Contribution of High Body Mass Index to the Global Burden of Esophageal Cancer: A Population-Based Study from 1990 to 2019.

BACKGROUND: The changing patterns of obesity have had a significant impact on the epidemiology of esophageal cancer (EC). AIMS: This study aimed to investigate the specific burden of EC associated with high body mass index (BMI) across different geographical and Sociodemographic Index (SDI) regions, using data from the Global Burden of Disease Study 2019. METHODS: Mortality, age-standardized death rates (ASDR), and disability-adjusted life-years (DALYs) from 1990 to 2019 were analyzed for 204 countries and territories. Decomposition analysis, frontier and health inequality analyses, and age-period-cohort models were employed to examine the factors driving disease burden and to predict future trends. RESULTS: High BMI contributed to 89,903.9 [95% uncertainty interval (UI): 27,878.9-171,254.6] EC-related deaths, an ASDR of 1.1 (95% UI 0.3-2.1) per 100,000 population, and 2,202,314.1 (681,901.4-4,173,080.3) DALYs in 2019. There was an increasing trend in these figures over the 29-year period. The middle SDI region (31,023.8, 95% UI 9,180.4-62,631.5) and East Asia (36,939.9, 95% UI 9,620.5-81,495) carried the highest burden of EC-related deaths. Disease burden increased across all age groups and genders globally. Population growth was a major factor driving EC deaths across all SDI quintiles. Disparities in disease burden were observed across countries at all development levels. Predictive models indicated a continued increase in EC-related deaths in the next decade. CONCLUSIONS: The study provided a comprehensive understanding of the global burden of EC associated with high BMI over the past decades. Opportunities exist to reduce this burden at all SDI levels through targeted interventions and policies.

A Fully Automated Mini-Mental State Examination Assessment Model Using Computer Algorithms for Cognitive Screening.

Background: Rapidly growing healthcare demand associated with global population aging has spurred the development of new digital tools for the assessment of cognitive performance in older adults. Objective: To develop a fully automated Mini-Mental State Examination (MMSE) assessment model and validate the model's rating consistency. Methods: The Automated Assessment Model for MMSE (AAM-MMSE) was an about 10-min computerized cognitive screening tool containing the same questions as the traditional paper-based Chinese MMSE. The validity of the AAM-MMSE was assessed in term of the consistency between the AAM-MMSE rating and physician rating. Results: A total of 427 participants were recruited for this study. The average age of these participants was 60.6 years old (ranging from 19 to 104 years old). According to the intraclass correlation coefficient (ICC), the interrater reliability between physicians and the AAM-MMSE for the full MMSE scale AAM-MMSE was high [ICC (2,1)=0.952; with its 95% CI of (0.883,0.974)]. According to the weighted kappa coefficients results the interrater agreement level for audio-related items showed high, but for items "Reading and obey", "Three-stage command", and "Writing complete sentence" were slight to fair. The AAM-MMSE rating accuracy was 87%. A Bland-Altman plot showed that the bias between the two total scores was 1.48 points with the upper and lower limits of agreement equal to 6.23 points and -3.26 points. Conclusions: Our work offers a promising fully automated MMSE assessment system for cognitive screening with pretty good accuracy.

The green economic impact of a green comprehensive industry agglomeration: An example from the sports industry.

