Landscape ecological risk assessment and its driving factors in the Weihe River basin,China

Weihe River basin is of great significance to analyze the changes of land use pattern and landscape ecological risk and to improve the ecological basis of regional development.Based on land use data of the Weihe River basin in 2000,2010,and 2020,with the support of Aeronautical Reconnaissance Coverage Geographic Information System(ArcGIS),GeoDa,and other technologies,this study analyzed the spatial-temporal characteristics and driving factors of land use pattern and landscape ecological risk.Results showed that land use structure of the Weihe River basin has changed significantly,with the decrease of cropland and the increase of forest land and construction land.In the past 20 a,cropland has decreased by 7347.70 km2,and cropland was mainly converted into forest land,grassland,and construction land.The fragmentation and dispersion of ecological landscape pattern in the Weihe River basin were improved,and land use pattern became more concentrated.Meanwhile,landscape ecological risk of the Weihe River basin has been improved.Severe landscape ecological risk area decreased by 19,177.87 km2,high landscape ecological risk area decreased by 3904.35 km2,and moderate and low landscape ecological risk areas continued to increase.It is worth noting that landscape ecological risks in the upper reaches of the Weihe River basin are still relatively serious,especially in the contiguous areas of high ecological risk,such as Tianshui,Pingliang,Dingxi areas and some areas of Ningxia Hui Autonomous Region.Landscape ecological risk showed obvious spatial dependence,and high ecological risk area was concentrated.Among the driving factors,population density,precipitation,normalized difference vegetation index(NDVI),and their interactions are the most important factors affecting the landscape ecological risk of the Weihe River basin.The findings significantly contribute to our understanding of the ecological dynamics in the Weihe River basin,providing crucial insights for sustainable management in the region.

Spatial-temporal heterogeneity of ecological quality changes across the Qinghai-Tibet Plateau under the influence of climate factors and human activities

Over the last few decades,the ecological quality of the Qinghai–Tibet Plateau(QTP)has significantly changed due to climate warming,humidification,and increasing human activities.Thus,evaluating this region's ecological quality and dominant factors is crucial for sustainable development.In this study,the changes in the ecological quality on the QTP from 2000 to 2020 were evaluated based on aggregated indices and Sen–MK trend analyses,and the dominant factors affecting the ecological quality of the QTP were quantitatively analyzed using decision tree classification.The results revealed that(1)the ecological quality of the QTP exhibited an overall high trend in the east and a low pattern in the west;(2)the ecological quality of the QTP significantly increased from 2000 to 2020,and human activities were the dominant factors causing this change;and(3)the changes in the ecological quality and dominant factors exhibited obvious spatiotemporal heterogeneity.The area with an improved ecological quality occurred mainly in the northern QTP region.It was governed by human activities and precipitation.In contrast,the area with a deteriorated ecological quality occurred largely in the southern QTP region and was dominated by human activities and temperature.The 2000–2010 period was the most significant period of heterogeneity regarding of ecological quality and its driving factors.(4)The change in the ecological quality was mainly affected by the synergistic relationship between human activities and climate change in this region,which encompassed multiple dominant factors.This study provides important information on the spatiotemporal heterogeneity of ecological quality change and its dominant factors on the QTP and offers systematic guidance for the planning and implementation of ecological protection projects.

Influencing Factors and Prediction of Risk of Returning to Ecological Poverty in Liupan Mountain Region,China

