RESUMEN
Given the great importance attached to ecological civilization and green development, exploring the heterogeneous effects of environmental regulation policy synergy on ecological resilience holds significance for improving environmental protection and the design of environmental policies. Based on the policy synergy perspective, this paper uses 30 provinces (municipalities and autonomous) in China as the research sample. Bayesian quantile regression is employed to explore the heterogeneous effects of environmental regulation policy synergy on ecological resilience from 2007 to 2021, and the moderating effect of the industrial structure is examined. The results indicate the following: (1) there is significant heterogeneity and variability in the effect of environmental regulation policy synergy on ecological resilience. Specifically, the effects of policy mixes 12, 13, and 23 on ecological resilience shows a U-shaped trend, while the impact of policy mix 123 on ecological resilience shows a positive effect. (2) There are significant differences in the effects of environmental regulation policy synergy under different quantiles of ecological resilience. Taking policy mix 12 as an example, we find that the effect of policy synergy on ecological resilience tends to decrease and then increase at a lower quantile. Additionally, the effect of policy synergy on ecological resilience tends to be positive at a higher quantile. (3) There are significant differences in the moderating effects of the industrial structure. Policy mix 12 can effectively enhance ecological resilience through industrial structure upgrading, while the moderating effects of alternative policy combinations are deemed insufficient. Finally, relevant policy recommendations are proposed to effectively improve ecological resilience.
Asunto(s)
Política Ambiental , Resiliencia Psicológica , Teorema de Bayes , China , Políticas , Desarrollo EconómicoRESUMEN
Background: Pulmonary artery hypertension (PAH) is a common complication of congenital heart disease (CHD) and is associated with worse outcomes and increased mortality. The Doppler echocardiography (DE) is a commonly used imaging tool for both diagnosis and follow-up examination of PAH. Here is to evaluate the diagnostic performance of DE combined with NTproBNP/BNP as screening strategy in PAH patients with CHD. Methods: A retrospective study in 64 patients with CHD has been carried out to compare estimate pulmonary artery systolic pressure (PASP) measured with DE to that measured with right heart catheterization (RHC). The Pearson correlation analyses were used to calculate the correlation coefficients between RHC and DE. The Bland-Altman analyses were carried out to assess the agreement between the two methods. ROC analyses were used to evaluate the diagnostic performance of DE, NTproBNP/BNP, and DE combined with NTproBNP/BNP. Results: Our data have demonstrated that a mild correlation (r = 0.4401, P < 0.01) was observed between PASP (78.1 ± 29.0 mmHg) measured during RHC and PASP (74.9 ± 19.7 mmHg) as estimated using DE. The Bland-Altman analysis demonstrated that the bias for DE PASP estimates was 3.2 mmHg with 95% limits of agreement ranging from -49.53 to 55.90 mmHg. The results of DE showed an AUC of 0.848 (95% CI = 0.666-1; P < 0.001), the sensitivity of which was 98.3% and the specificity was 77.8%. The AUC of NTproBNP/BNP for the identification of PAH was 0.804 (95% CI = 0.651-0.956; P < 0.001), the sensitivity of which was 81.4% and the specificity was 87.5%. The AUC of DE combined with NTproBNP/BNP was 0.857 (95% CI = 0.676-1; P < 0.001), of which sensitivity was 100% and specificity was 77.8%. The positive predictive value (PPV) and negative predictive value (NPV) were 96.6% and 100%, respectively. Conclusions: Our study shows that the Doppler echocardiography combined with NTproBNP/BNP has better diagnostic performance in pulmonary artery hypertension associated with congenital heart disease, especially when DE negative screening in PAH patients.
Asunto(s)
Cardiopatías Congénitas , Hipertensión Pulmonar , Hipertensión Arterial Pulmonar , Humanos , Arteria Pulmonar/diagnóstico por imagen , Estudios Retrospectivos , Ecocardiografía Doppler/métodos , Cardiopatías Congénitas/complicacionesRESUMEN
A comprehensive understanding of the effect of environmental regulation policy synergy on carbon emissions is essential for the design and decision-making of the other policy combinations. In this paper, the panel data from 30 provinces in China during 2000-2019 are used as samples to investigate the heterogeneity of different policy combinations and compare the differences using a Bayesian non-parametric generalized additive quantile method. The research results imply that the environmental regulation policy synergy has a significant heterogeneous effect on carbon emissions on different levels. Specifically, the effect of environmental regulation policy synergy on carbon emissions has an inverted U-shape trend at the low quintiles, i.e., before the turning point, it shows a "green paradox" effect, and after the turning point, it shows an "emission reduction" effect. However, the effect of environmental regulation policy synergy on carbon emissions shows a significant N-shape trend at the high quintiles, i.e., before the second turning point, it shows an "emission reduction" effect, and after the second turning point, it shows a "green paradox" effect. Moreover, the effect of environmental regulation policy combinations on carbon emissions reduction has been found to vary significantly across regions.