BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patie...BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.展开更多
This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the ...This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.展开更多
Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate...Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.展开更多
BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical interventio...BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.AIM To explore correlations between the systemic immune inflammatory index(SII)and geriatric nutritional risk index(GNRI)and HCC operation prognosis.METHODS This retrospective study included and collected follow up data from 100 HCC.Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival.SII and GNRI were calculated as follows:SII=neutrophil count×platelet count/lymphocyte count;GNRI=[1.489×albumin(g/L)+41.7×actual weight/ideal weight].We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic(ROC)curves,and the relationships between the SII,GNRI,and survival rate using Kaplan–Meier survival curves.Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.RESULTS After 1 year of follow-up,24 patients died and 76 survived.The area under the curve(AUC),sensitivity,specificity,and the optimal cutoff value of SII were 0.728(95%confidence interval:0.600-0.856),79.2%,63.2%,and 309.14,respectively.According to ROC curve analysis results for predicting postoperative death in HCC patients,the AUC of SII and GNRI combination was higher than that of SII or GNRI alone,and SII was higher than that of GNRI(P<0.05).The proportion of advanced differentiated tumors,tumor maximum diameter(5–10 cm,>10 cm),lymph node metastasis,and TNM stage III-IV in patients with SII>309.14 was higher than that in patients with SII≤309.14(P<0.05).The proportion of patients aged>70 years was higher in patients with GNRI≤98 than that in patients with GNRI>98(P<0.05).The 1-year survival rate of the SII>309.14 group(compared with the SII≤309.14 group)and GNRI≤98 group(compared with the GNRI>98 group)was lower(P<0.05).CONCLUSION The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.展开更多
Modified potential ecological risk index (MRI) was proposed based on the potential ecological risk index (RI) and risk assessment code (RAC) by modifying an index. The modified index was relevant to the chemical...Modified potential ecological risk index (MRI) was proposed based on the potential ecological risk index (RI) and risk assessment code (RAC) by modifying an index. The modified index was relevant to the chemical speciation of heavy metals. Xiawan Port, a typical region contaminated by industrial production, was selected as a case study area. The total concentrations and chemical speciation of heavy metals in sediments of Xiawan Port were analyzed. The experimental data indicate that Xiawan Port is seriously polluted by heavy metals, especially by Cd. The risks of heavy metals are evaluated by RI, RAC and MRI, respectively. The resluts of MRI show that the risks of heavy metals are in the decreasing order of Cd〉Pb〉Cu〉Zn. Comparison of results by different methods reveals that MRI integrates the characters of RI and RAC. MRI is recognized to be useful for risk managemnt of heavy metals in sediments.展开更多
Objective:To validate malnutrition screening tool of nutrition risk index (NRI) against patent-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiothe...Objective:To validate malnutrition screening tool of nutrition risk index (NRI) against patent-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiotherapy.Methods:Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA (gold standard method) and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results:The findings of PG-SGA and NRI showed that 52% and 45% of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66% and a specificity of 60% against PG-SGA.The positive predictive value was 64% and the negative predicative value was 62%.The agreement between NRI and PG-SGA was statistically insignificant (kappa =0.267; P>0.05).Conclusions:The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.展开更多
Safety is the foundation of sustainable development in civil aviation.Although catastrophic accidents are rare,indicators of potential incidents and unsafe events frequently materialize.Therefore,a history of unsafe d...Safety is the foundation of sustainable development in civil aviation.Although catastrophic accidents are rare,indicators of potential incidents and unsafe events frequently materialize.Therefore,a history of unsafe data are considered in predicting safety risks.A deep learning method is adopted for extracting reactions in safety risks.The deep neural network(DNN)model for safety risk prediction is shown to extract complex data characteristics better than a shallow network model.Using extended unsafe data and monthly risk indices,hidden layers and iterations are determined.The effectiveness of DNN is also revealed in comparison with the traditional neural network.Through early risk detection using the method in the paper,airlines and the government can mitigate potential risk and take proactive measures to improve civil aviation safety.展开更多
Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk....Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. Objectives: The purpose of the present study was to examine the significance of the GNRI as a mortality predictor in MHD patients. Methods: We retrospectively examined the GNRI of 259 MHD patients aged 59.2 ± 12.8 years, and followed up for 36 months. The patients were divided into two groups according to GNRI values of 91.0. Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. Results: During the follow-up period of 36 months, a total of 76 patients died. Kaplan-Meier survival analysis showed that the subjects with a GNRI 91 (n = 230) (Log-rank test,展开更多
The driver’s visibility is degraded when weather conditions deteriorate, which affects the traffic flow and induces traffic congestion or accidents. In particular, traffic accidents can be?led to chain reaction colli...The driver’s visibility is degraded when weather conditions deteriorate, which affects the traffic flow and induces traffic congestion or accidents. In particular, traffic accidents can be?led to chain reaction collisions, with high rate of fatality, when fog occurs in contrast to other weather factors that may restrict visibility. For the development of a traffic risk index, a deviation of the vehicle’s speed was set for the traffic risk index by referring to previous study results. In addition, factors that affected the deviation in a vehicle’s speed were selected as independent variables based on the traffic flow analysis during occurrences of fog. The visible distance, traffic volume, and speed were selected as the independent variables to estimate the optimal parameters in the regression model. The traffic risk index model during occurrences of fog proposed in this study is an exponential model, with the visible distance and the traffic volume defined as independent variables. According to the study model, traffic risk increased as the visible distance decreased and the traffic volume was lower. Thus, the visible distance that can affect traffic flow during occurrences of fog can be determined in the future based on the results of this study. The study results will be expected to contribute to not only traffic safety improvements, but also the facilitation of traffic flow as drivers and traffic operation managers intuitively recognize the level of risk.展开更多
