Epidemiological patterns of chronic kidney disease attributed to type 2 diabetes from 1990-2019.

Background: This study investigates the burden of chronic kidney disease attributed to type 2 diabetes (CKD-T2D) across different geographical locations and time periods from 1990 to 2019. A total of 204 countries and regions are included in the analysis, with consideration given to their socio-demographic indexes (SDI). The aim is to examine both spatial and temporal variations in CKD-T2D burden. Methods: This research utilized data from the 2019 Global Burden of Diseases Study to evaluate the age-standardized incidence rates (ASIR), Disability-Adjusted Life Years (DALYs), and Estimated Annual Percentage Change (EAPC) associated with CKD-T2D. Results: Since 1990, there has been a noticeable increase of CKD age-standardized rates due to T2D, with an EAPCs of 0.65 (95% confidence interval [CI]: 0.63 to 0.66) for ASIR and an EAPC of 0.92 (95% CI: 0.8 to 1.05) for age-standardized DALYs rate. Among these regions, Andean Latin America showed a significant increase in CKD-T2D incidence [EAPC: 2.23 (95% CI: 2.11 to 2.34) and North America showed a significant increase in CKD-T2D DALYs [EAPC: 2.73 (95% CI: 2.39 to 3.07)]. The burden was higher in male and increased across all age groups, peaking at 60-79 years. Furthermore, there was a clear correlation between SDI and age-standardized rates, with regions categorized as middle SDI and High SDI experiencing a significant rise in burden. Conclusion: The global burden of CKD-T2D has significantly risen since 1990, especially among males aged 60-79 years and in regions with middle SDI. It is imperative to implement strategic interventions to effectively address this escalating health challenge.

Optimization of Chinese land spatial pattern in the transformation process of resource-based cities: a case study in Tongling City, China.

Optimizing the spatial layout of the national territory is crucial for realizing the transformation and development of resource-oriented cities in the context of high-quality development in the new period. This paper takes Tongling City as a case study, based on the analysis of the historical development foundation, then uses the SD-FLUS comprehensive model to carry out a systematic analysis of the transformation in five dimensions of economy, society, population, science and technology, resources and environment, and discusses the optimization of spatial pattern under the contextual simulation. The conclusions are as follows: ① The hierarchical framework of "system-indicator-element" is not only internally interconnected, but also inextricably linked with the relationship between the various categories of the land use system. ② Decrease of cropland, forest, water, grassland, and barren decreases from the economic development, social progress, and comprehensive development, and there is a small increase in the area under the scenario of resource and environmental protection, and the direction of the change of the impervious is in the opposite direction. ③ Cultivated land is retained in situ and concentrated to a small extent, forested land is reduced to a small extent while the status quo is maintained, and the Yangtze River water system will be retained and protected to a large extent, but part of the waters of Zongyang County will give way to the expansion of construction land under the development objectives of the new county. Building land will be expanded and extended to the northeast in the original site area, while the southwest corner of the original county center will be expanded to some extent in Zongyang County to promote the county's economic development.

Comprehensive prognostic assessment in kidney cancer: A multidimensional approach analyzing Fufang Sanling granules, genetic variants, and immune infiltration.

This study delves into the potential therapeutic benefits of Fufang Sanling Granules for kidney cancer, focusing on their active components and the underlying mechanisms of their interaction with cancer-related targets. By constructing a drug-active component-target network based on eight herbs, key active compounds such as kaempferol, quercetin, and linolenic acid were identified, suggesting their pivotal roles in modulating immune responses and cellular signaling pathways relevant to cancer progression. The research further identified 51 central drug-disease genes through comprehensive bioinformatics analyses, implicating their involvement in crucial biological processes and pathways. A novel risk score model, encompassing six genes with significant prognostic value for renal cancer, was established and validated, showcasing its effectiveness in predicting patient outcomes through mutation analysis and survival studies. The model's predictive power was further confirmed by its ability to stratify patients into distinct risk groups with significant survival differences, highlighting its potential as a prognostic tool. Additionally, the study explored the relationship between gene expression within the identified black module and the risk score, uncovering significant associations with the extracellular matrix and immune infiltration patterns. This reveals the complex interplay between the tumor microenvironment and cancer progression. The integration of the risk score with clinical parameters through a nomogram significantly improved the model's predictive accuracy, offering a more comprehensive tool for predicting kidney cancer prognosis. In summary, by combining detailed molecular analyses with clinical insights, this study presents a robust framework for understanding the therapeutic potential of Fufang Sanling Granules in kidney cancer. It not only sheds light on the active components and their interactions with cancer-related genes but also introduces a reliable risk score model, paving the way for personalized treatment strategies and improved patient management in the future.

