Effects of serum inflammatory factors,health index and disease activity scores on ankylosing spondylitis patients with sleep disorder

BACKGROUND Patients with ankylosing spondylitis(AS)frequently suffer from comorbid sleep disorders,exacerbating the burden of the disease and affecting their quality of life.AIM To investigate the clinical significance of serum inflammatory factors,health index and disease activity scores in patients with AS complicated by sleep disorders.METHODS A total of 106 AS patients with comorbid sleep disorders were included in the study.The patients were grouped into the desirable and undesirable prognosis groups in accordance with their clinical outcomes.The serum levels of inflammatory factors,including C-reactive protein,erythrocyte sedimentation rate,interleukin(IL)-6,tumour necrosis factor-αand IL-1β,were measured.Disease activity scores,such as the Bath AS functional index,Bath AS disease activity index,Bath AS metrology index and AS disease activity score,were assessed.The health index was obtained through the Short Form-36 questionnaire.RESULTS The study found significant associations amongst serum inflammatory factors,health index and disease activity scores in AS patients with comorbid sleep disorders.Positive correlations were found between serum inflammatory factors and disease activity scores,indicating the influence of heightened systemic inflammation on disease severity and functional impairment.Conversely,negative correlations were found between disease activity scores and health index parameters,highlighting the effect of disease activity on various aspects of healthrelated quality of life.Logistic regression analysis further confirmed the predictive value of these factors on patient outcomes,underscoring their potential utility in risk assessment and prognostication.CONCLUSION The findings demonstrate the intricate interplay amongst disease activity,systemic inflammation and patientreported health outcomes in AS patients complicated by sleep disorders.The results emphasise the need for comprehensive care strategies that address the diverse needs and challenges faced by these patients and underscore the potential relevance of serum inflammatory factors,health index and disease activity scores as prognostic markers in this patient population.

Combining RUSLE model and the vegetation health index to unravel the relationship between soil erosion and droughts in southeastern Tunisia

Droughts and soil erosion are among the most prominent climatic driven hazards in drylands,leading to detrimental environmental impacts,such as degraded lands,deteriorated ecosystem services and biodiversity,and increased greenhouse gas emissions.In response to the current lack of studies combining drought conditions and soil erosion processes,in this study,we developed a comprehensive Geographic Information System(GIS)-based approach to assess soil erosion and droughts,thereby revealing the relationship between soil erosion and droughts under an arid climate.The vegetation condition index(VCI)and temperature condition index(TCI)derived respectively from the enhanced vegetation index(EVI)MOD13A2 and land surface temperature(LST)MOD11A2 products were combined to generate the vegetation health index(VHI).The VHI has been conceived as an efficient tool to monitor droughts in the Negueb watershed,southeastern Tunisia.The revised universal soil loss equation(RUSLE)model was applied to quantitatively estimate soil erosion.The relationship between soil erosion and droughts was investigated through Pearson correlation.Results exhibited that the Negueb watershed experienced recurrent mild to extreme drought during 2000–2016.The average soil erosion rate was determined to be 1.8 t/(hm2•a).The mountainous western part of the watershed was the most vulnerable not only to soil erosion but also to droughts.The slope length and steepness factor was shown to be the most significant controlling parameter driving soil erosion.The relationship between droughts and soil erosion had a positive correlation(r=0.3);however,the correlation was highly varied spatially across the watershed.Drought was linked to soil erosion in the Negueb watershed.The current study provides insight for natural disaster risk assessment,land managers,and stake-holders to apply appropriate management measures to promote sustainable development goals in fragile environments.

Prostate health index can stratify patients with Prostate Imaging Reporting and Data System score 3 lesions on magnetic resonance imaging to reduce prostate biopsies