The optimization of industrial structure and layout is essential for promoting the high-quality development of the regional economy. As a typical example of a green comprehensive industry, the agglomerations of the sports industry have the potential to release additional green benefits. Consequently, this paper uses the balanced panel data of 30 provinces, municipalities, and autonomous regions in China from 1998 to 2021 as samples and, based on the strategic background of China's dual-carbon target and the re-interpretation of the green economy, uses the Super-SBM model to re-measure the green economic efficiency of each region and applies the dynamic spatial Durbin model and the dynamic panel system GMM model to evaluate the direct effect, mediating mechanism, spatial spillover effect, and heterogeneity effect of sports industry agglomeration on the regional green economic efficiency. Empirical findings indicate that: (1) The improvement of green economic efficiency under China's dual-carbon target has the characteristics of dynamic accumulation, and there is a siphon effect between neighboring regions. (2) The effects of sports industry agglomeration on local green economy efficiency show an "inverted U-shape" with a positive spatial spillover effect on the green economy efficiency of neighboring regions; this conclusion is robust. (3) The green economy effect of sports industry agglomeration is more significant in the central and western regions, regions with strict environmental regulations, and regions with a higher willingness for resident participation in sports due to industrial density, compliance costs, and characteristics of sports industry development. (4) Sports industry agglomeration can promote regional green economy efficiency by escaping natural resource dependence and increasing healthy human capital; technological innovation, rationalization of industrial structure, and labor transfer serve as "inverted U-shaped" mediators between sports industry agglomeration and regional green economy efficiency. This study expands the meso- and spatial-level perspectives of the impact of the agglomeration of green industries and comprehensive industries on green development. It is of great theoretical and practical importance for promoting the construction of a regional green industrial system and the high-quality development of the green economy.

Monte Carlo study of X-ray grazing incidence microscopy using Geant4.

X-ray grazing incidence microscopy has extensive applications in the fields of laser inertial confinement fusion and synchrotron radiation. Monte Carlo methods can be used to determine the optical performance of X-ray grazing incidence microscopes and predict the experimental results, which is of great significance for studying physical experiments and diagnostics. In this paper, we proposed a Monte Carlo method based on Geant4 for studying X-ray grazing incidence microscopy. We introduced the G4MultilayerReflection class to describe the physical processes of X-ray multilayer mirrors. We designed a dual-energy Kirkpatrick-Baez microscope that can operate at 6.4 and 9.67 keV simultaneously. Monte Carlo simulations of the spatial resolution and throughput efficiency of the microscope were performed using Geant4, which was assembled and characterized. The spatial resolution results obtained by the Geant4 laboratory simulations, the theoretical model, and the experiments were in good agreement. Additionally, we conducted throughput efficiency calibration experiments for the 6.4 keV imaging channel. The difference between the experimental and Geant4-simulated throughput efficiency was evaluated and resulted in root mean square error values of 8.7% and 9.5% along the Y- and Z-axes, respectively.

Impaired cardiac pump function assessment with normalized cardiac power using cardiac magnetic resonance in patients with hypertrophic cardiomyopathy.

Background: Cardiac power (CP; CP = 0.222 × cardiac output × mean blood pressure) output in patients with heart failure has been studied previously, but its importance in patients with hypertrophic cardiomyopathy (HCM) remains unclear. The present study aimed to explore the role of normalized CP (normalized CP = CP/ventricle mass) in assessing cardiac function in patients with HCM with normal ejection fraction using cardiac magnetic resonance (CMR). Methods: This cross-sectional study enrolled 99 patients with HCM who underwent CMR from December 2020 to January 2022 at Beijing Anzhen Hospital, and these patients were classified into heart failure or non-heart failure subgroups. Meanwhile, a control group comprising 65 gender- and age-matched healthy volunteers was also enrolled. The baseline clinical characteristics and cardiac functional parameters were compared between the patients with HCM and the controls, and multivariable linear regression analysis was performed to analyze the relationship between normalized CP and the relevant factors. Results: Significantly higher CP (1.19 vs. 1.01 W; P=0.03) but lower normalized CP (0.73 vs. 1.12 W/100 g; P<0.001) were found in patients with HCM as compared with the controls. Multivariable analysis showed that HCM correlated well with normalized CP [ß=-0.235; 95% confidence interval (CI): -0.341 to -0.129; P<0.001]. In the HCM group, there were 34 cases with heart failure and 65 with non-heart failure, and the patients with HCM with heart failure showed similar CP (1.14 vs. 1.24 W; P=0.06) but significantly lower normalized CP (0.54 vs. 0.78 W/100 g; P<0.001). The correlation analysis of normalized CP and functional parameters revealed that normalized CP was inversely correlated with left ventricle mass/body surface area (R=-0.509; 95% CI: -0.646 to -0.341; P<0.001) in patients with HCM. Conclusions: Normalized CP decreased significantly and was negatively correlated with ventricle mass, indicating impaired cardiac pump function in patients with HCM. Normalized CP might play a critical role in detecting and evaluating impaired cardiac pump function in patients with HCM with preserved ejection fraction.