Changes in pharmaceutical retail market and regional inequality of community pharmacists accessibility in mainland China: a retrospective cross-sectional study.

OBJECTIVES: To describe the development of pharmaceutical retail market and community pharmacists in mainland China and identify challenges from both government and business perspectives. DESIGN: A retrospective cross-sectional study. SETTING: Community pharmacies providing primary care in mainland China. PARTICIPANTS: Community pharmacies and community pharmacists in all 31 provincial units in mainland China registered in the National Medical Products Administration during 2014-2020. Number of community pharmacies ranged from 433 529 (2014) to 553 892 (2020). Number of community pharmacists ranged from 129 895 (2014) to 541 264 (2020). PRIMARY AND SECONDARY OUTCOME MEASURES: Changes in pharmaceutical retail market and accessibility of community pharmacists over the study period. We also examined the qualification of pharmacists and regional differences. RESULTS: During 2014-2020, the total number of retail companies and pharmacies increased by 47.6% and 27.4%, respectively. The national retail chain rate boosted from 39.4% to 56.5%, and average number of stores per company increased from 40.2 to 49.7. The number of community pharmacists rose by 316.7%. Regarding accessibility, number of pharmacy stores per 10 000 inhabitants increased from 3.2 to 3.9; the average number of pharmacists per store and per 10 000 residents rose from 0.30 to 0.98 and from 0.95 to 3.83. However, the proportion holding a postgraduate or bachelor's degree dropped to one-third. Pharmacy resources were unevenly distributed across the country. Correlations were observed between economic indicators and number of pharmacy stores and pharmacists (p<0.05). CONCLUSIONS: In general, the accessibility and centralisation of retail pharmacies in China have shown a steady growth with a sign of regional disparities. The availability of community pharmacists has increased significantly, although with an unreasonable composition of academic qualifications and a shortage of personnel. Further efforts are necessary to provide sufficient pharmacy resources for community settings and resolve regional disparities.

[Risk Assessment Method of Non-point Source Pollution Output for Watershed Using High Resolution Data].

In recent years, non-point source pollution has become the main cause of water quality deterioration in some reservoirs in China. Taking the Panjiakou Reservoir as an example, the classical output risk model was improved by introducing a precipitation factor and terrain factor. Combined with high-resolution satellite precipitation products (GPM) and GF-6 satellite images, a high-resolution data-driven risk assessment method for non-point source pollution output was established to study the temporal and spatial distribution characteristics of non-point source pollution output risk in the Panjiakou Reservoir basin. The results showed that the non-point source pollution output risk was high in the study area in 2018. The areas with higher and highest risk of nitrogen pollution output accounted for approximately 70.6% of the total watershed area, whereas the higher risk of phosphorus pollution output accounted for approximately 21.9%. The temporal and spatial distribution characteristics of non-point source pollution output risk in the Panjiakou Reservoir basin were analyzed. It was found that the non-point source pollution output risk in the Panjiakou Reservoir basin increased first and then decreased from April to September. This was consistent with the spatial and temporal distribution of precipitation in the basin. Combined with the analysis of land use distribution characteristics, the upstream area of the basin was mainly cultivated land, whereas cities were concentrated in the downstream portion of the basin. Affected by agricultural production and human activities, the risk of non-point source pollution output was higher in these regions. In view of the temporal and spatial distribution characteristics of non-point source pollution output risk, it is necessary to formulate a reasonable agricultural fertilization method, plan the landscape layout of source-sinks, and construct vegetation buffer zones.