To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and correspo...To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and corresponding subsoil samples)were collected from the five representative land-use patterns.Inductively coupled plasma mass spectrometry(ICP-MS),Atomic fluorescence spectrometry(AFS),and Inductively coupled plasma optical emission spectrometry(ICP-OES)were used to determine the content of PTEs(As,Cd,Hg,Cu,Cr,Ni,Pb,Zn,Co,Mo,Sb,and V).Correlation analysis and factor analysis were used to determine the source of PTEs.Geo-accumulation index(I_(geo)),hazard quotient(HQ),and total carcinogenic risk index(TR)were used to measure the PTEs contamination and its relative health impacts.Results showed that the average values of 12 PTEs in topsoil were higher than the Hainan soil geochemical baseline,showing different degrees of PTEs accumulation effect.The concentration of PTEs in the topsoil was lower than those in the subsoil except for Cd and Hg.The I_(geo)revealed that the major accumulated element in soils was As followed by Mo.Source apportionment suggested that parent materials and agricultural practices were the dominant factors for PTEs accumulation in the topsoil.Noncarcinogenic risks of soil samples from five land-use patterns presented a trend of paddy field>dry field>woodland>orchard>garden plot.However,the HQ values of 12 PTEs were less than the recommended limit of HQ=1,representing that there are no non-carcinogenic risks of PTEs for children and adults in the study area.The TR values are within 6.95×10^(-6)-1.38×10^(-5),which corresponds to the low level.Therefore the PTEs in the agricultural soil of the study area show little influence on the health status of the local population.展开更多
BACKGROUND The measurement of triceps skinfold(TSF)thickness serves as a noninvasive metric for evaluating subcutaneous fat distribution.Despite its clinical utility,the TSF thickness trajectories and their correlatio...BACKGROUND The measurement of triceps skinfold(TSF)thickness serves as a noninvasive metric for evaluating subcutaneous fat distribution.Despite its clinical utility,the TSF thickness trajectories and their correlation with overall mortality have not been thoroughly investigated.AIM To explore TSF thickness trajectories of Chinese adults and to examine their associations with all-cause mortality.METHODS This study encompassed a cohort of 14747 adults sourced from the China Health and Nutrition Survey.Latent class trajectory modeling was employed to identify distinct trajectories of TSF thickness.Subjects were classified into subgroups reflective of their respective TSF thickness trajectory.We utilized multivariate Cox regression analyses and mediation examinations to explore the link between TSF thickness trajectory and overall mortality,including contributory factors.RESULTS Upon adjustment for multiple confounding factors,we discerned that males in the‘Class 2:Thin-stable’and‘Class 3:Thin-moderate’TSF thickness trajectories exhibited a markedly reduced risk of mortality from all causes in comparison to the‘Class 1:Extremely thin’subgroup.In the mediation analyses,the Geriatric Nutritional Risk Index was found to be a partial intermediary in the relationship between TSF thickness trajectories and mortality.For females,a lower TSF thickness pattern was significantly predictive of elevated all-cause mortality risk exclusively within the non-elderly cohort.CONCLUSION In males and non-elderly females,lower TSF thickness trajectories are significantly predictive of heightened mortality risk,independent of single-point TSF thickness,body mass index,and waist circumference.展开更多
Crude oil spills have inflicted extensive disruption upon the Niger Delta ecosystem, resulting in crop loss and severe environmental damage. Such spills exacerbate heavy metal concentration within soil due to the pres...Crude oil spills have inflicted extensive disruption upon the Niger Delta ecosystem, resulting in crop loss and severe environmental damage. Such spills exacerbate heavy metal concentration within soil due to the presence of metallic ions. The Okpare-Olomu community has borne the brunt of crude oil pollution from illicit bunkering, sabotage, and equipment malfunction. This study targets an evaluation of ecological hazards linked to heavy metals (HMs) in crude oil impacted agriculturally soils within Okpare-Olomu in Ughelli South LGA of Delta State. In this study, 24 topsoil samples were obtained from areas affected by crude oil pollution;the heavy metal content was evaluated through atomic absorption spectrometry. The concentration ranges for HMs (mg/kg) in soil were: 24.1 - 23,174 (Cu);0.54 - 37.1 (Cd);9.05 - 54 (Cr);12 - 174 (Ni);18.5 - 8611 (Pb);and 148 - 9078 (Zn) at a soil depth of 0 - 15 cm. Notably, metal concentrations were recorded to be above permissible World Health Organization limits. Predominantly, Zn and Pb recorded higher heavy metal concentration when compared to other heavy metals analysed, notably at sampling points PT7 through PT24. Zinc and Pb contamination exhibited highly significant contamination factors, and contamination severity was evidenced across all sample points, signifying a grave risk level. Pollution load indices indicated pervasive extreme pollution levels. Geoaccumulation indices signaled moderate to strong pollution, mainly by Pb and Zn. Ecological risk assessments revealed variable levels of heavy metal contamination, from low to very high, with potential ecological risk reflecting markedly elevated levels. This study underscores the imperative for soil remediation to rectify ecological imbalances in agriculturally affected soil constituents.展开更多
[Objective]The ecological vulnerability and landscape ecological risk of karst mountainous areas have increased as a result of enhanced disturbance of natural resources by human activities.This paper aimed to explore ...[Objective]The ecological vulnerability and landscape ecological risk of karst mountainous areas have increased as a result of enhanced disturbance of natural resources by human activities.This paper aimed to explore the characteristics of ecological risk evolution under different landscape patterns in the region,with a view to providing reference for land classification protection,sustainable use of resources and regional ecological risk optimization in karst mountainous areas.[Method]Taking Huangping County,a typical karst mountainous area,as an example,eight evaluation factors of natural and landscape patterns were selected to construct a landscape ecological risk evaluation model,to quantitatively explore the spatio-temporal evolution of landscape ecological risk and the trend of risk level transfer in the study area from^(2)010-2018,and to reveal the complex relationship between ecological risk and topography in karst mountainous areas.[Result]①From 2010 to 2018,land use types changed to different degrees,with the most amount of woodland transferred out(1627.37 hm^(2))and the most amount of construction land transferred in(1303.93 hm^(2));a total of 3552.31 hm^(2) of land was transferred,with a change ratio of 2.13%,and there was a significant conversion between construction land,arable land,and woodland.②From 2010 to 2018,the landscape ecological risk in the study area changed significantly,and the landscape ecological risk index decreased from 0.3441 to 0.1733,showing an upward and then downward trend;the landscape ecological risk of the whole region was dominated by low-risk and lower-risk zones,and the ecological risk level generally shifted from a high level to a low level,and the ecological environment was improved.③There was a negative correlation between ecological risk and topographic position,and high-risk zones were mainly distributed among low topographic zones;with the change of time,the advantage of risk level for the selection of topography was gradually weakened,and the influence of anthropogenic factors on the ecological risk of the landscape was becoming more and more prominent.[Conclusion]This paper can provide theoretical basis for land use optimization and ecological protection in karst mountainous areas.展开更多