We aim to evaluate prostate health index as an additional risk-stratification tool in patients with Prostate Imaging Reporting and Data System score 3 lesions on multiparametric magnetic resonance imaging.Men with biochemical or clinical suspicion of having prostate cancer who underwent multiparametric magnetic resonance imaging in two tertiary centers(Queen Mary Hospital and Princess Margaret Hospital,Hong Kong,China)between January 2017 and June 2022 were included.Ultrasound-magnetic resonance imaging fusion biopsies were performed after prostate health index testing.Those who only had Prostate Imaging Reporting and Data System score 3 lesions were further stratified into four prostate health index risk groups and the cancer detection rates were analyzed.Out of the 747 patients,47.3%had Prostate Imaging Reporting and Data System score 3 lesions only.The detection rate of clinically significant prostate cancer in this group was 15.0%.The cancer detection rates of clinically significant prostate cancer had statistically significant differences:5.3%in prostate health index<25.0,7.4%in prostate health index 25.0-34.9,17.9%in prostate health index 35.0-54.9,and 52.6%in prostate health index≥55.0(P<0.01).Among the patients,26.9%could have avoided a biopsy with a prostate health index<25.0,at the expense of a 5.3%risk of missing clinically significant prostate cancer.Prostate health index could be used as an additional risk stratification tool for patients with Prostate Imaging Reporting and Data System score 3 lesions.Biopsies could be avoided in patients with low prostate health index,with a small risk of missing clinically significant prostate cancer.

Analysing the relationship between drought and soil erosion using vegetation health index and RUSLE models in Godavari middle sub-basin,India

Drought is a natural phenomenon posing severe implications for soil,groundwater and agricultural yield.It has been recognized as one of the most pervasive global change drivers to affect the soil.Soil being a weakly renewable resource takes a long time to form,but it takes no time to degrade.However,the response of soil to drought conditions as soil loss is not manifested in the existing literature.Thus,this study makes a concerted effort to analyze the relationship between drought conditions and soil erosion in the middle sub-basin of the Godavari River in India.MODIS remote sensing data was utilized for driving drought indices during 2000-2019.Firstly,we constricted Temperature condition index(TCI)and Vegetation Condition Index(VCI)from Land Surface Temperature(LST)and Enhanced Vegetation Index(EVI)derived from MODIS data.TCI and VCI were then integrated to determine the Vegetation Health Index(VHI).Revised Universal Soil Loss Equation(RUSLE)was utilized for estimating soil loss.The relationship between drought condition and vegetation was ascertained using the Pearson correlation.Most of the northern and southern watersheds experienced severe drought condition in the sub-basin during2000-2019.The mean frequency of the drought occurrence was 7.95 months.The average soil erosion in the sub-basin was estimated to be 9.88 t ha^(-1)year^(-1).A positive relationship was observed between drought indices and soil erosion values(r value being 0.35).However,wide variations were observed in the distribution of spatial correlation.Among various factors,the slope length and steepness were found to be the main drivers of soil erosion in the sub-basin.Thus,the study calls for policy measures to lessen the impact of drought and soil erosion.

The Establishment of a New Air Health Index Integrating the Mortality Risks Due to Ambient Air Pollution and Non-Optimum Temperature

A composite Air Health Index(AHI)is helpful for separately emphasizing the health risks of multiple stimuli and communicating the overall risks of an adverse atmospheric environment to the public.We aimed to establish a new AHI by integrating daily mortality risks due to air pollution with those due to non-optimum temperature in China.Based on the exposure-response(E-R)coefficients obtained from time-series models,the new AHI was constructed as the sum of excess mortality risk associated with air pollutants and non-optimum temperature in 272 Chinese cities from 2013 to 2015.We examined the association between the“total AHI”(based on total mortality)and total mortality,and further compared the ability of the“total AHI”to predict specific cardiopulmonary mortality with that of“specific AHIs”(based on specific mortalities).On average,air pollution and non-optimum temperature were associated with 28.23%of daily excess mortality,of which 23.47%was associated with non-optimum temperature while the remainder was associated with fine particulate matter(PM2.5)(1.12%),NO2(2.29%,),and O3(2.29%).The new AHI uses a 10-point scale and shows an average across all 272 cities of 6 points.The E-R curve for AHI and mortality is approximately linear,without any thresholds.Each one unit increase in“total AHI”is associated with a 0.84%increase in all-cause mortality and 1.01%,0.98%,1.02%,1.66%,and 1.71%increases in cardiovascular disease,coronary heart disease,stroke,respiratory diseases,and chronic obstructive pulmonary disease mortality,respectively.Cause-specific mortality risk estimates using the“total AHI”are similar to those predicted by“specific AHIs.”In conclusion,the“total AHI”proposed herein could be a promising tool for communicating health risks related to exposure to the ambient environment to the public.

