Incidence and risk factors of neonatal hypothermia: A systematic review and meta-analysis

AIM

Hypothermia poses a threat to the health and lives of newborns. Therefore, it is essential to identify the factors that influence neonatal hypothermia and provide targeted intervention suggestions for clinical practice to reduce its occurrence.

METHODS

We conducted a literature search to identify factors influencing neonatal hypothermia and performed a meta-analysis to determine the prevalence of neonatal hypothermia and its associated factors. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of cohort and case-control studies, while the Agency for Healthcare Research and Quality (AHRQ) was used to evaluate the quality of cross-sectional studies.

RESULTS

Eighteen studies involving 44 532 newborns from 13 countries were included. The incidence of neonatal hypothermia was 52.5% (95% CI: 0.37, 0.68). Factors such as no skin-to-skin contact, prematurity, low birth weight, delayed breastfeeding, asphyxiation and resuscitation after birth, low APGAR score, not wearing a cap, and caesarean section were found to affect neonatal hypothermia.

CONCLUSION

Multiple factors influence neonatal hypothermia, and clinicians can utilise these factors to develop targeted intervention measures to prevent and reduce the incidence of neonatal hypothermia.

A retrospective analysis of children with mild and asymptomatic Omicron infections under 14: A single-center study

Omicron BA.5 subvariant has been proven to be more transmissible than other Omicron subvariants. But the studies on the spread of the Omicron BA.5 subvariant in children are still limited. This study aimed to analyze the clinical features of children infected with Omicron BA.5.2 variant in the mobile cabin hospital and the influence factors of the infections. Children with mild and asymptomatic Omicron infections under 14 years old who were admitted to the mobile cabin hospital from October 30 to December 7, 2022 were retrospectively collected. A total of 741 children, 424 boys (57.2%) and 317 girls (42.8%) were enrolled, including 145 asymptomatic cases (22.7%) and 493 (77.3%) mild cases. Upper respiratory tract infection was the dominant manifestation. Fever was the most common presenting symptom (80.7%), followed by cough (52.5%). The average time to symptom disappearance was 3.76 days, and the average negative conversion time of nucleic acid was 12.3 days. Univariate analysis showed that the negative conversion time of nucleic acid differed significantly across the age groups. The multivariate analysis showed that the older the age, the longer the negative conversion time of nucleic acid. Among those with the negative conversion time of nucleic acid longer than 12 days, age was positively correlated to the negative conversion time of nucleic acid, while the number of vaccine doses received was negatively correlated to the negative conversion time of nucleic acid. Omicron infection occurred in children of any age group, with good prospect for recovery. Age and number of vaccine doses received were risk factors influencing the negative conversion time of nucleic acid.

Clinical Characteristics and Risk Factors Associated With Adverse Pregnancy Outcomes in Patients With Gestational Hypothyroidism: A Case-Control Study

OBJECTIVE

To synthesize evidence, summarize the clinical features of patients diagnosed with gestational hypothyroidism (GH), and analyze the risk factors associated with adverse pregnancy outcomes.

METHODS

From February 2021 to March 2023, a case-control study was conducted on 298 hospitalized patients with GH and 312 pregnant women without GH who underwent physical examinations. The 312 pregnant women without GH were randomly selected during the same time period. They were allocated into the study and control groups for further comparison of clinical characteristics and pregnancy outcomes.

RESULTS

The parameters, including age, gestational diabetes, gestational hypertension, gravidity, parity, spontaneous abortion, history of gestation, thyroid-stimulating hormone, free triiodothyronine, thyroid peroxidase antibody (TPO-Ab), and free thyroxine were significantly different between the 2 groups (P <.05). Moreover, significant differences were found between the 2 groups in terms of preterm delivery, preeclampsia, premature rupture of membranes, placental abruption, and postpartum hemorrhage (P <.05). The multivariate logistic regression analysis revealed that the influencing factors of pregnancy outcome in patients with GH were age (≥30 years), gestational diabetes, gestational hypertension, gravidity (≥3 times), spontaneous abortion, parity, history of gestation (multiparity), and TPO-Ab (positive).

CONCLUSION

Our study revealed that the clinical features of patients with GH were age, gestational diabetes, gestational hypertension, gravidity, parity, spontaneous abortion, history of gestation, thyroid-stimulating hormone, free triiodothyronine, TPO-Ab, and free thyroxine.

Overview of Health-Monitoring Technology for Long-Distance Transportation Pipeline and Progress in DAS Technology Application

There are various health issues associated with the different stages of long-distance pipeline transportation. These issues pose potential risks to environmental pollution, resource waste, and the safety of human life and property. It is essential to have real-time knowledge of the overall health status of pipelines throughout their entire lifecycle. This article investigates various health-monitoring technologies for long-distance pipelines, providing references for addressing potential safety issues that may arise during long-term transportation. This review summarizes the factors and characteristics that affect pipeline health from the perspective of pipeline structure health. It introduces the principles of major pipeline health-monitoring technologies and their respective advantages and disadvantages. The review also focuses on the application of Distributed Acoustic Sensing (DAS) technology, specifically time and space continuous monitoring technology, in the field of pipeline structure health monitoring. This paper discusses the process of commercialization development of DAS technology, the main research progress in the experimental field, and the open research issues. DAS technology has broad application prospects in the field of long-distance transportation pipeline health monitoring.

Characteristic of the components and the metabolism mechanism of goat colostrum: a review

Colostrum contains large number of nutrients that promote the growth, differentiation, and biological functions for goat kids early somatic cells, which is crucial to meet the nutritional demands, immune function, and the health of goat kids later growth. Great attention has been given not only to nutritional ingredient differences between colostrum and normal milk, but also to function differences, and their effect on the physical and sensory properties of goat kid's growth performance and health status. This paper reviews the research progress of goat colostrum in recent years, mainly including the colostrum yield, components, i.e., proteins, lactose, and immunoglobulin, as well as the influence factor, i.e., number of lactation and littler size, nutrition during the gestation, and breeding environment. In addition, this review aims to summarize the synthesis and secretion mechanisms, and the digestion and absorption mechanism of goat colostrum. We conclude that even though the composition and physicochemical properties of goat colostrum are highly dynamic and variable, and the digestion and absorption mechanism has not been made fully clear until now, direct feed microbial (DFM) may be a promising alternative for improving the quality of colostrum that should be further explored for their practical usage.

[Research Progress on Removing Antibiotic Resistance Genes in Constructed Wetlands]

Recently, the issue of environmental pollution and emerging antibiotic resistance genes (ARGs) has gradually gained attention. Antibiotic resistant bacteria (ARB) can be effectively reduced via the conventional water treatment processes. Although the ARB are completely inactivated during the disinfection process, the free ARGs can be incorporated into other microorganisms through transformation or transduction, allowing the ARGs to spread and propagate. Therefore, ARGs in wastewater must be handled by a specific process. It has been demonstrated in several studies that treatment using constructed wetland is an effective, economical, and environmentally friendly method of removing antibiotics and resistance genes from wastewater. Here, the research progress on the removal effect of constructed wetland water treatment systems on ARGs at home and abroad was reviewed. The results revealed that the removal efficiency of ARGs in subsurface flow constructed wetland was higher than that in surface flow-constructed wetlands. The composite-constructed wetland had significantly improved removal efficiency of ARGs compared to that in the ordinarily constructed wetland; however, the parameter setting of the composite process still requires further research. Several studies have reported that the removal efficiency of ARGs using constructed wetlands varies depending on the type of constructed wetland enhancement, plant, temperature, pH, and other factors. The results of the current study revealed that cross-mixing was the best way to combine plants, whereas the selection of plant species has not yet shown a clear dominant species. Temperature and pH affected the removal of ARGs by altering the microbial community in constructed wetlands. Although longer hydraulic residence time could increase the removal efficiency of ARGs, it also increased the enrichment risk of ARGs. The selection of constructed wetland substrate type should focus on fillers with a high specific surface area; the flow direction of the up-flow type was generally more efficient than the down-flow type in removing ARGs. In conclusion, the various factors (such as, the constructed wetland type, substrate type, hydraulic retention time, ambient temperature, and plant species) need to be integrated into the design of the constructed wetland system parameters to achieve the most effective treatment effect. The application of constructed wetlands in removing ARGs from the environment has broad prospects but also faces challenges.

Influence factors of the survival in colorectal cancer patients with second primary malignancy after surgery: A SEER database analysis

The survival rate is significantly reduced in patients with colorectal cancer (CRC) who developing a second primary malignancy (SPM), and however, little has known about the factors that contribute to the mortality of SPMs among CRC survivors. This study aims to explore the influence factors in both the all-cause and cancer-specific mortality of patients with SPMs after CRC surgery. Data of adult CRC patients with SPMs were extracted from the Surveillance, Epidemiology, and End Results (SEER) database in this retrospective cohort study. The associations between potential influence factors and all-cause mortality and cancer-specific mortality were explored using univariate and multivariate Cox proportional hazards analyses. The evaluation indexes were hazard ratios (HRs), and 95% confidence intervals (CIs). We also drew pie charts to respectively reflect the distributions of SPMs sites and time interval in study population. A total of 1202 (56.14%) patients died for all-cause, and 464 (21.67%) died due to CRC. The results showed that after adjusting for covariates, age, sex, marital status, T stage of CRC, second primary cancer site, stage of SPMs, grade of SPMs, TNM stage of SPMs, and time interval were associated with all-cause mortality, while marital status, stage of CRC, T stage of CRC, chemotherapy, second primary cancer site, stage of SPMs, grade of SPMs, TNM stage of SPMs, and time interval were associated with cancer-specific mortality in patients with CRC. In addition, colon (23.5%) was the most common site of SPMs, followed by digestive system (19.0%), and the time interval between CRC and SPMs in most patients was over 5 years (28.4%). Our findings may assist clinicians to identify high-risk patients for SPMs after CRC surgery. Also, the postoperative long-term follow-up and close attention on the key systems where the SPMs may occur are of great necessary in patients with CRC.

