Socio-economic status and lifestyle factors are associated with achalasia risk: A population-based case-control study

AIM: To evaluate the association between various lifestyle factors and achalasia risk.METHODS: A population-based case-control study was conducted in Northern Ireland, including n = 151 achalasia cases and n = 117 age- and sexmatched controls. Lifestyle factors were assessed via a face-to-face structured interview. The association between achalasia and lifestyle factors was assessed by unconditional logistic regression, to produce odds ratios(OR) and 95% confidence interval(CI).RESULTS: Individuals who had low-class occupations were at the highest risk of achalasia(OR = 1.88, 95%CI: 1.02-3.45), inferring that high-class occupation holders have a reduced risk of achalasia. A history of foreign travel, a lifestyle factor linked to upper socioeconomic class, was also associated with a reduced risk of achalasia(OR = 0.59, 95%CI: 0.35-0.99). Smoking and alcohol consumption carried significantly reduced risks of achalasia, even after adjustment for socio-economic status. The presence of pets in the house was associated with a two-fold increased risk of achalasia(OR = 2.00, 95%CI: 1.17-3.42). Nochildhood household factors were associated with achalasia risk.CONCLUSION: Achalasia is a disease of inequality, and individuals from low socio-economic backgrounds are at highest risk. This does not appear to be due to corresponding alcohol and smoking behaviours. An observed positive association between pet ownership and achalasia risk suggests an interaction between endotoxin and viral infection exposure in achalasia aetiology.

Influence of socio-economic status and environmental factors on serologically diagnosed Japanese encephalitis cases in the state of West Bengal, India during 2005-2010

Objectives: The main aim of the current study is to examine the influence of socio-economic status and environmental factors on serologically diagnosed Japanese encephalitis cases in the state of West Bengal, India during 2005-2010. Materials and methods: A total of 648 blood/CSF specimens were collected and/or referred from the suspected AES cases, admitted in the different medical colleges and hospitals of the state during the year of 2005-2010. These specimens were subjected to JE Mac ELISA to determine the actual JE case amongst these AES. The association of the socio-economic status and environmental factors with the serologically diagnosed JE positive cases was studied by a statistical analysis through Normal Deviate test or Z test. Result: Out of 648 specimens, only 175 (27.0%) specimens were reactive to JE IgM antibody, of which 60.0% were from the male individuals and 40.0% from the female population. Major cases were observed in the age group of 0 - 10 years;followed by 11 - 20 years. Regarding literacy, only 58.3% cases had no education and 41.7% were from the literate with varying level of education, i.e., from primary level to post gra- duate level. A total of 65.7% cases were from low income group where as only 34.3% cases were from high income group. Regarding house type, 62.3% cases lived in mud house and 37.7% cases lived in the brick house. In most of the cases (74.3%), persons were living in close proximity to rice fields/lakes/ponds. 69.7% cases were found to occur in the monsoon and post-monsoon period whereas 30.3% cases were reported in the pre-monsoon period. Conclusion: Our study concludes that socio-economic status and environmental conditions were statistically significant contextual risk factors for serologically diagnosed JE incidences in West Bengal where JE is proved to be endemic in nature and such study constitutes a new report of this kind in the region.

Socio-Economic Status and Gender as Determinant of Dietary Practices of Secondary School Students’by Exposure to Pictorial Nutrition Education for Sustainability

Objectives:The study examined socio-economic status and gender as determinant of dietary practices of senior secondary school students in Edo South Senatorial district for healthy living and sustainability.Methodology:Quasi experimental research design was employed in the study.Three research questions were raised and formulated into hypotheses,tested at 0.05 level of significance.A multistage random sampling technique was used to sample 245 students from two public schools in Oredo local government areas within Edo south senatorial district.Two(2)instruments(questionnaire and achievement test)validated and reliability of 0.64 and 0.84 reliability co-efficient were obtained.The demographic data/SES,dietary practices(DDPSESQ)was used to obtain information on their dietary practices and socio-economic status,while the pictorial nutrition achievement test(PNAT)consisted of the pre-and post-test.The treatment package comprised planned lessons of 40 minutes each for six(6)weeks.The data collected were analyzed using inferential statistics;hypotheses 1 and 2 were tested using the independent t-test while hypothesis 3 was tested using One-Way ANOVA statistics.Findings:The study revealed that there is no significant difference in dietary practices of students of high,medium and low socio-economic status as a result of exposure to pictorial nutrition education.There was no significant difference in dietary practices by gender.The study concluded that socio-economic status does not determine dietary practices of secondary school students for responsible living.