Background Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk...Background Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system. Methods A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease. Results The composition of heart disease in pregnant women was arrhythmia (n=662, 38.00%), congenital heart disease (CHD; n=529, 30.40%), cardiomyopathy (n=327, 18.80%), rheumatic heart disease (RHD; n=151, 8.70%), and cardiopathy induced by pre-eclampsia (n=53, 3.00%). Main cardiac events were heart failure (n=110, 6.32%), symptomatic arrhythmia needing medication (n=43, 2.47%), cardiac arrest (n=2, 0.11%), syncope (n=3, 0.17%), and maternal death (n=10, 0.57%). Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy (heart failure, severe arrhythmia, cardiac shock, etc., P=0.000), New York Heart Association (NYHA) class 〉11 (m=0.000), oxygen saturation 〈90% (P=0.018), pulmonary artery hypertention (PAH) 〉50 mmHg (P=0.025), cyanotic heart disease without surgical correction (P=-0.015), and reduced left ventricular systolic function (ejection fraction 〈40%, P=0.003). Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and 〉4 was 2.10%, 31.61 %, 61.25%, 68.97%, and 100.00% respectively. Conclusions Pregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by risk index.展开更多
In the context of global warming,China is facing with increasing climate risks.It is imperative to develop quantitative indices to reflect the climate risks caused by extreme weather/climate events and adverse climati...In the context of global warming,China is facing with increasing climate risks.It is imperative to develop quantitative indices to reflect the climate risks caused by extreme weather/climate events and adverse climatic conditions in association with different industries.Based on the observations at 2288 meteorological stations in China and the meteorological disasters data,a set of indices are developed to measure climate risks due to water-logging,drought,high temperature,cryogenic freezing,and typhoon.A statistical method is then used to construct an overall climate risk index(CRI)for China from these individual indices.There is a good correspondence between these indices and historical climatic conditions.The CRI,the index of water-logging by rain,and the high temperature index increase at a rate of 0.28,0.37,and 0.65 per decade,respectively,from 1961 to 2016.The cryogenic freezing index is closely related to changes in the consumer price index for food.The high temperature index is correlated with the consumption of energy and electricity.The correlation between the yearly growth in claims on household property insurance and the sum of the water-logging index and the typhoon index in the same year is as high as 0.70.Both the growth rate of claims on agricultural insurance and the annual growth rate of hospital inpatients are positively correlated with the CRI.The year-on-year growth in the number of domestic tourists is significantly negatively correlated with the CRI in the same year.More efforts are needed to develop regional CRIs.展开更多
We aimed to develop a disease risk comorbidity index(DRCI)based on disease risk index(DRI)and Hematopoietic Cell Transplantation-Specific Comorbidity Index(HCT-CI)in patients receiving haploidentical hematopoietic ste...We aimed to develop a disease risk comorbidity index(DRCI)based on disease risk index(DRI)and Hematopoietic Cell Transplantation-Specific Comorbidity Index(HCT-CI)in patients receiving haploidentical hematopoietic stem cell transplantation(haplo-HSCT).We identified the prognostic factors of disease-free survival(DFS)in a training subset(n=593),then assigned a weighted score using these factors to the remaining patients(validation subset;n=296).The multivariable model identified two independent predictors of DFS:DRI and HCT-CI before transplantation.In this scoring system,we assigned a weighted score of 2 to very high-risk DRI,and assigned a weighted score of 1 to high-risk DRI and intermediate-and high-risk HCT-CI(i.e.,haplo-DRCI).In the validation cohort,the three-year DFS rate was 65.2%(95%confidence interval(CI),58.2%–72.2%),55.8%(95%CI,44.9%–66.7%),and 32.0%(95%CI,5.8%–58.2%)for the low-,intermediate-,and high-risk group,respectively(P=0.005).Haplo-DRCI can also predict DFS in disease-specific subgroups,particularly in acute leukemia patients.Increasing score was also significantly predictive of increased relapse,increased non-relapse mortality(NRM),decreased DFS,and decreased overall survival(OS)in an independent historical cohort(n=526).These data confirmed that haplo-DRCI could effectively risk stratify haplo-HSCT recipients and provide a tool to better predict who will best benefit from haplo-HSCT.展开更多
Heavy metal distribution in mining areas has always been a hot research topic due to the special environment of these areas. This study aims to explore the impact of heavy metal pollution on soils and crops in the stu...Heavy metal distribution in mining areas has always been a hot research topic due to the special environment of these areas. This study aims to explore the impact of heavy metal pollution on soils and crops in the study area, ensure the safety of local crops and the health of local residents, and provide a basis for the subsequent environmental restoration and the prevention and control of environmental pollution. Based on the analysis of the heavy metal concentrations in local soils and crops, the study investigated the spatial distribution, pollution degrees, and potential ecological risks of heavy metals in the farmland of a mining area in the southeastern Nanyang Basin, Henan province, China explored the sources of heavy metals and assessed the health risks caused by crop intake. The results of this study are as follows. The root soils of crops in the study area suffered heavy metal pollution to varying degrees. The degree of heavy metal pollution in maize fields is higher than that in wheat fields, and both types of fields suffer the most severe Cd pollution. Moreover, the root soils of different crops suffer compound pollution.The root soils in the maize fields suffer severe compound pollution at some sampling positions, whose distribution is similar to that of the mining area. Cd poses the highest potential ecological risks among all heavy metals, and the study area mainly suffers low and moderate comprehensive potential ecological risks. The principal component analysis(PCA) shows that the distribution of Zn, Cd, Pb, and As in soils of the study area is mainly affected by anthropogenic factors such as local mining activities;the distribution of Cr and Ni is primarily controlled by the local geological background;the distribution of Hg is mainly affected by local vehicle exhaust emissions, and the distribution of Cu is influenced by both human activities and the geological background. Different cereal crops in the study area are polluted with heavy metals dominated by Cd and Ni to varying degrees, especially wheat. As indicated by the health risk assessment results, the intake of maize in the study area does not pose significant human health risks;however, Cu has high risks to human health, and the compound heavy metal pollution caused by the intake of wheat in the study area poses risks to the health of both adults and children. Overall, the soils and crops in the study area suffer a high degree of heavy metal pollution, for which mining activities may be the main reason.展开更多
