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Two patients with ureteric fistulae who were unfit for reconstructive surgery were treated by renal ablation using intra-arterial ethanol, gelfoam fragments and in one case coils. In both cases the fistulae dried-up on the same day and both patients are well and normotensive a year later. Our conclusion is that renal ablation by arterial embolization with ethanol can be a valuable alternative to surgery to treat ureteric fistulae in patients who are poor surgical risks.

Objective The current guidelines suggest alcohol septal ablation (ASA) is less effective in hypertrophic obstructive cardiomyopathy (HOCM) patients with severe left ventricular hypertrophy, despite acknowledging that systematic data are lacking. Therefore, we analysed patients in the Euro-ASA registry to test this statement. Methods We compared the short-term and long-term outcomes of patients with basal interventricular septum (IVS) thickness <30 mm Hg to those with ≥30 mm Hg treated using ASA in nine European centres. Results A total of 1519 patients (57±14 years, 49% women) with symptomatic HOCM were treated, including 67 (4.4%) patients with IVS thickness ≥30 mm. The occurrence of short-term major adverse events were similar in both groups. The mean follow-up was 5.4±4.3 years and 5.1±4.1 years, and the all-cause mortality rate was 2.57 and 2.94 deaths per 100 person-years of follow-up in the IVS <30 mm group and the IVS ≥30 mm group (p=0.047), respectively. There were no differences in dyspnoea (New York Heart Association class III/IV 12% vs 16%), residual left ventricular outflow tract gradient (16±20 vs 16±16 mm Hg) and repeated septal reduction procedures (12% vs 18%) in the IVS <30 mm group and IVS ≥30 mm group, respectively (p=NS for all). Conclusions The short-term results and the long-term relief of dyspnoea, residual left ventricular outflow obstruction and occurrence of repeated septal reduction procedures in patients with basal IVS ≥30 mm is similar to those with IVS <30mm. However, long-term all-cause and cardiac mortality rates are worse in the ≥30 mm group.

This study examined the effects of climate change on rice production in 30 Chinese provinces spanning 1998–2017. The study used the pooled mean group technique to capture the long-run and short-run effects of changing climatic conditions on rice production. It further employed the Dumitrescu–Hurlin panel causality test to examine the path of causality between the key variables and rice production. The study found that, in the long run, average temperature negatively influenced rice production, but average rainfall had a positive effect on rice production. The results indicated that the cultivated area and fertilizer usage were positively related to rice production in the long run. The short-run results accentuated that average temperature favourably influenced nationwide rice production, whereas average rainfall had no substantial effect on national rice production. The cultivated area had a significant positive short-term relationship with rice production, although the impact of fertilizer usage on rice production was negligible in the short run. Besides, the results established a bidirectional causality between rice output and the cultivated area, but there was a one-way causality running from fertilizer usage to rice output. Finally, the results indicated that, except for rainfall, a unidirectional causality exists between temperature and rice production. The study, therefore, recommends that in the case of crop failure due to weather conditions, policymakers could implement a new pricing policy to mitigate the deterioration of the farmers’ income. The government must also develop and implement an insurance scheme that compensates farmers for catastrophes induced by rainfall deficiency.

This study aimed to examine whether the administration of losartan can prevent acute elevation of pulmonary arterial pressure (AEPAP) induced by endovascular ethanol injection and to assess its related mechanisms. Male swine were selected and performed with absolute ethanol endovascular injection. Saline was used as the negative control. Losartan was administered preoperatively. Pulmonary arterial pressure (PAP), femoral arterial pressure (FAP) and heart rate (HR) were monitored during operations. Venous plasma and pulmonary artery (PA) tissue were harvested for analyses. Protein level was detected by Western blotting and ELISA, whereas qRT-PCR was used in mRNA detection. H & E staining and immunohistochemistry were conducted to evaluate histopathology. Ethanol injection elevated PAP in swine. The concentration of RAS ligands was elevated in plasma (all P < 0.0001) but not in PA. The level of oxidative stress increased in both plasma and PA. MRNA level of AT1R (P < 0.01, 95% CI: 0.251-1.006), not AT2R increased in PA. Losartan failed to inhibit AEPAP after all sessions of ethanol injection, and partially reversed the ethanol-induced PA remodeling. The P38 MAPK was activated after ethanol injection and could be inhibited by losartan (P < 0.01, 95% CI: -0.391 to -0.164). Ethanol also promoted the translocation of the P40-PHOX/P47-PHOX/P67-PHOX complex and the activation of NOX, which was independent from RAS. Endovascular ethanol injection can induce AEPAP mainly by activating RAS and P38 MAPK signaling. Losartan can partially prevent AEPAP and vascular remodeling owing to the promotion of NOX activity by ethanol. Mechanism diagram of endovascular ethanol injection-induced acute elevation of pulmonary arterial pressure (AEPAP) partially prevented by losartan. RAS: Renin-angiotensin system; AGT: angiotensinogen; Ang I: angiotensin I; ACE: angiotensin I converting enzyme; Ang II: angiotensin II. AT1R: angiotensin II type 1 receptor. NOX2: NADPH oxidase 2. PA: pulmonary artery.

