU admission. The in-hospital mortality was defined as all-cause death within 3 months after admission. The discrimination of mortality was assessed using the area under the receiver-operating characteristics curve (AUC) and calibrated using the Hosmer-Lemeshow goodness-of-fit test. Results: A total of 4,770 eligible patients were recruited (median age 18.2 months, overall mortality rate 4.7%, median length of PICU stay 6 days), and 3,957 participants were included in the analysis. The AUC (95% confidence intervals, CI) were 0.74 (0.71-0.78), 0.76 (0.73-0.80), and 0.80 (0.77-0.83) for PCIS, PRISM IV, and PELOD-2, respectively. The Hosmer-Lemeshow test gave a chi-square of 3.16 for PCIS, 2.16 for PRISM IV and 4.81 for PELOD-2 (p ≥ 0.19). Cox regression identified five predictors from the items of scores better associated with higher death risk, with a C-index of 0.83 (95%CI 0.79-0.86), including higher platelet (HR = 1.85, 95% CI 1.59-2.16), invasive ventilation (HR = 1.40, 1.26-1.55), pupillary light reflex (HR = 1.31, 95% CI 1.22-1.42) scores, lower pH (HR 0.89, 0.84-0.94), and extreme PaO2 (HR 2.60, 95% CI 1.61-4.19 for the 1st quantile vs. 4th quantile) scores. Conclusions: Performances of the three scores in predicting PICU mortality are comparable, and five predictors were identified with better prediction to PICU mortality in Chinese patients.

Despite the importance of seasonal distribution and interannual variability of rainfall to the ecosystem and society, there is a lack of regional-level studies on rainfall seasonality, and teleconnections between global climate events and rainfall seasonality are not well understood. To address these issues, this study analyzed the spatial and temporal characteristics of rainfall seasonality across China from 1961 to 2012. A novel application of information theory-based rainfall seasonality indicators was conducted at the regional scale, and observed monthly precipitation data was used. The rainfall seasonality anomalies during negative and positive phases of the El Nino–Southern Oscillation, Indian Ocean Dipole, North Atlantic Oscillation, and Pacific Decadal Oscillation, and the possible physical mechanisms behind were also investigated. The results showed that rainfall seasonality increased, especially in Southeast China, which can be attributed to changes in magnitude (annual rainfall), timing, or duration of the wet season. Global climate events significantly affected rainfall seasonality indicators in Southeast China during negative and positive phases. The sea surface temperature (SST) or sea level pressure (SLP), and wind anomalies during the negative and positive phases might explain the spatial differences in the influences of global climate events on rainfall seasonality across China. These results may prove valuable for sustainable water resource management and agricultural production in China.

Objective: The aim of this study is to investigate the role of prophylactic anticoagulation regimens based on low molecular weight heparin (LMWH) or aspirin in thromboembolic events in patients with primary membranous nephropathy (PMN). Methods: A total of 717 patients with PMN were consecutively enrolled in this retrospective study. The propensity score matching method was utilized to adjust for the selection bias inherent in an analysis of outcomes, which was stratified by the anticoagulation prophylaxis regimen. Results: According to the anticoagulation prophylaxis regimen, patients were assigned into three groups: only LMWH therapy (L + A−, n = 53), only aspirin therapy (L − A+, n = 97), and no therapy of LMWH or aspirin (L − A−, n = 567). After performing 1:1 match, 37 patients were selected in the L + A − group and the L − A− group, respectively, and 94 patients were selected in the L − A+ group and the L − A− group, respectively. It showed that the prophylactic use of LMWH had no protective effects on arterial thromboembolic events (ATEs) (10.8% vs. 21.6%, p = .21) or venous thromboembolic events (VTEs) (8.1% vs. 10.8%, p = .69). The incidence of VTEs in the L − A+ group was lower than the L − A− group (2.1% vs. 10.6%, p = .02), while there were no significant differences in the incidences of ATEs between the L − A+ group and the L − A− group (5.3% vs. 7.4%, p = .55). Conclusions: The prophylactic use of LMWH showed no benefits on the incidence of ATEs or VTEs in patients with PMN. Aspirin effectively decreased the incidence of VTEs, without effects on the occurrence of ATEs.