Geohazards along highways are the main natural hazards that could affect the safety and operation of highway systems.Understanding the risks faced by highways in areas affected by geohazards is an urgent problem to be...Geohazards along highways are the main natural hazards that could affect the safety and operation of highway systems.Understanding the risks faced by highways in areas affected by geohazards is an urgent problem to be solved.This study used historical geohazard events from Sichuan Province and highway network data to propose a geohazard risk index that reflects the risk geohazards along highways.Furthermore,this work applied the entropy method and expert scoring to calculate the weight of the index.The spatial distributions of landslides,debris flows,collapses,and unstable slopes along the highways were analysed based on ArcGIS spatial statistics,and the highway geohazard intensity index were obtained.The relationships between slope,rainfall,vegetation coverage,rock type,land use,and incision depth with geohazards were analysed,and the highway geohazard susceptibility index was calculated by the weighted information method.Based on the intensity and susceptibility index,we obtained a geohazard risk index which can better evaluate the risk of highways,and made a highway geohazard risk map to aid the prevention and mitigation of geohazards along highways and assist with highway network planning.展开更多
The current pressure on the built historical heritage requires a global evaluation to develop strategies for its preservation.A combined vision of the state of conservation of architectural heritage is essential to hi...The current pressure on the built historical heritage requires a global evaluation to develop strategies for its preservation.A combined vision of the state of conservation of architectural heritage is essential to highlight the vulnerabilities of the structure from which harmonized measures can be proposed for its mitigation.This study proposes a multi-criteria analysis methodology that considers a qualitative and quantitative approach to organize the global conservation state of heritage buildings hierarchically.A global index can be determined on the basis of the generation of an interoperable data matrix by defining a set of indicators to assess different components of a building.This index describes the risk with respect to the stability,safety,and habitability of the building.This methodology aims to achieve the state of the building in an integral way by obtaining a simple and objective index that enables efficient comparison among different buildings.The application of this methodology to a historic area allows creating a hierarchical map of risk to stablish priorities for intervention and enable a sustainable and critical management and planning over the actions of maintenance,conservation,and restoration.In this way,a holistic vision of the complex reality of built heritage and the urban landscape is obtained to identify critical areas of priority intervention.展开更多
基金Supported by Social Development Projects of Nantong,No.MS22021008 and No.QNZ2022005.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM),a fast-growing issue in public health,is one of the most common chronic metabolic disorders in older individuals.Osteoporosis and sarcopenia are highly prevalent in T2DM patients and may result in fractures and disabilities.In people with T2DM,the association between nutrition,sarcopenia,and osteoporosis has rarely been explored.AIM To evaluate the connections among nutrition,bone mineral density(BMD)and body composition in patients with T2DM.METHODS We enrolled 689 patients with T2DM for this cross-sectional study.All patients underwent dual energy X-ray absorptiometry(DXA)examination and were categorized according to baseline Geriatric Nutritional Risk Index(GNRI)values calculated from serum albumin levels and body weight.The GNRI was used to evaluate nutritional status,and DXA was used to investigate BMD and body composition.Multivariate forward linear regression analysis was used to identify the factors associated with BMD and skeletal muscle mass index.RESULTS Of the total patients,394 were men and 295 were women.Compared with patients in tertile 1,those in tertile 3 who had a high GNRI tended to be younger and had lower HbA1c,higher BMD at all bone sites,and higher appendicular skeletal muscle index(ASMI).These important trends persisted even when the patients were divided into younger and older subgroups.The GNRI was positively related to ASMI(men:r=0.644,P<0.001;women:r=0.649,P<0.001),total body fat(men:r=0.453,P<0.001;women:r=0.557,P<0.001),BMD at all bone sites,lumbar spine(L1-L4)BMD(men:r=0.110,P=0.029;women:r=0.256,P<0.001),FN-BMD(men:r=0.293,P<0.001;women:r=0.273,P<0.001),and hip BMD(men:r=0.358,P<0.001;women:r=0.377,P<0.001).After adjustment for other clinical parameters,the GNRI was still significantly associated with BMD at the lumbar spine and femoral neck.Additionally,a low lean mass index and higherβ-collagen special sequence were associated with low BMD at all bone sites.Age was negatively correlated with ASMI,whereas weight was positively correlated with ASMI.CONCLUSION Poor nutrition,as indicated by a low GNRI,was associated with low levels of ASMI and BMD at all bone sites in T2DM patients.Using the GNRI to evaluate nutritional status and using DXA to investigate body composition in patients with T2DM is of value in assessing bone health and physical performance.
文摘This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal Surgery.It pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features valuable.There are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical surgery.Neutrophils release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell invasion.Neutrophils promote the adhesion of tumor cells to endothelial cells,through physical anchoring.That results in the migration of tumor cells.Pro-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply needs.Platelets can form a protective film on the surface of tumor cells.This allows avoiding blood flow damage as well as immune system attack.It also induces the epithelial-mesenchymal transformation of tumor cells that is critical for invasiveness.High SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall survival.HCC patients are a very special population that requires increased attention.SII and GNRI have significant survival prediction value in both palliative treatment and radical surgery settings.The underlying mechanisms of their possible predictive properties lie in the field of essential cancer features.Those features provide tumor nutrition,growth,and distribution throughout the body,such as vascular invasion.On the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in both postoperative and cancer-related settings.The article is of considerable interest.It would be helpful to continue the study follow-up to 2 years and longer.External validation of the data is needed.