Ecosystem Health and Comprehensive Ecological Benefit Assessment of an Artificial Wetland in Western Jilin Province

[Objective] This research aimed to assess the state of ecosystem health and comprehensive ecological benefit of an artificial wetland in western Jilin Province. [Method] To investigate the effects of reclaimed water from Yingtai Oil Production Plant on the wetland ecosystem, a comprehensive ecological assessment index of an artificial wetland in the west of Jilin Province was established to measure the ecological economic and social benefits. The quantitative evaluation on the ecosystem health and comprehensive ecological benefit of the artificial wetland were carried out from 2003 to 2010 and were measured by means of the square difference method. [Result] After eight years of irrigation by reclaimed water, the levels of ecosystem health and benefit of the artificial wetland improved from Grade IV to Grade II, and the ecological environment, economic and social development of the wetland tended to improve. [Conclusion] The results indicated that the use of reclaimed water for irrigation of wetland ecosystems was a suitable way to control drought in arid and semi-arid regions.

Examining Health of Wetlands with Multiple Ecosystem Services as Targets in China’s Coastal Regions

Coastal zones are key interconnectors of terrestrial and marine ecosystems.Due to the degradation and fragmentation of coastal wetlands,there is an urgent need to develop assessment methodology to compare the health of wetland ecosystems at different spatial scales.This will help efficiently develop and implement protections using easy-to-access ecosystem health data.This study aims to understand the spatial distribution of coastal and inland wetland health for China’s coastal regions.A Wetland Health Index(WHI)was developed to provide a basis for policy and decision making.Four utilization models—Long Term Model,Open Model,Nature Reserve Model,and Protected and Economic Model—were defined in the context of China’s coastal regions to specifically examine wetland health.Results show that the average WHI score was 63.6 with the range of 44.8–84.3 for 35 National Nature Reserves(NNRs),and the southern NNRs generally performed better than the northern NNRs.The wetlands in the southern provinces/municipalities are relatively healthier than their northern counterparts.The competent authority has slight influence on WHI scores but duration of conservation establishment does not show a clear correlation.With increasing economic activity,the differences in health conditions(WHI scores)of China’s coastal regions also increase.Gross Domestic Product(GDP)or economic intensification does not relate to WHI scores.Appropriate trade-offs between wetland management and economic development could contribute to improve health conditions,conservation and utilization of coastal and inland wetlands.

Health Assessment and Protection Countermeasures of Ecosystem of the Dajiu Lake in Shennongjia

The Dajiu Lake is an important subtropical alpine wetland in central China.In May of 2019,an ecological investigation was conducted on water quality and aquatic organisms(phytoplankton,zooplankton and zoobenthos)of the Dajiu Lake in Shennongjia forest region.The results showed that parameters of water quality in No.5 and No.9 sub lakes of the Dajiu Lake corresponded with standard of class II water of the Environmental Quality Standards for Surface Water(GB 3838-2002),while other sub lakes corresponded with standard of class III water.Diversity indexes of phytoplankton and zooplankton ranged from 2.0 to 3.0,and there were two families(Chironomidae and Libellulidae Rambur)of one phylum(Arthropoda)in zoobenthos.Comprehensive health index of entropy weight was used to evaluate water ecological status of the Dajiu Lake,and water quality of No.5,No.8 and No.9 sub lakes was in a healthy status,while other sub lakes were in sub-health status.Finally,corresponding countermeasures were proposed according to protection needs of the Dajiu Lake.

卫生健康现代化发展的多维测度、空间差异及收敛分析

目的:聚焦“健康中国”战略核心目标,测度2018~2022年31个省份的卫生健康现代化水平。方法:借助层次分析法构建“卫生健康事业现代化评价指标体系”,分别采用空间自相关、泰尔指数和绝对β收敛等方法探索全国及东、中、西部地区卫生健康现代化水平的时空格局、区域差异及收敛性特征。结果:卫生健康现代化水平展现出明显稳定性与波动性上升的复合特征;不存在显著的空间自相关性,呈现随机分布的地理格局;总体差异显著且区域内差异为主要来源;存在绝对β收敛,且中部表现出更迅速的收敛趋势。结论:现代化进程的深入将逐步消弭空间差异,展现出卫生健康现代化的内在统一性与均衡化趋势。

常州市湟里河生态与健康状况评价

河湖生态与健康状况评价是河湖管理的重要内容,通过评价河湖健康状况查找河湖存在问题,剖析问题产生原因,进一步提出河湖治理和保护对策。通过梳理2014年以来常州市河湖生态与健康评价工作进展,比较两种河湖生态与健康评价指标体系,通过对比分析湟里河生态状况评价与健康评价过程、结果 ,剖析湟里河存在的突出问题,并提出相应的整治措施,有助于加强河湖管理保护,保障河湖资源可持续利用。