Clinical characteristics and influencing factors of hypoglycemia in hospitalized patients with type 2 diabetes mellitus: A cross-sectional study

AIM

Analysed clinical characteristics and influencing factors for hypoglycemia in hospitalized patients with type 2 diabetes mellitus (T2DM), and providing a scientific reference for precision nursing care of hypoglycemia in hospitalized patients with T2DM.

DESIGN

A cross-sectional study.

METHODS

This study involved 378 hospitalized patients diagnosed with T2DM who have suffered hypoglycemia. Through questionnaires and electronic medical records to obtain the data concerning the general information, clinical symptoms, all recorded blood glucose information, and the diabetes knowledge and self-management level of the patients. The clinical characteristics and influencing factors for hypoglycemia were analysed on the basis of the classification of hypoglycemia published by the American Diabetes Association in 2020.

RESULTS

Among 378 patients, 207 patients (54.76%) were experiencing Grade 1 hypoglycemia and 171 patients (45.24%) were experiencing Grade 2 hypoglycemia. Hypoglycemia and Grade 2 hypoglycemia in patients with T2DM occurred predominantly within the first 3 days of hospitalization. Hypoglycemia occurred most frequently after breakfast (74 cases, 19.6%), of which Grade 1 hypoglycemia and Grade 2 hypoglycemia accounted for 50%, respectively. Multivariable logistic regression identified risk factors for Grade 2 hypoglycemia in hospitalized patients with type 2 diabetes: older age, longer duration of diabetes, low body weight, diabetic nephropathy stages 4-5, diabetic autonomic neuropathy, inadequate self-management ability and diabetes knowledge, and lower educational background.

CONCLUSIONS

Hypoglycemia in type 2 diabetes occurs in the first 3 days during the hospitalization and most often after breakfast during the full day. Identifying high-risk individuals and providing a scientific reference for precision nursing care of hypoglycemia in hospitalized patients with T2DM.

Analysis on the current situation of twin breastfeeding and its influencing factors

Studies have found that exclusive breastfeeding can not only promote the growth and development of infants, but also increase the emotional communication between mothers and infants, and reduce the incidence of maternal breast diseases. To analysis the current situation and influencing factors of breastfeeding twins. A total of 420 twin mothers delivered in our hospital from January 2019 to December 2022 were selected to investigate the situation of breastfeeding within 6 months after delivery. An electronic questionnaire was conducted, and clinical information were collected. Univariate analysis and multivariate logistic regression analysis were applied to analyze the factors influencing exclusive breastfeeding. The rate of exclusive breastfeeding was 21.90%; in the exclusive breastfeeding group, the age <35 years old, bachelor degree or above, rural areas, no nipple depression or flat, no breast distension, no postpartum depression, adequate breast milk, participation in health education during pregnancy, husband support for breastfeeding, no infant feeding difficulties, infant diarrhea, lactose intolerance and return to milk were 96.74%, 53.26%, 65.22%, 80.43%, 76.09%, 80.43%, 73.91%, 63.04%, 69.57%, 71.74%, 65.22%, 70.65%, and 66.30%, respectively. It was significantly higher than that in the non-exclusive breastfeeding group (P < .05). The score of Edinburgh Postpartum Depression Scale (EPDS) was (8.08 ± 1.03) in the exclusive breastfeeding group, which was significantly lower than that in the non-exclusive breastfeeding group (P < .001), while the score of Perceived Social Support Scale (PSSS) was (67.32 ± 9.92), which was significantly higher than that in the non-exclusive breastfeeding one(P < .001). Logistic regression analysis showed that age, education level, nipple depression or flat, breast tenderness, postpartum depression, breast milk volume, health education training during pregnancy, husband support for breastfeeding, PSSS score, infant diarrhea, lactose intolerance, and delectation were the influencing factors of exclusive breastfeeding (P < .001). Our findings suggest that various factors were associated with a low rate of exclusive breastfeeding in twin births, such as age, educational level, and social support. Corresponding measures should be formulated for intervention to promote exclusive breastfeeding.

Analysis of the detection rate and related factors of fatty liver disease in physical examination of healthy population in Chengdu district

BACKGROUND

In the present study, we analyzed the detection rate and related influencing factors of fatty liver in the health examination population in Chengdu area.

METHODS

The case-control study was performed to compare the gender, age (years), body mass index (BMI), smoking, drinking, abnormal lipid metabolism, hypertension, hyperglycemia, hyperuricemia Is there any statistically significant difference in the detection rate of diseases such as metabolic syndrome, and logistic regression analysis is conducted to analyze the comprehensive impact of each influencing factor on the prevention of fatty liver disease.

RESULTS

Among 14,426 survey subjects, a total of 6717 patients with fatty liver were detected, with a detection rate of 47.22%. There are significant differences in the incidence of fatty liver disease among different gender groups, with the incidence rate in males being significantly higher than that in females (P < .05); The incidence of fatty liver in elderly subjects was significantly higher than that in middle-aged and young subjects (P < .05); The prevalence rate of individuals with a BMI > 24 was significantly higher than that of individuals with a BMI < 24 (P < .05). The prevalence of fatty liver in the population with abnormal lipid metabolism, hypertension, hyperglycemia, hyperuricemia, metabolic syndrome and other diseases was significantly higher (P < .05); After stratified analysis by gender and age, the incidence of fatty liver in males was significantly higher than that in females in the 3 age groups < 60 years old (P < .05); In the age group ≥ 60 years old, the difference in the incidence of fatty liver disease between males and females was significantly reduced, and the difference was not statistically significant (P > .05).

CONCLUSION

The health screening of patients with fatty liver should be carried out regularly, and attention should be paid to the intervention and prevention of overweight people and people with basal metabolism diseases such as hyperglycemia and hypertension, so as to reduce the incidence of fatty liver.

Stress and influencing factors of public health and preventive medicine students in the post-pandemic period: a cross-sectional study in Changsha, China

Objectives

Little is known about the stress levels and associated factors of public health and preventive medicine students in the post-pandemic period. This study aims to investigate the stress levels of these students in the post-COVID-19 era and to determine the association of personal background, employment attitude, and psychological state with stress.

Methods

A cross-sectional survey was conducted in March 2023 among 620 public health and preventive medicine students from two universities in Changsha, China. The survey included demographic characteristics, employment attitudes, perceived stress scale 10, general anxiety disorder 7, the University of California at Los Angeles loneliness scale 20, and the PTSD checklist-civilian version. Two-sided t-tests and ANOVA tests were used to compare the differences in PSS scores among variables, and multiple hierarchical regression analysis was used to evaluate the associated factors with stress.

Results

The survey was completed by 504 students (mean age: 21.5 ± 2.6 years, 69.2% female). 24.8% of the students were screened for a high level of stress. 69.0% thought the epidemic positively impacted employment while 18.5% believed it had a negative impact. The results of regression analysis showed that older age (B = 0.42, p = 0.001), higher grade (B 1 = 3.59, p < 0.001, B 2 = 4.57, p < 0.001), having internship experiences (B = 1.16, p = 0.006), having anti-epidemic experiences (B = 1.77, p < 0.001), believing that COVID-19 has a negative impact on employment (B = 2.56, p < 0.001), and having higher GAD scores (B = 0.64, p < 0.001) and UCLA scores (B = 0.07, p = 0.002) were significantly associated with high-stress levels. Conversely, being female (B = -1.64, p < 0.001) and believing that the pandemic had a positive impact on employment (B = -1.98, p = 0.001) were associated with low-stress levels.

Conclusion

Public health and preventive medicine students in Changsha, China, experienced a high-stress level in the post-pandemic period, which was influenced by age, gender, grade, employment attitude, internship experience, anxiety, and loneliness. As one of the main guardians of the epidemic, these students should be given more attention and psychological interventions in the future.

[Study on Influencing Factors of Artificial Hip Joint Test Quality Based on ISO/IEC 17025 and GLP]

OBJECTIVE

Taking artificial hip joint test as the object, integrating ISO/IEC 17025 and GLP, and establishing a new set of management requirements for test influence factors.

METHODS

The requirements of ISO/IEC 17025 and GLP regulations for influencing factors were compared and analyzed, the similarities and differences were found, and the two were integrated to formulate new management requirements for each influencing factor.

RESULTS

From the personnel, equipment, materials, methods, reports, filing and other factors, a set of management requirements in line with ISO/IEC 17025 and GLP was formulated, so that the laboratory can provide the objective, real and accurate test data for medical equipment manufacturers and regulatory authorities.

CONCLUSIONS

It can improve the test quality of the laboratory and ensure the authenticity and reliability of the test data and conclusions.

Mechanism of community quitters' psychological traits on their smoking cessation effects: Based on a study of community intervention

INTRODUCTION

We study the relationship between psychological traits of smokers and their smoking cessation effects, and provide more scientific evidence for smoking cessation intervention.

METHODS

The study was conducted as a nested case-control study. Smokers who participated in the community smoking cessation intervention projects in Beijing in 2018-2020, were selected as the research participants and divided into two groups: a successful smoking cessation and unsuccessful smoking cessation group, according to their smoking cessation effects at 6 months. Psychological traits of quitters including smoking abstinence self-efficacy, willingness to quit smoking, and trait coping style, were compared between the two groups, and a structural equation model was established for confirmatory factor analysis to analyze their mechanisms.

