Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.

Reflections on the New Classification of Tumors by the WHO and Changes in Esophageal Cancer in a High-risk Area

ABSTRACT In year 2000, a book entitled the Pathology and Genetics of Tumors of the Digestive System was published by the WHO, presenting some new diagnostic criteria and treatment principles. I have analyzed the epidemiologic change of tumors in over 30 years in the high-risk area with esophageal cancer. The following phenomenon was found： accompanied by the sharp decrease in the incidence and mortality of esophageal cancer, there was an increase in the incidence and death rate of stomach cancer involving cardiac cancer. This fact should be considered when analyzing the sharp decrease in esophageal cancer incidence and mortality rate. More attention was given to diagnosis of cardiac cancer; at the same time it is more practical to improve the early screening of cancers. To observe the development of high and low - grade intraepithelial neoplasms will be an urgent task for esophageal cancer research in the high risk area, according to WHO＇s new classification.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Perspectives of high-risk pregnant women on home care program in high-risk pregnancies: A multicenter, qualitative study

Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.

Study on cook-off characteristics and thermal safety venting area of RBOE charge

RBOE is a new type of DNAN-based high-energy melt-cast mixed explosive,whose safety under thermal stimulation is significantly affected by heating conditions and venting area of the warhead.Based on the thermal decomposition reaction characteristics and combustion characteristics of each component of RBOE explosive,the cook-off calculation models of RBOE warhead before and after ignition were established.In addition,closed and vented warheads were designed,as well as fast and slow cook-off test devices.The cook-off characteristics and thermal safety venting area of RBOE warhead were extensively studied.The results showed that the closed RBOE warhead underwent deflagration reaction under both slow and fast cook-off conditions.The calculation result of the shell wall temperature before slow cookoff ignition response of the warhead was 454.06 K,with an error of+1.75%compared to the test result of462.15 K,and the temperature rise rate calculated was in good agreement with the test.The calculated ignition time of RBOE warhead under fast cook-off was 161 s,with an error of+8.8%compared to the test result of 148 s,which verified the accuracy of cook-off model of RBOE warhead before ignition.According to the cook-off calculation model of the warhead after ignition and cook-off test of the vented warhead,it was determined that the thermal safety venting area was 1124.61 mm^(2)for fast cook-off and 530.66 mm~2 for slow cook-off,effectively preventing the reaction of warhead above combustion.Therefore,this study provides a scientific basis for the thermal safety design and evaluation of insensitive warheads.

Associations between cancer family history and esophageal cancer and precancerous lesions in high-risk areas of China

Background:Family clustering of esophageal cancer(EC)has been found in high-risk areas of China.However,the relationships between cancer family history and esophageal cancer and precancerous lesions(ECPL)have not been comprehensively reported in recent years.This study aimed to provide evidence for identification of high-risk populations.Methods:This study was conducted in five high-risk areas in China from 2017 to 2019,based on the National Cohort of Esophageal Cancer.The permanent residents aged 40 to 69 years were examined by endoscopy,and pathological examination was performed for suspicious lesions.Information on demographic characteristics,environmental factors,and cancer family history was collected.Unconditional logistic regression was applied to evaluate odds ratios between family history related factors and ECPL.Results:Among 33,008 participants,6143(18.61%)reported positive family history of EC.The proportion of positive family history varied significantly among high-risk areas.After adjusting for risk factors,participants with a family history of positive cancer,gastric and esophageal cancer or EC had 1.49-fold(95%confidence interval[CI]:1.36-1.62),1.52-fold(95%CI:1.38-1.67),or 1.66-fold(95%CI:1.50-1.84)higher risks of ECPL,respectively.Participants with single or multiple first-degree relatives(FDR)of positive EC history had 1.65-fold(95%CI:1.47-1.84)or 1.93-fold(95%CI:1.46-2.54)higher risks of ECPL.Participants with FDRs who developed EC before 35,45,and 50 years of age had 4.05-fold(95%CI:1.30-12.65),2.11-fold(95%CI:1.37-3.25),and 1.91-fold(95%CI:1.44-2.54)higher risks of ECPL,respectively.Conclusions:Participants with positive family history of EC had significantly higher risk of ECPL.This risk increased with the number of EC positive FDRs and EC family history of early onset.Distinctive genetic risk factors of the population in high-risk areas of China require further investigation.Trial registration:ChiCTR-EOC-17010553.

