Lianyungang City Research Articles

Spatial inhomogeneity analyses of extreme sea levels along Lianyungang coast based on numerical simulation and Monte Carlo model

The prediction of extreme sea levels in coastal areas has been a prominent requirement of coastal engineering design and planning. The research was based on the frequent disasters caused by typhoon storm surges in China and the demand for reasonable improvement of port structures in coastal areas. Delft3D hydrodynamic model and the Monte Carlo model were integrated to predict the spatial distribution of extreme sea levels along the coast of Lianyungang city in Jiangsu province. The Monte Carlo model was adopted to generate stochastic typhoon characteristic sequences as meteorological driving forces. In the hydrodynamic model, meteorological factors were coupled with the astronomical tide to simulate storm surge scenarios. Extreme sea levels were estimated by ranking maximum levels of simulated storm surge events. This programming was feasible compared to the prediction results of frequency analysis methods. The research showed that the predicted 1 in 100-year extreme sea level of Lianyungang station was 3.75 m, while the predicted 1 in 200-year value was 3.85 m. The programming was adopted to predict extreme sea levels of several stations and analyze the spatial distribution characteristics of extreme sea levels in four port areas of Lianyungang Port. Results revealed that extreme sea levels in modeling areas had significant spatial inhomogeneity, which might be related to the concavity of coastlines, islands, and terrains. Estimating spatial extreme sea levels could better cognize the influence of inundation disasters in coastal areas and be conducive to the design of port structures and the safety of port operations.

The impact of diabetes mellitus on tuberculosis recurrence in Eastern China: a retrospective cohort study

BackgroundThe comorbidity of tuberculosis (TB) and diabetes mellitus (DM) is a significant global public health issue. This study aims to explore the recurrence risk and related factors of active pulmonary TB, specifically focusing on the impact of DM.MethodsA retrospective cohort study was conducted in Lianyungang City, Jiangsu Province, Eastern China by recruiting 12,509 individuals with newly diagnosed pulmonary TB between 2011 and 2019. The Cox proportional hazards models were performed to identify risk factors of recurrence and assess the association between DM and recurrence. The hazard ratio (HR) and 95% confidence interval (CI) were used to estimate the strength of the association.ResultsAfter a median follow-up period of 5.46 years, we observed 439 recurrent cases (incident recurrence rate: 6.62 per 1000 person-years). Males (HR: 1.30, 95% CI: 1.03–1.64), patients aged ≥ 60 years (HR: 1.39, 95% CI: 1.15–1.70), DM (HR: 2.40, 95% CI: 1.68–3.45), and etiologic positivity in the initial episode (HR: 2.42, 95% CI: 2.00-2.92) had a significantly increased risk of recurrence.ConclusionsRecurrence of pulmonary TB patients who have completed treatment, especially those who also suffer from DM, should be a concern. Enhanced follow-up and targeted surveillance of these high-risk groups are needed.

Investigation and Research on Tourism Status of Lianyungang City

Investigation and Research on Tourism Status of Lianyungang City

Magnetic resonance imaging scanning susceptibility weighted imaging sequences in the diagnosis and prognostic evaluation of neonatal hypoxic-ischemic encephalopathy

BACKGROUND Magnetic resonance imaging (MRI) scanning with susceptibility weighted imaging (SWI) sequences plays a significant role in the diagnosis and prognostic evaluation of neonatal hypoxic-ischemic encephalopathy (HIE). AIM To observe the role of MRI multi-parameter quantitative indexes in the diagnosis of neonatal HIE. METHODS The imaging data from 23 cases of neonatal HIE admitted to the Imaging Department of Ganyu District People's Hospital of Lianyungang City and 23 neonates without HIE admitted during the same period were analyzed retrospectively from August, 2021 to December, 2023. The results of clinical judgment were compared with the results of computed tomography (CT) and MRI examinations. RESULTS The degree of cerebral edema (more than moderate), the number of damaged brain regions (> 2), the number of cerebral hemorrhages (> 2), and the percentage of small venous dilatation detected were higher in MRI than in CT examination, and the differences were statistically significant (P < 0.05). The total area of the largest region of cerebral damage and of cerebral hemorrhage observed by MRI examination were significantly larger than those of CT examination (P < 0.01). Multiparametric quantitative MRI combined with diffusion weighted imaging and SWI had higher sensitivity and accuracy than CT diagnosis, and the difference was statistically significant (P < 0.05). The difference in the specificity of the two modes of diagnosis was not significant (P > 0.05). CONCLUSION The use of MRI multi-parameter quantitative indexes can accurately diagnose and evaluate neonatal HIE.

