Community Index Research Articles

Effects of socioeconomic burden on opioid use following total shoulder arthroplasty

Preoperative opioid users experience worse outcomes and higher complication rates compared to opioid-naïve patients following shoulder arthroplasty. This study evaluates the effects of socioeconomic status, as measured by the Distressed Communities Index (DCI), on pre- and postoperative opioid use and its influence on clinical outcomes such as readmission and revision surgery. A retrospective review of patients who underwent primary shoulder arthroplasty (Current Procedural Terminology code 23472) from 2014 to 2022 at a single academic institution was performed. Exclusion criteria included arthroplasty for fracture, active malignancy, and revision arthroplasty. Demographics, Charlson Comorbidity Index, DCI, and clinical outcomes including 90-day readmission and revision surgery were collected. Patients were classified according to the DCI score of their zip code. Using the Prescription Drug Monitoring Program database, patient pre- and postoperative opioid use in morphine milligram equivalents was gathered. Individuals from distressed communities used more opioids within 90 days preoperatively compared to patients from prosperous, comfortable, mid-tier, and at-risk populations, respectively. Patients from distressed communities also used significantly more opioids within 90 days postoperatively compared with prosperous, comfortable, and mid-tier, respectively. Of patients from distressed communities, 35.1% developed prolonged opioid use (filling prescriptions >30 days after surgery), significantly more than all other cohorts. Among all patients, 3.5% were readmitted within 90 days and were more likely to be prolonged opioid users (38.9 vs. 21.3%, P<.001). Similarly, 1.5% of patients underwent revision surgery. Those who underwent revision were significantly more likely to be prolonged opioid users (38.2 vs. 21.7%, P=.002). Shoulder arthroplasty patients from distressed communities use more opioids within 90 days before and after their surgery and are more likely to become prolonged opioid users, placing them at risk for readmission and revision surgery. Identifying patients at an increased risk for excess opioid use is essential to employ appropriate strategies that minimize the detrimental effects of prolonged use following surgery.

The relationship between neighborhood socioeconomic status and short-term outcomes following colon resection

BackgroundThis study investigates the association between neighborhood socioeconomic status, measured by the Distressed Communities Index (DCI), and short-term outcomes following colon resection. MethodsUtilizing the Maryland State Inpatient Sample database (SID 2018–2020), we determined the association between DCI and post-op outcomes following colon resection including length of stay, readmissions, 30-day in-hospital mortality, and non-routine discharges. Multivariate regression analysis was performed to control for potential confounding factors. ResultsOf the 13,839 patients studied, median age was 63, with 54.3 ​% female and 64.5 ​% elective admissions. Laparoscopic surgery was performed in 36.9 ​% cases, with a median hospital stay of 5 days. Patients in distressed communities faced higher risks of emergency admission (OR: 1.31), prolonged hospitalization (OR: 1.29), non-routine discharges (OR: 1.36), and readmission (OR: 1.33). Black patients had longer stays than White patients (OR: 1.3). Despite adjustments, in-hospital mortality did not significantly differ among neighborhoods. ConclusionOur study reveals that patients residing in distressed neighborhoods face a higher risk of prolonged hospitalization, non-routine discharges, and readmission rate after colon resection.

The Distance to Reference Communities Index (DRCI): a new tool to assess communities' restoration success

The concept of a reference ecosystem is fundamental in restoration ecology, especially in assessing the success of ecological restoration projects. In response to criticism, it has undergone conceptual evolutions in its definition and use in the last decades. Even though there is still a need to develop statistical methods and analyses to account for reference variability. Here, we focus on two original and one literature‐based calculation methods for designed indexes, which all aim to compare a community to be assessed (undergoing restoration) with a variable set of reference communities. These methods either use the average reference situation (species composition and abundance) as the restoration target or on the contrary, allow any reference site to be considered a relevant target. We compare the results of these methods by analyzing a simulated dataset. We then illustrate the application of the most relevant index by a real case study that compared a created Mediterranean temporary pond to a panel of 27 reference ponds located in the south of France. The results show that the Distance to Reference Communities Index (DRCI) correctly measures differences in species composition and abundance between an assessed and a reference panel of communities. It takes into account the variability of the reference communities, while the use of other indexes focuses on unrealistic average and fixed reference values. DRCI is complementary to a detailed ecological interpretation and to the use of other commonly used indexes, by giving a synthetic metric.