文摘Purpose: Few studies have evaluated the association between malnutrition and the risk of preoperative deep vein thrombosis (DVT) in patients undergoing primary total joint arthroplasty. This study aimed to investigate the prevalence of preoperative DVT in Japanese patients undergoing total knee arthroplasty (TKA) and the importance of malnutrition in the risk of preoperative DVT. Methods: We retrospectively analyzed 394 patients admitted for primary TKA at our institution between January 2019 and December 2023. All patients scheduled for TKA at our institution had serum D-dimer levels measured preoperatively. Lower-limb ultrasonography was examined to confirm the presence of DVT in patients with D-dimer levels ≥ 1.0 µg/mL or who were considered to be at high risk of DVT by the treating physician. Based on the results of lower-limb ultrasonography, all patients were divided into the non-DVT and DVT groups. The incidence of and risk factors for preoperative DVT were investigated, as well as the correlation of DVT with the patient’s nutritional parameters. We used two representative tools for nutritional assessment: the Geriatric Nutritional Risk Index (GNRI) and Controlling Nutritional Status Score. Results: The mean age was 77.8 ± 6.9 years. Preoperative DVT was diagnosed in 57 of the 394 (14.5%) patients. Multivariate logistic regression analysis showed that advanced age and malnutrition status, assessed using the GNRI, were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients who underwent TKA. Malnutrition status, as assessed using the GNRI, increased the risk of preoperative DVT. Our findings suggest that clinicians should consider these factors when tailoring preventive strategies to mitigate DVT risk in patients undergoing TKA.
基金the Soft Science Research Project of Liuzhou Association for Science and Technology,No.20200120Self-funded scientific research project of Guangxi Zhuang Autonomous Region Health Commission,No.Z20200258.
文摘BACKGROUND Radical surgery is the most commonly used treatment for hepatocellular carcinoma(HCC).However,the surgical effect remains not ideal,and prognostic evaluation is insufficient.Furthermore,clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.AIM To explore correlations between the systemic immune inflammatory index(SII)and geriatric nutritional risk index(GNRI)and HCC operation prognosis.METHODS This retrospective study included and collected follow up data from 100 HCC.Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival.SII and GNRI were calculated as follows:SII=neutrophil count×platelet count/lymphocyte count;GNRI=[1.489×albumin(g/L)+41.7×actual weight/ideal weight].We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic(ROC)curves,and the relationships between the SII,GNRI,and survival rate using Kaplan–Meier survival curves.Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.RESULTS After 1 year of follow-up,24 patients died and 76 survived.The area under the curve(AUC),sensitivity,specificity,and the optimal cutoff value of SII were 0.728(95%confidence interval:0.600-0.856),79.2%,63.2%,and 309.14,respectively.According to ROC curve analysis results for predicting postoperative death in HCC patients,the AUC of SII and GNRI combination was higher than that of SII or GNRI alone,and SII was higher than that of GNRI(P<0.05).The proportion of advanced differentiated tumors,tumor maximum diameter(5–10 cm,>10 cm),lymph node metastasis,and TNM stage III-IV in patients with SII>309.14 was higher than that in patients with SII≤309.14(P<0.05).The proportion of patients aged>70 years was higher in patients with GNRI≤98 than that in patients with GNRI>98(P<0.05).The 1-year survival rate of the SII>309.14 group(compared with the SII≤309.14 group)and GNRI≤98 group(compared with the GNRI>98 group)was lower(P<0.05).CONCLUSION The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.
基金Projects (51039001, 50978087, 51009063, 50808071) supported by the National Natural Science Foundation of ChinaProject (SX2010-026) supported by State Council Three Gorges Project Construction Committee Executive Office,China+2 种基金Project (2009ZX07212-001) supported by Ministry of Environmental Protection of ChinaProject (BYHGLC-2010-02) supported by Guangzhou Water Authority,ChinaProject (CX2010B157) supported by Hunan Provincial Innovation Foundation for Postgraduate,China
文摘Modified potential ecological risk index (MRI) was proposed based on the potential ecological risk index (RI) and risk assessment code (RAC) by modifying an index. The modified index was relevant to the chemical speciation of heavy metals. Xiawan Port, a typical region contaminated by industrial production, was selected as a case study area. The total concentrations and chemical speciation of heavy metals in sediments of Xiawan Port were analyzed. The experimental data indicate that Xiawan Port is seriously polluted by heavy metals, especially by Cd. The risks of heavy metals are evaluated by RI, RAC and MRI, respectively. The resluts of MRI show that the risks of heavy metals are in the decreasing order of Cd〉Pb〉Cu〉Zn. Comparison of results by different methods reveals that MRI integrates the characters of RI and RAC. MRI is recognized to be useful for risk managemnt of heavy metals in sediments.
基金the financial support of Nutrition Research Center,Tabriz University of Medical Sciences
文摘Objective:To validate malnutrition screening tool of nutrition risk index (NRI) against patent-generated subjective global assessment (PG-SGA) as a gold standard tool in colorectal cancer patients before radiotherapy.Methods:Nutritional status of 52 volunteer colorectal cancer patients with a mean age of 54.1±16.8 years who referred to radiotherapy center were assessed by PG-SGA (gold standard method) and NRI.Serum albumin levels of patients were determined by colorimetric method.A contingency table was used to determine the sensitivity,specificity,and predictive value of the NRI in screening patients at risk of malnutrition,in comparison with the PG-SGA in patients before radiotherapy.Results:The findings of PG-SGA and NRI showed that 52% and 45% of patients in our study were moderately or severely malnourished respectively.The NRI had a sensitivity of 66% and a specificity of 60% against PG-SGA.The positive predictive value was 64% and the negative predicative value was 62%.The agreement between NRI and PG-SGA was statistically insignificant (kappa =0.267; P>0.05).Conclusions:The findings of present study showed that the prevalence of malnutrition was high in patients with colorectal cancer.Moreover,NRI method had low sensitivity and specificity in assessing nutritional status of patients with cancer.It seems that the combination of anthropometric,laboratory parameters and a subjective scoring system may be helpful tools in screening of malnutrition in cancer patients.
基金supported by the Joint Funds of the National Natural Science Foundation of China (No. U1833110)
文摘Safety is the foundation of sustainable development in civil aviation.Although catastrophic accidents are rare,indicators of potential incidents and unsafe events frequently materialize.Therefore,a history of unsafe data are considered in predicting safety risks.A deep learning method is adopted for extracting reactions in safety risks.The deep neural network(DNN)model for safety risk prediction is shown to extract complex data characteristics better than a shallow network model.Using extended unsafe data and monthly risk indices,hidden layers and iterations are determined.The effectiveness of DNN is also revealed in comparison with the traditional neural network.Through early risk detection using the method in the paper,airlines and the government can mitigate potential risk and take proactive measures to improve civil aviation safety.
