Recent urbanization increases exposure to humid-heat extreme events over populated regions of China

目前对于高温的研究主要侧重于干热,针对湿热的研究相对较少,但它通常会造成更大的社会影响,尤其对人体健康的威胁.已有研究证实,当环境湿球温度超过35℃时,它会破坏人体正常生理代谢,进而威胁人体健康.本研究指出在过去四十年,中国区域日最高湿球温度几乎没有超过35℃,但部分地区日最高湿球温度超过了30℃,主要集中在中国的人口密集区,包括华东,华南和四川盆地等.进一步分析发现,中国区域近期的快速城市化加剧了极端湿热事件的社会影响,城市地区暴露于极端湿热事件的范围的增加速率明显大于其他地区,这也意味着快速城市化使得人口密集区暴露于极端湿热事件的风险明显增加.初步估算指出,自2000年以来,中国区域暴露于极端湿热事件的人口数以每年每天约3100人次的速率显著增加.

Prediction and stratification for the surgical adverse events after minimally invasive esophagectomy:A two-center retrospective study

BACKGROUND Minimally invasive esophagectomy(MIE)is a widely accepted treatment for esophageal cancer,yet it is associated with a significant risk of surgical adverse events(SAEs),which can compromise patient recovery and long-term survival.Accurate preoperative identification of high-risk patients is critical for improving outcomes.AIM To establish and validate a risk prediction and stratification model for the risk of SAEs in patients with MIE.METHODS This retrospective study included 747 patients who underwent MIE at two centers from January 2019 to February 2024.Patients were separated into a train set(n=549)and a validation set(n=198).After screening by least absolute shrinkage and selection operator regression,multivariate logistic regression analyzed clinical and intraoperative variables to identify independent risk factors for SAEs.A risk stratification model was constructed and validated to predict the probability of SAEs.RESULTS SAEs occurred in 10.2%of patients in train set and 13.6%in the validation set.Patients with SAE had significantly higher complication rate and a longer hospital stay after surgery.The key independent risk factors identified included chronic obstructive pulmonary disease,a history of alcohol consumption,low forced expiratory volume in the first second,and low albumin levels.The stratification model has excellent prediction accuracy,with an area under the curve of 0.889 for the training set and an area under the curve of 0.793 for the validation set.CONCLUSION The developed risk stratification model effectively predicts the risk of SAEs in patients undergoing MIE,facilitating targeted preoperative interventions and improving perioperative management.

Study on Functions and Countermeasures of Disaster Prevention and Reduction of Urban Green Land

From the advanced experiences at home and abroad,according to the requirements of emergency evacuation at earthquake disaster,then strategies and methods to disaster prevention and reduction functions of urban green land construction were put forward.

基于改进Event模型的通用航空器碰撞风险分析

随着通用航空的发展,空中交通流量将持续扩大,航空器碰撞风险增加。对Event模型进行改进,将拼接四棱锥碰撞盒代替原长方体碰撞盒,曲面间隔层代替平面间隔层,建立通用航空器碰撞风险模型。最后将塞斯纳172及运5B通用航空器作为实例对所建模型进行验证,结果表明,在两组均采用广义帕累托分布的条件下,改进后Event模型碰撞风险值分别为改进前的31.65%、14.98%,碰撞风险值较改进前大大减少,结果精度更高,能更好地评估交叉航路碰撞风险。

Distributions of typical contaminant species in urban short-term storm runoff and their fates during rain events:A case of Xiamen City