Community Construction and Development Path Analysis of Ecological Environment-Friendly Elderly Care Service.

As a new pension model, ecological pension is an important choice to relieve the pressure of population aging in China. This paper reviews the relevant literature on the integrated development of the ecological pension industry and rural revitalization in recent years and points out that the researchers have determined the model of the ecological pension industry, the path of rural revitalization, the comprehensive development of organic pension industry, and rural revitalization and the problems they face. Some results have been achieved. However, there is still a lot of research space for the integrated development of the ecological pension industry and rural revitalization, especially to establish a perfect index system of the ecological pension industry, the measurement standard of rural revitalization, and the theoretical basis and mechanism of integrated development. Regional cooperative symbiosis is based on industrial symbiosis. In terms of research methods, attention should be paid to the combination of theoretical analysis and empirical research, to the further development of this field, and to achieve remarkable results. In the process of social and economic development, the rural ecology can be built by solving the problems of the elderly, accurately reducing rural poverty, and protecting the environment. The healthy elderly care tourism destination has realized the integrated development of rural tourism, ecological health tourism, and elderly care tourism. Taking Chang'an District of Xi'an as an example, the advantages of the district in geographical location, climate, environment, tourism resource health, as well as the constraints in the system, talent, policy, and system are demonstrated, and the corresponding countermeasures are put forward.

Two competing simplicial irreversible epidemics on simplicial complex.

Higher-order interactions have significant implications for the dynamics of competing epidemic spreads. In this paper, a competing spread model for two simplicial irreversible epidemics (i.e., susceptible-infected-removed epidemics) on higher-order networks is proposed. The simplicial complexes are based on synthetic (including homogeneous and heterogeneous) and real-world networks. The spread process of two epidemics is theoretically analyzed by extending the microscopic Markov chain approach. When the two epidemics have the same 2-simplex infection rate and the 1-simplex infection rate of epidemic A ( λ) is fixed at zero, an increase in the 1-simplex infection rate of epidemic B ( λ) causes a transition from continuous growth to sharp growth in the spread of epidemic B with λ. When λ > 0, the growth of epidemic B is always continuous. With the increase of λ, the outbreak threshold of epidemic B is delayed. When the difference in 1-simplex infection rates between the two epidemics reaches approximately three times, the stronger side obviously dominates. Otherwise, the coexistence of the two epidemics is always observed. When the 1-simplex infection rates are symmetrical, the increase in competition will accelerate the spread process and expand the spread area of both epidemics; when the 1-simplex infection rates are asymmetrical, the spread area of one epidemic increases with an increase in the 1-simplex infection rate from this epidemic while the other decreases. Finally, the influence of 2-simplex infection rates on the competing spread is discussed. An increase in 2-simplex infection rates leads to sharp growth in one of the epidemics.

How Government Size Expansion Can Affect Green Innovation-An Empirical Analysis of Data on Cross-Country Green Patent Filings.

The expansion of government size will have dual effects on a country's green innovation. An appropriately sized government size increases marginal productivity and stimulates the development of green innovation by increasing government expenditure. On the contrary, an excessively sized government creates a huge administrative agency, which not only increases the tax burden but also damages social welfare by excessive intervention. Therefore, the effect of government size on green innovation is not linear. In order to prove this proposition, this study examines the impact of government size on green innovation in 166 countries between 1995 and 2018, using a two-way fixed effects model. The results reveal an inverted U-shaped relationship between government size and the level of green innovation, indicating that optimal government size may maximize a country's green innovation output. The results further suggest that this inverted U-shaped relationship is mainly influenced by environmental regulations and financial support. Finally, our heterogeneity analysis demonstrates that the inverted U-shaped relationship is more pronounced for countries with high organizational inertia and more R&D expenditure than for those with low organizational inertia and less R&D expenditure. This finding makes up for the research gap between government size and green innovation and provides a reference for countries to formulate the optimal government size to improve the level of green innovation.