Impurity removal, the purification process from metallurgical grade silicon (MG-Si) required to obtain solar grade silicon (SoG-Si), is crucial to the preparation of silicon-based solar cells. Some...

Few people have paid attention to community epidemic prevention workers in the postpandemic era of COVID-19. This study aimed to explore the prevalence and risk factors for mental health symptoms in community epidemic prevention workers during the postpandemic era. Mental health status was evaluated by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Chinese Perceived Stress Scale, Insomnia Severity Index, and Maslach Burnout Inventory-General Survey. The results showed that a considerable proportion of community epidemic prevention workers reported symptoms of depression (39.7%), anxiety (29.5%), high stress (51.1%), insomnia (30.8%), and burnout (53.3%). The prevalence of depression and anxiety in community epidemic prevention workers was higher than in community residents. Among community epidemic prevention workers, short sleep duration was a risk factor for depression, anxiety, high stress and insomnia. Concurrent engagement in work unrelated to epidemic prevention and current use of hypnotics were risk factors for depression, anxiety and insomnia. Our study suggests that during the postpandemic era, the mental health problems of community epidemic prevention workers are more serious than those of community residents. Several variables, such as short sleep duration and concurrent engagement in work unrelated to epidemic prevention, are associated with mental health among community epidemic prevention workers.

The periodic determination of land use changes over large areas is crucial for improving our understanding of land system dynamics. Jiangsu lies at the center of China&rsquo, s Yangtze Delta and has one of the fastest-developing economies in China. However, it is also a region where serious conflicts exist between the available land resources and the human demand for land. To address these conflicts, it is important to analyze the patterns of land use change in Jiangsu, as they can serve as a useful reference for other rapidly urbanizing regions in China as well as other developing countries. In this study, we propose a method of classification and regression tree-random forest (CART-RF) classification with a multifilter based on time-series Moderate Resolution Imaging Spectroradiometer (MODIS) imaging data. The proposed method integrates the CART decision tree and the random forest algorithms (CART-RF) to obtain accurate yearly land use data for large areas from multivariate time-series remote sensing data and employs a spatial-temporal-logical filter to exclude any abnormal changes in the multivariate time-series pixel data. The obtained results indicated that (1) the CART-RF classifier is effective for land use classification based on the multivariate time-series MODIS data, with the overall classification accuracy being greater than 90%, (2) the use of the proposed combinatorial spatial-temporal-logical filtering method effectively eliminates most anomalous changes and minimizes the effects of &ldquo, salt-and-pepper&rdquo, noise, and (3) from 2000 to 2015, land use in Jiangsu province underwent significant and spatiotemporally heterogeneous changes on a province-wide scale, owing to various factors, such as those related to the economy, location, and government policies. These changes were manifested as continuous expansions in the built-up land at the expense of farmland. While this expansion of built-up land has been very rapid in southern Jiangsu, especially in the region close to Yangtze River Delta, it has been relatively slower in northern Jiangsu.

This thesis discusses the decentralized iterative learning control problem for general interconnected discrete-time systems, which are interlinked by non-affine nonlinear dynamics. And each subsystem does not have direct transmission from input to output. That is to say, each system is irregular. According to the structural characteristics of the system, a D-type learning algorithm is constructed. Using the iterative converge principle, it is shown that the output tracking error of each subsystem can converge to zero along the iteration axis. The effectiveness of the algorithm is verified by simulation.