An Investigation of Iranian Students＇ English Proficiency Test Scores in Relation to Socio-Economic Status and Gender

Every day many students apply for and enroll in language-teaching courses to achieve their aims through learning another language. However, learning another language does not occur identically among all students. Some students learn a language, even their own mother tongue earlier but some others may need to spend more time acquiring a language. Seeking out for the probable reasons for such a difference, the current study following the constructivist approach to language learning and bearing in mind the role of society and human communities in language learning, was concluded to investigate the probable impact（s） of some social variables （social status, attitudinal and motivational status of learners） on language learning outcomes of Iranian adult learners assessed through a standardized English proficiency test. The findings have revealed that the social milieu in which learners live may play a decisive role as far as learning opportunities, input and resources are concerned.

Comparison between the Medullary Indexes of Hairs from Apodemus orestes and A.draco,with Discussion about the Taxonomic Status of A.orestes

The taxonomic status of long-tailed field mouse (Apodemus orestes) is still uncertain up to now.Some scholars regarded it as a subspecies or a synonym of dragon field mouse (A.draco),while other scholars considered it a valid species.In the study,five specimens of adult long-tailed field mouse,dragon field mouse and Chevrier's field mouse (A.chevrieri) (as a contrast) were chosen respectively.After treated,with the eyepiece micrometer in the inverted microscope,we made measurements of the widths of hairs and medullas and then calculated the medullary indexes of straight guard hairs from around the mouth,head,back,abdomen and forelimb of each species.The results indicate that,viewing at each of the five parts and the mixture of the five parts,there are no significant differences between A.orestes and A.draco,Significant differences can be found between A.orestes & A.chevrieri and A.draco & A.chevrieri though.The standpoint that A.orestes was listed as a valid species is not supported by this study.

Research of the Socio-economic Development in Dalian Chengshantou Nature Reserve

For the purpose of accommodating the relationship between the protection of nature reserve and the development of local society and economy,this paper,taking Dalian Chengshantou Nature Reserve as a study area and PRA as a main research method,investigated and analyzed the status of social and economical development and the existing problems in the study area. The result shows that: the contradictory between the protection of nature reserve and the local development of social and economical activities are still prominent,and the principle of " integration of protection and reasonable development" proposed by the general plan of nature reserve has not reached the expected result.Therefore,further efforts should be made firstly to accommodating relationship between the protection of nature reserve and the local development activities,secondly to accelerating the development of eco-tourism and the relevant service industries in accordance with the local practical situations,and finally to promoting the sustainable development of both the protection of nature reserve and the local society and economy.

Perceptions of Body Mass Index as a Valid Indicator of Weight Status among Adults in the United States

Background: Being overweight or obese increases risk for heart disease, stroke, type 2 diabetes, joint disease, and certain cancers. The Body Mass Index (BMI) is commonly used to determine weight status. As rates of overweight and obesity have risen sharply in the United States over the past 30 years, perceptions of a “normal” or healthy weight are subject to change. The purpose of this study was to analyze perceptions of BMI as an indicator of weight status. Methods: An online survey was administered to 376 US adults. The survey collected demographic information including height, weight, and perceived weight status (underweight, healthy weight, overweight and obese). The survey software calculated and presented participants with their personal BMI values. Participants then answered questions about their perception of the BMI as a valid indicator of weight status. Results: More participants reported a healthy weight status (51.6%) than were classified as such according to their computed BMI (43.6%). The majority of the sample (85.1%) considered BMI to be a valid indicator of weight status, although perceptions of validity varied by weight status. Participants that perceived BMI to be invalid most commonly cited incongruence with one’s perception of their own body weight, no accounting for unique body shapes, and no accounting for additional muscle mass. Conclusion: BMI is generally perceived to be a valid indicator of weight status. These perceptions of validity can vary depending on the individuals’ actual weight status. In instances where perceptions are not favorable toward BMI, it is largely attributable to opinions of incongruence with BMI and body shape, type, or composition. Continued use of BMI as a preliminary tool for determining weight status appears to be accepted. Efforts to increase BMI-related awareness and education may be necessary for individuals that currently see it as invalid.