China has resolved its overall regional poverty in 2020 by attaining moderate societal prosperity.The country has entered a new development stage designed to achieve its second centenary goal.However,ecological fragility and risk susceptibility have increased the risk of returning to ecological poverty.In this paper,the Liupan Mountain Region of China was used as a case study,and the counties were used as the scale to reveal the spatiotempora differentiation and influcing factors of the risk of returning to poverty in study area.The indicator data for returning to ecological poverty from 2011-2020 were collected and summarized in three dimensions:ecological,economic and social.The autoregressive integrated moving average model(ARIMA)time series and exponential smoothing method(ES)were used to predict the multidimensional indicators of returning to ecological poverty for 61 counties(districts)in the Liupan Mountain Region for 2021-2030.The back propagation neural network(BPNN)and geographic information system(GIS)were used to generate the spatial distribution and time variation for the index of the risk of returning to ecological poverty(RREP index).The results show that 1)ecological factors were the main factors in the risk of returning to ecological poverty in Liupan Mountain Region.2)The RREP index for the 61 counties(districts)exhibited a downward trend from 2021-2030.The RREP index declined more in medium-and high-risk areas than in low-risk areas.From 2021 to 2025,the RREP index exhibited a slight downward trend.From 2026 to2030,the RREP index was expected to decline faster,especially from 2029-2030.3)Based on the RREP index,it can be roughly divided into three types,namely,the high-risk areas,the medium-risk areas,and the low-risk areas.The natural resource conditions in lowrisk areas of returning to ecological poverty,were better than those in medium-and high-risk areas.

Spatiotemporal Characteristics of Typical Ecosystem Services and Their Spatial Responses to Driving Factors in Ecologically Fragile Areas in Upper Yellow River,China

The identification of dominant driving factors for different ecosystem services(ESs)is crucial for ecological conservation and sustainable development.However,the spatial heterogeneity of the dominant driving factors affecting various ESs has not been adequately elucidated,particularly in ecologically fragile regions.This study employed the integrated valuation of ESs and trade-offs(InVEST)model to evaluate four ESs,namely,water yield(WY),soil conservation(SC),habitat quality(HQ),and carbon storage(CS),and then to identify the dominant driving factors of spatiotemporal differentiation of ES and further to characterize the spatial heterogeneity characteristics of the dominant driving factors in the eco-fragile areas of the upper Yellow River,China from 2000 to 2020.The results demonstrated that WY exhibited northeast-high and northwest-low patterns in the upper Yellow River region,while high values of SC and CS were distributed in central forested areas and a high value of HQ was distributed in vast grassland areas.The CS,WY,and SC exhibited decreasing trends over time.The most critical factors affecting WY,SC,HQ,and CS were the actual evapotranspiration,precipitation,slope,and normalized difference vegetation index,respectively.In addition,the effects of different factors on various ESs exhibited spatial heterogeneity.These results could provide spatial decision support for eco-protection and rehabilitation in ecologically fragile areas.

Effects of main ecological factors on the growth of marine green alga Caulerpa sertularioides using the response surface methodology

Caulerpa sertularioides is an invasive potential blooming green alga in China but it remains poorly studied.We studied the effects of ecological factors on its growth.Optimum conditions of ecological factors,i.e.,irradiance,temperature,and salinity,for the growth of its fragments were determined in the response surface methodology(RSM).The specific growth rates(SGR)of the fragments were determined in single-factor experiment.The results show that the SGR of C.sertularioides peaked under the conditions of irradiance 37.5μmol/(m~2·s),temperature25℃,and salinity 30.Meanwhile,using the Box-Behnken design,the conditions were further optimized and verified to be:irradiance 39.03μmol/(m~2·s),temperature 25.29℃,and salinity 30.06,under which the SGR reached 4.66%.The results provide new theoretical data and solutions for the cultivation,invasion prediction,and monitoring of Caulerpa species in China and the world.The RSM method may have great potential applications in the environmental adaptation characteristics of new macroalgal cultivars,intensive orientation cultured germplasm,and environmental hazard analysis of cultivated species in the field.