现代化生态型灌区建设思考

灌区在保障国家粮食安全和重要农产品稳定安全供给中发挥着至关重要的作用。灌区是一个复杂的生态系统与社会系统,涵盖山、水、林、田、湖、草、沙等多个要素,随着新时代生态文明建设实践的深入,灌区生态问题与灌区高质量发展受到广泛关注。在总结近30年我国生态型灌区内涵发展的基础上,提出生态型灌区应该是高产高效、生态健康、经济效益显著、社会和谐发展的新型灌区。总结了我国生态型灌区评价指标体系的动态变化特征,结合新需求、新要求和新理念,从灌区工程建设标准、生态友好性、资源利用、农田内部生境以及与周边生态的协调性等多个方面进行综合考量,重构了现代化生态型灌区相关评价指标体系。针对生态型灌区建设与运行认知、总体规划、规范标准、建设范式、科技与人才以及管护与跟踪评价面临的挑战,从更新和完善建设理念与评价体系、科学制定相关标准与规划、加强科技研发和人才培养、完善规划建设与运行管理体制机制、拓宽投融资渠道等方面,提出生态型灌区高质量发展建议。

数字移民健康信息素养能力评价与提升策略

文章借鉴已有研究成果构建多维视阈下的数字移民健康信息素养评价指标体系,结合线上线下途径开展问卷调研,利用探索性因子分析萃取出“健康信息多元觅食技能与感知价值鉴别”“健康信息伦理道德与实践应用转化”等一级指标,利用变异系数法为各级指标赋予权重系数,进而开展实证分析。实证结果表明:健康中国建设进程下,数字移民群体已具备一定的健康信息素养,但能力水平处于欠佳状态,能力构成呈现失衡状态,年龄、受教育程度、城乡、健康水平等多元维度下均有不同程度的能力差异度,不同属性的数字移民群体能力上的差异化提升亟待重视。文章构建了“个体—社会—国家”三元主体协同的健康信息素养能力提升服务体系。

健康管理护理基本技术质量控制与评价指标体系的构建

目的:构建健康管理护理基本技术质量控制与评价指标体系,为健康管理护理基本技术规范化、同质化管理提供参考依据。方法:在三维质量结构理论基础上,采用文献检索法、研究小组讨论和德尔菲专家函询法,筛选指标并量化质量控制与评价的维度、条目及各级评价指标。结果:最终形成健康管理护理基本技术质量控制与评价指标体系,包括一级指标3项,二级指标10项,三级指标51项。2轮专家函询问卷有效应答率均为94.4%,函询专家的权威系数为0.879,第1、第2轮咨询的肯德尔和谐系数分别为0.210、0.199,均P<0.001。结论:本研究构建的健康管理护理基本技术质量控制与评价指标体系科学、有效、客观、可操作,对规范健康管理护理服务实践、培训和考核具有参考意义,也可为健康管理机构开展健康管理护理基本技术质量控制提供可借鉴的指标。

农村老年慢性病患者健康贫困脆弱风险指标体系构建

目的构建农村老年慢性病患者健康贫困脆弱风险指标体系。方法通过文献研究、半结构式访谈、实地调研、专家咨询及层次分析法,确定农村老年慢性病患者健康贫困脆弱风险指标及各指标权重。结果2轮专家咨询问卷回收率分别为100%、94.1%,专家权威系数分别为0.918、0.928,肯德尔和谐系数分别为0.201、0.242(均P<0.05)。最终形成的农村老年慢性病患者健康贫困脆弱风险指标体系包括6个一级指标、19个二级指标、78个三级指标。结论构建的农村老年慢性病患者健康贫困脆弱风险指标体系具有较高的可靠性、合理性,可为农村老年慢性病患者健康贫困脆弱风险识别和应对提供参考。

维持性血液透析患者健康教育效果评价指标体系的构建

目的:构建维持性血液透析患者健康教育效果评价指标体系,为临床护理人员评估维持性血液透析患者健康教育效果提供依据。方法:以“知信行”理论、护理结局分类系统为指导,通过文献研究、半结构式访谈法、德尔菲法及层次分析法,确定维持性血液透析患者健康教育效果评价指标体系及各指标权重。结果:两轮专家函询的有效问卷回收率分别为94.74%和100%,专家权威系数分别为0.93和0.95,构建的维持性血液透析患者健康教育效果评价指标体系包含了一级指标3项,二级指标7项,三级指标71项。结论:本研究构建的维持性血液透析患者健康教育效果评价指标体系,能够为临床护理人员进行全面、科学的健康教育效果评价提供参照标准。

