A phenology-based vegetation index for improving ratoon rice mapping using harmonized Landsat and Sentinel-2 data

Ratoon rice,which refers to a second harvest of rice obtained from the regenerated tillers originating from the stubble of the first harvested crop,plays an important role in both food security and agroecology while requiring minimal agricultural inputs.However,accurately identifying ratoon rice crops is challenging due to the similarity of its spectral features with other rice cropping systems(e.g.,double rice).Moreover,images with a high spatiotemporal resolution are essential since ratoon rice is generally cultivated in fragmented croplands within regions that frequently exhibit cloudy and rainy weather.In this study,taking Qichun County in Hubei Province,China as an example,we developed a new phenology-based ratoon rice vegetation index(PRVI)for the purpose of ratoon rice mapping at a 30 m spatial resolution using a robust time series generated from Harmonized Landsat and Sentinel-2(HLS)images.The PRVI that incorporated the red,near-infrared,and shortwave infrared 1 bands was developed based on the analysis of spectro-phenological separability and feature selection.Based on actual field samples,the performance of the PRVI for ratoon rice mapping was carefully evaluated by comparing it to several vegetation indices,including normalized difference vegetation index(NDVI),enhanced vegetation index(EVI)and land surface water index(LSWI).The results suggested that the PRVI could sufficiently capture the specific characteristics of ratoon rice,leading to a favorable separability between ratoon rice and other land cover types.Furthermore,the PRVI showed the best performance for identifying ratoon rice in the phenological phases characterized by grain filling and harvesting to tillering of the ratoon crop(GHS-TS2),indicating that only several images are required to obtain an accurate ratoon rice map.Finally,the PRVI performed better than NDVI,EVI,LSWI and their combination at the GHS-TS2 stages,with producer's accuracy and user's accuracy of 92.22 and 89.30%,respectively.These results demonstrate that the proposed PRVI based on HLS data can effectively identify ratoon rice in fragmented croplands at crucial phenological stages,which is promising for identifying the earliest timing of ratoon rice planting and can provide a fundamental dataset for crop management activities.

Spectral purification improves monitoring accuracy of the comprehensive growth evaluation index for film-mulched winter wheat

In order to further improve the utility of unmanned aerial vehicle(UAV)remote-sensing for quickly and accurately monitoring the growth of winter wheat under film mulching, this study examined the treatments of ridge mulching,ridge–furrow full mulching, and flat cropping full mulching in winter wheat.Based on the fuzzy comprehensive evaluation (FCE) method, four agronomic parameters (leaf area index, above-ground biomass, plant height, and leaf chlorophyll content) were used to calculate the comprehensive growth evaluation index (CGEI) of the winter wheat, and 14 visible and near-infrared spectral indices were calculated using spectral purification technology to process the remote-sensing image data of winter wheat obtained by multispectral UAV.Four machine learning algorithms, partial least squares, support vector machines, random forests, and artificial neural network networks(ANN), were used to build the winter wheat growth monitoring model under film mulching, and accuracy evaluation and mapping of the spatial and temporal distribution of winter wheat growth status were carried out.The results showed that the CGEI of winter wheat under film mulching constructed using the FCE method could objectively and comprehensively evaluate the crop growth status.The accuracy of remote-sensing inversion of the CGEI based on the ANN model was higher than for the individual agronomic parameters, with a coefficient of determination of 0.75,a root mean square error of 8.40, and a mean absolute value error of 6.53.Spectral purification could eliminate the interference of background effects caused by mulching and soil, effectively improving the accuracy of the remotesensing inversion of winter wheat under film mulching, with the best inversion effect achieved on the ridge–furrow full mulching area after spectral purification.The results of this study provide a theoretical reference for the use of UAV remote-sensing to monitor the growth status of winter wheat with film mulching.