Selection of household heating equipment: A case study of Lianyungang city

Abstract Based on the local climate in Lianyungang, this paper analyzes the local heating demand, a comprehensive comparison of mainstream heating equipment and terminal forms, and analysis and discussion, respectively. By simulating the heating situation in Lianyungang in winter, the heating cost of different equipment in Lianyungang in winter is calculated and combined with the operation of existing projects, and the differences in cost, use, installation, and maintenance of different heating equipment are compared. Finally, the most suitable heating form for Lianyungang users is summarized by integrating theoretical data and actual situations.

Prevalence and correlates of sleep disturbance among adolescents in the eastern seaboard of China

BackgroundSleep disturbances are serious public health issues that warrant increased attention, especially in adolescents. The aim of this study was to investigate the prevalence and factors associated with sleep disorders among urban adolescents in China.MethodsThis study utilized an online survey to assess the demographic characteristics and mental health status of secondary school students in Lianyungang City. The Patient Health Questionnaire-9 (PHQ-9) was used to evaluate sleep disturbances in adolescents. The seven-item Generalized Anxiety Disorder (GAD-7) assessed anxiety symptoms, and the Perceived Social Support Scale (PSSS) was used to measure perceived social support.ResultsAmong 3443 adolescents, the prevalence of sleep disorders were 10.8%, with significantly higher proportions of sleep disorders (13.7% VS 8.3%, P < 0.001) among female adolescents when compared to males. Binary regression analysis revealed that anxiety symptoms (OR = 1.305, 95% CI: 1.269–1.342, P < 0.001) was risk factor for sleep disturbances, and significant other support (OR = 0.944, 95% CI: 0.896–0.994, P = 0.028) and good annual household income (OR = 0.616, 95% CI: 0.394–0.963, P = 0.034) were protective factors. Furthermore, multinomial logistic regression analysis showed that age, sex, and anxiety symptoms were associated with an elevated risk of experiencing more frequent sleep disturbances (all P < 0.05).ConclusionsWe have found that 10.8% of adolescents experience sleep disorders, and it is evident that various factors can influence healthy sleeping. These results underscore the significance of addressing these factors to enhance sleep health among this population.

Association between previous surgical termination of pregnancy and pregnancy outcomes in frozen-thawed embryo transfer cycles of IVF/ICSI: a retrospective cohort study

This study aimed to evaluate the effect of previous surgical termination of pregnancy (STP) on pregnancy outcomes in women undergoing FET cycles of IVF/ICSI. Retrospective cohort study. Reproductive Center of Maternal and Child Health Care Hospital in Lianyungang city. Data were selected from all IVF/ICSI FET cycles performed between January 2014 and December 2020. A total of 761 cycles met the criteria were included in this study. The primary outcome measures were clinical pregnancy and live birth rates. Secondary outcome measures were biochemical pregnancy rate, spontaneous abortion rate, and preterm birth rate. After adjustments for a series of potential confounding factors, the previous STP was an influential factor in reducing FET cycle clinical pregnancy rate compared with women who had not previously undergone STP (OR = 0.614, 95% CI 0.413–0.911, P = 0.016). The effect of the previous STP on the live birth rate was not statistically significant. (OR = 0.745, 95% CI 0.495–1.122, P = 0.159). Also, an increase in the number of previous STPs relative to only 1-time abortion was an independent risk factor in reducing clinical pregnancy rate and live birth rate (OR = 0.399,95% CI 0.162–0.982, p = 0.046; OR = 0.32,95% CI 0.119–0.857, p = 0.023). Previous STP was an independent factor contributing to the decline in FET cycle clinical pregnancy rates.