文摘Background: Malnutrition is associated with higher risk of mortality in maintenance hemodialysis (MHD) patients. The geriatric nutritional risk index (GNRI) has been developed as a tool to assess the nutritional risk. Objectives: The purpose of the present study was to examine the significance of the GNRI as a mortality predictor in MHD patients. Methods: We retrospectively examined the GNRI of 259 MHD patients aged 59.2 ± 12.8 years, and followed up for 36 months. The patients were divided into two groups according to GNRI values of 91.0. Predictors for all-cause mortality were examined using Kaplan-Meier and Cox proportional-hazards analyses. Results: During the follow-up period of 36 months, a total of 76 patients died. Kaplan-Meier survival analysis showed that the subjects with a GNRI 91 (n = 230) (Log-rank test,
文摘The driver’s visibility is degraded when weather conditions deteriorate, which affects the traffic flow and induces traffic congestion or accidents. In particular, traffic accidents can be?led to chain reaction collisions, with high rate of fatality, when fog occurs in contrast to other weather factors that may restrict visibility. For the development of a traffic risk index, a deviation of the vehicle’s speed was set for the traffic risk index by referring to previous study results. In addition, factors that affected the deviation in a vehicle’s speed were selected as independent variables based on the traffic flow analysis during occurrences of fog. The visible distance, traffic volume, and speed were selected as the independent variables to estimate the optimal parameters in the regression model. The traffic risk index model during occurrences of fog proposed in this study is an exponential model, with the visible distance and the traffic volume defined as independent variables. According to the study model, traffic risk increased as the visible distance decreased and the traffic volume was lower. Thus, the visible distance that can affect traffic flow during occurrences of fog can be determined in the future based on the results of this study. The study results will be expected to contribute to not only traffic safety improvements, but also the facilitation of traffic flow as drivers and traffic operation managers intuitively recognize the level of risk.
基金supported by Open Foundation of the Key Laboratory of Coupling Process and Effect of Natural Resources Elements(No.2023KFKTB001)the Science&Technology Fundamental Resources Investigation Program(2022FY101800)+2 种基金the National Nonprofit Institute Research Grant of IGGE(AS2023D01)the projects of the China Geological Survey(DD20230309 and DD20190305)the National Natural Science Foundation of China(42002105)。
文摘To understand the levels of potentially toxic elements(PTEs)contamination in soils and their effects on human health from different agricultural land use in Sanya,China.128 soil samples(64 topsoil samples and corresponding subsoil samples)were collected from the five representative land-use patterns.Inductively coupled plasma mass spectrometry(ICP-MS),Atomic fluorescence spectrometry(AFS),and Inductively coupled plasma optical emission spectrometry(ICP-OES)were used to determine the content of PTEs(As,Cd,Hg,Cu,Cr,Ni,Pb,Zn,Co,Mo,Sb,and V).Correlation analysis and factor analysis were used to determine the source of PTEs.Geo-accumulation index(I_(geo)),hazard quotient(HQ),and total carcinogenic risk index(TR)were used to measure the PTEs contamination and its relative health impacts.Results showed that the average values of 12 PTEs in topsoil were higher than the Hainan soil geochemical baseline,showing different degrees of PTEs accumulation effect.The concentration of PTEs in the topsoil was lower than those in the subsoil except for Cd and Hg.The I_(geo)revealed that the major accumulated element in soils was As followed by Mo.Source apportionment suggested that parent materials and agricultural practices were the dominant factors for PTEs accumulation in the topsoil.Noncarcinogenic risks of soil samples from five land-use patterns presented a trend of paddy field>dry field>woodland>orchard>garden plot.However,the HQ values of 12 PTEs were less than the recommended limit of HQ=1,representing that there are no non-carcinogenic risks of PTEs for children and adults in the study area.The TR values are within 6.95×10^(-6)-1.38×10^(-5),which corresponds to the low level.Therefore the PTEs in the agricultural soil of the study area show little influence on the health status of the local population.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015CAMS Innovation Fund for Medical Sciences,No.2021-1-12M-002+1 种基金CAMS Innovation Fund for Medical Sciences,No.2023-I2M-C&T-B-043Beijing Municipal Natural Science Foundation,No.M22014.
文摘BACKGROUND The measurement of triceps skinfold(TSF)thickness serves as a noninvasive metric for evaluating subcutaneous fat distribution.Despite its clinical utility,the TSF thickness trajectories and their correlation with overall mortality have not been thoroughly investigated.AIM To explore TSF thickness trajectories of Chinese adults and to examine their associations with all-cause mortality.METHODS This study encompassed a cohort of 14747 adults sourced from the China Health and Nutrition Survey.Latent class trajectory modeling was employed to identify distinct trajectories of TSF thickness.Subjects were classified into subgroups reflective of their respective TSF thickness trajectory.We utilized multivariate Cox regression analyses and mediation examinations to explore the link between TSF thickness trajectory and overall mortality,including contributory factors.RESULTS Upon adjustment for multiple confounding factors,we discerned that males in the‘Class 2:Thin-stable’and‘Class 3:Thin-moderate’TSF thickness trajectories exhibited a markedly reduced risk of mortality from all causes in comparison to the‘Class 1:Extremely thin’subgroup.In the mediation analyses,the Geriatric Nutritional Risk Index was found to be a partial intermediary in the relationship between TSF thickness trajectories and mortality.For females,a lower TSF thickness pattern was significantly predictive of elevated all-cause mortality risk exclusively within the non-elderly cohort.CONCLUSION In males and non-elderly females,lower TSF thickness trajectories are significantly predictive of heightened mortality risk,independent of single-point TSF thickness,body mass index,and waist circumference.