RESULTS

There were differences in smoking cessation results between the successful smoking cessation group and the unsuccessful smoking cessation group in terms of smoking abstinence self-efficacy and willingness to quit smoking. Willingness to quit smoking (OR=1.06; 95% CI: 1.008-1.118) is a risk factor, while smoking abstinence self-efficacy in habit/addiction situations (OR=0.77; 95% CI: 0.657-0.912) is a protective factor. The results of the structural equation model showed that smoking abstinence self-efficacy (β=0.199, p=0.002) and trait coping style (β= -0.166, p=0.042) could influence smoking cessation effects. The structural equation model was well fitted, which showed that smoking abstinence self-efficacy (β=0.199, p=0.002) and trait coping style (β= -0.166, p=0.042) might have influenced the effect of smoking cessation among smokers.

CONCLUSIONS

Willingness to quit smoking has a positive impact on the smoking cessation effect, while smoking abstinence self-efficacy in habit/addiction situations and negative trait coping style have a negative impact. Smoking abstinence self-efficacy and trait coping styles can significantly affect smoking cessation outcomes.

Fecal microbiota transplantation for irritable bowel syndrome: a systematic review and meta-analysis of randomized controlled trials

Objective

Whether fecal microbiota transplantation (FMT) in patients with irritable bowel syndrome (IBS) is effective in improving outcomes remains controversial. We assessed the safety and efficacy of FMT for patients with IBS.

Methods

In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, the Cochrane Library, the clinicaltrials.gov and International Clinical Trials Registry Platform (ICTRP) up to February 25, 2022, updated to March 28, 2023. Randomized controlled trials (RCTs) compared the stool and capsule FMT with placebo in patients with IBS were included. Two authors independently assessed study eligibility, extracted the data, and assessed risk of bias. We did meta-analysis with RevMan, and the Stata software was used for sensitivity analysis and meta-regression. The GRADE system was used to assess the quality of evidences. Mean difference (MD) or standardized Mean difference (SMD) with 95% CI for continuous data, and risk ratios (RR) with 95% CI for dichotomous data were used with random-effects models. The primary outcomes included the clinical response rate and IBS-SSS score. This study is registered with PROSPERO: CRD42022328377.

Results

Nineteen reports from nine RCTs were included finally. Compared with the placebo, a single stool FMT could significantly decrease the IBS-SSS score at 1 month (MD=-65.75, 95%CI [-129.37, -2.13]), 3 months (MD=-102.11, 95% CI [-141.98, -62.24]), 6 months (MD=-84.38, 95%CI [-158.79, -9.97]), 24 months (MD=-110.41, 95%CI [-145.37, -75.46]), and 36 months (MD=-104.71, 95%CI [-137.78, -71.64]). It also could improve the clinical response rate at 3 months (RR=1.91, 95% [1.12, 3.25]), 24 months (RR=2.97, 95% [1.94, 4.54]), and 36 months (RR=2.48, 95% [1.65, 3.72]), and increase the IBS-QoL score at 3 months, 24 months, and 36 months. FMT did not increase the serious adverse event. The risk of bias was low, and the quality of evidence based on GRADE system was moderate in the stool FMT group. However, we did not find positive effect of capsule FMT on patients with IBS based on the current available data.

Conclusion

A single stool FMT is effective and safe for patients with IBS. However, some factors may affect the effectiveness of FMT, and the relationship between the gut microbiome and the effect of FMT for IBS is still unclear.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42022328377.

Endocrine characteristics and risk factors of type 2 diabetes complicated with gastrointestinal autonomic neuropathy: A single-center retrospective study

To analyze endocrine characteristics and risk factors of type 2 diabetes mellitus (T2DM) gastrointestinal autonomic neuropathy. A total of 202 patients with T2DM with obesity who were hospitalized at our institute between January 2019 and June 2021 were selected. Based on adrenocorticotropic hormone (ACTH) levels, 102 patients were placed in the ACTH abnormal group and 100 patients were placed in the non-ACTH abnormal group. Ninety-five healthy adults without diabetes, hyperlipidemia, osteoporosis, or endocrine system abnormalities who were examined at our hospital during the same period were selected as the control group. Fasting plasma glucose (FPG), fasting insulin (FINS), triglycerides (TG), total cholesterol (TC), homeostasis model assessment of insulin resistance (HOMA-IR), ACTH level, body mass index (BMI), and bone mineral density (BMD) were measured to evaluate endocrine characteristics and risk factors. BMI, FPG, FINS, HOMA-IR, TG, TC, and ACTH levels in the abnormal ACTH group were significantly higher than those in the other 2 groups, while BMD was significantly lower than that in the other 2 groups (all P < .05). BMI, FPG, FINS, HOMA-IR, TG, TC, and ACTH in the non-ACTH abnormal group were significantly higher than those in the control group, whereas BMD was significantly lower than that in the control group (all P < .05). The plasma ACTH level in patients with abnormal ACTH levels was significantly positively correlated with BMI, FPG, FINS, HOMA-IR, TG, and TC and negatively correlated with BMD (all P < .05). Multivariate regression analysis showed that BMI, advanced age, FINS, TG, and FPG were risk factors for ACTH abnormalities in patients with diabetes (odds ratio > 1, all P < .05). BMI, advanced age, FINS, TG and FPG are the risk factors of abnormal ACTH in T2DM patients with gastrointestinal autonomic neuropathy.

[Influencing Factors of Cadmium Content in Wheat Grain: A Meta-analysis and Decision Tree Analysis]

Rapid urbanization, industrialization, and agricultural intensification have resulted in serious soil problems, such as soil acidification and cadmium pollution, affecting food security and human health. Wheat is the second largest food crop in China and has a strong accumulation capacity for cadmium. Understanding the influencing factors of cadmium content in wheat grain is crucial to realize the safe production of wheat. However, a comprehensive and quantitative analysis of how soil physicochemical properties and cultivars affect wheat cadmium accumulation is lacking. The Meta-analysis and decision tree analysis of 56 related studies published in the past 10 years showed that the proportion of cadmium content in soil and wheat grain exceeding the national standard was 52.6% and 64.1%, respectively. Among soil physical and chemical properties, pH, organic matter, available phosphorus, and total soil cadmium content were the important factors affecting the cadmium content in wheat grains. When soil pH ≤ 5.5 and 5.5<pH ≤ 6.5, the proportion of cadmium content in wheat grain exceeding the national standard was 99.4% and 76.2%, respectively. When 20 g·kg^-1<soil organic matter content ≤ 30 g·kg^-1, the proportion of cadmium content in wheat grain exceeding the national standard was the highest (61.0%). Soil pH ≥ 7.1 and total cadmium content <1.60 mg·kg^-1 was suitable for wheat safety production. There were significant differences in grain cadmium content and cadmium enrichment factors among different wheat cultivars. Planting wheat cultivars with low cadmium accumulation is an economical and effective measure to decrease cadmium content in wheat grains. The current study can provide guidance for the safe production of wheat in cadmium-contaminated farmland.

Dynamic Changes and Influencing Factors of Vegetation in the "Green Heart" Zone of the Chang-Zhu-Tan Urban Agglomeration during the Past 21 Years

As a policy, protected green space in the rapidly developing the Chang-Zhu-Tan Urban Agglomeration is of great practical significance to study the vegetation changes and influencing factors in the Green Heart area. In this paper, data processing, grading and area statistics were carried out for the maximum value of normalized differential vegetation index (NDVI) from 2000 to 2020. Combined with Theil-Sen median trend analysis and Mann-Kendall, the change trend of long-time series NDVI was studied, and investigation of NDVI influencing factors, processes and mechanisms using geographical detectors. The results showed that: (1) The spatial distribution characteristics of NDVI in the study area were high in the middle and inlaid transition between adjacent grades. Except for the low grades, the distribution of NDVI in other grades was relatively scattered, and the overall trend of NDVI change was rising. (2) Population density was the main factor affecting NDVI changes, with an explanatory power of up to 40%, followed by elevation, precipitation and minimum temperature. (3) The influence of influencing factors on the change of NDVI was not the result of independent action of a single factor, but the result of the interaction between human factors and natural factors, and the factor combinations with greater interaction had significant differences in the spatial distribution of NDVI.

[Primary Factors Affecting Soil Bioavailable Cadmium and Asenic by Different Properties of Silicon Fertilizer]

To clarify the primary factors affecting soil bioavailable cadmium (Cd) and arsenic (As) by silicon fertilizer, we chose different properties of silicon fertilizer, including three types of alkaline silicon fertilizer[Na₂SiO₃, CaSiO₃, and ASSF (pH 9-11)] and one weak acid neutral soluble silicon fertilizer (NSSF, pH 5-6), to carry out a pot experiment by adding different amounts of Si fertilizer (25-800 mg·kg^-1, calculated as Si). After 21 days of flooding, soil basic physical and chemical properties, along with diffusive gradients in thin film Cd and As (DGT-Cd and DGT-As) were investigated. The results showed that the application of Si fertilizer with different properties had different significant effects on the basic physical and chemical properties of soil. Specifically, the three types of alkaline silicon fertilizer significantly increased the soil pH (P<0.05), among which Na₂SiO₃ exhibited the strongest ability; however, the application of NSSF remarkably reduced soil pH (P<0.05), and per unit (mg) Si application of NSSF could reduce soil pH by 0.0017 units. Furthermore, with each fertilizer application rate that reached 400 mg·kg^-1 (calculated as Si), the changes in soil pH and Eh tended to be gentle. The ability of the four types of silicon fertilizer to improve soil available silicon ranked as NSSF>Na₂SiO₃>ASSF>CaSiO₃. Additionally, the application of the three types of alkaline silicon fertilizer apparently decreased soil DGT-Cd while increasing soil DGT-As (P<0.05). When the addition rate of CaSiO₃ was up to 100 mg·kg^-1(calculated as Si), soil DGT-Cd concentration could be significantly decreased by approximately 50.89% without causing a significant increase in soil DGT-As concentration. Conversely, when the NSSF application rate was up to 400 mg·kg^-1 (calculated as Si), the soil DGT-As basically reached its steady-state, and the DGT-As reduction rate reached 85.87%. Strikingly, the correlation analysis of the influencing factors of soil DGT-Cd and DGT-As showed that soil pH was the main factor affecting soil bioavailable Cd and As (DGT-Cd and DGT-As), and the effect of soil available Si and P on soil Cd and As bioavailability was negligible. Consequently, soil DGT-Cd and soil DGT-As could reach a minimum when soil pH was adjusted to 6.5-7.0 or 5-5.5 by alkaline silicon fertilizer or NSSF, respectively. It is undoubtedly of great significance, to clarify the primary factors that influence soil bioavailable Cd and As to ensure food security production.