A Correlation Evaluation Between the Peripheral Blood Index and the Prognosis of Advanced Esophageal Squamous Cell Carcinoma Patients Treated with Camrelizumab.

This study aimed to investigate the relationship between peripheral blood indices and the efficacy and prognosis of advanced esophageal squamous cell carcinoma (ESCC) patients treated with camrelizumab. We retrospectively analyzed 64 patients who received camrelizumab for advanced ESCC at the Second People's Hospital of Lianyungang City between July 2020 and June 2022. The study included examination of the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the systemic inflammation index (SII), the lymph-to-monocytes ratio (LMR), the absolute lymphocyte count (ALC), and lactate dehydrogenase (LDH). We used multivariate logistic regression analysis to explore the link existing between peripheral blood and the efficacy of treatment. Determination of potential prognostic factors for Progression-free survival (PFS) and Overall survival (OS) using Cox regression analysis. The nomogram model was developed based on the results of the Cox multivariate analysis. Patients were divided into three groups according to the reduction in LDH and LDL levels before treatment, and the Kaplan-Meier survival curves for the three groups were compared and ROC curves for LDH combined with PLR were plotted. Lower LDH (OR=6.237, 95% CI: 1.625-23.944) were independently associated with disease control rates(DCR). LDH was independently correlated with PFS (HR: 0.227 95% CI: 0.099-0.517). LDH and PLR were independently linked to OS. The C index of the nomogram model is 0.819, indicating good predictive performance. Kaplan-Meier Survival Curve suggested better OS in patients with reduced pretreatment LDH and PLR. The area under the ROC curve showed that the LDH index combined with the PLR index predicts patient survival better than the index alone. LDH combined with PLR predicted prognosis in patients with ESCC treated with camrelizumab.

Research on the impact of parental self-affirmation on educational anxiety: a moderated chain mediation model

Based on the data of parents of primary school students in Lianyungang City, Jiangsu Province, China, this paper explores the impact of parental self-affirmation on educational anxiety, as well as the mechanism of parental trust in children’s autonomy, parental expectation, and family intimacy. A total of 983 parents of primary school students were surveyed using the GHQ-Self-Affirmation Scale, Parental Expectation Questionnaire, Parental Trust in Children’s Autonomy Questionnaire, Parental Education Anxiety Questionnaire, and the Chinese Version of FACES II, focusing on the dimension of close relationships. There is a significant positive correlation between parental self-affirmation and educational anxiety (r=0.17, p&lt;0.01), and self-affirmation positively predicts educational anxiety (β=0.07, P&lt;0.05). In other words, the higher the level of parental self-affirmation, the higher the degree of parental educational anxiety. Parental trust in children’s autonomy, and parental expectation play a chain mediating role between parental self-affirmation, and educational anxiety. The effect of parental self-affirmation on parental expectation is moderated by family intimacy. The study shows that parental trust in children’s autonomy, and parental expectation, serve as a mediating bridge between parental self-affirmation and educational anxiety, and family intimacy can significantly positively moderate the impact of parental self-affirmation on parental trust in children’s autonomy.

