Modelling Key Population Attrition in the HIV and AIDS Programme in Kenya Using Random Survival Forests with Synthetic Minority Oversampling Technique-Nominal Continuous

HIV and AIDS has continued to be a major public health concern, and hence one of the epidemics that the world resolved to end by 2030 as highlighted in sustainable development goals (SDGs). A colossal amount of effort has been taken to reduce new HIV infections, but there are still a significant number of new infections reported. HIV prevalence is more skewed towards the key population who include female sex workers (FSW), men who have sex with men (MSM), and people who inject drugs (PWID). The study design was retrospective and focused on key population enrolled in a comprehensive HIV and AIDS programme by the Kenya Red Cross Society from July 2019 to June 2021. Individuals who were either lost to follow up, defaulted (dropped out, transferred out, or relocated) or died were classified as attrition;while those who were active and alive by the end of the study were classified as retention. The study used density analysis to determine the spatial differences of key population attrition in the 19 targeted counties, and used Kilifi county as an example to map attrition cases in smaller administrative areas (sub-county level). The study used synthetic minority oversampling technique-nominal continuous (SMOTE-NC) to balance the datasets since the cases of attrition were much less than retention. The random survival forests model was then fitted to the balanced dataset. The model correctly identified attrition cases using the predicted ensemble mortality and their survival time using the estimated Kaplan-Meier survival function. The predictive performance of the model was strong and way better than random chance with concordance indices greater than 0.75.

Minority population and sustainable development in mountain regions a case study of the Tibetan inhabited region in Sichuan, China

China boasts 56 nationalities who are mostly inhabited in the sparsely populated mountain regions in West China. Like many other places in the Han nationality distributed regions, minority nationality inhabited regions are also facing the challenge of sustainable development in terms of both natural and human factors. Taking the Tibetan inhabited regions (TIR) in Sichuan Province as a case, this paper points out some major problems in the process of economic development in perspective of sustainability and leaves some hints for development strategies. While natural conditions such as geological instability are playing a major role to the environmental degradation, human activities and improper use of resources might constitute an important agent in the environmental deterioration. In order to promote local economic development and improve people’s living standard, sustainable planning is expected to be made and people’s awareness of sustainability should be strengthened.

Impact of Diabetes Mellitus on the Treatment Outcomes of Chemotherapy in Women with Breast Cancer——A Population-Based Prospective Cohort Study

There are few population-based data in investigating the impact of diabetes on chemotherapy adverse effects and treatment outcomes of non-metastatic breast cancer. The purpose of this study is to evaluate whether diabetes affects the patterns of use in chemotherapy, toxic effects of chemotherapy, and treatment outcomes for non-metastatic breast cancer in Taiwan. The study results can provide physicians for making a decision whether or not to use chemotherapy based on the individual patients＇ condition.

Migration routes,population status and important sites used by the globally threatened Black-faced Spoonbill(Platalea minor):a synthesis of surveys and tracking studies

Background:The Black-faced Spoonbill(Platalea minor)is a globally threatened species,nesting mainly in western Korea with smaller numbers breeding in Liaoning Province,China,and Far East Russia.Recent winter field surveys to estimate the species'population size were almost totally conducted in coastal areas,but tracking studies showed that some individuals now winter inland.To ensure its long-term survival,we need a more comprehensive assessment of the current distribution and abundance of the species.Methods:We combined the most recent count data and satellite tracking information to update existing informa-tion about the population abundance and distribution of the Black-faced Spoonbill at all stages of its annual life cycle,and how these have changed during 2004-2020.Results:Black-faced Spoonbills mainly breed on the west coast of the Korean peninsula,while immature birds show a wider summer distribution throughout Yellow Sea coastal areas,when a few remain on wintering sites in the south.Combined tracking results and mid-winter counts confirmed known wintering sites on the east and south coasts of China,but showed that the species also winters on wetlands in the Yangtze River floodplain and in Southeast Asia.During 2004-2020,counts of wintering birds in coastal habitats increased from 1198 to 4864,with numbers wintering on the island of Taiwan contributing most to the overall increase.Latest counts found 5222 in 2021.We also identify key wintering and stopover sites as well as their current conservation status.Conclusions:This study revised the known summering and wintering ranges of the Black-faced Spoonbill and assessed the conservation status of key sites based on a combination of field survey and satellite tracking data.We recommend prioritisation of further field research to identify and survey inland wintering areas in the Yangtze River floodplain and summering areas of immature birds.More tracking of adult individuals and birds during spring migration is necessary to fill these information gaps.We also suggest establishing a Black-faced Spoonbill monitoring platform to store,share and show real-time distribution range and population abundance data.