Influence of Smoking Status and Body Mass Index on Serum Carcinoembryonic Antigen Concentration in Patients with Thoracic Diseases

BACKGROUND: Although the serum carcinoembryonic antigen (CEA) concentration is the well-known prognostic marker of non-small cell lung cancer (NSCLC), serum CEA concentration has been reported to be affected by smoking status and body mass index (BMI). There are no previous investigations that examined the relationship between BMI and serum CEA concentration in thoracic disease, including NSCLC. METHODS: Consecutive 384 NSCLC patients and 87 patients with benign thoracic disease were enrolled. The relationship between serum CEA concentration and smoking status and BMI in patients with benign thoracic benign disease and NSCLC was examined. RESULTS: In patients with benign thoracic disease, serum CEA concentration significantly increased with smoking status and Brinkman index. However, serum CEA concentration was not related with BMI. Serum CEA concentration of patients with NSCLC was significantly higher than those with benign disease. In NSCLC patients, the relationship between serum CEA concentration and smoking status was also found. A significant relationship between serum CEA concentration and smoking status was also found in patients with adenocarcinoma which is known to have weaker associations with smoking in carcinogenesis. On the other hand, we failed to find the relationship between serum CEA concentration and BMI in NSCLC patients. CONCLUSION: Serum CEA concentration may be affected by smoking status but not BMI in our Japanese patients with thoracic disease.

Improvement in Socio-Economic Productivity of HIV Positive Individuals on Antiretroviral Treatment in a Private Setting in South India

PLHIV have decreased economic productivity both due to direct and indirect causes. Data from developed countries have shown that at the societal level, high costs ART are offset by increased productivity. We hypothesized that post-ART the SES would improve regardless of the baseline SES and will be sustained over time. Our objective was to perform a comprehensive SES evaluation pre/post ART initiation using an ambispective cohort study design. We used Indian household-specific SES validated tool, with score of 76 being affluent, along with clinical, ART adherence data at median of 6 and 18 months post ART, and compared using paired t-tests. Among 140 persons started on ART, with a median follow up of 22 months, 118 had Pre-ART SES data, of these: 57% were women;median age was 38 years;67% were married;89 (78%) had heterosexual sex as HIV risk;40 (34%) had major OI and/or TB at presentation. Reported self-occupation was: skilled labourers 41 (35%);12 (10%) unskilled labourers;27 (23%) housewives;26 (22%) pro-fessionals/blue collar job;1 student, 10 unemployed. The median pre-post ART CD4 cell counts were: 187 and 454 cells/cumm (P < 0.01);median body weight pre-post ART was 54 and 57 kg (P < 0.01);97% of the participants were 100% adherent. The mean Pre-ART total SES score was 37.06 (+/-10.2);and Post-ART SES score 40.62 (+10.1 P < 0.001) and these results were sustained over time and remained significant even when only monthly income was considered. Our data show a significant impact of ART on SES in a sustained manner in a developing world setting, which has policy level implications.

The Impact of Salivary pH Value and Dental Caries Index on Periodontal Status among Adult Age Groups of Patients from Aseer Region, Saudi Arabia

Background: The patients’ age is considered a modified risk factor that causes periodontal disease, dental caries, and their development. Objective: The present study was designed to evaluate the impact of salivary pH value and dental caries index on periodontal status among adult age groups of patients from Aseer region, Saudi Arabia. Methods: A cross-sectional analysis carried out in the college of dentistry, King Khalid University on 750 adult patients (400 males and 350 females). The adults patients were divided into three equal groups according to the patients’ age: group I (20 - 30 years), group II (31 - 40 years), and group III (41 - 50 years). Plaque index (PLI), gingival index (GI), clinical attachment loss (CAL), and the dental caries index (DMFT) recorded as well as salivary pH. All findings collected, then analyzed by an ANOVA test and the t-test. A p-value at <0.05 was considered a statistical significance level. Results: The clinical findings of the current study showed that there were statistically significant differences in the patients’ age of both males and females. Moreover, there were statistically significant differences in GI. On the other hand, there were highly statistically significant differences in PLI and DMFS, but there were no significant differences in CAL of both males and females Moreover, there were no statistically significant differences in salivary pH. Conclusion: We concluded that DMFT Index correlated to periodontal and oral health status and, it increased with the progression of the patient’s age and can be used in the epidemiological evaluation of periodontal and oral health status.

Malnutrition Assessed Using the Geriatric Nutritional Risk Index Is Associated with Preoperative Incidence of Deep Vein Thrombosis in Japanese Patients Undergoing Total Knee Arthroplasty

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.