Patient satisfaction after total hip arthroplasty: Influencing factors

It is reported that the dissatisfaction rate after primary total hip arthroplasty (THA) is between 7% and 20%. Patient satisfaction has already become a public health problem that puzzles the world, and it is a problem to be solved that cannot be ignored in the development of global public health. The purpose of this paper is to conduct a narrative review of the literature to answer the following questions: what are the main factors leading to high patient satisfaction or dissatisfaction after THA? The literature on patient satisfaction after THA was reviewed. As far as we know, there is no such detailed and timely overview of THA satisfaction as this article, and the purpose articles we use search engines to search are all RCT (Randomized Controlled Trial) type works, excluding cross-sectional studies and other experiments with low evidence level. Hence, the quality of this article is high. The search engines used are MEDLINE (PubMed) and EMBASE. The keywords used are "THA" and "satisfaction." The main preoperative, perioperative, and postoperative factors that affect patient satisfaction are summarized in detail below.

Predicting Older Adults' Mobile Payment Adoption: An Extended TAM Model

This study adopted an advanced model, combining the technology acceptance model, the theory of reasoned action, the diffusion of innovations, trust, and five aspects of perceived risk, to measure the factors that influence the behavioral intentions of older adults to use mobile payments. A total of 365 questionnaires were collected from older adults aged 55 years or older from 20 community care sites in central Taiwan. Partial least-squares structural equation modeling was used to test our research model. The results showed that attitude was the main determinant of M-payment in older adults. Moreover, increasing the usefulness, ease of use, and observability of M-payment helped older adults improve their attitudes toward M-payment, thereby increasing their intention to use it. Trust had a significant effect on the usefulness and ease of use of M-payment, while the main factors affecting trust were only performance and financial risks.

Factors influencing the financing behavior of large professional households engaged in green agricultural production in China

Green agriculture is the direction of sustainable development of China's modern agriculture and the inherent requirement of taking the road of characteristic new agricultural modernization. As one of the main bodies of new agricultural management, professional large households are of great significance to lead the development of efficient agriculture and accelerate the development of green agricultural economy in Heilongjiang. Therefore, based on the theory of planned behavior, this article includes 275 major professional households in Heilongjiang Province as a sample of demonstration counties (cities) for green, high-quality, and efficient creation, combined with field research data and structural equation model, and discusses the willingness of large professional households to participate in green agricultural production financing and behavioral factors and mechanisms of action. The perceived behavior control (PBC), attitude toward the behavior (AB), and subjective norms (SNs) of large professional households to engage in green agricultural production determine their financing intentions (FNs), which further determines their financing behavior (FB). The results show that PBC, AB, and SN have a significant positive impact on the FN of large professional households, and further indirectly affect the FB. It should be noted that SNs have the most significant impact on the FN of large professional households to participate in green agricultural production. Therefore, it is necessary to establish effective government propaganda measures and preferential policies, improve the awareness of the importance of green agricultural production financing, and create a good social atmosphere for agricultural sustainable development and active participation in financing. The purpose of this study is to provide a reference for policymakers to formulate relevant policies to cultivate major professional households and develop green agricultural economy in Heilongjiang Province.

Reducing the Impact of Influence Factors on the Measurement Results from Single-Coil Eddy Current Sensors

Single-coil eddy current sensors (SCECS) form a separate and independent branch among the existing eddy current probes. Such sensors are often used for aviation and aerospace applications where the conditions accompanying the measuring process are harsh and even extreme. High temperatures (up to +600 °C in the compressor and over +1000 °C in the turbine of gas turbine engines), the complex shape surfaces of the monitored parts, the multidimensional movement of the power plants' structural elements, restrictions on the probes number and their placement in the measuring zone are the main factors affecting the reliability and accuracy of the measurement results obtained by the sensors. The article provides an overview of the relevant approaches and methods for reducing the impact of influence factors on the measurement results from SCECS based on the extensive experience of more than 30 years of research and development being carried out in the Institute for the Control of Complex Systems of Russian Academy of Sciences. The scope of the solutions discussed in the article is not limited to SCECS measurement systems only but can also be extended to the systems with primary transducers of other designs or other physical principles.

Study on the Spatiotemporal Evolution and Influencing Factors of Agricultural Carbon Emissions in the Counties of Zhejiang Province

The accurate measurement of agricultural carbon emissions and the analysis of the key influential factors and spatial effects are the premise of the rational formulation of agricultural emission reduction policies and the promotion of the regional coordinated governance of reductions in agricultural carbon emissions. In this paper, a spatial autocorrelation model and spatial Dubin model are used to explore the spatiotemporal characteristics, influential factors and spatial effects of agricultural carbon emissions (ACEs). The results show that (1) From 2014 to 2019, the overall carbon emissions of Zhejiang Province showed a downward trend, while the agricultural carbon emission density showed an upward trend. ACEs are mainly caused by rice planting and land management, accounting for 59.08% and 26.17% of the total agricultural carbon emissions, respectively. (2) The ACEs in Zhejiang Province have an obvious spatial autocorrelation. The spatial clustering characteristics of the ACEs are enhanced, and the "H-H" cluster is mainly concentrated in the northeast of Zhejiang, while the "L-L" cluster is concentrated in the southwest. (3) The results of the Dubin model analysis across the whole sample area show that the ACEs exhibit a significant spatial spillover effect. The disposable income per capita in the rural areas of the county significantly promotes the increase in the ACEs in the neighboring counties, and the adjustment of the industrial structure of the county has a positive effect on the agricultural carbon emission reductions in neighboring counties. (4) The grouping results show that there is heterogeneity between 26 counties in the mountainous areas and non-mountainous areas. In the 26 mountainous counties, the urbanization rate, rural population, mechanization level and industrial structure have significant negative spatial spillover effects on the carbon emissions. In the non-mountainous counties, the agricultural economic development level and disposable income per capita of the rural residents have significant spatial spillover effects on the agricultural carbon emissions. These research results can provide a theoretical basis for the promotion of the development of low-carbon agriculture in Zhejiang according to the region and category.

Numerical Analysis of Factors Influencing the Ground Surface Settlement above a Cavity

In this study, ground stability was evaluated through vertical displacement distribution and surface settlement results. In particular, a finite element analysis was conducted considering various factors (namely, cavity type and area, traffic load, pavement thickness, and elastic modulus) that affect a road above a cavity. The aim of this study was to evaluate the effect of pavement layer and traffic load condition on surface settlement according to the cavity shape. Field measurement results were analyzed and compared with the results of previous studies to verify the reliability of the numerical analysis method applied herein. After performing the numerical analysis using the verified method, ground stability was evaluated by analyzing the underground mechanical behavior of a road above a cavity. To this end, the correlations among the vertical displacement distribution, surface settlement, and influencing factors obtained from the analysis results were analyzed. In the numerical analysis, the ground was simulated with a hardening soil model based on the elastoplastic theory. This mechanical soil model can accurately reproduce the behavior of actual ground and can closely represent the mechanical behavior of the soil surrounding a cavity according to the cavity generation. In addition, the elapsed time was not considered when applying a load on the pavement layer, and a uniformly distributed load was applied. Consequently, it was found that, with increasing cavity area and traffic load and decreasing pavement thickness and elastic modulus, the vertical displacement and maximum surface settlement above the cavity increased, and the reduction in ground stability was greater. Furthermore, the reduction in ground stability was greater when the cavity was rectangular than when it was circular.

[Cross-cultural adaptation and clinical application of Meniere's disease outcomes questionnaire]

Objective:To cross-culturally adapt the Meniere's Disease Outcomes Questionnaire（MDOQ） into Chinese language, to evaluate its reliability and validity, and to apply in clinical. Methods:The MDOQ was translated according to the Brislin model. Cross-cultural adaption was done by expert discussion and pilot study. The MDOQ was applied to 101 patients to test its reliability and validity. The quality of life（QOL） of 272 patients was measured by MDOQ-C, analyzing the influence factors of QOL of patients with Meniere's disease. Results:The CR value of each item of MDOQ-C exceeded 3.00, the Cronbach's α coefficient was 0.88, and the Spearman Brown coefficient was 0.90. The Pearson correlation coefficient of MDOQ-C and the DHI was 0.803（P<0.01）. Three factors were extracted by factor analysis, which could explain 60.503% of the total variance. The dimension composition was different from the original scale. The average QOL score of Meniere's disease patients was 52.94±13.87. The main influence factors were age, marital status, work status, with tinnitus and the number of vertigo attacks. Conclusion:The MDOQ-C is reliable and valid. After dimension reconstruction, MDOQ-C can be used to evaluate the QOL of patients with Meniere's disease. Through the preliminary clinical application, the influence factors of quality of life of patients with Meniere's disease were identified, thus providing reference for optimizing clinical management strategies.

Male nurses' work performance: A cross sectional study

BACKGROUND

Nursing performance is closely related to the success of hospital and patient outcome. Recently, the proportion of male nurses has gradually increased. However, we do not know how these male nurses perform in clinical work. The purpose of this study was to understand the job performance of male nurses in China and to identify their risk factors.