The relationship between acceptance of illness and quality of life among men who have sex with men living with human immunodeficiency virus:A cross-sectional study

Objectives To explore the relationship between acceptance of illness and quality of life(QOL),and factors associated with acceptance of illness among men who have sex with men(MSM)living with human immunodeficiency virus(HIV).Methods Three hundred and one MSM were recruited from an HIV clinic between August and December 2018.The battery of measurements consisted of the Acceptance of Illness Scale,World Health Organization Quality of Life Questionnaire for HIV brief version,HIV Cognitive Appraisal Scale and a self-designed questionnaire used to collect general information.Pearson correlation test was used to examine the relationship between acceptance of illness and QOL.Univariate and multivariate ordinal logistic regression analyses were used to examine whether the general data(demographic and HIV-related clinical data)and HIV cognitive appraisal were associated with acceptance of illness levels.Results Descriptive analysis showed the acceptance level among MSM living with HIV was moderate(Mean=26.29,SD=5.28).Those with a better acceptance of illness had a better QOL(r=0.69,P<0.01).In the multivariate ordinal logistic regression model,education level,threat appraisals(OR:1.09;95%CI[1.06–1.13]),and controllability appraisals(OR:0.82;95%CI[0.71–0.94])were significantly associated with acceptance of illness.Conclusions Results showed acceptance level was moderate and had a positive correlation with QOL.High level of education,low threat appraisals and high controllability appraisals were related to high illness acceptance.This finding highlights the importance of focusing on HIV-infected MSM with low education and on their perceptions of threat and controllability about HIV-related issues when designing interventions to promote illness acceptance in this vulnerable population.

Facing the 2013 Gold Rush: A Population Viability Analysis for the Endangered White-Lipped Peccary (<i>Tayassu pecari</i>) in Corcovado National Park, Costa Rica

The white-lipped peccary (Tayassu pecari) is facing range-wide declines throughout the Neotropics. It has been eliminated from about 89% of its historical range in Costa Rica. Corcovado National Park, in the Osa Peninsula of Costa Rica, is the last remaining stronghold for the white-lipped peccary in the country. In 2013, the Park experienced a sudden gold rush that brought with it a wave of 250 miners and vigorous hunting pressures on the population. Given that the species is endangered and is susceptible to hunting due to its herding behavior and tendency to cohere and attack when threatened rather than flee, it is important to assess its probability of extinction under various hunting scenarios. Incorporating data from studies on the life history of the species throughout its range in the Neotropics and in Corcovado, I used the population viability analysis software VORTEX to simulate the population trajectories and probabilities of extinction of the species under current hunting pressures and under various management scenarios. The results of this study revealed that under the 2013 scenario where 250 miners were present in the Park, the population of white-lipped peccaries has a about a 40% chance of extinction within five years and about a 99% chance of extinction within 10 years. Moreover, there is an “extinction threshold” for the population between the presence of 100 and 150 miners hunting in the Park. At this threshold, the population growth rate, r, drops from a positive growth rate (r = 0.09, SD = 0.08) to a negative one (r = -0.07, SD = 0.29). I suggest that anti-mining and anti-poaching laws be enforced immediately, and that the number of miners be reduced to 100 at a minimum, if not completely, in order to ensure that the population of white-lipped peccaries becomes viable and evades a local extinction.