The pollutants in urban storm runoff, which lead to an non-point source contamination of water environment around cities, are of great concems. The distributions of typical contaminants and the variations of their species in short term storm runoff from different land surfaces in Xiamen City were investigated. The concentrations of various contaminants, including organic matter, nutrients （i.e., N and P） and heavy metals, were significantly higher in parking lot and road runoff than those in roof and lawn runoff. The early runoff samples from traffic road and parking lot contained much high total nitrogen （TN 6-19 mg/L） and total phosphorus （TP 1-3 mg/L）. A large proportion （around 60%） of TN existed as total dissolved nitrogen （TDN） species in most runoff. The percentage of TDN and the percentage of total dissolved phosphorus remained relatively stable during the rain events and did not decrease as dramatically as TN and TP. In addition, only parking lot and road runoff were contaminated by heavy metals, and both Pb （25-120 μg/L） and Zn （0.1-1.2 mg/L） were major heavy metals contaminating both runoff. Soluble Pb and Zn were predominantly existed as labile complex species （50%-99%）, which may be adsorbed onto the surfaces of suspended particles and could be easily released out when pH decreased. This would have the great impact to the environment.

URBANIZATION EFFECTS ON OBSERVED CHANGES IN SUMMER EXTREME HEAT EVENTS OVER ZHEJIANG PROVINCE, EAST CHINA

Although the urban heat island(UHI) is a well-documented phenomenon, relatively little information in the literature is available about its impact on summer extreme heat event(EHE). As UHI is characterized by increased temperature, it can potentially increase the magnitude and duration of EHEs within cities. Based on daily maximum temperature records from 62 observation stations in Zhejiang province from the period 1971-2011 and satellite-measured nighttime light imagery from the Defense Meteorological Satellite Program(DMSP) Operational Linescan System(OLS) during 1992-2010, we analyzed the long-term change of summer EHEs and its association with the rapid urbanization process. The results could be concluded as follows:(1) Zhejiang has experienced rapid urbanization and dramatic growth in urban areas in the past two decades, especially after 2000.(2) The summer mean maximum temperature and the 95 th percentile of summer daily maximum temperature in most of its stations have increased, with the most significant increase occurring in the highly urbanized areas including the city belt around Hangzhou Bay, Taizhou-Wenzhou and Jinghua-Yiwu city belts.(3) The hot days and hot-day degrees, defined by both daily 95 th percentile and the threshold of 35℃, show that the UHI effect causes additional hot days and heat stress in urban stations compared to rural stations.The results in this study suggest that the UHI effect should be determined and incorporated in preparing high temperature forecasts in cities.

Planning of Urban Public Disaster-prevention Green Spaces: A Case Study of Living Water Park in Chengdu City

Based on disaster-prevention functions of urban public green spaces, necessity and significance of emergency shelters in a city were analyzed. Taking Living Water Park in Chengdu for example, planning of urban public disaster-prevention green spaces was analyzed to further explore planning of urban disaster-prevention green space system and refugee spaces, and provide instructions for the planning and construction of urban disaster-prevention green spaces in China.

APPLICATION OF WRF/UCM IN THE SIMULATION OF A HEAT WAVE EVENT AND URBAN HEAT ISLAND AROUND GUANGZHOU

This paper evaluated the performance of a coupled modeling system,Weather Research and Forecasting(WRF)/Urban Canopy Model(UCM),in the simulation of a heat wave event which occurred around Guangzhou during late June through early July,2004.Results from three experiments reveal that the UCM with new land data(hereafter referred to as E-UCM)reproduces the best 2-m temperature evolution and the smallest minimum absolute average error as compared with the other two experiments,the BPA-Bulk Parameterization Approach with new land data(E-BPA)and the UCM with original U.S. Geological Survey land data(E-NOU).The E-UCM is more useful in capturing the temporal and spatial distribution of the nighttime Urban Heat Island(UHI).Differences in surface energy balance between the urban and suburban areas show that low daytime albedo causes more absorption of solar radiation by urban areas.Due to the lack of vegetation which inhibits cooling by evapotranspiration,most of the incoming energy over urban areas is partitioned into sensible heat flux and therefore heats the surface and enhances the heat wave.During nighttime,the energy in the urban area is mainly from soil heat flux.Although some energy is partitioned as outgoing long wave radiation,most of the soil heat flux is partitioned into sensible heat flux due to the small latent heat flux at night.This leads to the development of nighttime UHI and the increase of the magnitude and duration of heat waves within the municipality.

