Based on observations and Coupled Model lntercomparison Project Phase 5 （CMIP5） results, multidecadal variations and trends in annual mean surface air temperature anomalies （SATa） at global, hemispheric, and hemis...Based on observations and Coupled Model lntercomparison Project Phase 5 （CMIP5） results, multidecadal variations and trends in annual mean surface air temperature anomalies （SATa） at global, hemispheric, and hemispheric land and ocean scales in the past and under the future scenarios of two representative concentration pathways （RCPs） are analyzed. Fifteen models are selected based on their performances in capturing the temporal variability, long-term trend, multidecadal variations, and trends in global annual mean SATa. Observational data analysis shows that the multidecadal variations in annual mean SATa of the land and ocean in the northern hemisphere （NH） and of the ocean in the southern hemisphere （SH） are similar to those of the global mean, showing an increase during the 1900-1944 and 1971-2000 periods, and flattening or even cooling during the 1945-1970 and 2001-2013 periods. These observed characteristics are basically reproduced by the models. However, SATa over SH land show an increase during the 1945-1970 period, which differs from the other hemispheric scales, and this feature is not captured well by the models. For the recent hiatus period （2001-2013）, the projected trends of BCC-CSM1-1-m, CMCC-CM, GFDL-ESM2M, and NorESM1-ME at the global and hemispheric scales are closest to the observations based on RCP4.5 and RCP8.5 scenarios, suggesting that these four models have better projection capability in SATa. Because these four models are better at simulating and projecting the multidecadal trends of SATa, they are selected to analyze future SATa variations at the global and hemispheric scales during the 2006-2099 period. The selected multi-model ensemble （MME） projected trends in annual mean SATa for the globe, NH, and SH under RCP4.5 （RCP8.5） are 0.17 （0.29） ℃, 0.22 （0.36） ℃, and 0.11 （0.23） ℃-decade-1 in the 21st century, respectively. These values are significantly lower than the projections of CMIP5 MME without model selection.展开更多
AIM:To investigate national trends in distal pancreatectomy(DP) through query of three national patient care databases.METHODS:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvem...AIM:To investigate national trends in distal pancreatectomy(DP) through query of three national patient care databases.METHODS:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvement Project(NSQIP,2005-2010),and the Surveillance Epidemiology and End Results(SEER,2003-2009) databases using appropriate diagnostic and procedural codes we identified all patients with a diagnosis of a benign or malignant lesion of the body and/or tail of the pancreas that had undergone a partial or distal pancreatectomy.Utilization of laparoscopy was defined in NIS by the International Classification of Diseases,Ninth Revision correspondent procedure code;and in NSQIP by the exploratory laparoscopy or unlisted procedure current procedural terminology codes.In SEER,patients were identified by the International Classification of Diseases for Oncology,Third Edition diagnosis codes and the SEER Program Code Manual,third edition procedure codes.We analyzed the databases with respect to trends of inpatient outcome metrics,oncologic outcomes,and hospital volumes in patients with lesions of the neck and body of the pancreas that underwent operative resection.RESULTS:NIS,NSQIP and SEER identified 4242,2681 and 11 082 DP resections,respectively.Overall,laparoscopy was utilized in 15%(NIS) and 27%(NSQIP).No significant increase was seen over the course of the study.Resection was performed for malignancy in 59%(NIS) and 66%(NSQIP).Neither patient Body mass index nor comorbidities were associated with operative approach(P = 0.95 and P = 0.96,respectively).Mortality(3% vs 2%,P = 0.05) and reoperation(4% vs 4%,P = 1.0) was not different between laparoscopy and open groups.Overall complications(10% vs 15%,P < 0.001),hospital costs [44 741 dollars,interquartile range(IQR) 28 347-74 114 dollars vs 49 792 dollars,IQR 13 299-73 463,P = 0.02] and hospital length of stay(7 d,IQR 4-11 d vs 7 d,IQR 6-10,P < 0.001) were less when laparoscopy was utilized.One and two year survival after resection for malignancy were unchanged over the course of the study(ductal adenocarinoma 1-year 63.6% and 2-year 35.1%,P = 0.53;intraductal papillary mucinous neoplasm and nueroendocrine 1-year 90% and 2-year 84%,P = 0.25).The majority of resections were performed in teaching hospitals(77% NIS and 85% NSQIP),but minimally invasive surgery(MIS) was not more likely to be used in teaching hospitals(15% vs 14%,P = 0.26).Hospitals in the top decile for volume were more likely to be teaching hospitals than lower volume deciles(88% vs 43%,P < 0.001),but were no more likely to utilize MIS at resection.Complication rate in teaching and the top decile hospitals was not significantly decreased when compared to non-teaching(15% vs 14%,P = 0.72) and lower volume hospitals(14% vs 15%,P = 0.99).No difference was seen in the median number of lymph nodes and lymph node ratio in N1 disease when compared by year(P = 0.17 and P = 0.96,respectively).CONCLUSION:There appears to be an overall underutilization of laparoscopy for DP.Centralization does not appear to be occurring.Survival and lymph node harvest have not changed.展开更多