Plastic and low-cost axial zero thermal expansion alloy by a natural dual-phase composite.

Zero thermal expansion (ZTE) alloys possess unique dimensional stability, high thermal and electrical conductivities. Their practical application under heat and stress is however limited by their inherent brittleness because ZTE and plasticity are generally exclusive in a single-phase material. Besides, the performance of ZTE alloys is highly sensitive to change of compositions, so conventional synthesis methods such as alloying or the design of multiphase to improve its thermal and mechanical properties are usually inapplicable. In this study, by adopting a one-step eutectic reaction method, we overcome this challenge. A natural dual-phase composite with ZTE and plasticity was synthesized by melting 4 atom% holmium with pure iron. The dual-phase alloy shows moderate plasticity and strength, axial zero thermal expansion, and stable thermal cycling performance as well as low cost. By using synchrotron X-ray diffraction, in-situ neutron diffraction and microscopy, the critical mechanism of dual-phase synergy on both thermal expansion regulation and mechanical property enhancement is revealed. These results demonstrate that eutectic reaction is likely to be a universal and effective method for the design of high-performance intermetallic-compound-based ZTE alloys.

Customized eye modeling for optical quality assessment in myopic femto-LASIK surgery.

Refractive surgery is recognized as an effective method for myopia treatment, but it can induce night vision disturbances such as glare. We present an eye modeling method for the optical quality assessment in response to the structural changes in the eyes by femto-LASIK surgery. Customized eye models were built from the measurements of 134 right eyes pre- and post-operatively. Optical performance was evaluated using spot diagrams, point spread functions (PSFs), modulation transfer functions (MTFs), and chromatic aberrations at various fields (0°-30°), different pupil diameters (2-6 mm), and initial myopias (- 1.25 to - 10.5 D). Pupil size and initial myopia are the two major factors that affect visual performance of post-operative eyes. The results of spot diagrams, PSFs, and MTFs indicated that post-operative visual performance deteriorated as the visual field and pupil size increased, and it was significantly influenced by initial myopia. Post-operative chromatic aberrations were also affected by initial myopia. As pupil size increased, the post-operative longitudinal chromatic aberrations tended to decrease slightly, while the transverse chromatic aberrations remained similar. The use of eye modeling for refractive surgery assessment could possibly provide a more personalized surgical approach, could improve the prediction accuracy of refractive surgery outcomes, and promote the invention and development of better surgical methods.

States Transitions Inference of Postpartum Depression Based on Multi-State Markov Model.

Background: Postpartum depression (PPD) has been recognized as a severe public health problem worldwide due to its high incidence and the detrimental consequences not only for the mother but for the infant and the family. However, the pattern of natural transition trajectories of PPD has rarely been explored. Methods: In this research, a quantitative longitudinal study was conducted to explore the PPD progression process, providing information on the transition probability, hazard ratio, and the mean sojourn time in the three postnatal mental states, namely normal state, mild PPD, and severe PPD. The multi-state Markov model was built based on 912 depression status assessments in 304 Chinese primiparous women over multiple time points of six weeks postpartum, three months postpartum, and six months postpartum. Results: Among the 608 PPD status transitions from one visit to the next visit, 6.2% (38/608) showed deterioration of mental status from the level at the previous visit; while 40.0% (243/608) showed improvement at the next visit. A subject in normal state who does transition then has a probability of 49.8% of worsening to mild PPD, and 50.2% to severe PPD. A subject with mild PPD who does transition has a 20.0% chance of worsening to severe PPD. A subject with severe PPD is more likely to improve to mild PPD than developing to the normal state. On average, the sojourn time in the normal state, mild PPD, and severe PPD was 64.12, 6.29, and 9.37 weeks, respectively. Women in normal state had 6.0%, 8.5%, 8.7%, and 8.8% chances of progress to severe PPD within three months, nine months, one year, and three years, respectively. Increased all kinds of supports were associated with decreased risk of deterioration from normal state to severe PPD (hazard ratio, HR: 0.42-0.65); and increased informational supports, evaluation of support, and maternal age were associated with alleviation from severe PPD to normal state (HR: 1.46-2.27). Conclusions: The PPD state transition probabilities caused more attention and awareness about the regular PPD screening for postnatal women and the timely intervention for women with mild or severe PPD. The preventive actions on PPD should be conducted at the early stages, and three yearly; at least one yearly screening is strongly recommended. Emotional support, material support, informational support, and evaluation of support had significant positive associations with the prevention of PPD progression transitions. The derived transition probabilities and sojourn time can serve as an importance reference for health professionals to make proactive plans and target interventions for PPD.