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

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

FibroScan-aspartate transaminase:A superior non-invasive model for diagnosing high-risk metabolic dysfunction-associated steatohepatitis

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4.

Correlation of periodontal inflamed surface area with glycated hemoglobin,interleukin-6 and lipoprotein(a)in type 2 diabetes with retinopathy

BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.

Carbon sequestration in a bamboo plantation:a case study in a Mediterranean area

In the Mediterranean region,despite bamboo being an alien species that can seriously alter plant and ani-mal biocoenosis,the area occupied by bamboo plantations continues to increase,especially for the purpose to seques-ter carbon(C).However,the C dynamics in the soil-plant system when bamboo is grown outside its native area are poorly understood.Here we investigated the C mitigation potential of the fast-growing Moso bamboo(Phyllostachys edulis)introduced in Italy for climate-change mitigation.We analyzed aboveground(AGB)and belowground(as root/shoot ratio)biomass,litter and soil organic C(SOC)at O-15-and 15-30-cm depths in a 4-year-old bamboo plantation in comparison with the former annual cropland on which the bamboo was established.To have an idea of the maximum C stored at an ecosystem level,a natural forest adjacent the two sites was also considered.In the plantation,C accumulation as AGB was stimulated,with 14.8±3.1 Mg C ha^(-1) stored in 3 years;because thinning was done to remove culms from the first year,the mean sequestration rate was 4.9 Mg C ha^(-1) a^(-1).The sequestration rates were high but comparable to other fast-growing tree species in Italy(e.g.,Pinus nigra).SOC was significantly higher in the bamboo plantation than in the cropland only at the 0-15 cm depth,but SOC stock did not differ.Possibly 4 years were not enough time for a clear increase in SOC,or the high nutrient uptake by bamboos might have depleted the soil nutrients,thus inhibiting the soil organic matter formation by bacteria.In comparison,the natural forest had significantly higher C levels in all the pools.For C dynamics at an ecosystem level,the bamboo plantation on the former annual cropland led to substantial C removal from the atmosphere(about 12 Mg C ha^(-1) a^(-1)).However,despite the promising C sequestration rates by bamboo,its introduction should be carefully considered due to potential ecological problems caused by this species in overexploited environments such as the Mediterranean area.

Predicting potential invasion risks of Leucaena leucocephala(Lam.)de Wit in the arid area of Saudi Arabia

The presence of invasive plant species poses a substantial ecological impact,thus comprehensive evaluation of their potential range and risk under the influence of climate change is necessary.This study uses maximum entropy(MaxEnt)modeling to forecast the likelihood of Leucaena leucocephala(Lam.)de Wit invasion in Saudi Arabia under present and future climate change scenarios.Utilizing the MaxEnt modeling,we integrated climatic and soil data to predict habitat suitability for the invasive species.We conducted a detailed analysis of the distribution patterns of the species,using climate variables and ecological factors.We focused on the important influence of temperature seasonality,temperature annual range,and precipitation seasonality.The distribution modeling used robust measures of area under the curve(AUC)and receiver-operator characteristic(ROC)curves,to map the invasion extent,which has a high level of accuracy in identifying appropriate habitats.The complex interaction that influenced the invasion of L.leucocephala was highlighted by the environmental parameters using Jackknife test.Presently,the actual geographic area where L.leucocephala was found in Saudi Arabia was considerably smaller than the theoretical maximum range,suggesting that it had the capacity to expand further.The MaxEnt model exhibited excellent prediction accuracy and produced reliable results based on the data from the ROC curve.Precipitation and temperature were the primary factors influencing the potential distribution of L.leucocephala.Currently,an estimated area of 216,342 km^(2)in Saudi Arabia was at a high probability of invasion by L.leucocephala.We investigated the potential for increased invasion hazards in the future due to climate change scenarios(Shared Socioeconomic Pathways(SSPs)245 and 585).The analysis of key climatic variables,including temperature seasonality and annual range,along with soil properties such as clay composition and nitrogen content,unveiled their substantial influence on the distribution dynamic of L.leucocephala.Our findings indicated a significant expansion of high risk zones.High-risk zones for L.leucocephala invasion in the current climate conditions had notable expansions projected under future climate scenarios,particularly evident in southern Makkah,Al Bahah,Madina,and Asir areas.The results,backed by thorough spatial studies,emphasize the need to reduce the possible ecological impacts of climate change on the spread of L.leucocephala.Moreover,the study provides valuable strategic insights for the management of invasion,highlighting the intricate relationship between climate change,habitat appropriateness,and the risks associated with invasive species.Proactive techniques are suggested to avoid and manage the spread of L.leucocephala,considering its high potential for future spread.This study enhances the overall comprehension of the dynamics of invasive species by combining modeling techniques with ecological knowledge.It also provides valuable information for decision-making to implement efficient conservation and management strategies in response to changing environmental conditions.

