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Objectives. To build a guideline for the individual treatment of Tetralogy of Fallot (TOF) with major aortopulmonary collaterals (MAPCAs) and tentatively establish the occlusion index of MAPCAs. Methods. According to the diameter of the aortopulmonary collaterals (R: mm) and the bodyweight of the children (weight: kg), K= ((∑R2)/Wt) was set as the occlusion index of TOF with MAPCAs. A retrospective study was initially performed in 171 patients who suffered from TOF with MAPCAs and underwent cardiac malformation repair to investigate the intervals of the K value: K≥2, 12)/Wt), which can effectively avoid unnecessary collateral occlusion, minimize trauma, and shorten the length of ICU and hospital stay. When K≥2, the collateral occlusion and surgical correction are recommended to be performed simultaneously. When 1

Regardless of the implementation of central environmental protection inspection, a campaign style enforcement, across China to address the upsurging environmental issues in recent years, very few studies have revealed the effect of central environmental protection inspection on corporate environmental actions in China. This paper focuses on China's central environmental protection inspection to evaluate the effectiveness of campaign-style enforcement in promoting corporate environmental actions. Using a regression discontinuity design and one of the most comprehensive datasets of environmental statistics on firm-level pollution from 2011 to 2018 in one province in south China. Based on 15,154 enterprise observations, we find that the central environmental protection inspection is associated with substantial changes in corporate environmental actions. We also find that the number of polluting firms shrank by 48% (and by even more among small and micro firms) after the implementation of the central environmental protection inspection. Furthermore, the central environmental protection inspection significantly reduces industrial chemical oxygen demand (COD) emissions by at least 46.5% without affecting the production output of surviving firms. These findings are robust to alternative specifications and different sampling strategies. This paper opens up a new viewpoint to focus on the effect of the central environmental protection inspection on corporate environmental actions. The available evidence leads us to cautiously conclude that environmental campaign-style enforcement promotes firms meeting emissions reduction goals in the short term through end-of-pipe abatement. A long-term inspection mechanism and incentives for firms to carry out green transformations are thus recommended for future practice. Image 1 • The Central Environmental Protection Inspection has caused a large number of polluting firms to be closed. • The surviving polluting firms reduce pollutant by carrying out end-of-pipe emission reduction. • Campaign-style enforcement can improve the corporate environmental performance in the short term. • In the long run, effective supporting policies should be employed to guide firms to achieve green transformations. [ABSTRACT FROM AUTHOR]

Objectives: Tetralogy of Fallot (TOF) with major aortopulmonary collaterals (MAPCA) is a well-known but always severe congenital heart disease. This study was designed to explore proper management after radical correction of TOF with MAPCA based on a hierarchical approach., Methods: The following data were collected from 39 patients planned to undergo radical correction of TOF: age, weight, number of aortopulmonary collaterals, total lumen diameter and collateral diameter-to-body weight ratio, transcatheter occlusion and cardiac catheterization findings, mechanical ventilation time, and ICU monitoring time. The patients were divided into 4 groups by collateral diameter-to-body weight ratio as follows: <0.200 mm/kg (group 1), 0.200-0.500 mm/kg (group 2), >0.500 mm/kg (group 3), and no MAPCA (group 4). Data analysis was performed using IBM SPSS Statistics software for Mac version 22.0 (SPSS Inc., Chicago, Ill., USA) with logistic regression and Fisher's exact test., Results: Most of the patients recovered well after radical correction; postoperative complications occurred in 12 patients and included bloody sputum, low cardiac output syndrome, and severe pulmonary infection that led to tracheotomy. By prolonging the mechanical ventilation time of the patients with postoperative complications, the conditions in 3 patients were improved. However, in the remaining patients, the condition worsened until transcatheter occlusions were performed. Transcatheter occlusion was performed in all 7 patients in group 3 (100%). Only 2 of the 8 patients in group 2 required transcatheter occlusion (25%), and none of the 9 patients in group 1 required transcatheter occlusion (0%). Only 1 patient (group 3) died after radical correction. The transcatheter occlusion results showed a strong association with the total lumen diameter and the collateral diameter-to-body weight ratio (p < 0.05) but no obvious association with age, weight, or the number of aortopulmonary collaterals (p > 0.05)., Conclusions: Postoperative management of patients with TOF and MAPCA has great significance. To reduce the morbidity and mortality, transcatheter coil embolization or surgical ligation should be performed in patients with a collateral diameter-to-body weight ratio of at least 0.500 mm/kg. In patients with values between approximately 0.200 and 0.500 mm/kg, prolongation of mechanical ventilation should have priority over transcatheter occlusion, and for patients with values below 0.200 mm/kg no additional treatment is needed., (© 2016 S. Karger AG, Basel.)