Increases in Anthropogenic Heat Release from Energy Consumption Lead to More Frequent Extreme Heat Events in Urban Cities

With economic development and rapid urbanization,increases in Gross Domestic Product and population in fastgrowing cities since the turn of the 21st Century have led to increases in energy consumption.Anthropogenic heat flux released to the near-surface atmosphere has led to changes in urban thermal environments and severe extreme temperature events.To investigate the effects of energy consumption on urban extreme temperature events,including extreme heat and cold events,a dynamic representation scheme of anthropogenic heat release(AHR)was implemented in the Advanced Research version of the Weather Research and Forecasting(WRF)model,and AHR data were developed based on energy consumption and population density in a case study of Beijing,China.Two simulations during 1999−2017 were then conducted using the developed WRF model with 3-km resolution with and without the AHR scheme.It was shown that the mean temperature increased with the increase in AHR,and more frequent extreme heat events were produced,with an annual increase of 0.02−0.19 days,as well as less frequent extreme cold events,with an annual decrease of 0.26−0.56 days,based on seven extreme temperature indices in the city center.AHR increased the sensible heat flux and led to surface energy budget changes,strengthening the dynamic processes in the atmospheric boundary layer that reduce AHR heating efficiency more in summer than in winter.In addition,it was concluded that suitable energy management might help to mitigate the impact of extreme temperature events in different seasons.

Application of Internet of Things in Urban Waterlogging Prevention Management System

This paper aims to realize the extensive application of Internet of things technology in urban waterlogging prevention management system, and has analyzed the security requirement and security architecture of Internet of things technology, and discussed the demand of urban waterlogging prevention management system in combination with the key technology of Internet of things technology, to do the overall design and functional design well during designing of urban waterlogging prevention management system. Finally, the application process of the Internet of things technology in Chongqing waterlogging prevention management system is summarized. The application result shows that the flood control and drainage function of Chongqing is gradually improved with smooth drainage facilities;the inspection and maintenance management is gradually standardized;operation monitoring and early warning management is fully strengthened. There is visual management for emergency command and dispatch, and at the same time, the drainage pipe network assessment management can be conducted correctly.

Multiscale Combined Action and Disturbance Characteristics of Pre-summer Extreme Precipitation Events over South China

The dominant frequency modes of pre-summer extreme precipitation events(EPEs)over South China(SC)between1998 and 2018 were investigated.The 67 identified EPEs were all characterized by the 3-8-d(synoptic)frequency band.However,multiscale combined modes of the synoptic and three low-frequency bands[10-20-d(quasi-biweekly,QBW);15-40-d(quasi-monthly,QM);and 20-60-d(intraseasonal)]accounted for the majority(63%)of the EPEs,and the precipitation intensity on the peak wet day was larger than that of the single synoptic mode.It was found that EPEs form within strong southwesterly anomalous flows characterized by either lower-level cyclonic circulation over SC or a deep trough over eastern China.Bandpass-filtered disturbances revealed the direct precipitating systems and their life cycles.Synoptic-scale disturbances are dominated by mid-high latitude troughs,and the cyclonic anomalies originate from downstream of the Tibetan Plateau(TP).Given the warm and moist climate state,synoptic-scale northeasterly flows can even induce EPEs.At the QBW and QM scales,the disturbances originate from the tropical Pacific,downstream of the TP,or mid-high latitudes(QBW only).Each is characterized by cyclonic-anticyclonic wave trains and intense southwesterly flows between them within a region of large horizontal pressure gradient.The intraseasonal disturbances are confined to tropical regions and influence SC by marginal southwesterly flows.It is concluded that low-frequency disturbances provide favorable background conditions for EPEs over SC and synoptic-scale disturbances ultimately induce EPEs on the peak wet days.Both should be simultaneously considered for EPE predictions over SC.