In the past few decades, a competitive landscape, learned customers and rigorous regulations have forced manufacturing industries to focus on sustainability alongside operational efficiency. The main objective of the present study is to develop a systematic Green Lean Six Sigma (GLSS) framework for improvement in operational efficiency together with environmental and social sustainability. Further, the proposed framework was tested in a leading manufacturing company. The framework was designed with insights gained from the literature and industrial personnel and encompasses the systematic application of different tools of the Green paradigm, Lean, and Six Sigma, from the identification and assessment of the problem to the sustainment of the adopted measures. A systematic application of lifecycle assessment and social lifecycle assessment was used to assess environmental and societal performance. The sustainability focused GLSS framework enhances the environmental capability, process performance and provides a new perspective for researchers and practitioners to support GLSS projects to achieving higher sustainability dynamics.

In a climate constrained future, hybrid energy-economy model coupling gives additional insight into interregional competition, trade, industrial delocalisation and overall macroeconomic consequences of decarbonising the energy system. Decarbonising the energy system is critical in mitigating climate change. This chapter summarises modelling methodologies developed in the ETSAP community to assess economic impacts of decarbonising energy systems at a national level. The preceding chapter focuses on a global perspective. The modelling studies outlined here show that burden sharing rules and national revenue recycling schemes for carbon tax are critical for the long-term viability of economic growth and equitable engagement on combating climate change. Traditional computable general equilibrium models and energy systems models solved in isolation can misrepresent the long run carbon cost and underestimate the demand response caused by technological paradigm shifts in a decarbonised energy system. The approaches outlined within have guided the first evidence based decarbonisation legislation and continue to provide additional insights as increased sectoral disaggregation in hybrid modelling approaches is achieved.

AbstractThis chapter assesses the macroeconomic effects of carbon‐energy taxation introduced under unilateral environmental tax reform (ETR) in the 1990s undertaken in six member states of the European Union: Denmark, Finland, Germany, the Netherlands, Sweden, and the UK. The effects are estimated using the large‐scale Energy–Environment–Economy (E3) model for Europe, E3ME, which covers the countries involved as well as the complete single market, so that the effects on other economies can be considered, along with any effects on competitiveness. The method is to identify the key characteristics of the green tax reform packages and include these in the modelling of the price and non‐price effects of the ETR on energy use and international trade in E3ME. The effects are then compared with a ‘reference case’ (i.e. a counterfactual case) generated by E3ME over the period 1995–2012, including current and expected developments in the EU economy, e.g. the impact of the EU Emission Trading Scheme, but without the ETR. The revenue recycling meant that the cost of ETR to the economy was significantly reduced and in several cases resulted in an increase in GDP. The method for revenue recycling strongly affects the results, as does the scale of exemptions offered to certain fuel user groups.

A growing body of research indicates that phubbing can negatively influence adolescent development, it is not clear how perceived parental phubbing, adolescent phubbing, and adolescents' adjustment problems concurrently relate to each other at the dimension level. This study conducted the contemporaneous network analyses and cross-lagged network analysis to examine the distinct relationships between the various dimensions of perceived father phubbing, perceived mother phubbing, adolescent phubbing and adolescent's adjustment problems. A total of 1447 Chinese students (60.5% females; Mean age = 16.15, SD = 0.65) completed a survey at two-time points. The results of the contemporaneous network analyses indicated that perceived father/mother ignorance have the strongest links with the dimensions of adolescent phubbing and adolescents' adjustment problems, suggesting that adolescents who reported high levels of perceived father/mother ignorance are more likely to concurrently face other issues and thus should be a primary focus of concern. The cross-lagged panel network analysis revealed that academic burnout is the primary catalyst in this dynamic network, which underscores a child-driven effect within the network. This emphasizes the importance of addressing adolescent academic burnout as a pivotal intervention point, both to alleviate phubbing in parent-adolescent interactions and to tackle adolescents' adjustment problems.

The paper presents a generic model for the emission and repayment of carbon debt for the agricultural sector. Clearing of pristine land for food and energy crops is a major contribution to the rise in carbon emission especially in developing countries. It releases carbon stocks in vegetation as well as those trapped underground, and it typically takes years to repay the resulting carbon debt. This paper attempts to utilize composite curves to construct a graphical representation of carbon dioxide (CO2) levels over a finite time period. The aim is to produce a plantation scheduling system based on CO2 emission and manipulate the sizes of the land plots to meet the emission limit for the planning horizon. The final aim is to ultimately achieve an overall net reduction in CO2 level.