The six papers in this special issue of China Population and Development Studies(CPDS)cover an interesting and broad range of topics related to households and living arrangements.Analyzing past trends and making proje...The six papers in this special issue of China Population and Development Studies(CPDS)cover an interesting and broad range of topics related to households and living arrangements.Analyzing past trends and making projections of households and living arrangements are important for understanding important issues such as older adults’care needs,and demands for housing and home-based energy.展开更多
The universal two-child policy,implemented in October,2015,is considered to be the most significant adjustment in the history of China's family planning program.Using data from the 2014 national population samplin...The universal two-child policy,implemented in October,2015,is considered to be the most significant adjustment in the history of China's family planning program.Using data from the 2014 national population sampling survey,this paper employs a population group-component calculation and projection method to compute the number of target population in 2016 and then to estimate the number of extra births that are likely to result from implementation of the universal two-child policy.The results show that the total number of extra births is estimated to be approximately 17.2 million in the years 2017-2021,with the number of extra births per year ranging from approximately 1.6 to 4.7 million.This will lead to a dramatic shift in China's TFR from an estimated 1.6 in 2016 to one approaching the replacement level,and then dropping to a projected 1.7.With the universal two-child policy in place,China's total population will grow to about 1.45 billion around 2028 and then gradually begin shrioking.The labor force will become larger under the universal two-child policy than it would if the stricter birth control policy were maintained,with an estimated 50 million additional people aged 15-59 in 2050.With implementation of China's new fertility policy,an estimated 34%of the population will be over 60 years of age in 2050,almost three percentage points lower than the level if the former fertility policy were continued.展开更多
基金This study was supported by National Key Research and Development Program of China （2016YFA0601801）, the State Key Program of National Natural Science Foundation of China （41530424）, National Program on Global Change and Air-Sea Interactions, State Oceanic Administration （SOA） （GASI-IPOVAI-03）, and the National Natural Science Foundation of China （41305121）. We sincerely thank two anonymous reviewers whose comments improved the paper.
文摘Based on observations and Coupled Model lntercomparison Project Phase 5 （CMIP5） results, multidecadal variations and trends in annual mean surface air temperature anomalies （SATa） at global, hemispheric, and hemispheric land and ocean scales in the past and under the future scenarios of two representative concentration pathways （RCPs） are analyzed. Fifteen models are selected based on their performances in capturing the temporal variability, long-term trend, multidecadal variations, and trends in global annual mean SATa. Observational data analysis shows that the multidecadal variations in annual mean SATa of the land and ocean in the northern hemisphere （NH） and of the ocean in the southern hemisphere （SH） are similar to those of the global mean, showing an increase during the 1900-1944 and 1971-2000 periods, and flattening or even cooling during the 1945-1970 and 2001-2013 periods. These observed characteristics are basically reproduced by the models. However, SATa over SH land show an increase during the 1945-1970 period, which differs from the other hemispheric scales, and this feature is not captured well by the models. For the recent hiatus period （2001-2013）, the projected trends of BCC-CSM1-1-m, CMCC-CM, GFDL-ESM2M, and NorESM1-ME at the global and hemispheric scales are closest to the observations based on RCP4.5 and RCP8.5 scenarios, suggesting that these four models have better projection capability in SATa. Because these four models are better at simulating and projecting the multidecadal trends of SATa, they are selected to analyze future SATa variations at the global and hemispheric scales during the 2006-2099 period. The selected multi-model ensemble （MME） projected trends in annual mean SATa for the globe, NH, and SH under RCP4.5 （RCP8.5） are 0.17 （0.29） ℃, 0.22 （0.36） ℃, and 0.11 （0.23） ℃-decade-1 in the 21st century, respectively. These values are significantly lower than the projections of CMIP5 MME without model selection.