Relationship of 2 100-2 300 nm Spectral Characteristics of Wheat Canopy to Leaf Area Index and Leaf N as Affected by Leaf Water Content

The effects of leaf water status in a wheat canopy on the accuracy of estimating leaf area index (LAI) and N were determined in this study using extracted spectral characteristics in the 2 000-2 300 nm region of the short wave infrared (SWI) band. A newly defined spectral index, relative adsorptive index in the 2000-2300 nm region (RAI2000-2300), which can be calculated by RAI2000-2300 = (R2224 - R2054) (R2224 + R2054)-1 with R being the reflectance at 2224 or 2054 nm, was utilized. This spectral index, RAI2000-2300, was significantly correlated (P < 0.01) with green LAI and leaf N concentration and proved to be potentially valuable for monitoring plant green LAI and leaf N at the field canopy scale. Moreover, plant LAI could be monitored more easily and more successfully than plant leaf N. The study also showed that leaf water had a strong masking effect on the 2 000-2 300 nm spectral characteristics and both the coefficient between RAI2000-2300 and green LAI and that between RAI2000-2300 and leaf N content decreased as leaf water content increased.

Nutrients distribution and trophic status assessment in the northern Beibu Gulf, China

Using historical and 2010 field data, the distribution of nutrients in the northern Beibu Gulf of China is described. There was a decreasing trend in the concentration of nutrients from the north coast to offshore waters of the northern Beibu Gulf, reflecting the influence of inputs from land-based sources. High concentrations of dissolved inorganic nitrogen （DIN） and phosphate （PO4-P） occurred mainly at Fangchenggang Bay, Qinzhou Bay, and Lianzhou Bay. Four different methods were used to assess eutrophication. The trophic status of the Beibu Gulf was characterized using the single factor, Eutrophication index （El）, Trophic index （TRIX） and Assessment of Estuarine Trophic Status （ASSETS） methods. Based on nutrient concentrations, 73.9% of DIN and 26.7% of PO4-P samples exceeded the fourth grade Seawater Quality Standard of China. Eutrophication index values varied widely, but higher levels of eutrophication were generally found in bays and estuaries. TRIX values ranged from 2.61 to 7.27, with an average of 4.98, indicating a mesotrophic and moderately productive system. A positive correlation between TRIX and harmful algal species richness and abundance was observed. The ASSETS model evaluates eutrophication status based on a Pressure-State-Response approach, including three main indices： influencing factors, overall eutrophic condition, and future outlook. The Beibu Gulf was graded as moderate using ASSETS. The single factor and Chinese nutrient index methods were considered inadequate for the assessment of trophic status. TRIX can be used as an indicator of trophic state and ASSETS showed good potential to assess eutrophication. The results of TRIX and ASSETS depend on threshold values. To establish these values, further research is required within the northern Beibu Gulf.

A comparison of the applicability of the Shannon-Wiener index,AMBI and M-AMBI indices for assessing benthic habitat health in the Huanghe(Yellow River) Estuary and adjacent areas

From a dataset of macrobenthos obtained from 18 cruises from 2004 to 2013 in the Huanghe（Yellow River）Estuary and its adjacent areas,the composition and characteristics of macrobenthos were analyzed,and the applicability of the Shannon-Wiener Index（H′）,AZTI＇s Marine Biotic Index（AMBI） and multivariate AMBI（MAMBI） for assessing benthic habitat quality was compared.The results showed a total of 203 macrobenthos in the study area.The macrobenthos were dominated by polychaetes,followed by mollusks and crustaceans.The macrobenthic ecological groups were dominated by EGI,EGII and EGIII,which respectively accounted for 31.5%,36.0% and 21.2% of the total.There were significant differences between the evaluation results of the three indices.The ecological quality status（EQS） levels given by the AMBI were greater than those given by the H′ and M-AMBI.The AMBI could not reflect the differences between 11 sites but the H′ and M-AMBI could do.Moreover,the three indices responded well to the variations in salinity（S） and dissolved oxygen（DO） in the waters.The H′ and MAMBI also responded sensitively to the differences in physical parameters,such as water depth and sediment texture.The correlation between M-AMBI and environmental pressure gradient data was the strongest.The MAMBI could effectively distinguish degraded conditions from undegraded but the H′ and AMBI could not.Therefore,the M-AMBI reflected benthic habitat health well in the study areas.However,the objectivity of evaluation results of M-AMBI needs further verification by physical,chemical and biological methods.The thresholds also need further discussion.