Heritability Estimation and Environmental Risk Assessment for Type 2 Diabetes Mellitus in a Rural Region in Henan, China: Family-Based and Case-Control Studies.

Objective: The prevalence of type 2 diabetes mellitus (T2DM) varies greatly in different regions and populations. This study aims to assess the heritability and environmental risk factors of T2DM among rural Chinese adults. Methods: Thousand five hundred thirty three participants from 499 extended families, which included 24 nuclear families, were recruited in the family-based study to assess the heritable risk of T2DM. Heritability of T2DM was estimated by the Falconer method. Using conditional logistic regression model, couple case-control study involving 127 couples were applied to assess the environmental risk factors of T2DM. Results: Compared with the Henan Rural Cohort, T2DM was significantly clustered in the nuclear families (OR: 8.389, 95% CI: 5.537-12.711, P < 0.001) and heritability was 0.74. No association between the heredity of T2DM and sex was observed between the extended families and the Henan Rural Cohort. Besides, results from the couple case-control study showed that physical activity (OR: 0.482, 95% CI: 0.261-0.893, P = 0.020) and fat intake (OR: 3.036, 95% CI: 1.070-8.610, P = 0.037) was associated with T2DM, and the proportion of offspring engaged in medium and high physical activity was higher than that of mothers in mother-offspring pairs. Conclusion: People with a family history of T2DM may have a higher risk of developing T2DM, however, there was no difference in genetic risk between males and females. Adherence to active physical activity and low fat intake can reduce the risk of T2DM.

Image definition assessment based on Tchebichef moments for micro-imaging.

This paper proposes a Tchebichef moment (TM)-based image definition assessment (IDA) method that employs the difference in the logarithmic spectra (DLS). To avoid the influence of the original image, the essential element point spread function (PSF) is extracted from the DLS to characterize the IDA function uniquely. The amplification of the PSF spot radius to the defocus amount in the micro-imaging system enhances the featural differences among the DLSs, thereby improving the sensitivity to the defocus amount. The DLS with an obvious geometric feature variation is described by a TM with a low order, which improves the anti-noise performance. The performed simulation and experiment verified the superiority of the proposed method.

Assessment of Ecosystem Service Quality and Its Correlation with Landscape Patterns in Haidian District, Beijing.

Landscape architecture with urban green space as the main research object is an evidence-based science. It is an important issue to optimize green space systems from the point of view of ecosystem services. In this paper, high-resolution (1.5 m resolution) remote sensing images are combined with data-processing software, such as ENVI, ArcGIS, and Fragstats, to evaluate ecosystem service quality and compute the landscape pattern in the Haidian District (Beijing, China), so that the relationship between the ecosystem service quality and landscape pattern can be quantitatively studied and a strategy can be provided for green space optimization in cities. The following conclusions are drawn: (1) for the evaluated quality of 14 ecosystem services in Haidian District (refer to Section Analysis of the Association of the Percentage of Patches (PLAND) Index of Forest Land and Quality of Ecosystem Service in Haidian District). Forest land is the main provider of the ecosystem service in Haidian District, while construction land only provides cultural services; (2) on the whole, the spatial distribution of the ecosystem services in Haidian District gradually decreases from the west to the east, which basically matches with the spatial distribution of the forest land. The regulating service and supporting service are matched with the distribution of the urban green space. The cultural service is closely associated with history resource points; and (3) the analysis results of the association between landscape pattern and ecosystem service quality show that the percentage of patches (PLAND) index for forest land has a significant logarithmic relationship with the regulating service and supporting service. The critical value of the PLAND index is 30. Besides the Xishan area with the most coverage of forest land, the landscape shape index (LSI) of the brushwood has a logarithmic relationship with the ecosystem service quality. The critical value of the LSI value is 50. Finally, this paper proposes an area optimization strategy of green space in Haidian District from the view of the ecosystem system service. The Xishan area is classified into the ecosystem red line to control city expansion. The regulating and supporting services can be enhanced in the north flat area by improving the patch shape index. The ecosystem service capabilities can be improved by adding the forest land in the existing green space for the southeast urban areas.