Three-dimensional choroidal vascularity index and choroidal thickness in fellow eyes of acute and chronic primary angle-closure using swept-source optical coherence tomography

AIM:To compare the three-dimensional choroidal vascularity index(CVI)and choroidal thickness between fellow eyes of acute primary angle-closure(F-APAC)and chronic primary angle-closure glaucoma(F-CPACG)and the eyes of normal controls.METHODS:This study included 37 patients with unilateral APAC,37 with asymmetric CPACG without prior treatment,and 36 healthy participants.Using swept-source optical coherence tomography(SS-OCT),the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally.Pearson’s correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors.RESULTS:The mean subfoveal CVIs were 0.35±0.10,0.33±0.09,and 0.29±0.04,and the mean subfoveal choroidal thickness were 315.62±52.92,306.22±59.29,and 262.69±45.55μm in the F-APAC,F-CPACG,and normal groups,respectively.All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes(P<0.05),while there were no significant differences between the F-APAC and F-CPACG eyes.In the peripapillary region,the mean overall CVIs were 0.21±0.08,0.20±0.08,and 0.19±0.05,and the mean overall choroidal thickness were 180.45±54.18,174.82±50.67,and 176.18±37.94μm in the F-APAC,F-CPACG,and normal groups,respectively.There were no significant differences between any of the two groups in all peripapillary sectors.Younger age,shorter axial length,and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness(P<0.05).CONCLUSION:The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls.Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG.A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.

Association between triglyceride-glucose index and colorectal polyps:A retrospective cross-sectional study

BACKGROUND Colorectal polyps(CPs)are frequently occurring abnormal growths in the colorectum,and are a primary precursor of colorectal cancer(CRC).The triglyceride-glucose(TyG)index is a novel marker that assesses metabolic health and insulin resistance,and has been linked to gastrointestinal cancers.AIM To investigate the potential association between the TyG index and CPs,as the relation between them has not been documented.METHODS A total of 2537 persons undergoing a routine health physical examination and colonoscopy at The First People's Hospital of Kunshan,Jiangsu Province,China,between January 2020 and December 2022 were included in this retrospective cross-sectional study.After excluding individuals who did not meet the eligibility criteria,descriptive statistics were used to compare characteristics between patients with and without CPs.Logistic regression analyses were conducted to determine the associations between the TyG index and the prevalence of CPs.The TyG index was calculated using the following formula:Ln[triglyceride(mg/dL)×glucose(mg/dL)/2].The presence and types of CPs was determined based on data from colonoscopy reports and pathology reports.RESULTS A nonlinear relation between the TyG index and the prevalence of CPs was identified,and exhibited a curvilinear pattern with a cut-off point of 2.31.A significant association was observed before the turning point,with an odds ratio(95% confidence interval)of 1.70(1.40,2.06),P<0.0001.However,the association between the TyG index and CPs was not significant after the cut-off point,with an odds ratio(95% confidence interval)of 0.57(0.27,1.23),P=0.1521.CONCLUSION Our study revealed a curvilinear association between the TyG index and CPs in Chinese individuals,suggesting its potential utility in developing colonoscopy screening strategies for preventing CRC.

Renal resistive index measurements by ultrasound in patients with liver cirrhosis:Magnitude and associations with renal dysfunction

BACKGROUND The hemodynamic alterations seen in liver cirrhosis lead to renal vasoconstriction,ultimately causing acute kidney injury(AKI).The renal resistive index(RRI)is the most common Doppler ultrasound variable for measuring intrarenal vascular resistance.AIM To evaluate the association of the RRI with AKI in patients with liver cirrhosis and to identify risk factors for high RRI.METHODS This was a prospective observational study,where RRI was measured using Doppler ultrasound in 200 consecutive hospitalized patients with cirrhosis.The association of RRI with AKI was studied.The receiver operating characteristic(ROC)curve analysis was utilized to determine discriminatory cut-offs of RRI for various AKI phenotypes.Multivariate analysis was conducted to determine the predictors of high RRI.RESULTS The mean patient age was 49.08±11.68 years,with the majority(79.5%)being male;the predominant etiology of cirrhosis was alcohol(39%).The mean RRI for the study cohort was 0.68±0.09,showing a progressive increase with higher Child-Pugh class of cirrhosis.Overall,AKI was present in 129(64.5%)patients.The mean RRI was significantly higher in patients with AKI compared to those without it(0.72±0.06 vs 0.60±0.08;P<0.001).A total of 82 patients(41%)had hepatorenal syndrome(HRS)-AKI,29(22.4%)had prerenal AKI(PRA),and 18(13.9%)had acute tubular necrosis(ATN)-AKI.The mean RRI was significantly higher in the ATN-AKI(0.80±0.02)and HRS-AKI(0.73±0.03)groups than in the PRA(0.63±0.07)and non-AKI(0.60±0.07)groups.RRI demonstrated excellent discriminatory ability in distinguishing ATN-AKI from non-ATN-AKI(area under ROC curve:93.9%).AKI emerged as an independent predictor of high RRI(adjusted odds ratio[OR]:11.52),and high RRI independently predicted mortality among AKI patients(adjusted OR:3.18).CONCLUSION In cirrhosis patients,RRI exhibited a significant association with AKI,effectively differentiated between AKI phenotypes,and predicted AKI mortality.