文摘Crude oil spills have inflicted extensive disruption upon the Niger Delta ecosystem, resulting in crop loss and severe environmental damage. Such spills exacerbate heavy metal concentration within soil due to the presence of metallic ions. The Okpare-Olomu community has borne the brunt of crude oil pollution from illicit bunkering, sabotage, and equipment malfunction. This study targets an evaluation of ecological hazards linked to heavy metals (HMs) in crude oil impacted agriculturally soils within Okpare-Olomu in Ughelli South LGA of Delta State. In this study, 24 topsoil samples were obtained from areas affected by crude oil pollution;the heavy metal content was evaluated through atomic absorption spectrometry. The concentration ranges for HMs (mg/kg) in soil were: 24.1 - 23,174 (Cu);0.54 - 37.1 (Cd);9.05 - 54 (Cr);12 - 174 (Ni);18.5 - 8611 (Pb);and 148 - 9078 (Zn) at a soil depth of 0 - 15 cm. Notably, metal concentrations were recorded to be above permissible World Health Organization limits. Predominantly, Zn and Pb recorded higher heavy metal concentration when compared to other heavy metals analysed, notably at sampling points PT7 through PT24. Zinc and Pb contamination exhibited highly significant contamination factors, and contamination severity was evidenced across all sample points, signifying a grave risk level. Pollution load indices indicated pervasive extreme pollution levels. Geoaccumulation indices signaled moderate to strong pollution, mainly by Pb and Zn. Ecological risk assessments revealed variable levels of heavy metal contamination, from low to very high, with potential ecological risk reflecting markedly elevated levels. This study underscores the imperative for soil remediation to rectify ecological imbalances in agriculturally affected soil constituents.
基金the National Natural Science Foundation of China(41661088)Project for Guizhou Province"High-level Innovative Talent Training Program‘Hundred’Level Talents"(QKHPTRC[2016]5674)Guizhou Science and Technology Plan Project(QKHZC[2023]GENERAL211).
文摘[Objective]The ecological vulnerability and landscape ecological risk of karst mountainous areas have increased as a result of enhanced disturbance of natural resources by human activities.This paper aimed to explore the characteristics of ecological risk evolution under different landscape patterns in the region,with a view to providing reference for land classification protection,sustainable use of resources and regional ecological risk optimization in karst mountainous areas.[Method]Taking Huangping County,a typical karst mountainous area,as an example,eight evaluation factors of natural and landscape patterns were selected to construct a landscape ecological risk evaluation model,to quantitatively explore the spatio-temporal evolution of landscape ecological risk and the trend of risk level transfer in the study area from^(2)010-2018,and to reveal the complex relationship between ecological risk and topography in karst mountainous areas.[Result]①From 2010 to 2018,land use types changed to different degrees,with the most amount of woodland transferred out(1627.37 hm^(2))and the most amount of construction land transferred in(1303.93 hm^(2));a total of 3552.31 hm^(2) of land was transferred,with a change ratio of 2.13%,and there was a significant conversion between construction land,arable land,and woodland.②From 2010 to 2018,the landscape ecological risk in the study area changed significantly,and the landscape ecological risk index decreased from 0.3441 to 0.1733,showing an upward and then downward trend;the landscape ecological risk of the whole region was dominated by low-risk and lower-risk zones,and the ecological risk level generally shifted from a high level to a low level,and the ecological environment was improved.③There was a negative correlation between ecological risk and topographic position,and high-risk zones were mainly distributed among low topographic zones;with the change of time,the advantage of risk level for the selection of topography was gradually weakened,and the influence of anthropogenic factors on the ecological risk of the landscape was becoming more and more prominent.[Conclusion]This paper can provide theoretical basis for land use optimization and ecological protection in karst mountainous areas.
文摘Background Pregnant women with heart disease are at high risk. Studies of risk factors of these patients are of great significance to improve maternal and fetal outcomes. In this paper, we try to discuss the main risk factors of cardiac events in pregnant women with heart disease and to establish a risk assessment system. Methods A retrospective analysis was carried out for pregnancies in 1741 women with heart disease who delivered in Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and September 2010. A Logistic regression model was used to identify independent risk factors of cardiac events and calculate the risk index in pregnant women with heart disease. Results The composition of heart disease in pregnant women was arrhythmia (n=662, 38.00%), congenital heart disease (CHD; n=529, 30.40%), cardiomyopathy (n=327, 18.80%), rheumatic heart disease (RHD; n=151, 8.70%), and cardiopathy induced by pre-eclampsia (n=53, 3.00%). Main cardiac events were heart failure (n=110, 6.32%), symptomatic arrhythmia needing medication (n=43, 2.47%), cardiac arrest (n=2, 0.11%), syncope (n=3, 0.17%), and maternal death (n=10, 0.57%). Six independent risk factors to predict cardiac events in pregnant women with heart disease were cardiac events before pregnancy (heart failure, severe arrhythmia, cardiac shock, etc., P=0.000), New York Heart Association (NYHA) class 〉11 (m=0.000), oxygen saturation 〈90% (P=0.018), pulmonary artery hypertention (PAH) 〉50 mmHg (P=0.025), cyanotic heart disease without surgical correction (P=-0.015), and reduced left ventricular systolic function (ejection fraction 〈40%, P=0.003). Every risk factor was calculated as 1 score. The incidence of cardiac events in patients with scores 0, 1, 2, 3, and 〉4 was 2.10%, 31.61 %, 61.25%, 68.97%, and 100.00% respectively. Conclusions Pregnancy with heart disease could lead to undesirable pregnancy outcomes. The risk of cardiac events in pregnant women with heart disease could be assessed by risk index.
基金Supported by the National Key Research and Development Program of China(2018YFA0606302 and 2012CB955900)
文摘In the context of global warming,China is facing with increasing climate risks.It is imperative to develop quantitative indices to reflect the climate risks caused by extreme weather/climate events and adverse climatic conditions in association with different industries.Based on the observations at 2288 meteorological stations in China and the meteorological disasters data,a set of indices are developed to measure climate risks due to water-logging,drought,high temperature,cryogenic freezing,and typhoon.A statistical method is then used to construct an overall climate risk index(CRI)for China from these individual indices.There is a good correspondence between these indices and historical climatic conditions.The CRI,the index of water-logging by rain,and the high temperature index increase at a rate of 0.28,0.37,and 0.65 per decade,respectively,from 1961 to 2016.The cryogenic freezing index is closely related to changes in the consumer price index for food.The high temperature index is correlated with the consumption of energy and electricity.The correlation between the yearly growth in claims on household property insurance and the sum of the water-logging index and the typhoon index in the same year is as high as 0.70.Both the growth rate of claims on agricultural insurance and the annual growth rate of hospital inpatients are positively correlated with the CRI.The year-on-year growth in the number of domestic tourists is significantly negatively correlated with the CRI in the same year.More efforts are needed to develop regional CRIs.