The Unreasonableness of Accommodation： A Strong Defence of Minority Nations＇ Right to Sovereignty

Citizens of liberal democracies hold that their theory of governance is the most just, the most consistent with freedom, and the most likely to promote human flourishing. Yet, Canada, one of the world＇s most liberal and progressive democracies, has consistently been unable to come to terms with the minority nations in its midst. Why would national minorities resist joining fully in a just liberal democratic state？ And in the face of this refusal, what sort of relationship should the majority establish with these national minorities？ I argue that their resistance stems from an axiom of mainstream liberalism, ＂the civic unity assumption,＂ which holds that, ideally, all citizens endorse a single, unified state. While seemingly innocuous, this assumption extinguishes First Nations and Qurbrcois＇ claims to sovereignty. I conclude that this assumption--that majority and minority nationals must all work within the boundaries of a single constitutional structure--is ultimately an assimilative one, demanding that minority nationals merge their political community into the civic project of the majority. Drawing from John Rawls＇ The Law of Peoples, I argue that minority nations are best characterized as ＂peoples＂--complete societies with their own unique moral, cultural, and political traditions. If we accept this claim, we will come to see the multinational state differently： not as a political project uniting all citizens, but as a pact between nations; equal sovereign peoples coming together in a spirit of reciprocity to work out fair terms of social and political cooperation.

Education and Employment （2005-2009） A Comparative Analysis Between the Spanish and Foreign Working Population

Spain became a net receiver country of a high number of foreigners entering the labour market in the first decade of the 21 st century. The ensuing economic crisis, beginning in 2007, led to the destruction of a large number of companies and jobs. The objective of this paper is to analyze the relationship between educational level, employment and economic activity, in the Spanish and foreign working population in the Spanish labour market and the impact that the economic crisis is having on employment and self-employment. The hypotheses considered have been as followed--HI： The economic crisis mainly affects the less educated working population, both Spanish and foreign; H2： Self-employment is characterized by being an initiative of a working population with low educational levels for both population groups （Spanish and foreign）; H3： Employment is related to the productive economic structure. Micro-data from the Labour Force Survey 2009 （EPA in Spanish） has been used, compiled by Spains National Statistics Office （INE in Spanish）, and it has been applied Multiple Correspondence Analysis （MCA） to detect possible associations among the study variables （nationality, level of education, salaried employment, self-employment and economic activity）. The results show significant differences between both groups： Spanish and foreign working population. The study also shows how the crisis affects employment, and the important role played by the educational level of the working population, especially foreigners employed in certain economic activities.

The trend of low fertility and aging in ethnic minority areas and the policy responses in China:An analysis based on data from the latest three censuses

Low fertility and population aging are important factors affecting economic and social development.From 2000 to 2020,the development of low fertility in ethnic minority areas shows three trends of accelerated declining,slow declining and first falling and then rising,which are the results of the balance between the inhibiting effect of controlling birth policy and the rapidly rising birth cost,and the promoting effect of encouraging birth policy on the fertility desire of social members.The development of aging in ethnic minority areas shows two trends of acceleration and deceleration,which are the results of the balance between the promoting effect of controlling birth policy,the outflow of young and middle-aged labor force and the rise of life expectancy,and the inhibiting effect of the encouraging birth policy,the restraint of talent return and talent introduction.Combined with the development degree of low fertility and aging,we can accurately classify and implement policies for different ethnic minority areas.The areas with serious low fertility and population aging problems need economic policies to change the population age structure as soon as possible.The areas with slight low fertility and population aging problems should carry out ideological policies in priority to maintain the benign structure of population age.

Alzheimer’s Disease among American Minority Populations: An Eco­logical Exploratory Study

A significant public health concern with regards to increasing rates of Alzheimer’s is that it disproportionately affects minority groups in the United States.The present ecological exploratory study uses secondary aggregate data from the fifty United States in the year of 2019.The pur­pose of this study was to address the disparities in Alzheimer’s in minori­ty populations in the US and explore associated factors.The“minority”populations considered were African American and Hispanic populations,and the“majority”population was referred to as“white”.The data were extracted from the United States Census Bureau,the CDC National Cen­ter for Health Statistics,and the Behavioral Risk Factor Surveillance Sys­tem(BRFSS)Dataset.The prevalence rates of Alzheimer’s disease are greatest in both older Hispanic(12.2%)and African Americans(13.8%),compared to older whites(10.3%)in the investigated time period.Our results showed that being over 65 years old(p=.009),with a below-av­erage($62,843)median household income(p=.024),history of stroke(p=.029),and being a part of the Hispanic population(p=.036),were significantly associated with Alzheimer’s mortality rates in the United States.By identifying disparities in access to Alzheimer’s healthcare and at-risk communities,more comprehensive intervention strategies can be developed to promote change and advocate for more Alzheimer’s educa­tion and resource allocation for minority populations.