Delineation of urban growth boundary based on FLUS model under the perspective of land use evaluation in hilly mountainous areas

With rapid economic development,the size of urban land in China is expanding dramatically.The Urban Growth Boundary(UGB)is an expandable spatial boundary for urban construction in a certain period in order to control the urban sprawl.Reasonable delineation of UGB can inhibit the disorderly spread of urban space and guide the normal development of the city.It is of practical significance for the construction of green urban space.The study utilizes GIS technology to establish a land construction suitability evaluation system for Nankang city,which is experiencing rapid urban expansion,and outlines the preliminary UGB under the future land use simulation(FLUS)model.At the same time,considering the coupled coordination of"Production-Living-Ecological Space",and based on the suitability evaluation,we revised the preliminary UGB by combining the advantages of the patch-generating land use simulation(PLUS)model and the convex hull model to delineate the final UGB.The results show that:1)the comprehensive score of the evaluation of the suitability of the construction of land from high to low shows the distribution of the center of the city to the surrounding circle type spread,the center of the city has the highest suitability score.The results of convex hull model show that the urban expansion type of Nankang is epitaxial.In the future,the urban expansion will mainly occur in the northern part of the city.The PLUS model predicts an increase of 3359.97 hm^(2)of construction land in Nankang by 2035,of which 2022.97 hm^(2)is urban construction land.2)The FLUS model has a prediction accuracy of 86.3%and delineates a preliminary UGB area of 9215.07 hm^(2).3)We used the results of the construction suitability evaluation,PLUS model simulation results,and convex hull model predictions to revise the originally delineated UGB.The final delineated UGB area is 8895.67 hm^(2)and it is capable of meeting the future development of the study area.The results of the delineation can promote sustainable urban development,and the delineation methodology can provide a reference basis for the preparation of territorial spatial planning.

Impact of Big Events on Urban Renewal Based on Urban Catalyst Theory: A Case Study of 2016 Rio Summer Olympics and 2010 Shanghai World Expo

With the acceleration of the process of economic globalization and information synchronization, every major event is accompanied by the simultaneous renewal of the city. In the era of urban development, the launch of major events is also for the renewal and development of the city. 2016 Rio Summer Olympics and 2010 Shanghai World Expo are taken as the research objects. Through the analysis of urban renewal from the perspective of the role of big event catalyst, it is verified that the big event catalyst has a positive impact on urban renewal, transportation, industrial transformation and other aspects. Moreover, it tries to combine the theory of urban catalyst to analyze its inspiration for the Beijing Winter Olympic Games, hoping to play a catalytic role in accelerating the urban renewal and transformation of Beijing and the reorganization of urban structure.

Projecting Spring Consecutive Rainfall Events in the Three Gorges Reservoir Based on Triple-Nested Dynamical Downscaling

Spring consecutive rainfall events(CREs) are key triggers of geological hazards in the Three Gorges Reservoir area(TGR), China. However, previous projections of CREs based on the direct outputs of global climate models(GCMs) are subject to considerable uncertainties, largely caused by their coarse resolution. This study applies a triple-nested WRF(Weather Research and Forecasting) model dynamical downscaling, driven by a GCM, MIROC6(Model for Interdisciplinary Research on Climate, version 6), to improve the historical simulation and reduce the uncertainties in the future projection of CREs in the TGR. Results indicate that WRF has better performances in reproducing the observed rainfall in terms of the daily probability distribution, monthly evolution and duration of rainfall events, demonstrating the ability of WRF in simulating CREs. Thus, the triple-nested WRF is applied to project the future changes of CREs under the middle-of-the-road and fossil-fueled development scenarios. It is indicated that light and moderate rainfall and the duration of continuous rainfall spells will decrease in the TGR, leading to a decrease in the frequency of CREs. Meanwhile, the duration, rainfall amount, and intensity of CREs is projected to regional increase in the central-west TGR. These results are inconsistent with the raw projection of MIROC6. Observational diagnosis implies that CREs are mainly contributed by the vertical moisture advection. Such a synoptic contribution is captured well by WRF, which is not the case in MIROC6,indicating larger uncertainties in the CREs projected by MIROC6.