The impact of digital finance on household participation in risky financial markets: Evidence-based study from China.

Chinese households have overinvested in risk-free financial assets, resulting in a single structure of financial assets. However, this proportion declined as digital finance developed. By combing the data from the China Household Finance Survey Data and the Peking University Digital Financial Inclusion Index of China, we find that digital finance significantly promotes household participation in risky financial markets. Further mechanistic analysis unveils that digital finance mainly affects households' participation in risky financial markets by reducing the lack of investment channels, promoting households' access to financial information and increasing the possibility of household risk appetite. In addition, the heterogeneity analysis suggests that digital finance effectively reduces the deterrent effect of wealth and cognitive thresholds on all households, reflecting the inclusive nature of financial development. Our findings provide an empirical basis for the mainstream positioning of digital finance in the development of inclusive finance, and display its positive impact on social welfare.

Establishment of a risk assessment score for deep vein thrombosis after artificial liver support system treatment.

BACKGROUND: The artificial liver support system (ALSS) is an effective treatment method for liver failure, but it requires deep venous intubation and long-term indwelling catheterization. However, the coagulation mechanism disorder of basic liver failure diseases, and deep venous thrombosis (DVT) often occur. AIM: To evaluate the risk factors for DVT following use of an ALSS and establish a risk assessment score. METHODS: This study was divided into three stages. In the first stage, the risk factors for DVT were screened and the patient data were collected, including ALSS treatment information; biochemical indices; coagulation and hematology indices; complications; procoagulant use therapy status; and a total of 24 indicators. In the second stage, a risk assessment score for DVT after ALSS treatment was developed. In the third stage, the DVT risk assessment score was validated. RESULTS: A total of 232 patients with liver failure treated with ALSS were enrolled in the first stage, including 12 with lower limb DVT. Logistic regression analysis showed that age [odds ratio (OR), 1.734; P = 0.01], successful catheterization time (OR, 1.667; P = 0.005), activity status (strict bed rest) (OR, 3.049; P = 0.005), and D-dimer level (≥ 500 ng/mL) (OR, 5.532; P < 0.001) were independent risk factors for DVT. We then established a scoring system for risk factors. In the validation group, a total of 213 patients with liver failure were treated with ALSS, including 14 with lower limb DVT. When the cutoff value of risk assessment was 3, the specificity and sensitivity of the risk assessment score were 88.9% and 85.7%, respectively. CONCLUSION: A simple risk assessment scoring system was established for DVT patients with liver failure treated with ALSS and was verified to have good sensitivity and specificity.

China's online parrot trade: Generation length and body mass determine sales volume via price.

The wildlife trade threatens global biodiversity and animal welfare, where parrots are among the taxa most frequently traded, supplying exotic pets and captive breeders worldwide. Using phylogenetic path analysis, we examine how biological factors interact with price to influence online protected parrot trade volumes in China, using transactions recorded for 46 species (n = 5862 individuals). Trade was greatest in smaller, faster breeding species that commanded a lower price. This price effect followed the economic law of demand, with Relatively Inelastic Demand (-0.758), outweighing indicators of 'quality' such as body coloration, and conservation status. We identify two areas of concern: those larger, slower-breeding, rarer species, even though sold at lower numbers, may be at conservation risk if harvested from the wild. In contrast, the sheer numbers (over 90% of the individuals were under median generation length, body mass and/or price) and ready availability of smaller and more common species comprises a substantial overall animal welfare issue, given that the capture, importation, or captive breeding of many parrot species in China is illegal and thus unregulated. Our investigation highlights the importance of properly understanding the internal relations among drivers of wildlife trade to inform appropriate management.

Geospatial, Clinical, and Social Determinants of Hospital Readmissions.