Ecological problems and ecological restoration zoning of the Aral Sea

The Aral Sea was the fourth largest lake in the world but it has shrunk dramatically as a result of irrational human activities, triggering the "Aral Sea ecological crisis". The ecological problems of the Aral Sea have attracted widespread attention, and the alleviation of the Aral Sea ecological crisis has reached a consensus among the five Central Asian countries(Kazakhstan, Uzbekistan, Tajikistan, Kyrgyzstan, and Turkmenistan). In the past decades, many ecological management measures have been implemented for the ecological restoration of the Aral Sea. However, due to the lack of regional planning and zoning, the results are not ideal. In this study, we mapped the ecological zoning of the Aral Sea from the perspective of ecological restoration based on soil type, soil salinity, surface water, groundwater table, Normalized Difference Vegetation Index(NDVI), land cover, and aerosol optical depth(AOD) data. Soil salinization and salt dust are the most prominent ecological problems in the Aral Sea. We divided the Aral Sea into 7 first-level ecological restoration subregions(North Aral Sea catchment area in the downstream of the Syr Darya River(Subregion Ⅰ);artificial flood overflow area in the downstream of the Aral Sea(Subregion Ⅱ);physical/chemical remediation area of the salt dust source area in the eastern part of the South Aral Sea(Subregion Ⅲ);physical/chemical remediation area of severe salinization in the central part of the South Aral Sea(Subregion Ⅳ);existing water surface and potential restoration area of the South Aral Sea(Subregion Ⅴ);Aral Sea vegetation natural recovery area(Subregion Ⅵ);and vegetation planting area with slight salinization in the South Aral Sea(Subregion Ⅶ)) and 14 second-level ecological restoration subregions according to the ecological zoning principles. Implementable measures are proposed for each ecological restoration subregion. For Subregion Ⅰ and Subregion Ⅱ with lower elevations, artificial flooding should be carried out to restore the surface of the Aral Sea. Subregion Ⅲ and Subregion Ⅳ have severe salinization, making it difficult for vegetation to grow. In these subregions, it is recommended to cover and pave the areas with green biomatrix coverings and environmentally sustainable bonding materials. In Subregion Ⅴ located in the central and western parts of the South Aral Sea, surface water recharge should be increased to ensure that this subregion can maintain normal water levels. In Subregion Ⅵ and Subregion Ⅶ where natural conditions are suitable for vegetation growth, measures such as afforestation and buffer zones should be implemented to protect vegetation. This study could provide a reference basis for future comprehensive ecological management and restoration of the Aral Sea.

Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning

BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration.

Ecological-Based Mining:A Coal-Water-Thermal Collaborative Paradigm in Ecologically Fragile Areas in Western China

A substantial reduction in groundwater level,exacerbated by coal mining activities,is intensifying water scarcity in western China’s ecologically fragile coal mining areas.China’s national strategic goal of achieving a carbon peak and carbon neutrality has made eco-friendly mining that prioritizes the protection and efficient use of water resources essential.Based on the resource characteristics of mine water and heat hazards,an intensive coal-water-thermal collaborative co-mining paradigm for the duration of the mining process is proposed.An integrated system for the production,supply,and storage of mining companion resources is achieved through technologies such as roof water inrush prevention and control,hydrothermal quality improvement,and deep-injection geological storage.An active preventive and control system achieved by adjusting the mining technology and a passive system centered on multiobjective drainage and grouting treatment are suggested,in accordance with the original geological characteristics and dynamic process of water inrush.By implementing advanced multi-objective drainage,specifically designed to address the“skylight-type”water inrush mode in the Yulin mining area of Shaanxi Province,a substantial reduction of 50%in water drillings and inflow was achieved,leading to stabilized water conditions that effectively ensure subsequent safe coal mining.An integrated-energy complementary model that incorporates the clean production concept of heat utilization is also proposed.The findings indicate a potential saving of 8419 t of standard coal by using water and air heat as an alternative heating source for the Xiaojihan coalmine,resulting in an impressive energy conservation of 50.2%and a notable 24.2%reduction in carbon emissions.The ultra-deep sustained water injection of 100 m^(3)·h^(-1)in a single well would not rupture the formation or cause water leakage,and 7.87×10^(5)t of mine water could be effectively stored in the Liujiagou Formation,presenting a viable method for mine-water management in the Ordos Basin and providing insights for green and low-carbon mining.