Anthropogenic activities decrease functional richness over time, but not other functional aspects of the fish community in a tropical bay

Functional diversity can be used to help understanding the processes shaping biological communities and the effects of human disturbances on the ecosystem's services. Untangling these biological processes is crucial to apply effective policies aiming the biodiversity conservation. Temporal changes (1983–1985, 1999–2001 and 2017–2019) in five functional indices (functional richness, divergence, evenness, specialization and originality) of the fish communities in two zones (inner and outer) of shallow areas in a tropical bay heavily human-impacted in recent decades were evaluated. The tested hypothesis was that functional indices decrease over time, because of the environmental degradation. A substantial decrease in species richness and abundance in the more recent periods (1999–2002 and 2017–2019) compared to 1983–1985 was observed. However, the functional structure remained relatively stable, with the exception of functional richness that showed a significant decrease over time. The apparent stability in the other functional indices may be due to the presence of dominant and functionally redundant species over time that compensates for the loss of species while maintaining similar functions. It was also discovered that decreases in fish richness in shallow bay areas result in losses in functional richness, with resident fish and benthivorous species being the most affected by environmental degradation. By employing a comprehensive approach that integrates the use of functional indices and taxonomic diversity to assess temporal changes in the fish community, it provides a broader understanding of ecological processes. Such insights could prove invaluable in guiding the implementation of conservation strategies.

The Impact of the Distressed Communities Index Score on Outcomes Following TEVAR for Type B Aortic Dissection

The Impact of the Distressed Communities Index Score on Outcomes Following TEVAR for Type B Aortic Dissection

Diversity of Bacterial Communities in Sediment in Inland Water Bodies in Relation to Environmental Factors and Human Impacts: A Case Study on Typical Regions in Vietnam

Environmental changes and human impact can alter biodiversity in negative manners that affect mankind’s sustainable development. Particularly, such effects on inland waters are even more concerning, as those ecosystems play essential roles in sustaining human life as well as relevant wildlife. Thus, in this study, we investigated such effects on microbial diversity in inland waters in Vietnam using bacterial communities in sediment as indicators. To do this, we collected sediment samples from various locations in three respective regions (Red river in the north, Ba river in the central area, and Mekong delta flood zone in the south) using standard methods, extracted their total DNA, sequenced their V3-V4 16S rRNA gene fragments using an Illumina Miseq platform and analyzed the sequences to infer the diversity of the bacterial communities in the samples. These communities were compared in terms of richness (alpha diversity) and composition (beta diversity), and the correlations between their diversity levels and environmental factors, as well as human activities, were analyzed by using standard statistical tools. Our results showed that the communities were different from each other solely by region, in richness and critically in composition, although there were some communities distinctively different from all the others. Among environmental factors, only water salinity (and conductivity) had negative correlations with alpha-diversity indices of the bacterial communities, and phosphate concentration and turbidity had positive correlations, while the other factors had almost no correlations, which partially explains the region-specific diversity. These results also suggest that climate change incidences, especially sea intrusion, can have significant effects on microbial diversity in inland waters. The impact of human activities did not appear severe, solely affecting bacterial community richness, but not significantly affecting bacterial community composition. However, apparently reduced bacterial diversity in several sites with intense human impacts and distinct environmental conditions should be noted and deserve further investigation.

Short‐term effects of Kernza and alfalfa on microbial communities

AbstractContinuous land disturbance could negatively impact microbial community, but perennial crops can potentially reverse this negativity. The objective of this study was to evaluate the effects of Kernza (Thinopyrum intermedium) and alfalfa (Medicago sativa L.) on soil microbial structure and stress condition using the phospholipid fatty acid profiling. The study was conducted at the Ross Jones Research Farm, University of Missouri and consisted of four treatments: Kernza fertilized, Kernza unfertilized, Kernza and alfalfa intercrop, and alfalfa monocrop with four replications. Treatments were established in September 2021 on 18.3 m × 18.3 m plots. Soils from 0‐ to 5‐cm and 5‐ to 15‐cm depths were sampled in September 2021 (before treatments were placed) and 2022 and analyzed for microbial communities. All microbial communities increased after 1 year with the perennial crops. Since differences were not significant among treatments in 2022, this may lead to positive impacts of perennial crops on microbial communities, irrespective of the crop species and management. Moreover, community structure modifications were also observed with the perennial crops, irrespective of the species and management, as evidenced with changes in bacterial community indices in 2022. While fungi/bacteria ratio increased, Gram‐positive/Gram‐negative bacteria ratio decreased in 2022, suggesting a reduction in microbial stress, which can be attributed to ecological functions of the perennial crops. The study showed improvements in soil microbial biomass and modifications in microbial community structure after 1 year of Kernza and alfalfa. As the system matures, relative benefits of management (fertilization and intercropping) and plant species may be realized.