基金This work was supported by the National Key Research and Development Program of China(2017YFA0104500)the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(81621001)+6 种基金the Key Program of the National Natural Science Foundation of China(81930004)Capital’s Funds for Health Improvement and Research(2018-4-4089)CAMS Innovation Fund for Medical Sciences(CIFMS)(2019-I2M-5-034)the Science and Technology Project of Guangdong Province of China(2016B030230003)the Project of Health Collaborative Innovation of Guangzhou City(201704020214)Peking University Clinical Scientist Program(BMU2019LCKXJ003)supported by the Fundamental Research Funds for the Central Universities.
文摘We aimed to develop a disease risk comorbidity index(DRCI)based on disease risk index(DRI)and Hematopoietic Cell Transplantation-Specific Comorbidity Index(HCT-CI)in patients receiving haploidentical hematopoietic stem cell transplantation(haplo-HSCT).We identified the prognostic factors of disease-free survival(DFS)in a training subset(n=593),then assigned a weighted score using these factors to the remaining patients(validation subset;n=296).The multivariable model identified two independent predictors of DFS:DRI and HCT-CI before transplantation.In this scoring system,we assigned a weighted score of 2 to very high-risk DRI,and assigned a weighted score of 1 to high-risk DRI and intermediate-and high-risk HCT-CI(i.e.,haplo-DRCI).In the validation cohort,the three-year DFS rate was 65.2%(95%confidence interval(CI),58.2%–72.2%),55.8%(95%CI,44.9%–66.7%),and 32.0%(95%CI,5.8%–58.2%)for the low-,intermediate-,and high-risk group,respectively(P=0.005).Haplo-DRCI can also predict DFS in disease-specific subgroups,particularly in acute leukemia patients.Increasing score was also significantly predictive of increased relapse,increased non-relapse mortality(NRM),decreased DFS,and decreased overall survival(OS)in an independent historical cohort(n=526).These data confirmed that haplo-DRCI could effectively risk stratify haplo-HSCT recipients and provide a tool to better predict who will best benefit from haplo-HSCT.
基金jointly funded by National Natural Science Foundation of China (41877398)project of the China Geological Survey (DD20221773)。
文摘Heavy metal distribution in mining areas has always been a hot research topic due to the special environment of these areas. This study aims to explore the impact of heavy metal pollution on soils and crops in the study area, ensure the safety of local crops and the health of local residents, and provide a basis for the subsequent environmental restoration and the prevention and control of environmental pollution. Based on the analysis of the heavy metal concentrations in local soils and crops, the study investigated the spatial distribution, pollution degrees, and potential ecological risks of heavy metals in the farmland of a mining area in the southeastern Nanyang Basin, Henan province, China explored the sources of heavy metals and assessed the health risks caused by crop intake. The results of this study are as follows. The root soils of crops in the study area suffered heavy metal pollution to varying degrees. The degree of heavy metal pollution in maize fields is higher than that in wheat fields, and both types of fields suffer the most severe Cd pollution. Moreover, the root soils of different crops suffer compound pollution.The root soils in the maize fields suffer severe compound pollution at some sampling positions, whose distribution is similar to that of the mining area. Cd poses the highest potential ecological risks among all heavy metals, and the study area mainly suffers low and moderate comprehensive potential ecological risks. The principal component analysis(PCA) shows that the distribution of Zn, Cd, Pb, and As in soils of the study area is mainly affected by anthropogenic factors such as local mining activities;the distribution of Cr and Ni is primarily controlled by the local geological background;the distribution of Hg is mainly affected by local vehicle exhaust emissions, and the distribution of Cu is influenced by both human activities and the geological background. Different cereal crops in the study area are polluted with heavy metals dominated by Cd and Ni to varying degrees, especially wheat. As indicated by the health risk assessment results, the intake of maize in the study area does not pose significant human health risks;however, Cu has high risks to human health, and the compound heavy metal pollution caused by the intake of wheat in the study area poses risks to the health of both adults and children. Overall, the soils and crops in the study area suffer a high degree of heavy metal pollution, for which mining activities may be the main reason.
基金funded by Chang’an University(Xi’an,China)through the National Key Research&Development Program of China(2020YFC1512003)。
文摘Geohazards along highways are the main natural hazards that could affect the safety and operation of highway systems.Understanding the risks faced by highways in areas affected by geohazards is an urgent problem to be solved.This study used historical geohazard events from Sichuan Province and highway network data to propose a geohazard risk index that reflects the risk geohazards along highways.Furthermore,this work applied the entropy method and expert scoring to calculate the weight of the index.The spatial distributions of landslides,debris flows,collapses,and unstable slopes along the highways were analysed based on ArcGIS spatial statistics,and the highway geohazard intensity index were obtained.The relationships between slope,rainfall,vegetation coverage,rock type,land use,and incision depth with geohazards were analysed,and the highway geohazard susceptibility index was calculated by the weighted information method.Based on the intensity and susceptibility index,we obtained a geohazard risk index which can better evaluate the risk of highways,and made a highway geohazard risk map to aid the prevention and mitigation of geohazards along highways and assist with highway network planning.
基金This work was supported by the Municipal Housing Institute of the city of Malaga.The presented research was within the framework of the research project“Malaka.Net:bases for the sustainable rehabilitation of the historic heritage of Ma´laga,”which was developed at the Superior Technical School of Architecture of the University of Malaga.The authors are grateful to the owners,tenants,and users of the facilities for providing access to the buildings.
文摘The current pressure on the built historical heritage requires a global evaluation to develop strategies for its preservation.A combined vision of the state of conservation of architectural heritage is essential to highlight the vulnerabilities of the structure from which harmonized measures can be proposed for its mitigation.This study proposes a multi-criteria analysis methodology that considers a qualitative and quantitative approach to organize the global conservation state of heritage buildings hierarchically.A global index can be determined on the basis of the generation of an interoperable data matrix by defining a set of indicators to assess different components of a building.This index describes the risk with respect to the stability,safety,and habitability of the building.This methodology aims to achieve the state of the building in an integral way by obtaining a simple and objective index that enables efficient comparison among different buildings.The application of this methodology to a historic area allows creating a hierarchical map of risk to stablish priorities for intervention and enable a sustainable and critical management and planning over the actions of maintenance,conservation,and restoration.In this way,a holistic vision of the complex reality of built heritage and the urban landscape is obtained to identify critical areas of priority intervention.