Analysis of the influencing factors and clinical related characteristics of pulmonary tuberculosis in patients with type 2 diabetes mellitus

BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poor glucose control,hypoproteinemia,lymphopenia,TB contact history,high infection,smoking and alcohol consumption were positively associated with PTB in T2DM patients;married,history of hypertension,treatment of oral hypoglycemic drugs plus insulin,overweight,obesity and regular exercise were negatively associated with PTB in T2DM patients.Results of multivariate stepwise regression analysis found lymphopenia(OR=17.75,95%CI:3.40-92.74),smoking(OR=12.25,95%CI:2.53-59.37),history of TB contact(OR=6.56,95%CI:1.23-35.03)and poor glycemic control(OR=3.37,95%CI:1.11-10.25)was associated with an increased risk of developing PTB in patients with T2DM,While being overweight(OR=0.23,95%CI:0.08-0.72)and obesity(OR=0.11,95%CI:0.02-0.72)was associated with a reduced risk of developing PTB in patients with T2DM.CONCLUSION T2DM-PTB patients are prone to worse glycemic control,higher infection frequency,and a higher proportion of people smoking,drinking alcohol,and lack of exercise.Lymphopenia,smoking,history of TB exposure,poor glycemic control were independent risk factors for T2DM-PTB,and overweight and obesity were associated with reduced risk of concurrent PTB in patients with T2DM.

Biological factors driving colorectal cancer metastasis

Approximately 20%of colorectal cancer(CRC)patients present with metastasis at diagnosis.Among Stage I-III CRC patients who undergo surgical resection,18%typically suffer from distal metastasis within the first three years following initial treatment.The median survival duration after the diagnosis of metastatic CRC(mCRC)is only 9 mo.mCRC is traditionally considered to be an advanced stage malignancy or is thought to be caused by incomplete resection of tumor tissue,allowing cancer cells to spread from primary to distant organs;however,increa-sing evidence suggests that the mCRC process can begin early in tumor development.CRC patients present with high heterogeneity and diverse cancer phenotypes that are classified on the basis of molecular and morphological alterations.Different genomic and nongenomic events can induce subclone diversity,which leads to cancer and metastasis.Throughout the course of mCRC,metastatic cascades are associated with invasive cancer cell migration through the circulatory system,extravasation,distal seeding,dormancy,and reactivation,with each step requiring specific molecular functions.However,cancer cells presenting neoantigens can be recognized and eliminated by the immune system.In this review,we explain the biological factors that drive CRC metastasis,namely,genomic instability,epigenetic instability,the metastatic cascade,the cancer-immunity cycle,and external lifestyle factors.Despite remarkable progress in CRC research,the role of molecular classification in therapeutic intervention remains unclear.This review shows the driving factors of mCRC which may help in identifying potential candidate biomarkers that can improve the diagnosis and early detection of mCRC cases.

Spatial-temporal differentiation and influencing factors of rural settlements in mountainous areas: an example of Liangshan Yi Autonomous Prefecture, Southwestern China