The continuous reduction of farmland poses a serious threat to national food security. Delineating essential basic farmland for special protection is urgently needed in China and is an important measure to stabilize food production capacity and ensure regional food security. Currently, research on basic farmland delineation is mostly based on the evaluation of the characteristics of the farmland and lacks the integration of multiple factors such as spatial connectivity and scale constraints. Solving these issues will help improve the rationality and scientificity of basic farmland delineation. This study performed a case study of Changsha City based on land use, spatial planning, economic and social factors, natural geography, and other multi-source data. The index method and the food demand method were used to predict the scale of basic farmland protection to determine the basic farmland scale thresholds. Buffer analysis method is used to measure the spatial connectivity of farmland. This study implemented the LESA evaluation system to construct a comprehensive quality evaluation index system for farmland. Finally, based on the technical framework of basic farmland delimitation of “serial priority, quality screening, and scale constraint,” the basic farmland scale was determined to be 23,104,701 ha.

The electricity market reform in China promotes the marketization process of the electricity market, but in this process, there are still some behaviors that disturb the market order. The operation of electricity market needs to be evaluated in order to evaluate its operation efficiency, and the regulatory agency is an important part of it, so it is very necessary to construct the evaluation index and method of the operation efficiency of electricity market from the perspective of the regulatory agency. This paper constructed an evaluation system of power market operation efficiency based on hybrid BP neural network. In the construction of methods, appropriate evaluation methods become very necessary when considering the uncertainty and ambiguity of the assessed things. Based on the above analysis, this paper constructed an evaluation index system of power market operation efficiency based on SCP model, and constructed evaluation methods based on fuzzy Delphi, fuzzy AHP and neural network. Finally, this paper selects the actual data of a certain region for example verification, and conducts sensitivity analysis to analyze the factors that have a key impact on the efficiency of market operation, and draws the conclusion of this paper. This paper hopes that the research results can be applied to the decision-making of regulators in order to make the electricity market run efficiently.

A forward-looking urban land use plan is crucial to a city’s sustainability, which requires a deep understanding of human-environment interactions between different domains, and modelling them soundly. One of the key challenges of modelling these interactions is to understand and model how human individuals make and develop their location decisions by learning that then shape urban land-use patterns. To investigate this issue, we have constructed an extended experience-weighted attraction learning model to represent the human agents’ learning when they make location decisions. Consequently, we propose and have developed an agent-based learning-embedded model (ABM-learning) for residential land growth simulation that incorporates a learning model, a decision-making model, a land use conversion model and the constraint of urban land use master plan. The proposed model was used for a simulation of the residential land growth in Shenzhen city, China. By validating the model against empirical data, the results showed that the site-specific accuracy of the model has been improved when embedding learning model. The analysis on the simulation accuracies has proved the argument that modelling individual-level learning matters in the agent’s decision model and the agent-based models. We also applied the model to predict residential land growth in Shenzhen from 2015 to 2035, and the result can be a reference for land-use allocation in detailed planning of Shenzhen. The ABM-learning is applicable to studying the past urban growth trajectory, aiding in the formulation of detailed residential land and public service facility planning and assessing the land use planning effectiveness.

Global warming and climate change have become a serious environmental problem and China's carbon emissions are currently the highest in the world. Cities are the main sources of carbon emissions and the key to solving these problems. Therefore, research on reducing carbon dioxide emissions is a matter of concern. In this study, a spatial autocorrelation analysis was performed to understand the spatial characteristics of carbon dioxide emissions in 171 Chinese cities. Then, stepwise and geographically weighted regressions were used to explore the processes that drive carbon dioxide emissions in Chinese cities. A two-step cluster was used to classify Chinese cities into different categories based on the degree of impact of each driver. The results showed that there is a spatial aggregation relationship between urban carbon dioxide emissions. High-high clusters mainly occur in the Beijing-Tianjin-Hebei and Yangtze River Delta urban agglomerations, while low-low clusters occur in the central, western, and southwestern cities. Among all variables, freight volume, per capita gross domestic product, population density, and the proportion of secondary industries correlate positively with carbon dioxide emissions, whereas the number of buses per 10,000 people correlates negatively with carbon dioxide emissions. The geographically weighted regression model provided more detailed results and revealed the spatial heterogeneity of the effects of the different drivers. The impact of population, economic factors, and industrial factors in the eastern region is significantly greater than that in the central and western regions. Freight volume and public transport have the most significant impact in the northeast region. The clustering results showed that cities can be divided into four types. These findings provide a reference and policy suggestions for how cities in different regions should reduce carbon dioxide emissions.