Research on the Relationship Between Environmental and Economic Coupling Systems in Bohai Bay Area Based on a Vector Autoregression(VAR)Model

This study analyzed the impact of land-based contaminants and tertiary industrial structure on economic development in the selected Bohai Bay area,China.Based on panel data spanning 2011-2020,a vector autoregressive(VAR)model is used to analyze and forecast the short-run and long-run relationships between three industrial structures,pollutant discharge,and economic development.The results showed that the environmental index had a long-term cointegration relationship with the industrial structure economic index.Per capital chemical oxygen demand(PCOD)and per capita ammonia nitrogen(PNH_(3)N)had a positive impact on delta per capita GDP(dPGDP),while per capita solid waste(PSW),the secondary industry rate(SIR)and delta tertiary industry(dTIR)had a negative impact on dPGDP.The VAR model under this coupling system had stability and credibility.The impulse response results showed that the short-term effect of the coupling system on dPGDP was basically consistent with the Granger causality test results.In addition,variance decomposition was used in this study to predict the long-term impact of the coupling system in the next ten periods(i.e.,ten years).It was found that dTIR had a great impact on dPGDP,with a contribution rate as high as 74.35%in the tenth period,followed by the contribution rate of PCOD up to 3.94%,while the long-term contribution rates of PSW,SIR and PNH3N were all less than 1%.The results show that the government should support the development of the tertiary industry to maintain the vitality of economic development and prevent environmental deterioration.

Seismic response of a mid-story isolated structure considering SSI in mountainous areas under long-period earthquakes

At present,there is not much research on mid-story isolated structures in mountainous areas.In this study,a model of a mid-story isolated structure considering soil-structure interaction(SSI)in mountainous areas is established along with a model that does not consider SSI.Eight long-period earthquake waves and two ordinary earthquake waves are selected as inputs for the dynamic time history analysis of the structure.The results show that the seismic response of a mid-story isolated structure considering SSI in mountainous areas can be amplified when compared with a structure that does not consider SSI.The structure response under long-period earthquakes is larger than that of ordinary earthquakes.The structure response under far-field harmonic-like earthquakes is larger than that of near-fault pulse-type earthquakes.The structure response under near-fault pulse-type earthquakes is larger than that of far-field non-harmonic earthquakes.When subjected to long-period earthquakes,the displacement of the isolated bearings exceeded the limit value,which led to instability and overturning of the structure.The structure with dampers in the isolated story could adequately control the nonlinear response of the structure,effectively reduce the displacement of the isolated bearings,and provide a convenient,efficient and economic method not only for new construction but also to retrofit existing structures.

Efficacy of mycophenolate mofetil combined with topical 0.05%tacrolimus in high-risk keratoplasty:1-year cohort study