文摘AIM:To investigate national trends in distal pancreatectomy(DP) through query of three national patient care databases.METHODS:From the Nationwide Inpatient Sample(NIS,2003-2009),the National Surgical Quality Improvement Project(NSQIP,2005-2010),and the Surveillance Epidemiology and End Results(SEER,2003-2009) databases using appropriate diagnostic and procedural codes we identified all patients with a diagnosis of a benign or malignant lesion of the body and/or tail of the pancreas that had undergone a partial or distal pancreatectomy.Utilization of laparoscopy was defined in NIS by the International Classification of Diseases,Ninth Revision correspondent procedure code;and in NSQIP by the exploratory laparoscopy or unlisted procedure current procedural terminology codes.In SEER,patients were identified by the International Classification of Diseases for Oncology,Third Edition diagnosis codes and the SEER Program Code Manual,third edition procedure codes.We analyzed the databases with respect to trends of inpatient outcome metrics,oncologic outcomes,and hospital volumes in patients with lesions of the neck and body of the pancreas that underwent operative resection.RESULTS:NIS,NSQIP and SEER identified 4242,2681 and 11 082 DP resections,respectively.Overall,laparoscopy was utilized in 15%(NIS) and 27%(NSQIP).No significant increase was seen over the course of the study.Resection was performed for malignancy in 59%(NIS) and 66%(NSQIP).Neither patient Body mass index nor comorbidities were associated with operative approach(P = 0.95 and P = 0.96,respectively).Mortality(3% vs 2%,P = 0.05) and reoperation(4% vs 4%,P = 1.0) was not different between laparoscopy and open groups.Overall complications(10% vs 15%,P < 0.001),hospital costs [44 741 dollars,interquartile range(IQR) 28 347-74 114 dollars vs 49 792 dollars,IQR 13 299-73 463,P = 0.02] and hospital length of stay(7 d,IQR 4-11 d vs 7 d,IQR 6-10,P < 0.001) were less when laparoscopy was utilized.One and two year survival after resection for malignancy were unchanged over the course of the study(ductal adenocarinoma 1-year 63.6% and 2-year 35.1%,P = 0.53;intraductal papillary mucinous neoplasm and nueroendocrine 1-year 90% and 2-year 84%,P = 0.25).The majority of resections were performed in teaching hospitals(77% NIS and 85% NSQIP),but minimally invasive surgery(MIS) was not more likely to be used in teaching hospitals(15% vs 14%,P = 0.26).Hospitals in the top decile for volume were more likely to be teaching hospitals than lower volume deciles(88% vs 43%,P < 0.001),but were no more likely to utilize MIS at resection.Complication rate in teaching and the top decile hospitals was not significantly decreased when compared to non-teaching(15% vs 14%,P = 0.72) and lower volume hospitals(14% vs 15%,P = 0.99).No difference was seen in the median number of lymph nodes and lymph node ratio in N1 disease when compared by year(P = 0.17 and P = 0.96,respectively).CONCLUSION:There appears to be an overall underutilization of laparoscopy for DP.Centralization does not appear to be occurring.Survival and lymph node harvest have not changed.
文摘The six papers in this special issue of China Population and Development Studies(CPDS)cover an interesting and broad range of topics related to households and living arrangements.Analyzing past trends and making projections of households and living arrangements are important for understanding important issues such as older adults’care needs,and demands for housing and home-based energy.
基金funded by National Natural Science Foundation of China(7WXJ731).
文摘The universal two-child policy,implemented in October,2015,is considered to be the most significant adjustment in the history of China's family planning program.Using data from the 2014 national population sampling survey,this paper employs a population group-component calculation and projection method to compute the number of target population in 2016 and then to estimate the number of extra births that are likely to result from implementation of the universal two-child policy.The results show that the total number of extra births is estimated to be approximately 17.2 million in the years 2017-2021,with the number of extra births per year ranging from approximately 1.6 to 4.7 million.This will lead to a dramatic shift in China's TFR from an estimated 1.6 in 2016 to one approaching the replacement level,and then dropping to a projected 1.7.With the universal two-child policy in place,China's total population will grow to about 1.45 billion around 2028 and then gradually begin shrioking.The labor force will become larger under the universal two-child policy than it would if the stricter birth control policy were maintained,with an estimated 50 million additional people aged 15-59 in 2050.With implementation of China's new fertility policy,an estimated 34%of the population will be over 60 years of age in 2050,almost three percentage points lower than the level if the former fertility policy were continued.