Study on the Role of Inclusive Financial Development in Promoting Rural Revitalization in Lianyungang City—Discussion Based on the Perspective of Common Prosperity

Study on the Role of Inclusive Financial Development in Promoting Rural Revitalization in Lianyungang City—Discussion Based on the Perspective of Common Prosperity

Microplastic distribution and ecological risk in water and sediments of marine ranching area in Haizhou Bay

The widespread existence of microplastics (MPs) in marine environment and organisms is always an undeniable fact, and more attention should be paid to its ecological risk. In this study, four areas (natural area (NA), comprehensive effective area (CEA), artificial area reef (AR), and aquaculture area (AA)) in the marine ranching area of Haizhou Bay (Lianyungang City, Jiangsu Province) were selected as a case study to quantitatively analyze the distribution and potential ecological risks of MPs in the surface water and sediment. The mean abundance of MPs in the surface water and sediment was 5.05 ± 1.05 n/m3 and 0.47 ± 0.18 n/g, respectively. MPs were mostly < 5 mm (>98%), fibrous (water: 74%; sediment: 64%), blue (water: 41%; sediment: 47%), and polyethylene terephthalate (PET) (water: 42%; sediment: 52%). CEA had the highest MP abundance (P < 0.05) and MPs in CEA significantly correlated with other areas (P < 0.05). Under the effect of currents or tides, we judge that MPs in AA and AR will accumulate in CEA from the surface water and sediment, and their transfer process will be blocked in sediments of AR. According to the hazard score (H score) and pollution loading index (PLI), the MPs in this region have middle and upper levels of ecological risk. We believe that the ecological risks of MPs should be closely monitored, and some assessment indicators should be added to help control and mitigate MP pollution.

The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study

BackgroundThe real-world data of long-term protection under moderate vaccination coverage is limited. This study aimed to evaluate varicella epidemiology and the long-term effectiveness under moderate coverage levels in Ganyu District, Lianyungang City, Jiangsu Province.MethodsThis was a population-based, retrospective birth cohort study based on the immunization information system (IIS) and the National Notifiable Disease Surveillance System (NNDSS) in Ganyu District. Varicella cases reported from 2009 to 2020 were included to describe the epidemiology of varicella, and eleven-year consecutive birth cohorts (2008–2018) were included to estimate the vaccine effectiveness (VE) of varicella by Cox regression analysis.ResultsA total of 155,232 native children and 3,251 varicella cases were included. The vaccination coverage was moderate with 37.1%, correspondingly, the annual incidence of varicella infection increased 4.4-fold from 2009 to 2020. A shift of the varicella cases to older age groups was observed, with the peak proportion of cases shifting from 5–6 year-old to 7–8 year-old. The adjusted effectiveness of one dose of vaccine waned over time, and the adjusted VE decreased from 72.9% to 41.8% in the one-dose group.ConclusionsThe insufficient vaccination coverage (37.1%) may have contributed in part to the rising annual incidence of varicella infection, and a shift of varicella cases to older age groups occurred. The effectiveness of one dose of varicella vaccine was moderate and waned over time. It is urgent to increase varicella vaccine coverage to 80% to reduce the incidence of varicella and prevent any potential shift in the age at infection in China.

Temporal and Spatial Characteristics of Troposphere O3 and Precursors HCHO and NO2 in East China

Based on OMI remote sensing satellite data, the temporal and spatial characteristics of tropospheric ozone (O3), nitrogen dioxide (NO2), and formaldehyde (HCHO) concentrations in East China from 2005 to 2021 were analyzed, and the backward trajectory (HYSPLIT) model was used to explore their sources. The results showed that ① during the 17 years, the tropospheric O3 concentration steadily increased, reached the maximum value in 2010, and then showed a fluctuating and undulating state. NO2 showed an increasing trend from 2005 to 2012 and slowly decreased from 2012 to 2021. The average HCHO concentration showed an increasing trend from 1.15×1016molec·cm-2 in 2005 to 1.8×1016 molec·cm-2 in 2021. ② In terms of spatial characteristics, the concentrations of the three pollutants generally showed a pattern of high concentration in the north and low concentration in the south, with a high concentration in the north, uncharacteristic concentration in the middle, and low concentration in the south. ③ The sensitivity of O3 was as follows:η<2.3 in spring, which belonged to the VOCs control area; η<4.2 in summer, showing that most areas were NOx-VOCs coordinated control areas and a few areas were VOCs control areas; η<4.2 in autumn, which was primarily controlled by VOCs, with a few of them being NOx-VOC synergistic control areas; and η<2.3 in winter, which was a VOCs-controlled area. VOCs were primarily controlled in Shandong Province. ④ Owing to the high concentration of O3 in Shandong Province from 2005 to 2021, Jinan, the capital city of Shandong Province in 2021, was selected for ozone source analysis. The O3 concentration increased in Jinan in 2021 owing to two aspects. First, the long-distance air transportation primarily originated from Lianyungang City in Jiangsu Province and Cangzhou City in Hebei Province. Second, the close air mass transport originated from the pollution of cities near Jinan and the economic zones of the Yellow Sea and Bohai Sea, and the aggregation analysis results corresponded with those of the potential source contribution factor algorithm (PSCF) and the weighted trajectory analysis (CWT).