AIM:To investigate the efficacy of systemic mycophenolate mofetil(MMF)as an adjunct in combination with topical tacrolimus(FK506)and corticosteroid eyedrops for preventing corneal graft rejection after high-risk keratoplasty(HRK).METHODS:In this cohort study,55 consecutive patients(55 eyes)from an eye center who met the criteria of HRK were included.The definition for HRK includes large grafts of no less than 9 mm diameter,vascularized cornea of two or more quadrants,regrafting,or eccentric grafts.After penetrating keratoplasty,25 patients treated with systemic MMF in combination with 0.05%FK506 and tapering corticosteroid eyedrops were enrolled in Group 1 from October 2019.Thirty patients receiving postoperative treatment with 0.05%FK506 and tapering corticosteroid eyedrops alone were enrolled in Group 2 from January 2018 to September 2019.All participants were closely monitored after surgery,and episodes of graft rejection and relevant clinical data were collected and assessed over a one-year follow-up period.RESULTS:After a follow-up of 9.6±3.2mo,graft rejection episodes occurred in 4 cases(16%)in Group 1 and 18 cases(60%)in Group 2.One reversible and 3 irreversible graft rejections occurred in Group 1,while 3 reversible and 15 irreversible rejections occurred in Group 2.Kaplan-Meier analysis revealed that 82.5%of grafts in Group 1 and 37.1%in Group 2 did not experience corneal graft rejection(P<0.01,log-rank test).The clear graft survival rate was 83.6%in Group 1 and 36.7%in Group 2(P<0.01,log-rank test)within one year of follow-up.No severe systemic side effects were observed in either group during the follow-up period.CONCLUSION:The triple treatment regimen consisting of MMF,topical FK506,and corticosteroid eyedrops represents a promising strategy for effectively preventing graft rejection and improving graft survival in patients with HRK.

Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage

AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR.

Spatio-temporal Evolution Characteristics and Driving Forces of Winter Urban Heat Island:A Case Study of Rapid Urbanization Area of Fuzhou City,China

Under the influence of anthropogenic and climate change,the problems caused by urban heat island(UHI)has become increasingly prominent.In order to promote urban sustainable development and improve the quality of human settlements,it is significant for exploring the evolution characteristics of urban thermal environment and analyzing its driving forces.Taking the Landsat series images as the basic data sources,the winter land surface temperature(LST)of the rapid urbanization area of Fuzhou City in China was quantitatively retrieved from 2001 to 2021.Combing comprehensively the standard deviation ellipse model,profile analysis and GeoDetector model,the spatio-temporal evolution characteristics and influencing factors of the winter urban thermal environment were systematically analyzed.The results showed that the winter LST presented an increasing trend in the study area during 2001–2021,and the winter LST of the central urban regions was significantly higher than the suburbs.There was a strong UHI effect from 2001 to 2021with an expansion trend from the central urban regions to the suburbs and coastal areas in space scale.The LST of green lands and wetlands are significantly lower than croplands,artificial surface and unvegetated lands.Vegetation and water bodies had a significant mitigation effect on UHI,especially in the micro-scale.The winter UHI had been jointly driven by the underlying surface and socio-economic factors in a nonlinear or two-factor interactive enhancement mode,and socio-economic factors had played a leading role.This research could provide data support and decision-making references for rationally planning urban layout and promoting sustainable urban development.

Diversity of Orchids in Terms of Their Distribution, Uses and Conservation in Annapurna Conservation Area of Nepal

The Annapurna Conservation Area (ACA), the first conservation area and the largest protected area (PA) in Nepal, is incredibly rich in biodiversity. Notwithstanding this, orchids in the ACA have not been explored enough yet thus making the need for ambitious research to be carried out. Previous study only included 81 species of orchids within ACA. This study aims to update the record of species and genera richness in the ACA. In total 198 species of orchids, belonging to 67 genera (40% and 62% of the total recorded orchid species and genera in Nepal) has been recorded in ACA. This represents an increase of 144% in species and 56% in genera over the previous data. Out of the 198 species, 99 were epiphytes, 6 were holomycotrophic and 93 were terrestrial. Among the 67 genera, Bulbophyllum (17) species were dominant, followed by Dendrobium (16), Herminium (10), Coelogyne, Plantanthera (9 each), Eria, Habenaria, Oberonia (8 each), Calanthe (7), and Liparis (6). Fifty-six species were found to be ornamentally significant and 85 species medicinally significant.