METHODS

This is a cross-sectional study. We contacted all the 30 public tertiary hospitals in Hunan Province and 26 of them cooperated. All the 647 male nurses in these hospitals were given questionnaires face-to-face between April 7 and August 8, 2020. The questionnaire included demographic information and the Schwirian's Six Dimension Scale. We also collected the family attitude and the main reason for choosing nursing. We then performed descriptive analyses and liner regressions on the collected data.

RESULTS

We obtained valid questionnaires from 599 individuals. The median age of these male nurses was 26 years old and the nursing age was 4 years. They were mainly distributed in intensive care unit (ICU) (36.12%), operating room (27.42%), and emergency department (23.08%). And the means of the total scores for work performance was 176.42 (standard deviation (SD) = 20.62). The result of the regression shows that length of service, relationship status, educational level, department, main reason for choosing nursing, and family attitude are all risk factors of male nurses' work performance.

CONCLUSION

Chinese male nurses are younger and have shorter working years. They mainly work in departments with higher work intensity and greater pressure. In addition, we found that years of service, education, marital status, department and main reasons for choosing nursing as factors influencing the job performance of male nurses.

Prediction of Higher Ki-67 Index in Pituitary Adenomas by Pre- and Intra-Operative Clinical Characteristics

Objective: The Ki-67 index is an indicator of the active proliferation and aggressive behavior of pituitary adenomas (PAs). Appropriate pre- and intra-operatives of the Ki-67 index can help surgeons develop better and more personalized treatment strategies for patients with PAs. This study aimed to investigate the influence factors for predicting the Ki-67 index in PAs. Methods: Data of 178 patients with PAs confirmed by pathology were retrospectively analyzed. According to the Ki-67 index, the patients were divided into the Ki-67 < 3% and Ki-67 ≥ 3% cohorts. Patient data, including age, sex, postoperative immunohistochemical pituitary hormone positive index, Knosp grade, tumor breaking through the sellar floor, rich blood supply to the tumor, tumor located inside the sella, erosion of the dorsum sellae bone, and pituitary-specific transcription factor, were collected. A univariate logistic analysis was used to evaluate the influence factors for a high Ki-67 index. Multiple regression and receiver operating characteristic (ROC) curve were used to analyze the factors with p < 0.05. The mutant status of Ki-67 index was predicted by nomogram. Results: Multivariate regression analysis showed that rich blood supply to the tumor and erosion of the dorsum sellae bone were independent risk factors for the Ki-67 proliferation index. The ROC curves demonstrated that age, rich blood supply to the tumor, and erosion of the dorsum sellae bone can predict the occurrence of a high Ki-67 index. Together, the three risk factors provide a stronger ability to predict the Ki-67 index. The nomogram was developed and validated. Conclusion: Age, rich blood supply to the tumor, and erosion of the dorsum sellae bone are influencing factors for predicting the Ki-67 index. Suitable nomogram prediction models were developed and validated, and there is potential for personalized treatment for PA patients.

Mixed Land Use Levels in Rural Settlements and Their Influencing Factors: A Case Study of Pingba Village in Chongqing, China

Mixed land use provides an important means of promoting the intensive and efficient use of land resources and stimulating endogenous development power in rural areas. This paper selected Pingba Village in Chongqing as the research area; the land use status data and the social and economic data on rural settlements in the study area for 2021 were obtained through field visits and interviews. Moreover, the land use types in the rural settlements were subdivided according to the principle of dominant function. Based on these subdivisions, a land mixed-use measurement system for rural settlements was constructed to analyze their levels of mixed land use. Furthermore, the influences of natural environmental, social, economic and other factors on mixed land use were comprehensively explored. The results showed that, (1) the mixed land use of rural settlements in the study area was at a medium level and showed significant spatial variability, and rural settlements in the high, medium and low mixed land use index zones accounted for 12.5%, 35% and 52.5% of the total, respectively. (2) The differences in the natural environment determined the level of mixed land use and the basic pattern of its spatial differentiation. Social and economic factors, such as resident population and average household income, were key impact factors. Rural tourism resources, homestead agglomeration policies and other factors had important impacts on the level of mixed land use. In conclusion, the research suggests that mixed land use is an important way to boost rural revitalization. In the future, village planning could introduce the concept of mixed land use to improve the efficiency of land use, optimize the land use structure according to local conditions and promote the integrated development of rural primary, secondary and tertiary industries. In addition, it is necessary to scientifically and rationally guide rural settlements to agglomerate appropriately to improve the utilization efficiency of land resources and public service resources.

Farmers' Willingness to Gather Homesteads and the Influencing Factors-An Empirical Study of Different Geomorphic Areas in Chongqing

Research purpose: to analyze farmers’ willingness to gather homestead and its influencing factors, so as to provide decision-making basis for the rational layout of rural homestead. Methods: questionnaire, logistic model. The results are as follows. (1) Farmers’ willingness to gather homesteads is highest in dam areas, followed by hilly areas, and is lowest in mountainous areas. (2) The respondents’ age, family support ratio, housing structure, whether the access road is paved, and the distance from the main road have significant negative impacts on farmers’ willingness to gather homesteads, while homesteads being idle, the service life of the house, the type of daily energy use, and whether they are far from relatives after relocation have significant positive impacts on farmers’ willingness to gather homesteads. (3) The main influencing factors of farmers’ homestead agglomeration in dam areas are the idle situation of a homestead, housing structure, the service life of the house, and whether they are satisfied with their current homestead residence. (4) The main influencing factors of farmers’ homestead agglomeration in hilly areas are the age of the respondents, the proportion of family workers, and whether they accept the relocation and are far from relatives. (5) The main influencing factors of farmers’ homestead agglomeration in mountainous areas are the age of the respondents, the ratio of family support, the housing structure, and whether the access road is paved. We conclude that there are significant differences in farmers’ willingness to gather homesteads and the influencing factors in different geomorphic areas. Policy makers should formulate differentiated homestead agglomeration optimization schemes and design the optimization paths of homestead agglomeration on the basis of geomorphic classification and subregion.

[Emission of Methane from a Key Lake in the Eastern Route of the South-to-North Water Transfer Project and the Corresponding Driving Factors]

Lakes play an important role in the biogeochemical cycling of dissolved organic matter (DOM) and the emission of methane (CH₄). We investigated the concentration and effluxes of CH₄ and then analyzed the corresponding driving factors in Lake Luoma, a key lake along the South-to-North Water Transfer Project. Our results indicated that Lake Luoma was a hotspot of CH₄ emissions with an annual mean concentration and efflux of (0.12±0.09) μmol·L^-1 and (21.0±18.5) mmol·(m²·d)^-1, respectively. We found higher mean CH₄ levels in the wet season than those in the dry season and further higher levels than those in the wet-to-dry transition season. Spatially, the CH₄ efflux was higher in the northwest inflowing regions and lower in the southeast outflow regions. The variability in annual CH₄ efflux was affected by a combination of water temperature and hydrological conditions. Terrestrial input of dissolved organic carbon (DOC) and chromophoric DOM (CDOM) had fueled the production of CH₄ by providing necessary carbon substrates, and four PARAFAC DOM components were identified including a microbial humic-like C1, a tryptophan-like C2, a terrestrial humic-like C3, and a tyrosine-like C4. The CH₄ efflux from the lake was significantly promoted by the input and accumulation of terrestrial humic-like components, and Chl-a had no correlation with CH₄ efflux, suggesting that algal degradation was not directly fueling the emission of CH₄. Lake Luoma had been significantly disturbed by human activities, and terrestrial input of nutrient loading (TN and TP) into the lake not only improved the productivity and trophic level of the water body but also enhanced the production and release of CH₄ from the surface water. We concluded that the CH₄ emissions in Lake Luoma can be influenced by the combination of environmental factors, CDOM composition, and nutrient level. Long-term observation is needed for better evaluation of the driving factors in fueling the emission of CH₄ so as to effectively reduce the emissions of CH₄ and other greenhouse gases by taking corresponding countermeasures.

Effective Remediation of Arsenic-Contaminated Soils by EK-PRB of Fe/Mn/C-LDH: Performance, Characteristics, and Mechanism

Arsenic is highly toxic and carcinogenic. The aim of the present work is to develop a good remediation technique for arsenic-contaminated soils. Here, a novel remediation technique by coupling electrokinetics (EK) with the permeable reactive barriers (PRB) of Fe/Mn/C-LDH composite was applied for the remediation of arsenic-contaminated soils. The influences of electric field strength, PRB position, moisture content and PRB filler type on the removal rate of arsenic from the contaminated soils were studied. The Fe/Mn/C-LDH filler synthesized by using bamboo as a template retained the porous characteristics of the original bamboo, and the mass percentage of Fe and Mn elements was 37.85%. The setting of PRB of Fe/Mn/C-LDH placed in the middle was a feasible option, with the maximum and average soil leaching toxicity removal rates of 95.71% and 88.03%, respectively. When the electric field strength was 2 V/cm, both the arsenic removal rate and economic aspects were optimal. The maximum and average soil leaching toxicity removal rates were similar to 98.40% and 84.49% of 3 V/cm, respectively. Besides, the soil moisture content had negligible effect on the removal of arsenic but slight effect on leaching toxicity. The best leaching toxicity removal rate was achieved when the soil moisture content was 35%, neither higher nor lower moisture content in the range of 25-45% was conducive to the improvement of leaching toxicity removal rate. The results showed that the EK-PRB technique could effectively remove arsenic from the contaminated soils. Characterizations of Fe/Mn/C-LDH indicated that the electrostatic adsorption, ion exchange, and surface functional group complexation were the primary ways to remove arsenic.

