Investigating the impact of import, export, and innovation on carbon emission: evidence from Belt and Road Initiative countries.

Carbon emissions are a major cause of global climate change. The public is aware that the world must rapidly reduce its windows to avoid the worst effects of climate change. But how this responsibility is distributed between regions, countries, and individuals has become a recurring element of debate in international debates. Most countries are willing to adopt new policies to tackle the global problem of carbon emission. Since China is a real model and the first country of initiating the goal of carbon neutrality, this study aimed to compare the different impacts of export, import, and innovation on carbon emission in 29 selected countries with the Belt and Road Initiative from 2008 to 2019. STIRPAT modeling, cross-sectional analysis, and integrated testing were used to analyze the obtained data. The results show that exports and imports have a negative effect on carbon emission, and population size and energy efficiency increase carbon emission since most countries under the BRI are developing countries, and they tend to emit greatly due to various factors. However, the adoption of green energy via innovation has a significant impact on carbon emissions. In addition, the adoption of modern technologies via innovation reduces carbon emission by increasing energy efficiency. We recommended a set of policies that can efficiently reduce the emission of carbon to achieve an eco-friendly environment in the selected countries. It is important to promote environmental sustainability and the development of professional enterprises in certain countries.

Investigating the impact of air pollution in selected African developing countries.

Air pollution is a major challenge faced by most countries due to the continuous quest of industrialization leading to a high pollution, which Africa is not an exception. Nowadays countries are trying to regulate their carbon emission by transitioning from traditional methods to modern technologies. However, measures to reduce environmental pollution due to carbon emissions and PM2.5 do not receive rational attention and represent a serious threat to the continent. The aim of this study is to investigate the impact of the adoption of green innovation technologies on carbon and particulate matter (PM2.5) emission reduction in some of the most polluted African countries and its effect on the economic growth from 2000 to 2019. We based on cross-sectional dependency analysis, unit root test, and other robust tests for the data analysis since they are best fit and accurate for the data interpretation. The short- and long-term CS-ARDL empirical evidence showed a negative and significant impact of the adoption of green energy technology innovation on carbon and particulate matter emissions, implying that the adoption of green energy technology significantly reduces the emission of carbon and PM2.5 emissions. However, the results show that the use of non-renewable energies has a negative effect on environmental sustainability since it increases carbon and particle matter emissions. There is a need for the selected African countries to efficiently adopt ecofriendly technologies to reduce their carbon and PM2.5 emissions and take advantage of natural resources such as the constant sunny weather to implement the installation of solar panels as a source of energy and other technologies. Various recommendations have been made to effectively reduce CO2 and particulate matter emissions; future studies should be conducted on the implementation of the recommended policies.

Revitalization of Chinese's manufacturing industry under the carbon neutral goal.

Since the beginning of the Industrial Revolution, the manufacturing industry has been crucial for economic growth. China's manufacturing activity began after China approved and opened legal reform to the rest of the world in 1978. There are usually three stages of development, including the catch-up period. At the same time, they reflect the private economic sector, manufacturing, and foreign exchange industries, and the opening up to the international markets. This advancement comes along with high energy consumption, leading to a high rate of pollution. Therefore, this study provides a detailed overview of the "Made in China 2025" pilot target and implementations of policies to achieve a carbon-neutral goal. We assessed the efficiency of implementing policies in the Chinese manufacturing sector and recommended decision-making policies to achieve the "Made in China 2025" plan and the 2030 carbon-neutral goal. The Quantitative Strategic Programming Matrix (QSPM) and SWOT analysis matrix were used to put forward some development strategies to transform and upgrade China's manufacturing industry by combining relevant strategic theories. This study is significant in terms of energy-saving and carbon emission-reducing policy implementations for the Chinese manufacturing industry. In addition, we suggested some measures to achieve a sustainable environment in line with carbon-neutral policies.

Outcome of renal transplant recipients admitted to an intensive care unit: a 10-year cohort study.

BACKGROUND: Epidemiology and prognosis of severe complications related to renal transplantation requiring admission to intensive care unit (ICU) have not been assessed precisely. This study was undertaken to evaluate the outcome in this population and to identify the factors of prognosis. METHODS: All records of adult renal transplant recipients admitted to our ICU from 1997 to 2007 were reviewed including transplant variables, clinical and biological parameters, use of mechanical ventilation, catecholamine support, or dialysis or both. Mortality was assessed and data were analyzed to identify predictive factors of outcome. RESULTS: Twenty-seven women and 30 men, median age 54 years, were included in the study. Eighteen patients were oliguric, 35 were mechanically ventilated, 32 underwent hemodialysis, and 36 needed catecholamine. Twenty-three patients died (40.3%), a mortality significantly higher than in a matched by age and gravity scores control group of nontransplant ICU patients. By univariate analysis, survivors had a significantly lower ICU severity scores, a higher mean arterial pressure, a higher Glasgow Coma Score, a higher serum albumin, and a lower serum lactate on ICU admission. The need for catecholamine support, mechanical ventilation or dialysis or both during the ICU stay worsens the outcome significantly. Using the multivariate analysis, only the mean arterial pressure and the need for mechanical ventilation were predictive of mortality. CONCLUSION: The incidence of severe transplant-related complications requiring an admission to an ICU was at 16 of 1000 patients year with a mortality rate higher than the general ICU population (40% vs. 20%). These data suggest that immunosuppressive treatment of transplant patients with severe complications worsens significantly their outcome.