Pratylenchus zeae a causative agent of Corn Root Rot in Jiangsu Province of China.

Corn (Zea mays L.) plays an important role in China's cash crops, not only as food, but a vital raw material for animal husbandry and industry (Li et al. 2022). Pratylenchus zeae is one of the most damaging root-lesion nematodes (RLN) that can result in decreased yield and quality of crops (Liu et al. 2017). In September 2020, five root/soil samples were collected from the rhizosphere of corn (cv. Zhengdan 958), which had weak growth and root brown lesions in Chenzhou Village, Taolin Town, Donghai County, Lianyungang City, Jiangsu Province of China. Nematodes were extracted from the collected samples using the modified Baermann funnel method (Hooper et al. 2005). RLN were found in all samples, an average of 46 RLN per gram of root and 138 RLN per 100 cm3 of soil. The obtained RLN females were sterilized with 0.3% streptomycin sulfate and then inoculated on each carrot disks individually to obtain the purified population. RLN were examined by morphological and molecular characteristics to confirm the species indentification. The main morphological measurements of adult (n = 15) included body length = 524.7 μm (mean) ± 15.1 (standard deviation) (range = 490.7 to 543.6 μm), stylet = 15.2 μm ± 0.8 (14.2 to 16.8 μm), tail length = 30.3 μm ± 2.5 (26.3 to 35.3 μm), a = 25.6 ± 1.3 (24.4 to 29.3), b = 5.3 ± 0.3 (4.7 to 5.8), c = 17.4 ± 1.4 (14.9 to 19.3), two annules on the lip region. No males were found in the specimens. The morphological characters of this population are consistent with the description of P. zeae (Castillo and Vovlas, 2007). Furthermore, DNA was extracted from individual nematodes. The primers of TW81/AB28 and D2A/D3B (Subbotin et al. 2006) were used to amplified the rDNA-ITS region and rDNA 28S D2-D3 region, respectively. The purified PCR products were ligated into One step ZTOPO-Blunt/TA vector and transformed to Escherichia coli strain DH5α, and then sequenced by Sunya Biotechnology Co., Ltd (Henan, China). The obtained seqences were submitted to NCBI. The rDNA-ITS sequences (669 bp, GenBank Accession No: OP456372 and OP466367) exhibited 95.0% to 97.1% of identity with P. zeae sequences (KU198980 and KU198975). The obtained D2-D3 region of the 28S rDNA sequences (782 bp, OP441397 and OP448675) exhibited 99.7% to 100% identity with P. zeae sequences (EU130893 and KY424269). Consequently, both morphological and molecular data confirmed the identity of P. zeae. To further confirm reproduction on corn, single corn seeds (cv. Zhengdan 958) were sown in eight 2-liter pots filled with 1.8-liter of sterilized soil in greenhouse at 28°C. About 15 days after sowing, each pot with one corn plant with the same growth status was selected to inoculate with 1,000 mixed stage nematodes of P. zeae , Eight pots of uninoculated corn plants were used as controls. After 60 days, the inoculated plants were harvested and brown lesions were observed on roots. No symptoms and nematodes was detected in the control. An average number of RLN per pot was 3,752 in soil and 1,183 in roots were extracted, the reproduction factor (final population/initial population) was 4.94, indicating that P. zeae infects and reproduces well on this corn cultivar. P. zeae has only been reported on corn in Guangxi Province, southern in China(Fang et al. 1994). To our knowledge, this is the fist report of P. zeae infecting corn in Jiangsu Province, eastern in China. As P. zeae can cause great damage to corn, necessary measures should be taken to prevent the spread of P. zeae to other areas.