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.

Anthropogenic Influence on Decadal Changes in Concurrent Hot and Dry Events over China around the Mid-1990s

The frequency and duration of observed concurrent hot and dry events(HDEs) over China during the growing season(April–September) exhibit significant decadal changes across the mid-1990s. These changes are characterized by increases in HDE frequency and duration over most of China, with relatively large increases over southeastern China(SEC), northern China(NC), and northeastern China(NEC). The frequency of HDEs averaged over China in the present day(PD,1994–2011) is double that in the early period(EP, 1964–81);the duration of HDEs increases by 60%. Climate experiments with the Met Office Unified Model(MetUM-GOML2) are used to estimate the contributions of anthropogenic forcing to HDE decadal changes over China. Anthropogenic forcing changes can explain 60%–70% of the observed decadal changes,suggesting an important anthropogenic influence on HDE changes over China across the mid-1990s. Single-forcing experiments indicate that the increase in greenhouse gas(GHG) concentrations dominates the simulated decadal changes,increasing the frequency and duration of HDEs throughout China. The change in anthropogenic aerosol(AA) emissions significantly decreases the frequency and duration of HDEs over SEC and NC, but the magnitude of the decrease is much smaller than the increase induced by GHGs. The changes in HDEs in response to anthropogenic forcing are mainly due to the response of climatological mean surface air temperatures. The contributions from changes in variability and changes in climatological mean soil moisture and evapotranspiration are relatively small. The physical processes associated with the response of HDEs to GHG and AA changes are also revealed.

Prediabetes: An overlooked risk factor for major adverse cardiac and cerebrovascular events in atrial fibrillation patients

BACKGROUND Prediabetes is a well-established risk factor for major adverse cardiac and cerebrovascular events(MACCE).However,the relationship between prediabetes and MACCE in atrial fibrillation(AF)patients has not been extensively studied.Therefore,this study aimed to establish a link between prediabetes and MACCE in AF patients.AIM To investigate a link between prediabetes and MACCE in AF patients.METHODS We used the National Inpatient Sample(2019)and relevant ICD-10 CM codes to identify hospitalizations with AF and categorized them into groups with and without prediabetes,excluding diabetics.The primary outcome was MACCE(all-cause inpatient mortality,cardiac arrest including ventricular fibrillation,and stroke)in AF-related hospitalizations.RESULTS Of the 2965875 AF-related hospitalizations for MACCE,47505(1.6%)were among patients with prediabetes.The prediabetes cohort was relatively younger(median 75 vs 78 years),and often consisted of males(56.3%vs 51.4%),blacks(9.8%vs 7.9%),Hispanics(7.3%vs 4.3%),and Asians(4.7%vs 1.6%)than the non-prediabetic cohort(P<0.001).The prediabetes group had significantly higher rates of hypertension,hyperlipidemia,smoking,obesity,drug abuse,prior myocardial infarction,peripheral vascular disease,and hyperthyroidism(all P<0.05).The prediabetes cohort was often discharged routinely(51.1%vs 41.1%),but more frequently required home health care(23.6%vs 21.0%)and had higher costs.After adjusting for baseline characteristics or comorbidities,the prediabetes cohort with AF admissions showed a higher rate and significantly higher odds of MACCE compared to the non-prediabetic cohort[18.6%vs 14.7%,odds ratio(OR)1.34,95%confidence interval 1.26-1.42,P<0.001].On subgroup analyses,males had a stronger association(aOR 1.43)compared to females(aOR 1.22),whereas on the race-wise comparison,Hispanics(aOR 1.43)and Asians(aOR 1.36)had a stronger association with MACCE with prediabetes vs whites(aOR 1.33)and blacks(aOR 1.21).CONCLUSION This population-based study found a significant association between prediabetes and MACCE in AF patients.Therefore,there is a need for further research to actively screen and manage prediabetes in AF to prevent MACCE.