Rural settlement is the basic spatial unit for compact communities in rural area. Scientific exploration of spatial-temporal differentiation and its influencing factors is the premise of spatial layout rationalization. Based on land use data of Liangshan Yi Autonomous Prefecture(hereinafter referred to as Liangshan Prefecture) in Sichuan Province, China from 1980 to 2020, compactness index, fractal dimension, imbalance index, location entropy and the optimal parameters-based geographical detector(OPGD) model are used to analyze the spatial-temporal evolution of the morphological characteristics of rural settlements, and to explore the influence of natural geographical factors, socioeconomic factors, and policy factors on the spatial differentiation of rural settlements. The results show that:(1) From 1980 to 2020, the rural settlements area in Liangshan Prefecture increased by 15.96 km^(2). In space, the rural settlements are generally distributed in a local aggregation, dense in the middle and sparse around the periphery. In 2015, the spatial density and expansion index of rural settlements reached the peak.(2) From 1980 to 2020, the compactness index decreased from 0.7636 to 0.7496, the fractal dimension increased from 1.0283 to 1.0314, and the fragmentation index decreased from 0.1183 to 0.1047. The spatial morphological structure of rural settlements tended to be loose, the shape contour tended to be complex, the degree of fragmentation decreased, and the spatial distribution was significantly imbalanced.(3) The results of OPGD detection in 2015 show that the influence of each factor is slope(0.2371) > traffic accessibility(0.2098) > population(0.1403) > regional GDP(0.1325) > elevation(0.0987) > poverty alleviation(0). The results of OPGD detection in 2020 show that the influence of each factor is slope(0.2339) > traffic accessibility(0.2198) > population(0.1432) > regional GDP(0.1219) > poverty alleviation(0.0992) > elevation(0.093). Natural geographical factors(slope and elevation) are the basic factors affecting the spatial distribution of rural settlements, and rural settlements are widely distributed in the river valley plain and the second half mountain area. Socioeconomic factors(traffic accessibility, population, and regional GDP) have a greater impact on the spatial distribution of rural settlements, which is an important factor affecting the spatial distribution of rural settlements. Policy factors such as poverty alleviation relocation have an indispensable impact on the spatial distribution of rural settlements. The research results can provide decisionmaking basis for the spatial arrangement of rural settlements in Liangshan Prefecture, and optimize the implementation of rural revitalization policies.

Incidence and risk factors of depression in patients with metabolic syndrome

BACKGROUND Many studies have explored the relationship between depression and metabolic syndrome(MetS),especially in older people.China has entered an aging society.However,there are still few studies on the elderly in Chinese communities.AIM To investigate the incidence and risk factors of depression in MetS patients in China's Mainland and to construct a predictive model.METHODS Data from four waves of the China Health and Retirement Longitudinal Study were selected,and middle-aged and elderly patients with MetS(n=2533)were included based on the first wave.According to the center for epidemiological survey-depression scale(CESD),participants with MetS were divided into depression(n=938)and non-depression groups(n=1595),and factors related to depression were screened out.Subsequently,the 2-,4-,and 7-year follow-up data were analyzed,and a prediction model for depression in MetS patients was constructed.RESULTS The prevalence of depression in middle-aged and elderly patients with MetS was 37.02%.The prevalence of depression at the 2-,4-,and 7-year follow-up was 29.55%,34.53%,and 38.15%,respectively.The prediction model,constructed using baseline CESD and Physical Self-Maintenance Scale scores,average sleep duration,number of chronic diseases,age,and weight had a good predictive effect on the risk of depression in MetS patients at the 2-year follow-up(area under the curve=0.775,95%confidence interval:0.750-0.800,P<0.001),with a sensitivity of 68%and a specificity of 74%.CONCLUSION The prevalence of depression in middle-aged and elderly patients with MetS has increased over time.The early identification of and intervention for depressive symptoms requires greater attention in MetS patients.

Ecological environmental quality evaluation and driving factor analysis of the Lijiang River Basin,based on Google Earth Engine

For regional ecological management,it is important to evaluate the quality of ecosystems and analyze the underlying causes of ecological changes.Using the Google Earth Engine(GEE)platform,the remote sensing ecological index(RSEI)was calculated for the Lijiang River Basin in Guangxi Zhuang Autonomous Region for 1991,2001,2011,and 2021.Spatial autocorrelation analysis was employed to investigate spatiotemporal variations in the ecological environmental quality of the Lijiang River Basin.Furthermore,geographic detectors were used to quantitatively analyze influencing factors and their interaction effects on ecological environmental quality.The results verified that:1)From 1991 to 2021,the ecological environmental quality of the Lijiang River Basin demonstrated significant improvement.The area with good and excellent ecological environmental quality in proportion increased by 19.69%(3406.57 km^(2)),while the area with fair and poor ecological environmental quality in proportion decreased by 10.76%(1860.36 km^(2)).2)Spatially,the ecological environmental quality of the Lijiang River Basin exhibited a pattern of low quality in the central region and high quality in the periphery.Specifically,poor ecological environmental quality characterized the Guilin urban area,Pingle County,and Lingchuan County.3)From 1991 to 2021,a significant positive spatial correlation was observed in ecological environmental quality of the Lijiang River Basin.Areas with high-high agglomeration were predominantly forests and grasslands,indicating good ecological environmental quality,whereas areas with low-low agglomeration were dominated by cultivated land and construction land,indicating poor ecological environmental quality.4)Annual average precipitation and temperature exerted the most significant influence on the ecological environmental quality of the basin,and their interactions with other factors had the great influence.This study aimed to enhance understanding of the evolution of the ecological environment in the Lijiang River Basin of Guangxi Zhuang Autonomous Region and provide scientific guidance for decision-making and management related to ecology in the region.

