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1.
PLoS One ; 13(2): e0192546, 2018.
Article in English | MEDLINE | ID: mdl-29394287

ABSTRACT

[This corrects the article DOI: 10.1371/journal.pone.0169483.].

2.
PLoS One ; 12(1): e0169483, 2017.
Article in English | MEDLINE | ID: mdl-28046106

ABSTRACT

Many payment for ecosystem services (PES) programs, such as the Slope Land Conversion Program (SLCP), are passive and require full participation by impacted households. In contrast, this study considers the alternative of "active and incomplete" participation in PES programs, in which participants are not obliged to contract their own land, and have the right to select into the program or not. This type of program has been popular over the last decade in China; however, there have been few studies on the characteristics of willingness to participate and implementation. As such, this paper uses the Choice Experiment (CE) method to explore ways for inducing effective program participation, by analyzing the effects of different regime attributes. The case study used to analyze participation utility was the Jing-Ji Afforestation Program for Ecological and Water Protection (JAPEWP), a typical active-participation forestry PES program, and a key source of water near Beijing in the Miyun Reservoir Catchment (MRC). Analyzing rural household survey data indicated that the program faces a variety of challenges, including long-term maintenance, implementation performance, cost-effectiveness, and monitoring approaches. There are also challenges with one-size-fits-all payment strategies, due to ineffective program participation or imperfect implementation regimes. In response, this study proposes several policies, including providing secure and complete land tenure to the participants, creating more local off-farm employment opportunities, designing performance-based monitoring systems that are integrated with financial incentives, applying differentiated payment strategies, providing capacity building to support forestation activities, and establishing a comprehensive implementation regime that would address these challenges. These policy conclusions provide valuable lessons for other active-participation PES programs as well.


Subject(s)
Choice Behavior , Conservation of Natural Resources , Ecosystem , Agriculture/methods , China , Cost-Benefit Analysis , Family Characteristics , Forestry/economics , Humans , Public Policy , Rural Population , Social Class , Socioeconomic Factors
3.
Am J Hematol ; 86(11): 923-7, 2011 Nov.
Article in English | MEDLINE | ID: mdl-21812017

ABSTRACT

Anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the most prevalent forms of anemia and often occur concurrently. Standard tests of iron status used in differential diagnosis are affected by inflammation, hindering clinical interpretation. In contrast, soluble transferrin receptor (sTfR) indicates iron deficiency and is unaffected by inflammation. Objectives of this prospective multicenter clinical trial were to evaluate and compare the diagnostic accuracy of sTfR and the sTfR/log ferritin index (sTfR Index) for differential diagnosis using the automated Access(®) sTfR assay (Beckman Coulter) and sTfR Index. We consecutively enrolled 145 anemic patients with common disorders associated with IDA and ACD. Subjects with IDA or ACD + IDA had significantly higher sTfR and sTfR Index values than subjects with ACD (P < 0.0001). ROC curves produced the following cutoffs for sTfR: 21 nmol/L (or 1.55 mg/L), and the sTfR Index: 14 (using nmol/L) (or 1.03 using mg/L). The sTfR Index was superior to sTfR (AUC 0.87 vs. 0.74, P < 0.0001). Use of all three parameters in combination more than doubled the detection of IDA, from 41% (ferritin alone) to 92% (ferritin, sTfR, sTfR Index). Use of sTfR and the sTfR Index improves detection of IDA, particularly in situations where routine markers provide equivocal results. Findings demonstrate a significant advantage in the simultaneous determination of ferritin, sTfR and sTfR Index. Obtaining a ferritin level alone may delay diagnosis of combined IDA and ACD.