Population Density and Habitat Utilization of Ibex(Capra ibex)in Tomur National Nature Reserve,Xinjiang,China

Surveys was conducted to study the population density and habitat utilization of the ibex （Capra ibex） in Tomur National Nature Reserve during October- December 2005. The results are as follows： ① The mean group size of the ibex in Tomur Nature Reserve is 8.43 and the population density is 269.76/100 km^2; ② The ibex prefer areas with steep slope （between 30° -45°）, broken substrates and cliffs nearby （ 〈 100 m）. They avoid grasslands and fiat hillsides; ③The probable reason for this habitat selection is serf-protection.

预科英语精读教学中的交互式教学模式探究——以The Virtue Called Devotion的教学设计为例

本文在Wilga M.Rivers提出的交互式教学原则的基础上,以The Virtue Called Devotion一课的教学设计与教学过程为例,探讨了在多媒体环境下,将交互式教学模式引入预科英语精读课堂教学的可行方法,旨在为学生创造更多使用英语的机会,增强学生的学习兴趣,从而提高课堂教学质量。

Genetic polymorphism of mitochondrial DNA HVS-I and HVS-II of Chinese Tu ethnic minority group

We analyzed the two hypervariable segments HVS-I and HVS-II of 108 Chinese Tu ethnic minority group samples for forensic and population genetics purposes, Comparing with Anderson sequence, 79 polymorphic loci in HVS-I and 40 in HVS-II were found in Chinese Tu ethnic minority group mtDNA sequences, and 90 and 64 haplotypes were then defined. Haplotype diversity and the mean pairwise differences were 0.9903±0.0013 and 5.7785 in HVS-I, and 0.9777±0.0013 and 3.5819 in HVS-II, respectively. By analyzing the hypervariable domain from nucleotide 1,6180 to 1,6193 in HVS-I, we defined some new types of sequence variations. We also compared the relationship between Tu population and other populations using mtDNA HVS-I sequences. According to Rst genetic distances, the phylogenetic tree showed that the Tu population, the Xi＇an Han population, the Chinese Korean, and the Mongol ethnic group were in a clade. This indicated a close genetic relationship between them. There were far relations between the Tu population and other Chinese southern Han populations, Siberian, European, African, and other foreign populations. The results suggest that Tu population has a multi-origin and has also merged with other local populations.

Topographic and lithologic controls behind mountain depopulation in Zlatibor District(Western Serbia)

Mountain depopulation is a worldwide phenomenon observed in all continents. It has varied socio-economic reasons;among others, the low profitability of traditional agriculture, the better job possibilities and the higher level of services in urban settlements. However, it is often recognized that depopulation is related to natural factors such as elevation, slope or lithology. It is also observed that protected areas are frequently established in depopulated mountain regions. Their primary aim is the conservation of nature, but they may help tourism development as well. Tourism, in turn, may slow down or even reverse the process of depopulation. In this study, we investigate the impact of topographic and lithologic factors, namely of karst settings, on mountain demographic processes and the relationship of protected areas and tourism through the example of the northern part of Zlatibor District(Western Serbia). The study area is characterized by mountains and hills at elevations from 200 to 1600 m a.s.l. Our aim is to find GIS-based statistical relationships between topographic, lithologic factors and demographic characteristics. In this area, mountain depopulation started after WWII, and weproved that this process was strongly controlled by topographic factors. The higher and more dissected the area, the more significant is the decrease of the population and the more advanced is the ageing. As a result, population density contrasts are much more pronounced now than 70 years ago. After WWII, depopulation and ageing became gradually more serious on karstic terrains than on non-karst. However, by using compound topographic and lithologic types, we proved that it is not the effect of karst, but the effect of topography. The flow of population from hills and mountains to valleys and basins are closely related to the restructuring of the economic sectors. At present, for the study area, the development of tourism is unequivocally naturebased and connected to protected areas, namely to Tara National Park, Zlatibor Nature Park and ?argan–Mokra Gora Nature Park. In this paper, we also demonstrate how lithology influences tourism possibilities. The leading role of Zlatibor in tourism development is largely thanks to its favourable position on a main transit route.