Assessing benthic ecological status in coastal area near Changjiang River estuary using AMBI and M-AMBI

The Changjiang(Yangtze)River estuary has been subject to a variety of anthropogenic pressures in recent decades.To assess the ecological health of the coastal benthic ecosystem adjacent to the estuary,three surveys were conducted in 2005,2009,and 2010.The AZTI's Marine Biotic Index(AMBI)and multivariate-AMBI(M-AMBI)were used to analyse the benthic ecological status of this coast.The AMBI indicate that the ecological status of the coast adjacent to the Changjiang River estuary was only slightly degraded in all 3 years.In contrast,the M-AMBI indicated that the ecological status was seriously degraded,a result that is most likely due to pollution and eutrophication induced by human activities.The assessment of the coast's ecological status by the AMBI was not in agreement with that of the M-AMBI at some stations because of lower biodiversity values at those sites.The analysis of the two indices integrated with abiotic parameters showed that the M-AMBI could be used as a suitable bio-indicator index to assess the benthic ecological status of the coast adjacent to the Changjiang River estuary.The reference conditions proposed for the coast of the Changjiang River estuary should be further evaluated in future studies.Designation of local species could also provide an important reference for Chinese waters.To improve the reliability of AMBI and M-AMBI,further research into the ecology of local species is required to understand their arrangement in ecological groups.

A soil quality index for evaluation of degradation under land use and soil erosion categories in a small mountainous catchment, Iran

Soil erosion and land use type have long been viewed as being particularly important drivers of soil degradation.The objectives of this study,therefore,were to select a new soil quality index(SQI)which varies significantly with land use/soil erosion,and to evaluate the new SQI using expert opinion.In total,18 soil physical,chemical,and biochemical properties(indicators)were measured on 56 soil samples collected from four land use/soil erosion categories(rangeland/surface erosion,rangeland/subsurface erosion,cultivated land/surface erosion and dry-farming land/surface erosion).Principal component and classification analysis(PCCA)identified five PCs that explained 77.7%of the variation in soil properties with the biochemical PC varying significantly with land use/soil erosion.General discriminant analysis(GDA)selected urease and clay as the most sensitive properties distinguishing the land use/soil erosion categories.The GDA canonical scores for the new SQI were significantly correlated with expert opinion soil surface summed scores(for soil movement,surface litter,pedestalling,rills and flow pattern)derived using the U.S.Department of the Interior Bureau of Land Management(BLM)method.A forward stepwise general regression model revealed that the new SQI values were explained by soil movement,surface litter,and the summed values of the soil surface factors.Overall,this study confirmed that soil quality in the study area in Iran is controlled by land use and corresponding soil erosion.

Changes in the nutritional status of nine vitamins in patients with esophageal cancer during chemotherapy

BACKGROUND Many studies have investigated the relationships between vitamins and esophageal cancer(EC).Most of these studies focused on the roles of vitamins in the prevention and treatment of EC,and few studies have examined the changes in vitamin nutritional status and their influencing factors before and after chemotherapy for EC.Chemotherapy may have a considerable effect on EC patients’vitamin levels and hematological indicators.AIM To research the nutritional status of multiple vitamins in EC patients during chemotherapy and to assess its clinical significance.METHODS EC patients admitted to our center from July 2017 to September 2020 were enrolled in this study.Serum concentrations of nine vitamins(A,D,E,B9,B12,B1,C,B2 and B6),hemoglobin,total protein,albumin,blood calcium,blood phosphorus concentrations and body mass index(BMI)were measured in all EC patients.The changes in nine vitamins,hematological indicators and BMI were compared before and after two cycles of chemotherapy.The possible influential factors were analyzed.RESULTS In total,203 EC patients receiving chemotherapy were enrolled in this study.Varying degrees of vitamin A,D,C and B2 deficiency and weight loss were found in these patients,and the proportions of vitamin B2 and vitamin C deficiencies increased significantly after chemotherapy(both P<0.05).Serum concentrations of vitamins A,C,B2 and B6 and BMI before and after chemotherapy were statistically significant(all P<0.05).Multivariate analysis showed that vitamin A levels significantly differed between male and female EC patients,whereas vitamin D concentration significantly differed in EC patients in different stages(all P<0.05).Correlations were observed between the changes in serum concentrations of vitamin A and C before and after two cycles chemotherapy and the change in BMI(P<0.05).Hemoglobin,total protein,serum albumin and blood calcium concentrations significantly decreased in EC patients after chemotherapy(all P<0.05),while the blood phosphorus level significantly increased after chemotherapy(P<0.05).Using the difference in vitamin concentrations as the independent variables and the difference in BMI as the dependent variable,logistic regression analysis revealed statistically significant differences for vitamin A,vitamin D and vitamin C(F=5.082,P=0.002).CONCLUSION Vitamin A,D,C and B2 were mainly deficient in patients with EC during chemotherapy.Multivitamin supplementation may help to improve the nutritional status,chemotherapy tolerance and efficacy.