Statewide Hospital Admissions for Adult Survivors of Infant Surgical Diseases Over a 10-Year Period

IntroductionThe number of patients with congenital disease living to adulthood continues to grow. Often undergoing surgical correction in infancy, they continue to require lifelong care. Their numbers are largely unknown. We sought to evaluate hospital admissions of adult patients with esophageal atresia with tracheoesophageal fistula (EA/TEF), congenital diaphragmatic hernia (CDH), and Hirschsprung disease (HD). MethodsThe Florida Agency for Healthcare Administration inpatient database was merged with the Distressed Communities Index and Centers for Medicare and Medicaid Services Hospital and Physician Compare datasets. The dataset was queried for adult patients (≥18 y, born after 1970) with EA/TEF, CDH, and HD in their problem list from 2010 to 2020. Patient demographics, hospitalization characteristics, and discharge information were obtained. ResultsIn total, 1140 admissions were identified (266 EA/TEF, 135 CDH, 739 HD). Patients were mostly female (53%), had a mean age of 31.6 y, and often admitted to an adult internist in a general hospital under emergency. Principal diagnoses and procedures (when performed) varied with diagnosis and age at admission. EA patients were admitted with dysphagia and foregut symptoms and often underwent upper endoscopy with dilation. CDH patients were often admitted for diaphragmatic hernias and underwent adult diaphragm repair. Hirschsprung patients were often admitted for intestinal obstructive issues and frequently underwent colonoscopy but trended toward operative intervention with increasing age. ConclusionsAdults with congenital disease continue to require hospital admission and invasive procedures. As age increases, diagnoses and performed procedures for each diagnoses evolve. These data could guide the formulation of multispecialty disease-specific follow-up programs for these patients.

Fungi play a crucial role in sustaining microbial networks and accelerating organic matter mineralization and humification during thermophilic phase of composting

Fungi play an important role in the mineralization and humification of refractory organic matter such as lignocellulose during composting. However, limited research on the ecological role of fungi in composting system hindered the development of efficient microbial agents. In this study, six groups of lab-scale composting experiments were conducted to reveal the role of fungal community in composting ecosystems by comparing them with bacterial community. The findings showed that the thermophilic phase was crucial for organic matter degradation and humic acid formation. The Richness index of the fungal community peaked at 1165 during this phase. PCoA analysis revealed a robust thermal stability in the fungal community. Despite temperature fluctuations, the community structure, predominantly governed by Pichia and Candida, remained largely unaltered. The stability of fungal community and the complexity of ecological networks were 1.26 times and 5.15 times higher than those observed in bacterial community, respectively. Fungi-bacteria interdomain interaction markedly enhanced network complexity, contributing to maintain microbial ecological functions. The core fungal species belonging to the family Saccharomycetaceae drove interdomain interaction during thermophilic phase. This study demonstrated the key role of fungi in the composting system, which would provide theoretical guidance for the development of high efficiency composting agents to strengthen the mineralization and humification of organic matter.

Characteristics of Microorganisms and Antibiotic Resistance Genes of the Riparian Soil in the Lanzhou Section of the Yellow River

Riparian soil is a critical area of watersheds. The characteristics of biological contaminants in riparian soil affect the pollution control of the watershed water environment. Thus, the microbial community structure, antibiotic resistance genes (ARGs), and mobile genetic elements (MGEs) in the riparian soil of the Lanzhou section of the Yellow River were investigated by analyzing the characteristics of soil samples collected from farmland, mountains, and industrial land. The results showed that the Proteobacteria, Bacteroidetes, and Actinobacteria were the dominant phyla in the riparian soil of Lanzhou section of the Yellow River. The microbial structure in the riparian soil was significantly correlated with the land use type (P &lt; 0.05). The α diversity index of bacterial communities in land types was in the order of farmland &gt; mountain &gt; industry. Sulfonamide-typed ARGs were the most dominant genes in the soil of the Lanzhou section of the Yellow River Basin, among which the sul1 gene had the highest abundance, 20-36 000 times that of other detected ARGs. Moreover, the total absolute abundance of ARGs in industrial soil was the highest. Principal coordinate analysis (PCoA) displayed that the ARGs characteristics had a significant correlation with land types (P &lt; 0.05), and intl1 and tnpA-04 drove the diffuseness of sulfonamide and tetracycline ARGs, respectively. Redundancy analysis (RDA) demonstrated that the content of inorganic salt ions and total phosphorus in the soil of the riparian zone of the Yellow River Lanzhou section were the main environmental factors, modifying the distribution of the microbial structure. Halobacterota and Acidobacteriota were the main microflora that drove the structural change in ARGs.