Adoption of nanoparticle micro-infusion valve in venous port access for tumor patients and self-care analysis.

It aimed to discuss the adoption of nanoparticle micro-infusion valves in the totally implantable venous access port (TIVAP) of tumor patients and analyze the self-care of patients after surgery. A total of 189 tumor patients who received TIVAP chemotherapy were selected from the day chemotherapy outpatient department of the Second People's Hospital of Lianyungang City from June to October 2021. The questionnaire survey was conducted to collect and analyze the general information about the patients and the patient's self-care ability. All the surveys and analyses were performed using a general information questionnaire, self-care competence scale, self-management efficacy scale, social support scale, and self-rating anxiety scale. Moreover, the nanoparticle micro-infusion valve was prepared, and its characterization, in vitro drug release, and cytotoxicity were studied. The self-management ability of patients was concentrated in the middle and high levels. Marital status, education level, and economic status all had a great impact on the patient's self-care ability. The infusion of dithiothreitol (DTT) increased the drug release of the nanoparticle micro-infusion valve. When pH=5.0, the drug-loaded nanoparticle micro-infusion valve release amount was greater than when pH=7.4. When pH=5.0 and pH=7.4, the cell survival rates under the drug-loaded nanoparticle micro-infusion valve were both lower than that without drug loading. Nanoparticle micro-infusion valves can specifically identify tumor cells, and have good adoption prospects in TIVAP implantation in tumor patients. Gender, marital status, education level, etc. all affected the self-care ability of patients.

Head-to-head immunogenicity comparison of an Escherichia coli-produced 9-valent human papillomavirus vaccine and Gardasil 9 in women aged 18–26 years in China: a randomised blinded clinical trial

An Escherichia coli-produced human papillomavirus (HPV) 16 and 18 bivalent vaccine (Cecolin) was prequalified by WHO in 2021. This study aimed to compare the immunogenicity of the E coli-produced HPV 9-valent vaccine Cecolin 9 (against HPV 6, 11, 16, 18, 31, 33, 45, 52, and 58) with Gardasil 9. This was a randomised, single-blind trial conducted in China. Healthy non-pregnant women aged 18-26 years, who were not breastfeeding and with no HPV vaccination history, were enrolled in the Ganyu Centre for Disease Control and Prevention (Lianyungang City, Jiangsu Province, China). Women were stratified by age (18-22 years and 23-26 years) and randomly assigned (1:1) using a permutated block size of eight to receive three doses of Cecolin 9 or Gardasil 9 at day 0, day 45, and month 6. All participants, as well as study personnel without access to the vaccines, were masked. Neutralising antibodies were measured by a triple-colour pseudovirion-based neutralisation assay. The primary outcomes, seroconversion rates and geometric mean concentrations (GMCs) at month 7, were analysed in the per-protocol set for immunogenicity (PPS-I). Non-inferiority was identified for the lower limit of the 95% CI of the GMC ratio (Cecolin 9 vs Gardasil 9) at a margin of 0·5 and a seroconversion rate difference (Cecolin 9-Gardasil 9) at a margin of -5%. This study was registered at ClinicalTrials.gov (NCT04782895) and is completed. From March 14 to 18, 2021, a total of 553 potential participants were screened, of which 244 received at least one dose of Cecolin 9 and 243 received at least one dose of Gardasil 9. The seroconversion rates for all HPV types in both groups were 100% in the PPS-I, with the values of the lower limits of 95% CIs for seroconversion rate differences ranging between -1·8% and -1·7%. The GMC ratios of five types were higher than 1·0, with the highest ratio, for HPV 58, at 1·65 (95% CI 1·38-1·97), and those of four types were lower than 1·0, with the lowest ratio, for HPV 11, at 0·79 (0·68-0·93). The incidence of adverse reactions in both groups was similar (43% [104/244] vs 47% [115/243]). Cecolin 9 induced non-inferior HPV type-specific immune responses compared with Gardasil 9 and is a potential candidate to accelerate the elimination of cervical cancer by allowing for global accessibility to 9-valent HPV vaccinations, especially in low-income and middle-income countries. National Natural Science Foundation, Fujian Provincial Natural Science Foundation, Xiamen Science and Technology Plan Project, Fundamental Research Funds for the Central Universities, CAMS Innovation Fund for Medical Sciences of China, and Xiamen Innovax.