Subject(s)
Anemia, Iron-Deficiency/diagnosis , Anemia/diagnosis , Biomarkers/blood , Ferritins/analysis , Iron Deficiencies , Receptors, Transferrin/analysis , Adult , Aged , Aged, 80 and over , Anemia/blood , Anemia/complications , Anemia/pathology , Anemia, Iron-Deficiency/blood , Anemia, Iron-Deficiency/complications , Anemia, Iron-Deficiency/pathology , Chronic Disease , Diagnosis, Differential , Female , Humans , Inflammation/blood , Inflammation/complications , Male , Middle Aged , Prospective Studies , ROC Curve , Solubility , Transferrin/metabolism
4.
Nephrol Dial Transplant ; 26(10): 3207-11, 2011 Oct.
Article in English | MEDLINE | ID: mdl-21355066

ABSTRACT

BACKGROUND: We describe urinary neutrophil gelatinase-associated lipocalin (uNGAL) values in association with clinical characteristics and urinary parameters in adults undergoing coronary angiography. METHODS: This is an observational study of consecutive patients who underwent elective coronary angiography during a 4-month period in a large urban tertiary care hospital. RESULTS: One hundred and thirteen patients were enrolled, and 100 had sufficient data to be included in the analyses. A large range of preprocedural uNGAL levels were observed (range 1-269 ng/mg Cr). Median preprocedural uNGAL was 8 ng/mg Cr. Age (P = 0.009), serum creatinine (P = 0.077) and albumin excretion (P = 0.009) were significant predictors of baseline uNGAL. Half the cohort demonstrated an increase and half a decrease in the absolute values of uNGAL after angiography, irrespective of preprocedural levels. CONCLUSIONS: We observed variable, but relatively low absolute levels of uNGAL prior to angiography in this 'cardiac' cohort. Only age, serum creatinine and albumin excretion could explain some of this variability. When designing studies of at-risk individuals where uNGAL may be used as a marker for acute kidney injury, this variability should be taken into account.


Subject(s)
Acute-Phase Proteins/urine , Biomarkers/urine , Coronary Angiography , Creatinine/urine , Heart Diseases/diagnostic imaging , Heart Diseases/urine , Lipocalins/urine , Proto-Oncogene Proteins/urine , Adult , Aged , Cohort Studies , Female , Humans , Lipocalin-2 , Male , Middle Aged , Sensitivity and Specificity
5.
Radiology ; 222(3): 652-60, 2002 Mar.
Article in English | MEDLINE | ID: mdl-11867781

ABSTRACT

PURPOSE: To compare T2-weighted breath-hold single-shot fast spin-echo (SE) and gadolinium-enhanced spoiled gradient-echo (GRE) MR imaging with contrast material administered orally and rectally for evaluating patients with Crohn disease. MATERIALS AND METHODS: Twenty-eight patients with Crohn disease received 2% barium sulfate and water enema. The abdomen and pelvis were imaged with transverse and coronal single-shot fast SE and gadolinium-enhanced spoiled GRE MR imaging. Two radiologists reviewed the two types of images for bowel disease. The extent, severity, and conspicuity of the disease were determined. Proof of bowel disease at MR imaging was compared with that at endoscopy, barium study, and surgery. Statistical analysis was performed with the McNemar test. RESULTS: Twenty-five of 28 patients had proven abnormal bowel segments. The per-patient sensitivity of gadolinium-enhanced spoiled GRE MR imaging for the two radiologists was 100% and 96% versus 60% and 60% (P <.05) with single-shot fast SE MR imaging. Gadolinium-enhanced spoiled GRE MR images depicted more segments (54 and 52 of 61 segments; sensitivity, 89% and 85%, respectively) of the diseased bowel than did single-shot fast SE MR images (31 and 32 of 61 segments; sensitivity, 51% and 52%, respectively; P <.001). Severity of Crohn disease was correctly depicted at gadolinium-enhanced spoiled GRE imaging in 93% of patients versus in 43% of patients at single-shot fast SE imaging. CONCLUSION: In patients with Crohn disease, gadolinium-enhanced fat-suppressed spoiled GRE MR imaging better depicted the extent and severity of intestinal disease compared with single-shot fast SE imaging.


Subject(s)
Contrast Media , Crohn Disease/diagnosis , Endoscopy, Gastrointestinal , Gadolinium DTPA , Intestine, Large/pathology , Magnetic Resonance Imaging , Adult , Barium Sulfate , Crohn Disease/diagnostic imaging , Diagnostic Errors , Enema , Female , Humans , Intestine, Large/diagnostic imaging , Male , Middle Aged , Radiography , Retrospective Studies , Sensitivity and Specificity
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