Clinical, echocardiographic and cardiac MRI predictors of outcomes in patients with apical hypertrophic cardiomyopathy.

Recent studies have found that some adverse cardiovascular events could also occur in patients with apical hypertrophic cardiomyopathy (ApHCM), which is different with previous studies suggesting benign nature of this condition. Therefore, the present study aimed to observe the clinical prognosis of ApHCM and to identify the predictors of poor prognosis in clinical, echocardiography and cardiac magnetic resonance (CMR). A total of 126 ApHCM patients with both echocardiography and CMR were identified retrospectively from January 2008 to December 2018. Adverse clinical events were defined as a composite of cardiac death, progressive heart failure, myocardial infarction, thromboembolic stroke, appropriate implantable cardioverter-defibrillator (ICD) interventions for ventricular tachycardia or ventricular fibrillation, and new-onset atrial fibrillation (AF). During a mean follow-up of 96.8 ± 36.0 months, clinical events were observed in 34 (27.0%) patients. As compared with patients without clinical events, patients with clinical events were older and had a higher incidence of heart failure. Moreover, patients with clinical events had a higher incidence of non-sustained ventricular tachycardia (NSVT) and had larger left atrial volume index (LAVI), thicker apical thickness, lower peak systolic mitral annular velocity (S') than those without clinical events. In addition, late gadolinium enhancement (LGE) in CMR were more frequently observed in patients with clinical events. Five predictors of poor prognosis were identified: age ≥ 55 years, LAVI ≥ 36.7 ml/m2, S' ≤ 6.7 cm/s, NSVT and LGE. ApHCM was not as benign as expected. Age ≥ 55 years, LAVI ≥ 36.7 ml/m2, S' ≤ 6.7 cm/s along with NSVT and LGE were independent predictors for poor prognosis of ApHCM.

Comprehensive and high-resolution emission inventory of atmospheric pollutants for the northernmost cities agglomeration of Harbin-Changchun, China: Implications for local atmospheric environment management.

Using a bottom-up estimation method, a comprehensive, high-resolution emission inventory of gaseous and particulate atmospheric pollutants for multiple anthropogenic sectors with typical local sources has been developed for the Harbin-Changchun city agglomeration (HCA). The annual emissions for CO, NOx, SO2, NH3, VOCS, PM2.5, PM10, BC and OC during 2017 in the HCA were estimated to be 5.82 Tg, 0.70 Tg, 0.34 Tg, 0.75 Tg, 0.81Tg, 0.67 Tg, 1.59 Tg, 0.12 Tg and 0.26 Tg, respectively. For PM10 and SO2, the emissions from industry processes were the dominant contributors representing 54.7% and 49.5%, respectively, of the total emissions, while 95.3% and 44.5% of the total NH3 and NOx emissions, respectively, were from or associated with agricultural activities and transportation. Spatiotemporal distributions showed that most emissions (except NH3) occurred in November to March and were concentrated in the central cities of Changchun and Harbin and the surrounding cities. Open burning of straw made an important contribution to PM2.5 in the central regions of the northeastern plain during autumn and spring, while domestic coal combustion for heating purposes was significant with respect to SO2 and PM2.5 emissions during autumn and winter. Furthermore, based on Principal Component Analysis and Multivariable Linear Regression model, air temperature, relative humidity, electricity and energy consumption, and the urban and rural population were optimized to be representative indicators for rapidly assessing the magnitude of regional atmospheric pollutants in the HCA. Such indicators and equations were demonstrated to be useful for local atmospheric environment management.

Does the prohibition on open burning of straw mitigate air pollution? An empirical study in Jilin Province of China in the post-harvest season.

Straw open burning is common practice in agricultural production, and has been identified as highly relevant to regional haze. A variety of control measures for straw open burning have been adopted in agricultural areas to mitigate air pollution, but their contribution to air quality improvement is difficult to estimate, and has been addressed by few studies. Using Jilin Province during the post-harvest season (PHS) as a study area, we empirically evaluated the contribution of the Straw Open Burning Prohibition Plan (SOBP) to air quality improvement by response surface methodology (RMS) modeling combined with scenario analysis, and constructed and introduced a stagnant index to the RMS model. The results indicated that the adoption of the SOBP by Jilin Province in the 2018 PHS mitigated air pollution effectively. The contribution of the plan to air quality improvement was also evaluated under two scenarios: if the SOBP had been implemented during the 2015 PHS, 2016 PHS, and 2017 PHS, the cumulative PM2.5 concentration would have declined in these years by 23%, 15%, and 22%, respectively, compared with their actual values; if the SOBP had not been implemented in the 2018 PHS, the cumulative PM2.5 concentration would have increased by 10%-14% compared with the actual value. The results can provide decision makers with a reference to assess the environmental performance of the SOBP, and guidance for establishing scientific environmental regulations for cleaner agricultural production and sustainable development.