Coastal reclamation has been regarded as an effective means to provide space for urban expansion and industrial development in China, given its low cost and flexible utilization. The Chinese government has issued a series of policies to boost or slow down reclamation to cope with varied conditions of domestic and international environments for China's economic development and marine environment problems. This paper aims to improve Chinese sea use management policy by analyzing reclamation area, the introduction of policies, and the impacts of these policies on reclamation from 2002 to 2018. First, statistical data and remote sensing data are used for analyzing the reclamation area and the construction area of the reclaimed land in the coastal areas of China. The results show that China reclaimed 2976.1 km2 from the sea, of which 910.8 km2 was constructed for urbanization and industrialization during 2002–2018. Whilst the statistical data from the Sea-Use Bulletin show that 1449.4 km2 reclamation area was issued sea area user's right. The results indicate an increased trend of annual reclamation area from 2002 to 2015, a relatively stable annual construction area, and a declining construction ratio. Second, we connect the reclamation change and the change of the policy system following a review on the sea use management policy system. The analysis demonstrates that the stability and predictability of the policy system need improvement. Special efforts should be devoted to reinforcing law enforcement supervision and the concept of sustainable sea use should be advocated.

Background: Several clinical practice guidelines noted the potential benefits of urate-lowering therapy (ULT) on cardiovascular disease (CVD) and chronic kidney disease (CKD) progression, however effect of this regimen remains much uncertainty. In this systematic review, we aimed to evaluate the efficacy of ULT on major adverse cardiovascular events(MACEs), all-cause mortality and kidney failure events. Methods: We systematically searched MEDLINE, Embase, and the Cochrane databases for trials published through April 2019. We included prospective, randomized, controlled trials assessing the effects of ULT on cardiovascular or renal outcomes. We extracted published data and did a meta-analysis of urate-lowering therapy on relative risks (RRs) of major adverse cardiovascular events, all-cause mortality, kidney failure events, and adverse events. Summary estimates of RR reductions were calculated with a random effects model. Findings: We identified 28 trials including a total of 9194 participants, of which 5070 participants received ULT, 4104 participants received placebo, usual-care or no treatment. Finally, 1279 MACEs, 377 deaths and 87 kidney failure events were recorded. Among all the population with 3103 (34·18%) participants having chronic kidney disease and 5718 (61·14%) having cardiovascular disease or stroke, ULT reduced the risk of MACEs [risk ratio (RR) 0·80, 95% confidence interval (CI) 0·67-0·95; I2 = 42·7%] and all-cause mortality (RR 0·80, 95% CI 0·66-0·97; I2 =0·0%), but had no effect on kidney failure (RR 1·04, 95%CI 0·43-2·42; I2 =64·4%). There was no significant difference (RR=0·99, 95% CI 0·95 to 1·03; I2 =55·7%) in the risk of adverse events between the participants receiving ULT and the control group. Interpretation: ULT has a beneficial effect on reducing the risk of MACEs and all-cause mortality. However, there is insufficient evidence to support an effect of ULT in reducing risk of kidney failure events. Funding Statement: This work was funded by National Key Research and Development Program of China (2018YFC1314004). JL was supported by the grant from the National Natural Science Foundation of China (no. 81270795), JZ was supported by the National Natural Science Foundation of China (81874401). Dr Badve is supported by a John Chalmers Clinical Research Fellowship with the support of Servier from The George Institute for Global Health. Declaration of Interests: Dr Badve reports grants from the National Health and Medical Research Council of Australia, personal fees from Bayer AG and Amgen Australia, and nonfinancial support from Bayer AG. Other authors listed in this paper declare no competing interests. Ethics Approval Statement: This study is registered with PROSPERO, number CRD42018104227.