Monte Carlo simulation investigation on the minitype reference radiation employed for the calibration of gamma ray dose or dose rate meters.

Minitype reference radiation (MRR) based on a cesium-137 (Cs-137) isotope radioactive source is a core component for carrying out field calibration on gamma ray dose or dose rate meters. To explore the source of scattering rays in the MRR, and their influence on dose field distribution, we calculated the radiation field of the MRR with different shielding wall materials, different sizes of shielding boxes, and different detectors. The investigation results provide theoretical and technical support for better understanding the MRR, and for developing field calibration technologies.

Controlled trial of the effectiveness of community rehabilitation for patients with schizophrenia in Shanghai, China.

BACKGROUND: The 'Sunshine Soul Park' is a network of social welfare institutions that provides communitybased rehabilitation services for individuals with mental illness. AIMS: Assess the effectiveness of the rehabilitation services provided at the 'Sunshine Soul Park' on the psychotic symptoms and social functioning of individuals with schizophrenia and, based on these findings, provide a theoretical model of community-based rehabilitation. METHODS: Sixty individuals with schizophrenia in the Huangpu District of Shanghai volunteered for the rehabilitation training program provided at six 'Sunshine Soul Park' community centers that involves day treatment, medication monitoring, biweekly rehabilitation training, and other recreational, social, and intellectual activities. A matched control group was recruited from individuals with schizophrenia registered on the Huangpu District registry of the 'Severe Mental Illness Prevention and Rehabilitation System'. All participants continued their medication without change for the full year of follow-up. Both groups were assessed at baseline, and 3, 6, and 12 months after enrollment using the Insight and Treatment Attitude Questionnaire (ITAQ), Social Disability Screening Schedule (SDSS), Generic Quality of Life Inventory-74 (GQOLI-74), and Positive and Negative Syndrome Scale (PANSS). RESULTS: In the intervention group the ITAQ, SDSS, GQOLI-74, and PANSS scores showed statistically significant improvement compared to baseline at each follow-up assessment. Moreover, the trend in improvement in the interventions group is significantly faster than that in the control group. CONCLUSIONS: The 'Sunshine Soul Park' rehabilitation training program enhances patients' knowledge about their disorder and improves their social functioning and quality of life. Further studies to assess methods for up-scaling this intervention to other areas of China are warranted.

Comparison and evaluation of two exome capture kits and sequencing platforms for variant calling.

BACKGROUND: To promote the clinical application of next-generation sequencing, it is important to obtain accurate and consistent variants of target genomic regions at low cost. Ion Proton, the latest updated semiconductor-based sequencing instrument from Life Technologies, is designed to provide investigators with an inexpensive platform for human whole exome sequencing that achieves a rapid turnaround time. However, few studies have comprehensively compared and evaluated the accuracy of variant calling between Ion Proton and Illumina sequencing platforms such as HiSeq 2000, which is the most popular sequencing platform for the human genome. The Ion Proton sequencer combined with the Ion TargetSeq Exome Enrichment Kit together make up TargetSeq-Proton, whereas SureSelect-Hiseq is based on the Agilent SureSelect Human All Exon v4 Kit and the HiSeq 2000 sequencer. RESULTS: Here, we sequenced exonic DNA from four human blood samples using both TargetSeq-Proton and SureSelect-HiSeq. We then called variants in the exonic regions that overlapped between the two exome capture kits (33.6 Mb). The rates of shared variant loci called by two sequencing platforms were from 68.0 to 75.3% in four samples, whereas the concordance of co-detected variant loci reached 99%. Sanger sequencing validation revealed that the validated rate of concordant single nucleotide polymorphisms (SNPs) (91.5%) was higher than the SNPs specific to TargetSeq-Proton (60.0%) or specific to SureSelect-HiSeq (88.3%). With regard to 1-bp small insertions and deletions (InDels), the Sanger sequencing validated rates of concordant variants (100.0%) and SureSelect-HiSeq-specific (89.6%) were higher than those of TargetSeq-Proton-specific (15.8%). CONCLUSIONS: In the sequencing of exonic regions, a combination of using of two sequencing strategies (SureSelect-HiSeq and TargetSeq-Proton) increased the variant calling specificity for concordant variant loci and the sensitivity for variant loci called by any one platform. However, for the sequencing of platform-specific variants, the accuracy of variant calling by HiSeq 2000 was higher than that of Ion Proton, specifically for the InDel detection. Moreover, the variant calling software also influences the detection of SNPs and, specifically, InDels in Ion Proton exome sequencing.