Complications, effects on dialysis dose, and survival of tunneled femoral dialysis catheters in acute renal failure.

BACKGROUND: Availability of a functional vascular access is a mandatory prerequisite for extracorporeal renal replacement therapy in patients with acute renal failure. The femoral site of insertion commonly is chosen because it is an easy and convenient access. However, an array of complications may substantially alter the quality of treatment, and it appears that catheter-related morbidity and dysfunction are more frequent with the femoral than internal jugular site. This study is designed to evaluate the potential benefits of using soft silicone tunneled catheters ((ST)Caths) at the femoral site. METHODS: Thirty patients with acute renal failure treated by intermittent hemodialysis (IHD) and/or continuous venovenous hemodiafiltration (CVVHDF) were assigned to either twin (ST)Caths or twin polyurethane nontunneled femoral catheters. Time necessary for catheter insertion, catheter-related complications, and catheter lifespan were monitored. Catheter performance during IHD and the effect of catheter type on dialysis dose were evaluated. RESULTS: The time necessary for (ST)Cath insertion was significantly longer. The incidence of vein thrombosis and catheter-related infection was lower, and the ratio of venous return pressure to catheter blood flow was better with an (ST)Cath. Recirculation rates were similar for both types of catheters. Whether treated by using IHD or CVVHDF, patients with an (ST)Cath benefited from a greater delivered dialysis dose. Multivariate analysis confirmed that (ST)Cath use was a determinant factor to optimize dialysis dose delivery. (ST)Cath patency was significantly longer. CONCLUSION: In patients with acute renal failure, use of an (ST)Cath minimizes catheter-related morbidity and improves dialysis efficiency compared with conventional femoral catheters.

Outcome and prognosis of severe thrombotic microangiopathies treated by plasma exchange.

BACKGROUND: Plasma exchange (PE) therapy has dramatically improved the outcome of thrombotic microangiopathies (TMA) in adults. However, resistance to PE, which indicates a poor prognosis, is observed in 1/3 of patients and remains not fully understood. We evaluated in this study the survival and the long-term outcome of severe TMA treated by PE and identified the predictive factors of resistance to PE and of mortality. MATERIAL/METHODS: Records of adults with severe TMA treated by PE were reviewed. Clinical and biological data, therapeutic delay to PE, plasma volume exchange per procedure, and number of PE sessions were collected. Mortality was assessed at one month and at one-year follow-up. All data were analyzed and compared between survived/deceased and between responder/non-responder patients. RESULTS: Nineteen females and six males were included. Mean age (+/-SD) was 46.8+/-16.3 years, Glasgow coma score 11+/-3, and Sequential Organ Failure Assessment (SOFA) score 5.8+/-2.8. Nineteen patients partially or fully responded to PE. Twenty patients were alive at one month and 19 at one year. The response to PE was the single discriminating parameter between survivors and non-survivors. A longer delay of PE and a neoplastic cause of TMA were significantly higher in the non-responders. CONCLUSIONS: Severe TMA treated by PE had a fair prognosis, with a survival rate at 76% after one year of follow-up. Unresponsiveness to PE was the only predictive factor of mortality; a neoplastic etiology of TMA and a longer therapeutic delay of PE were predictive of resistance to PE.

Superoxide anion overproduction in sepsis: effects of vitamin e and simvastatin.