This study aims to support sustainable urban and environmental planning by using urban growth simulation models, in which environmental quality is employed as one of the inputs. We proposed an extended SLEUTH urban growth model (UGM) for the regions threatened by environmental quality degradation caused by uncontrolled urban expansion. In this model, habitat quality is assessed by the InVEST model and is used to represent environmental quality, which is utilized in urban growth simulation. The habitat quality map is used to replace the slope layer as input for the SLEUTH model's urban growth simulation for cities where relatively flat topography makes this layer of minimal explanatory value. The extended SLEUTH UGM was calibrated using data for Changzhou city, China in 1990, 2000, 2010, and 2014. The best value of the Optimal SLEUTH Metric (OSM) was calculated for both the standard SLEUTH UGM and the extended SLEUTH UGM independently. The OSM value for the latter model was much higher than that of the former model, which indicated that the extended model provided a better explanation of urban growth in the study area. The calibrated extended SLEUTH UGM was applied to predict growth in Changzhou city from 2014 to 2030. The result showed that the urban area is expected to expand about 626 km2 by 2030. Comparison with the prediction result by using standard SLEUTH UGM showed that the area with high habitat quality could be reserved and the urban expansion could be limited by using our model. The findings demonstrate that the extended SLEUTH UGM could be a valuable tool for sustainable urban and environmental planning and management in developing regions where environmental protection should be considered as one of the major land-use objectives in their rapid urbanization process.

Polygon rasterisation is a fundamental process in geographic information science. Because of recent increases in the quantity of vector data, rapid rasterisation techniques are urgently needed. This study explores methods for combining processes and threads on multi-core CPUs to accelerate large-scale polygon rasterisation. First, a data decomposition method is adopted for effective load balancing between processes and threads. Second, a polygon processing strategy is proposed to manage four types of exceptional polygons. Using these approaches, a hybrid parallel framework is proposed to parallelise sequential rasterisation algorithms while maximising their processing speed. The experimental results show that the implemented parallel algorithm can efficiently reduce rasterisation time (from 40.62 h to 1.97 h) and obtain a satisfactory speed-up of 20.62. The proposed hybrid parallel algorithm outperforms pure process-level or pure thread-level implementations. Moreover, the proposed decomposition methods c...

Conventional algorithms for polygon rasterization are typically designed to maintain non-topological characteristics. Consequently, topological relationships, such as the adjacency between polygons, may also be lost or altered, creating topological errors. This paper proposes a topology-preserving polygon rasterization algorithm to avoid topological errors. Four types of topological error may occur during polygon rasterization. The algorithm starts from an initial polygon rasterization and uses a set of preserving strategies to increase topological accuracy. The count of the four types of error measures the topological errors of the conversion. Topological accuracy is summarized as 1 minus the ratio of actual topological errors to the total number of possible error cases. When applied to a land-use dataset with a data volume of 128 MB, 127,836 polygons, and extending 1352 km2, the algorithm achieves a topological accuracy of more than 99% when raster cell size is 30 m or smaller (100% for 5 and 10 m). The effects of cell size, polygon shape, and number of iterations on topological accuracy are also examined.

