Ensuring water resource security in China; the need for advances in evidence based policy to support sustainable management.

China currently faces a water resource sustainability problem which is likely to worsen into the future. The Chinese government is attempting to address this problem through legislative action, but faces severe challenges in delivering its high ambitions. The key challenges revolve around the need to balance water availability with the need to feed a growing population under a changing climate and its ambitions for increased economic development. This is further complicated by the complex and multi-layered government departments, often with overlapping jurisdictions, which are not always aligned in their policy implementation and delivery mechanisms. There remain opportunities for China to make further progress and this paper reports on the outcomes of a science-to-policy roundtable meeting involving scientists and policy-makers in China. It identifies, in an holistic manner, new opportunities for additional considerations for policy implementation, continued and new research requirements to ensure evidence-based policies are designed and implemented and identifies the needs and opportunities to effectively monitor their effectiveness. Other countries around the world can benefit from assessing this case study in China

Research Progress on the Polymeric Immunoglobulin Receptor (pIgR) in Fish

There are a large number of pathogens in the water where fish live, and the mucosal-associated lymphoid tissues (MALTs), such as skin, gill and intestine, are the first contact parts when pathogens infect fish. The secreted mucus of these tissues constitutes the first barrier for fish against the invasion of external pathogens. Mucosal immunity can identify and neutralize pathogens and induces immunocytes to devour pathogens and the like. As a key factor in the mucosal immune system, the polymeric immunoglobulin receptor (pIgR) is capable of mediating the transport and secretion of polymeric immunoglobulins towards mucus. The effective secretion of the pIgR is necessary for polymeric immunoglobulins (pIg) to exert mucosal defence and plays a significant role in fish immunity. With the deepening of research into fish immunoglobulins, the pIgR has become a research hotspot. The molecular structure, genetic structure and expression pattern of the pIgR and the important role it plays in mucosal immunity were summarized in this study, which contributed to a deeper understanding of fish mucosal immunity and laid a foundation for further exploration of the action mechanism and functions of the pIgR in fish

Reduced- or Half-Dose Rivaroxaban Following Left Atrial Appendage Closure: A Feasible Antithrombotic Therapy in Patients at High Risk of Bleeding?

The optimal antithrombotic strategy after percutaneous left atrial appendage closure (LAAC) has not yet been established. The advisability of administering low-dose direct oral anticoagulation after LAAC to patients at high risk of bleeding is uncertain. Thus, in the present study, we evaluated the safety and effectiveness of reduced-(15 mg) or half-dose rivaroxaban (10 mg) versus warfarin regarding real-world risks of thromboembolism, bleeding, and device-related thrombosis (DRT) after LAAC. Patients with non-valvular atrial fibrillation and HASBLED ≥ 3 who had undergone successful LAAC device implantation from October 2014 to April 2020 were screened and those who had received 10 mg or 15 mg rivaroxaban or warfarin therapy were enrolled. The patients were followed up 45 days and 6 months after LAAC to evaluate outcomes, including death, thromboembolism, major bleeding, and DRT. Of 457 patients with HASBLED ≥ 3 who had undergone LAAC, 115 had received warfarin and 342 rivaroxaban (15 mg: N = 164; 10 mg: N = 178). There were no significant differences in the incidence of thromboembolism or DRT between the warfarin and both doses of rivaroxaban groups (all p > 0.05). The incidence of major bleeding was significantly higher in the warfarin group than in either the reduced- or half-dose rivaroxaban groups (warfarin vs. rivaroxaban 15 mg: 2.6% vs. 0%, p = 0.030; warfarin vs. rivaroxaban 10 mg: 2.6% vs. 0%, p = 0.038). Either reduced- or half-dose rivaroxaban may be an effective and safe alternative to warfarin therapy in patients with LAAC and who are at high risk of bleeding, the risk of thromboembolism being similar and of major bleeding lower for both doses of rivaroxaban