Assessment on eco-environmental quality of the Yellow River Basin by considering desertification index

Desertification has had a significant impact on the ecological environment of the Yellow River Basin(YRB)in China.However,previous studies on the evaluation of the ecological environment quality(EEQ)in the YRB have paid limited attention to the indicator of desertification.It is of great significance to incorporate the desertification index into the spatiotemporal assessment of the EEQ in the YRB in order to protect the ecological environment in the region.In this study,based on multi-source remote sensing data from 91 cities in the YRB,this article proposes a desertification remote sensing ecological index(DRSEI)model,which builds upon the traditional Remote Sensing Ecological Index(RSEI)model,to analyze the spatiotemporal changes in the EEQ in the YRB from 2001 to 2021.Furthermore,using the geographic detector(GD),and geographically and temporally weighted regression(GTWR)model,the study assesses the impact of human and natural factors on the EEQ in the YRB.The research findings indicate that:(1)Compared to the traditional RSEI,the improved DRSEI shows a decreasing trend in the evaluation results of the EEQ.Among the 24 cities,the change in DRSEI exceeds 0.05 compared to RSEI,accounting for 26.37%of the YRB.The remaining 67 cities have changes within a range of less than 0.05,accounting for 73.63%of the YRB.(2)The results of the GD for individual and interactive effects reveal that rainfall and elevation have significant individual and interactive effects on the EEQ.Furthermore,after the interaction with natural factors,the explanatory power of human factors gradually increases over time.The spatial heterogeneity results of GTWR demonstrate that rainfall has a strong direct positive impact on the EEQ,accounting for 98.90%of the influence,while temperature exhibits a more pronounced direct inhibitory effect,accounting for 76.92%of the influence.Human activities have a strong negative impact on the EEQ and a weak positive impact.

On traceable iterated line graph and hamiltonian path index

Xiong and Liu[21]gave a characterization of the graphs G for which the n-iterated line graph L^(n)(G)is hamiltonian,for n≥2.In this paper,we study the existence of a hamiltonian path in L^(n)(G),and give a characterization of G for which L^(n)(G)has a hamiltonian path.As applications,we use this characterization to give several upper bounds on the hamiltonian path index of a graph.

An evaluation of ureteral diameter ratio and vesicoureteral reflux index in the treatment of primary vesicoureteral reflux

Objective:Vesicoureteral reflux(VUR)index is a simple,validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children.The aim of this study was to evaluate and compare the ureter diameter ratio(UDR)and VUR index(VURx)of patients treated with endoscopic injection(EI)and ureteroneocystostomy(UNC)methods in the pediatric age group due to primary VUR.Methods:Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the participants.The UDR was assessed using voiding cystourethrography,and the VURx score was determined prior to treatment based on hospital records included in the study.Results:A total of 255 patients,60(23.5%)boys and 195(76.5%)girls,with a mean age of 76.5(range 13.0e204.0)months,were included in the study.EI was applied to 130(51.0%)patients and UNC was applied to 125(49.0%)patients due to primary VUR.The optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0%and 63.0%,respectively.The positive and negative predictive values were 66.0%and 70.0%,respectively.Conclusion:When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group,it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

A Transparent Photoresist Made of Titanium Dioxide Nanoparticle-Embedded Acrylic Resin with a Tunable Refractive Index for UV-Imprint Lithography

Transparent photoresists with a high refractive index(RI)and high transmittance in visible wavelengths have promising functionalities in optical fields.This work reports a kind of tunable optical material composed of titanium dioxide nanoparticles embedded in acrylic resin with a high RI for ultraviolet(UV)-imprint lithography.The hybrid film exhibits a tunable RI of up to 1.67(589 nm)after being cured by UV light,while maintaining both a high transparency of over 98%in the visible light range and a low haze of less than 0.05%.The precision machining of optical microstructures can be imprinted easily and efficiently using the hybrid resin,which acts as a light guide plate(LGP)to guide the light from the side to the top in order to conserve the energy of the display device.These preliminary studies based on both laboratory and commercial experiments pave the way for exploiting the unparalleled optical properties of nanocomposite resins and promoting their industrial application.