Seasonal changes of ammonia-oxidizing bacterial communities during tropical forest restoration

In this study, we used a high-throughput sequencing technology to survey the dry-wet seasonal change characteristics of soil ammonia-oxidizing bacteria (AOB) communities in the three restoration stages [i.e., Mallotus paniculatus community (early stage), Millettia leptobotrya community (middle stage), and Syzygium oblatum community (later stage)] of Xishuangbanna tropical forest ecosystems. We analyzed the effects of soil physicochemical characteristics on AOB community composition and diversity during tropical forest restoration. The results showed that tropical forest restoration significantly affected the relative abundance of dominant AOB phyla and their dry-wet seasonal variation. The maximum relative abundance of Proteobacteria (71.3%) was found in the early recovery stage, while that of Actinobacteria was found in the late recovery stage (1.0%). The abundances of Proteobacteria and Actinobacteria had the maximum ranges of dry-wet seasonal variation in the early and late stages, respectively. The abundance of dominant AOB genera and its dry-wet seasonal variation varied across tropical forest restoration stages. The maximum average relative abundance of Nitrosospira and Nitrosomonas in the late recovery stage was 66.2% and 1.5%, respectively. In contrast, the abundance of Nitrosovibrio reached its maximum (25.6%) in the early recovery stage. The maximum dry-wet seasonal variation in relative abundance of Nitrosospira and Nitrosomonas occurred in the early recovery stage, while that of Nitrosovibrio occurred in the middle recovery stage. The Chao1, Shannon, and Simpson diversity indices of AOB communities increased along the restoration stages, which were significantly higher in the wet season than in the dry season. The results of canonical correspondence analysis showed that soil easily oxidized carbon was the main factor controlling AOB community diversity and Actinobacteria abundance. Soil bulk density and temperature were the main factors affecting Proteobacteria abundance. Soil pH, microbial biomass carbon, water content, ammonium nitrogen, bulk density, and temperature were the main factors controlling the abundances of Nitrosospira, Nitrosomonas, and Nitrosovibrio. Therefore, tropical forest restoration can regulate the change of relative abundance of dominant AOB taxa via mediating the changes of soil temperature, bulk density, and readily oxidized carbon, leading to an increase in soil AOB community diversity.

Impact of regional differences and neighborhood socioeconomic deprivation on the outcomes of patients with lower extremity wounds evaluated by a limb-preservation service

ObjectiveManagement of lower extremity (LE) wounds has evolved with the establishment of specialized limb preservation services. Although clinical factors contribute to limb outcomes, socioeconomic status and community factors also influence the risk for limb loss. The Distressed Community Index (DCI) score is a validated index of social deprivation created to provide an objective measure of economic well-being in United States communities. Few studies have examined the influence of geographic deprivation on outcomes in patients with LE wounds. We examined relationships between socioeconomic deprivation and outcomes of inpatients evaluated by a dedicated limb preservation service (Functional Limb Extremity Service [FLEX]). MethodsInpatients referred to FLEX over a 5-year period were included. Wound, Ischemia, foot Infection (WIfI) staging was collected. DCI scores were determined using seven indices based on ZIP Code. Outcomes included any minor or major amputations, any endovascular or open LE revascularization, or wound care procedures. Disease etiology, demographic, and anthropometric data were collected. Associations between neighborhood deprivation and limb-specific outcomes were evaluated in models for the DCI and each of its components separately. ResultsA total of 677 patients were included. Thirty-eight percent were female, with a mean age of 64 years. Sixty percent had WIfI stage 3 or 4 risk of amputation, and 43% had WIfI stage 3 or 4 risk of revascularization. Mean ankle-brachial index and toe pressure were 0.96 (standard deviation [SD], 0.43) and 80 (SD, 57) mmHg. Thirty-five percent were non-White. Amputation was performed in 31% of patients, whereas 17% underwent revascularization. The mean distress score was 64 (SD, 24). Mean DCI scores did not differ across WIfI scores. Likewise, overall DCI distress score was not related to any of the outcomes in univariable or multivariable linear regression models. In univariable linear regression models for amputation, higher poverty rate (odds ratio for SD increase 1.20; 95% confidence interval, 1.02-1.42; P = .025) was significantly associated with the outcome. In multivariable models, neither DCI distress score nor any of its components remained significantly associated with the outcome. ConclusionsDespite known racial disparities in limb-specific outcomes, an aggregate measure of community level distress was not found to be related to outcomes. Although the poverty rate demonstrated a significant relationship with amputation in univariable analysis, this association was not found in multivariable models. Notably, non-White race emerged as a predictor of amputation, underscoring the importance of addressing racial disparities in LE outcomes. Further investigation of potential determinants of LE outcomes is needed, particularly the interaction of such factors with race.