Prevalence and risk factors of diabetes mellitus among elderly patients in the Lugu community

BACKGROUND Age is a significant risk factor of diabetes mellitus(DM).With the develop of population aging,the incidence of DM remains increasing.Understanding the epidemiology of DM among elderly individuals in a certain area contributes to the DM interventions for the local elderly individuals with high risk of DM.AIM To explore the prevalence of DM among elderly individuals in the Lugu community and analyze the related risk factors to provide a valid scientific basis for the health management of elderly individuals.METHODS A total of 4816 elderly people who came to the community for physical examination were retrospectively analyzed.The prevalence of DM among the elderly was calculated.The individuals were divided into a DM group and a non-DM group according to the diagnosis of DM to compare the differences in diastolic blood pressure(DBP)and systolic blood pressure(SBP),fasting blood glucose,body mass index(BMI),waist-to-hip ratio(WHR)and incidence of hypertension(HT),coronary heart disease(CHD),and chronic kidney disease(CKD).RESULTS DM was diagnosed in 32.70%of the 4816 elderly people.The BMI of the DM group(25.16±3.35)was greater than that of the non-DM group(24.61±3.78).The WHR was 0.90±0.04 in the non-DM group and 0.90±0.03 in the DM group,with no significant difference.The left SBP and SBP in the DM group were 137.9 mmHg±11.92 mmHg and 69.95 mmHg±7.75 mmHg,respectively,while they were 126.6 mmHg±12.44 mmHg and 71.15 mmHg±12.55 mmHg,respectively,in the non-DM group.These findings indicate higher SBP and lower DBP in DM patients than in those without DM.In the DM group,1274 patients were diagnosed with HT,accounting for 80.89%.Among the 3241 non-DM patients,1743(53.78%)were hypertensive and 1498(46.22%)were nonhypertensive.The DM group had more cases of HT than did the non-DM group.There were more patients with CHD or CKD in the DM group than in the non-DM group.There were more patients who drank alcohol more frequently(≥3 times)in the DM group than in the non-DM group.CONCLUSION Older adults in the Lugu community are at a greater risk of DM.In elderly individuals,DM is closely related to high BMI and HT,CHD,and CKD.Physical examinations should be actively carried out for elderly people to determine their BMI,SBP,DBP,and other signs,and sufficient attention should be given to abnormalities in the above signs before further diagnosis.

A new monitoring index for ecological vulnerability and its application in the Yellow River Basin,China from 2000 to 2022