[Pollution Characteristics and Influencing Factors of PM2.5 in Shanxi Province Based on Wavelet Transform]

Based on the daily average concentration of PM_2.5, social influencing factor data, and meteorological data of 11 cities in Shanxi Province from 2015 to 2019, the concentration period of PM_2.5 was determined using wavelet transform. The correlation between PM_2.5 and social influencing factors and meteorological factors was explored respectively through Spearman correlation and the wavelet coherence spectrum, and the main influencing factors of long-term and short-term management and control of PM_2.5 were determined. The results showed that the concentration of PM_2.5 in Shanxi Province showed an upward trend from 2015 to 2017, with an average annual increase rate of 4.3% and a downward trend from 2018 to 2019, with an average annual decrease rate of 4.2%. The average concentration of PM_2.5 showed a "U" distribution, with the highest value in January (95 μg·m^-3) and the lowest in August (34 μg·m^-3); the average value in winter was approximately twice that in summer. The ρ(PM_2.5) in southern cities such as Linfen was 62 μg·m^-3, and the average value in Datong and other northern cities was 45 μg·m^-3, which was high in the south and low in the north. There were significant periodic changes in PM_2.5 concentration in the 11 cities, including a long period of approximately 293 d and a short period of approximately 27 d. Among them, the energy consumption level and industrial structure were the strong driving factors affecting the PM_2.5 concentration in the long period of Shanxi Province. In the short period, it was greatly affected by the change in atmospheric circulation, and different cities were affected by typical meteorological factors. Linfen, Yuncheng, Datong, Shuozhou, and Xinzhou were vulnerable to wind speed; Jinzhong and Luliang were vulnerable to temperature; and Taiyuan, Jincheng, Yangquan, and Changzhi were uniquely and significantly affected by relative humidity. Therefore, industrial structure adjustment and energy structure adjustment are key to the long-term control of atmospheric PM_2.5 and the long-term improvement of air quality in Shanxi Province. The differential impact of different urban meteorological factors on PM_2.5 should be considered when carrying out short-term regional joint prevention and control.

[Study on Influencing Factors of Environmental Testing Quality of Medical Device Manufacturers Clean Workshops]

OBJECTIVE

Improve the quality of testing in medical device manufacturers clean workshops to ensure the authenticity and reliability of testing data.

METHODS

Analyze the problems and influencing factors found in the process of testing of medical device manufacturers clean workshops from 2016 to 2020, and put forward reasonable suggestions to ensure the quality of testing.

RESULTS

In the process of testing, there are six factors that affect the quality of testing, including testing personnel, instruments and equipment, testing consumables, testing methods, testing environment and actual operation.

CONCLUSIONS

To improve the quality of testing, should strengthen the training of testing personnel, continuously improve the testing quality management system, establish an effective information communication mechanism, find out the influencing factors in time, provide objective, real and effective testing data for medical device manufacturing enterprises, and provide technical support for the production and supervision of medical devices.

Sleep Quality and Its Determinants Among Type 2 Diabetes Patients with Comorbid Metabolic Syndrome

PURPOSE

The prevalence of poor sleep quality in patients with diabetes was higher than the general population. This study aimed to explore risk factors for not only poor sleep quality, but also long sleep latency, short sleep duration and low sleep efficiency, in type 2 diabetes patients (T2DM) with comorbid metabolic syndrome (MS).

PATIENTS AND METHODS

A total of 281 patients aged 18-75 years were enrolled from Ningbo First Hospital during October 2021 to March 2022. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI). Sleep latency, sleep duration and sleep efficiency were obtained by a response to the questionnaire. Descriptive, independent two-sample t-test, Chi-square test and multiple logistic regression were conducted using SPSS Version 28.

RESULTS

The prevalence of poor sleep quality in T2DM with comorbid MS patients was 59.10%. The factors significantly associated with poor sleep quality were depression symptoms (OR = 3.10, 95% CI: 1.38 to 6.96, P = 0.006), poor quality of life (OR = 2.49, 95% CI: 1.24 to 4.99, P = 0.010), and age (OR = 1.07, 95% CI: 1.04 to 1.10, P < 0.001). The factor significantly associated with long sleep latency was depression symptoms (OR = 2.19, 95% CI: 1.15 to 4.16, P = 0.017). The factors significantly related to short sleep duration were depression symptoms (OR = 2.56, 95% CI: 1.31 to 5.00, P = 0.006) and age (OR = 1.05, 95% CI: 1.02 to 1.08, P = 0.002). The factor significantly related to short sleep efficiency was age (OR = 1.03, 95% CI: 1.01 to 1.06, P = 0.019).

CONCLUSION

This study found that depression symptoms, together with poor quality of life, and increasing age were associated with poor sleep quality. Symptoms of depression were related to long sleep latency and short sleep duration. The increasing age was associated with short sleep duration and low sleep efficiency.

A survey of mental health status of obstetric nurses during the novel coronavirus pneumonia pandemic

To investigate the mental health status of obstetric nurses and its influencing factors during the novel coronavirus epidemic period, so as to provide theoretical reference for hospital decision-makers and managers.From February 25 to March 20, 2020, we conducted a cross-sectional survey through online questionnaire, and selected obstetric nurses from Jilin and Heilongjiang Provinces as the research objects by convenience sampling.Three hundred eighteen valid questionnaires were collected; the results of Symptom Checklist 90 showed that the scores of "obsessive-compulsive", "depression", "anxiety", "hostility", "phobia", and "psychosis" were higher than the Chinese norm (P < .01). There were 107 people whose total score of Symptom Checklist 90 was more than 160, and 83 people whose number of positive items was more than 43. Logistic regression results showed that married, temporary employment, lack of support and communication from family and relatives, onerous task, and unbearable responsibility were independent risk factors for mental disorder.There is a great psychological burden for obstetric nurses during the epidemic period. Decision makers should focus on necessary psychological intervention for those that are married, temporarily employed, and those lacking family supports including communication. At the same time, managers should distribute tasks reasonably to avoid psychological burdens caused by overwork.

Analysis of Bacterial Biofilm Formation in Patients with Malignancy Undergoing Double J Stent Indwelling and Its Influencing Factors

Objective

To analyze the bacterial biofilm (BF) formation in patients with malignancy undergoing double J stent indwelling and its influencing factors.

Methods

A total of 167 patients with malignant tumors who received double J stent indwelling in the hospital from January 2018 to January 2021 were included in the study. The urine and double J stent samples were collected for bacterial identification and observed for BF formation on the surface of the urinary catheter under a scanning electron microscope (SEM). Univariate and multivariate logistic regression analyses were used to analyze the influencing factors of BF.

Results

The BF formation rate was 34.73% (58/167). The BF formation rate of positive specimens cultured in urine and double J stent was significantly higher than that of negative ones (P<0.05). Staphylococcus was the main BF bacteria in double J stent and urine culture specimens, followed by Enterococcus, Pseudomonas, Enterobacter, and Acinetobacter. Compared with the non-BF group, the number of viable bacteria in the double J stent and urine and the catheterization time in the BF group rose markedly (P<0.05). Advanced age, chemotherapy, anemia, indwelling time ≥90d, and urinary tract infection were risk factors for BF formation in patients with malignancy undergoing double J stent indwelling (P<0.05).

Conclusion

There is a high rate of BF formation in patients with malignancy undergoing double J stent indwelling, with Staphylococcus as the dominant species. Treatment requires enhanced urinary catheter management and nutritional status to inhibit BF formation and lower the rate of urinary catheter-related infections.

[Prevalence and risk factors for anemia of Chinese lactating women in 2013]

OBJECTIVE

To investigate the prevalence of anemia and its risk factors for lactating women in China.

METHODS

Data was extracted from Chinese National Nutrition and Health Surveillance-Mothers for children under 2 years of age(2013). Totally, 11 178 mothers of children under 2 years old were selected from 55 counties of 30 provinces in China by using the multi-stage stratified cluster randomization sampling method. Among these women 7129 are lactating. The basic information of lactating women was collected through the questionnaire survey. Hemoglobin concentration was measured by photometric determination of haemiglobincyanide(HiCN) method. Participants without blood sample and basic information were excluded. Finally, 6255 lactating women were included in the analysis. Complex sampling method with weighted analysis was used.

RESULTS

Totally, with a complex sampling method with weighted analysis, the prevalence of anemia for lactating women was 9.3%. The mean hemoglobin level was(136.1±0.9) g/L. The mild and moderate anemia accounted for 98.8% of all anemic cases. Compared with those lactating time&lt;6 months, lactating time between 6 to 12 months had a lower risk of anemia(OR=0.74, 95%CI 0.61-0.90). Compared with those living in large cities, the maternal living in poor rural areas had a higher risk of anemia(OR=1.69, 95%CI 1.29-2.20).

CONCLUSION

In 2013, the prevalence of anemia was mild for the lactating women in China. Lactating women in poor rural areas, within 6 months after deliveryhad the higher risk for anemia.

[Feeding patterns and influencing factors of infants under 0-6 months of age in rural areas of Nanchong City in 2019]

OBJECTIVE

To evaluate the feeding patterns of infants under 6 months of age in rural areas of Nanchong City, Sichuan Province, and to explore the driving factors of different feeding patterns.

METHODS

A total of 837 pairs of infants under 6 months of age(&lt;183 days of age) and their primary caregivers(450 male infants and 387 female infants, with an average age of(2.9±1.8) months, most of the primary caregivers were mothers(95.70%)) were selected by multi-stage random cluster sampling in Nanchong City in 2019.An electronic tablet equipped with a computer assisted system was used to input the face-to-face inquiry questionnaire to collect information, mainly including the sociodemographic characteristics of the subjects, infant feeding patterns, mothers&apos; feeding knowledge, mothers&apos; feeding attitudes, family support for breastfeeding, negative support from the surrounding population and other relevant information. Using disordered multi-classification Logistic regression, excluding non-maternal nursing samples, non-lactating mothers and mothers unable to breastfeed due to disease, 789 pairs of infants and their mothers were included in the regression model. After controlling the demographic characteristics of infants and their mothers, the independent influencing factors of exclusive breastfeeding relative to mixed feeding and artificial feeding were analyzed.