Impact of artificial barriers on benthic macroinvertebrate functional diversity in estuarine ecosystems

AbstractFunctional diversity research enhances our understanding of ecosystems and both their functioning and their responses to environmental variations. This study investigated the biological trait responses of benthic invertebrate communities to various environmental conditions in estuarine habitats. We analyzed benthic macroinvertebrate communities in freshwater and estuarine environments to compare their characteristics between estuary sites with and without artificial barriers. Moreover, we combined taxonomic analyses (species richness, abundance, and four community indices) with functional diversity indices and biological trait analyses. The major results are as follows: (i) the most important environmental factors shaping species distribution in estuarine habitats were salinity and electrical conductivity; (ii) comparing functional diversity indices, tidal estuaries revealed that seawater intrusion induced changes in species distribution and the dispersion of benthic macroinvertebrates; (iii) the presence or absence of artificial barriers in estuaries affected biological traits owing to the influence of specific functional strategies of certain species. Consequently, the presence or absence of artificial barriers in estuaries can lead to significant changes in habitat connectivity and functional diversity related to ecosystem functions. These findings indicate that the presence of artificial barriers can significantly influence the ecological dynamics of estuarine ecosystems, thereby affecting species distribution, functional diversity and habitat connectivity. Understanding these effects contributes to a more comprehensive understanding of ecosystem functionings, as it complements existing taxonomic findings and integrates information about the functional aspects of diverse ecosystems.

Cyanobacterial bloom affects structural and functional succession of microbial communities in urban wetland sediments in the Qinghai Plateau

Abstract Algal blooms significantly affect microbial communities in wetland ecosystems. However, little is known about the succession of sediment microbial communities during algal blooms. This study aimed to investigate the temporal patterns of sediment bacterial community structure and function succession during algal blooms (March to May 2022) with high-throughput sequencing technology. To this end, algal blooms were divided into the bloom stage (BS), decomposition stage (DS) and end stage (ES). The results showed that: (i) The algal blooms were dominated by Microcystis species within Cyanobacteria. Both phytoplankton abundance and biomass reached the peak in the BS, with 45.78 × 105 cells/L and 5.97 mg/L, respectively. (ii) The alpha diversity indices of the sediment bacterial community showed a monotonically increasing trend, with the lowest value in the BS. Cyanobacterial blooms reduced the relative abundance of Actinobacteria and Chloroflexi, and raised that of Firmicutes, Proteobacteria and Bacteroidetes. (iii) Cyanobacterial blooms remarkably decreased the complexity of the co-occurrence network of the sediment bacterial community, which resisted extreme environmental conditions in the BS and DS by increasing positive relationships. (iv) Mantel test showed that phytoplankton biomass, T, dissolved oxygen and organic carbon had significant effects on the sediment bacterial community. The results of this study are important for the ecological management of algal blooms through microorganisms.