湿地公园健康评价指标体系构建与应用——以广州海珠国家湿地公园二期为例

湿地公园健康状态是开展湿地保护、修复与指导其规划设计的重要依据。近年来城市区域内湿地公园建设迅速但湿地生境整体衰退严重,如珠三角乃至华南地区湿地公园面临高度外部干扰与环境限制,亟需有效手段评估区域内湿地公园健康状态以实现可持续发展。以“稳定性-功能性-可持续性”为框架,构建了包含3准则11因素40指标的湿地公园健康评价指标体系,采用层次分析法计算指标权重,并通过遥感影像处理、实地调研、统计年鉴查阅以及问卷调查等方式获取指标数据,对生态修复后的广州海珠国家湿地公园二期进行综合健康评价与分析,以期指导其保护修复与可持续发展,为城市区域内湿地公园健康评估与优化提供参考。结果表明:(1)稳定性是影响湿地公园健康状态的主要准则,权重排序为稳定性(0.5094)>功能性(0.3046)>可持续性(0.1860);(2)海珠湿地二期综合健康指数为3.7735,呈健康状态;(3)影响二期健康状态的主要因素是生态功能与水体特征,其中,权重排序前5的主要指标为水质类别、净化能力、水文调节、水陆面积比、水体富营养化程度;(4)结合评价结果,从水体修复、植物管护、园区管理等方面提出优化建议。

运营交通隧道结构健康状态诊断研究进展

为形成运营隧道结构健康状态诊断的系统认识,从诊断指标体系、诊断指标分级判定标准、健康状态诊断方法和健康诊断系统4个方面,详细阐述和分析了隧道健康诊断发展现状,探讨健康诊断研究存在的不足,并指出未来可能的研究方向。

区域健康绩效评价指标体系的构建研究

目的 构建“健康中国”背景下的区域健康绩效评价指标体系,为区域健康绩效评定提供参考。方法通过文献分析及小组讨论构建体系框架,邀请来自卫生管理部门、医疗机构以及学术界的32名专家进行两轮德尔菲专家咨询,构建区域健康绩效评价指标体系。结果 两轮专家函询问卷的有效回收率均为100%,专家权威系数为0.83;最终形成了包含4个一级指标、12个二级指标、57个三级指标的“健康中国”背景下区域健康绩效评价指标体系。结论 运用德尔菲法建立的指标体系具有较好的科学性和可靠性,可为评价区域健康绩效水平提供参考。在区域健康的绩效考核中,应重点关注健康服务工作,巩固已有的疾病预防优势,兼顾其他健康相关领域工作,促进各领域协同发展。

基于人体信息计量的城市居民健康指数构建研究

目的/意义基于人体信息计量构建城市居民健康指数,测量与评价城市居民整体健康状况,以促进居民健康管理,提升健康素养。方法/过程结合人体信息计量和健康指数相关研究,构建城市居民健康评价指标体系并开展问卷调查研究,运用熵值法和综合指数法计算居民健康指数,进而开展实证分析。结果/结论城市居民健康指数的外部关系指标区别最小,自然环境指标区别最大;不同性别和年龄的群体健康指数有较大差异。建议开展居民健康教育、加强高危人群健康管理、构建居民健康画像。

卫生发展援助动因分析指标体系构建

目的:构建卫生发展援助动因分析指标体系,以深入了解当今以发达国家为主的援助国自21世纪以来的卫生发展援助动因,并为卫生发展援助动因提供量化分析工具。方法:基于“混合模型”(hybrids models)构建初始动因分析理论框架,运用德尔菲专家咨询法进行指标筛选,采用层次分析法确定指标权重。结果:构建了包含4个一级指标、10个二级指标、22个三级指标的指标体系。4个一级指标分别为:援助国政治利益、援助国经济利益、援助国安全利益、受援国需求。两轮专家咨询的问卷有效回收率均为95.5%,专家权威系数为0.867,Kendall’s W系数分别为0.216~0.322,结果可靠。结论:本研究初步构建了一套用于分析卫生发展援助动因的指标体系,有助于增加对援助国援助行为的理解,加强与他国在卫生发展援助的协调合作。同时,该指标体系为中国未来在卫生发展援助决策方面提供了辅助的量化分析工具。