Development and validation of a mechanical power-oriented nomogram model for predicting the risk of weaning failure in mechanically ventilated patients: an analysis using the data from MIMIC-IV

To develop and validate a mechanical power (MP)-oriented nomogram prediction model of weaning failure in mechanically ventilated patients. Patients who underwent invasive mechanical ventilation (IMV) for more than 24 hours and were weaned using a T-tube ventilation strategy were collected from the Medical Information Mart for Intensive Care-IV v1.0 (MIMIC-IV v1.0) database. Demographic information and comorbidities, respiratory mechanics parameters 4 hours before the first spontaneous breathing trial (SBT), laboratory parameters preceding the SBT, vital signs and blood gas analysis during SBT, length of intensive care unit (ICU) stay and IMV duration were collected and all eligible patients were enrolled into the model group. Lasso method was used to screen the risk factors affecting weaning outcomes, which were included in the multivariate Logistic regression analysis. R software was used to construct the nomogram prediction model and build the dynamic web page nomogram. The discrimination and accuracy of the nomogram were assessed by receiver operator characteristic curve (ROC curve) and calibration curves, and the clinical validity was assessed by decision curve analysis (DCA). The data of patients undergoing mechanical ventilation hospitalized in ICU of the First People's Hospital of Lianyungang City and the Second People's Hospital of Lianyungang City from November 2021 to October 2022 were prospectively collected to externally validate the model. A total of 3 695 mechanically ventilated patients were included in the model group, and the weaning failure rate was 38.5% (1 421/3 695). Lasso regression analysis finally screened out six variables, including positive end-expiratory pressure (PEEP), MP, dynamic lung compliance (Cdyn), inspired oxygen concentration (FiO2), length of ICU stay and IMV duration, with coefficients of 0.144, 0.047, -0.032, 0.027, 0.090 and 0.098, respectively. Logistic regression analysis showed that the six variables were all independent risk factors for predicting weaning failure risk [odds ratio (OR) and 95% confidence interval (95%CI) were 1.155 (1.111-1.200), 1.048 (1.031-1.066), 0.968 (0.963-0.974), 1.028 (1.017-1.038), 1.095 (1.076-1.113), and 1.103 (1.070-1.137), all P < 0.01]. The MP-oriented nomogram prediction model of weaning failure in mechanically ventilated patients showed accurate discrimination both in the model group and external validation group, with area under the ROC curve (AUC) and 95%CI of 0.832 (0.819-0.845) and 0.879 (0.833-0.925), respectively. Furthermore, its predictive accuracy was significantly higher than that of individual indicators such as MP, Cdyn, and PEEP. Calibration curves showed good correlation between predicted and observed outcomes. DCA indicated that the nomogram model had high net benefits, and was clinically beneficial. The MP-oriented nomogram prediction model of weaning failure accurately predicts the risk of weaning failure in mechanical ventilation patients and provides valuable information for clinicians making decisions on weaning.