Hand hygiene knowledge and practices of nursing students in Singapore.

Hand hygiene is an important means of preventing nosocomial infections. Studies have shown a <50% compliance rate for hand hygiene among health care workers. A hand hygiene survey was administered to nursing students in a tertiary institution in Singapore. The results of this survey strongly indicate that nursing students understand the importance of hand hygiene compliance and perceive clinical internship programs and practical laboratory sessions to be effective methods of hand hygiene education.

[Ecosystem services evaluation based on geographic information system and remote sensing technology: a review].

Ecosystem services evaluation is a hot topic in current ecosystem management, and has a close link with human beings welfare. This paper summarized the research progress on the evaluation of ecosystem services based on geographic information system (GIS) and remote sensing (RS) technology, which could be reduced to the following three characters, i. e., ecological economics theory is widely applied as a key method in quantifying ecosystem services, GIS and RS technology play a key role in multi-source data acquisition, spatiotemporal analysis, and integrated platform, and ecosystem mechanism model becomes a powerful tool for understanding the relationships between natural phenomena and human activities. Aiming at the present research status and its inadequacies, this paper put forward an "Assembly Line" framework, which was a distributed one with scalable characteristics, and discussed the future development trend of the integration research on ecosystem services evaluation based on GIS and RS technologies.

[Evaluation of a pilot study on needle and syringe exchange program among injecting drug users in a community in Guangdong, China].

OBJECTIVE: To evaluate the feasibility and effectiveness of needle and syringe exchange program among a community of injecting drug users (IDUs) on AIDS prevention. METHODS: A quasi-experiment design was used in a controlled community intervention study. Needle and syringe exchange program was implemented for 10 months in IDUs of an intervention community, including peer education and health education, provision of free needles and syringes, and collecting back of used needles and syringes by trained peer educators and local health workers, whereas no intervention measure in a control community was instituted. Interviews with IDUs were conducted before and after intervention with a snowballing strategy to evaluate its effectiveness. RESULTS: A total of 428 and 429 IDUs were interviewed with structured questionnaire before and after intervention in intervention and control communities, respectively. Results revealed that awareness of HIV-related knowledge increased from 29.4% to 58.7% in the intervention community. Multivariate logistic regression analysis showed that awareness of HIV-related knowledge was higher in those who had read health education materials (OR = 2.93, 95% CI 2.12 - 4.04). As compared with the baseline data, frequency of sharing needles and syringes in past 30 days in the intervention community decreased from 48.9% to 20.4% in before intervention community (chi(2) = 41.02, P = 0.001), whereas there was no significant change in the control community. The causes of sharing needles and syringes in the intervention community included 'disable to get needle and syringe during the night', 'lack of needle and syringe when injecting at friend's home', 'not daring to buy needle and syringe for fear of being arrested' and 'no money to buy needle and syringe', declined markedly. CONCLUSIONS: Needle and syringe exchange program was feasible and effective in reducing their risky drug injecting behavior among IDUs in communities. Such strategy should be adopted in the country to reduce rapid spread of HIV.