Long-term Dynamics of Cultivated Land Resources and Their Driving Forces of Guyuan City in Upper Reaches of Jinghe River

The land use patterns in Guyuan City,Ningxia Hui Autonomous Region of China,have changed greatly over the years,due to population growth and farming and stock raising development.This study,using 50-year statis-tical data of cultivated land and 14-year spatial data of land use pattern,analyzed the developmental stages,the char-acter,and the spatial variance of farmland in the city,and discussed the driving forces of cultivated land changes based on empirical and conceptual statistical models.First,the change of cultivated land area went through different stages of rapid increase,fluctuating change,decrease and rapid decrease from 1949 to 2004,additionally,social and economic policies in different stages had an important impact on farmland variance.Second,from 1986 to 2000,the quantity of cultivated land increased,but its quality decreased.Third,social and economic factors are determinant factors in culti-vated land transition.Five constructed paths explain cultivated land transition.Factors that have direct or indirect ef-fects on farmland include the economy(Xeco),the population(Xpop),agricultural output(Xagr),and scientific input(Xsci).The sequence of impact was Xeco>Xpop>Xsci>Xagr.Among all these impacts,Xeco was the major positive one,and Xpop was the major negative one.It is urgent to take measures or adopt a policy to stop the vicious cycle in eco-environment and agriculture production.Otherwise,negative patterns of farmland use will increase,and high-quality cultivated land will continue to decline.

Inland-coastal demographic transformations in a karst area:a case study of the surroundings of Krka National Park(Croatia)

According to geographic possibilism,environment does not determine socio-economic development.However,the environment sets certain constraints and limitations for development.How do natural settings influence population dynamics?In this study,we examine this question using the example of?ibenik-Knin County,which includes Krka National Park(NP)with a GIS-based statistical approach.The following parameters represent natural factors:elevation,slope,distance from water,and proportion of karst areas.In addition,distance from Krka NP was also added as an independent seminatural factor(despite the fact that it is a social construction).The dependent social parameters are population density for selected historical dates,population change,year of maximum population,natural increase,migration,and age index.The analysis units are the 199 settlements found in the county,and the 20 local administrative units(LAU2).The study period can be divided into five phases:from the first census in 1857 to 1921,there was a slow increase in most settlements;then a relatively constant phase up to 1961(some settlements began shrinking in this period);a slow decrease until 1991;arapid decrease during the next decade;and relative stabilisation to present day.These processes were also accompanied by significant inner and outer migrations.As for the relationships between natural and demographic factors,we found that although the coastal-inland area dichotomy is dominant in the study area,elevation has the highest correlation with most population parameters.However,distance from water is also significantly correlated with population change and migration in certain periods.In the inland areas,there are statistically significant differences between the demographic processes of fully-karstic and partially-karstic areas,while in the coastal zone,the karst effect is overshadowed by other social processes.The impact of Krka NP on the demographic characteristics of the surrounding settlements was statistically not detectable.Our final conclusion is that correlations between natural and population parameters are low or moderately strong but statistically significant in many cases,thus the basic principles of geographic possibilism are valid for the area.