Prognostic value of preoperative weight loss-adjusted body mass index on survival after esophagectomy for esophageal squamous cell carcinoma

BACKGROUND The impact of body mass index(BMI)on survival in patients with esophageal squamous cell carcinoma(ESCC)undergoing surgery remains unclear.Therefore,a definition of clinically significant BMI in patients with ESCC is needed.AIM To explore the impact of preoperative weight loss(PWL)-adjusted BMI on overall survival(OS)in patients undergoing surgery for ESCC.METHODS This retrospective study consisted of 1545 patients who underwent curative resection for ESCC at West China Hospital of Sichuan University between August 2005 and December 2011.The relationship between PWL-adjusted BMI and OS was examined,and a multivariate analysis was performed and adjusted for age,sex,TNM stage and adjuvant therapy.RESULTS Trends of poor survival were observed for patients with increasing PWL and decreasing BMI.Patients with BMI≥20.0 kg/m2 and PWL<8.8%were classified into Group 1 with the longest median OS(45.3 mo).Patients with BMI<20.0 kg/m2 and PWL<8.8%were classified into Group 2 with a median OS of 29.5 mo.Patients with BMI≥20.0 kg/m2 and PWL≥8.8%(HR=1.9,95%CI:1.5-2.5),were combined into Group 3 with a median OS of 20.1 mo.Patients in the three groups were associated with significantly different OS(P<0.05).In multivariate analysis,PWL-adjusted BMI,TNM stage and adjuvant therapy were identified as independent prognostic factors.CONCLUSION PWL-adjusted BMI has an independent prognostic impact on OS in patients with ESCC undergoing surgery.BMI might be an indicator for patients with PWL<8.8%rather than≥8.8%.

A Comparative Analysis of Primary and Extreme Characteristics of Dry or Wet Status between Asia and North America

In this study, the Palmer Drought Severity Index （PDSI） was used to analyze the average and extreme dry/wet states of Asia and North America from 1953 to 2003. The results indicate that the two continents underwent drying trends during this period. Compared with North America, Asia showed more severe drought trends. However, more significant and regular seasonal variation for drought was found in North America. The driest regions in Asia were located in the northern region of China, Mongolia, and eastern mid-Siberian plateau. Most regions in central North America were relatively wetter than other regions. The northern and southwestern regions of North America, as well as the Atlantic and Pacific coastal areas, experienced the most drought during this period. A sharp increase of the drought area and the number of extreme drought events took place from 1997 to 2003 in both Asia and North America. Severe drought events were more likely to occur during the summer on both continents. Asia had the most extreme drought events during July, but North America reached its highest drought frequency from June to September. In Asia, a persistent increasing trend of extreme drought emerged throughout the studied period. However, a more complex evolution of drought emerged in North America： a decreasing trend appeared before the mid-1960s and an increasing trend appeared after the late 1970s. A relatively steady dry/wet status was observed between the mid-1960s and the late 1970s. The role of exceptional, extreme drought events with respect to the La Nin？a event was considered during 1997–2003.

Vision-Based Learning Status Monitoring on Color and Depth Live Facial Videos

This study analyzes live facial videos for recognizing nonverbal learning-related facial movements and head poses to discover the learning status of students. First, color and depth facial videos captured by a Kinect are analyzed for face tracking using a three-dimensional （3D） active appearance model （AAM）. Second, the facial feature vector sequences are used to train hidden Markov models （HMMs） to recognize seven learning-related facial movements （smile, blink, frown, shake, nod, yawn, and talk）. The final stage involves the analysis of the facial movement vector sequence to evaluate three status scores （understanding, interaction, and consciousness）, each represents the learning status of a student and is helpful to both teachers and students for improving teaching and learning. Five teaching activities demonstrate that the proposed learning status analysis system promotes the interpersonal communication between teachers and students.