Oxidative stress during sepsis induces tissue damage, leading to organ dysfunction and high mortality. The antioxidant effects of vitamin E have been reported in several diseases, but not in sepsis. Statins have cholesterol-independent anti-inflammatory effects that are related to a decrease of isoprenoid proteins and oxidative stress. Therefore, we evaluated superoxide anion (O2- degree) production and ex vivo effects of vitamin E and simvastatin in sepsis. Fourteen healthy volunteers, 14 intensive care unit (ICU) nonseptic, and 14 ICU patients with sepsis were included in this prospective study. Plasma cholesterol, triglyceride, and vitamin E levels were determined by routine laboratory tests. Superoxide anion production was measured in the venous blood by chemiluminescence technique after phorbol myristate acetate stimulation. Effects of vitamin E and simvastatin on O2- degree production was investigated ex vivo. Luminescence was indexed to the leukocyte count. We also investigated the in vitro effect of simvastatin on translocation of NADPH oxidase p21 Rac2 subunit in THP-1 monocytic cell line. The ratio of vitamin E/cholesterol + triglycerides was significantly decreased in septic as compared with nonseptic patients and volunteers. The O2- degree production was significantly higher in the group of septic patients than in the others, regardless of the polymorphonuclear leukocyte count. Vitamin E and simvastatin induced ex vivo an inhibition of O2- degree production of 20% and 40% respectively. In vitro, simvastatin inhibited phorbol myristate acetate-induced- O2- degree production by monocytes through NADPH oxidase inactivation. We conclude that sepsis is associated with a significant decrease in vitamin E and an overproduction of O2- degree. Vitamin E and simvastatin lessen this phenomenon through NADPH oxidase inactivation.

Vascular access for dialysis in the intensive care unit.

Management of the vascular access (VA) for renal replacement therapy (RRT) in acute renal failure (ARF) patients is faced with a twofold problem: first, the creation of an angio-access that is adequate for RRT in the acute setting; second, the preservation of the patient's vascular network in order not to preclude further use of the vessel in the event of evolution to chronic renal failure. Central venous catheters are the preferred VA for RRT in the intensive care setting. Semi-rigid double-lumen polyurethane catheters may be considered for short-time use (up to 2-3 weeks). Soft silicone double-lumen or twin-catheters, preferably with subcutaneous tunnelling, are highly desirable for prolonged RRT (over 3 weeks). The femoral route is the first option in the presence of associated risk factors (respiratory failure, pulmonary oedema, bleeding...). The internal jugular route should be considered for mid-term use in order to facilitate the patient's mobilization and to reduce the risk of infection. The subclavian route should be avoided because of the risk of stenosis and/or thrombosis of the outflow vein. Catheter insertion must be performed by a trained physician with ultrasound guidance using either skin mapping or continuous vein guidance. Catheter handling and care should comply with best practice guidelines and should be part of a continuous quality improvement programme in order to reduce catheter-related morbidity. Preservation of the upper limb vascular network of the patient consists of sparing the native vessels (artery and vein) of the patient and preserving the functionality of the permanent VA in chronic renal failure patient. This 'lifeline' of chronic renal failure patients may be maintained by preventing inflammation, infection and thrombosis of the superficial vessels of the arm and forearm of patient.

Continuous veno-venous hemofiltration improves hemodynamics in septic shock with acute renal failure without modifying TNFalpha and IL6 plasma concentrations.

BACKGROUND: Continuous hemofiltration improves hemodynamics in critically ill patients by removing cytokines from the plasma. The mechanism, however, remains to be clarified since recent studies show conflicting findings. The present study was therefore designed to evaluate hemodynamic changes and kinetics of tumor necrosis factor (TNF)alpha, interleukin (IL)1beta and IL6 in patients with septic shock and acute renal failure (ARF) undergoing continuous veno-venous hemofiltration (CWHF), over a 24-hour period. METHODS: Eleven patients admitted to the ICU for septic shock with ARF were investigated with radial artery and pulmonary artery catheterization during isovolemic CWHF using AN69 hemofilters at a blood flow rate of 240 mL/min and ultrafiltration 1.65 +/- 0.33 L/h. Hemodynamic measurements (mean arterial pressure, right arterial pressure, pulmonary artery pressure, pulmonary vascular resistance, systemic vascular resistance, cardiac output and tissue oxygenation indeces) were obtained before and after 2h, 4h, 6h, 12h and 24 h of CVVHF. Blood samples from the pre- and postfilter lines and ultrafiltrate samples were collected for the radioimmunoassay of TNFalpha, IL1beta and IL6 before and at 2h, 4h, 6h, 12h and 24h. RESULTS: During CVVHF, mean arterial pressure rose from 67 +/- 7 mm Hg to 89 +/- 5 mm Hg (p < 0.05) and indexed systemic vascular resistance from 711 +/- 153 dyne.s.cm(-5)/m2 to 1,200 +/- 100 dyne.s.cm(-5)/m2 (p < 0.05). Serum lactate and oxygen consumption did not change. Mean arterial pressure and systemic vascular resistance were not correlated to the lowering of body temperature during CVVHF. Significant clearance of IL6 was achieved, but not of TNFa, though the plasma concentrations of both cytokines were unaffected throughout the study. IL1beta was not detectable. Two patients were discharged alive with normal renal function. CONCLUSION: In patients with septic shock and ARF, CVVHF improves mean arterial pressure and systemic vascular resistance. This effect does not appear to be related to the removal of cytokines. The effect of CVVHF on mortality and morbidity in the long term, in septic shock has still to be established.