The ecological environment of the Yellow River Basin has become more fragile under the combined action of natural and manmade activities.However,the change mechanisms of ecological vulnerability in different sub-regions and periods vary,and the reasons for this variability are yet to be explained.Thus,in this study,we proposed a new remote sensing ecological vulnerability index by considering moisture,heat,greenness,dryness,land degradation,and social economy indicators and then analyzed and disclosed the spatial and temporal change patterns of ecological vulnerability of the Yellow River Basin,China from 2000 to 2022 and its driving mechanisms.The results showed that the newly proposed remote sensing ecological vulnerability index had a high accuracy,at 86.36%,which indicated a higher applicability in the Yellow River Basin.From 2000 to 2022,the average remote sensing ecological vulnerability index of the Yellow River Basin was 1.03,denoting moderate vulnerability level.The intensive vulnerability area was the most widely distributed,which was mostly located in the northern part of Shaanxi Province and the eastern part of Shanxi Province.From 2000 to 2022,the ecological vulnerability in the Yellow showed an overall stable trend,while that of the central and eastern regions showed an obvious trend of improvement.The gravity center of ecological vulnerability migrated southwest,indicating that the aggravation of ecological vulnerability in the southwestern regions was more severe than in the northeastern regions of the basin.The dominant single factor of changes in ecological vulnerability shifted from normalized difference vegetation index(NDVI)to temperature from 2000 to 2022,and the interaction factors shifted from temperature∩NDVI to temperature∩precipitation,which indicated that the global climate change exerted a more significant impact on regional ecosystems.The above results could provide decision support for the ecological protection and restoration of the Yellow River Basin.

Assessment of Dependent Performance Shaping Factors in SPAR-H Based on Pearson Correlation Coefficient

With the improvement of equipment reliability,human factors have become the most uncertain part in the system.The standardized Plant Analysis of Risk-Human Reliability Analysis(SPAR-H)method is a reliable method in the field of human reliability analysis(HRA)to evaluate human reliability and assess risk in large complex systems.However,the classical SPAR-H method does not consider the dependencies among performance shaping factors(PSFs),whichmay cause overestimation or underestimation of the risk of the actual situation.To address this issue,this paper proposes a new method to deal with the dependencies among PSFs in SPAR-H based on the Pearson correlation coefficient.First,the dependence between every two PSFs is measured by the Pearson correlation coefficient.Second,the weights of the PSFs are obtained by considering the total dependence degree.Finally,PSFs’multipliers are modified based on the weights of corresponding PSFs,and then used in the calculating of human error probability(HEP).A case study is used to illustrate the procedure and effectiveness of the proposed method.

Interplay between microglia and environmental risk factors in Alzheimer's disease

Alzheimer s disease,among the most common neurodegenerative disorders,is chara cterized by progressive cognitive impairment.At present,the Alzheimer’s disease main risk remains genetic ris ks,but major environmental fa ctors are increasingly shown to impact Alzheimer’s disease development and progression.Microglia,the most important brain immune cells,play a central role in Alzheimer’s disease pathogenesis and are considered environmental and lifestyle"sensors."Factors like environmental pollution and modern lifestyles(e.g.,chronic stress,poor dietary habits,sleep,and circadian rhythm disorde rs)can cause neuroinflammato ry responses that lead to cognitive impairment via microglial functioning and phenotypic regulation.However,the specific mechanisms underlying interactions among these facto rs and microglia in Alzheimer’s disease are unclear.Herein,we:discuss the biological effects of air pollution,chronic stress,gut micro biota,sleep patterns,physical exercise,cigarette smoking,and caffeine consumption on microglia;consider how unhealthy lifestyle factors influence individual susceptibility to Alzheimer’s disease;and present the neuroprotective effects of a healthy lifestyle.Toward intervening and controlling these environmental risk fa ctors at an early Alzheimer’s disease stage,understanding the role of microglia in Alzheimer’s disease development,and to rgeting strategies to to rget microglia,co uld be essential to future Alzheimer’s disease treatments.

Predictive factors and model validation of post-colon polyp surgery Helicobacter pylori infection