Relationship between phytoplankton community structure and environmental factors in Yinchuan City water

The freshwater ecosystem, formed through the interaction between biological communities and the environment, serves as a vital resource for sustainable human development. Phytoplankton plays a pivotal role in environmental monitoring and ecological assessment, serving as a biological indicator in water quality assessment. However, the rapid urban development poses a significant threat to aquatic ecosystems, leading to environmental changes that alter phytoplankton community structures and degrade ecosystem functions. The research on the phytoplankton community structure and its correlation with environmental factors in Yinchuan remains insufficient. Therefore, it is imperative for Yinchuan's water ecosystem to comprehensively understand the phytoplankton community structure and identify the driving factors influencing the water ecological environment.A survey of phytoplankton was conducted in 40 stations across the Diannong River Basin, Yuehai Wetland, Baohu Wetland, and Hequanhu Wetland in Yinchuan in April 2023. The results revealed the presence of seven phyla and 211 species of phytoplankton in Yinchuan. Bacillariophyta comprised the majority of observed species, followed by Chlorophyta and Cyanophyta, with a smaller proportion of other species distributed throughout. Key influencing factors included total nitrogen (TN), total phosphorus (TP), ammonia nitrogen (NH3-N), dissolved oxygen (DO), and transparency (SDD). Significant disparities were noted in both the Simpson index and Pielou's evenness index of the phytoplankton community.

The Diversity and Community Composition of Three Plants' Rhizosphere Fungi in Kaolin Mining Areas.

Mining activities in the kaolin mining area have led to the disruption of the ecological health of the mining area and nearby soils, but the effects on the fungal communities in the rhizosphere soils of the plants are not clear. Three common plants (Conyza bonariensis, Artemisia annua, and Dodonaea viscosa) in kaolin mining areas were selected and analyzed their rhizosphere soil fungal communities using ITS sequencing. The alpha diversity indices (Chao1, Shannon, Simpson, observed-species, pielou-e) of the fungal communities decreased to different extents in different plants compared to the non-kauri mining area. The β-diversity (PCoA, NMDS) analysis showed that the rhizosphere soil fungal communities of the three plants in the kaolin mine area were significantly differentiated from those of the control plants grown in the non-kaolin mine area, and the extent of this differentiation varied among the plants. The analysis of fungal community composition showed that the dominant fungi in the rhizosphere fungi of C. bonariensis and A. annua changed, with an increase in the proportion of Mycosphaerella (genus) by about 20% in C. bonariensis and A. annua. An increase in the proportion of Didymella (genus) by 40% in D. viscosa was observed. At the same time, three plant rhizosphere soils were affected by kaolin mining activities with the appearance of new fungal genera Ochrocladosporium and Plenodomus. Predictive functional potential analysis of the samples revealed that a significant decrease in the potential of functions such as biosynthesis and glycolysis occurred in the rhizosphere fungal communities of kaolin-mined plants compared to non-kaolin-mined areas. The results show that heavy metals and plant species are the key factors influencing these changes, which suggests that selecting plants that can bring more abundant fungi can adapt to heavy metal contamination to restore soil ecology in the kaolin mining area.

The Socioeconomic Distressed Communities Index Predicts 90-Day Mortality Among Intracranial Tumor Patients

Socioeconomic status (SES) is a major determinant of quality of life and outcomes. However, SES remains difficult to measure comprehensively. Distress communities index (DCI), a composite of 7 socioeconomic factors, has been increasingly recognized for its correlation with poor outcomes. As a result, the objective of the present study is to determine the predictive value of the DCI on outcomes following intracranial tumor surgery. A single institution, retrospective review was conducted to identify adult intracranial tumor patients undergoing resection (2016-2021). Patient ZIP codes were matched to DCI and stratified by DCI quartiles (low:0-24.9, low-intermediate:25-49.9, intermediate-high:50-74.9, high:75-100). Univariate followed by multivariate regressions assessed the effects of DCI on postoperative outcomes. Receiver operating curves were generated for significant outcomes. A total of 2389 patients were included: 1015 patients (42.5%) resided in low distress communities, 689 (28.8%) in low-intermediate distress communities, 445 (18.6%) in intermediate-high distress communities, and 240 (10.0%) in high distress communities. On multivariate analysis, risk of fracture (adjusted odds ratio= 1.60, 95% confidence interval 1.26-2.05, P < 0.001) and 90-day mortality (adjusted odds ratio= 1.58, 95% confidence interval 1.21-2.06, P < 0.001) increased with increasing DCI quartile. Good predictive accuracy was observed for both models, with receiver operating curves of 0.746 (95% CI 0.720-0.766) for fracture and 0.743 (95% CI 0.714-0.772) for 90-day mortality. Intracranial tumor patients from distressed communities are at increased risk for adverse events and death in the postoperative period. DCI may be a useful, holistic measure of SES that can help risk stratifying patients and should be considered when building healthcare pathways.