RESULTS

The rates of exclusive breastfeeding, mixed feeding and artificial feeding were 35.13%(294/837), 50.30%(421/837) and 14.57%(122/837) in rural areas of Nanchong. Compared with mixed feeding, mothers with high feeding knowledge(OR=2.06, 95%CI 1.47-2.86) were more likely to exclusively breastfeed. Compared with artificial feeding, mothers with high feeding knowledge(OR=2.48, 95%CI 1.36-4.54), positive attitude towards breastfeeding(OR=2.57, 95%CI 1.12-5.87) and high family support for breastfeeding(OR=3.01, 95%CI 1.73-5.24) were more likely to exclusively breastfeed, and mothers with negative support from the surrounding population(OR=0.37, 95%CI 0.14-0.98) were more likely to carry out artificial feeding.

CONCLUSION

In rural areas of Nanchong City, Sichuan Province, three ways of exclusive breastfeeding, mixed feeding and artificial feeding coexist. Mixed-feeding is the main method, and the rate of exclusive breastfeeding is low. Mothers&apos; feeding knowledge is an important factor influencing feeding patterns, and breastfeeding attitudes and breastfeeding family support are the main drivers of artificial feeding.

[Advances in Mechanism and Influencing Factors Affecting Hydrogen Sulfide Adsorption by Biochar]

Hydrogen sulfide(H₂S) is one of the most common gas products from modern industrial processes. It is highly toxic, corrosive, and polluting, and poses harm to both the natural environment and human health if it is not properly removed. Biochar has been widely applied for the treatment of environmental pollution due to its excellent adsorption ability, low cost, and wide choice of source materials. Currently, although studies on hydrogen sulfide adsorption by biochar have attracted increasing attention, the factors involved are complex and varied, leading to a necessity to review and summarize the available knowledge and advances. To bridge the research gap, this paper presents the advances in H₂S adsorption by biochar, including properties, influencing factors(i.e., biomass feedstock, pyrolysis temperature, residence time, and particle size), control measures(i.e., humidity, adsorption temperature, operating conditions, and modification of biochar by activation), and adsorption mechanism. The work will provide further reference for the preparation and optimization of biochar adsorption conditions to realize a highly efficient removal of H₂S.

[Clarifying the factors affecting Larix gmelinii forest regeneration based on structural equation model]

Based on data from 49 plots of natural Larix gmelinii forests in Cuigang Forest Farm of Xinlin Forestry Bureau, Daxing'anling Mountains, China, we used 37 measurable variables that mainly focused on stand non-spatial structure, stand spatial structure, species diversity, soil condition, and site condition to construct the structural equation model of natural regeneration densities and size diversities (i.e., height and ground-diameter). The direct, indirect, and total influence coefficients of each path were quantified to extract the critical and controllable factors that influence regeneration density and diversity of natural L. gmelinii forests, which would help implement sustainable forest management. The results showed that the effects of various latent variables on rege-neration density were following an order as: stand non-spatial structure (-0.410) > species diversity (0.380) > soil condition (0.250) > site condition (0.249) > stand spatial structure (0.197), while the order were changed as: soil condition (0.778) > site condition (0.748) > stand spatial structure (0.684) > stand non-spatial structure (0.287) > forest diversity (0.105), when evaluated on the regeneration diversity. Generally, the critical and controllable factors affecting rege-neration quantity and diversity were soil pH, total potassium concentration, species diversity, tree height diversity, uniform angle index and stand volume per hectare. In the management, suitable thinning treatments or replanting broadleaved trees were recommended for optimizing and adjusting species composition, species diversity, soil pH and nutrition, which would promote natural regene-ration.

[Influence Factor and Evaluation Discuss of IVD Medical Equipment Service Life]

In order to help the IVD medical equipment manufacturers to establish the service life of products scientifically, we analyze the main factors that may affect the service life of IVD medical equipment in accordance with the guiding principles for technical review of active medical devices issued by the center of medical device evaluation of NMPA, and focuse on an evaluation method of accelerated fatigue test, in order to standardize and guide the IVD medical equipment manufacturers to evaluate and formulate the product service life scientifically.

Prevalence and Related Factors of Low Back Pain in the General Elderly Population: A Japanese Cross-Sectional Study Randomly Sampled from a Basic Resident Registry

Low back pain (LBP) is one of the main etiologies of disability in daily life. In the face of LBP increases in super-aged societies, there are serious concerns of escalating medical costs and deteriorations in the social economy. It is therefore important to identify the factors associated with LBP for prompt preventative and therapeutic measures. This study investigated the prevalence of LBP and the impact of subject-specific factors on LBP development in Japanese community-dwelling older adults. We established eight groups based on age (50's, 60's, 70's, and 80's) and gender after random sampling from a resident registry. A total of 411 participants (201 male and 210 female) were enrolled for a whole-spine lateral radiographic examination and dual-energy X-ray absorptiometry. All subjects were evaluated for the presence and degree of LBP. We analyzed the impact of clinical factors on LBP using multivariate analysis. Fifty-three (12.9%) participants (23 (11.4%) male and 30 (14.3%) female) were found to have LBP. The prevalence of LBP tended to increase with age, and similar results were found between genders. In univariate analysis, the subject-related factors of the sagittal vertebral axis, pelvic incidence minus lumbar lordosis (PI-LL) mismatch, and aging had significant associations with LBP. PI-LL mismatch was a significant independent factor in multivariate analysis. In conclusion, this study identified LBP prevalence and subject-specific factors on a general population basis. Multivariate analysis revealed PI-LL mismatch as an independent factor associated with LBP in the healthy community-dwelling elderly.

A retrospective study of endodontic microsurgery about 302 patients

OBJECTIVES

To investigate the outcome of endodontic microsurgery and analyze the potential prognostic factors, and to evaluate the value of surgical classification by Kim and Kratchman.

METHODS

Collecting clinical examination and radiographical examination of endodontic microsurgery cases (which were followed up at least 1 year), which were classified according to Kim and Kratchman, and we analyzed the outcome of endodontic microsurgery and its potential prognostic factors.

RESULTS

302 patients (400 teeth) who received endodontic microsurgery were included. The one year success rate of endodontic microsurgery was 94.25%. Different classification had significant influences on the outcome of endodontic microsurgery (P<0.05), and the success rate of class B and C were better than those of class D, E, and F. The position of teeth had significant influences on the outcome of endodontic microsurgery (P<0.05). The success rate of maxillary teeth was higher than that of mandibular teeth. The success rate of anterior teeth was higher than that of posterior teeth (P<0.05). The quality of root end filling and first or second surgery had no effect on the outcome (P>0.05).

CONCLUSIONS

Endodontic microsurgery is an effective treatment method for saving affected teeth, and it can get a good result. Tooth position and classification are the potential prognostic factors. The surgical classification of Kim and Kratchman can help to predict the outcome of endodontic microsurgery.

Analysis of the physiological and pathological factors of hospitalized patients taking warfarin and the correlation between drug interactions and warfarin efficacy

BACKGROUND

To study the various factors affecting the anticoagulant effect of warfarin, and to promote the rational use of warfarin.

METHODS

We collected the medical records of 125 hospitalized patients who used warfarin from January 2018 to December 2019. Statistical analysis was performed on characteristics such as gender, age, treatment, diabetes, hyperlipidemia, hyperthyroidism, hypothyroidism, hepatitis, renal insufficiency, and nephritis; along with other pathological factors, such as aspirin, clopidogrel, spironolactone, amiodarone, amlodipine, trimetazidine, bisoprolol, isosorbide, atorvastatin, furosemide, digoxin, metoprolol, acarbose, levamlodipine, enoxaparin, moxifloxacin, levofloxacin, other drug interactions, and comorbidities.

RESULTS

Gender and age did not have a significant effect on the efficacy of warfarin. Infection and bleeding extended the number of days of warfarin administration. Acarbose, enoxaparin, and moxifloxacin had a likely effect on warfarin treatment-related indicators.

CONCLUSIONS

Warfarin anticoagulation is affected by many factors. Therefore, medical personnel should pay close attention to the impact of these factors on the anticoagulant effect of warfarin. This study found that warfarin-related bleeding adverse drug reactions and anticoagulant effects have a significant association. Bleeding not only affected the total number of days hospitalized, but also extended the number of days of warfarin administration. However, in terms of patients' pathological states, international normalized ratio values combined with drugs used were not associated with disease and may only be a reference for bleeding risk.

[Status and influencing factors of breastfeeding behavior in rural areas of Han, Tibetan and Yi nationalities in Sichuan Province]

OBJECTIVE

To evaluate the status of breastfeeding among infants aged 0-18 months in rural areas of Han, Tibetan and Yi ethnic in Sichuan Province, and to explore the relevant impact factors.

METHODS

Using multistage sampling method, choose two Han county, two Tibetan county and two Yi county rural 0-18 months infants and young children with their mother as the subjects in Sichuan Province, to collect mothers and infants and young children&apos;s demography, family status, the information such as breastfeeding knowledge and behavior through questionnaires. Unconditional Logistic regression was used to analyze the influencing factors of breastfeeding.