Unnecessary hospital readmissions increase patient burden, decrease health care quality and efficiency, and raise overall costs. This retrospective cohort study sought to identify high-risk patients who may serve as targets for interventions aiming at reducing hospital readmissions. The authors compared geospatial, social demographic, and clinical characteristics of patients with or without a 90-day readmission. Electronic health records of 42 330 adult patients admitted to 2 Midwestern hospitals during 2013 to 2016 were used, and logistic regression was performed to determine risk factors for readmission. The 90-day readmission percentage was 14.9%. Two main groups of patients with significantly higher odds of a 90-day readmission included those with severe conditions, particularly those with a short length of stay at incident admission, and patients with Medicare but younger than age 65. These findings expand knowledge of potential risk factors related to readmissions. Future interventions to reduce hospital readmissions may focus on the aforementioned high-risk patient groups.

Efficacy and Safety of Tapentadol Immediate Release Assessment in Treatment of Moderate to Severe Pain: A Systematic Review and Meta-Analysis.

Objective: To assess the efficacy and safety of tapentadol IR for moderate to severe pain compared to oxycodone IR. Methods: A search was carried out up to July 2015 for randomized controlled trials (RCTs) of tapentadol IR compared to placebo or oxycodone HCL IR 10 mg for moderate to severe pain. Studies were pooled by risk ratio (RR) and weighted mean differences (WMD) with 95% confidence interval (CI). Results: Nine RCTs (n = 3,961) were analyzed. In this meta-analysis, tapentadol IR (50-, 75-, and 100-mg doses) showed significant improvements in moderate to severe pain relief on the sum of pain intensity difference over 48 hours (SPID 48 ) scores ( P < 0.00001 or P = 0.01). No statistically significant difference among all three doses of tapentadol IR and oxycodone HCL IR 10 mg on both SPID 48 and total pain relief over 48 hours (TOTPAR 48 ) scores (all P > 0.05) was found. Compared with tapentadol IR 50 mg, tapentadol IR 75 mg demonstrated significant improvement in moderate to severe pain relief based on both SPID 48 and TOTPAR 48 scores (all P < 0.05). For total adverse events (AEs) incidence, tapentadol IR 50 and 75 mg were significantly lower than oxycodone HCL IR 10 mg. Incidence of nausea and constipation were significantly lower with either tapentadol IR 50 or 75 mg compared with oxycodone HCL IR 10 mg (all P < 0.05). Conclusions: Tapentadol IR 75 mg might be an optimal dose for moderate to severe pain control with fewer side effects. All three doses of tapentadol IR could provide comparable efficacy to oxycodone HCL IR 10 mg.

Assessment of anti-fouling strategies for membrane coupled with upflow anaerobic sludge blanket (MUASB) process.

In this novel process, domestic wastewater was filtered by a hollow-fibre membrane coupled with an upflow anaerobic sludge blanket (MUASB) bioreactor. To improve the process sustainability and decrease energy costs, the membranes were operated under low fluxes with little, or no, shear. The efficiency of anti-fouling strategies, including relaxation, backwashing and supply of low aeration and stir rates, was assessed through detailed characterization of the fouling layers. Results indicated that backwashing was more efficient than relaxation, even when the systems were operated under the same flux productivity. In terms of shear supply, stir provided a better fouling limitation strategy compared to aeration, at similar shear stress values. Physical and chemical cleaning methods were applied to recover three fouling fractions (i.e. cake, residual and irreversible) for better characterization of the fouling layers. Under the sustainable operating conditions used in this study, most of the fouling was easily reversible by simple rinsing. In addition, permanent and irreversible fouling, resulting in the need for frequent chemical cleanings and potential membrane degradation, is limited once small shear stresses are applied. These outcomes are expected to form the basis for the future assessment of trade-off between operation, maintenance and replacement costs of membrane filtration processes used in wastewater treatment.

Application of stochastic method to optimum design of energy-efficient induction motors with a target of LCC.

For an energy-efficient induction machine, the life-cycle cost (LCC) usually is the most important index to the consumer. With this target, the optimization design of a motor is a complex nonlinear problem with constraints. To solve the problem, the authors introduce a united random algorithm. At first, the problem is divided into two parts, the optimal rotor slots and the optimization of other dimensions. Before optimizing the rotor slots with genetic algorithm (GA), the second part is solved with TABU algorithm to simplify the problem. The numerical results showed that this method is better than the method using a traditional algorithm.