The environmental analysis and site selection of mussel and large yellow croaker aquaculture areas based on high resolution remote sensing

Mussel aquaculture and large yellow croaker aquaculture areas and their environmental characteristics in Zhoushan were analyzed using satellite data and in-situ surveys.A new two-step remote sensing method was proposed and applied to determine the basic environmental characteristics of the best mussel and large yellow croaker aquaculture areas.This methodology includes the first step of extraction of the location distribution and the second step of the extraction of internal environmental factors.The fishery ranching index(FRI1,FRI2)was established to extract the mussel and the large yellow croaker aquaculture area in Zhoushan,using Gaofen-1(GF-1)and Gaofen-6(GF-6)satellite data with a special resolution of 2 m.In the second step,the environmental factors such as sea surface temperature(SST),chlorophyll a(Chl-a)concentration,current and tide,suspended sediment concentration(SSC)in mussel aquaculture area and large yellow croaker aquaculture area were extracted and analyzed in detail.The results show the following three points.(1)For the extraction of the mussel aquaculture area,FRI1 and FRI2 are complementary,and the combination of FRI1 and FRI2 is suitable to extract the mussel aquaculture area.As for the large yellow croaker aquaculture area extraction,FRI2 is suitable.(2)Mussel aquaculture and the large yellow croaker aquaculture area in Zhoushan are mainly located on the side near the islands that are away from the eastern open waters.The water environment factor template suitable for mussel and large yellow croaker aquaculture was determined.(3)This two-step remote sensing method can be used for the preliminary screening of potential site selection for the mussels and large yellow croaker aquaculture area in the future.the fishery ranching index(FRI1,FRI2)in this paper can be applied to extract the mussel and large yellow croaker aquaculture areas in coastal waters around the world.

Prevalence of Malnutrition and Anaemia in Children ≤ 5 Years of Age in Some Conflict Hit Areas of Meme Division of the South West Region of Cameroon

Malnutrition refers to the deficiency, imbalances, or excesses in a person’s intake of energy or nutrients [1]. Khan defines anaemia as below level of Haemoglobin in red blood shown by a lower number of functioning red blood cells [2]. The crisis in the North West and South West Regions of Cameroon has led to several negative effects on children’s living conditions. There has been an increase in malnutrition and anaemia in the South West Region and Kumba in particular. The main objective of this study was “to examine the prevalence of malnutrition and anaemia in children ≤ 5 years of age in some conflict-hit areas of Meme Division”. A descriptive cross-sectional study was conducted in 2023 from March to June. We recruited 200 children ≤ 5 years into the study from three hospitals. The regional hospital annex in Kumba, Presbyterian General Hospital Kumba and the Ntam Hospital in Kumba. Socio-demographic factors were assessed using questionnaire, nutritional status was assessed by the use anthropometric measurements and an auto haematology analyser was used to determine anaemia. The overall prevalence of malnutrition in the study area was 40.5%. The prevalence of malnutrition varied significantly (P < 0.001) with the study sites. The overall prevalence of anaemia in the study area was 70.5%. The prevalence of anaemia was not significantly associated with the study sites. The prevalence of Malnutrition and Anaemia in children ≤ 5 years of age is very high in the Kumba municipalities. This could be attributed to the ongoing crisis which has caused a lot of social migrations from rural areas to Urban areas which are safer.

Using negative exponential function to characterize built-up land density along slope gradient for 19 urban areas in China

In China,numerous cities are expanding into sloping land,yet the quantitative distribution patterns of urban built-up land density along the slope gradient remain unclear,limiting the understanding of sloping land urbanization.In this paper,a simple negative exponential function was presented to verify its applicability in 19 typical sloping urban areas in China.The function fits well for all case urban areas(R^(2)≥0.951,p<0.001).The parameters of this function clearly describe two fundamental attributes:initial value a and decline rate b.Between 2000 and 2020,a tends to increase,while b tends to decrease in all urban areas,confirming the hypothesis of mutual promotion between flatland densification and sloping land expansion.Multiple regression analysis indicates that the built-up land density and the ruggedness of background land can explain 70.7%of a,while the average slope ratio of built-up land to background land,the built-up land density and the built-up land area can explain 82.1%of b.This work provides a quantitative investigative tool for distribution of urban built-up land density along slope gradient,aiding in the study of the globally increasing phenomenon of sloping land urbanization from a new perspective.