Application of a three-dimensional printed pelvic model in laparoscopic radical resection of rectal cancer.

To investigate the application value of a three-dimensional (3D) printed pelvic model in laparoscopic radical resection of rectal cancer. Clinical data of patients undergoing laparoscopic radical rectal cancer surgery in The Second People's Hospital of Lianyungang City from May 2020 to April 2022 were selected. Patients were randomly divided into general imaging examination group (control group, n=25) and 3D printing group (observation group, n=25) by random number table method, and the perioperative situation of patients in the two groups was compared. There was no significant difference in general data between the two groups (p>0.05). Operation time, intraoperative blood loss, intraoperative time to locate inferior mesenteric artery, intraoperative time to locate left colic artery, first postoperative exhaust time and length of hospital stay in the observation group were all lower than those in the control group (P < 0.05); There were no significant differences in the total number of lymph nodes and complications between the two groups (P > 0.05). The application of 3D printed pelvic model in laparoscopic radical resection of rectal cancer is conducive to understanding pelvic structure and mesenteric vascular anatomy, reducing intraoperative bleeding and shortening operation time, which is worthy of further clinical application.

A Bayesian network-GIS probabilistic model for addressing human disturbance risk to ecological conservation redline areas

Population growth and associated ecological space occupation are posing great risks to regional ecological security and social stability. In China, “Ecological Conservation Redline” (ECR) that prohibited urbanization and industrial construction has been proposed as a national policy to resolve spatial mismatches and management contradictions. However, unfriendly human disturbance activities (e.g., cultivation, mining, and infrastructure construction) still exist within the ECR, posing a great threat to ecological stability and safety. In this article, a Bayesian network (BN)-GIS probabilistic model is proposed to spatially and quantitatively address the human disturbance risk to the ECR at the regional scale. The Bayesian models integrate multiple human activities, ecological receptors of the ECR, and their exposure relationships for calculating the human disturbance risk. The case learning method geographic information systems (GIS) is then introduced to train BN models based on the spatial attribute of variables to evaluate the spatial distribution and correlation of risks. This approach was applied to the human disturbance risk assessment for the ECR that was delineated in 2018 in Jiangsu Province, China. The results indicated that most of the ECRs were at a low or medium human disturbance risk level, while some drinking water sources and forest parks in Lianyungang City possessed the highest risk. The sensitivity analysis result showed the ECR vulnerability, especially for cropland, that contributed most to the human disturbance risk. This spatially probabilistic method can not only enhance model's prediction precision, but also help decision-makers to determine how to establish priorities for policy design and conservation interventions. Overall, it presents a foundation for later ECR adjustments as well as for human disturbance risk supervision and management at the regional scale.

A comprehensive performance evaluation methodology for sea-crossing cable-stayed bridges under wind and wave loads

This study proposes a probabilistic performance evaluation framework for sea-crossing cable-stayed bridges (SCBs) subjected to wind and wave excitations with the incorporation of wind speed and direction, bridge orientation, wind-wave correlation and parameter uncertainties. Both the bridge serviceability and safety are taken into account in the performance assessment. The fragility analysis of the SCB under wind and wave loads is conducted using the wind-wave correlation model constructed based on field data. The actual damage probability of a local SCB is computed by combining the fragilities of bridge under different wind incidence angles with the copula-based joint probability distribution (JPD) of wind speed and direction, which is developed using the wind field data recorded in Lianyungang city of China from 1971 to 2020. The results show that under the defined wind incidence angle of 0°, the exemplar SCB suffers the highest fragility. Moreover, with the data-based occurrence probability model of wind and wave hazards, the damage probabilities under all possible wind speeds and directions are computed; then the optimal and most unfavorable orientations of the SCB are obtained. This investigation provides a comprehensive and practical method for the performance evaluation and design optimization of SCBs under wind and wave loads with long-term recorded hazard data at the local site.