Increased retinal venule diameter as a prognostic indicator for recurrent cerebrovascular events:a prospective observational study

Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for identifying high-risk patients who require closer monitoring and more aggressive management.

Impact of body mass index on adverse kidney events in diabetes mellitus patients: A systematic-review and meta-analysis

BACKGROUND The incidence of chronic kidney disease among patients with diabetes mellitus(DM)remains a global concern.Long-term obesity is known to possibly influence the development of type 2 diabetes mellitus.However,no previous meta-analysis has assessed the effects of body mass index(BMI)on adverse kidney events in patients with DM.AIM To determine the impact of BMI on adverse kidney events in patients with DM.METHODS A systematic literature search was performed on the PubMed,ISI Web of Science,Scopus,Ovid,Google Scholar,EMBASE,and BMJ databases.We included trials with the following characteristics:(1)Type of study:Prospective,retrospective,randomized,and non-randomized in design;(2)participants:Restricted to patients with DM aged≥18 years;(3)intervention:No intervention;and(4)kidney adverse events:Onset of diabetic kidney disease[estimated glomerular filtration rate(eGFR)of<60 mL/min/1.73 m2 and/or microalbuminuria value of≥30 mg/g Cr],serum creatinine increase of more than double the baseline or end-stage renal disease(eGFR<15 mL/min/1.73 m2 or dialysis),or death.RESULTS Overall,11 studies involving 801 patients with DM were included.High BMI(≥25 kg/m2)was significantly associated with higher blood pressure(BP)[systolic BP by 0.20,95%confidence interval(CI):0.15–0.25,P<0.00001;diastolic BP by 0.21 mmHg,95%CI:0.04–0.37,P=0.010],serum albumin,triglycerides[standard mean difference(SMD)=0.35,95%CI:0.29–0.41,P<0.00001],low-density lipoprotein(SMD=0.12,95%CI:0.04–0.20,P=0.030),and lower high-density lipoprotein(SMD=–0.36,95%CI:–0.51 to–0.21,P<0.00001)in patients with DM compared with those with low BMIs(<25 kg/m2).Our analysis showed that high BMI was associated with a higher risk ratio of adverse kidney events than low BMI(RR:1.22,95%CI:1.01–1.43,P=0.036).CONCLUSION The present analysis suggested that high BMI was a risk factor for adverse kidney events in patients with DM.

Prevention of type 2 diabetes in urban American Indian/Alaskan Native communities: The Life in BALANCE pilot study

Objective: The Life in BALANCE (LIB) study is a pilot translational study modeling the Diabetes Prevention Program (DPP) intensive lifestyle coaching intervention among an underserved, high-risk population: American Indians/Alaska Natives (AI/ANs) living in a large urban setting (Las Vegas, Nevada). Research Design and Methods: A total of 22 overweight/obese AI/ANs (age, 39.6 ± 10.4 years;BMI, 34.1 ± 6.3 kg/m2) at increased risk for developing type 2 diabetes (HbA1c > 5.4 (36 mmol/mol) Results: Only 12 of the 22 participants remained?in the LIB program at the final post-program follow-up. Participants demonstrated significant decreased waist circumference and elevated HDL cholesterol. Triglycerides manifested the highest percentage change without statistical significance. No significant change was observed in blood pressure or fasting blood glucose. Conclusions: LIB participants’ improvements in BMI, waist circumference, HDL cholesterol and triglycerides suggests type 2 diabetes prevention programs aimed at urban AI/ANs show significant potential for reducing the risk of developing type 2 diabetes among this underserved and high risk community. Qualitative data suggest the main challenge for type 2 diabetes prevention specific to this population is a need for improved community outreach strategies.