Objective To investigate the efficacy and safety of rituximab (RTX) in the treatment of idiopathic membranous nephropathy (IMN) with nephrotic syndrome with a systematic review and meta-analysis. Methods PubMed, Embase, Cochrane Library and Clinical Trials (December 2016) were searched to identify researches investigating the treatment of RTX in adult patients with biopsy-proven IMN. Complete remission (CR) or partial remission was regarded as effective therapy, and the cumulated remission rate was calculated. Result Seven studies involved 120 patients (73% were men) were included in our systematic review and meta-analysis. All were prospective observation cohort studies or matched-cohort studies, mainly came from two medical centers, and one study was multi-centric (four nephrology units in northern Italy). The creatinine clearance was more than 20 ml/(min·1.73 m2) and persistent proteinuria higher than 3.5 g/d for at least 6 months. All patients received treatment previously [44 (36.7%) had immunosuppressive treatment]. In 12- and 24-month, 56% (95%CI, 0.47-0.65) and 68% (95%CI, 0.41-0.87) patients could reach remission, while 15% (95%CI, 0.09-0.23) and 20% (95%CI, 0.12-0.32) patients could reach CR. The reduction in proteinuria was gradual and obvious, paralleled with upward trend of serum albumin level and decreasing serum cholesterol level. Renal functions were stable. Relapses happened in 24 months were around 8%. RTX related adverse events were mild and were mostly infusion-related reactions. Conclusions RTX treatment in IMN was efficient, well tolerated and safe. More than 60% patients can reach partial remission or CR in 24 months, and relapse is rare. Adverse events of RTX are mostly infusion-related reactions and generally mild.

Objective The aims of this study were to assess incidences and characteristics of arterial thromboembolic events (ATEs) and venous thromboembolic events (VTEs) in Chinese patients with idiopathic membranous nephropathy (IMN), and to identify the predisposing risk factors of them.Methods A total of 766 consecutive Chinese patients with IMN were enrolled in this retrospective cohort study. The cumulative incidences of newly diagnosed ATEs and VTEs were calculated using Kaplan-Meier methods. Univariable risk prediction model analysis followed by multivariable survival analysis was used to evaluate the potential risk factors of ATE and VTE.Results At 0.5, 1, 2, 3, and 5 years after biopsy diagnosis of IMN, the cumulative incidence of newly diagnosed ATEs were 4.3%, 5.7%, 6.3%, 7.1%, and 8.0%, and of newly diagnosed VTEs were 5.9%, 6.8%, 6.9%, 7.0%, and 7.2%, respectively. In 78 ATEs events (71 patients), cardiovascular diseases, thrombotic ischemic stroke (IS) and peripheral artery disease accounted for 50%, 45% and 5% respectively; in 60 VTEs events(53 patients), the deep vein thrombosis, renal vein thrombosis and pulmonary embolism accounted for 60%, 13% and 27% respectively. At the time of event, 42.1% patients with ATEs and 81.5% patients with VTEs were at nephrotic syndrome(NS) status (χ 2=18.1, P

With increasing interest in optical in vivo imaging, there is a corresponding increase in demand for near-infrared (NIR) dyes. Such probes can be used, for example, to detect intracellular GSH, which would be helpful for understanding the mechanisms of diseases. In this work, we report a cyanine-based fluorescent probe that undergoes biothiol-promoted specific O-S cleavage and subsequent self-immolation through intramolecular 1,6-elimination. In addition, we investigated the cell viability of the system and successfully applied the probe to living cells, in vivo, and in various tissues.

A reaction-based two-photon (TP) ratiometric fluorescence probe Z2 has been developed and successfully applied to detect and image fluoride ion in living cells and tissues. The Z2 probe was designed designed to utilize an ICT mechanism between n-butylnaphthalimide as a fluorophore and tert-butyldiphenylsilane (TBDPS) as a response group. Upon addition of fluoride ion, the Si-O bond in the Z2 would be cleaved, and then a stronger electron-donating group was released. The fluorescent changes at 450 and 540 nm, respectively, made it possible to achieve ratiometric fluorescence detection. The results indicated that the Z2 could ratiometrically detect and image fluoride ion in living cells and tissues in a depth of 250 μm by two-photon microscopy (TPM).