Genetic variation and selection of 10-year-old Eucalyptus camaldulensis based on wind damage index and wood properties

Typhoons are becoming frequent and intense with ongoing climate change,threatening ecological security and healthy forest development in coastal areas.Eucalyptus of a predominant introduced species in southern China,faces significant growth challenges because of typhoon.Therefore,it is vital to investigate the variation of related traits and select superior breeding materials for genetic improvement.Variance,genetic parameter,and correlation analyses were carried out on wind damage indices and eight wood proper-ties in 88 families from 11 provenances of 10-year-old Euca-lyptus camaldulensis.The selection index equation was used for evaluating multiple traits and selecting superior prov-enances and family lines as future breeding material.The results show that all traits were highly significantly differ-ent at provenance and family levels,with the wind damage index having the highest coefficient of genetic variation.The heritability of each trait ranged from 0.48 to 0.87,with the wind damage index,lignin and hemicellulose contents,and microfibril angle having the highest heritabilities.The wind damage index had a positive genetic correlation with wood density,a negative correlation with lignin content,a negative phenotypic correlation and a negative genetic correlation with microfibril angle.Wind damage index and genetic progress in the selection of eight wood traits varied from 7.2%to 614.8%.Three provenances and 12 superior families were selected.The genetic gains of the wind damage index were 10.2%and 33.9%for provenances and families,and these may be starting material for genetic modification for wind resistance in eucalyptus and for their dissemination to typhoon-prone coastal areas of southern China.

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.

Early peripheral perfusion index predicts 28-day outcome in patients with septic shock

BACKGROUND:To investigate the prognostic value of the peripheral perfusion index(PPI)in patients with septic shock.METHODS:This prospective cohort study,conducted at the emergency intensive care unit of Peking University People's Hospital,recruited 200 patients with septic shock between January 2023 and August 2023.These patients were divided into survival(n=84)and death(n=116)groups based on 28-day outcomes.Clinical evaluations included laboratory tests and clinical scores,with lactate and PPI values assessed upon admission to the emergency room and at 6 h and 12 h after admission.Risk factors associated with mortality were analyzed using univariate and multivariate Cox regression analyses.Receiver operator characteristic(ROC)curve was used to assess predictive performance.Mortality rates were compared,and Kaplan-Meier survival plots were created.RESULTS:Compared to the survival group,patients in the death group were older and had more severe liver damage and coagulation dysfunction,necessitating higher norepinephrine doses and increased fl uid replacement.Higher lactate levels and lower PPI levels at 0 h,6 h,and 12 h were observed in the death group.Multivariate Cox regression identifi ed prolonged prothrombin time(PT),decreased 6-h PPI and 12-h PPI as independent risk factors for death.The area under the curves for 6-h PPI and 12-h PPI were 0.802(95%CI 0.742-0.863,P<0.001)and 0.945(95%CI 0.915-0.974,P<0.001),respectively,which were superior to Glasgow Coma Scale(GCS),Sequential Organ Failure Assessment(SOFA)scores(0.864 and 0.928).Cumulative mortality in the low PPI groups at 6 h and 12 h was signifi cantly higher than in the high PPI groups(6-h PPI:77.52%vs.22.54%;12-h PPI:92.04%vs.13.79%,P<0.001).CONCLUSION:PPI may have value in predicting 28-day mortality in patients with septic shock.

Advancing prognostic precision in gastric cancer with an immunoinflammatory index

Gastric cancer remains a major global health challenge with high morbidity and mortality rates.Recent advancements in immunology and inflammation research have highlighted the crucial roles that these biological processes play in tumor progression and patient outcomes.This has sparked new interest in developing prognostic biomarkers that integrate these two key biological processes.In this letter,we discuss the recent study by Ba et al,which proposed a novel prognostic immunoinflammatory index for patients with gastric cancer.We underscore the importance of this research,its potential impact on medical practice,and the prospective avenues for further investigation in this rapidly emerging area of study.