RESULTS

Among the 1087 infants, early initiation of breastfeeding rate was 22. 45%, among the 985 infants aged 6 months and above, the rate of exclusive breastfeeding under 6 months was 35. 94%, among the 658 infants aged 12 months and above, the rate of continued breastfeeding at 1 year was 34. 50%. The favorable factors for early initiation of breastfeeding were that normal delivery(OR=2. 80, 95% CI 1. 82-4. 30) and mothers with knowledge of early initiation of breastfeeding behavior(OR=2. 48, 95% CI 1. 69-3. 64). Tibetan mother(OR=1. 56, 95% CI 1. 02-2. 39), very good family economic status(OR=2. 70, 95% CI 1. 47-4. 98), mother&apos;s knowledge of exclusive breastfeeding under 6 months(OR=1. 47, 95% CI 1. 07-2. 02) were favorable factors for exclusive breastfeeding behavior under 6 months. Second birth and above(OR=1. 67, 95% CI 1. 11-2. 52) and mothers&apos; knowledge of weaning(OR=3. 96, 95% CI 2. 65-5. 93) were favorable factors for continued breastfeeding at 1 year.

CONCLUSION

The status of breastfeeding in the multi-ethnic rural areas of Sichuan Province is poor. The mother&apos;s ethnicity, delivery method, and whether they have relevant knowledge, parity and family economic status will affect the breastfeeding behavior of infant mothers.

Influence Factors for Lymph Node Metastasis in Papillary Thyroid Carcinoma: Hashimoto's Thyroiditis Has a Weak Effect on Central or Lateral Lymph Node Metastasis

Purpose

To analyze the effect of Hashimoto’s thyroiditis (HT) concurrent with papillary thyroid cancer (PTC) on cervical lymph node metastasis (LNM).

Methods

Two thousand nine hundred twenty-six patients who underwent thyroidectomy and lymph node dissection between January 2015 and December 2018 were enrolled in this study. Patient demographics and clinicopathologic features were analyzed.

Results

Of the total enrolled patients, 598 (20.4%) had concurrent HT. There were 1482 PTC cases with N0, 1033 cases with N1a, and 411 cases with N1b. Patients with HT had lower frequency of extrathyroidal extension (ETE), lymphatic vascular (LV) invasion, high pathological T stage (III+IV) and central LNM rate. Stratifying central LNM by non-ETE or without intrathyroidal spreading, it was further found that central LNM rate in patients with HT was lower than that of patients without HT. However, there was no significant difference in the central LNM rate in patients with PTC stratified by ETE or intrathyroidal spreading. HT with PTC played a weak protective role in N1a, reducing the risk of N1a by 16.4%. Conversely, HT is a risk factor for N1b, increasing the risk by 1.336 times compared to patients without HT. TgAb is an independent risk factor for N1b, which appears related to the promotion of N1b by HT.

Conclusion

In PTC, HT has a protective effect on central LNM and a risk effect on lateral LNM, although the difference was not significant. This weak protective effect on N1a is more obvious in PTC with less aggressive clinicopathologic characteristics. The risk effect of HT on N1b may be associated with TgAb.

The impact of age on anxiety in Covid-19 patients in quarantine wardwards

This study aimed to explore which age group out of the patients in quarantine wards with novel coronavirus pneumonia is the most susceptible to anxiety. The data of 32 Covid-19 patients isolated in the quarantine wards of the second Infectious Diseases Department of Baoding Hospital and 71 Covid-19 patients in Tangshan City Infectious Disease Hospital from January 24^th to March 5^th, 2020, a total of 103 patients, were analyzed. Among these patients, 97 isolated patients were scored with a self-rating anxiety scale (SAS) score seven days after quarantine, and the correlation between age and score was analyzed. These 97 isolated patients were then divided into three groups according to age: group A (up to 35 years old), group B (36-60 years), and group C (over 60 years). One-way analysis of variance was used to compare the scores among groups. The Q-test was used for pairwise comparison.P < 0.05 was considered statistically significant.There was a negative correlation between age and SAS score in isolated Covid-19 patients, and the differences in the score among groups were statistically significant. Patients under 35 years old were more prone to anxiety when they were isolated for seven days. Isolated patients aged up to 35 years old need more attention from quarantine medical staff, communication should be strengthened, and psychological intervention from psychotherapists should be given if necessary.

Analysis of the influencing factors and nursing strategy for acute atelectasis after traumatic brain injury surgery

BACKGROUND

Acute atelectasis is common after traumatic brain injury (TBI), but the related factors and treatment are still unclear. This study is to analyze the independent risk factors for acute atelectasis after TBI and propose an interventional nursing strategy, in order to correct respiratory function and improve the prognosis of patients.

METHODS

The clinical data of 93 patients with TBI admitted to our hospital from April 2015 to October 2019 were retrospectively analyzed. Clinical data were analyzed by single factor analysis, the cutoff value of influencing factors was obtained by receiver operating characteristic (ROC) curve analysis, and the influencing factors for acute atelectasis after TBI were examined by multi-factor logistic regression.

RESULTS

Twenty-two patients (23.66%) were complicated with acute atelectasis during the observation period, while the remaining 71 patients (76.34%) did not have acute atelectasis. Univariate analysis showed that there were significant differences in the Glasgow Coma Scale (GCS), history of vomiting and aspiration, mannitol use, mechanical ventilation, hypoalbuminemia, and serum hypoxia-inducible factor-1α (HIF-1α) between the acute atelectasis group and the non-acute atelectasis group (P<0.05). The AUC area of HIF-1α level predicting acute atelectasis was 0.896 [95% confidence interval (CI): 0.814-0.978, P=0.042], and the cut-off value was 2.12 mmol/L, with a sensitivity of 76.9% and a specificity of 93.3%. Logistic regression analysis showed that a history of vomiting and aspiration [odds ratio (OR) 3.908, 95% confidence interval (CI): 1.201-12.712], mechanical ventilation (OR 3.250, 95% CI: 1.139-9.271), hypoalbuminemia (OR 5.741, 95% Cl: 1.926-17.113), and HIF-1α ≥2.12 mmol/L (OR 6.623, 95% CI: 2.364-16.346) were independent risk factors for acute atelectasis after TBI.

CONCLUSIONS

A history of vomiting and aspiration, mechanical ventilation, hypoalbuminemia, and high expression of HIF-1α are all independent risk factors for postoperative acute atelectasis in patients with TBI. In clinical practice, patients should be guided to swallow properly, breathe smoothly, eat well, and regularly check the relevant indexes.

[Microbial Diversity and Influencing Factors in a Small Watershed in Winter]

The water quality of a small watershed will directly affect the water quality safety of the entire watershed. The Lidu small watershed of the Fulin District in Chongqing was selected for this study. The characteristics of runoff and the microbial community in the receiving water body were analyzed by high-throughput sequencing technology. The effects of the physical and chemical factors of the water body on the microbial diversity in the water body were also investigated. The results showed that the small watershed of Lidu was an important source of nitrite and dissolved organic carbon for the receiving water. There was no significant difference in the microbial richness and diversity of the water flowing through different pollution sources in the small watershed, and the microbial diversity index was negatively correlated with the total phosphorus (r -0.79--0.84, P ≤ 0.01) and phosphate (r -0.71--0.80, P ≤ 0.01) of the water. At the phylum level, Actinobacteria (37.33% ±14.69%) accounted for the largest proportion of runoff flowing through the agricultural area, followed by Proteobacteria (32.53% ±7.18%), Cyanobacteria (14.65% ±22.64%), Bacteroidetes (8.50% ±3.67%), and others. Proteobacteria (43.67% ±10.80%) accounted for the largest proportion of runoff flowing through the industrial area, followed by Bacteroidetes (25.33% ±11.97%), Actinobacteria (24.17% ±14.66%), Firmicutes (2.53% ±0.72%), and others. At the genus level, hgcI_clade (19.08% ±13.46%) accounted for the largest proportion of runoff flowing through the agricultural area, followed by CL 500-29 _marine_group (7.40% ±4.44%), Limnohabitans (7.05% ±3.14%), and others. Flavobacterium (20.40% ±12.37%) accounted for the largest proportion of runoff flowing through the industrial area, followed by hgcI_clade (15.30% ±11.11%), Acinetobacter (9.33% ±11.50%), and others. The Flavobacterium in the runoff water may be related to the input of industrial sources in the watershed. Nitrous nitrogen, total phosphorus, phosphate, pH, and Zn²⁺ were the main environmental factors that affected the microbial community in the small watershed. They can explain the variance of microbial community 0.26, 0.21, 0.20, 0.15, and 0.14, respectively. DOC, nitrate nitrogen, and heavy metal ions such as Cu²⁺, Zn²⁺, Mn²⁺, and As³⁺ were also related to the proportion of some microorganisms in the water.

The Needs of Older Adults With Disabilities With Regard to Adaptation to Aging and Home Care: Questionnaire Study

Background

The home environment is an important means of support in home-based care services for older people. A home environment that facilitates healthy aging can help older adults maximize their self-care abilities and integrate and utilize care resources. However, some home environments fail to meet the needs of older adults with disabilities.

Objective

This paper aimed to study the needs of older adults with disabilities with respect to adaptation to aging, and to analyze the associations of individual factors and dysfunction with those needs.

Methods

A questionnaire survey was administered to 400 older adults with disabilities from 10 communities in Ningbo City, Zhejiang Province, China. The survey was conducted from August 2018 to February 2019.

Results

A total of 370 participants completed the survey. The proportion of participants with mild dysfunction was the highest (128/370, 34.59%), followed by those with extremely mild (107/370, 28.92%), moderate (72/370, 19.46%), and severe (63/370, 17.03%) dysfunction. The care needs of older adults with extremely mild and mild dysfunction pertained primarily to resting, a supportive environment, and transformation of indoor activity spaces. The care needs of older adults with moderate dysfunction pertained mainly to resting and renovation of bathing and toilet spaces. Factors influencing the needs of older adults with disabilities were dysfunction (P=.007), age (P=.006), monthly income (P=.005), and living conditions (P=.04).

Conclusions

The needs of older adults with disabilities varied by the degree of dysfunction, and many factors influenced these needs in the community. These findings may provide a scientific basis for developing community-specific aging-related adaptation services for older adults with disabilities in the future.