BACKGROUND Recently,research has linked Helicobacter pylori(H.pylori)stomach infection to colonic inflammation,mediated by toxin production,potentially impacting colorectal cancer occurrence.AIM To investigate the risk factors for post-colon polyp surgery,H.pylori infection,and its correlation with pathologic type.METHODS Eighty patients who underwent colon polypectomy in our hospital between January 2019 and January 2023 were retrospectively chosen.They were then randomly split into modeling(n=56)and model validation(n=24)sets using R.The modeling cohort was divided into an H.pylori-infected group(n=37)and an H.pylori-uninfected group(n=19).Binary logistic regression analysis was used to analyze the factors influencing the occurrence of H.pylori infection after colon polyp surgery.A roadmap prediction model was established and validated.Finally,the correlation between the different pathological types of colon polyps and the occurrence of H.pylori infection was analyzed after colon polyp surgery.RESULTS Univariate results showed that age,body mass index(BMI),literacy,alcohol consumption,polyp pathology type,high-risk adenomas,and heavy diet were all influential factors in the development of H.pylori infection after intestinal polypectomy.Binary multifactorial logistic regression analysis showed that age,BMI,and type of polyp pathology were independent predictors of the occurrence of H.pylori infection after intestinal polypectomy.The area under the receiver operating characteristic curve was 0.969[95%confidence interval(95%CI):0.928–1.000]and 0.898(95%CI:0.773–1.000)in the modeling and validation sets,respectively.The slope of the calibration curve of the graph was close to 1,and the goodness-of-fit test was P>0.05 in the two sets.The decision analysis curve showed a high rate of return in both sets.The results of the correlation analysis between different pathological types and the occurrence of H.pylori infection after colon polyp surgery showed that hyperplastic polyps,inflammatory polyps,and the occurrence of H.pylori infection were not significantly correlated.In contrast,adenomatous polyps showed a significant positive correlation with the occurrence of H.pylori infection.CONCLUSION Age,BMI,and polyps of the adenomatous type were independent predictors of H.pylori infection after intestinal polypectomy.Moreover,the further constructed column-line graph prediction model of H.pylori infection after intestinal polypectomy showed good predictive ability.

Klebsiella pneumoniae infections after liver transplantation:Drug resistance and distribution of pathogens,risk factors,and influence on outcomes

BACKGROUND Liver transplantation(LT)is the only curative treatment for end-stage liver disease.However,LT recipients are susceptible to infection,which is the leading cause of early mortality after LT.Klebsiella pneumoniae infections(KPIs)in the bloodstream are common in LT recipients.We hypothesized that KPIs and carbapenemresistant Klebsiella pneumoniae(CRKP)infections may affect the outcomes of LT recipients.AIM To assess KPI incidence,timing,distribution,drug resistance,and risk factors following LT and its association with outcomes.METHODS This retrospective study included 406 patients undergoing LT at The Third Xiangya Hospital of Central South University,a tertiary hospital,from January 2015 to January 2023.We investigated the risk factors for KPIs and assessed the impact of KPIs and CRKP infections on the prognosis of LT recipients using logistic regression analysis.RESULTS KPI incidence was 7.9%(n=32),with lung/thoracic cavity the most frequent site of infection;the median time from LT to KPI onset was 7.5 d.Of 44 Klebsiella pneumoniae isolates,43(97.7%)and 34(77.3%)were susceptible to polymyxin B or ceftazidime/avibactam and tigecycline,respectively;>70%were resistant to piperacillin/tazobactam,ceftazidime,cefepime,aztreonam,meropenem,and levofloxacin.Female sex[odds ratio(OR)=2.827,95%confidence interval(CI):1.256-6.364;P=0.012],pre-LT diabetes(OR=2.794,95%CI:1.070-7.294;P=0.036),day 1 post-LT alanine aminotransferase(ALT)levels≥1500 U/L(OR=3.645,95%CI:1.671-7.950;P=0.001),and post-LT urethral catheter duration over 4 d(OR=2.266,95%CI:1.016-5.054;P=0.046)were risk factors for KPI.CRKP infections,but not KPIs,were risk factors for 6-month all-cause mortality post-LT.CONCLUSION KPIs occur frequently and rapidly after LT.Risk factors include female sex,pre-LT diabetes,increased post-LT ALT levels,and urethral catheter duration.CRKP infections,and not KPIs,affect mortality.

Analysis of risk factors leading to anxiety and depression in patients with prostate cancer after castration and the construction of a risk prediction model

BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.