When estimating national PM2.5 concentrations, the results of traditional interpolation algorithms are unreliable due to a lack of monitoring sites and heterogeneous spatial distributions. PM2.5 spatial distribution is strongly correlated to elevation, and the information diffusion algorithm has been shown to be highly reliable when dealing with sparse data interpolation issues. Therefore, to overcome the disadvantages of traditional algorithms, we proposed a method combining elevation data with the information diffusion algorithm. Firstly, a digital elevation model (DEM) was used to segment the study area into multiple scales. Then, the information diffusion algorithm was applied in each region to estimate the ground PM2.5 concentration, which was compared with estimation results using the Ordinary Kriging and Inverse Distance Weighted algorithms. The results showed that: (1) reliable estimate at local area was obtained using the DEM-assisted information diffusion algorithm; (2) the information diffusion algorithm was more applicable for estimating daily average PM2.5 concentrations due to the advantage in noise data; (3) the information diffusion algorithm required less supplementary data and was suitable for simulating the diffusion of air pollutants. We still expect a new comprehensive model integrating more factors would be developed in the future to optimize the interpretation accuracy of short time observation data.

Chiral amino acid-based monosubstituted acetylene monomers [ N - tert -butoxy-carbonyl- l -phenylalanine- N ′-propargylamide (LP), and N - tert -butoxycarbonyl- l -serine- N ′-propargylamide (LS)] were (co)polymerized with rhodium zwitterion catalyst in THF to afford helical polyacetylenes (PAs) with moderate molecular weights (4400–14,800) in good yields. The optically active PA copolymers were soluble in common organic solvents and proven to adopt predominately single-handed helical conformations according to their intense Cotton effect and large specific rotations. Various contents of amino acid units in side chains facilitated controllable helical secondary structure while the helix was primarily stabilized by hydrogen bonding and steric repulsion between the substituents. Intramolecular hydrogen bonds constructed between hydroxyl and amide groups, in particular, played a significant role in adjusting the helicity and orderliness of the helix. The infrared emissivity values of the PAs at wavelength of 8–14 μm were measured and the correlation between helical conformations and their effect on infrared emission were systematically investigated. The results showed that more well-ordered and compact screw-sense could enhance the performance of organic polymers in lowering their infrared emissivity. Among all the as-prepared PAs, poly(LP 50 - co -LS 50 ) exhibited the lowest infrared emissivity value ( e 25 = 0.632) and possessed excellent resistance against heat.

In the present study, a kind of single-hole glutathione (GSH)-responsive degradable hollow silica nanoparticles (G-DHSNs) was synthesized and used as carriers of doxorubicin (DOX) (DOX-G-DHSNs). The G-DHSNs were accurately designed and fabricated with a simple and convenient method, and without any extra pernicious component. The composition, morphology and properties of the G-DHSNs had been characterized by (1)HNMR spectra, Fourier transform infrared spectrograph, thermo gravimetric analysis, transmission electron microscope, and scanning electron microscope. The degradation study of G-DHSNs showed that the G-DHSNs would be broken into pieces after interacting with GSH. Besides, the negligible hemolytic activity and low cytotoxicity of the G-DHSNs demonstrated its excellent biocompatibility. pH- and GSH-triggered release of DOX followed by the decomposition of G-DHSNs within TCA8113 cancer cells was further confirmed by flow cytometry and confocal laser scanning microscopy studies. All of these results indicated that G-DHSNs can be used as safe and promising drug nanocarriers.

Optically active polyacetylenes (LPA and DPA) and racemic polyacetylenes (RPA) were prepared by the polymerization of N-propioloyl-tyrosine methyl esters that derived from chiral and racemic tyrosine. All the polymers were characterized by Fourier transform infrared spectroscopy, 1H NMR, 13C NMR, gel permeation chromatography, thermogravimetric analysis, UV–vis spectroscopy, and circular dichroism spectroscopy; furthermore, the infrared emissivity values were also investigated. Both LPA and DPA possessed the helical conformations and a higher degree of intra- and interchain hydrogen bonds compared with RPA, which presented irregular polymer chain. The thermal stability of LPA and DPA was higher than that of RPA due to the helical conformations, which could be easy to form a high degree of intra- and interchain hydrogen bonds in the structure. Therefore, LPA and DPA exhibited lower infrared emissivity values (8–14 μm) than that of RPA, which resulted from the helical conformations and a higher degree of intra- and interchain hydrogen bonds.