Research on Evaluation Index System oF Low-carbon Existing Communities

In recent years, China has carried out urban renewal in an orderly manner. Based on the new stage, to accelerate the construction of a low-carbon innovative society under the urban renewal, we should improve the low-carbon indicator system, deepen the transformation of existing urban communities, and enhance the urban low-carbon innovation capacity. Based on the review and reference of the evaluation system of low-carbon related pilot work, the practice of low-carbon community index system in foreign countries, and the existing research and practice of other Chinese scholars on the existing community low-carbon index system, this paper proposes the construction principles of low-carbon community evaluation index system. This paper summarizes the influencing factor framework of the construction of energy-saving buildings, low-carbon transportation and low-carbon living environment in the process of low-carbon existing communities, and selects the secondary and tertiary indicators according to the influencing factors. A set of low-carbon community index system is proposed to evaluate the existing community, and the operability of the evaluation index system is verified by questionnaire survey

Differential response patterns of soil fungal and bacterial communities to typical vegetation types in the Yellow River floodplain ecosystem

Soil microorganisms are one of the primary driving factors of biogeochemical cycles in floodplain ecosystems. Vegetation type has an impact on the activities of soil microorganisms. However, it is currently unclear whether the composition and structure of soil bacterial and fungal communities in floodplain ecosystems have a consistent response pattern to vegetation communities. In this research, Illumina Mi-Seq sequencing technology was employed to study the soil fungal and bacterial communities covered by three typical vegetation communities in the Yellow River floodplain ecosystem. Our results showed that the underground biomass, total carbon (TC) and nitrogen (TN) were significantly different between the three vegetation communities. In the surface soil of summer, the Shannon index of fungi community was the highest in Tamarix chinensis (T. chinensis) and the lowest in Phragmites australis (P.australis). In autumn, the Shannon and Simpson indices of bacterial communities in surface soil were the highest in the P.australis and the lowest in the Sonchus arvensis (S.arvensis), but there was no significant difference in the β-diversity of bacterial community among the three vegetation communities. In autumn, the Chao1 index of fungal community in subsoil was the highest in P.australis and the lowest in S.arvensis, while there was no significant difference in the α-diversity of bacterial community among the three vegetation communities. In addition, there were considerable disparities in the fungal and bacteria community structure in various vegetation soils. Redundancy analysis (RDA analysis) showed that TN, TC, AP, pH, NO3 -, NH4 + and moisture content were key factors driving bacterial community structure, while TP, NH4 +, pH and moisture content were essential factors driving fungal community composition. These outcomes help to improve our understanding of the ecological model of soil fungal and bacterial community in floodplain ecosystems and give assistance in improving the role of an ecological barrier and floodplain service possibilities.

Can artificially induced habitat complexity alter macroinvertebrates diversity? A case study from a freshwater wetland ecosystem

Habitat complexity can enhance the resilience of wetlands against environmental stressors such as extreme weather events, pollution, and habitat loss. The introduction of artificial induced complexity (AIC) can play a significant role in reshaping the macroinvertebrate communities within wetland ecosystems by enhancing habitat quality in protected areas. Therefore, this study was designed to examine the variation of macroinvertebrates community structure in artificially induced complex sanctuary site (SS), partially protected (PP) and open sites (OS) from July 2019-April 2020. AIC in the sanctuary sites was established through the installation of cemented hexapods and ring pipes. Over the study period, a total of 665 macroinvertebrates were gathered, with 55.55% originating from SS, 31.14% from PP, and 18.21% from OS sites. The community consists mainly of Lymnaea acuminatatea and Tubifex tubifex, with the most abundant species being Limnodrillus hoffmeisteri and Branchiura sowerbyi. A notable positive impact of AIC was evident in the increased total abundance and diversity indices of macroinvertebrate communities. The Analysis of Similarity (ANOSIM) revealed significant distinctions in community structures among various intervention types, which was further corroborated by a non-metric multidimensional scaling (nMDS) plot. Similarity of Percentage Analysis (SIMPER) highlighted that Limnodrillus hoffmeisteri made the most significant contribution to the dissimilarity observed among the different intervention types. Canonical Correspondence Analysis (CCA) revealed a close association between the structure of the macroinvertebrate community and three key ecological factors: periphyton biomass, macrophyte cover, and sediment properties. These findings could offer a more effective approach for managers and policymakers engaged in the conservation of macroinvertebrates and the sustainable management of fisheries resources within wetland ecosystems.