The Diversity and Composition of Woody Plants in Chebera Churcura National Park (CCNP), Southern Ethiopia

National parks harbor the most valuable biological diversities of national and global significance. The study of these diversities assists for the proper resource management. This study was carried out to determine woody species diversity and composition in CCNP. Systematic sampling was used to collect vegetation data from 67 plots (400 m2 each), which were laid following altitudinal gradient. From each plot presence/absence of woody species, abundance and structural data were recorded. R Program, Sorensen’s similarity, Shannon diversity index were used for vegetation analysis. Our result indicated that a total of 106 plant specimens belonging to 42 families and 90 genera were identified, of which 57.6% were trees, followed by 18.8% shrubs, 7.6% liana and 16% tree/shrub. The three most dominant families were Fabaceae, Rubiaceae and Combretaceae. Five vegetation community types were identified. Millettia ferugenia—Vepris danelii, and, Combrutum molle—Terminalia browni are among others. The tree density and basal area were 426.5 trees/hectare and 30.92 m2/hectare, respectively. The diversity and evenness indices were 3.88 and 0.46 for the study area, respectively. CCNP has more similarity with Bonga and Yayu afromontane forests of Ethiopia. Disturbances caused by the human activities and wild animals such as elephant were major threats to plant biodiversity in CCNP. We recommend floristic as well as ethnobotanical investigations to realize fully the existing plant diversity and their importance. Moreover, national attention should be given to ensure sustainable use of CCNP with its incredible biological resources.

Reducing psychiatric illness in the perinatal period:A review and commentary

This brief overview highlights the global crisis of perinatal psychiatric illness(PPI).PPI is a major contributor to many adverse pregnancy,childbirth,and childhood development outcomes.It contributes to billions of dollars in spending worldwide each year and has a significant impact on the individual,their family,and their community.It is also highly preventable.Current recommendations for intervention and management of PPI are limited and vary considerably from country to country.Furthermore,there are several significant challenges associated with implementation of these recommendations.These challenges are magnified in number and consequence among women of color and/or minority populations,who experience persistent and negative health disparities during pregnancy and the postpartum period.This paper aims to provide a broad overview of the current state of recommendations and implementation challenges for PPI and layout a framework for overcoming these challenges.An equityinformed model of care that provides universal intervention for pregnant women may be one solution to address the preventable consequences of PPI on child and maternal health.Uniquely,this model emphasizes the importance of managing and eliminating known barriers to traditional health care models.Culturally and contextually specific challenges must be overcome to fully realize the impact of improved management of PPI.

European Governments and Populist Challenge： Towards an Institutional Reform of the EU？

This paper argues that the debate about a possible reform of the EU （or, at least, of the Eurozone） is strictly connected to the role populism plays within the European political systems. In particular, the national governments are inclined to modify the European governance in so far as they perceive the populist movements as a threat for their consensus among the citizens. This interpretation is confirmed by three different approaches emerging in 2010-2015, which are examined in the article： the UK welcomed a part of the populist propaganda and tried to take advantage of it to carry out a radical reform of the EU, re-nationalizing a series of functions; Germany did not focus on the populist rhetoric and defended the current EU model, but recognized the federal goal to which the integration process was addressed; France and Italy, in spite of theoretical divergences about the idea of Europe, shared a strategy meant to defeat populism by strengthening the European institutions and reducing the gap with the citizens. This heterogeneous scenario prevented any agreement on the future of the EU, but the effects of recent events--- such as migrations and terrorism, potential causes of a new populist offensive---might convince the Member States to rethink their positions.

Human Insecurity in Myanmar: Varied Responses and the Way Forward

The very name Myanmar brings to mind a precarious picture of human insecurity.It is the land where the world’s most persecuted minorities still struggle to survive;and,it is the theatre where the longest-ever civil war in the world has been staged since 1948.Murder of people,rape,violence,and,censorship of the press,etc.,are common scenes in the country.A Nobel laureate(for peace in 1991)Mrs.Aung San Suu Kyi who brought hopes to Myanmar assuring resolution of all such issues through democracy,could not do something substantial,and she is now languishing in detention.Despite international pressure and sanctions,the Military Junta(called Tatmadaw)is still in the seat of power at Nay Pyi Daw dislodging a democratically elected government led by Mrs.Kyi that won the elections held in November last year by staging a coup d’état in February 2021.However,literature in this regard(i.e.human security)is scantily comprehensive and scarcely suggestive of recourses to be taken.Against this background,this paper looks into these developments and suggests the way forward to secure the security for the insecure.This paper argues that Militarism and Majoritarian Nationalism are responsible for this state of affairs in Myanmar.