Association between the cumulative triglyceride-glucose index and the recurrence of atrial fibrillation after radiofrequency catheter ablation

BACKGROUND Triglyceride-glucose(TyG)index values are a new surrogate marker for insulin resistance.This study aimed to explore the relationship between cumulative TyG index values and atrial fibrillation(AF)recurrence after radiofrequency catheter ablation(RFCA).METHODS A total of 576 patients with AF who underwent RFCA at the Second Affiliated Hospital of Xi'an Jiaotong University were included in this study.The participants were grouped based on cumulative TyG index values tertiles within 3 months after ablation.Cox regression and restricted cubic spline analyses were used to determine the relationship between cumulative TyG index values and AF recurrence.The predictive value of all risk factors was assessed by receiver operating curve analysis.RESULTS There were 375 patients completed the study(age:63.23±10.73 years,64.27%male).The risk of AF recurrence increased with increasing cumulative TyG index values tertiles.After adjusting for potential confounders,patients in the medium cumulative TyG index group[hazard ratio(HR)=4.949,95%CI:1.778–13.778,P=0.002]and the high cumulative TyG index group(HR=8.716,95%CI:3.371–22.536,P<0.001)had a higher risk of AF recurrence than those in the low cumulative TyG index group.The restricted cubic spline regression model also showed an increased risk of AF recurrence with increasing cumulative TyG index values.When considering cumulative TyG index values,left atrial diameter,and lactate dehydrogenase levels as a comprehensive factor,the model could effectively predict AF recurrence after RFCA[area under the curve(AUC)=0.847,95%CI:0.797–0.897,P<0.001].CONCLUSIONS Cumulative TyG index values were a risk factor for AF recurrence after RFCA.Monitoring longitudinal TyG index values may assist with optimized for risk stratification and outcome prediction for AF recurrence.

OFDM with Generalized Cascade Index Modulation for Secure Communications

Cascade index modulation(CIM) is a recently proposed improvement of orthogonal frequency division multiplexing with index modulation(OFDM-IM) and achieves better error performance.In CIM, at least two different IM operations construct a super IM operation or achieve new functionality. First, we propose a OFDM with generalized CIM(OFDM-GCIM) scheme to achieve a joint IM of subcarrier selection and multiple-mode(MM)permutations by using a multilevel digital algorithm.Then, two schemes, called double CIM(D-CIM) and multiple-layer CIM(M-CIM), are proposed for secure communication, which combine new IM operation for disrupting the original order of bits and symbols with conventional OFDM-IM, to protect the legitimate users from eavesdropping in the wireless communications. A subcarrier-wise maximum likelihood(ML) detector and a low complexity log-likelihood ratio(LLR) detector are proposed for the legitimate users. A tight upper bound on the bit error rate(BER) of the proposed OFDM-GCIM, D-CIM and MCIM at the legitimate users are derived in closed form by employing the ML criteria detection. Computer simulations and numerical results show that the proposed OFDM-GCIM achieves superior error performance than OFDM-IM, and the error performance at the eavesdroppers demonstrates the security of D-CIM and M-CIM.

Surface phonon resonance:A new mechanism for enhancing photonic spin Hall effect and refractive index sensor

Metal-based surface plasmon resonance(SPR)plays an important role in enhancing the photonic spin Hall effect(SHE)and developing sensitive optical sensors.However,the very large negative permittivities of metals limit their applications beyond the near-infrared regime.In this work,we theoretically present a new mechanism to enhance the photonic SHE by taking advantage of SiC-supported surface phonon resonance(SPhR)in the mid-infrared regime.The transverse displacement of photonic SHE is very sensitive to the wavelength of incident light and the thickness of SiC layer.Under the optimal parameter setup,the calculated largest transverse displacement of SiC-based SPhR structure reaches up to 163.8 ym,which is much larger than the condition of SPR.Moreover,an NO_(2) gas sensor based on the SPhR-enhanced photonic SHE is theoretically proposed with the superior sensing performance.Both the intensity and angle sensitivity of this sensor can be effectively manipulated by varying the damping rate of SiC.The results may provide a promising paradigm to enhance the photonic SHE in the mid-infrared region and open up new opportunity of highly sensitive refractive index sensors.

Developments in the study of Chinese herbal medicine's assessment index and action mechanism for diabetes mellitus

In traditional Chinese medicine(TCM),based on various pathogenic symptoms and the‘golden chamber’medical text,Huangdi Neijing,diabetes mellitus falls under the category‘collateral disease’.TCM,with its wealth of experience,has been treating diabetes for over two millennia.Different antidiabetic Chinese herbal medicines re-duce blood sugar,with their effective ingredients exerting unique advantages.As well as a glucose lowering effect,TCM also regulates bodily functions to prevent diabetes associated complications,with reduced side effects compared to western synthetic drugs.Chinese herbal medicine is usually composed of polysaccharides,saponins,al-kaloids,flavonoids,and terpenoids.These active ingredients reduce blood sugar via various mechanism of actions that include boosting endogenous insulin secretion,enhancing insulin sensitivity and adjusting key enzyme activity and scavenging free radicals.These actions regulate glycolipid metabolism in the body,eventually achiev-ing the goal of normalizing blood glucose.Using different animal models,a number of molecular markers are available for the detection of diabetes induction and the molecular pathology of the disease is becoming clearer.Nonetheless,there is a dearth of scientific data about the pharmacology,dose-effect relationship,and structure-activity relationship of TCM and its constituents.Further research into the efficacy,toxicity and mode of action of TCM,using different metabolic and molecular markers,is key to developing novel TCM antidiabetic formulations.

Thornthwaite moisture index and depth of suction change under current and future climate‒An Australian study

Climate change is one of the major global challenges and it can have a significant influence on the behaviour and resilience of geotechnical structures.The changes in moisture content in soil lead to effective stress changes and can be accompanied by significant volume changes in reactive/expansive soils.The volume change leads to ground movement and can exert additional stresses on structures founded on or within a shallow depth of such soils.Climate change is likely to amplify the ground movement potential and the associated problems are likely to worsen.The effect of atmospheric boundary interaction on soil behaviour has often been correlated to Thornthwaite moisture index(TMI).In this study,the long-term weather data and anticipated future projections for various emission scenarios were used to generate a series of TMI maps for Australia.The changes in TMI were then correlated to the depth of suction change(H s),an important input in ground movement calculation.Under all climate scenarios considered,reductions in TMI and increases in H s values were observed.A hypothetical design scenario of a footing on expansive soil under current and future climate is discussed.It is observed that a design that might be considered adequate under the current climate scenario,may fail under future scenarios and accommodations should be made in the design for such events.

Systemic immune-inflammation index,neutrophilto-lymphocyte ratio,and platelet-to-lymphocyte ratio in patients with type 2 diabetes at different stages of diabetic retinopathy

AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.

Optimizing polypharmacy interventions and evaluating their impact on elderly inpatients using dual criteria and medication appropriateness index

With the acceleration of society’s aging process,the widespread phenomenon of polypharmacy among the elderly has become a significant concern.This research aimed to analyze potential inappropriate medication among 178 inpatients in the geriatric general department of our hospital from January 2022 to September 2022.The participants were randomly assigned to an observation group and a control group.The observation group received pharmaceutical intervention,whereas the control group did not.The objective was to explore the impact of pharmaceutical intervention on polypharmacy in this population.The results revealed that after pharmaceutical intervention,there were no significant differences in medication adherence,medication appropriateness index(MAI),quantity of medicine,and potentially inappropriate medication(PIM)in the control group compared to before the intervention(P>0.05).However,the observation group showed significant improvement(P<0.05).The proportion of patients with good adherence increased from 57%to 78%,and the percentage of patients with MAI scores over 10 decreased from 60%to 40%.Moreover,there was a reduction in the number of medications prescribed,with only 47%of patients receiving more than five different types compared to the initial rate of 64%.Additionally,the occurrence of PIM declined from an initial rate of 64%to just 44%,surpassing that observed in the control group.Therefore,the implementation of pharmaceutical intervention can effectively enhance medication adherence and appropriateness among elderly patients,mitigate the risk of PIM,and promote rational medicine utilization.